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After more than twenty years of programming and activism aimed at stemming the sexual transmission of HIV (and addressing the needs of those most vulnerable to infection) the HIV/AIDS epidemic continues to grow worldwide. Taking up this concern, this paper argues that one of the reasons why HIV prevention has had limited success is because of inadequate conceptualization of human sexuality in such work. Giving sexuality a more prominent position in responses to the epidemic raises a range of issues, including theorization of gender, understanding of sexual subjectivity, the significance of pleasure (or lack of pleasure) in sexual decision-making, and conceptualization of sexual behaviour and culture. Taking these themes forward entails asking significant questions about the underlying paradigmatic and methodological commitments of mainstream HIV/AIDS research, especially the tendency to reproduce accounts of human sexuality as if it were a measurable form of conduct only. Advocating new approaches that take the meaning and symbolic value of sexualities into account complicates established orthodoxies in the field whilst offering potential for more effective HIV prevention strategies. [ABSTRACT FROM AUTHOR]

Community health workers (CHWs) are central to the global health response to crises like the AIDS epidemic. Yet community health work remains undervalued and undercompensated worldwide owing in large part to the gendered and racialized contexts of care work. This paper investigates the possibility of occupational security for CHWs by comparing two cases from South Africa's response to AIDS. The first draws on ethnographic research (2007–2009) in rural KwaZulu‐Natal province and documents the fraught formation of a union representing CHWs. The second examines legal action in the Free State province for a group of CHWs known as the Bophelo House 94, who were arrested and criminally charged in June 2014 after protesting their sudden dismissal by the government. This case comparison finds that collective action has thus far had limited effects on CHWs' position as a nascent occupation. The South African Ministry of Health has obstructed CHW professionalization, and non‐state actors' involvement has been a mixture of benefit and impediment: some social justice agencies have facilitated CHW advocacy, while many AIDS service organizations have cooperated with the state and exacerbated the precarity of CHWs' working conditions. However, the consolidation of CHW work roles—owing to advances in AIDS prevention and treatment—holds promise for future CHW collective organization. [ABSTRACT FROM AUTHOR]

Copyright of Revista Estudos Feministas is the property of Revista Estudos Feministas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Intimate partner violence (IPV), HIV, and substance use are serious intersecting public health issues. This paper aims to describe the Social Intervention Group (SIG)'s syndemic-focused interventions for women that address the co-occurrence of IPV, HIV, and substance use, referred to as the SAVA syndemic. We reviewed SIG intervention studies from 2000 to 2020 that evaluated the effectiveness of syndemic-focused interventions which addressed two or more outcomes related to reducing IPV, HIV, and substance use among different populations of women who use drugs. This review identified five interventions that co-targeted SAVA outcomes. Of the five interventions, four showed a significant reduction in risks for two or more outcomes related to IPV, substance use, and HIV. The significant effects of SIG's interventions on IPV, substance use, and HIV outcomes among different populations of women demonstrate the potential of using syndemic theory and methods in guiding effective SAVA-focused interventions. [ABSTRACT FROM AUTHOR]

Previous literature reports that low male partner support is a barrier to women's adherence and retention in HIV care programs. This qualitative study explored the relationships between partners to understand what is meant by male partner support in adherence of HIV-positive women in four healthcare facilities in Southern Malawi. We conducted 8 semi-structured focus group discussions (FGDs) with 73 participants (40 men and 33 women) and 10 in-depth interviews (IDIs) between August 2018 to December 2019. Participants were HIV-positive patients, healthcare workers (HCWs), expert patients (EPs), and couples attending the clinic. All data were digitally recorded, transcribed verbatim, and analysed using a gender-responsive grounded theory approach. This study confirms previous literature, which suggests male partner support is expressed by providing access to transport to the clinic and accompaniment to appointments. However, we found that men can also control access to resources and decision-making. Support is more complex than previous literature reported and, in some cases, gender norms significantly limit women's capacity to engage in care independently of male support since women need male partner permission to access the resources to attend clinics. This paper suggests that restrictive male-partner gender norms limit women's power to engage in care. Most importantly, the gender analysis reveals that what previous literature describes as male partner support can sometimes hide male partner control in permitting access to resources to attend health facilities. For this reason, policies enhancing male support should consider the gender power relationship between partners to avoid reinforcing gender inequality. [ABSTRACT FROM AUTHOR]

