Search

HIV/AIDS-COVID-19 co-infection is a major public health concern especially in developing countries of the world. This paper presents HIV/AIDS-COVID-19 co-infection to investigate the impact of interventions on its transmission using ordinary differential equation. In the analysis of the model, the solutions are shown to be non-negative and bounded, using next-generation matrix approach the basic reproduction numbers are computed, sufficient conditions for stabilities of equilibrium points are established. The sensitivity analysis showed that transmission rates are the most sensitive parameters that have direct impact on the basic reproduction numbers and protection and treatment rates are more sensitive and have indirect impact to the basic reproduction numbers. Numerical simulations shown that some parameter effects on the transmission of single infections as well as co-infection, and applying the protection rates and treatment rates have effective roles to minimize and also to eradicate the HIV/AIDS-COVID-19 co-infection spreading in the community. [ABSTRACT FROM AUTHOR]

As an interface between health and education, comprehensive sexuality education (CSE) offers a potent tool among other interventions to accelerate healthy transition of adolescents into adulthood. With increasing interest in in-school CSE provision/delivery, young people in out-of-school contexts may be left behind. This study forms part of implementation research to understand if the activities used to train and support the facilitators are feasible, appropriate, acceptable, and effective in enabling them to engage a defined group of young people, deliver CSE to them in the out-of-school context, and assist them in obtaining relevant services. This paper presents findings of mapping of out-of-school CSE interventions in Ghana, ongoing or completed between 2015 and 2020, and then discusses a needs assessment of two purposively selected groups of vulnerable out-of-school youth: young people living with HIV and AIDS (YPLHIV) and those living in detention (YPiD). We conducted 10 interviews with YPLHIV and three focus group discussions with YPiD in November 2020. Qualitative data were analysed thematically using both deductive and inductive approaches. The mapping yielded 29 interventions (18/62% were ongoing) focused extensively on the delivery of CSE-related knowledge and information; none were aimed at building facilitators' capacity and most targeted the northern regions. Among YPLHIV, living positively after diagnosis, disclosure skills and use of HIV/AIDS health services were critical. YpID sought clarification on personal hygiene, consent in sexual relationships, medium/channel to deliver CSE, and issues around same-sex sexual intercourse. Both groups sought skills in dealing with stigmatisation and discrimination. Implications of the findings for our own and other interventions are highlighted. [ABSTRACT FROM AUTHOR]

HIV is a virus that weakens a person's immune system. HIV has three stages, and AIDS is the most severe stage of HIV (Stage 3). People with HIV should take medicine (called ART) recommended by WHO as soon as possible to reduce the amount of virus in the body. In this paper, we formulate a mathematical model for HIV/AIDS with a new approach by focusing on two groups of infectious individuals, HIV and AIDS. We also introduce a controlled class (treated patients and being monitored), and people in this class can spread the disease. We further investigate the essential dynamics of the model through an equilibrium analysis. Optimal control theory is applied to explore effective treatment strategies by combining two control measures: standard antiretroviral therapy and AIDS treatments. Numerical simulation results show the effects of the two time-dependent controls, and they can be used as guidelines for public health interventions. [ABSTRACT FROM AUTHOR]

This paper presents empirical material drawn from an intentionally local AIDS quilting project in a disadvantaged inner-city district of Dublin, Ireland. The paper aims to address two key gaps in human geography. Firstly, by examining the AIDS quilts through their primary functions of therapy, activism, and commemoration, this paper finds an emphasis on place, rather than names that foregrounds the geographical, as opposed to merely rhetorical dimensions of the AIDS quilt. In doing so, it questions the forms of political community that have been claimed through the more well-studied NAMES Memorial Quilt. Secondly, by conceptualising AIDS quilts through the lens of humanistic geography, it reflects upon the act of quilting as producing what Yi-Fu Tuan described as a "field of care," a place that may be more attentive to the structural AIDS vulnerability visited upon affected communities. It concludes with implications for the study of AIDS interventions amid wounded cities. As these damaged communities seek ways to repair themselves, the quilts act as paradigmatic cases of care for others, through care for place. [ABSTRACT FROM AUTHOR]

Since reports of the first incidence of the HIV virus in Zimbabwe in 1985, the epidemic has negatively impacted on every facet of human security. Rural areas, by virtue of being the periphery and constrained in terms of resources and health care provision, bear the brunt of the epidemic. In light of the above background, this paper examined how the establishment of Ruvheneko Programme by the people of Chirumhanzu helped in mitigating on the impact of HIV and AIDS in the rural sphere. The paper analyses how the community of Chirumhanzu successfully engaged each other to the extent of coming up with such a vibrant programme. This is raised against the backdrop of failure usually associated with HIV and AIDS engagement projects. The study made use of field interviews and focus group discussions as data collection instruments. Participants were purposively selected on the basis of their knowledge and participation in the establishment and activities of Ruvheneko Programme. Selected were 5 St Theresa's Hospital Staff, 10 Roman Catholic Church members of which, 5 were from the St Anna's woman prayer group and 5 men from St Joseph's men prayer group, 1 village head and 2 elders from the same nearby village constituted key informants. Complementing the use of interviews and focus group discussions was the analysis of secondary data sources on HIV and AIDS in Zimbabwe as well as the Ruvheneko Programme. To understand the collective role of various sectors of the community in establishing Ruvheneko Programme, the paper derives insights from the perspective of social capital theory and its notion of commonality to strengthen communities. Findings from the study show that, unlike other HIV and AIDS programmes that are exported from the urban to the rural areas, Ruvheneko Programme demonstrates a grassroots-level response to HIV and AIDS. Again, social cohesion fostered by aspects such as religiosity, cultural ethos of Ubuntu, and a consultative approach played a key role in unifying people towards fighting HIV and AIDS in Rural Chirumhanzu. [ABSTRACT FROM AUTHOR]

This paper attempts to assess the knowledge and attitude on HIV/AIDS among school students of Iran. The following data sources were searched for eligible studies: Medline, Science Direct, CINAHL, Scopus, Web of Science, SID, ISC, Magiran, and Google Scholar from 1990 to the end of 2016. The quality of the studies was evaluated using the 22-item STROBE checklist. The highest level of awareness belonged to sharing clothes (93.15) and blood transfusion, respectively (86.31), while the lowest level of awareness was related to transmitting HIV from mother to child (42.05). The study identified a substantial gap in the knowledge, negative attitude towards HIV/AIDS and its transmission among Iranian school students. Accordingly, schools should be regarded as one of the main focuses of activities in the strategies of AIDS risk reduction, and education of school students about all aspects of HIV/AIDS has to be considered seriously by the education policymakers. [ABSTRACT FROM AUTHOR]

What could be more logical than a gay–feminist alliance to respond to the AIDS epidemic in Latin America? However, drawing on published articles and the author''s experience in HIV/AIDS work in Chile, this paper argues that such an alliance is more rhetorical than real. Instead, both groups tend to stick to their respective niches and view the epidemic through the prism of the particular needs and concerns of their target constituencies, rather than learn from and support each other. Feminist rhetoric sometimes suggests that AIDS is a problem only because it affects women. The African paradigm of vulnerable women is inexactly applied, given the predominantly male and homosexual nature of the epidemic in most Latin American countries. Both women and homosexually active men are highly vulnerable to HIV infection, and little is gained by competing for the top slot on the “tragedy honour roll”. Latin American gay men''s groups, torn between AIDS and gay rights activism, often resist both protagonism by women and women''s issues. Although the fight for access to antiretroviral treatment has obscured this conflict, it resurfaces in associations of HIV-positive people and may increase along with heterosexual transmission in the region. Discussion and exchanges should be encouraged to overcome these largely hidden divisions. [Copyright &y& Elsevier]

