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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]

Introduction The HIV/AIDS prevention program among pregnant mothers aims to reduce the risk of HIV transmission from mother to baby. It also aims to reduce stigma and discrimination, as well as deaths due to HIV/AIDS. This paper aimed to find out obstacles that occur in the implementation of HIV/AIDS transmission program in Indonesia. Methods Online literature search was done on Google Scholar, Science Direct and PubMed databases with the keywords related to “HIV/AIDS” and transmission prevention program among mothers to children. The search resulted in a total of 343 articles. Results After the abstracts were reviewed, there were only 16 articles selected. Conclusions The implementation of the program in Indonesia has been run but is not yet optimal because of several obstacles i.e., the insufficient number of health workers and poor knowledge of health workers. Figuring out solutions to the obstacles could ease the program implementation to reduce the cases of HIV/AIDS. Obstacles were found in the implementation of the HIV/AIDS prevention program among mothers and children in Indonesia. [ABSTRACT FROM AUTHOR]

Mitigating the impacts of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) and substance use requires comprehensive and systematic thinking in designing interventions and developing policies. This study describes the growth of research publications from 1991 to 2021 in the Web of Science database and points out current research landscapes in the fields of HIV/AIDS and substance use. Latent Dirichlet Allocation was used for classifying 21 359 papers into corresponding topics. The most common topics were HIV transmission, HIV infection, quality of life and mental health of substance users, and the biomedical effect of substance use. Emerging research landscapes include vulnerabilities of people who inject drugs to HIV transmission and related health problems. This study found a lack of research on health services, interdisciplinary and inter-sectoral in combination with clinical evaluation and treatment services. Future investment and implementation of HIV/AIDS and substance use programs should focus on research of health services and clinical evaluation, especially context-specific interventions. [ABSTRACT FROM AUTHOR]

Mitigating the impacts of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) and substance use requires comprehensive and systematic thinking in designing interventions and developing policies. This study describes the growth of research publications from 1991 to 2021 in the Web of Science database and points out current research landscapes in the fields of HIV/AIDS and substance use. Latent Dirichlet Allocation was used for classifying 21 359 papers into corresponding topics. The most common topics were HIV transmission, HIV infection, quality of life and mental health of substance users, and the biomedical effect of substance use. Emerging research landscapes include vulnerabilities of people who inject drugs to HIV transmission and related health problems. This study found a lack of research on health services, interdisciplinary and inter-sectoral in combination with clinical evaluation and treatment services. Future investment and implementation of HIV/AIDS and substance use programs should focus on research of health services and clinical evaluation, especially context-specific interventions. [ABSTRACT FROM AUTHOR]

Taking into account the effects of the heterogeneity of the population and media coverage on disease transmission, in this paper, a hybrid HIV/AIDS model with age-structure, self-protection awareness and media coverage is formulated, which is made up of five partial differential equations (PDEs) and one ordinary differential equation (ODE). We establish the existence of the solution associated with the hybrid system and prove that the solution is unique, bounded and positive utilizing the semigroup approach. Based on the basic reproduction number R 0 , the threshold dynamics of this model are rigorously investigated, that is, there always is a unique disease-free steady state E 0 and it is globally stable when R 0 < 1 , that is, the disease dies out. Further, there exists a unique endemic steady state E * and it is locally stable when R 0 > 1 and some additional technical conditions are met. In addition, the uniform persistence of this hybrid system is demonstrated for R 0 > 1 , which means that the disease remains at the endemic level for a long time, which is not discussed in other age-structured infectious disease articles. Numerical simulations are also given to explain the main theoretical results, which suggest that age variability is a non-negligible factor in HIV/AIDS transmission, that is, the moment and scale of HIV/AIDS outbreaks are diverse for people of different ages, and media coverage can encourage people to take steps to avoid potential infection and control the spread of the disease. [ABSTRACT FROM AUTHOR]

