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• Published: 24 November 2021

A study of awareness on HIV/AIDS among adolescents: A Longitudinal Study on UDAYA data

• Shobhit Srivastava   ORCID: orcid.org/0000-0002-7138-4916 1 ,
• Shekhar Chauhan   ORCID: orcid.org/0000-0002-6926-7649 2 ,
• Ratna Patel   ORCID: orcid.org/0000-0002-5371-7369 3 &
• Pradeep Kumar   ORCID: orcid.org/0000-0003-4259-820X 1  

Scientific Reports volume  11 , Article number:  22841 ( 2021 ) Cite this article

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Acquired Immunodeficiency Syndrome caused by Human Immunodeficiency Virus (HIV) poses a severe challenge to healthcare and is a significant public health issue worldwide. This study intends to examine the change in the awareness level of HIV among adolescents. Furthermore, this study examined the factors associated with the change in awareness level on HIV-related information among adolescents over the period. Data used for this study were drawn from Understanding the lives of adolescents and young adults, a longitudinal survey on adolescents aged 10–19 in Bihar and Uttar Pradesh. The present study utilized a sample of 4421 and 7587 unmarried adolescent boys and girls, respectively aged 10–19 years in wave-1 and wave-2. Descriptive analysis and t-test and proportion test were done to observe changes in certain selected variables from wave-1 (2015–2016) to wave-2 (2018–2019). Moreover, random effect regression analysis was used to estimate the association of change in HIV awareness among unmarried adolescents with household and individual factors. The percentage of adolescent boys who had awareness regarding HIV increased from 38.6% in wave-1 to 59.9% in wave-2. Among adolescent girls, the percentage increased from 30.2 to 39.1% between wave-1 & wave-2. With the increase in age and years of schooling, the HIV awareness increased among adolescent boys ([Coef: 0.05; p  < 0.01] and [Coef: 0.04; p  < 0.01]) and girls ([Coef: 0.03; p  < 0.01] and [Coef: 0.04; p  < 0.01]), respectively. The adolescent boys [Coef: 0.06; p  < 0.05] and girls [Coef: 0.03; p  < 0.05] who had any mass media exposure were more likely to have an awareness of HIV. Adolescent boys' paid work status was inversely associated with HIV awareness [Coef: − 0.01; p  < 0.10]. Use of internet among adolescent boys [Coef: 0.18; p  < 0.01] and girls [Coef: 0.14; p  < 0.01] was positively associated with HIV awareness with reference to their counterparts. There is a need to intensify efforts in ensuring that information regarding HIV should reach vulnerable sub-groups, as outlined in this study. It is important to mobilize the available resources to target the less educated and poor adolescents, focusing on rural adolescents.

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Introduction

Acquired Immunodeficiency Syndrome (AIDS) caused by Human Immunodeficiency Virus (HIV) poses a severe challenge to healthcare and is a significant public health issue worldwide. So far, HIV has claimed almost 33 million lives; however, off lately, increasing access to HIV prevention, diagnosis, treatment, and care has enabled people living with HIV to lead a long and healthy life 1 . By the end of 2019, an estimated 38 million people were living with HIV 1 . More so, new infections fell by 39 percent, and HIV-related deaths fell by almost 51 percent between 2000 and 2019 1 . Despite all the positive news related to HIV, the success story is not the same everywhere; HIV varies between region, country, and population, where not everyone is able to access HIV testing and treatment and care 1 . HIV/AIDS holds back economic growth by destroying human capital by predominantly affecting adolescents and young adults 2 .

There are nearly 1.2 billion adolescents (10–19 years) worldwide, which constitute 18 percent of the world’s population, and in some countries, adolescents make up as much as one-fourth of the population 3 . In India, adolescents comprise more than one-fifth (21.8%) of the total population 4 . Despite a decline projection for the adolescent population in India 5 , there is a critical need to hold adolescents as adolescence is characterized as a period when peer victimization/pressure on psychosocial development is noteworthy 6 . Peer victimization/pressure is further linked to risky sexual behaviours among adolescents 7 , 8 . A higher proportion of low literacy in the Indian population leads to a low level of awareness of HIV/AIDS 9 . Furthermore, the awareness of HIV among adolescents is quite alarming 10 , 11 , 12 .

Unfortunately, there is a shortage of evidence on what predicts awareness of HIV among adolescents. Almost all the research in India is based on beliefs, attitudes, and awareness of HIV among adolescents 2 , 12 . However, few other studies worldwide have examined mass media as a strong predictor of HIV awareness among adolescents 13 . Mass media is an effective channel to increase an individuals’ knowledge about sexual health and improve understanding of facilities related to HIV prevention 14 , 15 . Various studies have outlined other factors associated with the increasing awareness of HIV among adolescents, including; age 16 , 17 , 18 , occupation 18 , education 16 , 17 , 18 , 19 , sex 16 , place of residence 16 , marital status 16 , and household wealth index 16 .

Several community-based studies have examined awareness of HIV among Indian adolescents 2 , 10 , 12 , 20 , 21 , 22 . However, studies investigating awareness of HIV among adolescents in a larger sample size remained elusive to date, courtesy of the unavailability of relevant data. Furthermore, no study in India had ever examined awareness of HIV among adolescents utilizing information on longitudinal data. To the author’s best knowledge, this is the first study in the Indian context with a large sample size that examines awareness of HIV among adolescents and combines information from a longitudinal survey. Therefore, this study intends to examine the change in the awareness level of HIV among adolescents. Furthermore, this study examined the factors associated with a change in awareness level on HIV-related information among adolescents over the period.

Data and methods

Data used for this study were drawn from Understanding the lives of adolescents and young adults (UDAYA), a longitudinal survey on adolescents aged 10–19 in Bihar and Uttar Pradesh 23 . The first wave was conducted in 2015–2016, and the follow-up survey was conducted after three years in 2018–2019 23 . The survey provides the estimates for state and the sample of unmarried boys and girls aged 10–19 and married girls aged 15–19. The study adopted a systematic, multi-stage stratified sampling design to draw sample areas independently for rural and urban areas. 150 primary sampling units (PSUs)—villages in rural areas and census wards in urban areas—were selected in each state, using the 2011 census list of villages and wards as the sampling frame. In each primary sampling unit (PSU), households to be interviewed were selected by systematic sampling. More details about the study design and sampling procedure have been published elsewhere 23 . Written consent was obtained from the respondents in both waves. In wave 1 (2015–2016), 20,594 adolescents were interviewed using the structured questionnaire with a response rate of 92%.

Moreover, in wave 2 (2018–2019), the study interviewed the participants who were successfully interviewed in 2015–2016 and who consented to be re-interviewed 23 . Of the 20,594 eligible for the re-interview, the survey re-interviewed 4567 boys and 12,251 girls (married and unmarried). After excluding the respondents who gave an inconsistent response to age and education at the follow-up survey (3%), the final follow-up sample covered 4428 boys and 11,864 girls with the follow-up rate of 74% for boys and 81% for girls. The effective sample size for the present study was 4421 unmarried adolescent boys aged 10–19 years in wave-1 and wave-2. Additionally, 7587 unmarried adolescent girls aged 10–19 years were interviewed in wave-1 and wave-2 23 . The cases whose follow-up was lost were excluded from the sample to strongly balance the dataset and set it for longitudinal analysis using xtset command in STATA 15. The survey questionnaire is available at https://dataverse.harvard.edu/file.xhtml?fileId=4163718&version=2.0 & https://dataverse.harvard.edu/file.xhtml?fileId=4163720&version=2.0 .

Outcome variable

HIV awareness was the outcome variable for this study, which is dichotomous. The question was asked to the adolescents ‘Have you heard of HIV/AIDS?’ The response was recorded as yes and no.

Exposure variables

The predictors for this study were selected based on previous literature. These were age (10–19 years at wave 1, continuous variable), schooling (continuous), any mass media exposure (no and yes), paid work in the last 12 months (no and yes), internet use (no and yes), wealth index (poorest, poorer, middle, richer, and richest), religion (Hindu and Non-Hindu), caste (Scheduled Caste/Scheduled Tribe, Other Backward Class, and others), place of residence (urban and rural), and states (Uttar Pradesh and Bihar).

Exposure to mass media (how often they read newspapers, listened to the radio, and watched television; responses on the frequencies were: almost every day, at least once a week, at least once a month, rarely or not at all; adolescents were considered to have any exposure to mass media if they had exposure to any of these sources and as having no exposure if they responded with ‘not at all’ for all three sources of media) 24 . Household wealth index based on ownership of selected durable goods and amenities with possible scores ranging from 0 to 57; households were then divided into quintiles, with the first quintile representing households of the poorest wealth status and the fifth quintile representing households with the wealthiest status 25 .

Statistical analysis

Descriptive analysis was done to observe the characteristics of unmarried adolescent boys and girls at wave-1 (2015–2016). In addition, the changes in certain selected variables were observed from wave-1 (2015–2016) to wave-2 (2018–2019), and the significance was tested using t-test and proportion test 26 , 27 . Moreover, random effect regression analysis 28 , 29 was used to estimate the association of change in HIV awareness among unmarried adolescents with household factors and individual factors. The random effect model has a specific benefit for the present paper's analysis: its ability to estimate the effect of any variable that does not vary within clusters, which holds for household variables, e.g., wealth status, which is assumed to be constant for wave-1 and wave-2 30 .

Table 1 represents the socio-economic profile of adolescent boys and girls. The estimates are from the baseline dataset, and it was assumed that none of the household characteristics changed over time among adolescent boys and girls.

Figure  1 represents the change in HIV awareness among adolescent boys and girls. The percentage of adolescent boys who had awareness regarding HIV increased from 38.6% in wave-1 to 59.9% in wave-2. Among adolescent girls, the percentage increased from 30.2% in wave-1 to 39.1% in wave-2.

The percenate of HIV awareness among adolescent boys and girls, wave-1 (2015–2016) and wave-2 (2018–2019).

Table 2 represents the summary statistics for explanatory variables used in the analysis of UDAYA wave-1 and wave-2. The exposure to mass media is almost universal for adolescent boys, while for adolescent girls, it increases to 93% in wave-2 from 89.8% in wave-1. About 35.3% of adolescent boys were engaged in paid work during wave-1, whereas in wave-II, the share dropped to 33.5%, while in the case of adolescent girls, the estimates are almost unchanged. In wave-1, about 27.8% of adolescent boys were using the internet, while in wave-2, there is a steep increase of nearly 46.2%. Similarly, in adolescent girls, the use of the internet increased from 7.6% in wave-1 to 39.3% in wave-2.

Table 3 represents the estimates from random effects for awareness of HIV among adolescent boys and girls. It was found that with the increases in age and years of schooling the HIV awareness increased among adolescent boys ([Coef: 0.05; p  < 0.01] and [Coef: 0.04; p  < 0.01]) and girls ([Coef: 0.03; p  < 0.01] and [Coef: 0.04; p  < 0.01]), respectively. The adolescent boys [Coef: 0.06; p  < 0.05] and girls [Coef: 0.03; p  < 0.05] who had any mass media exposure were more likely to have an awareness of HIV in comparison to those who had no exposure to mass media. Adolescent boys' paid work status was inversely associated with HIV awareness about adolescent boys who did not do paid work [Coef: − 0.01; p  < 0.10]. Use of the internet among adolescent boys [Coef: 0.18; p  < 0.01] and girls [Coef: 0.14; p  < 0.01] was positively associated with HIV awareness in reference to their counterparts.

The awareness regarding HIV increases with the increase in household wealth index among both adolescent boys and girls. The adolescent girls from the non-Hindu household had a lower likelihood to be aware of HIV in reference to adolescent girls from Hindu households [Coef: − 0.09; p  < 0.01]. Adolescent girls from non-SC/ST households had a higher likelihood of being aware of HIV in reference to adolescent girls from other caste households [Coef: 0.04; p  < 0.01]. Adolescent boys [Coef: − 0.03; p  < 0.01] and girls [Coef: − 0.09; p  < 0.01] from a rural place of residence had a lower likelihood to be aware about HIV in reference to those from the urban place of residence. Adolescent boys [Coef: 0.04; p  < 0.01] and girls [Coef: 0.02; p  < 0.01] from Bihar had a higher likelihood to be aware about HIV in reference to those from Uttar Pradesh.

This is the first study of its kind to address awareness of HIV among adolescents utilizing longitudinal data in two indian states. Our study demonstrated that the awareness of HIV has increased over the period; however, it was more prominent among adolescent boys than in adolescent girls. Overall, the knowledge on HIV was relatively low, even during wave-II. Almost three-fifths (59.9%) of the boys and two-fifths (39.1%) of the girls were aware of HIV. The prevalence of awareness on HIV among adolescents in this study was lower than almost all of the community-based studies conducted in India 10 , 11 , 22 . A study conducted in slums in Delhi has found almost similar prevalence (40% compared to 39.1% during wave-II in this study) of awareness of HIV among adolescent girls 31 . The difference in prevalence could be attributed to the difference in methodology, study population, and study area.

The study found that the awareness of HIV among adolescent boys has increased from 38.6 percent in wave-I to 59.9 percent in wave-II; similarly, only 30.2 percent of the girls had an awareness of HIV during wave-I, which had increased to 39.1 percent. Several previous studies corroborated the finding and noticed a higher prevalence of awareness on HIV among adolescent boys than in adolescent girls 16 , 32 , 33 , 34 . However, a study conducted in a different setting noticed a higher awareness among girls than in boys 35 . Also, a study in the Indian context failed to notice any statistical differences in HIV knowledge between boys and girls 18 . Gender seems to be one of the significant determinants of comprehensive knowledge of HIV among adolescents. There is a wide gap in educational attainment among male and female adolescents, which could be attributed to lower awareness of HIV among girls in this study. Higher peer victimization among adolescent boys could be another reason for higher awareness of HIV among them 36 . Also, cultural double standards placed on males and females that encourage males to discuss HIV/AIDS and related sexual matters more openly and discourage or even restrict females from discussing sexual-related issues could be another pertinent factor of higher awareness among male adolescents 33 . Behavioural interventions among girls could be an effective way to improving knowledge HIV related information, as seen in previous study 37 . Furthermore, strengthening school-community accountability for girls' education would augment school retention among girls and deliver HIV awareness to girls 38 .

Similar to other studies 2 , 10 , 17 , 18 , 39 , 40 , 41 , age was another significant determinant observed in this study. Increasing age could be attributed to higher education which could explain better awareness with increasing age. As in other studies 18 , 39 , 41 , 42 , 43 , 44 , 45 , 46 , education was noted as a significant driver of awareness of HIV among adolescents in this study. Higher education might be associated with increased probability of mass media and internet exposure leading to higher awareness of HIV among adolescents. A study noted that school is one of the important factors in raising the awareness of HIV among adolescents, which could be linked to higher awareness among those with higher education 47 , 48 . Also, schooling provides adolescents an opportunity to improve their social capital, leading to increased awareness of HIV.

Following previous studies 18 , 40 , 46 , the current study also outlines a higher awareness among urban adolescents than their rural counterparts. One plausible reason for lower awareness among adolescents in rural areas could be limited access to HIV prevention information 16 . Moreover, rural–urban differences in awareness of HIV could also be due to differences in schooling, exposure to mass media, and wealth 44 , 45 . The household's wealth status was also noted as a significant predictor of awareness of HIV among adolescents. Corroborating with previous findings 16 , 33 , 42 , 49 , this study reported a higher awareness among adolescents from richer households than their counterparts from poor households. This could be because wealthier families can afford mass-media items like televisions and radios for their children, which, in turn, improves awareness of HIV among adolescents 33 .

Exposure to mass media and internet access were also significant predictors of higher awareness of HIV among adolescents. This finding agrees with several previous research, and almost all the research found a positive relationship between mass-media exposure and awareness of HIV among adolescents 10 . Mass media addresses such topics more openly and in a way that could attract adolescents’ attention is the plausible reason for higher awareness of HIV among those having access to mass media and the internet 33 . Improving mass media and internet usage, specifically among rural and uneducated masses, would bring required changes. Integrating sexual education into school curricula would be an important means of imparting awareness on HIV among adolescents; however, this is debatable as to which standard to include the required sexual education in the Indian schooling system. Glick (2009) thinks that the syllabus on sexual education might be included during secondary schooling 44 . Another study in the Indian context confirms the need for sex education for adolescents 50 , 51 .

Limitations and strengths of the study

The study has several limitations. At first, the awareness of HIV was measured with one question only. Given that no study has examined awareness of HIV among adolescents using longitudinal data, this limitation is not a concern. Second, the study findings cannot be generalized to the whole Indian population as the study was conducted in only two states of India. However, the two states selected in this study (Uttar Pradesh and Bihar) constitute almost one-fourth of India’s total population. Thirdly, the estimates were provided separately for boys and girls and could not be presented combined. However, the data is designed to provide estimates separately for girls and boys. The data had information on unmarried boys and girls and married girls; however, data did not collect information on married boys. Fourthly, the study estimates might have been affected by the recall bias. Since HIV is a sensitive topic, the possibility of respondents modifying their responses could not be ruled out. Hawthorne effect, respondents, modifying aspect of their behaviour in response, has a role to play in HIV related study 52 . Despite several limitations, the study has specific strengths too. This is the first study examining awareness of HIV among adolescent boys and girls utilizing longitudinal data. The study was conducted with a large sample size as several previous studies were conducted in a community setting with a minimal sample size 10 , 12 , 18 , 20 , 53 .