This paper explores the manifestation of HIV-related stigma in seven- and eight-year-old white South African children's responses to HIV and AIDS. Drawing from elements of ethnographic and interview data, it shows how young children's responses to HIV and AIDS are inscribed within popular accounts of contagion and articulate gendered, sexual, raced and classed discourses in South Africa. Rejecting static accounts of stigma, the paper shows how children resist and confirm power inequalities involving intense self-regulation as well as inscribing within discourses of care and concern for others infected with HIV and AIDS. The findings have implications for scaling up educational efforts to address awareness of HIV and AIDS and stigma, but also to build on positive insights that young children demonstrate with regard to the disease. [ABSTRACT FROM AUTHOR]

This paper analyses how TIME magazine represents sub-Saharan African women in its coverage of HIV/AIDS. As rates of infection escalate across the continent, researchers are increasingly emphasising the need to understand the socioeconomic and cultural contexts that make women particularly vulnerable to infection. Yet popular media representations of AIDS continue to rely on older colonial imageries of Africa as the feminised, diseased 'dark continent'. This article identifies three major themes in TIME's representation of sub-Saharan African women and HIV/AIDS: the metaphor of Africa as a woman in crisis, the construction of women as the means of transmission, and the engendered nature of the debate about the impact of international development policies. It is argued that the reliance on familiar cultural narratives often obscures the epidemiological, economic and cultural realities within which sub-Saharan women live. Not merely a consequence of unprotected sex, AIDS in sub-Saharan Africa is also the result of global economics and politics, reflecting the inequities between the West and Africa, male and female, white and black. The paper concludes with a call for further research on the role of representations of HIV/AIDS and its actual routes of transmission. [ABSTRACT FROM AUTHOR]

The primary objective in this study was to explore what HIV and AIDS mean to seven- and eight-year-old children in South Africa and how sexual and gender dynamics are embedded within these meanings. Against representations that associate young children with innocence, the paper argues for a more capacious view of young children as sexual and gendered agents with the ability to exercise their rights. In contrast to research that addresses children as relatively passive desexualised beings, focusing on their dependence on adults, their innocence and their need for protection, this paper examines how HIV and AIDS are constructed and negotiated by young people. It views children not simply in terms of their need for sexual rights but as potentially active participants in the negotiation of their rights. Viewing children's rights as highly contested, the notion that young children have sexual rights opens up possibilities for children (including those from marginalised groups) to talk about their concerns and pleasures, fears and hopes, as well as issues relating to sexual rights and resistances. By working creatively with teachers, it may be possible to broaden young children's knowledge of HIV and AIDS and sexuality within a more supportive environment. [ABSTRACT FROM AUTHOR]

This paper questions international public health theories that characterize AIDS in Africa as an unambiguous heterosexual epidemic. It does so by describing the daily sexual lives of a community of Namibian youth who engage in same‐sex sexual practices. The author outlines how the ongoing vilification of “homosexuals” by ruling State officials serves as a stigmatizing backdrop against which young people experience and practice their sexuality. Drawing upon 20 months of ethnographic research, the paper discusses the HIV sexual risk perceptions and practices of young men, highlighting the complexities in sexual subjectivity that form within the cultural politics of competing masculinities, state‐sponsored anti‐homosexual rhetoric and transnational queer rights protest. Bounded and monolithic notions of gender and sexual identity do not lend themselves to HIV risk and vulnerability analysis in this community. [ABSTRACT FROM AUTHOR]

The HIV epidemic has had a profound impact on people's everyday life in most African societies. A large proportion of all new HIV infections involves young people between 15 and 25 years. The objective of this paper is to explore local moral worlds of young people in Bobo‐Dioulasso, Burkina Faso, and discuss how the HIVS epidemic affects their reflections on their everyday life and their perceptions of sexual relationships. Based on anthropological fieldwork, including focus‐group discussions, in‐depth interviews and participant observation, a total of 57 young people between 15 and 25 years were followed over a 3‐month period. Using the notion of ‘lifestyle’, the paper shows how structural factors of unemployment and poverty paired with global discourse on AIDS present the young people with frustrations and quandaries in relation to their hopes and images of love, faithfulness and modern living. The data shows that the HIV epidemic contributes to and accelerates their feeling of living in a risk society and of being at risk. In order to cope with these uncertainties and contingencies, local discourses of trust and fidelity become extremely important and to most young people HIV prevention is synonymous with finding a faithful partner and/or using condoms. [ABSTRACT FROM AUTHOR]

This paper examines Korean views on the subject of male homosexuality. Using historical and contemporary sources, it seeks to explain elements of new cultural openness towards homosexuality in modern Korea. Korean people's understanding and knowledge of male homosexuality is ambiguous and limited. In the absence of knowledge and open communication, most Korean people imagine that male homosexuality is an abnormal and impure modern phenomenon. Prejudice and confusion lead most Korean male homosexuals to be estranged from their families, religious communities and non-homosexual peers. Moreover, they are often viewed as the ‘carriers’ of AIDS and Sexually Transmitted Diseases (STDs). The purpose of this paper is to examine current Korean perspectives on male homosexuality by exploring both the ancient history of the practice of male homosexuality and current thinking about homosexual life among Koreans, which has played an important part in the formation of contemporary attitudes toward homosexuality. Résumé Cet article examine les opinions sur la question de l'homosexualité masculine en Corée. En utilisant des sources historiques et contemporaines, il cherche à expliquer les éléments d'une nouvelle ouverture culturelle vis à vis de l'homosexualité dans la Corée moderne. Les connaissances et la compréhension de l'homosexualité masculine par le peuple coréen sont ambiguës et limitées. En l'absence de connaissances et de communication ouverte, la plupart des coréens imaginent que l'homosexualité masculine est un phénomène moderne, anormal et impur. Les préjugés et la confusion font que la plupart des hommes homosexuels coréens sont séparés de leurs familles, de leurs communautés religieuses et de leurs pairs non homosexuels. De plus, ils sont souvent considérés comme les « porteurs » du sida et des infections sexuellement transmissibles (IST). L'objectif de cet article est d'examiner les perspectives actuelles sur l'homosexualité masculine en explorant à la fois l'histoire ancienne des pratiques homosexuelles et les opinions communes sur la vie homosexuelle chez les coréens, qui ont joué un rôle important dans l'émergence des attitudes contemporaines vis à vis de l'homosexualité. Resumen En este documento se analizan los puntos de vista de Corea sobre el tema de la homosexualidad masculina. Con ayuda de fuentes históricas y contemporáneas pretendemos explicar los elementos de la nueva apertura cultural hacia la homosexualidad en la Corea moderna. La comprensión y los conocimientos de los coreanos sobre la homosexualidad masculina son ambiguos y limitados. A falta de conocimientos y una actituad abierta de comunicación, la mayoría de los coreanos se imaginan que la homosexualidad masculina es un fenómeno moderno anormal e impuro. Los prejuicios y la confusión llevan a que la mayoría de homosexuales coreanos pierdan los vínculos con sus familias, comunidades religiosas y compañeros no homosexuales. Además, a menudo son vistos como “portadores” del sida y enfermedades de transmisión sexual. La finalidad de este documento es analizar las perspectivas actuales de los coreanos sobre la homosexualidad masculina estudiando la historia antigua de los métodos de los homosexuales y su opinión actual sobre la vida homosexual entre los coreanos, que ha desempeñado una parte importante en la formación de las actitudes contemporáneas hacia la homosexualidad. [ABSTRACT FROM AUTHOR]

