Social Stigma and Quality of Life in the Female HIV/AIDS Patients

( Eunsuk Lee ) 한국모자보건학회 2018 한국모자보건학회 학술대회 연제집 Vol.2018 No.2

Background and Aim: Social stigma and discrimination associated with HIV/AIDS are viewed as one of the greatest challenges for the female HIV/AIDS patients. HIV-infected female patients are considered socially unusual. They are unpleasantly different from the public and threatening to the public. Stigmatization from the disease deeply degrades the person's overall quality of life. Stigma and discrimination are world events which seriously affect the lives of people with HIV/AIDS. Culturally, women are exposed to more stigma, especially women living with HIV are blamed of sexual deviances and adul-tery. Several studies have implied that women have been more vulnerable to stigma, especially when HIV/AIDS is mentioned as a transmittable sexual disease. The purpose of the study is to examine the relationships between social stigma and quality of life in female HIV/AIDS patients. Methods: This research used a descriptive study design. Data were collected using Stigma Scale for Receiving Psychological Help to measure social stigma and SF-12 to measure quality of life. A convenience sample of 78 female HIV/AIDS patients was recruited in C general hospital in C city. Data were analyzed with number, percentage, Pearson’s correlation, and multiple regression analysis using SPSS/Win 25.0. Inclusion criteria were age of 20 years or over and female HID/AIDS participants who were able to understand the purpose of the study and agreed to participate in this study. Result: Out of 78 participants, the majority was Caucasian (n=34; 45.6%), not married (n=64; 82.1%), employed (n=62; 79.5%), Bachelor’s degree earned (n=60; 76.9%), protestant affiliation (n=40; 51.3%), and middle class socioeconomic status (n=52; 66.7%). Most of the participants reported their previous awareness of HIV/AIDS (n=46; 59.0%). Participants’ average age was 48.03 (±8.11) and duration of illness in year was 2.10(±0.58). There was a significant positive correlation between quality of life physical component summary and previous awareness of HIV/AIDS (r=.31, p<.01); and between social stigma and duration of HIV/AIDS illness in years (r=.84, p<.01). There was a significant negative correlation between social stigma and quality of life physical component summary (r=-.45, p<.01); between social stigma and quality of life mental component summary (r=-.32, p<.01); between duration of HIV/ AIDS illness in years and quality of life physical component summary (r=-.56, p<.01); and between duration of HIV/ AIDS illness in years and quality of life mental component summary (r=-.28, p<.01). The regression model significantly explained 39% of the variances in terms of quality of life physical component summary; the most influential factor to predict quality of life physical component summary was socioeconomic status (β=.463, p<.01). The participant’s race ethnicity (β=.254, p<.01), religion (β=.087, p<.01), the duration of HIV/AIDS illness in years (β=-.050, p<.01), and social stigma (β=-.027, p<.01) were also significant predictors for quality of life physical component summary. The regression model significantly explained 16% of the variances in terms of quality of life mental component summary; the most influential factor to predict quality of life mental component summary was social stigma (β=-.427, p<.01). The duration of HIV/AIDS illness in years (β=-.387, p<.01) and previous awareness of HIV/AIDS (β=.125, p<.01) were also significant predictors for quality of life mental component summary. Conclusion: Social stigma, race ethnicity, religion, and the duration of HIV/AIDS illness in years play an important role in patients' quality of life physical component summary and hinder them from accessing the treatment. Social stigma, the duration of HIV/AIDS illness in years, and previous awareness of HIV/AIDS are considerably important predicting factors to quality of life mental component summary. The results may be crucial to develop strategy in order to decrease the disease prevalence. As HIV/AIDS infection is increasing in worldwide, it is neces-sary to plan and practice proper strategies for eliminat-ing wrong conception among public, families and medi-cal teams, by which stigma could be reduced to the least extend. According to the findings, HIV/AIDS stigma has a negative impact on the society and it has been a barrier for the participants to access and gain equal social and medical rights. The insufficient knowledge, miscon-ceptions about the transmission ways, and the fear of be-ing infected as a woman may lead to inappropriate social behaviors towards. In conclusion, a cultural background for the public as well as a general knowledge about HIV/AIDS may contribute to positive attitudes for patients' health care.

