Psychology

There are beds full of dying men and children in hospitals, most of them dying because of the despondency associated with the way the society view them. Some children are coiled in a corner of a hut, lonely and rejected because they are termed as outcasts, as a result of being orphaned and living with HIVAIDS. Their neighbors believe they are cursed, and therefore subject the poor children to the leper treatment of the biblical days. A HIVAIDS infected woman is wailing, as the children watch helplessly, as all her livestock have been snatched away from her after losing her husband. The society members believe she is not in a position to rear the livestock, as she is cursed. Such cases are representations of the level of rejection that the HIVAIDS people are going through. As a result, they go through a lot of psychological effects from the society, culture and the religion they are affiliated to.

Psychological problems relating to society, culture and religion in the HIVAIDS affected people will be discussed at length, as well as the approaches in dealing with the same.   
 Several researchers have been trying to invent ways of educating and sensitizing the public about the HIVAIDS pandemic. This is a topic which has gotten the attention of most of the people in the world as a result of the impact it has had on human beings. There are several campaigns which have been enacted so as to ensure that all the people are aware of the pandemic and the way to curb it. It is important, however to realize that it is not only physiological effects that are related to the pandemic, but also psychological ones. The people who live with HIVAIDS are usually referred to as the infected, while those who care for them are referred to as the affected (Bezuidenhoudt).

Aids The persistent pandemic
Retrospective research reveals that cases of Aids occurred from the early 1950s. One of the first people who were described as having Aids was a sailor from England, who died at the age of twenty six. He experienced severe gingivitis, a persistent cough, anal and nasal ulcers which became worse each day (Kallings, 2008). The numbers of the infected people are overwhelming. According to the UNAIDS, WHO (2007), there was a total of 32.2 million people who were infected with the disease in the whole world as at 2007. This was however a reduction of the estimates that was present in the previous years. According to research, the reason why there was this reduction of the numbers is because of the several exercises that were present so as to assess the HIV pandemic in India and which resulted to a great change of the estimates of the country. The estimates were also revised in other parts of the world, like the Sub-Saharan Africa. Additionally, as the people become aware of the risks of the disease, they tend to decrease risky behavior.
           
Definition of psychological effects
It is important to understand the effects of the HIVAIDS infected people as far as their psychological well-being is concerned. Psychological effects are defined as those thoughts, feelings, emotions that affect the mental state and well being of the infected and affected persons (Bezuidenhoudt).Therefore, statistics in the pandemic are important, but they are merely used to present the findings that are collected. However, statistics are not keen on discussing the critical matters such as psychological manifestations of the pandemic. The best way to assist the infected, as well as the affected is making them aware of the psychological issues associated with the disease (Bezuidenhoudt).

The infected psychological problems and how to deal with them
The internal or psychological challenges associated with people living with HIVAIDS changes from one person to another. Not all people experience the same psychological problems. All HIVAIDS situations are unique. Some individuals go through very severe catastrophic changes while others experience problems not only in their job and personal relationships but also in their self esteem, self image and physical bodies. Therefore, these factors may lead to a great change on the behavior of the people. Most of these people usually become withdrawn, rude and aggressive to friends and colleagues. The infected may face low self esteem as well as loss of confidence. This is because the societies they live in perceive them as lesser people, and in most cases, they are devalued (Bezuidenhoudt).
 
The infected are in most cases fearful because they are forced to look for ways of adjusting to the new lifestyle. It is very difficult for the people to accept that they are infected. Therefore, there is disbelief and shock which in most case leads to denial. This is one of the initial responses. There are very many emotional responses that are associated with the psychological effects of the infected. In many instances, the infected are usually confronted with the examination of their sexual identity, and all the behavioral choices associated with it. In most societies, religions and cultures, HIVAIDS is associated with immorality. In such a situation, the infected person will look for ways to reaffirm his or her feelings so that he or she may continually feel good about him or herself. The infected are also viewed to be suffering from contagious diseases, which may lead to the people being socially isolated, and their feelings become undisclosed and withdrawn. As a result of suppressing their feelings, there may be an emotional breakdown (Bezuidenhoudt).

There is also another stress factor associated with the infected, which is the feeling of being independent. The infected person relies so much on the supporters and care givers. This is especially so when the infected people apply for care from social services. Some countries have continued to suppress the infected, and have even led to further psychological effects on the affected by ensuring that the infected do not get any form of life insurance policies. Indeed, this is a very sensitive issue as it degrades the people and renders them psychologically affected (Bezuidenhoudt).