This paper examines the shifting nature of contemporary epidemiological classifications in the HIV/AIDS epidemic. It first looks at assumptions that guide a discourse of vulnerability and circulate around risk categories. It then examines the underlying emphasis in public health on the popular frame of “vulnerable women” who acquire HIV through heterosexual transmission. Drawing on work on gender, sexuality, and intersectionality, the paper asks why a discourse of vulnerability is infused into discussions of heterosexually‐active women's HIV risks but not those pertaining to heterosexually‐active men's. The paper then moves to current surveillance categories that are hierarchically and differentially applied to women's and men's risks in the HIV epidemic. Here, the focus is on the way in which contemporary classifications allow for the emergence of the vulnerable heterosexually‐active woman while simultaneously constituting lack of fathomability concerning bisexual and lesbian transmission risk. Lastly, theories of intersectionality, are used to examine current research on woman‐to‐woman transmission, and to suggest future more productive options. [ABSTRACT FROM AUTHOR]

Studies of sexual risk behaviour in the context of HIV/AIDS often utilize theories of risk which are predicated on the idea of the rational actor making choices, and thus operate with a strong notion of the autonomous individual. The underlying assumption is that a well-informed individual would strive to reduce risk and therefore choose not to engage in risky behaviour in sexual encounters. Drawing on longitudinal fieldwork in Arusha town and the surrounding districts in northern Tanzania, this paper explores how people draw on a complexity of knowledge and experience when they try to reduce the likelihood of contracting HIV. It shows how the embeddedness of social relationships, and the constraints of culture restrict the possible range of options, particularly for women. The paper examines the paired concepts of risk and trust, arguing that trust in a sexual relationship is gendered in particular ways. Gender hierarchies often place women in a subordinate position to men as a result of which women have to make compromises which put their health at risk. [ABSTRACT FROM AUTHOR]

This paper argues that the relationship between homophobia and HIV/AIDS is not as direct as is often assumed. This argument is pursued through an examination of the situation of gay men in Australia, a country where the HIV epidemic is largely confined to gay men, and Bangladesh, a country and culture where sex between men does not conform to categories of human sexuality privileged in Western theory. Both of these countries reveal something different about cultures of sex between men, which provides a counterpoint to the often compelling and usually pervasive accounts of HIV-related discrimination that are derived particularly from North America. The paper concludes with a plea that as efforts are geared up to fight the HIV pandemic in Asia and the Pacific, researchers, planners and practitioners become more critical of the conceptual tools they rely on in thinking about HIV/AIDS and human sexual activity, so that it is possible to mobilize (and do less damage to) local cultures of sexuality. [ABSTRACT FROM AUTHOR]

Recent advances in treatment have improved the health of many people living with HIV/AIDS. The research described in this paper shows that the changing context of care is also impacting significantly on people who provide services. In this paper, we explore both perspectives by comparing recent service provider data with that derived from research involving people living with HIV/AIDS. We explore four themes: (1) hope and optimism; (2) changing context, roles and identities; (3) changing relationships; and (4) quality of life. Treatment advances and a new focus on living has altered the context of working with people living with HIV/AIDS and challenges health professionals to find new meanings and relationships within that context. Study findings have implications for the wider health care context and the changing roles and power balances within this arena. [ABSTRACT FROM AUTHOR]

HIV/AIDS is the major threat to development, economic growth and poverty alleviation in much of Africa. And yet the full extent of the catastrophe facing the continent is only just being recognized, and still not by all. The international development targets set by the great and the good of the global community--or at least by those members of the community who attend the international summits that set these goals--do not consider what HIV/AIDS means and are unachievable. This paper begins by setting the scene, describing the epidemic, explaining why it is so important and what makes HIV/AIDS different. It then explores how the poverty/epidemic cycle works, whereby poverty increases the spread of HIV and AIDS increases poverty. It suggests we need to look beyond monetary poverty to understand these relationships. Finally the paper assesses what can and should be done to break the HIV/AIDS poverty cycle. [ABSTRACT FROM AUTHOR]

This article reports on a paper which reviews the clinical decision theory using a clinical utility theory. Also, it reevaluates the problem of prediction as it relates to HIV/AIDS by examining the use of multiple tests, the relevance of a utility theory, and the significance of both immediate and projected costs and benefits. The efficiency of a diagnostic test is largely determined by the base rate, or prevalence, of disease in the population under study, with the consequence that low prevalence diseases are often difficult to detect. In conclusion, current models of AIDS epidemiology suggest that the growth of the epidemic is very sensitive to certain parameters, including the average rate of needle sharing among IV drug abusers and the rate of sexual interaction among members of high-risk groups. The implications of these results for HIV/AIDS epidemiology are stressed throughout and are discussed in detail in the final section of the paper. Any discussion of the relative costs and benefits of AIDS intervention programs must seriously consider the projected benefits in addition to more immediate ones.

The epidemiology of HIV transmission, and hence AIDS, depends upon phenomena such a sexual mixing patterns, about which very little is known. Mathematical models of sexually transmitted WV assume random mixing among susceptible and infected individuals, across differing levels of sexual activity. Given that this representation of sexual mixing is probably wrong (in the sense of descriptive accuracy) should such models be used to formulate and/or evaluate AIDS intervention strategies? This paper presents an example where random mixing, though wrong descriptively identifies a useful policy. In the process, the concept of worst case sexual mixing is introduced. Arguments for involving simple models of the AIDS epidemic in policy analysis conclude the paper. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to consider a very simple model of the AIDS epidemic. This model illustrates how the spread of AIDS can be affected by parameters whose values, at the present time, are very imprecise or unknown. Of particular interest are the data related to sexual encounters and practices, data which are often unreliable or ambiguous. In this regard, the present model also suggests that the epidemiology of AIDS is particularly sensitive to the limitations in the assessment of sexuality/drug-related behavior. Using a system of elementary differential equations, the present paper illustrates (using 3 examples) that depending upon the value of critical parameters, one could predict either very rapid increases of seropositivity or a decreasing rate of seropositivity. Thus, in order to diminish the ambiguity, it becomes crucial to make careful estimates of the sexual "interaction" coefficients, along with all other parameters, to insure that reasonable predictions can be made. [ABSTRACT FROM AUTHOR]

The integration of the history and geography of diseases is essential to understanding and revealing a true picture of epidemiology and disease patterns as they are today. This is particularly true for the current pandemic of the Acquired Immunodeficiency Syndrome (AIDS). The complexity and capabilities of the disease agent, the Human Immunodeficiency Virus Type 1 (HIV-I), generate increasing concern about this fatal disease. Thus far, treatment merely temporarily extends lives of the victims, and hope for a vaccine against infection remains remote. Understanding the mechanisms and patterns of the origin and diffusion of the infection and disease are central to developing appropriate intervention strategies for controlling its spread. In this paper an overview of AIDS is presented from the perspective of medical geography. Characteristics of the virus and the mechanisms of infection are described, and, using available evidence, an attempt is made to piece together the spatial-temporal patterns of the disease. Theories about the African origin and its diffusion there are discussed and pathways out of Africa to other parts of the world presented. Specific attention is directed to the spatial diffusion of AIDS within the United States. Cultural, social, behavioral, economic, political and transportation factors play important roles in the current and historical spatial patterns of AIDS. The historic importance of this disease and the complex of geographic factors necessary to its understanding require the interest and cooperation of a broad range of geographic specialties. We hope this paper informs and stimulates discussion among geographers to undertake this effort. [ABSTRACT FROM AUTHOR]

In countries most afflicted by HIV/AIDS in sub-Saharan Africa, orphanhood has increased dramatically, but the potential consequences of the increase have been mitigated by the ability of households to absorb orphans. This paper examines what the rising levels of orphanhood mean for the common practice of non-orphan child fostering in regions of high and low HIV prevalence in sub-Saharan Africa, which has a long history of child fostering. Using Demographic and Health Survey data from 135 regions within 14 sub-Saharan countries that undertake HIV testing and have had at least two surveys, we examine changes in fostering patterns. In most regions, we find a more accommodating relationship between orphan and non-orphan fostering: communities are able to absorb the demand for both orphans and non-orphans. Where HIV prevalence exceeds 10 per cent there is some evidence that the need to care for orphans is beginning to reduce opportunities for non-orphan fostering. [ABSTRACT FROM PUBLISHER]