Korean HIV/AIDS Policy on International Migrants

Jung-Whan Lee,Aeree Sohn 한국보건교육건강증진학회 2006 보건교육건강증진학회지 Vol.23 No.5

Objectives: This study aims to identify gaps between knowledge regarding migration and the spread of HIV/AIDS, to improve understanding of migrants with HIV/AIDS and their human rights, and to make suggestions for Korean policy makers to reform laws and policies towards granting migrants with HIV/AIDS more human rights and access to treatment and care. Methods: This study is based on an extensive literature review, questionnaire surveys and in-depth interviews from randomly selected 8 countries from 5 different continents: Japan from Asia; Australia from Oceania; Finland, Germany, Ireland and United Kingdom(UK) from Europe; and Canada and United States of America(USA) in North America. Results: This study has found that Korea has a discriminating policy regarding HIV/AIDS and foreigners. Classifying HIV/AIDS into a legal communicable disease, it requires a presentation of HIV/AIDS test results from foreigners wanting a long-term stay before entering. In principle, foreigners with HIV/AIDS cannot either enter or stay in Korea. If they are known infected with HIV/AIDS by any reason, they became to face an immediate deportation regardless of their sojourn statuses and purposes. Conclusion: With the results, this study suggests three reasons why Korean government needs to change the current HIV/AIDS policy on foreigners: 1) HIV-related travel restrictions have no public health justification, 2) its strict HIV/AIDS policy on foreigners could result in restriction on the mobility and migration of its people by the other countries, inversely, and 3) it needs to meet international guidelines and to observe conventions that international organizations suggest to maintain its status as a member of the international society.

한국 HIV/AIDS 감염인 운동의 흐름과 쟁점 -KANOS와 나누리+를 중심으로-

임정섭 ( Jeong Seob Lim ),윤수종 ( Soo Jong Yoon ) 전남대학교 사회과학연구소 2011 현대사회과학연구 Vol.15 No.-

후천성면역결핍증을 의미하는 에이즈(AIDS)는 단순히 질병의 이름이 아니라 죽음의 공포와 부도덕, 타락과 같은 부정적인 은유와 연결된다. 은유는 언어활동에 그치는 것이 아니라 몸에 대해 직접적으로 작용하는 생체권력으로서 그 대상에 사회적 낙인을 찍는다. 이러한 낙인은 HIV/AIDS 감염인들을 차별과 감시, 통제 속의 삶을 살아가게끔 순응시킨다. 이러한 상황 속에서도 한국의 HIV/AIDS 감염인들은 2000년대 초반부터 편견의 해소, 치료와 복지를 중심으로 한 소극적 운동에서 벗어나, HIV/AIDS에 가해진 낙인 자체에 대한 문제제기와 치료과정에서의 구조적 모순에 대해 이야기하는 적극적 운동으로 나서기 시작하였다. 그 중심에 한국 HIV/AIDS 감염인연대 ``KANOS``와 HIV/AIDS 인권연대 ``나누리+``가 있다. 이들은 HIV/AIDS 감염인에 대에 규율기제로 작동하는 법률에 대해서 뿐만 아니라 다국적기업의 치료제 독점에 대해서 문제제기를 하며 활발히 활동하고 있다. 이들의 운동은 기존의 사회운동과는 달리 다양한 가치를 지닌 개별단체들의 연대를 통해서 이뤄진다는 특징을 지니고 있다. AIDS(Acquired Immune Deficiency Syndrome) means not just the disease name. It is also connected to the negative metaphors about fear of death, immorality, prostitution, and corruption. The metaphor does not only operate as a linguistic activity, but gives infectees the social stigma. This stigma enforces HIV/AIDS infectees to live a life of discrimination, monitoring, and control. Since the early 2000s, Korean HIV / AIDS infectees began to talk about the issue of stigma and the structural contradiction in a treatment process. These active movements began to move away from negative movement which focused on elimination of prejudices, treatment and welfare. Korea HIV/AIDS Network of Solidarity ``KANOS`` and HIV/AIDS Human Right Solidarity ``Nanuri+`` are among the active groups of HIV / AIDS infectees movement. They actively promoted the recommendation of the law concerning HIV / AIDS infectees, and struggled against the monopoly and high prize of HIV / AIDS remedy(drugs) under multinational enterprises. Unlike the established movement, these movements have the character to be accomplished through the solidarity of the independent groups carrying the various values.