The study noted a higher awareness among adolescent boys than in adolescent girls. Specific predictors of high awareness were also noted in the study, including; higher age, higher education, exposure to mass media, internet use, household wealth, and urban residence. Based on the study findings, this study has specific suggestions to improve awareness of HIV among adolescents. There is a need to intensify efforts in ensuring that information regarding HIV should reach vulnerable sub-groups as outlined in this study. It is important to mobilize the available resources to target the less educated and poor adolescents, focusing on rural adolescents. Investment in education will help, but it would be a long-term solution; therefore, public information campaigns could be more useful in the short term.

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This paper was written using data collected as part of Population Council’s UDAYA study, which is funded by the Bill and Melinda Gates Foundation and the David and Lucile Packard Foundation. No additional funds were received for the preparation of the paper.

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Contributions

Conception and design of the study: S.S. and P.K.; analysis and/or interpretation of data: P.K. and S.S.; drafting the manuscript: S.C., and R.P.; reading and approving the manuscript: S.S., P.K., S.C. and R.P.

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Srivastava, S., Chauhan, S., Patel, R. et al. A study of awareness on HIV/AIDS among adolescents: A Longitudinal Study on UDAYA data. Sci Rep 11 , 22841 (2021). https://doi.org/10.1038/s41598-021-02090-9

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Schools Are Vital in the Fight Against Youth HIV Infection

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Each April 10th, we recognize National Youth HIV & AIDS Awareness Day (NYHAAD) . Since 2013, this day has provided an opportunity for education and served as a reminder that our young people continue to be at risk for HIV. It is also a time to highlight the work still needed.

Schools play a critical role in promoting the health and safety of youth and hold a pivotal place in the fight to prevent HIV. Every day, more than 56 million students spend their day in school, which provides a unique opportunity to provide them with the knowledge, skills, and resources they need to prevent HIV during adolescence and into adulthood. True primary prevention includes quality health education, a connection to needed health services, and school environments that support youth and help them feel safe and connected, which can ensure their academic success.

Over the last 10 years: condom use among adolescents continued to decrease; 14% of youth report that they have used illicit drugs; more than 10% of high school females have been the victims of sexual assault; and more than 30% of students have experienced emotional distress in the last year. At the same time STDs among young people have continued to increase and 1 in 5 new HIV diagnoses were reported in young people aged 13-24 years.

CDC’s adolescent and school health program implements activities focused on primary prevention within the U.S. education system. Currently, CDC reaches approximately 2 million students by funding education agencies and a network of leaders in school-based HIV, STD, and pregnancy prevention . These funded partners:

• Deliver HIV, STD, and pregnancy prevention programs grounded in the latest research
• Select and implement effective health education curricula
• Build local capacity to connect students to school- and community-based health services , and
• Establish safe environments where students feel connected to school and supportive adults.

Over the last 5 years, these programs have increased the number of middle and high schools implementing quality sexual health education, made over 65,000 referrals for youth-friendly sexual health services, and expanded by 60% the establishment of student-led clubs dedicated to creating safe and supportive environments for all students.

Through analysis of CDC’s data on youth risk behaviors and experiences [PDF, 16.7MB] and school health policies and practices , we know that progress is being made. For example, from 2007 to 2017, CDC data showed declines in sexual risk behaviors among youth, including fewer currently sexually active high school students. There was also a decrease in the proportion of high school students who ever had sex during that same time period (from 48% in 2007 to 40% in 2017).

All youth deserve a healthy future. That is why schools, families, and communities must work together to provide safe and nurturing environments for youth. On NYHAAD, CDC joins with partners across the country to recommit to our efforts and resources to ensure that youth know how to protect themselves against HIV infection. We know what works and have the tools to provide support for all students. By providing sexual health education, health services, and safe and supportive school environments for all students, we can make a difference and help end the HIV epidemic.

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Introduction

Subjects and methods, assessing hiv/aids knowledge, awareness, and attitudes among senior high school students in kuwait.

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AlMunther Alhasawi , Saroj Bala Grover , Ali Sadek , Ibrahim Ashoor , Iqbal Alkhabbaz , Sameh Almasri; Assessing HIV/AIDS Knowledge, Awareness, and Attitudes among Senior High School Students in Kuwait. Med Princ Pract 18 September 2019; 28 (5): 470–476. https://doi.org/10.1159/000500307

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Objectives: An estimated 1.8 million individuals worldwide became newly infected with human immunodeficiency virus (HIV) in 2016, which amounts to 5,000 new infections per day. This includes 160,000 children. The HIV epidemic not only affects the health of individuals but also impacts households, communities, and the development and economic growth of nations [ 1 ]. The prevention and control of HIV infection and acquired immune deficiency syndrome (AIDS) are recognized as a national priority in Kuwait. This study assesses the knowledge, awareness, and attitudes about HIV/AIDS among senior high school students in Kuwait. Materials and Methods: A cross-sectional study was conducted in a convenience sample of 346 students in 8 randomly selected high schools in 3 governorates of Kuwait, using a questionnaire designed to measure the student’s knowledge and attitude towards HIV/AIDS. The survey questionnaire was administered to the students in their classrooms. Results: This study revealed that the students were knowledgeable with regard to the nature and mode of transmission of HIV/AIDS, but they needed a more detailed understanding of the disease to prevent stigmatization and discrimination of an infected person. Conclusion: This study provides a benchmark for further elaborate studies in the community to develop appropriate health education and awareness programs.

Knowledge about HIV is the key strategy utilized in the prevention and control of HIV/AIDS worldwide, and data from Kuwait are sparse. This study assesses the knowledge, awareness, and attitude about HIV/AIDS among senior high school students in Kuwait. The observations of this study will serve as a basis for further tailored approaches to strategic programs to control this disease in Kuwait.

The human immunodeficiency virus (HIV) has emerged as the single most formidable challenge to public health, human rights, and development in the new millennium [ 1, 2 ]. Spreading knowledge and awareness about HIV is one of the key strategies utilized in the prevention and control of HIV/AIDS worldwide. Inadequate knowledge and risky practices are major hindrances in preventing the spread of HIV. In many countries, sexually transmitted diseases (STD) and unplanned pregnancies are frequently observed among adolescents. During the last century, and especially during the last few decades of that century, the early onset of puberty and initiation of sexual relationships were observed to occur at decreasing ages in many industrialized nations, whereas the average age of marriage increased.Thus, many adolescents began having sexual relationships with one or multiple sexual partners prior to marriage, and this facilitated the spread of STD and HIV.In many countries a significant proportion of youth initiate sexual activity by the age of 15 years [ 3 ]. Thus, adolescents in general are at a higher risk of contracting HIV through sexual transmission.Youth aged 13–14 years accounted for more than 1 in 5 new diagnoses in 2015 [ 4 ].

Adolescents in Kuwait represented 11.5% of the total population as of January 2017. Kuwait is a conservative Islamic society. It is still taboo to talk openly about sex-related topics.Hence, it becomes even more important to fathom the knowledge and attitude of the young towards HIV/AIDS. Furthermore, this data could serve as a basis for a tailored approach to a strategic disease control program [ 5 ].

In Kuwait, there is a paucity of data regarding awareness of HIV among adolescents. The aim of this study was to survey HIV-related knowledge and attitudes toward HIV and AIDS- infected individuals among high school students in Kuwait.

There are 6 governorates and 141 governmental high schools in Kuwait. Of these, 64 are for male students and 77 are for female students. The total number of high school students during the study period was 73,832; of these 63,379 were Kuwaiti and 10,553 were non-Kuwaiti [ 6 ]. A cross-sectional study was conducted in a student population from 8 randomly selected high schools in 3 governorates in Kuwait in April 2017. Students from 10th to the 12th grade were included in this study. A total of 346 students (both boys and girls) were enrolled. This was a convenience sample.

Tools for Data Collection

A questionnaire (Table 1 ) designed to measure the student’s knowledge and attitude towards HIV/AIDS was used as a tool for data collection. The questionnaire consisted of 7 questions pertaining to knowledge about various aspects of HIV/AIDS and 3 questions to examine their attitude towards the disease.

The questionnaire

Consent was obtained from the principals of the schools and the Ministry of Health and Ministry of Education. The entire questionnaire was explained to the students who self-completed it, staying completely anonymous. Only verbal consent was taken from the participating students in the presence of their teachers.

Statistical Methodology

The questionnaire was validated via the content validation approach, as 4 experts familiar with AIDS/HIV were consulted to approve the 10 questions and their scale. Data were collected, coded, and then entered into an IBM-compatible computer using SPSS version 24 for Windows. Entered data were checked for accuracy and normality using Kolmogorov-Smirnov and Shapiro-Wilk tests. The data were found to be not normally distributed. A 75% agreement of the type of question was the cut-off point for distribution of the questions into knowledge and attitude. Reliability was tested using Cronbach’s α coefficient (i.e., 0.823 for the knowledge part and 0.754 for the attitude part). Qualitative variables were expressed as numbers and percents while quantitative variables were expressed as medians as a measure of central tendency. IQR were used as a measure of dispersion. Two scores were computed, i.e., one for total knowledge (Q1 + Q2 + Q3 + Q4 + Q5 + Q8 + Q10) and the other for total attitude or stigma- and discrimination-related questions (Q6 + Q7 + Q9). These were based on the UNAIDS global AIDS monitoring report and indicators (2017).

For independent samples, the Mann-Whitney’s U test (or Z test) was used as a nonparametric test of significance for comparison between 2 sample medians (for sex and specialty). The Kruskal-Wallis test (χ 2 value) was used as a nonparametric test of significance for one-way comparisons between more than 2 samples means when the one-way ANOVA test was not appropriate. p < 0.05 was considered statistically significant.

A total of 346 senior students, both boys and girls, from 8 different schools located in 3 governorates of Kuwait were enrolled into this study. Of the 346 students, 192 (55.5%) were male. The majority were Kuwaiti (93.1%), while 5.5% were non-Kuwaiti and 1.4% were bedoons (stateless). Around 15.9% of the participants were in the 10th grade, 17.1% were in the 11th grade, and 67.1% were in the 12th grade. Of these, 38.2% of the participants were from the science stream and 46% were from arts stream whereas 15.9% did not reveal their major subject of study (Table 2 ).

Distribution of the study sample according to their general characteristics

With regard to the knowledge of students about modes of transmission of HIV, the majority (82.1%) did not consider that shaking hands with an affected individual could transmit the disease, whereas 16.8% thought that it could. More than two fifths (41%) of the students believed that kissing could transmit the disease; 56% assumed that it was not transmitted by kissing and 2.9% did not give their opinion (Table 3 ).

Distribution of the study sample according to their responses to the questions about awareness and knowledge about HIV

Additionally, 58.4% of the respondents felt that sharing barber tools might transmit the disease; 40.8% assumed that it would be not transmitted by such a practice and 0.8% refrained from answering this question (Q8 in Table 3 )

The majority of the students (85.3%) knew that sharing a syringe is a mode of transmission (Q3 in Table 3 ). Students were also questioned about the course of the disease. About 51.4% knew that an HIV-infected person can remain asymptomatic for many years (Q5 in Table 3 ).

The overall knowledge about HIV among the study population was higher in males than in females ( p = 0.000). Students in the science stream had a statistically higher total knowledge score compared to students in arts stream ( p = 0.001; Table 4 ).

Total knowledge scores of the studied students according to demographics

In reply to the questions regarding stigma and discrimination, the majority (74.6%) stated that they would not buy vegetables from an infected vegetable vendor. About 59.5% refused to share the class with an infected person, and 52.6% felt that a person infected with HIV does not require isolation in a hospital and can stay outside of a hospital. (Q6, Q7, and Q9 in Table 5 ). Male and female students showed no difference in their attitude towards persons affected with HIV ( p = 0.019), but a significant positive attitude was shown towards such people by students in the science stream ( p = 0.008; Table 6 ).

Distribution of the study sample according to responses to the questions about attitudes toward HIV/AIDS-infected persons

Total attitude scores of the studied students according to demographics

The participants were asked to suggest 2 methods that would give protection from HIV/AIDS (Q10 in Table 3 ) as an indicator to judge their knowledge about the disease. The various answers given included abstinence from all sexual contact by being faithful, use of a condom, avoidance of the use of i.v. drugs, not sharing barber tools, use of pre- and postexposure prophylaxis, regular premarital testing, and voluntary HIV testing. Around 31.5% were able to give 1 correct answer and 24.0% gave 2 correct answers (Table 3 ).

This study highlights the high awareness of the disease among the students, but it also indicates some significant lacunae in complete understanding of the disease among the population.

Compared to the review of similar studies from different parts of the world, the findings of our study are in general consistent with the findings reported by Uddin et al. [ 7 ] and Huda and Amanullah [ 8 ] from Bangladeshi students and by Othman [ 9 ] from high school students in Erbil City, Iraq. In a review of the published literature on awareness and knowledge of STD among school-going adolescents between 13 and 20 years of age in Europe, Samkange-Zeeb et al. [ 10 ] reported a high (90%) awareness about HIV. Macek and Matković [ 11 ], in a cross-sectional study in Croatia, reported similar observations.

However, our observations differ from those reported by Shirin and Ahmed [ 12 ] from another group of students in Bangladesh. They noted that very few students had good knowledge about HIV/AIDS (average knowledge, 56.1%; poor knowledge, 34.5%; and good knowledge, 9.4%). Selim and El-Shereef [ 13 ] also observed similar low levels of knowledge in secondary technical school students in Assiut, Egypt. Investigators in Nigeria [ 14 ] and Nepal [ 2 ] observed similar results among secondary school students. Thus, improving the awareness about STD, especially HIV/AIDS, among the youth is a prerequisite for any national control program.

Our study also highlights the awareness among the young about the mode of transmission of HIV/AIDS. In our study 93.9% of the respondents knew that sexual contact is a means of transmission. The same percentage (93.7%) was found in a survey done in Jeddah, Saudi Arabia, in high school students [ 15 ]. The majority of participants (82.1%) knew that HIV is not transmitted by shaking hands with an infected person. A significant number of students (85.3%) were aware that HIV is transmitted by sharing syringes used for i.v. administration of drugs. At the same time, educating them on misconceptions about other commonly believed modes of transmission is equally important.

Our observations demonstrate some gaps in the understanding of the disease among the young. More than half of the participants (54.1%) felt that a person infected with HIV can survive for many years without symptoms and 52.6% indicated that an infected person can stay outside a hospital without the need for isolation.

Our study underlines the need to educate the public about prevention of HIV/AIDS using time-tested tools. In response to the question which asked to suggest at least 2 means that would give protection from HIV, only 24.5% of the participants could give 2 correct answers and 31.5% could give only 1 correct answer. This was another parameter used to judge their knowledge about the disease. Similar observations were noticed in a study conducted among secondary school students in China [ 16 ]. In this study, although most students could identify models of HIV transmission, a large proportion of students had misconceptions regarding symptoms, activities that did not transmit the disease, and treatment and preventive measures. In a recent study by Mackman and Hussein [ 17 ] in Michigan, USA, the majority of the participants (98%) knew that HIV is transmitted sexually and by sharing needles, but they expressed misconceptions similar to those in our study. Dehghani et al.,[ 18 ] also reported similar observations in a study from Shiraz, Iran.

In a comparative study in Kenyan and Swedish teenagers, Eriksson et al. [ 19 ] reported that the overall knowledge of HIV was high in both groups. In addition, they were highly aware of the danger of sexual transmission of HIV. This compares well with our study. Swedish students were more knowledgeable about i.v. drug use and homosexuality as risk factors, whereas Kenyan students were more likely to implicate breastfeeding and sex as modes of transmission. Further studies are needed to clarify the knowledge about high-risk factors in our population.

Sachsenweger et al. [ 20 ] demonstrated the relevance of imparting better awareness of the disease in Germany. The pupils demonstrated a significant gap in their level of knowledge about methods of infection. More precise knowledge was demonstrated by pupils (60% of 769 students) following an awareness event compared to 40% in those who attended no awareness event.

Our study highlighted many other areas of concern. The majority (74.6%) indicated that they would not buy vegetables from an infected vendor, and 59.5% refused to share the same class with an infected student. Discrimination and stigmatization of HIV/AIDS-affected children and adolescents by their schoolmates are well-known as demonstrated by Dehghani et al. [ 18 ] in Iran. In contrast, Macek and Matković [ 11 ], in a cross-sectional study in Croatia, showed positive attitudes of students toward the integration of children with HIV/AIDS into regular schools. In our study, the students in the science stream showed a more positive attitude and better knowledge about HIV than the students in the arts stream.

Gender differences were also found, as male students showed a better awareness than females. Similar findings have been observed among high school students in Iraq [ 9 ] and adolescents in Bangladesh [ 7 ]. The possible reason for this could be that male students are probably less hesitant in discussing the taboo subject of HIV with others and hence become better informed.

The most important limitation of this study is its small sample size. However, the observations made in our study may serve as a pilot study for other, more elaborate studies in the future. The consensus that emerged from comparing the various studies is that most students in general have reasonable awareness about the disease but lack thorough knowledge, which influences their attitude of discrimination and stigmatization of affected individuals.

These outcomes highlight the need for a better and more robust education about HIV/AIDS, especially in a setting such as in Kuwait, where talking freely about sex education is not readily accepted. Hence, it becomes even more important to fathom the knowledge and attitude of the young towards HIV/AIDS. The data generated by this preliminary study may be used to plan a more comprehensive study coupled with suitably tailored health education programs for a strategic disease control of STD as well as HIV/AIDS.

This study provides preliminary data from a country and region where current information on the knowledge of young adults about HIV/AIDS and their attitude toward infected persons are sparse. This study highlights the lack of basic knowledge of HIV/AIDS among young students, modes of transmission, and management; it also indicates that stigma about the disease and discrimination of affected individuals in society is common among students. The basic approach for control and prevention of HIV/AIDS remains prevention through better knowledge and awareness since an effective cure or vaccine is not yet available.