Despite the urgency of improving an understanding of sexual cultures in the face of a globally devastating HIV epidemic, methodological reflection and innovation has been conspicuously absent from qualitative research in recent years. Findings from fieldwork on condom use among young people in Mozambique confirm the need to remain alert to the ideological and linguistic bias of applied methods. Interviewing young people about their sexuality using a conventional health discourse resulted in incorrect or socially acceptable answers rather than accurate information about their sexual behaviour. Young people's resistance to enquiry, the paper argues, is due to ideological contradictions between their sexual culture and slang, on the one hand, and Western health discourses associated with colonial and post-colonial opposition to traditional culture and languages, on the other. Mixing colloquial Portuguese and changana sexual slang is constructed around ideas of safedeza and pleasure, while dominant health discourses address sexuality as both 'risky' and 'dangerous'. In order to gain a deeper understanding of sexual cultures and to make HIV prevention efforts relevant to young people, it is suggested that researchers and policy makers approach respondents with a language that is sensitive to the local ideological and linguistic context. [ABSTRACT FROM AUTHOR]

This paper presents the findings, shares the methodology and outlines the benefits of a multi-country participatory research process on a unique data source: stories about HIV and AIDS written by young Africans. Between 1997 and 2005, more than 105,000 young people from 37 countries participated in competitions inviting them to think up storylines for short fiction films to educate their communities about HIV and AIDS as part of the 'Scenarios from Africa' communication process. The winning stories were selected by juries made up of: PLWH and other local specialists in prevention, treatment and care; former contest winners and other young people; and communication specialists, including the top African directors, who went on to transform the ideas into short films. In 2005, over 200 jurors selected 30 winners from the 22,894 stories submitted that year by 63,327 contest participants. After reading around 200 stories each and participating in the selection process, jurors compiled their observations and recommendations. The jurors' findings reveal notable persistent shortcomings in existing communication efforts and identify key emerging needs. In some areas, they show remarkable consistency across the continent. Jurors view this as a powerful needs assessment, networking and capacity building process that motivates action. [ABSTRACT FROM AUTHOR]

This paper examines the culturally shaped meanings of AIDS and perceptions of accidental occupational exposure to HIV among a group of twenty nurses in Bangkok, Thailand. The findings are based on data collected as a part of a larger mixed-methods study that examined how perceptions of risk behaviours (including sexual promiscuity) shape health workers' perceptions of patients living with HIV/AIDS. Nurses' narratives revealed that despite acknowledgement of the low probability of occupational exposure to HIV, the fear of HIV infection remained and was largely driven by the enormity of the anticipated social (rather than the health) consequences of being HIV-positive. The perceived certainty of social ostracism was reinforced by participants' observations of the social rejection experienced by people living with HIV/AIDS both within and outside clinical settings. For female nurses, the dominant social perception that women living with HIV/AIDS were violators of gender norms, and thus 'guilty' victims, was an issue central to their self-identities. Ways of improving care for people living with HIV in the light of the nurses concerns and future research are discussed. [ABSTRACT FROM AUTHOR]

Most social science research on HIV has focused on prevention. The arrival of new therapies generated more studies on life with HIV. However most have been carried out in developed world contexts. Much less is known about the vast majority of those living with HIV and dying from AIDS. If this gap is to be filled, more qualitative research will be needed on affected individuals in the developing world and also among migrants who have left developing countries to live in the diaspora. It will also be essential to explore the lives of individuals from the same communities who may experience HIV in very different ways as a result of their gender and/or sexuality. This paper presents findings from three studies of Black African migrants living with HIV in London. It uses an intersectional approach to examine the similarities and the differences between the experiences of heterosexual women, heterosexual men and gay and/or bisexual men. The article highlights the importance of research of this kind both for providing the evidence base for context-specific policy development and also for making better conceptual and theoretical sense of the impact of HIV on individuals and their lives. [ABSTRACT FROM AUTHOR]

This article examines some methodological issues in using the life history approach in social research. Although there are diverse opinions on how the approach should be used, there are certain methods of collecting, analysing, and reporting ensuing data that are often associated with it; these methods were used by the authors in recent studies carried out in Uganda and Zimbabwe. The authors' experiences show that conducting life history research in the area of HIV and AIDS in a rural African context presents some methodological and ethical dilemmas, which cannot always be resolved. The paper also highlights the methodological, moral, and ethical dilemmas faced by African women carrying out research on other African women, and some ways of resolving these. [ABSTRACT FROM AUTHOR]

All over the world HIV has been stigmatised, making it difficult for people living with HIV to access testing, treatment, care and counselling or even to act on a diagnosis or get advice and treatment, for fear of being judged. Prejudice in society has also often been reflected and reproduced by health care providers. A human rights approach, which positively incorporates sexual and reproductive rights, rather than a restricted medical view, is therefore essential for the achievement of true partnerships between health care providers and service users. This paper is about the experiences of HIV positive women and men in sexual and reproductive health services and HIV testing. It provides guidance not only on how things could and should be done but also on how they should not be done. It outlines the sexual and reproductive rights positive people consider crucial and gives examples of how these are being violated. It presents perceptions and implications of HIV testing and how health services can support people after a positive diagnosis. It analyses the importance of confidentiality, continuity of care, knowledge and information, and the role of support groups and home-based care. It calls on sexual and reproductive health services to address issues of stigma and discrimination when offering and carrying out HIV testing and counselling, and in providing treatment, care and support. Partout dans le monde, les personnes vivant avec le VIH souffrent de stigmatisation, ce qui entrave leur accès au dépistage, au traitement et aux soins, les empêche d'agir après le diagnostic et d'obtenir des conseils ou un traitement, par crainte d'être jugées. Le personnel sanitaire a souvent reproduit les préjugés de la société. Une approche des droits de l'homme, qui inclut positivement les droits génésiques, de préférence à une perspective médicale restreinte, est donc essentielle pour établir de véritables partenariats entre le personnel sanitaire et les patients. Cet article porte sur les expériences d'hommes et de femmes séropositifs dans les services de santé génésique et de dépistage du VIH. Il conseille non seulement sur la manière dont les choses peuvent et doivent être faites, mais aussi sur la manière dont il ne faut pas les faire. Il répertorie les droits génésiques jugés fondamentaux par les personnes séropositives et donne des exemples de violations. Il présente des conceptions et des conséquences du dépistage du VIH et montre comment les services de santé peuvent soutenir les patients après un diagnostic positif. Il analyse l'importance de la confidentialité, de la continuité des soins, de la connaissance et de l'information, et du rôle des groupes de soutien et des soins à domicile. Il demande aux services de santé génésique d'aborder les questions de stigmatisation et de discrimination quand ils proposent et assurent des programmes de conseil et dépistage du VIH, et dispensent un traitement, des soins et un soutien. Por todo el mundo el VIH ha sido estigmatizado, lo cual dificulta que las personas que viven con VIH tengan acceso a pruebas, tratamiento, atención y consejería, o incluso que tomen medidas respecto al diagnóstico u obtengan consejos y tratamiento, por temor a ser juzgados. El prejuicio de la sociedad con frecuencia también ha sido reflejado y reproducido por los prestadores de servicios de salud. Por tanto, un enfoque de derechos humanos, que incorpore de manera positiva los derechos sexuales y reproductivos, en vez de una visión médica restringida, es esencial para lograr verdaderas alianzas entre los prestadores de servicios de salud y los usuarios. Este artículo trata sobre las experiencias de mujeres y hombres VIH-positivos con servicios de salud sexual y reproductiva y pruebas de VIH. Proporciona orientación no sólo respecto a cómo pueden y deben hacerse las cosas, sino también respecto a cómo no deben hacerse. Esboza los derechos sexuales y reproductivos que las personas seropositivas consideran cruciales y da ejemplos de cómo estos están siendo violados. Expone percepciones e implicaciones de las pruebas de VIH y cómo los servicios de salud pueden apoyar a las personas después de un diagnóstico positivo. Analiza la importancia de la confidencialidad, continuidad de la atención, conocimiento e información, y la función de los grupos de apoyo y la atención en el hogar. Hace un llamado a los servicios de salud sexual y reproductiva para que traten los problemas de estigma y discriminación al ofrecer y realizar pruebas y consejería de VIH, y al brindar tratamiento, atención y apoyo. [ABSTRACT FROM AUTHOR]