동아시아에서의 HIV/AIDS 역학

신소연,최준용,김영근,박윤선,김연아,김명수,송영구,Shuzo Matsshita,Taisheng Li,Hsi-Hsun Lin,Patrick Li,김준명,동아시아 HIV 네트워크(East-Asia Network on HIV; EAN-HIV) 대한감염학회 2007 감염과 화학요법 Vol.39 No.1

목적 : 최근 동아시아에서의 HIV 감염자 수의 급속한 증가는 여러 가지 심각한 문제를 야기하고 있다. 따라서 이지역에서의 HIV/AIDS 역학에 대해서 정확한 조명 및 분석이 무엇보다 필요하다. 이에 저자들은 동아시아 HIV 네트워크(East Asia Network on HIV; EAN-HIV)를 통하여 동아시아 HIV/AIDS 유행의 시작, 변천 및 현황에 관하여 알아보고자 한다. 재료 및 방법 : 동아시아에 HIV/AIDS가 처음 유입된 1984년부터 2005년까지 한국, 일본, 중국, 대만, 홍콩의 HIV/AIDS 관련 역학 자료를 동아시아 HIV 네트워크(East Asia Network on HIV; EAN-HIV)를 통하여 수집하고 분석하였다. 결과 : 동아시아에서의 HIV/AIDS 유행은 1980년대 중반에 시작되었다. 2005년 말까지 한국에서는 3,829명, 일본에서는 7,078명(혈우병 환자 제외), 대만에서는 10,423명,홍콩에서는 2,825명의 HIV 감염자가 보고되 었으며, 중국에서는 141,241명이 보고되었으나 실제로는 84만명 이상의 감염자가 존재할 것으로 추정하고 있다. 주사마약사용, 혈장매매, 성접촉에 의한 감염이 주를 이루고 있으며, 감염자중 남자가 많고 20-30대가 다수를 차지하였다. 중국이나 대만의 경우에는 최근 감염자 수가 급증하고 있으며 주사마약사용에 의한 감염이 주로 문제가 되고 있는 반면, 한국, 일본, 홍콩의 경우에는 남성동성애자에 의한 전파가 주가 되고 있다. 동아시아에서 유행하는 HIV의 주 아형은 B, C, CRFO1_AE 형이며, 최근에는 CRF07_BC형이 확산되고 있다. 결론 : 동아시아의 HIV 감염률은 빠르게 증가하며, 또한 HIV/AIDS 역학도 빠르게 변화하고 있다. 이 지역의 유행은 중국이 부분적으로 커다란 영향을 미치고 있다. Background : Recent predictions of catastrophic epidemic surge of HIV infection in East Asia concern experts and governmental organizations. As in many other areas, countries in East Asia show diversities in their HIV epidemics, both geographically and temporally. However, they have similar regional, cultural and racial characteristics which allow them to have certain common factors. Having a clear picture of the current extent and feature of HIV/AIDS in this region is a very difficult task largely due to the fast pacing of expending epidemic and difficulty in data-sharing among countries in the region. Hence, we decided to study the epidemiologic feature of HIV/AIDS in East Asia through East Asia Network on HIV (EAN-HIV). Materials and Methods : The epidemiological patterns of HIV/AIDS in East Asian countries were investigated by collecting data through EAN-HIV. Results : The HIV/AIDS epidemic in East Asia started relatively late at mid 1980s. Since then, the number of newly infected HIV/AIDS cases has been steadily increasing with stiffer escalation in recent years. In China and Taiwan, IDU plays an important part in the swiftly growing HIV epidemics; however, in other regions like Korea, Japan, and Hong Kong, MSM (men who have sex with men) seems to be more of a problem. The major subtypes of HIV in East Asia are subtype B, C, and CRF01_AE, and rapidly evolving circulating recombinant forms (CRF) between subtypes such as CRF07_BC give dynamic change to the current status. Conclusion : The incidence of HIV/AIDS is rapidly increasing in East Asia. The epidemic pattern has undergone dynamic changes over time. China seems to be the leading source of HIV/AIDS epidemic in East Asia due to its large population and rapidly growing epidemics.