Background: In the lives of women, puberty is marked by the onset of menarche. From this stage onwards until menopause, reproductive health and menstrual hygiene are important aspects of women's lives. In Zambia's Western Province, the natural process of menstruation is a taboo and dealt with secretly. Information and knowledge about menstruation and menstrual hygiene among adolescent girls is inadequate. This paper explores the factors influencing the understanding, experiences and practices of menstrual hygiene among adolescent girls in Mongu District, Western Province of Zambia.Methods: An explorative study design was used by means of six focus group discussions conducted with 51 respondents, aged 13-20 years, from three secondary schools. Their age at menarche was 11-15. For data analysis thematic content analysis was used.Results: The paper shows that the girls suffer from poor menstrual hygiene, originating from lack of knowledge, culture and tradition, and socio-economic and environmental constraints, leading to inconveniences, humiliation and stress. This leads to reduced school attendance and poor academic performance, or even drop outs, and ultimately infringes upon the girls' human rights.Conclusion: To address these shortcomings, a 'super setting approach' is recommended, in which a Health Promoting School could improve the girls' individual and group needs, and a community setting which would address the broader socio-economic, cultural and environmental conditions. This would enable creating a supportive environment for the girls to manage their periods. To successfully utilize the approach, all stakeholders (parents, teachers, children, governments and communities) should cooperate to generate context-specific solutions for creating safe menstrual care, and better and dignified conditions for adolescent girls. Therefore, this calls for comprehensive, strident advocacy for policy changes at national level, and mediation and involvement at community level. [ABSTRACT FROM AUTHOR]

Since access to HIV testing, counselling, and drug therapy has improved so dramatically, scholars have investigated ways this ‘scale-up’ has interacted with HIV/AIDS-related stigma in sub-Saharan Africa. Drawing on data collected during ethnographic research in a trading centre in western Kenya, this paper critically analyses two violent and localised case studies of panic over the ill health of particular community residents as a nuanced lens through which to explore the dynamic interplay of gender politics and processes of HIV/AIDS-related stigma in the aftershocks of the AIDS crisis. Gaining theoretical momentum from literatures focusing on stigma, gender, witchcraft, gossip, and accusation, we argue that the cases highlight collective anxieties, as well as local critiques of shifting gender roles and the strain of globalisation and legacies of uneven development on myriad forms of relationships. We further contend that these heightened moments of panic and accusation were deployments of power that ultimately sharpened local gender politics and conflicts on the ground in ways that complicated the social solidarity necessary to tackle social and health inequalities. The paper highlights one community’s challenge to eradicate the stigma associated with HIV/AIDS during a period of increased access to HIV services. [ABSTRACT FROM PUBLISHER]

This paper explores how HIV/AIDS education messages are transmitted through popular Zambian music lyrics. The focus is on the recontextualisation of lived experiences and Zambian cultural practices in the fight against HIV/AIDS. Using multimodal discourse analysis, the paper uses Zambian popular music lyrics to show how Zambian musicians deliberately blend languages, socio-cultural artefacts and knowledge into a hybrid of ‘infotainment’ in the fight against HIV/AIDS. The paper concludes that although male dominance is still prevalent, choices regarding sex and discussions on sexual matters are no longer a preserve for the men, and that musicians are able to use language to reframe dominant cultural practices and taboos in the process of disseminating HIV/AIDS messages. This has produced altered social conditions, which sometimes distort the intended messages, but allow musicians to operate without fear of government censorship boards or running foul of cultural taboos. [ABSTRACT FROM PUBLISHER]