At online internet newsgroups, members who self-identify as Giftgivers and Bugchasers post messages describing exchanging HIV as a gift, as the Gift. Using the literature on the social function of gift exchanges, this paper considers how Giftgiver and Bugchaser messages mobilize the language of gifts. In doing so, newsgroup members generate an ontological narrative wherein HIV, as the Gift, promotes social bonds, the creation and maintenance of self identity and social roles, and the meeting of particular goals. Thus the Gift appears to fulfill (at least discursively) many of the social functions of gift exchanges as described in the literature. Online newsgroups function as fora for the expression of a contrarian, transgressive HIV/AIDS narrative and act as 'carnivalesque' spaces in which normative social roles and meaning are inverted in the establishment of a realm whereby HIV becomes a gift. [ABSTRACT FROM AUTHOR]

Most sexual health education programmes use fear and risk of disease to try to motivate people to practise safer sex. This gives the impression that safer sex and pleasurable sex are mutually exclusive. Yet there is growing evidence that promoting pleasure alongside safer sex messaging can increase the consistent use of condoms and other forms of safer sex. To this end, the Pleasure Project created The Global Mapping of Pleasure, a document that identifies projects and organisations worldwide that put pleasure first in HIV prevention and sexual health promotion, and sexually provocative media that include safer sex. This article summarises some of the findings of this mapping exercise and what we learned about incorporating pleasure from it. We found that there are a variety of organisations, including religious and youth groups, and HIV/AIDS organisations and NGOs, promoting pleasurable safer sex. The techniques they use include promoting sexual techniques and dialogue about sex, teaching married couples how to have better sex and putting images of desire in sexual education materials. This paper focuses on ways of eroticising female and male condoms as examples of effective ways of using pleasure in HIV prevention and sexual health promotion. La plupart des programmes d'éducation en matière de santé génésique tablent sur la peur et le risque d'infection pour inciter les couples à se protéger lors des relations sexuelles, donnant l'impression que la protection et le plaisir s'excluent mutuellement. Pourtant, on comprend de mieux en mieux que promouvoir le plaisir avec des messages sur les relations sexuelles protégées, peut accroître l'utilisation régulière de préservatifs et d'autres formes de relations protégées. À cette fin, le Projet Plaisir a dressé la carte mondiale du plaisir qui recense les projets et les organisations qui donnent la priorité au plaisir dans la prévention du VIH et la promotion de la santé génésique, et les films érotiques avec relations sexuelles protégées. Cet article résume certaines des conclusions et des enseignements de cette initiative. Nous avons constaté que des organisations diverses, notamment des groupes religieux et de jeunes, des organisations sur le VIH/SIDA et des ONG prônent les relations sexuelles sûres et agréables. Pour cela, elles encouragent les techniques sexuelles et le dialogue sur les rapports sexuels, elles apprennent aux couples mariés à améliorer leur sexualité et introduisent des images du désir dans le matériel d'éducation sexuelle. Cet article décrit en particulier les moyens d'érotiser les préservatifs masculins et féminins, afin d'illustrer l'utilisation du plaisir dans la prévention du VIH et la promotion de la santé génésique. La mayoría de los programas de educación sexual utilizan el temor y el riesgo de enfermedades para motivar a las personas a tener sexo más seguro. Esto da la impresión de que el sexo más seguro y el sexo por placer son mutuamente exclusivos. No obstante, cada vez existen más pruebas de que la promoción del placer con los mensajes de sexo más seguro pueden aumentar el uso sistemático de los condones y otras formas de sexo más seguro. Con este fin, el Proyecto Placer creó el Mapa Mundial del Placer, un documento que identifica proyectos y organizaciones internacionales que anteponen el placer en la prevención del VIH y la promoción de la salud sexual, y medios de comunicación sexualmente provocativos que tratan sobre el sexo más seguro. En este artículo se resumen algunos hallazgos de este ejercicio y lo que se aprendió respecto a la incorporación del placer. Encontramos que una variedad de organizaciones, incluidos los grupos religiosos y de jóvenes, y ONG y organismos dedicados a la lucha contra el VIH/SIDA, promueven el sexo más seguro placentero. Algunas tácticas empleadas son promover diálogo y técnicas sexuales, enseñar a las parejas casadas cómo mejorar sus relaciones sexuales e incluir imágenes del deseo en los materiales de educación sexual. Este artículo se centra en las formas de erotizar los condones masculino y femenino como ejemplos de medios eficaces de utilizar el placer en la prevención del VIH y la promoción de la salud sexual. [ABSTRACT FROM AUTHOR]

The HIV epidemic has had major impact on men who have sex with men in China. Most current studies view male-to-male sex as a behavioural dimension or variable affecting HIV infection, paying little attention to the socio-cultural meanings of homosexuality and their impacts on men's experiences with HIV/AIDS. This oversight has impeded understanding of the health practices of this population. Based on a qualitative study of experiences of Chinese people living with HIV/AIDS, this paper explores the complex processes in which men who have sex with men struggle and negotiate with their sexuality, family obligations, and this disease. To facilitate Chinese men who have sex with men in responding effectively to HIV and AIDS, researchers and practitioners should take into account a wide range of contextual factors including desired gender roles, family obligations, homophobia, and HIV-related stigma that contribute to current constructions of 'homosexuality' in China. [ABSTRACT FROM AUTHOR]

This paper reports on an assessment of community preparedness for HIV vaccine trials in the Democratic Republic of Congo. Formative research was conducted in the capital city of Kinshasa during the period October 2003 to March 2004 to answer questions pertinent to planning trials of a preventive HIV vaccine and to identify related issues. Twenty-seven in-depth interviews and two focus groups were held with potential trial participants and community leaders. Data was collected on the subjects of vaccines, HIV/AIDS and sexual behaviour, and an HIV vaccine. The study also sought to identify factors that motivate a person to volunteer for a vaccine trial or which are disincentives to participation, along with preparedness of the larger community for trials. Personal concerns for health and for the impact of the epidemic on families and country were common motivations for participation. The danger of an experimental vaccine and the stigma of a positive HIV antibody test as the result of vaccination are major concerns and disincentives. The health, educational, and local non-governmental sectors are identified as having important roles to play in assuring preparedness for trials, although significant challenges exist to achieving community preparedness. [ABSTRACT FROM AUTHOR]

Behaviour change models in HIV prevention tend to consider that risky sexual behaviours reflect risk assessments and that by changing risk assessments behaviour can be changed. Risk assessment is however culturally constructed. Individuals use heuristics or bounded cognitive devices derived from broader cultural meaning systems to rationalize uncertainty. In this study, we identify some of the cultural heuristics used by migrant men in Goa, India to assess their risk of HIV infection from different sexual partners. Data derives from a series of in‐depth interviews and a locally informed survey. Cultural heuristics identified include visual heuristics, heuristics of gender roles, vigilance and trust. The paper argues that, for more culturally informed HIV/AIDS behaviour change interventions, knowledge of cultural heuristics is essential. [ABSTRACT FROM AUTHOR]