고등학생의 에이즈 지식, 낙인 및 감염인 차별: 에이즈 공익광고 노출여부를 중심으로

손애리 한국보건사회학회 2013 보건과 사회과학 Vol.0 No.34

The principal objective of this study is to describe HIV/AIDS knowledge andstigma and discrimination toward HIV/AIDS and lives with HIV-infected persons,according to the exposure to HIV/AIDS prevention campaign for adolescents. Thepopulation of this study comprised senior high students in Seoul, Korea. Eight highschools were randomly selected and 1,566 adolescents participated in the survey. Atotal sample of 1,547 cases (19 cases were excluded) was used for analysis. Aself-administered questionnaire measuring general and transmission knowledge (13true-false-don’t know items) and discriminatory attitudes PWHAs (8 items, 5-pointLikert-type scale) was utilized. t-test and chi-square test were used for analysisusing SPSS 19.0 software. Path analysis was conducted using AMOS 9.0. The level of HIV/AIDS knowledge was found to be relatively low. The resultsindicated that students answered correctly about HIV transmission by kissing at50.2% (exposure group 54.7%, non-exposure group 45.1%), toilets at 59.4%(exposure group 62.8%, non-exposure group 55.6%), cup sharing at 57.4%(exposure group 54.7%, non-exposure group 45.1%) and school daily life at60.5% (exposure group 62.2%, non-exposure group 52.1%). The exposure groupof the HIV/AIDS prevention campaign had a significantly higher level ofknowledge than the non-exposure group. The level of discriminatory attitudes towards HIV-infected persons was high. The exposure group had a significantly lower level of discriminatory attitudesthan the non-exposure group. According to the results of path analysis, the exposure to HIV/AIDS preventioncampaign       and HIV/AIDS knowledge      directly affected the level of discriminatory attitudes towards HIV-infected persons. In conclusion, the HIV/AIDS prevention campaign was effective in reducing thelevel of discriminatory attitudes towards HIV-infected persons. Therefore, it isimportant to develop and design the HIV prevention communication message thatincrease in the knowledge of HIV transmission and reducing discriminatoryattitudes in adolescents in Korea. 본 연구는 서울시 본 연구는 서울시 고등학생을 대상으로 에이즈 공익광고 캠페인이 에이즈에 대한 지식에 매개변인의 역할을 하여 궁극적으로 낙인 및 감염인에 대한 차별의식에 영향을 미치는지파악하여 홍보효과를 평가하고 향후 국가 에이즈 관련 사업 계획과 평가 시 활용되도록 함을 목적으로 한다. 본 연구에서 조사 대상 모집단은 서울시 고등학생이며, 고등학교는 인문계 고등학교 6개교와 실업계 고등학교 2개교를 무작위로 총8개교가 추출되었고, 각 학년별로 2개의 반을 추출하여 모두 모두조사하는 방법을 이용하였다. 설문조사를 통하여 수집된 총 1,566부의 설문지 중 불성실한 설문지19부를 제외한 총 1,547부가 분석에 사용되었다. 수집된 자료는 SPSS 19.0 프로그램을 사용하여 분석하였고, 경로분석은 AMOS 9.0을 이용하였다. 에이즈 감염인에 대한 낙인 및 차별의식 최종내생변인으로 에이즈 감염경로 지식을 매개변인으로설정한 상태에서 공익광고 노출여부를 외생변인으로 하여 경로분석을 하였으며, 공익광고의 직접, 간접 및 총효과를 분석하였다. 본 연구결과는 첫째, 일상생활 중 키스 50.2%(노출 54.7%, 비노출 45.1%), 변기 59.4% (노출62.8%, 비노출 55.6%), 물잔 57.4%(노출 62.2%, 비노출 52.1%), 학교생활 60.5%(노출 65.4%, 비노출 55.1%)로 50~60% 정도만이 일상생활을 통해서는 에이즈 감염이 되지 않는다는 것을 올바르게인지하고 있었으며, 공익광고에 노출된 집단이 그렇지 않은 집단에 비하여 정답률이 유의하게 높았다. 둘째, 에이즈 감염인을 바라보는 시각 또한 여전히 상당수가 부정적이다. 에이즈는 혐오스럽다(58.6%), 감염학생이 옆자리에 않으면 피하겠다(52.1%). 에이즈는 자신의 잘못된 성행위에 근거를하기 때문에 그에 대한 책임을 져야 한다는 생각(45.4%), 에이즈 감염인과 같이 식사를 하지 못하겠다든가(43.2%) 등으로 차별의식이 높았다. 그러나 에이즈 공익광고에 노출된 집단이 그렇지 않은 집단에 비하여 차별의식이 유의하게 낮았다. 셋째, 경로분석결과 에이즈 낙인 및 차별의식에 에이즈 공익광고(     )와 에이즈지식(      이 직접적으로 영향을 미치는 것으로 나타났다. 에이즈 공익광고에 노출된 집단은 그렇지 않은 집단에 비하여 에이즈 지식이 유의미하게 높았다(      . 에이즈 공익광고는 낙인 및 차별에 직접적으로 영향을 줄 뿐만 아니라, 에이즈 지식에 매개과정을 통해에이즈 감염인에 대한 낙인 및 차별의식에도 영향을 주는 것으로 나타났다. 결론적으로 에이즈 공익광고 캠페인은 에이즈에 대하여 올바른 지식을 전달하여 감염인에 대한 차별의식을 감소시키는 것으로 나타나 에이즈 예방 및 홍보프로그램 개발 시 이를 적용한 메시지 개발전략이 필요한 것으로 여겨진다.