South Africa possesses the largest anti-retroviral therapy (ART) program in the world, but the path to this record was dramatic. There is scarce literature employing a comprehensive framework to explain this achievement and inform epidemic responses. This paper applies the Advocacy Coalition Framework (ACF) to analyse the interactions among diverse actors, institutions and networks that were associated with the AIDS policy change in South Africa. Post-apartheid, HIV/AIDS and AIDS-related mortality were serious public health problems. At the time, the discernible coalitions in the HIV/AIDS policy subsystem were the pro-science coalition and AIDS dissidents. In view of the availability of compelling scientific evidence on the pathogenesis of HIV/AIDS, the clinical usefulness of ART, the availability of funding for national ART roll-out, strong global advocacy to reduce the cost of ART, all of these in an era when access to adequate HIV treatment/care was increasingly considered a human right, the environment to establish an appropriate HIV/AIDS policy for the country was conducive. However, AIDS dissidents dominated the policy agenda via their control over key institutions, the use of various dimensions of power, biasing evidence to inform policy, and promoting the activities of strong interest groups that were not in support of ART. National ART roll-out finally emerged as a political priority because of external shocks (on the AIDS policy subsystem) which disfavoured the dominant coalition. As in this important experience in the history of HIV treatment, stakeholders involved in epidemic response tend to engage in intense ideological conflicts. An adequate appraisal of the outcomes of these conflicts in terms of population health gains and adopted public health and social measures to control epidemics would require the supplementation of complex system thinking with relevant public policy concepts, notably power dimensions, governance, emergence of global health networks and evidence use in policy. [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]

Background: The rapid decrease in international funding for HIV/AIDS has been challenging for many nations to effectively mobilize and allocate their limited resources for HIV/AIDS programs. Economic evaluations can help inform decisions and strategic planning. This study aims to examine the trends and patterns in economic evaluation studies in the field of HIV/AIDS and determine their research landscapes.Methods: Using the Web of Science databases, we synthesized the number of papers and citations on HIV/AIDS and economic evaluation from 1990 to 2017. Collaborations between authors and countries, networks of keywords and research topics were visualized using frequency of co-occurrence and Jaccards' similarity index. A Latent Dirichlet Allocation (LDA) analysis to categorize papers into different topics/themes.Results: A total of 372 economic evaluation papers were selected, including 351 cost-effectiveness analyses (CEA), 11 cost-utility analyses (CUA), 12 cost-benefit analyses (CBA). The growth of publications, their citations and usages have increased remarkably over the years. Major research topics in economic evaluation studies consisted of antiretroviral therapy (ART) initiation and treatment; drug use prevention interventions and prevention of mother-to-child transmission interventions. Moreover, lack of contextualized evidence was found in specific settings with high burden HIV epidemics, as well as emerging most-at-risk populations such as trans-genders or migrants.Conclusion: This study highlights the knowledge and geographical discrepancies in HIV/AIDS economic evaluation literature. Future research directions are also informed for advancing economic evaluation in HIV/AIDS research. [ABSTRACT FROM AUTHOR]

In the epidemic era of HIV/AIDS, sexually transmitted infections (STIs) are one the most common identifiable health challenges globally. The paper attempts to take account of and understand the incidence of sexually transmitted infections (and HIV/AIDS) in Arunachal Pradesh, the largest state in North East, India. The study reveals high STI cases in the state; and the districts recorded the high cases of STIs includes West Kameng (781 cases), East Siang (7113) and Changlang (642 cases) in 2012-13 and Papum Pare (683 cases) and West Kameng (593 cases) in 2013-14. All this reflects the deficit of knowledge for protecting and preventing oneself from these preventable STI cases. The study underscores the importance of promoting knowledge and awareness of STIs and particularly of HIV/AIDS amongst the youth of the state. [ABSTRACT FROM AUTHOR]

Background: Before 2014 (the year of closure of the two largest needle exchange programs in Hungary, which halved the number of available syringes in the country despite increased injecting risk practices) no HIV was reportedly acquired in Hungary among people who inject drugs (PWIDs) who were not also men who had sex with other men (MSM). In 2014, one and in 2015 two non-MSM PWIDs were newly diagnosed with HIV who supposedly became infected in Hungary, and both incident HIV cases in 2015 were diagnosed in the AIDS stage. In addition, two new (albeit supposedly imported) non-MSM PWID cases were also registered in the first three quarters of 2016, one of which subsequently was diagnosed with and then died of AIDS. At the same time, the prevalence of HCV doubled among PWIDs (from 24% to 49% in Hungary and from 34% to 61% in Budapest). Case presentation: The case that we discuss in this paper is a male PWID, who was diagnosed with HIV and AIDS in May of 2015 and then died of AIDS the next month. His HIV infection status was detected with delay, and then appeared in the official statistics as an incident PWID HIV case and an incident PWID AIDS case, but not as an incident PWID AIDS death. No contact tracing followed, even though it would have been relatively easy considering the circumstances. To our knowledge, no HIV post-exposure protocol exists in hospitals, in case of HIV exposure due to an eventual needle-stick injury. Conclusions: Our paper draws attention to recently published HIV and AIDS surveillance data, and shows the failure of the system. While sounding the alarm based on three newly detected PWID HIV cases in the past 2 years may be premature, there are definitely serious problems in the HIV detection and tracing system among PWIDs in Hungary. [ABSTRACT FROM AUTHOR]