The paper examines the context of women's risk for HIV by assessing men's and women's sexual behaviour, attitudes towards sex work, and perception of risk for HIV in the city of Chiang Mai, Thailand. The findings are based on data collected in the mid‐1990s, at the height of the epidemic. A range of significant issues were highlighted by the men and women who participated in this study. First, some men continued to have unsafe sex with sex workers. Second, fear of HIV motivated men to seek out friends and acquaintances instead of sex workers for sexual encounters because they were considered ‘safe’ from infection. Third, women in this study were largely unaware of this expansion of the sexual network beyond the sex work itself. Lastly, women's sexuality was largely unrecognized in public health responses, or by the male and female participants, leaving them at risk for HIV. Résumé Dans cet article, l'auteur explore le contexte dans lequel la femme risque d'attraper le virus du Sida dans la ville de Chiang Mai en Thaïlande. Il examine le comportement sexuel des hommes et des femmes, leur attitude vis‐à‐vis des métiers du sexe et la perception du risque d'attraper le VIH. Ses conclusions sont tirées des données recueillies au milieu des années 90, au plus fort de l'épidémie. Les hommes et les femmes qui participèrent à cette recherche soulignèrent un certain nombre de thèmes importants. Tout d'abord, certains hommes continuaient à avoir des rapports sexuels non protégés avec des professionnelles du sexe. Deuxièmement, au lieu d'avoir recours aux professionnelles du sexe, les hommes, étant donné leur crainte du Sida, étaient conduits à chercher des partenaires sexuels parmi leurs amies et connaissances car ces personnes étaient censées ne présenter aucun danger par rapport à l'éventuelle transmission du virus. Troisièmement, les femmes qui participèrent à cette recherche ignoraient en grande partie cette extension du réseau sexuel au delà du milieu professionnel du sexe proprement dit. Enfin, la sexualité des femmes était en grande partie méconnue de ceux chargés de promouvoir la politique de santé publique; les participants hommes et femmes n'en tenaient pas compte non plus, ce qui mettait les femmes en danger d'attraper le VIH. Resumen En este artículo examino en qué contexto las mujeres corren el riesgo de contraer VIH valorando la conducta sexual de hombres y mujeres, las actitudes hacia el trabajo sexual y la percepción de riesgo de HIV en la ciudad tailandesa de Chiang Mai. Los resultados se basan en datos recopilados durante mediados de los noventa cuando la epidemia estaba en su punto más álgido. Los hombres y mujeres que participaron en este estudio destacaron una serie de cuestiones importantes. En primer lugar, algunos hombres seguían teniendo sexo arriesgado con las trabajadoras sexuales. En segundo lugar, el miedo a contraer VIH motivaba a los hombres a buscar amigas y conocidas en lugar de trabajadoras sexuales para sus encuentros amorosos porque pensaban que así estaban seguros de no infectarse. En tercer lugar, las mujeres de este estudio desconocían en gran medida la expansión de la red sexual más allá del trabajo sexual. Por último, la sexualidad de las mujeres en general no era reconocida en las respuestas de salud pública o por los participantes masculinos y femeninos, con lo que corrían el riesgo de contraer VIH. [ABSTRACT FROM AUTHOR]

Recent studies suggest that regular male partners who engage in unprotected anal intercourse (UAI) are currently at risk of HIV infection. In this paper, we try to offer a single and coherent theoretical framework to understand this profile of HIV infection. Data on transformations of intimacy in recent times, UAI and condom use between regular male partners and their correlates are reviewed. Firstly, we describe the social and historical context of modern intimate relationships. The differentiation of intimate relationships and their newfound autonomy from traditional social forces are explored to determine how they may contribute to the destabilization of intimate trajectories. Secondly, we theorize UAI as an attempt to stabilize intimate relationships and a strategy to reaffirm mutual trust, desire and intimacy between regular male partners. The impacts of such an approach to social vulnerability and HIV prevention are also discussed. Résumé Des études récentes suggèrent que les relations anales non protégées entre partenaires masculins réguliers, et non plus uniquement celles entre partenaires occasionnels, constituent un facteur de risque de séroconversion au VIH. Dans cet article, nous proposons une lecture sociologique de la vulnérabilité sociale au VIH qui met l'accent sur la quéte d'intimité entre les partenaires réguliers comme facteur de vulnérabilité. En résumé, nous proposons que le processus de différenciation et d'autonomisation des relations intimes à l'égard des déterminants sociaux traditionnels notamment liés à la stratification a contribué à rendre instables les trajectoires intimes, qui deviennent plus difficiles à initier et à faire durer. Nous théorisons la prise de risques sexuels comme une tentative de stabilisation de la relation intime et une réitération de la confiance mutuelle. Les impacts d'une telle approche de la vulnérabilité sociale au pour la prévention sont discutés. Resumen Según los recientes estudios, los hombres que tienen relaciones anales sin protección, no solo con compañeros ocasionales sino también con parejas sexuales estables, corren el riesgo de infectarse con el virus de inmunodeficiencia humana (VIH). En este artículo, proponemos una lectura sociológica de la vulnerabilidad social frente al VIH, el cual hace un énfasis sobre la intimidad entre parejas estables como factor de riesgo. Asimismo, analizaremos las diferencias entre las relaciones íntimas y su nueva autonomía lejos de las fuerzas sociales tradicionales, a fin de determinar como podrían éstas contribuir a desestabilizar las trayectorias de la pareja con respecto a la intimidad. De otra parte, suponemos que el no uso del preservativo en las relaciones anales es empleado como una manera de afianzar las relaciones de pareja, y al mismo tiempo, este tipo de estrategia es utilizado para reafirmar la fidelidad mutua entre homosexuales con relaciones estables. Las repercusiones de este planteamiento, en cuanto a la vulnerabilidad social y la prevención del VIH, serán discutidas a lo largo del artículo. [ABSTRACT FROM AUTHOR]

This paper reports on a study of the relationship of homophobia to HIV/AIDS-related stigma in Jamaica. Ethnography, key informant interviews and focus groups were used to gather data from a sample of 33 male and female adults during the summer of 2003. The sample included health and social service providers, HIV positive men and women, and men and women with same sex partners in urban and rural Jamaica. A strong and consistent relationship between homophobia and HIV/AIDS-related stigma was reported, but the relationship varied according to geographic location, social class, gender, and skin colour (complexion)—to the extent that this coincided with class. Stigma against people living with HIV/AIDS and homosexuality was implicated in low levels of use of HIV testing, treatment and care services and the reluctance of HIV positive people to reveal their serostatus to their sexual partners. Data reveal a pressing need for anti-stigma measures for both homophobia and HIV/AIDS, and for training for health and human service professionals. [ABSTRACT FROM AUTHOR]