국내 일개 대학병원에서 경험한 AIDS 환자의 폐 감염성 질환의 임상적 특성

정재우 ( Jae Woo Jung ),정진원 ( Jin Won Chung ),송주한 ( Ju Han Song ),전은주 ( Eun Ju Jeon ),이영우 ( Young Woo Lee ),최재철 ( Jae Cheol Choi ),신종욱 ( Jong Wook Shin ),박인원 ( In Whon Park ),최병휘 ( Byoung Whui Choi ),김재열 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.6

배경: AIDS환자에게서 기회감염은 가장 치명적인 합병증으로 대부분은 폐 감염의 형태로 발현된다. 본 연구는 타 국가에 비해 아직까지는 유병률이 낮아서 상대적으로 자료가 부족한 국내의 현황에서, HIV 감염자 및 AIDS 환자의 임상양상을 살펴보고 특히 AIDS 환자들이 주로 어떤 호흡기 질환으로 발현하며, 호흡기 질환이 발현된 AIDS 환자와 기타 폐외 질환으로 발현하거나, HIV 단순감염자와의 임상상에 어떤 차이가 있는지를 중점적으로 살펴보고자 하였다. 방법: 2001년부터 2006년 2월까지 중앙대학교 병원에 내원한 HIV 감염자 총28명을 대상으로, 이들 환자의 의무기록을 후향적으로 조사하여 분석하였다. 결과: 총 28명의 HIV 감염자 중 27명이 남자이었고 평균연령은 40.6세로 30대가 40%로 가장 많은 분포를 보였다. 이 중에서 폐질환을 동반한 경우가 11명이었고, 폐외질환 환자가 16명이었다. 폐질환을 동반환 환자군과 폐외질환자에서 내원시 CD4+림프구수와 HIV RNA 수는 평균 79.5/mm3, 48,903 IU/ml, 400/㎣, 60,256 IU/ml을 보여(P value: 0.001, 0.695) 폐감염이 동반된 경우에 더 심한 면역억제 상태가 심하였다. 폐감염의 종류로는 폐결핵, 주폐포자충 폐렴이 가장 많은 빈도를 차지하였으며, 이들의 평균 CD4+림프구 수를 보면, 폐결핵이 56/㎣, 주폐포자충폐렴이 42/㎣이었다. 결론: HIV에 관련된 폐질환이 동반된 경우 그렇지 않은 경우에 비해 월등히 면역억제가 심하였다. 이 중에서 폐결핵과 주폐포포자충 폐렴이 가장 흔한 형태의 폐감염이었다. 본 연구는 일개 대학병원에서 경험한 HIV 감염자와 특히 폐질환이 발현된 AIDS 환자의 임상상의 특징을 확인할 수 있었고 빠른 조기진단과 치료의 필요성을 다시 한번 확인하였다. Background: In AIDS patients, the respiratory tract is one of the most frequently involved site of by an opportunistic infection, and an even common, casual pulmonary infection manifests in a peculiar ways in AIDS patients. In Korea, because of the low prevalence of AIDS, there is insufficient data compared with other Southeast Asian counties. However, considering the sexual behavior of the younger generation, it is expected that it will not be long before AIDS becomes a major public health issue in Korea. This study examined the clinical manifestation of HIV positive people and AIDS patients. The pulmonary manifestion of HIV-positive was evaluated. This study focused on the differences in the clinical manifestation between AIDS patients with pulmonary disease and simple HIV positive people. The characteristics of common pulmonary infections in AIDS patients were also analyzed. Method: The medical records of 28 HIV positive patients who visited the hospital of ChungAng University Hospital from January, 2001 to February, 2006 were analyzed retrospectively. Result: Twenty-seven patients out of 28 HIV positive patients were male and the average age was 40.6(23-65). Patients in their thirties were most commonly affected. Elven patients had pulmonary diseases. Pulmonary tuberculosis (4 cases) and pneumocystis pneumonia (4 cases) were the most common respiratory infection. One patient showed a peculiar type of systemic cryptococcus. which was accompanied by lung and pleural dissemination. The CD4+lymphocyte count of patients with a pulmonary infection was significantly lower in patients with a pulmonary manifestation than those with only a HIV infection (79.5/㎣ vs 400/㎣, respectively)(p<.05). Patients with pulmonary disease were in a more severe immunosuppressive state. There were 4 patients with pulmonary tuberculosis, 4 with pneumocystis pneumonia, 4 with secondary syphilis, 2 with primary syphilis, and 2 with HZV infection. The average CD4 lymphocyte counts was 56/㎣ in those with pulmonary tuberculosis, 42/㎣ in those with pneumocystis pneumonia, and 455/㎣ in those with secondary syphilis. Conclusion: This study examined the clinical manifestation of HIV positive patients, particularly AIDS patients with pulmonary disease, A more severe immunosuppressive status was observed in HIV-related pulmonary compared with those with HIV-related extrapulmonary disease, and the frequency of pulmonary tuberculosis in pulmonary disease was higher than expected. Respiratory infection in AIDS manifest in uncommon ways e.g. disseminated cryptococcosis involving the lung and pleura. Evidently, AIDS patients with a respiratory infection have a more severe form of immunosuppression than those with a simple HIV infection. As expected, patients with a pulmonary infection were in a more severe immunosuppressed state than those with a simple HIV infection. Opportunistic infections can show peculiar clinical presentations in AIDS patients. (Tuberc Respir Dis 2006; 61: 554-561)