Background: A gender gap exists in knowledge regarding persons living with HIV/AIDS in Ghana. Women living with HIV/AIDS (WLHIV) greatly outnumber males living with HIV/AIDS (MLHIV) in Ghana and Sub-Saharan Africa generally. This necessitates more gender-nuanced evidence-based information on HIV/AIDS to guide individuals, healthcare workers, and other stakeholders in Ghana particularly. This paper undertook a gender-focused analysis of the experiences of WLHIV and MLHIV in a municipal area in Ghana which has been most impacted by HIV/AIDS.Methods: In-depth interviews of 38 HIV-positive persons recruited using combined purposive and random sampling for one month, were tape recorded and analyzed using thematic content analysis. Participants were out-patients who were receiving routine care for co-morbidities at two specially equipped HIV/AIDS Voluntary Counseling and Testing Centers in the Lower Manya Krobo Municipality (LMKM), Eastern Region, Ghana.Results: Our data yielded three major themes: characteristics of participants, health status and health seeking behavior, and challenges encountered living with HIV/AIDS. Except for feeling of sadness due to their HIV/AIDS-positive status, there were significant differences in the experiences of MLHIV, compared to WLHIV. WLHIV were more likely to be housing insecure, unemployed due mostly to stigmatization/self-stigmatization, less likely to have revealed their HIV-positive status to multiple family members, and had more profound challenges regarding their healthcare. Most MLHIV expected, demanded, and had support from their wives; WLHIV were mostly single-never married, divorced or widowed (mostly due to HIV/AIDS). The vast majority of WLHIV complained of near-abject poverty, including for most of them, lack of food for taking their anti-retroviral medicines and/or taking it on time.Conclusions: The experiences of the MLHIV and WLHIV with living and coping with the virus mostly differed. These experiences were unequivocally shaped by differential socio-cultural tenets and gendered nuances; WLHIV had more negative experiences. Public education on the extra burden of HIV/AIDS on WLHIV, more social support, and affirmative action in policy decisions in favor of WLHIV in the study district are needed to seek public sympathy and improve health outcomes and livelihoods of WLHIV particularly. Further studies using multiple sites to explore these differences are warranted. [ABSTRACT FROM AUTHOR]

Objectives: Nigeria has the second largest number of adolescents and young people living with HIV/AIDS in the world. Misconceptions about HIV/AIDS contribute to spread of HIV, and constrain uptake of preventive services. This paper explored misconceptions about HIV/AIDS among adolescents in south-east Nigeria. A qualitative study was conducted in six urban and rural local government areas of Ebonyi state. Data were collected through twelve focus group discussions (FGD) with unmarried adolescents aged 13–18 who were either attending school or out-of-school. The FGDs were conducted using a pre-tested topic guide. Data were coded manually and analyzed using a thematic framework approach. Results: There are persistent misconceptions about transmission of HIV/AIDS through mosquito bites and sharing of personal belongings. Some adolescents had inaccurate notions that a HIV infected person could be identified through changes in physical features such as abdominal swelling and longer fingernails. A few of them also reported that HIV could be treated with antibiotics. These misconceptions were expressed by both male and female adolescents. Adolescents have some mistaken beliefs about HIV/AIDS which constrain them from taking necessary preventive measures. Hence, the need to target adolescents with health education interventions on HIV/AIDS. [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]