Despite important advances in expanding access to antiretroviral therapy in the countries most heavily affected by HIV/AIDS, there has been little consideration of the connections between HIV prevention, care and treatment programmes and reproductive health services. In this paper, we explore the integration of reproductive health services into HIV care and treatment programmes. We review the design and progress of the MTCT-Plus Initiative, which provides HIV care and treatment services to HIV positive women as well as their HIV positive children and partners. By emphasising the long-term follow-up of families and the provision of comprehensive care across the spectrum of HIV disease, MTCT-Plus highlights the potential synergies in linking reproductive health services to HIV care and treatment programmes. While HIV care and treatment programmes in resource-limited settings may not be able to integrate all reproductive health services into a single service delivery model, there is a clear need to include basic reproductive health services, such as access to appropriate contraception and counselling and management of unplanned pregnancies. The integration of these services would be facilitated by greater insight into the reproductive choices of HIV positive women and men, and into how health care providers influence access to reproductive health services of people with HIV and AIDS. Malgré une amélioration de l'accès à la thérapie antirétrovirale dans les pays les plus touchés par le VIH/SIDA, les liens entre les programmes de prévention, soins et traitement du VIH et les services de santé génésique n'ont guère été étudiés. Dans cet article, nous examinons l'intégration des services de santé génésique dans les programmes de soins et traitement du VIH. Nous analysons la conception et les progrès de l'Initiative PTME-Plus, qui assure des services de soins et traitement aux femmes séropositives ainsi qu'à leurs enfants et partenaires infectés. En privilégiant le suivi familial à long terme et les soins complets à tous les stades de l'infection, PTME-Plus souligne les synergies déclenchées en liant les services de santé génésique avec les programmes de soins et traitement du VIH. Si dans les environnements à ressources limitées, ces programmes ne peuvent pas toujours intégrer tous les services de santé génésique en un modèle unique de services, il faut néanmoins y inclure des services de santé génésique de base, comme l'accès à une contraception adaptée et des consultations, et la gestion des grossesses non désirées. L'intégration de ces services serait facilitée par une meilleure connaissance des choix génésiques offerts aux femmes et aux hommes séropositifs, et de l'influence des prestataires de soins de santé sur l'accès des séropositifs aux services de santé génésique. Pese a los importantes avances en la ampliación del acceso a la terapia antirretroviral en los países más afectados por el VIH/SIDA, no se ha pensado mucho en las conexiones entre los programas de prevención, atención y tratamiento del VIH, y los servicios de salud reproductiva. En este artículo, exploramos la integración de estos ãltimos a los programas de atención y tratamiento del VIH. Revisamos el diseño y los avances de la Iniciativa MTCT-Plus, que proporciona servicios de atención y tratamiento del VIH a las mujeres VIH-positivas, sus hijos y sus parejas VIH-positivos. Al dar énfasis al seguimiento de las familias a largo plazo y a la provisión de atención integral en todo el espectro de la enfermedad del VIH, la MTCT-Plus destaca las posibles sinergias en vincular los servicios de salud reproductiva a los programas de atención y tratamiento del VIH. Aunque es posible que, en ámbitos con pocos recursos, estos programas no logren integrar todos los servicios de salud reproductiva a un solo modelo de prestación de servicios, indudablemente es necesario incluir los servicios esenciales de salud reproductiva, como el acceso a anticonceptivos y consejería apropiada y el manejo de embarazos no planeados. La integración de estos servicios se facilitaría al tener más conocimiento sobre las decisiones reproductivas de las mujeres y los hombres VIH-positivos, y sobre cómo los profesionales de la salud influyen en el acceso de las personas con VIH/SIDA a los servicios de salud reproductiva. [ABSTRACT FROM AUTHOR]

Studies of female sexuality in Africa tend to adopt an instrumental approach, many times problematizing sexual conduct in relation to HIV infection and/or reproduction. This study aimed to explore sexuality as a relational concept. Using interviews and participant observation, the paper shows how sexuality becomes a point of self-identification for young professional women in Nairobi between 20 and 30 years-old. These women form a group who implicitly and explicitly criticize conventional gender roles through the overt pursuit of sexual pleasure as recognition of their womanhood. This aspect of the feminine sense of self is at odds with normative notions of femininity. To avoid criticism for being ‘un-proper’, women adopt a deferential attitude towards men. The focus on upwardly mobile professional women and their experiments with new types of heterosexual relations in dating provides insight into both sexuality and gender. [ABSTRACT FROM AUTHOR]

This paper examines the intellectual and social origins of racialist homophobia in contemporary Zimbabwean political discourse, exemplified by President Robert Mugabe's anti-homosexual speeches since the mid-1990s. It challenges the notions that such homophobia is either essential to African patriarchy or simple political opportunism. Tracing overt expressions of intolerance towards male-male sexuality back to the colonial period, it focuses on ways in which notions of appropriate, respectable, exclusive heterosexuality within the ‘cowboy’ culture of White Southern Rhodesia trickled into, or were interpreted in, the African nationalist movement. It concludes that understanding this history could improve efforts to address concerns around sexual health in Zimbabwe and elsewhere in the region, particularly silences around same-sex sexuality in HIV/AIDS education and prevention. [ABSTRACT FROM AUTHOR]

Examines how the medical community has manipulated medical knowledge about AIDS and how the manipulation enhanced social control over transgender sex workers in San Juan, Puerto Rico. History and definition of AIDS; Influence of transnational pharmaceutical corporations on scientists working on AIDS; Censorship of papers opposing the traditional AIDS science.

After years of passionate advocacy informed by solid policy work on the ground, the global response to HIV/AIDS is better resourced. Poor countries can absorb considerably higher levels of aid than they currently receive, but recent increases in funding have generated a number of concerns. This paper analyses the capacity of NGOs, community-based organisations and governments to ensure that the influx of funds has a significant effect on the HIV epidemic and people's lives. Limited absorptive capacity may be an obstacle to the uptake of funding. To avoid community-based organisations being over-stretched by AIDS and to ensure capacity is maintained, HIV-positive staff must be enabled to continue their work through access to antiretroviral therapy and related services. Equally challenging, given that donors are increasingly using governments as intermediaries to fund civil society organisations, is increasing the capacity of developing country governments to disburse funds effectively. If donors do not accept that governments and civil society organisations need technical support in order to accept, distribute and account for increases in funding, there is a danger that home-grown responses will be replaced with imported solutions. The community sector is the glue that holds responses to HIV/AIDS together; now it needs to adapt to new partnerships with government and other emerging HIV/AIDS service providers. Après des années de plaidoyer passionné fondé sur un solide travail politique sur le terrain, la lutte mondiale contre le VIH/SIDA dispose de meilleures ressources. Les pays pauvres peuvent absorber des niveaux nettement plus élevés d'assistance, mais les accroissements récents du financement ont suscité certaines préoccupations. L'article analyse la capacité des ONG, des organisations à assise communautaire et des gouvernements de s'assurer que l'afflux de fonds améliore sensiblement la lutte contre l'épidémie et la vie de la population. Une capacité d'absorption limitée peut s'opposer à l'accroissement du financement. Pour éviter que les organisations communautaires ne soient mises à rude épreuve par le SIDA, et pour garantir le maintien de la capacité, le personnel séropositif doit continuer à travailler grâce à l'accès à la thérapie antirétrovirale et aux services liés. Tout aussi difficile, étant donné que les donateurs utilisent de plus en plus les gouvernements comme intermédiaires pour financer les organisations de la société civile, il convient d'accroı̂tre la capacité des gouvernements des pays en développement d'allouer efficacement les fonds. Si les donateurs ne reconnaissent pas que les gouvernements et les organisations de la société civile requièrent un appui technique pour accepter, distribuer et comptabiliser les hausses de financement, les solutions nationales risquent d'être remplacées par des approches importées. Le secteur communautaire assure la cohésion des réponses au VIH/SIDA ; il doit s'adapter aux nouveaux partenariats avec les pouvoirs publics et d'autres prestataires de services émergents en matière de VIH/SIDA. Después de años de realizar vehementes esfuerzos de gestorı́a y defensa informados por medio de un trabajo sólido de formulación de polı́ticas en este tema, la respuesta mundial al VIH/SIDA cuenta con mejores recursos. Los paı́ses pobres pueden asimilar niveles de ayuda financiera considerablemente más altos de los que reciben actualmente, pero los recientes aumentos en el financiamiento han generado varias inquietudes. En este artı́culo se analiza la capacidad de las ONG, las organizaciones comunitarias y los gobiernos de garantizar que el flujo de fondos tenga un efecto significativo sobre la epidemia del VIH y la vida de las personas. Una capacidad limitada de asimilación puede ser un obstáculo a la captación de financiamiento. Para evitar que las organizaciones comunitarias se extralimiten por el SIDA y para garantizar que se mantenga la capacidad, se debe facultar al personal VIH-positivo para que continúe su trabajo mediante el acceso a la terapia antirretroviral y a los servicios complementarios. Igual de desafiante, dado que los donantes emplean cada vez más a los gobiernos como intermediarios para financiar a las organizaciones de la sociedad civil, es aumentar la capacidad de crear gobiernos en cada paı́s con el fin de desembolsar los fondos de manera eficaz. Si los donantes no aceptan el hecho de que los gobiernos y las organizaciones de la sociedad civil necesitan apoyo técnico para poder aceptar, distribuir y explicar los aumentos en el financiamiento, existe el peligro que las respuestas formuladas a nivel local se sustituyan con soluciones importadas. El sector comunitario es el elemento que mantiene unidas las respuestas al VIH/SIDA; y ahora necesita adaptarse a las nuevas alianzas con el gobierno y a otros prestadores de servicios de VIH/SIDA emergentes. [ABSTRACT FROM AUTHOR]