An improved multisectoral approach for HIV/AIDS education is suggested for Kuwait. The National HIV/AIDS control committee and school health programs should come forward to design awareness programs and campaigns tailored to targeting the youth and filling the lacunae in their understanding of HIV/AIDS. Implementations of such programs could be done in a variety of settings including schools, educational institutions, STD clinics, mosques, and public sport facilities and establishments commonly used by the youth and more importantly at the community level. Also future studies should try to explore and clear the common misconceptions about the disease in general, including handling by society.

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• Stigma and Psychological Distress in HIV Caregivers The inclusion criteria of the participants in the study were if they had a confirmed HIV diagnosis. This study’s findings are similar to the findings in “Depression, anxiety, stress, and stigma in informal caregivers of […]
• Math: Aspects of HIV Modeling The indicator of the fit of the constructed model to the data set is the parameter R2, the coefficient of determination.
• Ethical and Legal Issues With the Disclosure of HIV Status of Healthcare Workers The first glance at the situation compels one to immediately support the idea that healthcare professionals should disclose their HIV status since the alternative scenario would pose a significant health risk to a patient.
• Adherence to Antiretroviral Therapy Among HIV People The abstract provides a concise summary of the background of the research, aims, methodology, results, and conclusions to help the audience understand the without reading the entire report.
• HIV Infection: Diagnosing and Testing Therefore, a comprehensive approach to clarifying the diagnosis, using a synthesis of scientifically based and subjective aspects of the course of the disease. The purpose of this study is to determine a comprehensive approach to […]
• HIV-AIDS Prevention & Advocacy Through Legislation Despite the existing programs to promote HIV/AIDS prevention among the population and criminalization of the failure to disclose HIV status prior to sexual intercourse, the Florida state legislature does not obtain any mandatory outreach and […]
• Increasing Public Awareness of HIV Infection The HIV denialism movement, which emerged almost immediately after the discovery of the disease and its identification as the cause of AIDS, actively promotes anti-scientific hypotheses about the absence of both the virus itself and […]
• Stories of People Battling HIV-AIDs She always ensures that supportive communication is at the center of her engagement with the children and shows acceptance and respect to improve her relationship with them.
• Counseling Clients With HIV-AIDS Thus, the central recommendation for human service professionals counseling clients with HIV/AIDS is to allow time for the shock of the news to sink.
• HIV Subtype Diversity Worldwide HIV is a severe global health issue because almost 40 million people were infected in 2017. That is why it is not surprising that Australians also suffer from this health problem.
• Los Angeles: Community Strategic Plan For STD and HIV Reduction Thus, one of the main concerns is the risk of transmission of both STDs and HIV due to the crisis of homelessness and loneliness in Los Angeles Country.
• Vulnerable Population: HIV-AIDS The latest statistics identify HIV/AIDS as a major medical problem affecting the health sector. The disease currently affects over one million citizens.
• African American Women With HIV: HIV Treatment Compliance The sampling strategy that will be used in the study is simple random sampling. This strategy will be appropriate because it is likely that the sample will be representative of the general population, for any […]
• HIV, STI as a Public Health Issue In light of the fact that the HIV/STI development levels remain rather high among the target population, the necessity to educate young people about the threats of HIV/STI, as well as the methods of avoiding […]
• Health Interventions in the AIDS Epidemic This development has created the need for introducing the social-ecological model in curbing the increased rates of HIV infection in some communities. This paper identifies income and stigma as the main social factors that affect […]
• Changes in the Research on AIDS Some of the current researches on this disease include treatment of the disease, the content of Aids protein and the preventive modes.
• The Most Effective Methods of Preventing the Spread of HIV Recent statistics show that in the United States the number of people living with HIV and AIDS is higher among men than women.
• Segregation of HIV-Positive Prisoners The biggest debate on segregation of HIV-positive prisoners surrounds the ethical impact it renders to the inmates. The proponents of segregation of HIV-positive prisoners believe that segregation protects prisoners and the correctional staff from catching […]
• The Problem of Homeless Youths With HIV-AIDS Studies carried out in the city of New York in 2008 showed that 21 percent of homeless youth males and 24 percent of homeless female youths had “more than 100 lifetime partners”. 5 percent of […]
• Country Health Policy Proposal on Improving HIV-AIDS Outcomes in South Africa One of the significant public health problems facing the South African public health system is the high prevalence of HIV/AIDs. Inefficiency of the public health system contributes significantly to the HIV burden in South Africa.
• HIV/AIDS and International Health Community Over the years, the level of people’s awareness about the notion of HIV/AIDS has increased dramatically, yet the health condition itself remains frowned upon and stigmatized by the global community.
• AIDS, Then and Now This view spread to the U.S.culture at large and contributed to an exaggerated representation of the disease as a “gay plague” in the media.
• Film “The Silent Partner: HIV in Marriage” In a region whose fight against HIV is slowed by a lack of awareness, the film shows how traditional ways of fighting the pandemic fail to serve the needs of married women.
• Communicable Disease Health Education Tool: HIV, AIDS The Human Immunodeficiency Virus (HIV) is a contagious that causes a condition known as the Acquired Immune Deficiency Syndrome (AIDS).
• The HIV/AIDS Situation in India Most of the initial cases had occurred through heterosexual sex; but at the end of the 1980s, a rapid spread of HIV was observed among injecting drug users in Manipur, Mizoram and Nagaland. An explosion […]
• HIV, Health & Rights – Sustaining Community Action In general, the strategies are useful since they focus on the existing challenges and address the target population. In conclusion, one can state that the strategic drivers have been successfully developed into the four directional […]
• Saudi Student Nurses’ Perception of Their Educational Preparation for HIV/AIDS Patient Care In this research, the review will explore the current knowledge and literature regarding the level of comfort of nursing student’s on educational program preparation for the care of people living with HIV/AIDS in Saudi Arabia.
• HIV in Saudi Arabian Children Analysis For a long time, this society has considered those who are suffering from HIV as adulterous and are not living according to the teachings of the Quran.
• Problem of HIV in Saudi Arabian Children Although the rate of HIV infection still remains low when compared to the world’s average, the number has been on the rise over the past five years.
• HIV and AIDS as a Chronic Disease: The Unique Contributions of Nursing Through Philosophical, Theoretical, and Historical Perspectives In most societies across the world, the responsibility of caring for the sick in the community feel on the family and the entire society.
• The Historical and Current Role of Stigma in the Provision of HIV and AIDS Care: The Context of Ghana The paper describes the historical and current role of stigma in the provision and care of people living with HIV and AIDS in the context of Ghana.
• Men Issues With HIV/AIDS in Miami Various men’s issues and social well-being have contributed to the increased rate of infection among men in Miami and Florida. In conclusion, the rate of HIV/AIDS infection in Miami is higher among men than among […]
• From Exceptional to Chronic Illness: New Challenges in HIV Prevention in the UK The current paper is an attempt to analyze the shift in the perception of HIV from an exception to a chronic illness and the new challenges experienced in HIV prevention in the UK.
• Researching HIV, AIDS and Social Justice Disney claims that poverty and social injustice lead to the spread of HIV/AIDS among underprivileged people in all countries. The disease was a kind of stigma and infected people were subjected to discrimination and alienation.
• The Threat of HIV, AIDS and the Means to Avoid It Taking into account the results of the case study conducted by Cornish and Ghosh, instances of people in India becoming infected with the HIV virus have increased recently, which is given as a reason for […]
• The Combivir Medication in HIV, AIDS Treatment Hence by blocking the enzyme the rate of virus multiplication is reduced and consequently the amount of HIV cells in the blood is reduced.
• Natural HIV Control by Bruce Walker The ability of the immune system of individuals to fight HIV infection depends on T cells and not by how many T cells are produced. The article is important in that it shows the role […]
• The Policy Topic on the Impact of HIV/AIDS Pandemic in the USA This paper will discuss the policy topic on the impact of the HIV/AIDS pandemic in the United States and the rest of the world.
• Circumcision of Male Infants as a Way to Combat the HIV Therefore, by circumcising all the men, the rate of heterosexual infections in Australia will reduce considerably as circumcised men are lesser prone to HIV infections than uncircumcised ones.
• Genco Company: A Distribution of HIV-AIDS Drugs in Malaysia The management of Genco Company should be keen on setting out the date of registration because it helps to determine the period, which the business will be legal to operate in the country.
• HIV From a Social Sciences Perspective In the US, the disease was initially associated with gays only but in the recent past, it is has been claiming many lives in the country and other parts of the world. The first social […]
• Microbiological View of HIV Epidemic and Possibility of Discovering Its Cure The glycoprotein facilitates attachment and fusion of the virus to human cell membrane. In Golgi complex it is cleaved by protease and proceased in to human immunodeficiency virus and released.
• HIV (Human Immunodeficiency Virus) Prevention In so doing, they ignore the importance of the community in the prevention of HIV transmission. HIV prevention strategies that focus on the social drivers of HIV transmission are usually very effective.
• HIV/AIDS Pandemic Facing the Female Global Population The questions that arise are; what factors are contributing to the prevalence, who are the most affected and what are the actions taken to mitigate the HIV/AIDS epidemic?
• HIV Transmission From Homosexual Men Receiving Cure The study reaches the following conclusions: In general, male partners to MSM receiving treatment are at risk of contracting HIV virus although the risk is relative to condom use as well as the last time […]
• Depressive Symptoms and HIV Disease Relationship Moreover, the study also noted that it was imperative to identify and treat causes of physical symptoms while self-esteem and emotional support for HIV-positive pregnant women required strengthening in Thailand.
• Hepatitis C and HIV Among Intravenous Drug Users In relation to this health issue of HIV and HCV, the community health nurse has the responsibility of promoting health among intravenous drug users.
• Addressing the Needs of HIV Patients According to the latest report published on the subject matter, the therapy provided to the patients in question implies that the family members should take an active part in the process of managing the disorder […]
• Decreasing Inflammation in People With HIV: The Efficiency of Low-Dose Methotrexate The principal objective of the research is to obtain a numerical estimate of the issue and the reaction of respondents towards it.
• HIV Pandemic in Africa and the United States However, there is no epidemic of AIDS in the United States due to appropriate measures conducted by the government including the prohibition of the polygamy and anti-drug policy. Additionally, authors regard the role of the […]
• Communicable Disease Control Strategies for AIDS Governments should consider AIDS as a health priority, among the strategies to control the spread of disease are ensuring that public and private sectors are sharing AIDS’ responsibility, provision of enough resources to research on […]
• Guidelines on HIV and Infant Feeding The objective of this guideline was to find ways through which HIV-positive mothers can protect their HIV-free children from a possible infection.
• People Infected With HIV in India The proposed research aims to highlight the particular factors that led to a decrease in the number of people infected with HIV in India.
• Pneumonia Infection & Risk of Mortality in HIV-Infected Children The topic is quite interesting because only a few studies have attempted to focus on the role of HIV infection on the rates of mortality and morbidity rates in pneumonia infections. It is the first […]
• HIV Rates and Infant Mortality: US, UK and Kenya The purpose of this paper is to compare the HIV rates and infant mortality cases of the United States with the situation in a developed country such as the United Kingdom) and a developing nation […]
• Disclosure of a Physician’s HIV Status The addition of another corpus that needs the disclosure of HIV/AIDS status to partners is as important as it is harmful if done without prior consent.
• AIDS: The Legal Rights and Responsibilities of Employees and Patients It is the responsibility of employees to adhere to adjusted schedules and to maintain high productivity and efficiency. Employees also have a right to assess information on HIV and AIDS in the workplace.
• Late Phase of HIV Type 1 Replication The Late Phase of HIV type 1 replication involves the assembly of Gag proteins with the plasma membrane of hematopoietic cells.
• Baby With HIV Is Deemed Cured After reading the article, the first question I asked myself was whether it is possible for a baby with HIV to be cured without medication.
• Routes of HIV Transmission Based on the NACO annual report, it can be seen that the primary drivers of the HIV epidemic in India are commercial female sex workers, drug use and unprotected sex between homosexuals and heterosexuals.
• Health Services Research: AIDS-Related Stigma The information obtained from the analysis of the research findings are used by the healthcare organizations and policy makers to improve on the delivery of quality healthcare services to the people.
• HIV Intervention in Gay Community The AIDS scourge is at the center of this study because this paper seeks to address AIDS as a special health concern affecting the gay community in the Montrose area, with a clear aim of […]
• Risks for HIV&AIDS in Juvenile Detention The participants in this study willingly shared their perceptions and experience of risk for HIV/AIDS within the context of their social and ecological environments and, in so doing, embodied other models of interaction and behavior […]
• The Impact of HIV and AIDS Epidemic on Women In the anatomy while having intercourse the vagina is very susceptible to tears and irritations when engaging in sex and thus with the tears and the irritations the exposed flesh offers a good penetrating surface […]
• The Impact of Social Determinants of Health in the HIV-AIDS Efforts have been made to contain the pandemic but in vain, and that is why researchers are concentrating on the social determinants of health in the context of HIV/AIDS.
• The Social Environments and the Effectiveness of Youth HIV Prevention It is saddening that most of the youth view sex education negatively since their elders have socialized them to view it as a curse.
• Combining Efforts to Combat HIV and AIDS The difference in health care systems and standards of health care resources available in different parts of the world, greatly affect the course of the disease in individuals and groups.
• HIV Testing of High School Seniors Should Not Be a Mandatory Requirement for Graduation Still if a policy like mandatory HIV screening of students is formulated by the governing body of the University it is the indication of a serious lack of proper understanding of HIV/AIDS and the rights […]
• Research Into the Causes of HIV Though HIV is still incurable in modern days, one of the problems that people in slow developing countries face is high death rate from HIV due to the lack of funds for purchasing effective medication […]
• The Problem of HIV & AIDS in Spain: The Leading Rate of Infection in Europe Considering the fact that Spain has the leading number of the homosexual in Europe, the rate of the infections in this group stands at 10%.
• HIV and People Who Use Drugs: Cases of Infection Caused by Injection Drug Use The existing condition of the epidemic in a certain region can be termed as low-level, concentrated, or generalized depending on the prevalence levels of the virus in the specified demographic.
• Concepts of Culture and Disease Paper: AIDS However, in general, African governments and non-governmental organizations with the help of the United Nations Department of AIDS, UNAids, continue to educate Africans on the spread, symptoms, and other AIDS factors. In sub-Saharan Africa, numerous […]
• AIDS and Its Trends: An Infectious Disease That Causes the Vulnerability of the Human Internal System These facts address the query of the author having the valid experience to make writings regarding the Disease, it is clear that he had first-hand experiences. The disease is manageable with the use of drugs […]
• Effects of HIV and AIDS on Young Children and Women The hypothesis of this study is to establish the prevalence of HIV and AIDS on the general population this is with particular attention to the young children and the women who are more vulnerable.
• HIV Counseling and Testing: Lifetime Treatment Program Some of the possible intervention that can be adopted by the clinicians in order to improve adherence include the encouragement of the patients to be in contact with people of their age who will encourage […]
• Epidemiological Analysis of the Acquired Immune Deficiency Syndrome (AIDS) The virus is found in most of the body fluids of the infected person; and this is the main route of infections.
• Drugs for the Treatment of HIV Infection: Over 30 Antiretroviral Drugs to Counter the Effects of the Deadly AIDS Virus By the latest study, the Food and Drug Administration has approved 30 antiretroviral drugs to counter the effects of the deadly AIDS virus According to the National Institute of Allergy and Infectious Diseases, the drugs, […]
• Health Care Management: HIV and AIDS Prevention and Treatment To define the measurement system, and define the failure or success of HIV/AIDS treatment it is necessary to give the image of the situation in general.
• HIV, AIDS Health Determinants in Africa: The Research and Development in Curative and Preventive Medicare Emphasis was laid on the research and development in curative and preventive Medicare so that the members of the society lived a healthy life. This is compared to a total of between 130,000 and 180,000 […]
• HIV Crisis in Africa: Review of Major Public Health Concerns on the Continent The paper will examine the issue of HIV/AIDS in Africa, focusing on the effects of the disease, procedures of its containment, and the prevention tactics used by the African public.
• The Spread of HIV and AIDS in Prisons: Causes and Measures of Control Other causes of the spread of the disease include overcrowding and lack of education on the danger of the virus. At-risk individuals need to be sensitized about the devastating consequences of this virus and the […]
• ART HIV Medicine Saves Lives: Maintains Functions of the Immune System and Prevents Opportunistic Infections The goal of the essay is to increase the level of awareness of readers on the importance of ART. A brief overview of HIV treatment programs should also be included in the essay to support […]
• HIV: Overview of the Clinical Manifestations of Infection and Symptoms and Known Cases of Complete Cure The information includes detailed information about the molecular structure of the virus, the form of the genome, and the mechanism of self-reproduction within a targeting cell.
• Faith-Based Organization Services as the Best Means to Prevent HIV and AIDS in Southern Cameroons The HIV/AIDS issue was complicated by the fact that at the moment of this research, there was no cure and the only way of addressing the infection spread was through prevention and ensuring that people […]
• An Enzyme-Linked Immunosorbent Assay and Drug Treatment for HIV and AIDS It is also vital to stress that non-adherence leads to the return of the symptoms and the development of HIV-related diseases that could lead to death.
• HIV & AIDS Diagnosis and Treatment Measures After decades of its first appearance, the human immunodeficiency virus, which causes AIDS at a more severe stage, continues to be a major threat to human health and searches for developments in diagnosis and treatment.
• Breast Cancer and AIDS: Significant Issues in the United States in the Late 20th Century Thus, the given paper is going to explain why these activists challenged regulatory and scientific authorities and what they demanded. That is why the enthusiasts challenged their practices and made specific demands to improve the […]
• The Effect of HIV Treatment on Individuals and Contributing to a Longer Life of the Patients As a result, better treatment of the illnesses globally and especially in Africa has contributed to a longer life expectancy of the patients.
• Male Circumcision for HIV Prevention in South Africa The primary purpose of this study is to determine the cost-effectiveness of the use of circumcision and if this practice is appropriate.
• Misinform Partner’s HIV-AIDS Status: How to Prevent From Being Misinformed However, I believe that the key to avoiding the issue of the HIV growing epidemic does not lie in the doctor’s duty to anonymously inform one’s sexual partners.
• The Issue of HIV-AIDS-Positive Status Disclosure Whereas at the beginning of the epidemic, the therapists felt it was their duty to inform the patient’s surroundings of the issue, the introduction of the HIV/AIDS Confidentiality Act turned this duty into a forthright […]
• Global Health Issue Analysis: HIV – A Relatively New Disease Rapid detection and treatment are crucial to limit the spread of HIV and limit the patient’s effects. As the frequency and intensity of symptoms vary from person to person, testing is the only clear way […]
• High Risk of HIV Among Injection Drug Users The aim of this Health Promotion Plan is to improve the situation with infection diseases spreading among the injection drug users due to the social importance of this problem and the high level of mortality […]
• Childhood Sexual Abuse and HIV Risk in San Salvador Still, the women interviewed presented a peculiar layer of the society that made it possible to understand the clear connection of the CSA to HIV/AIDS and drug addictions.
• New Directions and Strategies for Current and Future Research in HIV The authors therefore are in agreement that future research paradigms focusing on HIV should lay much focus on developing an efficacious vaccine to curtail further spread of the virus.
• Health and Health Policy of HIV and AIDS: Physical and Psychological Wellbeing Health is defined and understood as the state of full physical and psychological wellbeing, and not just the absence of diseases in the body, while a health policy is the plans, strategies and actions undertaken […]
• Bubonic Plague and AIDS: Differences and Similarities Transmission of the diseases is also another area that generated debate in the entire course of The Plague and during the initial stages of AIDS.
• Pricing AIDS Drugs Sold to Developing Countries The majority of the world’s HIV/AIDS cases are in Africa particularly the sub-Saharan and many of the infected have been faced with a huge challenge to live a normal life due to limitations in access […]
• HIV-AIDS and Male Circumcision: The Cases of Kenya and Sri Lanka In India, religion and culture have been identified as impediments to the fight and prevention of HIV-AIDS. Religion as the main basis of culture has resulted in the entrenchment of the ban on circumcision to […]
• Does Black America Need White Support in Order to Combat HIV, AIDS Epidemic? The economic instability, the lack of education and improper health care facilities all attribute to the spread of the epidemic in the black community which is set to rise in the coming years.
• Women With AIDS in Africa: Treatment Possibilities Starting with the economical issues, the countries of Africa are the countries of the third world and the economy is very weak in the area.
• The Relationship Between the High Rate of Urbanization in Africa and AIDS Spread This movement results in to increase in the number of people in the towns and cities in a particular year. The increased social interaction of people in towns has led to increased HIV/AIDS infections in […]
• Language and Stigmatization: Cancer, HIV, and AIDS Much has been written concerning the alarming spread and effects of HIV/AIDS in the society and the effects of cancer and the position of its victims and how to care for them.
• The Human and Economic Effects of AIDS on the United States The social impact of HIV has been well documented and widely distributed which has served to educate the public and acted to stem the tide of the epidemic.
• Workplace Stereotypes About People With HIV: Business Ethics After analyzing the every angel of the case, it can be said that this is the picture of the stereotyping prejudice of people with AIDS.
• Capitalism and Industrialization as a Cause of AIDS Spread Population growth rates are the highest in most of Asia, Africa, and Latin America due to the high degree of fertility and the dramatic decrease in mortality following World War II.
• The Pharmaceutical Industry Faces AIDS in Africa Food insecurity in these countries has to lead to the quick progression of patients to full brown AIDS and completely worsened the immunity of the patients.
• HIV, AIDS and the Social Environment The obvious place to start is to find out the sociological impact of HIV/AIDS with regards to the infected person. Thus, there is a tendency to concentrate on the scientific aspect of the disease as […]
• African Gold: Ethics and AIDS in the Workplace The issue that is troubling the management of the organization in the case, African Gold is that of the costs, medical costs and disability programs as a result of the rising workforce succumbing to the […]
• Center for Disease Control and HIV Prevention Goals The first short-term mission of the CDC Preventions is to increase the percentage of those HIV-affected people who indulge in such activities which alleviates the risks or dangers of HIV transmission.
• AIDS Infection in Europe Statistics: A National Disaster in Many Countries Most of these young men and women that engage in this business are end up being infected with HIV virus since they do not have the power to negotiate for safe sex and especially the […]
• Rational System of HIV Disclosure Laws Since the start of HIV pandemic, the humanity aimed to regulate and minimize the spread of the infection. The people, who became the victims, as they were unaware of the danger of the infection, finally […]
• World AIDS Day Celebration: Increasing the Awareness of the People About the Disease The World AIDS Day is not just celebrated in the United States, Europe, or Asia, it is observed all over the world because the disease does not only affect this part of the globe, but […]
• Public Policy Development. AIDS.gov Benefit Types CDC is a premier public health agency which undertakes the control and prevention of AIDS in US, and their mission is to promote health and quality of life.
• Public Policy. Eligibility Rules Used by AIDS.gov There are no restrictions that prohibit the tailoring of health care programs by clients and using various services and providers that are eligible for meeting the health care needs of individuals.
• HIV/AIDS and Orphans in Sub-Saharan Africa On the choice of orphans in sub-Saharan Africa as the topic for this research, it aims at addressing the cause of overwhelming numbers of orphans in the region and how this impacts society.
• Social Networks of People Living With HIV and AIDS The purpose of the study was to compare the social networks of younger patients with the older ones. The convoy theory of social support lent credence to the research.
• Changes in Prostitution and AIDS Epidemic in Thailand This provided information on commercial sex trends such as the types of CSEs in existence, the number of sex workers, and the price of sex. However, the decline in the number of sex workers was […]
• How AIDS.gov Fund Its Programs to Respond to the Impact of the Epidemic on Ethnic and Minority Populations Transportation costs to go to the clinic and lost wages should be accounted for and records kept acting as evidence of how the funds were used.
• The Pharmaceutical Industry and the AIDS Crisis in Developing Countries One of the reasons of this difference is that excise and custom duties that are responsible for the unaffordable prices of medicines have been avoided by the developed countries by the creation of pharmaceutical industries, […]
• Advancements in AIDS Research: A Potential Advancement in the Attempt to Cure HIV Infection After HIV’s genetic code is altered from a single thread to a double-strand by the reverse transcriptase enzyme, it gets included in the genetic code of the infected cell.
• Ethics of Leukemia Treatment With Disabled HIV Cells In recent years, the medical community has pondered the radically new approach to cancer treatment, which is isolating and collecting T-cells from the patient.
• AIDS: Emergence Factors of Infectious Disease Emerging diseases refer to the newly identified pathogens that have been recognized in the past few decades that lead to a new manifestation of diseases.
• AIDS and Its Impact on Humankind: The Leading Killer Disease in the World From these statistics, it is easy to deduce the effect of the disease of humankind. At the international level, more and more funds have been committed to the treatment of AIDS.
• AIDS in a Different Culture Review: Cultural Differences, Prejudice, and Racism Now, gay youth and men face the possibility of HIV infection in the course of sexual relationships. The pejorative view of gay men prevalent in some black and Hispanic communities can inhibit they are coming […]
• Lewis’ Race Against Time: Curbing HIV&AIDS in Africa Lewis points out that, “HIV/AIDS has sabotaged all of the socioeconomic indices, and the continued damaging western policies in trade and aid and debt, serve to drive the nails into the coffins”.
• Community Health. HIV/AIDS Prevention for the 50+ The specificity of the paper is that it relates the issue of HIV prevention for the people over 50. It is necessary to mention, that: 10% of all AIDS cases in the USA are people […]
• Microbiology. AIDS Vaccine Studies: Different Developments Strategy So far there is no practical hope that ongoing AIDS vaccine development will produce tangible results, According to one of the leading AIDS vaccine expert Mr. Clinical trials will have to continue as they will […]
• Medical Anthropology. HIV&AIDS Preventive Measures Since the detection of the first case of HIV in India, the government introduced both surveillance and preventative plans to reduce the risk of the disease spread.
• Drug Treatments for HIV/AIDS To lower the complacency of people to HIV/AIDS and change the perceptions about the condition for individuals with and without HIV/AIDS, health care professionals should focus on such aspects as safety, responsibility, and stigma.
• Descriptive and Analytical Epidemiology: Tuberculosis and HIV The establishment of trends in the epidemic process for the rapid introduction of adjustments helps optimize preventive and anti-epidemic measures alongside the evaluation of the effectiveness of the activities.
• AIDS and Its Related Aspects The report aims to show that clinicians and nurses should discuss AIDS and associated risks with their patients to enhance individuals’ health outcomes and eliminate the prevalence of the disease.
• Anti-HIV Nonprofit’s Organizational Design
• HIV and AIDS: Legal and Ethical Conduct
• OraQuick Home HIV Test and Its Pros & Cons
• Female HIV-Positive Patients’ Medication Adherence
• Immunology and Virology of HIV Infection
• Mandatory HIV Screening: Ethical Issues
• Spreading and Dying From AIDS and the Increasing Spread of the Disease
• Health Fraud: HIV/AIDS and Sexual Enhancement Scams
• HIV and AIDS Early History and Risks
• HIV Prevention Programs in Africa
• HIV and AIDS Infection Levels and Their Social Effects
• HIV Prevalence Among American Queer Communities
• HIV Testing Among African American Women
• HIV Rates Among African American Women
• HIV Prevention Policy Development for Chicago
• HIV Prevention Among Young Adults in Chicago
• Techniques for Helping Women With HIV
• Group Policy Regarding the HIV/AIDS Transmission Issue
• Pharmacology: HIV Drug Resistance
• HIV Prevention in Youth: Public Health Campaign
• HIV/AIDS as a Long-Wave Event in Politics
• Act Up Movement for Surviving HIV/AIDS Plague
• HIV/AIDS Prevention by Anti-Retroviral Drugs
• HIV/AIDS Policies in India and Antropological Study
• AIDS in New York in “How to Survive a Plague” Film
• ”The Cure for AIDS” by Apoorva Mandavilli and Various Ethical Issues
• Qatari Laws: HIV/AIDS Visitors, Pets, Dressing Code
• Legal Ethics, Patients’ Rights, and HIV/AIDS
• HIV/AIDS as a Communicable Disease
• Ancillary Services for HIV/AIDS Patients
• HIV/AIDS Patients: Legal Ethics and Patient Rights
• Medicine: HIV/ AIDS Campaign Slogan
• Medicine: HIV/AIDS as the Key Threat for the Kenyan Population
• HIV and AIDS in Kenya
• HIV/AIDS in Kenya: Evaluation Plan
• Health Promotion Program HIV/AIDS in Kenya
• HIV Among Adolescents – Treatment and Prevention
• HIV/AIDS Definition, Prevention and Treatment
• Medical Issues: HIV in the U.S.
• 5 Years Strategic Plan for HIV Prevention in Swaziland
• HIV and AIDS Prevention Among the Youth in Asia
• STD/HIV Health Promotion Evaluation Plan
• HIV and AIDS: an Evolving Global Response
• HIV Epidemic in Enrique’s Native Country
• AIDS: From the Perspective of Sociology
• Critical Analysis of Avahan – the India AIDS Initiative
• HIV/AIDS by Allan Whiteside
• Thailand Issues: Environment, Child Prostitution, and HIV/AIDS
• The Rate of Smoking Among HIV Positive Cases.
• Critical Review of Chapter 5 and 6 of the Book HIV/AIDS
• AIDS Combating in the 21st Century: Issues and Challenges
• HIV/AIDS in the UK
• History of Treatment the HIV/AIDS
• Pathology of HIV and AIDS
• How the AIDS Epidemic Has Affected the World on a Political, Social, Economical Way
• The HIV and AIDS Problem Between Educated and Non-Educated Children in Uganda
• Implementation of AIDS Control Policies in Australia and South Africa
• HIV/AIDS Among African Americans
• AIDS: The Guilt and Failure of the West in a Spread of the Disease
• AIDS as an Epidemic of Signification: A Globally Potential Threat
• Key Drivers of HIV/AIDS in Sub Saharan Africa and in San Francisco
• Key Drivers of HIV and AIDS in Sub-Saharan Africa and in San Francisco and Church’s Response to the AIDS Pandemic
• Drivers of HIV and AIDS in Sub-Saharan Africa and San Francisco
• Impact of HIV/AIDS on Microeconomics
• Why Lack of Awareness Leads to the Spread of HIV/AIDS in New York Prisons
• Theory, Methodology and Human Development: HIV/AIDS and Education in African Countries
• Vital Signs: HIV Testing and Diagnosis Among Adults – United States, 2001-2009
• Community HIV/AIDS Mobilization Project (CHAMP)
• Communicable Diseases: HIV and AIDS
• Why HIV/AIDS Crises Are High in African-American Community
• A Project on Establishment of Jousing Flats Voluntary Counselling and Testing Centers in Njoro Area to Reduce Prevalence of HIV/AIDS and Provide Nutritional Support Among the Youths Aged Between 16-35 Years
• HIV/AIDS Issues in African Women
• AIDS in Lesotho, Africa: The Highest Prevalence Rate of HIV Infections in the World
• Prevention of HIV/AIDS in Rural Ethiopia: Identifying Risks
• Is Being HIV Positive a Disability?
• Why Does the Immune System Weaken With HIV Infection?
• What Is the Main Cause of HIV?
• How Does HIV Gain Entry Into the Cells It Attacks?
• What Can Gamma Delta T Cells Contribute to an HIV Cure?
• What Are the 4 Stages of HIV Infection?
• What Are the 5 Symptoms of HIV?
• Does the HIV Virus Evolve?
• What Is the Good News for HIV-Positive Patients?
• What Is the Impact of HIV on Society?
• What Are the Symptoms of HIV/Aids?
• How Long Will HIV Take to Show Up?
• Can Mosquitoes Transmit HIV?
• How Can You Get HIV?
• How Fast Does HIV Spread in the Body?
• What Can the Government Do to Stop HIV?
• When Did HIV First Arise?
• Why Are Child Victims of Sexual Abuse at Greater Risk of HIV?
• How Long Do HIV Symptoms Last?
• Will There Be a Cure for HIV by 2030?
• Can You Survive HIV-Positive?
• How Many Teenagers Are Affected by HIV?
• Is There Currently a Cure for HIV?
• What Age Group Has the Highest HIV Infection Rate?
• How Long Can You Live After Having HIV?
• What Are the Three Biggest Risk Factors for HIV?
• Which Antibody Functions Are Important for an HIV Vaccine?
• Can You Drink When HIV Positive?
• Why Is HIV Research Important?
• What Resources Are Available for HIV Patients?
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Essay on AIDS for Students and Children