The purpose of this paper is to highlight methodological issues and considerations which will be of use to researchers interested in further understanding the complexity of intimate partner violence in the lives of Hispanic men who have sex with men. We present a brief review of the research on intimate partner violence which highlights intersections of health and behavior risk factors (i.e., alcohol-related-intimate-partner-violence and HIV/AIDS risk) pertaining to gender, ethnicity, and sexuality in this population of males. We then present the reader with a synthesis and critique of several methodological concerns relevant to furthering research in this area including: locating participants, considerations of the impact of local cultural contexts, and impact of researcher positionality. Research recommendations for addressing intimate partner violence as a complex public health concern embedded in “hidden populations” conclude the paper. [ABSTRACT FROM AUTHOR]

Effective youth participation in social development and civic life can enhance young peoples' health and well-being. Yet many obstacles stand in the way of such involvement. Drawing on 105 interviews, 52 focus groups and fieldworker diaries, this paper reports on a study of a rural South African project which sought to promote effective youth participation in HIV/AIDS management. The paper highlights three major obstacles which might be tackled more explicitly in future projects: (i) reluctance by community adults to recognise the potential value of youth inputs, and an unwillingness to regard youth as equals in project structures; (ii) lack of support for meaningful youth participation by external health and welfare agencies involved in the project; and (iii) the failure of the project to provide meaningful incentives to encourage youth involvement. The paper highlights five psycho-social preconditions for participation in AIDS projects (knowledge, social spaces for critical thinking, a sense of ownership, confidence and appropriate bridging relationships). We believe this framework provides a useful and generalisable way of conceptualising the preconditions for effective 'participatory competence' in youth projects beyond the specialist HIV/AIDS arena. [ABSTRACT FROM AUTHOR]

At an historical juncture where HIV/AIDS is rapidly disappearing as a public health issue throughout the Caribbean region, alongside stagnant or reduced funding for HIV-related support services, spirituality and membership in Christian communities of faith occupy a central role for older, working-class women from Barbados living with HIV. However, many of these Christian religious organisations are historically responsible for discriminatory discourses about people living with HIV, creating practical and moral challenges for HIV positive members. Through interviews and ethnographic fieldwork, this paper explores how and why a group of Barbadian women living with HIV develop a strong personal commitment to a spiritual life, and why membership in communities of faith, where HIV infection is often associated with sin and immorality, continues to be important for many of them. I argue that these women's HIV status transforms and/or intensifies their personal spiritual commitments but also contributes to a critical reflexivity of the wider institutionalised religious communities to which they belong. [ABSTRACT FROM AUTHOR]

Public health and media discourses on men and HIV prevention in India have largely focused on changing knowledge, attitudes and risk behaviour pertaining to condom use and safe sex. Little attempt has been made towards intervening in areas such as masculinity, dominant gender norms and intimate partner violence (IPV) that have been shown to have a direct link to HIV prevalence. In this paper, drawing on findings from an ethnographic study in northern Karnataka (India), we show how socio-political and communicative contexts influence and perpetuate violent behaviours by men in intimate relationships with female sex workers (FSW). We argue that constructions of masculinity, the stereotypes of which are reinforced through contemporary media, and movies, are intricately linked with processes of nationalism and play out in forms of chauvinism among working-class men. Violence, celebrated through various patriarchal discourses, legitimises and reinforces gender ideals that govern the private lives of men and their female intimate partners. This study provides a complex and nuanced understanding of structural factors that lead to IPV against FSWs and offers implications for HIV intervention planning in the region and beyond. [ABSTRACT FROM AUTHOR]