In Nigeria, popular understandings of HIV/AIDS and individual risk assessment and behaviour unfold within an interpretative grid that draws on a religious moral framework. This paper reports results from a two-year study of HIV/AIDS-related beliefs and behaviour among adolescent and young adult rural-urban migrants in two Nigerian cities. The young people in the study originate from south-eastern Nigeria; they almost uniformly identify themselves as Christian; and they commonly situate their understandings and explain their behaviours in response to the HIV/AIDS epidemic in terms of religion, especially in relation to the increasingly popular and dominant religious discourses of evangelical and Pentecostal Christianity. Findings suggest that popular religious interpretations of HIV risk pose real dangers, leading many young migrants to imagine themselves as at little or no risk, and contributing to inconsistent protective practices. The study highlights the limitations of intervention strategies that ignore the extent to which religion, health, sexuality and morality intersect in people's everyday lives. [ABSTRACT FROM AUTHOR]

Sex workers in Kerala, India, live in a coercive environment and face violence from the police and criminals, lack of shelter, lack of childcare support and have many physical and mental health problems. This paper documents the environment in which women have been selling sex in Kerala since 1995, and their efforts to claim their rights. It is based on sex workers'' own reports and experiences, a situation analysis and a needs assessment study by the Foundation for Integrated Research in Mental Health. Involvement in HIV/AIDS prevention projects first gave sex workers in Kerala an opportunity to come together. Some have become peer educators and distribute condoms but they continue to be harassed by police. Most anti-trafficking interventions, including rescue and rehabilitation, either criminalise or victimise sex workers, and sex workers reject them as a solution to sex work. They understand that the lack of sexual fulfillment in other relationships and their own lack of access to other work and resources are the reasons why commercial sex flourishes. Sex workers are not mere victims without agency. They have a right to bodily integrity, pleasure, livelihood, self-determination and a safe working environment. Sex workers are organising themselves for these objectives and demand decriminalisation of sex work. [Copyright &y& Elsevier]

Early sexual debut and premarital sex are increasingly common features of female adolescence in Kenya--putting girls at the risk of unwanted pregnancy and infection by sexually transmitted infections and HIV/AIDS. Levels of knowledge concerning the protective value of condoms and other contraceptives are high, but unprotected sex is still common. Against this background, this paper examines the strategies used by young women to deal with these risks. Qualitative data were obtained from eight focus group discussions conducted with school attending girls aged between 15 and 19 years in Makueni District of Eastern Kenya. Findings suggest that, despite knowledge of the protective value of condoms and other contraceptives, the use of these methods by girls is hampered by inability to access them, the fear of the side effects of contraceptives, and the desire by girls to remain faithful to their religious calling. Most girls also resort to the use of traditional methods such whose potency and efficacy is unproven. These findings suggest the need to make condoms more easily accessible to girls in rural areas, and also for education in the proper use of 'natural' family planning methods. Young women may also benefit from training in how to be more assertive in sexual negotiations. [ABSTRACT FROM AUTHOR]

There has been little research into how the diverse cultures within Papua New Guinea interpret, represent and understand the HIV/AIDS epidemic. Using qualitative ethnographic research, this study examines how incoming ideas about AIDS relate to the existing cultural frameworks of a rural Christian community. Although L, elet respondents in New Ireland have recourse to indigenous conceptions, apocalyptic Christianity is the most influential framework in their understanding of AIDS. Two interconnected issues are examined: how the epidemic is understood in apocalyptic terms, and how this affects practical approach to the disease. The paper indicates a need for more research into the stances taken by different Christian groups towards HIV/AIDS. This is especially important in the Pacific, where Christianity is the dominant worldview and where there has been a rapid spread of apocalyptic forms of Christianity, which may have particularly significant consequences for the epidemic. [ABSTRACT FROM AUTHOR]

The Global Fund to Fight AIDS offers great promise as an instrument of global action to address the devastating effects of the disease. Yet the enormity of its promise also speaks to the scope of its mission: to facilitate the financing by governments, corporations, philanthropical bodies and individuals of a massive effort to address the epidemic that has to date outpaced previous efforts at effective control. A key challenge is to devise a governance structure that makes effective action likely, satisfies donors, responds efficiently, and produces observable results. By examining recent developments, this paper seeks to outline facets of the governance challenge facing the Global AIDS Fund. [ABSTRACT FROM AUTHOR]

This paper explores the obstacles and opportunities experienced by a diverse group of persons living with HIV and AIDS in accessing medical and social services. A social networks approach is used to analyse data from 56 in-depth interviews conducted with persons living with HIV and AIDS in Orange County, California. From this analysis, the service pathways by White/Caucasian gay men, Latina/Hispanic women who speak only Spanish, and injecting drug users of diverse ethnicities are used to illustrate the influence of race/ethnicity, gender, and sexual orientation on service access. Implications for service provision and future research are discussed. [ABSTRACT FROM AUTHOR]

Using data from research in Zambia, and drawing on the broader literature on HIV/AIDS, reproductive health, and gender, this paper examines the difficulties faced by women who wish - or are pressured - to have children, but at the same time want to protect themselves and their children against HIV infection. [ABSTRACT FROM AUTHOR]

The fertility-stimulating effect of high rates of child mortality on reproductive decision making (RDM) is a central tenet of population studies, yet the effects of the HIV/AIDS epidemic on RDM have not been thoroughly explored in the literature. This paper investigates how RDM is articulated in the context of high HIV/AIDS prevalence in Zimbabwe. Using qualitative methods (35 focus groups and 46 in-depth interviews), we found that childbearing is extremely important in the lives of adult Zimbabweans and that children are needed to cement the couple's relationship, whether it is the first or subsequent marriage. Most respondents said that rates of both adult and child mortality were greatly increasing due to the AIDS epidemic. However, contrary to expectations based upon the insurance strategy, most respondents said that they would have fewer children as a result of the perceived increase in child mortality. They were also hesitant to continue childbearing after a child death, indicating only weak replacement motivation. Instead, many respondents expressed the desire to limit family size due to concerns about their own mortality and its negative effects on their children. Furthermore, new reproductive strategies seem to be emerging, which focus upon the health of parents and child and are based upon perceptions of 100 per cent maternal-infant HIV transmission. Adult HIV status is linked to child survival as respondents explained that having a healthy child who survives to age five indicates that the parents are also free of the virus and, at this point, they can safely continue childbearing. Additionally, couples who have experienced the death of a child are hesitant to give birth again because they believe future children would die. Finally, there was some talk of having children early in an attempt to avoid contracting HIV. This study presents evidence that Zimbabweans are altering their reproductive strategies in order to protect both parents and children from the threat of AIDS. [ABSTRACT FROM AUTHOR]