500+ words essay on aids.

Acquired Immune Deficiency Syndrome or better known as AIDS is a life-threatening disease. It is one of the most dreaded diseases of the 20 th century. AIDS is caused by HIV or Human Immunodeficiency Virus, which attacks the immune system of the human body. It has, so far, ended more than twenty-nine million lives all over the world. Since its discovery, AIDS has spread around the world like a wildfire. It is due to the continuous efforts of the Government and non-government organizations; AIDS awareness has been spread to the masses.

AIDS – Causes and Spread

The cause of AIDS is primarily HIV or the Human Immunodeficiency Virus. This virus replicates itself into the human body by inserting a copy of its DNA into the human host cells. Due to such property and capability of the virus, it is also known as a retrovirus. The host cells in which the HIV resides are the WBCs (White Blood Cells) that are the part of the Human Immune system.

HIV destroys the WBCs and weakens the human immune system. The weakening of the immune system affects an individual’s ability to fight diseases in time. For example, a cut or a wound takes much more time to heal or the blood to clot. In some cases, the wound never heals.

HIV majorly transmits in one of the three ways – Blood, Pre-natal and Sexual transmission. Transfusion of HIV through blood has been very common during the initial time of its spread. But nowadays all the developed and developing countries have stringent measures to check the blood for infection before transfusing. Usage of shared needles also transmits HIV from an infected person to a healthy individual.

As part of sexual transmission, HIV transfers through body fluids while performing sexual activity. HIV can easily be spread from an infected person to a healthy person if they perform unprotective sexual intercourse through oral, genital or rectal parts.

Pre-natal transmission implies that an HIV infected mother can easily pass the virus to her child during pregnancy, breastfeeding or even during delivery of the baby.

AIDS – Symptoms

Since HIV attacks and infects the WBCs of the human body, it lowers the overall immune system of the human body and resulting in the infected individual, vulnerable to any other disease or minor infection. The incubation period for AIDS is much longer as compared to other diseases. It takes around 0-12 years for the symptoms to appear promptly.

Few of the common symptoms of AIDS include fever , fatigue, loss of weight, dysentery, swollen nodes, yeast infection, and herpes zoster. Due to weakened immunity, the infectious person falls prey to some of the uncommon infections namely persistent fever, night sweating, skin rashes, lesions in mouth and more.

Get the huge list of more than 500 Essay Topics and Ideas

AIDS – Treatment, and Prevention

Till date, no treatment or cure is available for curing AIDS, and as a result, it is a life-threatening disease. As a practice by medical practitioners, the best way to curb its spread is antiretroviral therapy or ART. It is a drug therapy which prevents HIV from replicating and hence slows down its progress. It is always advisable to start the treatment at the earliest to minimize the damage to the immune system. But again, it is just a measure and doesn’t guarantee the cure of AIDS.