In some of the traditional cultures, especially in African countries, some communities are very discriminative once they realize that one of their society members suffers from HIVAIDS. In some African communities, if the head of a certain household passes away because of the pandemic, all the livestock that belongs to the victim are taken away from the family as soon as he dies. As a result, the family is subjected to great hunger, poverty and desperation (Bezuidenhoudt).

Solution to the psychological problems
One of the best approaches in dealing with those that are affected with the pandemic is to ensure that there is a positive mentality which is created on all the people, both affected and infected. There should be constant minimization on the stigma about dying, so that all people can contribute living healthy and productive lives. Campaigning and mass advertising should be encouraged for this to happen.

Therefore, it would be very beneficial as several people will be comfortable in regard to getting tested. The keys to this are education and psychotherapy. In Namibia, there are a lot of ways in which the non-governmental organizations have stated that would be of benefit to the infected. This would be through the offering of subsidies to all the families that have been infected and affected. However, the income level of the family has to be considered (Bezuidenhoudt).

Psychological effects to the affected
In most cases, the infected include the children, as they experience the pain associated with the sickness of their parents. Some of the children might also be infected and therefore may be going through double suffering, as they are both infected and affected (Bezuidenhoudt).

One of the psychological effects of the affected, especially to the children is that since the parents are sick, they may not provide the necessary affection that the child requires from the parents. This is because they have dramatic mood swings as a result of the pressure of the infection. In most cases, the children are unaware of the problems of their mother or father. They do not understand that the mood swings are not intentional. Therefore, the child has a tendency of acting with anxiety and fear, and even blaming themselves in most cases. Ordinarily, most children hate seeing their parents sick. Therefore, the pressure starts in a child when he or she realizes the sickness of the parent. The structure of the family changes as a result, and the child is exposed to very many responsibilities, especially the performance of the household chores (Bezuidenhoudt).

Additional psychological effects come in when the responsibilities at home are too much for the children to bear. This is common especially in the rural areas where the children are required to perform so many activities as compared to those in the urban settlements. Such children are also rejected by their peers as a result of their suffering. The other children tease them, especially if they cannot afford to go to school like their peers. As a result, they feel neglected, and are in constant anger (Bezuidenhoudt).

The psychosocial impacts related to grief, stress, and avoidance also add to additional effects. All these instances of discrimination and social isolation could result to fatalism, emotional disturbances, and increased abuse opportunities. Most of the childrens time is spent as they ponder on whom will take care of them once their parents die. They are always afraid that their infected parents will die once they leave them alone. As a result, most of these children do not go to school. If they do, they are often inattentive or hyperactive in school (Bezuidenhoudt).

The children are also left with much suffering as far as the economic provision is concerned. This is because the parents are the main breadwinners of the family. In most cases, especially when there are no other caring relatives, the responsibility of provision of food and earning money is entirely left to the children. As a result, they are often malnourished, and cannot concentrate in school (Bezuidenhoudt). 
They lack school fees, clothing and all the basic needs. In school, there are constant poor performers, who keep on dropping out from school. There are symptoms which are associated with trauma, lack of bonding and depression for the young children. The children therefore are deprived of all the enjoyment of their childhood. The trauma is so much that in most cases, the children contemplate suicide. For the orphans that have an extended family, they are considered lucky they have caregivers (Bezuidenhoudt).

For an infected child, the stigma is even more as the child always fears death. He or she is rejected in the society because some of the parents in the neighborhood even restrict their children from playing with the affected children (Bezuidenhoudt). If there are other caregivers of the infected, they are also exposed to the same challenges from their society. Some of the care givers are advised to bury the infected alive, especially in some parts of Asia and Africa. This is especially so in societies which believe that the pandemic results from a curse and burying is the only way to wipe out the curse from the community. These types of beliefs are associated with some cultures of the global societies.

Additionally, the care givers also receive pressure from their religious counterparts, who claim that the HIVAIDS is as a result of immorality, and therefore the victim deserves to die. Some of these responses from the society make the care givers a very depressed lot. Failure to respond to the advice of the members of the society leads to a high level of depression. The care givers are often faced with discrimination, and are challenged because they fear death and loss. They are also faced with the fear of being infected as they cater for their loved ones. Other types of fear include helplessness, shame, fear of infection and anticipatory grief (Bezuidenhoudt).

HIV AIDS Psychological effects on children
 In addition to the infections associated with HIV, the children have problems which act as stressors. HIVAIDS is said to be very challenging as it presents several psychosocial issues in relation to the medical condition. Since there is the overlapping of cultural, individual, financial and family factors, the healthcare and communities often have a challenge, and they therefore strive in the provision of comprehensive services to this type of people (Fischer, 1999).