Aim: This paper examines financial, emotional, and physical responsibilities elderly women are being asked to take on due to the incapacity of their adult children to care for the next generation; such incapacity is likely to increase as the HIV/AIDS epidemic worsens. Methods: This paper combines quantitative and qualitative data. Census data from the Agincourt health and demographic surveillance system (AHDSS) describe the presence of the elderly (specifically women over the age of 60 and men over the age of 65) in households in the Agincourt study site. Semi-structured interviews with 30 female residents aged 60-75 complement the census data by exploring the roles that older women, in particular, are playing in their households. Results: An elderly man and/or woman lives in 27.6% of households; 86% of elders live with non-elders. Households with a woman over the age of 60 resident (as opposed to those without) are twice as likely to have a fostered child living in the household and three times as likely to have an orphaned child in the household. Elderly women face financial, physical, and emotional burdens related to the morbidity and mortality of their adult children, and to caring for grandchildren left behind due to adult children's mortality, migration, (re)marriage, and unemployment. Conclusions: Older women provide crucial financial, physical, and emotional support for ill adult children and fostered and orphaned grandchildren in their households. As more prime-aged adults suffer from HIV/AIDS-related morbidity and mortality, these obligations are likely to increase. [ABSTRACT FROM AUTHOR]

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Purpose - The purpose of this paper is to discuss the practice of female genital mutilation (FGM) in the context of gender and HIV/AIDS among the Shangani people in Zimbabwe. Broadly, the discussion ais to fcus on how FGM has been used as tool to maintain the subordinate position of women in the Shangani community. Design/methodology/approach - In addition to secondary material, the paper hugely benefited from interviews with Shangani women in order to appreciate the challenges of eradicating FGM in their society. The sources pointed to the fact that in addition to being exploitative, FGM has no direct health benefits to women. Findings - The paper confirms that eliminating FGM is difficult because it is deeply entrenched in the patriarchal establishment of the Shangani society. As a result of the patriarchal nature of the society, women find themselves subjected to positions of powerlessness as compared to their male counterparts. Originality/value - The paper confirms that FGM is a widespread practice in many African communities including Zimbabwe. As communities grapple with the challenges of eradicating or minimising the practice, it is important in the meantime to modernise cultural practices like FGM as a way of doing away with the spreading of HIV/AIDS. Indonesia has already taken that route. FGM as a cultural practice exposes young women to HIV infection because of blood conduct. [ABSTRACT FROM AUTHOR]

Although health researchers have begun to examine the forms of violence and power dynamics that play out in the intimate relationships of female sex workers (FSWs) in India, this knowledge has tended to focus on the perspectives of women, leaving men's motivations and attitudes relatively unexamined. This paper examines the contours of masculinity and gender norms from the perspective of the intimate partners of FSWs. Based on six months of ethnographic research in Northern Karnataka, the study employed two focus group discussions (FGDs) with Devadasi FSWs (N = 17), as well as four FGDs (N = 34) and 30 in-depth interviews with their intimate partners. Given the precarious labour conditions in this region, tensions developed in the participants' relationships with FSWs, as these men were unable to meet local ideals of manhood. Violence became a way that men attempted to re-secure a sense of control in their relationships with women, and to fulfil fantasies of male power. We recommend that programs engaging men not only address intimate partner violence but also attend to the social and structural realities surrounding these men's daily lived experiences. [ABSTRACT FROM AUTHOR]

There is growing interest in engaging men and boys in health and development programmes targeting the intersection of HIV risk, substance abuse, and violence. Understanding the conceptualisations of masculinities or masculine identities that shape both behaviours and opportunities for intervention is central to advancing the global agenda to engage men in health and development interventions. This paper examines an intervention using soccer and job training to engage and deliver activities for HIV prevention, substance abuse, and gender-based violence in a South African township. A literature review provides theoretical, historical and social context for the intersection of gender, masculinity, soccer, violence, and sexual relationships. Qualitative data from in-depth interviews and focus groups is analysed using theoretical and contextual frames to elucidate the negotiation of shifting, contradictory, and conflicting masculine roles. Results highlight how changing risky, normative behaviours among young men is a negotiated process entailing men's relationships with women and with other men. [ABSTRACT FROM AUTHOR]