HIV/AIDS 감염인과 일하는 사회복지사의 딜레마

박형원(Hyung Won Park) 한국사회복지실천연구학회 2020 미래사회복지연구 Vol.11 No.1

본 연구는 “HIV/AIDS 관련기관에서 일하는 사회복지사가 경험하는 딜레마는 무엇인가?”라는 연구질문으로 질적연구를 하였다. HIV/AIDS영역에서 1년 이상 근무한 사회복지사 7명을 심층인터뷰하여 수집한 자료를 분석하였다. 연구 참여자들은 HIV감염인을 만나면서 클라이언트와의 관계에서 존엄한 삶과 생명에 대한 가치의 흔들림, 클라이언트의 경험과 가치 차이에서 오는 갈등, 비밀보장의 딜레마를 경험하였다. 사회복지조직에서 일하는 사회복지사로서 한정된 자원사용 시 형평성의 딜레마, 자원확보와 클라이언트 보호에서의 딜레마, 조직의 규칙과 클라이언트 이익간의 갈등 속에서 균형을 이루고자 노력하고 있었다. 연구참여자들은 AIDS를 둘러싸고 있는 사회의 무관심 속에서 무뎌지지 않으려 노력하고, AIDS사업의 전달체계 안에서 실적중심의 성과요구, 한계가 있는 법과 제도를 따를 수 밖에 없지만 한편으로는 클라이언트를 위해 부단히 정부의 문을 두드리고 있다. 이러한 연구참여자의 경험들은 ‘무한반복하는 딜레마의 악순환 속에서 감염인을 중심에 놓고 일함’으로 범주화하였다. 이러한 딜레마 요인을 파악함으로써 미시적으로는 조직에서의 수퍼비젼 및 딜레마 논의체계구축, 사회복지사 교육과정에 윤리적 이슈에 대한 부분의 강화, 거시적으로는 AIDS에 대한 사회적 낙인 감소, 정부의 적극적인 대응을 제언하였다. The purpose of this study was to gain better understanding of social workers dilemma who work at HIV/AIDS organizations. In-depth interviews were conducted with seven social workers who had worked in HIV/AIDS agencies, and qualitative research method was used for analysis. The findings revealed that the workers experienced their value of life and human dignity being challenged, conflicts arising from differences in client s experience and values, and the dilemma of confidentiality. Within organizations, they were trying to balance the dilemma of equity in using limited resources, and of securing resources and protecting clients, and the conflict between organizational rules and clients’ interests. The participants tried not to be dull to society’s indifference to AIDS, they were also forced to follow performance-oriented demands, limited laws and systems of the AIDS project. Despite the difficulties, they continue to knock on the door of the government on their clients’ behalf. Their work experiences were categorized as ‘working with the clients in a vicious cycle of recurrent dilemmas’. Based on the findings, the following were suggested: the use of supervision system within organizations along with peer support group, promotion of HIV/AIDS in social work education, the government s active policy for and the reduction of social stigma against HIV/AIDS.