AIDS prevention lies in the process of curbing its spread. One should regularly and routinely get tested for HIV. It is important for an individual to know his/her own and partner’s HIV status, before performing any sexual intercourse activity. One should always practice safe sex. Use of condoms by males during sexual intercourse is a must and also one should restrict oneself on the number of partners he/she is having sex with.

One should not addict himself/herself to banned substances and drugs. One should keep away from the non-sterilized needles or razors.  Multiple awareness drives by the UN, local government bodies and various nonprofit organizations have reduced the risk of spread by making the people aware of the AIDS – spread and prevention.

Life for an individual becomes hell after being tested positive for AIDS. It is not only the disease but also the social stigma and discrimination, felling of being not loved and being hated acts as a slow poison. We need to instill the belief among them, through our love and care, that the HIV positive patients can still lead a long and healthy life.

Though AIDS is a disease, which cannot be cured or eradicated from society, the only solution to AIDS lies in its prevention and awareness. We must have our regular and periodical health checkup so that we don’t fall prey to such deadly diseases. We must also encourage and educate others to do the same. With the widespread awareness about the disease, much fewer adults and children are dying of AIDS. The only way to fight the AIDS disease is through creating awareness.

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HIV/AIDS College Essays Samples For Students

109 samples of this type

Regardless of how high you rate your writing skills, it's always a worthy idea to check out an expertly written College Essay example, especially when you're dealing with a sophisticated HIV/AIDS topic. This is precisely the case when WowEssays.com collection of sample College Essays on HIV/AIDS will come in handy. Whether you need to brainstorm a fresh and meaningful HIV/AIDS College Essay topic or examine the paper's structure or formatting peculiarities, our samples will provide you with the required material.

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Good Essay On Health Care And HIV/AIDS Management Policy In United States

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Health care is one of the major concern topics for Botswana government to solve for it is citizens. They have started looking to effect and solution to improve their healthy living since last decade (Encyclopedia of the Nations, 2013). It is clear to tell there are main diseases in Botswana, which are AIDS, malnutrition, tuberculosis and cancer (BBC, 2013). Good thoughts and solution should be taken to fight against them as well as to organize the problems very well. In this essay reasons and effects will be discussed

Description of the problem of diseases in Botswana

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Since the diagnosis of the first case of HIV/AIDS in 1981, the disease continues to spread unabated with new infections reported daily. Figures provided by UNAIDS (2009) indicate that more than 60 million and 25 million people have been infected and died of the scourge respectively since 1981. In light of its omnipresent nature, the disease has and will continue to have severe repercussions on the social, political and economic development of countries around the globe. Moreover, it has an impact on the global disease burden.

Free Communicable Disease Of HIV Essay Example

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Description of HIV

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Social issues cut across a large spectrum of our daily lives, cutting across from human to local area development. In the exploration of considering topics to research on, the researcher looked at the topics which are most relevant to this generations and future generations and settled on these three areas: these are potential topics that were looked into

Child Abuse

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Hiv/aids essay examples.

HIV/AIDS has been and still is the greatest cause of suffering and death in the world. Its impact has been felt from lives to livelihoods and lifestyles of millions of people and their families and societies. The Resolution 1308 was passed by the UN Security Council, which aimed at changing how people perceived HIV/AIDS (Mcinnes & Rushton, pp. 225). This way, many societies may look for the different possibilities for activities and actions that would fight the impact of HIV/AIDS and its further spread. Africa’s Economy and its growth are directly affected by HIV/AIDS.

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This paper gives an overview of three visual communication approaches and how they tend to communicate and transmits a message on a single problem, which is HIV/AIDS awareness. The paper is divided into two parts. The first part shows how each visual communication approach communicate and transmit messages on this particular issue. In this part the diagrammatic representation are provided. The second part of the paper deals with the overall reflection on how these three approaches work and which of the three is more effective. The approaches include Symbols and signs, Charts and graphs and Cartoons and illustrations.

INTRODUCTION

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The sixth-millennium goal is on the strategies to combat HIV/AIDS, malaria, and other infectious diseases. The plan according to the United Nations is to tackle it in stages that will lead to combat eventually the menace. The targets that were set were in three primary sectors whereby by the year 2010 all the affected by HIV/AIDS get access to treatment then by 2015 the spread of the be reversed significantly as well as the reversal of the spread of malaria and communicable diseases that were giving the community problems.

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The world has seen a significant number of technological advances, including sophisticated applications targeted for the health sector; yet the burden of death remains high for the largest portion of the world. Developing countries do not have the resources to make these devices available for their people. However, a few countries are beginning to experiment with the more affordable use of information technology in healthcare systems. This part of the study explores the global burden of disease.

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E-health in Developing Countries with a Special Focus on Nigeria

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Article #A1: Wu, H., Li, Z., Li, H, & Wu, S. (2016). Quantitative phase imaging of breast cancer cell based on SLIM. Journal of Physics: Conference Series, 679(1), 1-5. doi: 10.1088/1742-6596/679/1/012003

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The analysis of the collected data is the most exciting and creative stage of sociological research that requires thorough study as well as distinctive imagination, intuition, professional and life experience. However, this step is the most complex of all components of the research process of social reality. The most common is this definition of data interpretation: “data interpretation is a set of actions committed in the process of studying the empirical data for in order to formulate an idea of the characteristics of the researched object, or simply the primary processing of empirical data” (Macionis et al. 2010).

Hence it becomes clear that the main themes and issues of data interpretation are:

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The daily lives of people with HIV infection: A qualitative study of the control group in an expressive writing intervention

Maria metaweh.

University of Miami, Coral Gables, Florida, USA

Gail Ironson

University of Miami, Miami, Florida, USA.

Julie Barroso

Medical University of South Carolina College of Nursing, Charleston, South Carolina, USA.

Emotional disclosure is an expressive writing technique used in psychotherapy to process traumatic and stressful life experiences. While emotional disclosure interventions frequently use control groups, there are few qualitative analyses of these control groups. Our study's purpose was to analyze the control essays written by HIV-infected informants about their daily activities in an augmented written emotional disclosure intervention. Latent and manifest qualitative content analyses revealed prevalent contextual themes within the data. The emergent themes were socioeconomic status (SES), self-care, religiosity/spirituality, and social support. Emotional disclosure control subjects contributed substantial findings in terms of SES, self-care, resiliency, religiosity/spirituality, and social support and altruism.

Emotional disclosure is an expressive writing technique used in psychotherapy to process traumatic and stressful life events. Although control groups are commonly used when examining the effect of expressive writing on health-related outcomes, few qualitative assessments of the control groups’ writing exist in the literature. In fact, an expressive writing meta-analysis by Frisina, Borod, and Lepore (2004) reinforced the superiority of experimental trauma writing over control group writing when investigating health outcome variables. To our knowledge, there were no qualitative studies in the literature on HIV and emotional disclosure interventions that exclusively examined control writing. Our purpose was to analyze control essays written by HIV-infected informants in an augmented written emotional disclosure intervention ( Ironson et al., 2013 ) to illuminate the substantial information attention control (i.e., daily events control writing) participants may provide about the daily lives of people living with HIV (PLWH).

Empirical evidence has demonstrated the beneficial effects of emotional disclosure in expressive writing since Pennebaker and Beall (1986) introduced the writing paradigm. Pennebaker and Beall (1986) randomly assigned individuals to disclose their deepest thoughts and emotions concerning a traumatic event (i.e., experimental, expressive writing, or trauma writing condition) or to write about neutral/trivial topics for several consecutive sessions (i.e., attention control condition). Their results revealed that confronting intimate thoughts and sentiments regarding a stressor or trauma improved physical health, as evidenced by reductions in medical visits, aspirin usage, and overall positive assessments of the effect of the experiment ( Pennebaker & Beall, 1986 ). Since then, these findings have prompted numerous studies to examine the effect of expressive writing on physiological and psychological health outcomes in both healthy and clinical populations ( Pennebaker & Chung, 2011 ). In 2006, Frattaroli (2006) conducted the largest expressive writing meta-analysis to date, using 146 randomized studies that implemented some variation on the Pennebaker and Beall (1986) writing paradigm. She found that written emotional disclosure (i.e., experimental disclosure) improved psychological health (e.g., depression), physical health (e.g., immune function), and overall function; successful studies tended to use participants with a health ailment or history of trauma ( Frattaroli, 2006 ). Her review accelerated the study of the impact of expressive writing in chronically ill patient samples.

Few studies of PLWH have examined the effects of written emotional disclosure in randomized controlled trials (RCT), and even fewer have used qualitative methods to assess the written content disclosed by participants. The Pennebaker expressive writing paradigm ( Pennebaker & Beall, 1986 ) provided an ideal avenue for PLWH to disclose their thoughts and emotions regarding the trauma and stress associated with an HIV diagnosis, the social implications of living with HIV, and disease progression. Petrie, Fontanilla, Thomas, Booth, and Pennebaker (2004) reported that experimental participants had a positive biological response with a significant increase in CD4+T lymphocyte cell counts compared to control writing; moreover, the treatment group rated their essays as more meaningful and emotionally revealing than those in the control condition. Contrasting these findings, Rivkin, Gustafson, Weingarten, and Chin (2006) examined adjustment to living with HIV in an expressive writing study and revealed that control participants (who were instructed to write contemporaneously and factually about their day) reported the process to be just as personal, emotional, and nearly as valuable as did those in the expressive writing arm of the exercise. Despite control participants not expressing as much emotion or cognitive processing as treatment participants, the control prompt enabled them to disclose information concerning their social lives ( Rivkin et al., 2006 ). Even though the experimental condition enabled participants to address problematic emotions, strengthen self-awareness and insight, and confront reality, the control condition still allowed participants to meditate, reflect on their day, and recognize that people in their lives cared for them. Wagner, Hilker, Hepworth, and Wallston (2010) found no effects of expressive writing on psychological, physical, or pain outcomes compared to control writing. In a computerized structured writing intervention on depressed mood for PLWH, Kraaij et al. (2010) found that respondents who followed the cognitive-behavioral self-help program improved significantly in mood but not in health outcomes. Our parent study ( Ironson et al., 2013 ) investigated gender-specific effects between conditions and found that the women in the trauma writing group showed significant reductions in symptoms of post-traumatic stress disorder, depression, and HIV-related symptoms, compared to the women in the control group. Unexpectedly, the control condition's men showed significant reductions in depression when compared to the men in the experimental condition. Seeing that the data demonstrated evidence for an effect within the control condition, this provided an opportunity to conduct qualitative analyses on these essays to understand the daily lives of PLWH.

In order to ensure an inclusive literature review, we conducted a preliminary survey of contextual themes in our data as well as in the literature. These overarching themes were socioeconomic status (SES), self-care, religiosity/spirituality, and social support. All of these variables have shown an effect on health in chronically ill populations. In caregivers and chronically ill adults, social support has been shown to serve as a protective factor for mental health ( Casale, Wild, Cluver, & Kuo, 2014 ). In patients suffering from heart failure, social support (particularly from the individual's family) was positively related to heart failure self-care behaviors ( Graven & Grant, 2014 ). Additional research has shown how self-care behaviors provided an effective mechanism to reduce heart-failure patient expenses and to ameliorate negative patient health outcomes; however, those individuals with low SES still faced extenuating circumstances that exacerbated negative self-care ( Macabasco-O'Connell, Crawford, Stotts, Stewart, & Froelicher, 2008 ). People with heart failure also suffered from disordered sleep, which had a negative impact on self-care ( Redeker, 2008 ).

The current state of research with PLWH has shown an increase in self-management interventions that help when coping with daily life ( Bernardin, Toews, Restall, & Vuongphan, 2013 ). In their review of HIV self-management interventions, Bernardin et al. (2013) concluded that the collaborations between health providers and clients promoted self-care, interpersonal and cognitive skills, knowledge, positive attitudes, future planning, and role management; outcomes included well being, health and illness management, and use of health services. Group-based interventions also encouraged social support from program leaders and other participants. In addition, self-management interventions have been shown to improve perceptions of sleep quality, decrease stress, and ameliorate problems with physical functioning and psychological coping ( Bernardin et al., 2013 ). HIV-related fatigue has been the most frequent complaint by PLWH and was predominately an outcome of stressful life events ( Barroso, Leserman, Harmon, Hammill, & Pence, 2015 ); furthermore, fatigue in HIV has impaired both basic and instrumental daily activities, especially activities related to work, family, and social life ( Barroso, Harmon, Madison, & Pence (2014) .

Research on the relationship between self-care and social support in HIV has been sparse; however, perceived HIV-related stigma has been found to contribute to lower perceived levels of social support ( Earnshaw & Chaudoir, 2009 ). Zhang et al. (2014) found that teaching stigma reduction and educational interventions to augment the social support systems of PLWH (e.g., family members, friends, peers) could improve active interpersonal coping, a form of self-care. Coping may manifest as positive or negative self-care behaviors, which suggests a link between social support and self-care in HIV. A qualitative study on the role of social support in HIV-infected refugees identified how emotional support helped people cope with an HIV diagnosis and instrumental support encouraged medication adherence ( Rouhani et al., 2016 ). High levels of perceived social support in gay and bisexual HIV-infected men were associated with higher use of positive coping methods and actively searching for support, and low levels of perceived social support were related to higher use of self-destructive coping methods ( Tate, Van Den Berg, Hansen, Kochman, & Sikkma, 2006 ). Coping by avoidance and conflicting social interactions were significantly related to each other, where negative interactions with others encouraged social isolation as a means of coping, resulting in poorer social function ( Fleishman et al., 2000 ).

In a nationally representative cohort of 2,266 patients receiving care for HIV infection, respondents affirmed that spirituality (85%) and religiosity (65%) were somewhat or very important in their lives ( Lorenz et al., 2005 ). In fact, HIV diagnoses have been known to inaugurate a re-exploration of one's relationship to spirituality. An increase in religiosity/spirituality has been shown to occur post-HIV diagnosis and that it predicted slower disease progression ( Ironson, Stuetzle, & Fletcher, 2006 ). It is important to emphasize that we found other precursors for spiritual transformations or drastic changes in spiritual beliefs, self-views, and attitudes in HIV-infected participants. Such precursors accompanied a profoundly spiritual experience (e.g., a near death experience) or substance abuse recovery where principle themes such as education, social support, aspirations to change, confrontations with illness and death, lifestyle, helplessness, and depression were prevalent ( Kremer & Ironson, 2009 ). In the context of religiosity, which entailed a search of the sacred within a social institutional setting, HIV-related stigma revealed a perceived disassociation between PLWH and religious institutions. These social religious organizations could have provided PLWH with a support network, but HIV-related stigma stripped this potential support system from them ( Kremer & Ironson, 2009 ).

Regardless of this disconnection, PLWH preserved a sense of religiosity/spirituality in order to cope with the disease and manage their lives ( Ironson & Kremer, 2011 ; Ironson, Kremer, & Ironson, 2006 ); therefore, religiosity/spirituality provided helpful coping mechanisms, where prayer, meditation, and giving credence to a higher power were common. Participants stressed how their beliefs in God and the role of religion helped them cope with the virus ( Ironson, Kremer, et al., 2006 ). Spirituality facilitated constructive coping mechanisms that influenced self-care cognitions and behaviors in HIV. Prayer has been used and rated as a highly effective self-care strategy to manage HIV-related symptoms ( Eller et al., 2013 ). In Ironson and Kremer's (2011) review on spiritual coping in HIV, the ways in which spirituality/religiosity may aid coping with HIV were elucidated: (a) it may provide hope by encouraging belief in a higher power; (b) it can foster more positive appraisals; (c) it can empower individuals with a feeling of wellbeing, tranquility, and safety during uncertainties; (d) it may encourage the feeling that one has support and is not alone; (e) it may promote a greater respect for one's body; (f) it can take a person out of the realm of suffering through transcendence; (g) it can give meaning; and (h) it may activate surrendering to a higher power ( Ironson & Kremer, 2011 ).

The purpose of our study was to analyze the control essays written by HIV-infected informants in an expressive writing study ( Ironson et al., 2013 ). To our knowledge, there have been no qualitative studies that solely examined control conditions from emotional disclosure interventions in HIV; therefore, our study enhances the understanding of the daily lives of these informants. The themes of SES, self-care, religiosity/spirituality, and social support reflected prevalent patterns found within these data.

HIV-infected informant ( n = 119) essays revealed how SES, self-care, religiosity/spirituality, and social support impacted the daily lives of our participants. These data came from the first time-point control group in the primary study in an augmented written emotional disclosure intervention ( Ironson et al., 2013 ). The University of Miami Institutional Review Board approved the parent study; participants provided written consent prior to study initiation. The information reported here served as a secondary qualitative data analysis of the control condition.

Participants

Participants from the written emotional disclosure intervention were randomly assigned to write about a traumatic event (the intervention group, n = 121) or to write about their daily lives (the control group, n = 123, with attrition, n = 119).

Between February 2004 and January 2009, participants were recruited from southeast Florida (i.e., Miami-Dade and Broward Counties) with follow-up sessions that continued into February 2010. Inclusion criteria required participants to be within mid-range of illness (where 85% fell into a CD4+ T cell count range of 100-600 cells/mm 3 ) and to be within 18 to 70 years of age. Subjects were excluded if they had any severely symptomatic AIDS-defining conditions in the year prior to enrolling in the study. Exclusion criteria also omitted those suffering from current alcohol or substance dependence, psychotic symptoms, or active systemic diseases or disorders (e.g., stroke or cancer, or liver, lung, kidney, or heart problems) that could potentially hamper participation or measures of disease progression. A Test of Written Language ( Hammill & Larsen, 1996 ) also excluded those who could not read at an eighth-grade or higher level ( Ironson et al., 2013 ). Participants were recruited from various community organizations, family health centers, physician offices, and gay social networking places (i.e., bookstores, clubs, bars, etc.), via newsletters and online advertisements, at relevant events (i.e., AIDS walk and Gay Pride), and by word of mouth. Participants received 50 USD for each writing session.