Background: There have been only limited studies assessing the economic burden of HIV/AIDS in terms of direct costs, and there has been no published study related to productivity costs in Nepal. Therefore, this study explores in detail the economic burden of HIV/AIDS, including direct costs and productivity costs. This paper focuses on the direct costs of seeking treatment, productivity costs, and related factors affecting direct costs, and productivity costs.Methods: This study was a cross-sectional, quantitative study. The primary data were collected through a structured face-to-face survey from 415 people living with HIV/AIDS (PLHIV). The study was conducted in six representative treatment centres of six districts of Nepal. The data analysis regarding the economic burden (direct costs and productivity costs) was performed from the household's perspective. Descriptive statistics have been used, and regression analyses were applied to examine the extent, nature and determinants of the burden of the disease, and its correlations.Results: Average total costs due to HIV/AIDS (the sum of average total direct and average productivity costs before adjustment for coping strategies) were Nepalese Rupees (NRs) 2233 per month (US$ 30.2/month), which was 28.5% of the sample households' average monthly income. The average total direct costs for seeking HIV/AIDS treatment were NRs 1512 (US$ 20.4), and average productivity costs (before adjustment for coping strategies) were NRs 721 (US$ 9.7). The average monthly productivity losses (before adjustment for coping strategies) were 5.05 days per person. The major determinants for the direct costs were household income, occupation, health status of respondents, respondents accompanied or not, and study district. Health status of respondents, ethnicity, sexual orientation and study district were important determinants for productivity costs.Conclusions: The study concluded that HIV/AIDS has caused a significant economic burden for PLHIV and their families in Nepal. The study has a number of policy implications for different stakeholders. Provision of social support and income generating programmes to HIV-affected individuals and their families, and decentralising treatment services in each district seem to be viable solutions to reduce the economic burden of HIV-affected individuals and households. [ABSTRACT FROM AUTHOR]

Health information activities essentially are geared towards raising people's awareness on good health and holistic living, thereby reducing the risks of opportunistic illness. In this regard, a related health promotional activity was undertaken in four local communities in Southern Nigeria. The purpose was gingered by the compelling efforts made by various government bodies and NGOs to curb the scourging HIV/AIDS pandemic, particularly in local communities. This Paper is therefore based on a three-day health and legal information outreach programme spearheaded by this author as a volunteer librarian in one of the communities. Planning and implementation of this endeavour undertook participatory approach with beneficiaries being predominantly youths, in cognizance to their 'reachability'. Team work makes effort worthwhile, as such some NGOs and faith-based groups collaborated, in addition to the village head (chief) of host community. High point of this activity was massive and voluntary HIV/AIDS screening which prior to the health information awareness programme, was dreaded. [ABSTRACT FROM AUTHOR]

This paper examines the dynamics of condom policymaking in Malawi by analyzing debates, which took place in the Malawi National Assembly between the year 2000 and 2004. Using content analysis and key informant interviews, and situating the overall discussion within policy and science literature, we examine how scientific evidence is being applied in the policymaking process as it relates to the place of condoms within the context of HIV/AIDS prevention. The study not only shows the extent to which the policymaking process on condoms in Malawi largely embodies a tendency to blur the conventional divide between science and politics, but also demonstrates why controversy around condoms still persists at the highest level of government in a country with one of the highest HIV prevalence rates in the world. It was found that even when people are dying, consensus in HIV/AIDS policymaking can be difficult to achieve in a policy climate characterized by a binary perspective to social problems, and where different actors compete for control over the policy terrain. The paper makes recommendations that may be helpful in facilitating a more inclusive HIV/AIDS policymaking process in Malawi. [ABSTRACT FROM AUTHOR]

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 reflects on the institutional mechanisms that are employed for passing on federal funds to non-governmental organizations (NGOs) on a regular basis, when they are considered as being the executors of public policies. Starting from a theoretical reference point that analyses the relationship between the Government and NGOs in the provision of public services and the creation of the Single Health System (SUS) the contractual system of the national policy for fighting HIV/Aids, which was implemented by the initially centralized National STD/Aids Program and which over the last few years has involved states and municipalities in a more intense way, is described. The paper compares the centralized and decentralized systems and indicates the difficulties encountered in this transition. Documents were analyzed that set out the rules for the passing on of funds to NGOs under the Government's HIV/Aids policy and federal managers and members of NGOs were interviewed. The conclusion reached is that the federal model has institutionalized the support for NGO projects and that this system entered a new phase that started with decentralization. [ABSTRACT FROM AUTHOR]