HIV/AIDS 대응과 국제기구의 역할

김이연(KIM Yi Yeon) 한국정치학회 2015 한국정치학회보 Vol.49 No.5

본 연구는 HIV/AIDS에 대응하는 국제기구의 역할을 살펴보고 이러한 국제기구의 도움이 성공적이기 위한 국내정치적 요소들을 우간다, 세네갈, 짐바브웨, 케냐의 사례연구를 통해 살펴보고자 한다. 세계보건기구와 유엔에이즈가 협력하여 HIV/AIDS 퇴치를 위해 노력하고 있는데, HIV/AIDS에 대응하는 국제기구의 역할을 제도주의/구성주의의 관점에서 보면 각국의 감염 실태 등 정보를 취합, 제공하여 거래비용을 낮춰 주는 것은 제도주의자들이 주장했던 국제기구의 역할이며, HIV 퇴치를 주창하는 등 규범을 확산하는 것은 구성주의자들이 주장했던 국제기구의 역할이다. 하스(Haas 1992)의 주장을 고려하면 HIV/AIDS 문제 해결을 위해서 각국의 전문가들로 구성된 인식공동체가 중요한 역할을 할 수 있겠으나, 유드(Youde 2005)는 남아공의 예를 들어 HIV라는 하나의 이슈에 대해서도 여러 개의 인식공동체가 존재할 수 있음을 보여준다. 남아공에서 반인식공동체가 형성되어 자국의 HIV 문제를 부인하고 국제사회의 도움을 거절했던 상황은 HIV/AIDS 문제가 국제사회의 의지만으로 해결되기에는 부족할 수 있다는 문제를 제기한다. 한편, 각국의 민주화 수준이 HIV 감염률에 미치는 영향에 대한 정량적 연구들은 성숙된 민주주의 국가일수록 HIV 감염률이 감소한다는 결과를 보여주는데, 우간다와 세네갈은 HIV 감염률 감소에 성공했으나 기존의 민주화 수준을 측정한 기준에 따르면 이러한 평가를 받았던 1990년대 말까지 민주주의 국가와는 거리가 멀었다. 본 연구는 우간다, 세네갈, 짐바브웨, 케냐 4개국 사례 분석을 통해 HIV/AIDS 감염률 감소를 위해서는 국제기구의 지원과 동시에 정치 지도자의 리더십, 국제기구의 원조를 수행하고 도와줄 NGO의 역할이 필요하다고 주장한다. 본 연구는 국제사회의 HIV/AIDS 대응에 있어 국제기구가 각국의 HIV/AIDS 관련 NGO들의 역할을 더욱 활성화시키는 방안이 필요하며, 국제사회가 HIV/AIDS를 안보의 위협으로 인식하는 만큼, 각국의 정치 지도자들이 같은 인식을 할 때 더 급속한 퇴치가 가능할 것이라는 함의를 제시한다. Although there are many studies about international organizations, specific IOs such as international health organizations, are rarely investigated. This study focuses on health IOs and their roles in reducing HIV rates considering countries` domestic political factors. In some states, the efforts of IOs have reduced the HIV prevalence rate, while in other states, they have not contributed to a decrease in the disease rate. One might ask what accounts for this difference. IR literature is not very clear about the conditions necessary for achievement of IOs` goals. Even though studies(Vieria 2006; Youde 2007) about the WHO suggest its importance, they are limited because they do not consider domestic factors. Constructivists cannot explain the situations when IOs are short of finances and thus cannot implement the norm. Rationalists also do not sufficiently consider domestic factors that may be relevant. Using case studies, I argue that only when IOs work together with domestic factors, such as political leadership and NGOs`vigorous role, can the disease be reduced.

