Executive summary
Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) pandemic has created terrible burden for millions of individuals, families and communities worldwide. All sorts of exertions have been tried to curtail this tormentor and yet no known cure or vaccines have been discovered to prevent it. Religious prayers and even rituals have also seemed futile. However, the only option now is to only provide tender care, love and even nurture for those that are infected and consequently affected. This might prevent further spread and in turn minimise further impacts. This study seeks to improve on the care that should be rendered to HIV/AIDS patients and even strategize on how to improve the well-being of these ill-fated people. This study is a combination of situational analysis through a scientific study to understand various dynamics of management of HIV/AIDS patients in Zambia accompanied by formulation of strategies based on findings of the study.
Background
The HIV/AIDS prevalence rate in Zambia has even become one of the highest in the world. The prevalence rate in the general population is estimated to be 14.3 per cent with approximately 930, 000 people living with HIV/AIDS. Generally, despite all the campaigns, the stigma associated with HIV/AIDS still exists. On one hand, patients who are infected and have all the symptoms claim to be neglected at the hospitals and are not given the best services. It may not be out of order to query whether these health care providers are really taking care of HIV/AIDS patients. Several interventions have been staked so far but they do not seem to adequately address and even assess if HIV/AIDS patients are fully attended to by health care providers.
For example, though not very successful, the National HIV/AIDS/STI/TB intervention strategy plan 2002–2005 was developed with providing care to people living and affected by HIV/AIDS as one of the strategies of reducing the spread of AIDS. This research endeavours to provide a fundamental overview of how best the society at large can prevent further spread of HIV through care. This is deemed necessary for the implementation of an HIV/AIDS free management policies. If it comes out necessary to quarantine HIV patients, we will not hesitate to articulate that.
Rationale
This study aims at creating space for all people living with HIV/AIDS in different settings; especially in hospital environment, where most of them seek medical advice. This study shall improvise core framework for any change/s at the institutional and individual levels and across all sectors that in turn shall help create an environment of understanding, empathy, love, trust, hope, human rights and dignity for those most in need, that is, HIV/AIDS patients.
Problem
The major problem is the increased levels of stigmatization, discrimination and violation of human rights of HIV/AIDS patients in various settings. Minor problems include: * Lack of better strategies to deal with matters of HIV/AIDS * Lack of consistency in delivery of health care
* Lack of friendly or social relationship between HIV/AIDS patients and care takers
Objectives
In addressing the problems stated above, the following specific research objectives have to be achieved: i. To investigate the extent to which patients are cared for by health care providers and relations. ii. To investigate the nutritional well-being of HIV/AIDS patients. iii. To identify factors leading to stigma, discrimination and human rights violation of HIV/AIDS patients. iv. To frame recommendations/strategies for policy makers and other influential groups for improvements in social well-being of HIV/AIDS patients.
Methodology
Participants
Our sample size is 150 and these consist of all HIV/AIDS patients in the selected hospitals within Lusaka. The number of patients to approach per hospital will be determined on the total number of admitted patients at the time of data collection. Our target population is all HIV/AIDS patients that have been admitted to the selected hospitals for at least one week. However, since it will be impossible to survey all HIV/AIDS patients in all hospitals in the City of Lusaka, our study population will be patients admitted to University Teaching Hospital (UTH) and Levy Mwanawasa General Hospital. These patients are to be found on weekdays/weekends during the stipulated visiting hours per hospital. Data Analysis
Data will be entered in excel and analysed using SPSS version 16 and descriptive statistics will be computed using the same software. SPSS will be selected because it is user friendly. Research Method
Our research method is to perform a situational analysis study using a questionnaire capturing the HIV/AIDS patients’ nutritional status, social relationship with care takers and how often they are visited by their relations. The questionnaire is as simple as possible to avoid frustrating the patients. Our sampling method will be convenience sampling where we would simply visit HIV/AIDS patients in hospitals under study. Convenience sampling will be used because this method would not impose a huge cost. Due to confidentiality and ethical considerations, the then main clinicians during data collection, at the hospitals under study will help to distribute questionnaires to those HIV/AIDS patients willing to participate. Currently, at UTH, we have Dr Nyirenda and Dr Musonda who are willing to administer the questionnaires in clinic five of UTH and Dr Alfred at Levy Mwanawasa General Hospital. We will simply approach any HIV/AIDS patient and ask them to volunteer in our survey.
We will conduct an in-person survey by briefly introducing to them the purpose of our survey and explain why their participation will be valuable to the public. We will ask them if they have 3 minutes to do our survey. By having given them a brief introduction before we interview them, we can have a better sense of whether or not our survey is applicable to them. All non-HIV/AIDS patients in the stated hospitals will be ineligible to participate in the survey. In addition, a focus group will also be used to discuss the perceived prejudices that HIV/AIDS patients face.
We will simply ask two HIV/AIDS patients, one representative from UNZA HIV/AIDS response office and one representative from the Ministry of Health to volunteer to give us one hour on one evening to get their opinions about the current levels of stigmatization, discrimination and violation of human rights of people living with HIV/AIDS. A facilitator will be present to conduct the group discussion and ask several open-ended questions while another representative will record the respondents’ answers during the discussion. The advantage of this focus group study is that it is not costly, not time consuming and we can get in-depth information and opinions from people who are directly and frequently affected by the problem. Anticipated Results
Expected Outcomes:
Mounting evidence suggests that no known cure for HIV/AIDS has been unearthed so far. This simply entails that we can only reduce further spread of the pandemic by improving the lives of the people who are infected and affected by the pandemic. Consequently, this study will not only enlighten the policy makers on the real strategy of reducing the further spread of HIV/AIDS but also propose measures that may deal with the problem more effectively.
It is further expected that this study will generate a research report and a fact sheet on the dynamics and impact of stigmatization and discrimination on those infected and affected by HIV/AIDS in Zambia. In the final analysis, it is expected that Government through the Ministry of Health and indeed the donors will be better informed, and could adopt some of the findings and recommendations in their policies. Impact:
Results from this study are expected to feed into policies aimed at improving the well-being of HIV/AIDS patients in the country. From these, it is expected that the policies can be inferred to other countries facing HIV/AIDS.
Utilisation:
It is expected that findings from this study will be utilised by policy makers and implementers to enhance health care planning and ensure that the scarce national resources are allocated efficiently on projects that give the highest social and economic returns to HIV/AIDS patients.
Dissemination
Findings from this study will be disseminated through workshops that will be held so that all the stakeholders are informed about the viability of report findings as a remedial measure to the spread of HIV/AIDS in Zambia. Lastly, the study report will be available on the UNZA website and at UNZA HIV/AIDS response office for all to read.