Research is commonly evaluated through an analysis of research outputs (i.e. theses and dissertations, papers in scholarly journals and conference proceedings, etc.) and research outcomes (i.e. new discoveries, Nobel prize winners, graduating students, new developments of drugs. etc.) using research units (e.g. persons or bodies responsible, sources in which the findings are published, medium of communication, nature of information conveyed, timing and frequency with which information is conveyed, amount of information conveyed, etc). Some of the methods of research evaluation that have been proposed and are commonly used include peer-review and informetric approaches. This paper reports findings of an informetric study of HIV/AIDS literature published by and on Eastern and Southern Africa in order to find out the number of countries engaged in the publication of HIV/AIDS literature: the most productive authors, institutions and countries; and the countries in which the literature is published. A comparison is made between regional (i.e. African) and foreign (or international) productivity. Results indicate that foreign authorship dominates the scene and that majority of the publications are published in foreign countries. The implications of this pattern of publication for researchers based in Africa are discussed. Finally, recommendations based on the findings are provided. [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 locates NGOs dealing with HIV/AIDS problems in sub-Saharan Africa into the larger governance context within which they function. This aims at a theoretical shift to assess the aspirational characteristics for the agency of NGOs that are used to legitimate contracting out implementation of internationally designed HIV/AIDS policies to these organizations. The paper interrogates the nature and impact of the governance structure on NGOs and then looks at the implications of this for HIV/AIDS. The questioning is based on a juxtaposition of the perspective of international policy fora in relation to civil society organizations with the way NGO work is perceived by the people at the receiving end of the policies. The paper suggests that as part of the international governance structure, NGOs are limited within the policy frameworks created by this structure. Furthermore, due to their organizational characteristics, NGOs lack capacity to establish sustainable long-term interventions relevant for sociocultural change as perceived by people themselves. [ABSTRACT FROM AUTHOR]

The main goal of this article is to exhibit the importance of awareness programs and travel-blocking operations, in the prevention of HIV/AIDS outbreaks, based on a multi-domains SIR epidemic model. The model devised describes the spatial-temporal spread of HIV/AIDS, in p neighboring domains, taking into account the epidemiological diversity of their populations. For a first case of the study, we focus on discussing the benefits of awareness campaigns that aim to raise public consciousness among susceptible people, about the danger of HIV/AIDS. Thus, for the reason that intra-domains interventions are not always sufficient to prevent people belonging to a domain (neighborhood, town or city for example), from a rapid expansion of HIV/AIDS, we propose the travel-blocking strategy, as a second approach presenting inter-domains interventions that health-policy makers could follow, by restricting the number of suspicious people that can participate in spreading HIV/AIDS via travel, coming from domains at high-risk of infection to enter domains with lower risk. The optimal control theory, based on Pontryagin's maximum principle, is applied twice in this paper, for the characterizations of the awareness and travel-blocking controls. The numerical results associated to the multi-points boundary value problems are obtained based on the Forward-Backward Sweep Method combined with progressive-regressive Runge-Kutta fourth-order schemes. [ABSTRACT FROM AUTHOR]

Background: Globally, the majority of people with HIV/AIDS live in sub-Saharan Africa. While the increasing availability of antiretroviral therapy is improving the outlook for many, its effects are yet to reach all of those in need and patients still present with advanced disease. This paper reports findings from qualitative interviews with patients living with AIDS and their caregivers who were receiving palliative care from Hospice Africa Uganda (HAU). We aimed to understand what motivated patients and their families to seek formal healthcare, whether there were any barriers to help- seeking and how the help and support provided to them by HAU was perceived. Methods: We invited patients with AIDS and their relatives who were newly referred to HAU to participate in qualitative interviews. Patients and carers were interviewed in their homes approximately four weeks after the patient's enrolment at HAU. Interviews were translated, transcribed and analysed using narrative and thematic approaches. Results: Interviews were completed with 22 patients (10 women and 12 men) and 20 family caregivers, nominated by patients. Interviews revealed the extent of suffering patients endured and the strain that family caregivers experienced before help was sought or accessed. Patients reported a wide range of severe physical symptoms. Patients and their relatives reported worries about the disclosure of the AIDS diagnosis and fear of stigma. Profound poverty framed all accounts. Poverty and stigma were, depending on the patient and family situation, both motivators and barriers to help seeking behaviour. Hospice services were perceived to provide essential relief of pain and symptoms, as well as providing rehabilitative support and a sense of caring. The hospice was perceived relieve utter destitution, although it was unable to meet all the expectations that patients had. Conclusion: Hospice care was highly valued and perceived to effectively manage problems such as pain and other symptoms and to provide rehabilitation. Participants noted a strong sense of being "cared for". However, poverty and a sense of stigma were widespread. Further research is needed to understand how poverty and stigma can be effectively managed in hospice care for patients for advanced AIDS and their families. [ABSTRACT FROM AUTHOR]