Our study examined the 119 control essays produced at the first time-point of the primary study. The age range of participants was from 18 to 70 years ( M = 41.54, SD = 9.36), and included 73 males and 46 females, 19 Caucasians and a total of 100 African Americans, American Indians, Asian Americans, Hispanics, Haitians, Afro-Caribbeans, and others who considered themselves biracial ( Table 1 ).

Demographics

For the control condition, informants were asked to write an account of their daily activities for 20 continuous minutes; instructions included writing about what they did yesterday from the time you got up until the time you went to bed. While the intervention condition focused on traumatic emotional disclosure and in-depth processing, the control prompt instructed them to avoid writing about your emotions or opinions but to try to be as accurate and objective as possible.

Data Analysis

Our study was a latent and manifest qualitative content analysis ( Graneheim & Lundman, 2004 ), based on the work of Ironson et al. (2013) . A manifest content analysis codes the apparent and measurable content of the data; a latent content analysis, on the other hand, codes the hidden and deeper structural meanings in the data. Collectively, these analyses provide a broader analysis of the data ( Graneheim & Lundman, 2004 ).

We used qualitative descriptive analysis to develop a comprehensive overview of participants’ daily life events and to obtain descriptive and interpretive validity ( Sandelowski, 2000 ). After having transcribed a large amount of the hand-written data to electronic format over the previous years, the first author already had a firm understanding of the content. We started the analysis by reading 20 essays to gain a sense of their content. We then identified common storylines or key patterns and regularities within the data to categorize the data. With each sequential batch (20-30 essays) of data, we deduced the data's patterns into more abstract emerging themes. Latent content analysis involved an in-depth systematic reading of the meaning of the data ( Graneheim & Lundman, 2004 ). We categorized/coded each essay, developing prevalent themes regarding daily life events. Our manifest content analysis included calculating frequencies of patterns discovered within the themes ( Graneheim & Lundman, 2004 ). We then defined the meanings and characteristics of each theme and compared our findings to the literature.

The most predominant groups in the sample were African American women and gay men. The sample was predominantly people of lower SES with a mean annual income of $10,000. The essays ( n = 119) contained the following themes: the effects of socioeconomic status, self-care, religiosity and spirituality, and social support (see Table 2 ).

Daily Activity Essays Themes

Socioeconomic Status

The SES theme differentiated financially secure individuals from those who were financially burdened. Participants ( n = 46) categorized as financially secure were those who owned vehicles, were employed, owned property, or had more education. Of the financially secure participants, 26 owned a vehicle, 17 indicated they were employed, and 6 attended classes at a local educational institution. Some participants mentioned the types of classes they were taking and their majors included mathematics, interior design, law, and architecture. These participants also described property they owned or would own in the near future, such as apartments, land, or duplexes. One employed participant mentioned an upcoming vacation.

In contrast, 13 participants described economic struggles with impoverished living conditions. Financially burdened individuals reported poor living conditions and an overall hardscrabble life marked by poverty and destitution. Such individuals reported using duct tape to repair their home window screens, walked miles to reach a bus stop to go to the physician and run errands, and were not able to buy a $5.00 USD pair of sandals. Some talked about sitting outside on milk crates waiting for buses while it rained. One participant wrote, “I rode my bike to the bus stop to see the doctor; I had foot surgery and I had to change my bandages. I got my feet cleaned and had them rewrapped then caught the bus back home.”

Financially burdened participants also mentioned living in darkness because they could not pay their electric bills: “We got to the buffet. My mother say get full because we don't have no lights.” Other informants described being elated at the sight of food that their research studies supplied: “A bunch of people were there. Near the door was a table filled with sandwiches, chips, and sodas. Yummy! I was really hungry! I started scarfing down their food.” Some would collect recyclable materials and garbage as a way to earn money, and some were homeless. A participant described,

[I] went to my mother's house, and she started to fight with me about my brother. She said to never come back over to her house. So I don't have anywhere to stay now; I am out on the streets. I ate sandwiches last night and nothing else so far but I feel really bad because I have nowhere to stay or nothing to eat. I am scared to tell my mother and father that I have HIV because they don't want me. They don't want nothing to do with me.

Poverty is critical when considering self-care, the next theme.

Of the 46 individual essays that expressed greater financial security, 42 practiced positive self-care. Self-care was defined as cognitions and behaviors that influence health maintenance and improvement, including mental, emotional, and physical well-being. Participants who performed positive self-care behaviors expressed optimistic attitudes and engaged in constructive actions that provided stress reduction for the physical body and emotional state of mind. Participants who demonstrated negative self-care behaviors wrote about self-defeating thoughts and maladaptive behaviors, which may have provided temporary stress reduction for the body, yet had a negative long-term impact on mind and body health.

A total of 114 essays conveyed positive self-care with cognitions and behaviors that provided stress reduction on the physical body and mental/emotional well-being. Mental-emotional activities ranged from creating or listening to music, singing, writing, reading, playing board games, taking time to relax, getting organized, and watching television or movies, to surfing the Internet. Activities that had a positive impact on physical health ranged from exercising and swimming, playing outdoor games, taking medications or vitamins, engaging in personal hygiene, to eating well. The participants employed additional activities that encompassed the complete emotional, mental, and physical health spectrum of well-being. These activities included meditating, decorating, gardening, fishing, ceasing illicit drug use, attending medical or counseling appointments, and smoking cannabis.

Despite 13 participants indicating economic difficulties, some were able to access free food and inexpensive meals. Many prepared healthy meals and participated in matters of personal hygiene. Participants would take time out of their days to cook and eat fulfilling meals; some were so meticulous that they prepared their meals in advance (i.e., soaking almonds), made sure to drink sufficient amounts of water throughout their day, and occasionally rewarded themselves with treats of their favorite foods and desserts. In regard to personal hygiene, informants discussed caring for wounds to reduce the risk of infection, taking baths, taking time to prepare a nice outfit, and cleaning their living spaces. One participant even made the effort to meet with the university dean before attending his scheduled dental appointment with a student hygienist to ensure the process would occur smoothly. Only 10 exercised moderately; some walked, some went to the gym, and some swam. One informant discussed eating well and exercising while integrating social support:

Breakfast is a must; I never skip it. I ate cereal with bananas, piece of toast with butter and jam, tea, followed by [a] large glass of water. I went to the gym for 2 hours, relieves stress, good for my overall being, and like my social time with my workout buddies.

Within a small fraction of this participant's day, he successfully managed to incorporate components of positive social support (i.e., exercising with his workout buddies) with positive self-care (i.e., exercising, eating well) in order to reduce stress.

Furthermore, three participants’ essays discussed maintenance of sobriety, and two of the three essays described the use of positive self-care to avoid relapse. One informant said, “I didn't stay because they did drugs so I left, went home and read a book...”. After eating breakfast, engaging in matters of personal hygiene, and getting dressed, one participant wrote, “On my way to church I stopped by some people I had not seen in over 2 years. I told them that life was good without alcohol or drugs and then I drove on to church.” These essays captured how positive self-care practices can act as a buffer against involving themselves in future detrimental behaviors (i.e., negative self-care) that could lead to relapse.

In terms of negative self-care, a total of 30 essays presented behaviors where individuals did not eat well, drank too much coffee, habitually smoked cigarettes ( n = 22), and experienced disordered sleep. Two essays in this category described not eating for an entire day due to lack of food, lack of appetite, and being too busy. A total of 50 essays indicated symptoms of disordered sleep, where participants would take several naps during the day, stay up late, have trouble falling and staying asleep, and oversleep. One individual wrote,

The phone rang four different times in the morning and I finally got out of bed. I was very groggy, which is my usual state every morning because I don't sleep much during the night. My sleep is sporadic, and I am in it intermittently.

Some abnormal sleepers experienced excruciating body aches, which woke them at night. Most who had pain had to get up and take pain medications just to fall back to sleep; some would be unsuccessful. One informant described, “I awoke around 5:00 AM in pain, went to the bathroom, and then I went to the kitchen for water and pain medication. After that, I tried unsuccessfully to go back to sleep; so I watched television.” All participants with disordered sleep watched television repeatedly throughout the day, and especially during the night before bedtime, which exacerbated their sleeplessness.

Resiliency was defined as patterns of positive adaptation in the context of significant risk or hardships; 38 participants expressed strong self-worth, an overall optimism despite daily negative circumstances, and positive self-care in terms of HIV management. They made an effort to smile at everyone (including strangers) and to be cordial, to engage in positive hobbies for personal enjoyment, to continue to job hunt despite previous difficulties, to schedule earned vacations, to attend health-related conventions for personal enrichment, to care for themselves despite the event of a natural disaster (i.e., hurricane), to push for their health care despite negative social contexts, and to care for children. Although one participant had served time in prison, he described:

I waited tables for 6 hours. I ran errands with a coworker and also was driving another waiter home. After doing so, the other worker and I went to the courthouse where I had to go to the probation office for a urine analysis. After that, I got my prescription medications. After the pharmacy, we got fast food - where I purchased a burger and a soda in which I scarfed the food down. Never really slept, just relaxed until about 7:00 pm and went to visit a friend to get my belongings that he kept for me while I was in prison.

Despite having been incarcerated and needing to fulfill his probation obligations, this participant expressed resiliency by attaining a job, owning a vehicle, having a strong network of social support, and engaging in positive self-care.

Religiosity and Spirituality

Depictions of religiosity/spirituality in the essays were also indicative of self-care. Of the 35 essays containing religious and spiritual behaviors, 34 also demonstrated positive self-care behaviors, showing a relationship between positive self-care and religiosity/spirituality. Religiosity and spirituality relate to expressions, thoughts, behaviors, or experiences that originated from an exploration of the divine. Religious participants indicated a system of worship and doctrine affiliated with certain religious institutions, whereas spiritual participants focused more on the transcendent by expressing faith, devotion, and reverence. A total of 35 individuals practiced religious and spiritual behaviors, which ranged from attending religious institutions (mostly church), praying throughout the day, expressing gratitude to God, to listening to gospel music. Of the 35, 26 participants engaged in prayer, both personal and intercessory, and they chanted, meditated, or praised God. One participant said, “I began every morning with my usual prayer. You didn't have to wake me this morning, but you did and I thank you Lord.” Another praised God, stating, “How good he is to me to keep me alive and be my own person.” Participants also stressed the nature of trusting in God during times of hardship. One wrote,

I called my pastor. We talk about how good God is. Then I call another friend who was sick and let him know that he will be all right. I told him to keep trusting God. So I call one of my kids to check on them. I let them know to keep the good work up in school, that I was proud of them and that I was going through something. I then pray and gave to God because I was a little down, but he work it out for me. Peace came over me.

Nine attended institutions of faith, including Sunday school, holy communion, Jehovah witness ceremonies, and chapel and ministry attendances. One informant described elements of positive self-care and altruism, while attending a religious service:

The service began and I had pie and pastries to eat. They spoke about difficulties that one may encounter: loss of job, no job, death of a loved one, and how God (Jehovah) can be there for you, his love, knowing that he will never leave you nor forsake you. It was very uplifting and encouraging.

Five read religious texts throughout the day. One participant integrated social support, personal and intercessory prayer, and Bible reading. In these essays, participants expressed elements of spirituality and transcendence while incorporating gratitude and reverence.

Finally, a few essays depicted religious and spiritual cognitions negatively in terms of coping with the disease (i.e., getting angry or rejecting God or a higher power). But most cognitive and behavioral elements of religiosity and spirituality were written within a positive frame of reference.

Social Support

The social support theme included a continuum of social support where participants depicted one of the following themes: no social support, only social interactions, some social support, or abundant social support . In addition to this continuum of social support, a separate category of unsettling social support represented the negative aspects of social interactions described by participants. A total of 115 essays were categorized into one subcategory within the established continuum of social support, and 10 of these essays overlapped into the separate unsettling social support category; four essays fell exclusively into the unsettling social support category.

Degree of social support

Essays that indicated no social support were devoid of any social interactions or support in daily events. Five of the 115 essays fell into this subcategory. While one participant did not provide much description in her essay, a majority of these people stayed at home all day and slept intermittently while watching television. When integrating elements of religiosity, one participant explained, “My body needed rest as much as it can. If I go out all the time I become like most people thinking about what's going on in the streets. So I stay away from that and pray a lot.” For this participant, a paucity of social interactions or support became a positive aspect in her life because it kept her away from negative influences.

Essays categorized as having only social interactions were individuals who engaged in social scenarios that enabled communication and connection with others, yet did not provide any supportive networks or relationships. Thus, these interactions did not include friendships, support groups, or long-lasting relationships. Nine participants interacted with random strangers while running errands, or went out to people watch or to be around other living beings; none of these informants fostered substantial relationships from these interactions. One informant wrote,

In route to the bus stop, I acknowledged the beach's homeless population; greeting the day with sleepy faces and hands out to request “spare change” from passersby. Another day of business for storekeepers while onlookers seemed to awaken to the smell of coffee in the air.

Despite this participant not receiving nor mentioning any significant value from his social greetings and observations, he still made the effort to engage in social interactions.

For those in the some social support subcategory, which included activities such as provider-patient scenarios, essays briefly mentioned dialogues with other individuals (i.e., colleagues, clients, or friends), or phone calls from friends and family. These 27 informants barely elaborated on any emotional connections with these individuals, yet were still able to network and participate in support groups or discussions. For example:

I walked to the hospital said, “Hi” to a few people I knew. I made a human immunodeficiency virus lecture and medical education class. When group time was over I spoke to a few peers that attended and went to eat lunch.

While this informant greeted some colleagues, attended his social support group, and communicated with his peers, he never spoke of the overall extent of these relationships, but still experienced some social support.

The abundant social support subcategory within the social support continuum represented individuals who had a great deal of social support in their daily lives. A total of 74 essays indicated receiving copious amounts of social support from family (i.e., children, grandchildren, spouses, parents, other extended relatives); pets (i.e., dogs, cats, parrots, and turtles); significant others; roommates; co-workers; community organizations; sponsors; support groups (i.e., Alcoholics Anonymous, Narcotics Anonymous, or other research study support groups); deeply-rooted friendships and neighbors; coaches; psychotherapists and counselors; and health care providers who spent considerable time with the participant. A majority of these participants openly discussed their HIV diagnosis with their loved ones. One hopeful participant wrote, “[I] play with my kids, play ball, running and sat down with my kids to talk about human immunodeficiency virus and sex [and] try to be positive.” Despite the social stigma and hardships associated with HIV, this participant made the effort with his children to educate them while remaining open-minded about the topic at hand. Parents and grandparents mentioned engaging in activities with children where they braided hair, helped with homework, played games, and ate together. Two mothers with several children described heartfelt moments with their kids.

Another participant, who received social support from his dog, church community, and grandchildren, expressed gratitude for his social support network; he stated, “I want you to know that I am doing my best but I cannot do it alone so thank you for your support.” He realized how fundamental these relationships were for his overall well-being.

In addition, some participants attended up to five distinct support group meetings provided by their treatment facilities and mentioned engaging in quality conversations with peers. They elaborated on how they cognitively processed the information provided by their meetings in order to manifest these changes in their daily lives. Many participants also discussed the substantial advice they received from therapists and counselors who helped reframe self-defeating cognitions and behaviors and improved participant quality of life. Cognitive Processing Therapy and Cognitive Behavioral Therapy were vital therapeutic methods that enhanced the quality of these individuals’ lives.

Lastly, 14 essays from the sample demonstrated unsettling social support . These informants emphasized complicated relationships with family members, coworkers, and roommates; some expressed vexation from landlords, neighbors, telemarketers, and people they socialized with during the day. Participants had ex-roommates steal from them, while some discussed arguments and major discrepancies with others.

Closely related to social support, altruism for 15 participants included verbal expressions of concern and active contributions of caring for the wellbeing of others, including volunteerism, caregiving, and random acts of kindness. Altruistic participants actively helped others outside of their routine obligations despite their own responsibilities and hardships. They volunteered at food warehouses, prayed for others on phone prayer lines, babysat and attended to the needs of children who were not related to them, provided rides for people, donated money to the needy, volunteered at their local religious organizations, and lent a helping hand to random strangers they saw in passing. One participant wrote,

There were a lot of people with disabilities. The bus driver wasn't all that helpful. I tried to help a young man in a wheelchair but I couldn't get the seat up for him. No one else seemed to care. Finally the bus driver helped when he saw I took action.

Her assistance stimulated the bus driver's help, and provided the incapacitated man the service that he deserved.

Informants also engaged in caregiving for loved ones. While spending time with her mother, one informant described,

[I] went to my mother's house and talk to her about how she feel and clean up her house and give her a bath, then I made her something to eat. I call my mother on the phone when I got back home and told her that I love her and not to worry about me.

While this informant was not obligated to perform these actions for her mother, she still made the time to do so despite her own life circumstances.

Our results revealed how qualitative analysis of control data in emotional disclosure writing interventions can contribute substantial information to the existing literature on PLWH. The written accounts of HIV-infected people's daily lives reflected the themes of SES, self-care, religiosity/spirituality, and social support. These variables illuminated influences on mental, emotional, and physical well-being in the context of HIV infection.