일도시의 보건복지직 공무원과 일반인의 HIV/AIDS에 대한 태도와 지식에 관한 연구

김화선,최은정,양정남 한국보건사회학회 2010 보건과 사회과학 Vol.0 No.28

HIV/AIDS is recognised to be one of the most serious public health problems in recent times. It is having a profound impact on society and particularly on the lives of infected people and their families. This study explores the level of knowledge and attitude towards HIV/AIDS and the relationship between knowledge and attitude among adults from the general public, including health care officers working in the public sector in G. city, S. Korea. Data for the present analysis was obtained from a purposive sampling of health care officers who work in the public sector in G. city, S. Korea to determine their knowledge and attitude towards HIV/AIDS. The sample was composed of 240 health care officers including nurses and social workers and 204 adults from the general public. The study relied on a self-administered questionnaire. The data was collected between December 2008 and January 2009. All data was analyzed using SPSS WIN version 12.0 for technical statistics. t-Test, ANOVA and multiple regression analysis was used. The result of this study is outlined in the following:First, the result of this research showed that the average level of participants knowledge on HIV/AIDS was 84.4%. The health care officer'sscore was 87%, adults from the general public was 81% which showed that health care officer's score was higher than that of adults from the general public. Second, the outcome also showed that health care officers generally had a more positive attitude about HIV/AIDS patients than adults from the general public but it was not significant. Third, the result of this study showed that there is a positive corelation between participant's attitudes towards HIV/AIDS and their level of knowledge. Fourth, the results also showed that knowledge on HIV/AIDS is the most important influential factor towards participant's attitude. This result has important implications for future education programs designed for health care officers in the public sector including nurses and social workers. 최근 HIV/AIDS는 가장 심각한 공중 보건 문제들 중 하나로 인식되고 있으며, 감염인과 그 가족들은 물론 사회전반에 심각한 영향을 주는 보건복지의 문제이다. 본 연구는 G광역시의 보건복지직 공무원과 일반인들의 HIV/AIDS에 대한 지식과 태도 수준, 그리고 지식과 태도 사이의 관계에대해 연구하였다. HIV/AIDS에 대한 지식과 태도를 측정하기 위해 분석에 사용된 자료는 G광역시의 보건복지직 공무원과 일반인을 대상으로 편의표집되었다. 표본은 보건직과 사회복지직을 포함하여 보건복지직 공무원 240명, 일반인 204명으로 구성되었고, 구조화된 질문지에 자기기입 하도록 하였으며, 자료수집 시기는 2009년 1월이었다. 전체 자료는 SPSS Win 12.0을 사용하여 기술통계, t-Test, ANOVA, 다중회귀분석을 통해 분석되었다. 본 연구의 결과를 정리하면 다음과 같다: 첫째, HIV/AIDS에 대한 대상자들의 지식의 평균 정답률은 84.4%였다. 보건복지직 공무원은87%, 일반인은 81%로 보건복지직 공무원이 일반인보다 지식에 대한 평균 정답률이 더 높은 것으로 나타났다. 둘째, 보건복지직 공무원이 일반인보다 HIV/AIDS 감염인에 대해 더 긍정적인 태도를 가지는 것으로 나타났으나, 통계적으로 유의미하지는 않았다. 셋째, HIV/AIDS에 대한 대상자들의 태도와 지식 수준 사이에는 긍정적인 상관관계가 있는 것으로 나타났다. 넷째, HIV/AIDS에대한 지식이 대상자들의 태도에 가장 중요한 영향 요인인 것으로 나타났다. 이러한 연구결과는 보건복지직 공무원에 대한 향후 교육 프로그램 개발과 체계구축에 중요한 함의를 가지고 있고 본다.

Ethical Considerations on Health Policy Making for Vulnerable People : Focused on HIV/AIDS Patients

Ahn, Kyongjin,Bae, Hyuna Ewha Institute for Biomedical Law & Ethics 2009 BIOMEDICAL LAW & ETHICS Vol.3 No.2

AIDS (Acquired Immunodeficiency Syndrome) is the greatest threat to health in the world. However, AIDS is not only related to health issues but also to social, economic and justice issues. The HIV/AIDS epidemic, which raised many ethical and moral question is a global issue. Even though AIDS is an important global issue, it has not been discussed in the public because there are still many unfair social stigmas attached to HIV/AIDS. The purpose of this paper is to address the seriousness of HIV/AIDS in social context and to reconsider how false perceptions of HIV/AIDS result in social stigma. Also we will examine the theoretical foundations that can help to solve the HIV/AIDS issue centered on human rights. To motivate practical action among people on the global HIV/AIDS issue, examination of our moral and ethical obligations to others who are needy and vulnerable is necessary. This kind of work will help to solve the question of how we can change the social discourse on HIV/AIDS and to make better heath policy for vulnerable group.