Introduction Extant studies universally document a positive gradient between socioeconomic status (SES) and health. A notable exception is the apparent concentration of HIV/AIDS among wealthier individuals. This paper uses data from the Demographic Health Surveys and AIDS Indicator Surveys to examine socioeconomic inequalities in HIV/AIDS prevalence in 24 sub-Saharan African (SSA) countries, the region that accounts for two-thirds of the global HIV/AIDS burden. Methods The relative and generalized concentration indices (RC and GC) were used to quantify wealth-based socioeconomic inequalities in HIV/AIDS prevalence for the total adult population (aged 15-49), for men and women, and in urban and rural areas in each country. Further, we decomposed the RC and GC indices to identify the determinants of socioeconomic inequalities in HIV/AIDS prevalence in each country. Results Our findings demonstrated that HIV/AIDS was concentrated among higher SES individuals in the majority of SSA countries. Swaziland and Senegal were the only countries in the region where HIV/AIDS was concentrated among individuals living in poorer households. Stratified analyses by gender showed HIV/AIDS was generally concentrated among wealthier men and women. In some countries, including Kenya, Lesotho Uganda, and Zambia, HIV/AIDS was concentrated among the poor in urban areas but among wealthier adults in rural areas. Decomposition analyses indicated that, besides wealth itself (median = 49%, interquartile range [IQR] = 90%), urban residence (median = 54%, IQR = 81%) was the most important factor contributing to the concentration of HIV/AIDS among wealthier participants in SSA countries. Conclusions Further work is needed to understand the mechanisms explaining the concentration of HIV/AIDS among wealthier individuals and urban residents in SSA. Higher prevalence of HIV/AIDS could be indicative of better care and survival among wealthier individuals and urban adults, or reflect greater risk behaviour and incidence. Moreover, differential findings across countries suggest that effective intervention efforts for reducing the burden of HIV/AIDS in the SSA should be country specific. [ABSTRACT FROM AUTHOR]

Abstract: In this paper, we propose a novel time delayed HIV/AIDS mathematical model and further analyze the effect of vaccination and ART (antiretroviral therapy) on this time delayed model, in which the time delay is due to the strong immune response to AIDS for the HIV-infected-aware because of the good physical conditions. We introduce the different stages of the period of AIDS infection having different abilities of transmitting disease, which reflects the developing progress of AIDS infection more realistically. By using suitable Lyapunov functionals and the LaSalle invariant principle, we obtain the basic reproduction number and derive that if and some parameters satisfy a given condition, the disease-free equilibrium is globally asymptotically stable, while the disease will be died out. Numerical simulations are carried out to verify the obtained stability criteria and demonstrate the effect of the vaccination rate and and the ART on the infective individuals. [Copyright &y& Elsevier]

Although the relationship between HIV/AIDS risk and alcohol and other drug (AOD) use is well documented, individuals living with both HIV/ AIDS and AOD addictions present health and social service providers and funders with unique challenges. Historically, clients diagnosed with HIV and AOD addictions have been treated at either a medical facility that had few addiction professionals or an addiction treatment facility that had few medical professionals sensitive to the needs of the HIV-positive individual. This paper examines the histories of HIV/AIDS and AOD treatment as separate services, followed by recent approaches to blend treatments. Finally, considerations regarding funding policies for agencies interested in rendering services to people living with both HIV and AOD diagnoses will be discussed, in the context of professional social work ethics. [ABSTRACT FROM AUTHOR]