The Hemophilic children and HIVAIDS
There are several studies which have revealed that the HIV infected children and who also suffer from hemophilia have a tendency of suffering from greater psychosocial issues. According to research, these children develop social incompetence, and very high levels of anxiety. Mothers of theses types of children have reported that their children have a lot of psychosocial symptoms compared to their peers. The general populations of the children with HIV and hemophilia differ from those who are HIV infected but do not have the hemophilic condition. Studies have revealed that stigma is most in the children with hemophilia (Fischer, 1999).
 
Studies have revealed that the background of the families that most of these children come from is one of the contributing factors .Several of theses types of children come from families with low incomes and also from urban environments. In most cases, the parents are usually diagnosed with HIV, either both or one of them (Fischer, 1999).
 
The families of children with HIVAIDS have so many issues to cope with apart from the ones related to HIV. There are additional stressors which are associated with inner-city living. This includes violence, drug abuse and violence. Research reveals that most of these children are working hard so as to cope, as most of their parents are drug users. They are usually in wrangles with the law, thereby affecting the children, and adding more effects on them. Therefore, they are required to deal with all the psychosocial ramifications which are associated with this (Fischer, 1999).
 
Families are also faced with a challenge in the addressing all the medical concerns and the medical environment. Therefore, families are faced with a challenge of dealing with insurance and financial difficulties as they try to seek audience with the physicians. Additionally, they have the constant pressure to cope with clinic visits, hospitalizations and vital medical decisions. The people who are responsible for these children are given the task of caring for the medical conditions of their children and that of all family members. The medical regimen can also be a very difficult task to undertake (Fischer, 1999).
 
Most of the children suffering from the pandemic have been orphaned at a very early stage. They are presented with a very difficult task of not only dealing with the loss associated with their grief, but also with constant disruptions in their homes and family life. This is because most of the orphaned children are placed in foster care or in other relatives homes (Fischer, 1999).
 
The other psychological issue associated with infected children is that of isolation. Despite the frantic efforts of encouragement, the children are most of the times faced with stigma and secrecy associated with it. Those infected are in constant fear, prejudice and rejection when diagnosed. Cultural issues may be the contributing factors in the communication of the affected and the others in the society. As a result, they may not be willing to access help from the psychological and social support systems (Fischer, 1999).

The children are also infected with psychosocial difficulties which are associated with behavior. These difficulties include hyperactivity, social withdrawal and attention deficits. It is sometimes difficult to test whether these symptoms and their disorders are neurological and emotional in nature. The academic performance of these children can be affected by the neurological symptoms, which include learning disabilities, developmental delay and cognitive deficits (Fischer, 1999).

Dealing with the effects
In the field of pediatric psychology, there is a very large literature body which aims at addressing the means of disclosing the status of the disease to all the pediatric patients. A very great deal of the literature has been researched in the pediatric oncology. The research has revealed that it is important for all the children to have a good method of helping the children to adjust emotionally. This is not possible unless the children are told about their condition (Fischer, 1999).
 
Additionally, the open discussion of their condition with the medical caregivers and family is important. Research has revealed that this has worked even for the terminally ill children. However, if the parents and caregivers are contemplating revealing the childrens condition to them, they must ensure that the environment will be supportive to the children, and the children must get all the necessary reassurance and information (Fischer, 1999).

It is also necessary to place more emphasis on stories and the lives of people who are infected, and not only relying on statistics. As (Bezuidenhoudt) puts it, .the statistics are people and not just numbers. We must create a paradigm shift in thinking about HIVAIDS (Bezuidenhoudt).

There must be provisions for money, love and time given to the care givers, especially if they are children. The children who are orphaned as a result of the pandemic are in most cases traumatized, as the child is dealing with the loss of the parent, as well as the ridicule from peers. There are several support groups in the world which are meant to deal with those infected and affected by the pandemic, especially on matters related to their psychological health. However, there is need to establish more information structures. There should also be other means of support provided to these children. The immediate family of all the affected should receive the correct information on the best ways that they can provide psychological and emotional support to their peers (Bezuidenhoudt).

Conclusion
There has been a much talking regarding HIVAIDS in the world today. Most people are only interested in dealing with the statistics, and are not involved in dealing with the psychosocial effects of the infected and affected. Therefore, most people who are infected die because of the stigma that their religion, culture and society associates them to. They receive high class rejection, and the neighbors do not want any association with them. Some of the government authorities in the world are also not concerned with their welfare, as they even deny the infected the necessary help that is required from them. The perception of the world to the HIVAIDS infected and affected ought to change, so that the stigma associated with the diseases can be reduced.