Our SES theme found that financially burdened individuals faced challenging circumstances (i.e., homelessness, destitution, lack of food) that stopped them from taking care of themselves, similar to the findings on low SES heart failure patients ( Macabasco-O'Connell et al., 2008 ). Our results on negative self-care paralleled the relationship between disordered sleep and negative self-care in heart failure patients ( Redeker, 2008 ), where disordered sleep in HIV illness was related to negative self-care influences on health. A total of 50 of the 119 participants (42%) showed symptoms of disordered sleep with maladaptive self-care behaviors, in that all of these participants watched television while trying to sleep. Perhaps, as with heart failure populations ( Macabasco-O'Connell et al., 2008 ), low SES contributed to negative self-care in HIV. It is critical to assess quality of sleep as part of care for PLWH. Cognitive-behavioral techniques are quite successful ( Butler, Chapman, Forman, & Beck, 2006 ) and include altering cognitions (e.g., the fear of dying from HIV) and behaviors (e.g., keeping the television illuminated out of loneliness or fear) that could be hindering regular sleep.

Regarding positive self-care, 42 of the 46 participants who were financially secure (91%) in our sample practiced healthy self-care behaviors, which was consistent with the findings of Macabasco-O'Connell et al. (2008) , where high SES heart failure patients practiced positive self-care and had better health outcomes. Our self-care results showed how positive self-care practices could act as a buffer against potential negative self-care behaviors (e.g., reading a book instead of relapsing). Perhaps this was connected with resiliency; the 38 participants indicating resiliency also discussed positive self-care practices. Despite the challenges of living with HIV, these people showed a determination to prevail against all odds, took care of themselves, and were optimistic. Mexican women with HIV faced similar circumstances managing their illness, poverty, and caring for children ( Holtz, Sowell, & Velasquez, 2012 ), suggesting that the relationships between resiliency, self-care, SES, and social support might be related and should be further examined. Future research should seek to examine the potential moderating or mediating effects of resiliency on self-care and SES in HIV, as well as its relationship to social support.

Other studies on the connection between self-care and social support have shown a significant positive relationship in people with heart failure ( Graven & Grant, 2014 ), and social support was shown to protect against disease and increase longevity ( Koenig, 2012 ). As high levels of perceived social support were related to positive coping methods ( Tate et al., 2006 ) and positive coping was significantly related to an active search for social support in HIV, perhaps the participants in the positive spectrum of social support (i.e., only social interactions, some social support and an abundant amount of social support ) practiced positive self-care. Low levels of perceived social support and negative coping methods were related ( Tate et al., 2006 ), as were negative social interactions and avoidance coping ( Fleishman et al., 2000 ). Perhaps then unsettling social support and no social support might be significantly related to negative self-care in HIV. Future research should examine these relationships in the context of HIV and inspect the impact of SES in relation to social support. These measures could then be related to health/medical outcomes and other chronically ill populations.

Paralleling the results of Rivkin et al. (2006) , we found that our control writing participants had people in their lives who cared for them. Thus, our descriptive results for social support revealed the importance of being cared for, loved, understood, and accepted by one's support network. This gives rise to the psychosocial construct of mattering ( Rosenberg & McCullough, 1981 ), where people perceive themselves to be a significant part of the world on individual and social levels. Because feeling understood and loved mediated the relationship between coping style choice (i.e., avoidant vs. active coping) and social support in HIV ( Schmitz & Crystal, 2000 ), self-management programs should implement strategies to detect if individuals are at a loss of mattering to prevent maladaptive coping strategies.

Furthermore, our descriptive results on social support showed the importance of encouraging a positive accepting conversation between PLWH and their support networks. Informants in our sample who felt secure enough to educate family members or personal friends about HIV without being stigmatized were able to cultivate those relationships, thus adding to a perceived level of positive social support. As perceived level of social support has been found to mediate the relationship between HIV-related stigma and post-traumatic stress disorder ( Breet, Kagee, & Seedat, 2014 ), teaching and stigma reduction interventions to support networks of PLWH can help facilitate positive conversations and may, in turn, alleviate the trauma experienced with living with HIV. Zhang et al. (2014) found that education and stigma reduction interventions were related to active interpersonal coping and that loving, understanding, and accepting environments between PLWH and their support networks may help individuals retain a sense of mattering and encourage positive coping methods to enhance self-care.

Our results on religiosity/spirituality were indicative of self-care, where 34 of the 35 religious/spiritual essays (97%) also demonstrated positive self-care cognitions and behaviors. The results paralleled the findings of Ironson and Kremer (2011) on how religiosity/spirituality helped people cope in the context of HIV when participants felt uplifted and empowered by believing in a higher power. Informants in that study were able to apply meaning and purpose to their lives by reading passages from holy texts. People who were high in religiosity/spirituality endorsed more positive appraisals of the self ( Ironson & Kremer, 2011 ); informants saw each day as a blessing. Informants surrendered their worries to a higher power and gained a sense of harmony, encouragement, and well-being in the face of major difficulties, such as the loss of a job, joblessness, social isolation, or the death of a loved one. Participants never felt alone; they continuously felt an omnipotent presence, support, and guidance ( Ironson & Kremer, 2011 ). Some informants even prevented themselves from relapsing into drug use by leaving environmental triggers and attending church services. Religious/spiritual beliefs helped shape a greater respect for their bodies, thus promoting good nutrition and motivation to engage in constructive coping methods ( Ironson, Kremer, et al., 2006 ; Ironson & Kremer, 2011 ). Because an increase in religiosity/spirituality occurred post-HIV diagnosis and predicted slower disease progression ( Ironson, Kremer, et al., 2006 ), future research should examine the relationship between self-care and religiosity/spirituality. Positive self-care may be significantly related to religiosity/spirituality in HIV, thus negatively impacting disease progression.

Additionally, participants who wrote about religiosity/spirituality expressed cognitions and behaviors within a positive frame of reference toward a higher power when coping with their daily lives and illnesses; a positive view of God has been shown to predict slower disease progression in HIV ( Ironson et al., 2011 ). Psychodynamic techniques have recognized God as a projection of self-beliefs ( Freud, 1957 ), while self-beliefs and a person's image of God were significantly related ( Lawrence, 1997 ), so our results suggest that self-care may be a manifestation of one's self-beliefs and one's image of God. Future research should examine the relationship between a view of a higher power and self-care; a positive benevolent view of a higher power may predict positive self-care. Furthermore, because many of our religious/spiritual participants expressed a benevolent view of a higher power, they may have reaped health benefits as well ( Ironson et al., 2011 ).

Our results on altruism in HIV showed how social behaviors can lead to human support and encourage actions of kindness, volunteering, and caregiving. In a longitudinal study, Ironson (2007) found that acts of altruism were associated with better HIV prognosis and that these health outcomes were more strongly related to the report of active altruistic behaviors rather than expressions of concern. Her findings can be applied to our results, where 15 participants actively helped others outside routine obligations. While altruistic acts were not overwhelming, those people benefitted both mentally and physically, particularly in terms of longevity ( Post, 2005 ).

Limitations

We reported data on the first time-point control essays only here; more information can be found by examining the remaining three control time-points in the primary study ( Ironson et al., 2013 ). A minimal loss of data when transcribing content from paper to electronic format may have occurred due to illegibility. Despite these limitations, our results illuminated the substantial information that control writing of daily life activities can add to the literature on HIV and other chronically ill populations.

We have highlighted the potential impact of using qualitative research methods in emotional disclosure interventions, which can be quantitatively investigated further in relation to health outcomes. We hope that our results will inspire researchers to investigate expressive writing control data and the rich information it may provide about people's daily lives.

Key Considerations

• Because disordered sleep negatively influences self-care in people living with HIV infection (PLWH), their quality of sleep should be routinely assessed. Cognitive-behavioral techniques may successfully treat disordered sleep.
• HIV interventionists should address low self-perceptions of mattering in PLWH because it mediates the relationship between coping style (active vs. avoidant) and social support.
• The quality of social support should be routinely assessed in patients with HIV infection.
• Religiosity/spirituality is associated with self-care for PLWH, and those who are religious/spiritual may reap health benefits. Furthermore, although it is controversial for health professionals to discuss religiosity/spirituality with clients, those who want to connect with religiosity/spirituality could be encouraged to discuss it with their religious/spiritual guides.
• Despite significant hardships, PLWH are often able to positively adapt and show resiliency.
• Socioeconomic status is an important factor that impacts the lives of PLWH.

Acknowledgements

Maria Metaweh extends gratitude to the two influential women, Dr. Gail Ironson and Dr. Julie Barroso, who apprenticed her throughout this journey. They are both eminent researchers who inspired her as a growing researcher and individual.

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Conflict of Interest Statement:

The authors report no real or perceived vested interests that relate to this article that could be construed as a conflict of interest.

Contributor Information

Maria Metaweh, University of Miami, Coral Gables, Florida, USA.

Gail Ironson, University of Miami, Miami, Florida, USA.

Julie Barroso, Medical University of South Carolina College of Nursing, Charleston, South Carolina, USA.

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Guest Essay

We Don’t See What Climate Change Is Doing to Us

By R. Jisung Park

Dr. Park is an environmental and labor economist and assistant professor at the University of Pennsylvania and the author of “Slow Burn: The Hidden Costs of a Warming World.”

Many of us realize climate change is a threat to our well-being. But what we have not yet grasped is that the devastation wreaked by climate change comes not just from headline-grabbing catastrophes but also from the subtler accumulation of innumerable slow and unequal burns that are already underway — the nearly invisible costs that may not raise the same alarm but that, in their pervasiveness and inequality, may be much more harmful than commonly realized. Recognizing these hidden costs will be essential as we prepare ourselves for the warming that we have ahead of us.

Responsibility for mitigating climate change on the local level lies in part with public institutions not only in encouraging emissions reductions but also in facilitating adaptation. Public discourse around climate change too often misses the central role that local institutions play in this latter function, how much of the realized pain locally depends on not simply the physical phenomena of climate change per se but also how they interact with human systems — economic, educational, legal and political.

Let’s start with heat, which is killing more people than most other natural disasters combined. Research shows that record-breaking heat waves are only part of the story. Instead, it may be the far more numerous unremarkably hot days that cause the bulk of societal destruction, including through their complex and often unnoticed effects on human health and productivity. In the United States, even moderately elevated temperatures — days in the 80s or 90s Fahrenheit — are responsible for just as many excess deaths as the record triple-digit heat waves, if not more, according to my calculations based on a recent analysis of Medicare records.

In some highly exposed and physically demanding industries, like mining, a day in the 90s can increase injury risk by over 65 percent relative to a day in the 60s. While some of these incidents involve clear cases of heat illness, my colleagues and I have found that a vast majority appear to come from ostensibly unrelated accidents, like construction workers falling off ladders and manufacturing workers mishandling hazardous machinery. In California, our research shows, heat might have routinely caused 20,000 workplace injuries per year, only a tiny fraction of which were officially recorded as heat-related.

A growing body of literature links temperature to cognitive performance and decision making. Research shows that hotter days lead to more mistakes, including among professional athletes ; more local crime ; and more violence in prisons , according to working papers. They also correspond with more use of profanity on social media , suggesting that even an incrementally hotter world is likely to be a nontrivially more irritable, error-prone and conflictual one.

Children are not immune. In research using over four million student test scores from New York City, I found that, from 1999 to 2011, students who took their high school Regents exams on a 90-degree day were 10 percent less likely to pass their subjects relative to a day in the 60s. In other research, my colleagues Joshua Goodman, Michael Hurwitz and Jonathan Smith and I found that across the country, hotter school years led to slower gains on standardized exams like the Preliminary SAT exams. It may not seem a huge effect, on average: roughly 1 percent of learning lost per one-degree-hotter school year temperatures. Probably hardly noticeable in any given year. But because these learning effects are cumulative, they may have significant consequences.

And that’s just heat. Researchers are bringing to light the more subtle yet cumulatively damaging effects of increased wildfires and other natural disasters. The hidden consequences of wildfire smoke may cut even deeper than the more visible death and destruction caused by the flames. Tallying the downstream economic and health costs of smoke exposure, researchers have estimated in a not-yet-published paper that increased wildfire smoke due to climate change may cause more than 20,000 additional deaths per year nationwide by 2050. Very few of these will be officially categorized as having been caused by wildfires, because they will have been the result of the cumulative influence of worsened air quality and weakened health over the course of many weeks and months. Research now suggests that wildfire smoke can adversely affect fetal health , student learning and workers’ earnings as well.

Since even noncatastrophic climate change may be more subtly damaging and inequality amplifying than we used to think, local interventions are essential to help us prepare for the warming that is to come.

At present, our social and economic systems are not well prepared to adjust to the accumulating damage wreaked by climate change, even though much of what determines whether climate change hurts us depends on the choices we make as individuals and as a society. Whether a hot day leads to mild discomfort or widespread mortality comes down to human decisions — individual decisions such as whether to install and operate air-conditioning and collective decisions around the pricing and availability of insurance, the allocation of hospital beds or the procedures and norms governing how and when people work.

Recent research indicates that how temperature affects human health depends greatly on the adaptations that happen to be at play locally. For instance, a day above 85 degrees in the coldest U.S. ZIP codes has nearly 10 times the effect on elderly mortality relative to in the warmest ZIP codes. In other words, a string of such days in a place like Seattle will lead to a much higher increase in the mortality rate than in a place like Houston, even though both places have similar income levels. In rural India , institutional factors like access to banking may affect how many lives are ultimately lost because of heat; heat can reduce crop yields, leaving subsistence farmers dependent on financing sources to keep them afloat.

In our research of heat and learning , we found that the adverse effects of a one-degree-hotter school year are two to three times as large for Black and Hispanic students, who are less likely to have working air-conditioning at school or at home even within a given city, and are virtually nonexistent in schools and neighborhoods with high levels of home and school air-conditioning. We estimate that hotter temperatures may already be responsible for 5 percent of racial academic achievement gaps. Without remedial investments, climate change is likely to widen these gaps. With a shift in focus to these subtler social costs, we can devise and carry out more effective strategies. But right now, adaptation efforts remain highly fragmented and are often focused on more visibly salient climate hazards, like storm surges .

And, of course, an empirically nuanced understanding of climate damages makes it even clearer that reducing emissions aggressively makes cost-benefit sense not only because we want to insure against total ecological breakdown (cue “extinction rebellion” and “tipping points”) but also because the economic costs of even noncatastrophic warming may be considerable. Recent Environmental Protection Agency estimates that incorporate just some of these cumulative impacts suggest that a single ton of carbon dioxide sets in motion $190 worth of future social costs, which means that technologies that can reduce such emissions at a lower per-ton cost are most likely worth pursuing.

Climate change is a complex phenomenon whose ultimate costs will depend not only on how quickly we transition away from fossil fuels but also on how well we adapt our social and economic systems to the warming we have in store. A proactive stance toward adaptation and resilience may be useful from the standpoint of safeguarding one’s own physical and financial security, whether as a homeowner or the head of a Fortune 500 company. It may be vital for ensuring that the ladders of economic opportunity are not deteriorating for those attempting to climb its lower rungs.

R. Jisung Park is an environmental and labor economist and assistant professor at the University of Pennsylvania and the author of “Slow Burn: The Hidden Costs of a Warming World.”

The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips . And here’s our email: [email protected] .

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Orange High School junior earns second place in City Club’s Free Speech Essay Contest

• Updated: Apr. 19, 2024, 4:39 p.m. |
• Published: Apr. 19, 2024, 9:08 a.m.

Orange High School junior Lucy Campbell earned second place in the City Club of Cleveland’s 2024 Hope and Stanley Adelstein Free Speech Essay Contest (Photo Courtesy of Orange City Schools)

• Ed Wittenberg, special to cleveland.com

PEPPER PIKE, Ohio -- Orange High School junior Lucy Campbell earned second place and $750 in the 11th/12th-grade category of the City Club of Cleveland’s 2024 Hope and Stanley Adelstein Free Speech Essay Contest.

Winners were announced April 9.

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40 facts about elektrostal.

Written by Lanette Mayes

Modified & Updated: 02 Mar 2024

Reviewed by Jessica Corbett

Elektrostal is a vibrant city located in the Moscow Oblast region of Russia. With a rich history, stunning architecture, and a thriving community, Elektrostal is a city that has much to offer. Whether you are a history buff, nature enthusiast, or simply curious about different cultures, Elektrostal is sure to captivate you.

This article will provide you with 40 fascinating facts about Elektrostal, giving you a better understanding of why this city is worth exploring. From its origins as an industrial hub to its modern-day charm, we will delve into the various aspects that make Elektrostal a unique and must-visit destination.

So, join us as we uncover the hidden treasures of Elektrostal and discover what makes this city a true gem in the heart of Russia.

Key Takeaways:

• Elektrostal, known as the “Motor City of Russia,” is a vibrant and growing city with a rich industrial history, offering diverse cultural experiences and a strong commitment to environmental sustainability.
• With its convenient location near Moscow, Elektrostal provides a picturesque landscape, vibrant nightlife, and a range of recreational activities, making it an ideal destination for residents and visitors alike.

Known as the “Motor City of Russia.”

Elektrostal, a city located in the Moscow Oblast region of Russia, earned the nickname “Motor City” due to its significant involvement in the automotive industry.

Home to the Elektrostal Metallurgical Plant.

Elektrostal is renowned for its metallurgical plant, which has been producing high-quality steel and alloys since its establishment in 1916.

Boasts a rich industrial heritage.

Elektrostal has a long history of industrial development, contributing to the growth and progress of the region.

Founded in 1916.

The city of Elektrostal was founded in 1916 as a result of the construction of the Elektrostal Metallurgical Plant.

Located approximately 50 kilometers east of Moscow.