Background The fact that HIV prevention often deals with politicised sexual and drug taking behaviour is well known, but structural HIV prevention interventions in particular can involve alteration of social arrangements over which there may be further contested values at stake. As such, normative frameworks are required to inform HIV prevention decisions and avoid conflicts between social goals. Methods This paper provides a conceptual review and discussion of the normative issues surrounding structural HIV prevention strategies. It applies political and ethical concepts to explore the contested nature of HIV planning and suggests conceptual frameworks to inform future structural HIV responses. Results HIV prevention is an activity that cannot be pursued without making value judgements; it is inherently political. Appeals to health outcomes alone are insufficient when intervention strategies have broader social impacts, or when incidence reduction can be achieved at the expense of other social values such as freedom, equality, or economic growth. This is illustrated by the widespread unacceptability of forced isolation which may be efficacious in preventing spread of infectious agents, but conflicts with other social values. Conclusions While no universal value system exists, the capability approach provides one potential framework to help overcome seeming contradictions or value trade-offs in structural HIV prevention approaches. However, even within the capability approach, valuations must still be made. Making normative values explicit in decision making processes is required to ensure transparency, accountability, and representativeness of the public interest, while ensuring structural HIV prevention efforts align with broader social development goals as well. [ABSTRACT FROM AUTHOR]

Background: While sustainability of health programmes has been the subject of empirical studies, there is little evidence specifically on the sustainability of Community Based Organisations (CBOs) for HIV/AIDS. Debates around optimal approaches in community health have centred on utilitarian versus empowerment approaches. This paper, using the World Bank Multi-Country AIDS Program (MAP) in Zambia as a case study, seeks to evaluate whether or not this global programme contributed to the sustainability of CBOs working in the area of HIV/AIDS in Zambia. Lessons for optimising sustainability of CBOs in lower income countries are drawn. Methods: In-depth interviews with representatives of all CBOs that received CRAIDS funding (n = 18) and district stakeholders (n= 10) in Mumbwa rural district in Zambia, in 2010; and national stakeholders (n=6) in 2011. Results: Funding: All eighteen CBOs in Mumbwa that received MAP funding between 2003 and 2008 had existed prior to receiving MAP grants, some from as early as 1992. This was contrary to national level perceptions that CBOs were established to access funds rather than from the needs of communities. Funding opportunities for CBOs in Mumbwa in 2010 were scarce. Health services: While all CBOs were functioning in 2010, most reported reductions in service provision. Home visits had reduced due to a shortage of food to bring to people living with HIV/AIDS and scarcity of funding for transport, which reduced antiretroviral treatment adherence support and transport of patients to clinics. Organisational capacity and viability: Sustainability had been promoted during MAP through funding Income Generating Activities. However, there was a lack of infrastructure and training to make these sustainable. Links between health facilities and communities improved over time, however volunteers' skills levels had reduced. Conclusions: Whilst the World Bank espoused the idea of sustainability in their plans, it remained on the periphery of their Zambia strategy. Assessments of need on the ground and accurate costings for sustainable service delivery, building on existing community strengths, are needed before projects commence. This study highlights the importance of enabling and building the capacity of existing CBOs and community structures, rather than creating new mechanisms. [ABSTRACT FROM AUTHOR]

Media messages directed to African American women are more likely to have health content that emphasizes negative outcomes or sexual stereotypes. This paper critiques the use of health messages that focus on high mortality and morbidity rates, yet have not reduced health disparities, but have instead reduced Black women's bodies to carriers of disease. I introduce an ethic of resistance that privileges the authority and wholeness of Black women rather than disease and fragmentation. An ethic of resistance helps Black women connect to their spiritual health, move from passive receiver to active resister of negative messages, and break the generational silence to demystify sexuality and integrate it into a lifestyle of wholeness. My hope is to improve the health outcomes of African American women by improving the message. [ABSTRACT FROM AUTHOR]

This paper offers an analysis of HIV/AIDS dynamics, defined by CD4 levels and Viral load, carried out from a macroscopic point of view by means of a general stochastic model. The model focuses on the patient's age as a relevant factor to forecast the transitions among the different levels of seriousness of the disease and simultaneously on the chronological time. The third model considers the two previous features simultaneously. In this way it is possible to quantify the medical scientific progresses due to the advances in the treatment of the HIV. The analyses have been performed through non-homogeneous semi-Markov processes. These models have been implemented by using real data provided by ISS (Istituto Superiore di Sanità, Rome, Italy). They refer to 2159 subjects enrolled in Italian public structures from September 1983 to January 2006. The relevant results include also the survival analysis of the infected patients. The computed conditional probabilities show the different responses of the subjects depending on their ages and the elapsing of time. [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]