Elektrostal is situated in close proximity to the Russian capital, making it easily accessible for both residents and visitors.

Known for its vibrant cultural scene.

Elektrostal is home to several cultural institutions, including museums, theaters, and art galleries that showcase the city’s rich artistic heritage.

A popular destination for nature lovers.

Surrounded by picturesque landscapes and forests, Elektrostal offers ample opportunities for outdoor activities such as hiking, camping, and birdwatching.

Hosts the annual Elektrostal City Day celebrations.

Every year, Elektrostal organizes festive events and activities to celebrate its founding, bringing together residents and visitors in a spirit of unity and joy.

Has a population of approximately 160,000 people.

Elektrostal is home to a diverse and vibrant community of around 160,000 residents, contributing to its dynamic atmosphere.

Boasts excellent education facilities.

The city is known for its well-established educational institutions, providing quality education to students of all ages.

A center for scientific research and innovation.

Elektrostal serves as an important hub for scientific research, particularly in the fields of metallurgy, materials science, and engineering.

Surrounded by picturesque lakes.

The city is blessed with numerous beautiful lakes, offering scenic views and recreational opportunities for locals and visitors alike.

Well-connected transportation system.

Elektrostal benefits from an efficient transportation network, including highways, railways, and public transportation options, ensuring convenient travel within and beyond the city.

Famous for its traditional Russian cuisine.

Food enthusiasts can indulge in authentic Russian dishes at numerous restaurants and cafes scattered throughout Elektrostal.

Home to notable architectural landmarks.

Elektrostal boasts impressive architecture, including the Church of the Transfiguration of the Lord and the Elektrostal Palace of Culture.

Offers a wide range of recreational facilities.

Residents and visitors can enjoy various recreational activities, such as sports complexes, swimming pools, and fitness centers, enhancing the overall quality of life.

Provides a high standard of healthcare.

Elektrostal is equipped with modern medical facilities, ensuring residents have access to quality healthcare services.

Home to the Elektrostal History Museum.

The Elektrostal History Museum showcases the city’s fascinating past through exhibitions and displays.

A hub for sports enthusiasts.

Elektrostal is passionate about sports, with numerous stadiums, arenas, and sports clubs offering opportunities for athletes and spectators.

Celebrates diverse cultural festivals.

Throughout the year, Elektrostal hosts a variety of cultural festivals, celebrating different ethnicities, traditions, and art forms.

Electric power played a significant role in its early development.

Elektrostal owes its name and initial growth to the establishment of electric power stations and the utilization of electricity in the industrial sector.

Boasts a thriving economy.

The city’s strong industrial base, coupled with its strategic location near Moscow, has contributed to Elektrostal’s prosperous economic status.

Houses the Elektrostal Drama Theater.

The Elektrostal Drama Theater is a cultural centerpiece, attracting theater enthusiasts from far and wide.

Popular destination for winter sports.

Elektrostal’s proximity to ski resorts and winter sport facilities makes it a favorite destination for skiing, snowboarding, and other winter activities.

Promotes environmental sustainability.

Elektrostal prioritizes environmental protection and sustainability, implementing initiatives to reduce pollution and preserve natural resources.

Home to renowned educational institutions.

Elektrostal is known for its prestigious schools and universities, offering a wide range of academic programs to students.

Committed to cultural preservation.

The city values its cultural heritage and takes active steps to preserve and promote traditional customs, crafts, and arts.

Hosts an annual International Film Festival.

The Elektrostal International Film Festival attracts filmmakers and cinema enthusiasts from around the world, showcasing a diverse range of films.

Encourages entrepreneurship and innovation.

Elektrostal supports aspiring entrepreneurs and fosters a culture of innovation, providing opportunities for startups and business development.

Offers a range of housing options.

Elektrostal provides diverse housing options, including apartments, houses, and residential complexes, catering to different lifestyles and budgets.

Home to notable sports teams.

Elektrostal is proud of its sports legacy, with several successful sports teams competing at regional and national levels.

Boasts a vibrant nightlife scene.

Residents and visitors can enjoy a lively nightlife in Elektrostal, with numerous bars, clubs, and entertainment venues.

Promotes cultural exchange and international relations.

Elektrostal actively engages in international partnerships, cultural exchanges, and diplomatic collaborations to foster global connections.

Surrounded by beautiful nature reserves.

Nearby nature reserves, such as the Barybino Forest and Luchinskoye Lake, offer opportunities for nature enthusiasts to explore and appreciate the region’s biodiversity.

Commemorates historical events.

The city pays tribute to significant historical events through memorials, monuments, and exhibitions, ensuring the preservation of collective memory.

Promotes sports and youth development.

Elektrostal invests in sports infrastructure and programs to encourage youth participation, health, and physical fitness.

Hosts annual cultural and artistic festivals.

Throughout the year, Elektrostal celebrates its cultural diversity through festivals dedicated to music, dance, art, and theater.

Provides a picturesque landscape for photography enthusiasts.

The city’s scenic beauty, architectural landmarks, and natural surroundings make it a paradise for photographers.

Connects to Moscow via a direct train line.

The convenient train connection between Elektrostal and Moscow makes commuting between the two cities effortless.

A city with a bright future.

Elektrostal continues to grow and develop, aiming to become a model city in terms of infrastructure, sustainability, and quality of life for its residents.

In conclusion, Elektrostal is a fascinating city with a rich history and a vibrant present. From its origins as a center of steel production to its modern-day status as a hub for education and industry, Elektrostal has plenty to offer both residents and visitors. With its beautiful parks, cultural attractions, and proximity to Moscow, there is no shortage of things to see and do in this dynamic city. Whether you’re interested in exploring its historical landmarks, enjoying outdoor activities, or immersing yourself in the local culture, Elektrostal has something for everyone. So, next time you find yourself in the Moscow region, don’t miss the opportunity to discover the hidden gems of Elektrostal.

Q: What is the population of Elektrostal?

A: As of the latest data, the population of Elektrostal is approximately XXXX.

Q: How far is Elektrostal from Moscow?

A: Elektrostal is located approximately XX kilometers away from Moscow.

Q: Are there any famous landmarks in Elektrostal?

A: Yes, Elektrostal is home to several notable landmarks, including XXXX and XXXX.

Q: What industries are prominent in Elektrostal?

A: Elektrostal is known for its steel production industry and is also a center for engineering and manufacturing.

Q: Are there any universities or educational institutions in Elektrostal?

A: Yes, Elektrostal is home to XXXX University and several other educational institutions.

Q: What are some popular outdoor activities in Elektrostal?

A: Elektrostal offers several outdoor activities, such as hiking, cycling, and picnicking in its beautiful parks.

Q: Is Elektrostal well-connected in terms of transportation?

A: Yes, Elektrostal has good transportation links, including trains and buses, making it easily accessible from nearby cities.

Q: Are there any annual events or festivals in Elektrostal?

A: Yes, Elektrostal hosts various events and festivals throughout the year, including XXXX and XXXX.

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100 Creative Writing Prompts for Middle & High School – 2024

April 15, 2024

Some high school students dream of writing for a living, perhaps pursuing an English major in college, or even attending a creative writing MFA program later on. For other students, creative writing can be useful for school assignments, in English and other subjects, and also for preparing their Common App essays . In a less goal-oriented sense, daily freewriting in a journal can be a healthy life practice for many high schoolers. Not sure where to start? Continue reading for 100 creative writing prompts for middle school and high school students. These middle/high school writing prompts offer inspiration for getting started with writing in a number of genres and styles.

Click here to view the 35 Best Colleges for Creative Writing .

What are Creative Writing Prompts?

Similar to how an academic essay prompt provides a jumping-off point for forming and organizing an argument, creative writing prompts are points of initiation for writing a story, poem, or creative essay. Prompts can be useful for writers of all ages, helping many to get past writer’s block and just start (often one of the most difficult parts of a writing process).

Writing prompts come in a variety of forms. Sometimes they are phrases used to begin sentences. Other times they are questions, more like academic essay prompts Writing prompts can also involve objects such as photographs, or activities such as walking. Below, you will find high school writing prompts that use memories, objects, senses (smell/taste/touch), abstract ideas , and even songs as jumping-off points for creative writing. These prompts can be used to write in a variety of forms, from short stories to creative essays, to poems.

How to use Creative Writing Prompts

Before we get started with the list, are a few tips when using creative writing prompts:

Experiment with different formats : Prose is great, but there’s no need to limit yourself to full sentences, at least at first. A piece of creative writing can begin with a poem, or a dialogue, or even a list. You can always bring it back to prose later if needed.

Interpret the prompt broadly : The point of a creative writing prompt is not to answer it “correctly” or “precisely.” You might begin with the prompt, but then your ideas could take you in a completely different direction. The words in the prompt also don’t need to open your poem or essay, but could appear somewhere in the middle.

Switch up/pile up the prompts : Try using two or three prompts and combine them, or weave between them. Perhaps choose a main prompt, and a different “sub-prompt.” For example, your main prompt might be “write about being in transit from one place to another,” and within that prompt, you might use the prompt to “describe a physical sensation,” and/or one the dialogue prompts.  This could be a fun way to find complexity as you write.

Creative Writing Prompts for Middle School & High School Students (Continued)

Write first, edit later : While you’re first getting started with a prompt, leave the typos and bad grammar. Obsessing over details can take away from your flow of thoughts. You will inevitably make many fixes when you go back through to edit.

Write consistently : It often becomes easier to write when it’s a practice , rather than a once-in-a-while kind of activity. For some, it’s useful to write daily. Others find time to write every few days, or every weekend. Sometimes, a word-count goal can help (100 words a day, 2,000 words a month, etc.). If you set a goal, make sure it’s realistic. Start small and build from there, rather than starting with an unachievable goal and quickly giving up.

100 Creative Writing Prompts for Middle School & High School Teens

Here are some prompts for getting started with your creative writing. These are organized by method, rather than genre, so they can inspire writing in a variety of forms. Pick and choose the ones that work best for you, and enjoy!

Prompts using memories

• Begin each sentence or group of sentences with the phrase, “I remember…”
• Describe a family ritual.
• Choose an event in your life, and write about it from the perspective of someone else who was there.
• Pick a pathway you take on a regular basis (to school, or to a friend’s house). Describe five landmarks that you remember from this pathway.
• Write about your house or apartment using a memory from each room.
• Write an imaginary history of the previous people who lived in your house or apartment.
• Write about an ancestor based on stories you’ve heard from relatives.
• What’s your earliest memory?
• Who was your first friend?
• Write a letter to someone you haven’t seen since childhood.
• Write about yourself now from the perspective of yourself twenty, or eighty, years from now.
• Write about the best month of the year.
• Write about the worst day of the year.
• Rant about something that has always annoyed you.
• Write about the hottest or coldest day you can remember.
• Visualize a fleeting moment in your life and as though it’s a photograph, and time yourself 5 minutes to write every detail you can remember about the scene.
• Draw out a timeline of your life so far. Then choose three years to write about, as though you were writing for a history book.
• Write about a historical event in the first person, as though you remember it.
• Write about a memory of being in transit from one place to another.

Objects and photographs as creative writing prompts

• Describe the first object you see in the room. What importance does it have in your life? What memories do you have with this object? What might it symbolize?
• Pick up an object, and spend some time holding it/examining it. Write about how it looks, feels, and smells. Write about the material that it’s made from.
• Choose a favorite family photograph. What could someone know just by looking at the photograph? What’s secretly happening in the photograph?
• Choose a photograph and tell the story of this photograph from the perspective of someone or something in it.
• Write about a color by describing three objects that are that color.
• Tell the story of a piece of trash.
• Tell the story of a pair of shoes.
• Tell the story of your oldest piece of clothing.

Senses and observations as creative writing prompts

• Describe a sound you hear in the room or outside. Choose the first sound you notice. What are its qualities? It’s rhythms? What other sounds does it remind you of?
• Describe a physical sensation you feel right now, in as much detail as possible.
• Listen to a conversation and write down a phrase that you hear someone say. Start a free-write with this phrase.
• Write about a food by describing its qualities, but don’t say what it is.
• Describe a flavor (salty, sweet, bitter, etc.) to someone who has never tasted it before.
• Narrate your day through tastes you tasted.
• Narrate your day through sounds you heard.
• Narrate your day through physical sensations you felt.
• Describe in detail the physical process of doing an action you consider simple or mundane, like walking or lying down or chopping vegetables.
• Write about the sensation of doing an action you consider physically demanding or tiring, like running or lifting heavy boxes.
• Describe something that gives you goosebumps.
• Write a story that involves drinking a cold glass of water on a hot day.
• Write a story that involves entering a warm house from a cold snowy day.
• Describe someone’s facial features in as much detail as possible.

Songs, books, and other art

• Choose a song quote, write it down, and free-write from there.
• Choose a song, and write a story in which that song is playing in the car.
• Choose a song, and write to the rhythm of that song.
• Choose a character from a book, and describe an event in your life from the perspective of that character.
• Go to a library and write down 10 book titles that catch your eye. Free-write for 5 minutes beginning with each one.
• Go to a library and open to random book pages, and write down 5 sentences that catch your attention. Use those sentences as prompts and free-write for 5-minutes with each.
• Choose a piece of abstract artwork. Jot down 10 words that come to mind from the painting or drawing, and free-write for 2 minutes based on each word.
• Find a picture of a dramatic Renaissance painting online. Tell a story about what’s going on in the painting that has nothing to do with what the artist intended.
• Write about your day in five acts, like a Shakespearean play. If your day were a play, what would be the introduction, rising action, climax, falling action, and resolution?
• Narrate a complicated book or film plot using only short sentences.
• Read a short poem. Then write a poem that could be a “sister” or “cousin” of that poem.

Abstract ideas as creative writing prompts

• Write about an experience that demonstrates an abstract idea, such as “love” or “home” or “freedom” or “loss” without ever using the word itself.
• Write a list of ways to say “hello” without actually saying “hello.”
• Write a list of ways to say “I love you” without actually saying “I love you.”
• Do you believe in ghosts? Describe a ghost.
• Invent a mode of time travel.
• Glass half-full/half-empty: Write about an event or situation with a positive outlook. Then write about it with a miserable outlook.
• Free-write beginning with “my religion is…” (what comes next can have as much or as little to do with organized religion as you’d like).
• Free-write beginning with “my gender is…” (what comes next can have as much or as little to do with common ideas of gender as you’d like).
• Write about a person or character that is “good” and one that is “evil.” Then write about the “evil” in the good character and the “good” in the evil character.
• Write like you’re telling a secret.
• Describe a moment of beauty you witnessed. What makes something beautiful?

Prompts for playing with narrative and character

• Begin writing with the phrase, “It all started when…”
• Tell a story from the middle of the most dramatic part.
• Write a story that begins with the ending.
• Begin a story but give it 5 possible endings.
• Write a list of ways to dramatically quit a terrible job.
• Write about a character breaking a social rule or ritual (i.e., walking backwards, sitting on the floor of a restaurant, wearing a ballgown to the grocery store). What are the ramifications?
• You are sent to the principal’s office. Justify your bad behavior.
• Re-write a well-known fairytale but set it in your school.
• Write your own version of the TV show trope where someone gets stuck in an elevator with a stranger, or a secret love interest, or a nemesis.
• Imagine a day where you said everything you were thinking, and write about it.
• Write about a scenario in which you have too much of a good thing.
• Write about a scenario in which money can buy happiness.
• Invent a bank or museum heist.
• Invent a superhero, including an origin story.
• Write using the form of the scientific method (question, hypothesis, test, analyze data conclusion).
• Write using the form of a recipe.

Middle School & High School Creative writing prompts for playing with fact vs. fiction

• Write something you know for sure is true, and then, “but maybe it isn’t.” Then explain why that thing may not be true.
• Write a statement and contradict that statement. Then do it again.
• Draft an email with an outlandish excuse as to why you didn’t do your homework or why you need an extension.
• Write about your morning routine, and make it sound extravagant/luxurious (even if it isn’t).
• You’ve just won an award for doing a very mundane and simple task. Write your acceptance speech.
• Write about a non-athletic event as though it were a sports game.
• Write about the most complicated way to complete a simple task.
• Write a brief history of your life, and exaggerate everything.
• Write about your day, but lie about some things.
• Tell the story of your birth.
• Choose a historical event and write an alternative outcome.
• Write about a day in the life of a famous person in history.
• Read an instructional manual, and change three instructions to include some kind of magical or otherwise impossible element.

Prompts for starting with dialogue

• Write a texting conversation between two friends who haven’t spoken in years.
• Write a texting conversation between two friends who speak every day and know each other better than anyone.
• Watch two people on the street having a conversation, and imagine the conversation they’re having. Write it down.
• Write an overheard conversation behind a closed door that you shouldn’t be listening to.
• Write a conversation between two characters arguing about contradicting memories of what happened.
• You have a difficult decision to make. Write a conversation about it with yourself.
• Write a conversation with a total lack of communication.
• Write a job interview gone badly.

Final Thoughts – Creative Writing Prompts for Middle School & High School 

Hopefully you have found several of these creative writing prompts helpful. Remember that when writing creatively, especially on your own, you can mix, match, and change prompts. For more on writing for high school students, check out the following articles:

• College Application Essay Topics to Avoid
• 160 Good Argumentative Essay Topics
• 150 Good Persuasive Speech Topics
• Good Transition Words for Essays
• High School Success

Sarah Mininsohn

With a BA from Wesleyan University and an MFA from the University of Illinois at Urbana-Champaign, Sarah is a writer, educator, and artist. She served as a graduate instructor at the University of Illinois, a tutor at St Peter’s School in Philadelphia, and an academic writing tutor and thesis mentor at Wesleyan’s Writing Workshop.

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