The ongoing HIV/AIDS pandemic in southern Africa continues to manifest itself in unexpected ways. While the consequences of the disease appear straightforward in some aspects—e.g., medical, labor, cost—in other respects the repercussions, while large, are nonetheless highly nuanced and can be counterintuitive. This paper reports on the intersection of HIV/AIDS, migration, livelihood adaptation, land tenure, and forest conservation, to outline how adaptation to the pandemic has reworked significant aspects of land tenure to result in increased forest conservation in southern Zambia in the near to medium-term. The research uses a combination of ethnography, case studies, household survey and spatial analyses and finds that HIV/AIDS is used in customary legal settings to enhance land access. We also draw links to practical and theoretical implications of the relationship between HIV/AIDS, land tenure, and deforestation in Sub-Saharan Africa. [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]

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]

Little attention has been given to understanding the emotional well-being of people living with HIV/AIDS in developing countries, despite the fact that emotions may impact on people's sense of purpose and value, and ultimately their ability and resolve to hold livelihood and familial responsibilities together. Drawing upon research undertaken in the Caprivi Region of Namibia, this paper examines the use of solicited text and photo diaries in enabling insight into the emotional impacts of HIV/AIDS. The advantages and constraints of diary methods are examined, focusing on informant-directed research and the ethical considerations surrounding their use. [ABSTRACT FROM AUTHOR]

Rugby league is the national sport of Papua New Guinea and the game's huge popularity and international profile has been used in recent condom promotion campaigns in the nation's fight against the HIV/AIDS epidemic. In this paper, I argue that the promotion of condom use through rugby league requires a national campaign strategy that includes understandings of condom use and masculinity at the rural level. I demonstrate this through a study of Gogodala men's understandings of the epidemic and condom use in Western Province. The Gogodala are a Christian-based society and many blame the national condom promotion strategy for an increase in promiscuity and for 'turning sex into a game'. Condom availability in this rural area continues to be restricted to a family planning program that promotes Christian values and excludes unmarried men. I explore the male condom dilemma where young men are more concerned with avoiding accusations that their sexual behaviour puts them at risk of contracting HIV despite acknowledging the preventative value of using condoms. In this context young men disassociate themselves from the disease and condom use through a process of calculated risk or risk minimisation. [ABSTRACT FROM AUTHOR]

This paper investigates the extent of knowledge about HIV/AIDS among young Yupno women and men. Local understanding of sikAIDS is shaped by cultural, moral and religious concepts and processes that are based on social values and practices. Difficulties these young people face in accessing information about HIV/AIDS and using it to implement preventative measures -- for example by obtaining condoms -- have to be seen in the framework of 'kastom' and a moral discourse coined and influenced by the Lutheran Church. As the research shows, there is an urgent need for a broad and contextually sensitive approach to sexual health, including information about conception, family planning methods, and sexually transmitted diseases when planning awareness campaigns for teenagers in rural regions. [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]

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]

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]

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]

In 2003, India had over 5.1 million infected individuals living with HIV/AIDS. The percentage of all HW cases attributed to perinatal transmission has been increasing steadily from 0.33% of total cases in 1999 to 2.80% in 2004. Recent statistics indicate that over 180,000 infants have been infected through this route, Despite recent advances in reducing in utero and interbartum transmission with the use of antiretrovirals, there is a critical need to make infant feeding safer. Current UNAIDS/WHO/UNICEF recommendations stress avoidance of all breastfeeding if replacement feeding fulfills the key requirements of being affordable, feasible, acceptable, sustainable, and safe, In this paper, we examine how the UNAIDS/WHO/UNICEF recommendations have been actualized within the context of an urban government hospital in India. The documented patterns of infant feeding by HIV-positive mothers in Pune, India, from 2000 to 2004, highlight the complexities of making an informed and healthy choice under suboptimal conditions. The data indicate that interpersonal variations in the key requirements greatly influence the optimal practice to minimize mortality risks. Moreover, local information on health outcomes is crucial to tailoring policy recommendations to save lives. We propose the development of a decision-making algorithm that includes factors affecting mother-to-infant transmission, including site-specific data on health risks to the mother and the child. Such an algorithm would allow identification of the healthiest feeding choice and would minimize the pitfalls of promoting homogeneous practices lacking site-specific evidence-based evaluation. [ABSTRACT FROM AUTHOR]