Throughout Sub-Saharan Africa, forest resources play a crucial role in enabling households to control and adapt to HIV/AIDS; however, little is known about how the disease impacts the gendered use of forest resources. This exploratory study characterizes how the dependence on forest resources changes for female and male respondents in HIV/AIDS-affected households in Malawi through three phases: before HIV was known to be present; during HIV-related morbidity; and after AIDS-related mortality. The results presented for female and male respondents in this paper are strikingly similar, and many respondents report that there are no longer any traditional gender roles for household tasks due to HIV/AIDS. Therefore, we question the thinking around gender-specific forest-related interventions for HIV-affected people. Moreover, given the gendered knowledge base that must surround resource use, what do these changes in traditional roles mean for sustainable forest resource use in the future? Further research on knowledge transmission around these resources is warranted. [ABSTRACT FROM AUTHOR]

BACKGROUND: The HIV epidemiological situation has worsened in the past decade in the Czech Republic. This paper analyses relevant factors from the perspective of two key populations - men who have sex with men (MSM) and people who inject drugs (PWID). METHODS: A non-systematic literature review comparing relevant factors such as risk behaviours, preventive measures, and stigma in both populations. RESULTS: A total of 286 newly diagnosed HIV cases were reported in 2016. Sex between men accounted for 74.5% (and has been rising recently), the proportion of PWID was only 2.4%. HIV prevalence among MSM exceeds 5% regionally (in Prague), while among PWID it is close to zero. Sharing of injecting equipment among PWID seems to be decreasing, the trend in high-risk sexual behaviour among MSM is unknown. There is significantly higher coverage and provision of preventive measures in PWIDs as compared to MSM. There is a lack of support for effective interventions such as post- or pre-exposure prophylaxis (PEP and PrEP). Destigmatisation of drug use has been a part of the drug policy for a long time, the destigmatisation of MSM has not been incorporated into the HIV prevention strategy yet. CONCLUSION: HIV prevention in MSM should be scaled up and include state-of-the-art strategies such as PrEP and target the stigma attached to HIV and MSM. [ABSTRACT FROM AUTHOR]

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The feminisation of HIV/AIDS commonly refers to the feminisation of the epidemic: women are disproportionately infected and affected by the disease. This paper argues that there is a dual feminisation of HIV/AIDS; that of the epidemic and that of its governance. Women are at the forefront of HIV/AIDS governance from the leadership of global programmes, directing national and district HIV/AIDS councils in-country, forming influential women and HIV/AIDS non-governmental organisations, and organising local communities. Yet this feminisation of governance has not led to better outcomes for the feminisation of the epidemic. This paper argues that this is because of the misapplication of gender mainstreaming and the politics of presence, the sidelining of gender expertise and institutional bias, and wider systematic issues with processes of HIV/AIDS governance that are exacerbated when addressing the concerns of women. La feminizacion del VIH/SIDA se refiere comunmente a la feminizacion de la epidemia: las mujeres estan infectadas y afectadas desproporcionadamente por la enfermedad. Este estudio sostiene que existe una doble feminizacion del VIH/SIDA; la de la epidemia y la de su control. Las mujeres estan al frente del control del liderazgo de los programas globales del VIH/SIDA, dirigiendo concejos distritales e internos del pais, formando a mujeres influyentes y organizaciones no gubernamentales del VIH/SIDA y organizando comunidades locales. Sin embargo, esta feminizacion del control no ha dado mejores resultados a la feminizacion de la epidemia. Este estudio sostiene que esto se debe al mal manejo de la integracion de la perspectiva de genero y a la politica de la presencia, la marginacion de la experiencia del genero y el prejuicio institucional, y otros amplios asuntos sistematicos con el control del VIH/SIDA, que se agravan cuando abordan los asuntos de las mujeres. 艾滋病问题的女性化指的是在传染方面的女性化：女性不成比例地被传染和受到该疾病影响。本文认为艾滋病问题存在双重的女性化：不仅是传染方面，还有治理方面。女性以全球性项目的领导地位处于艾滋病治理的最前沿，在国内她们指导国家的和地区的相关艾滋病委员会，组建有影响力的妇女和艾滋病非政府组织，并建立地方社团。然而治理的女性化并未对传染的女性化产生更好的结果。本文认为原因在于性别主流化的滥用和现存政治、性别专门知识的边缘化和制度偏见，以及艾滋病治理进程中解决妇女的关切时还在恶化的更为广泛的各种体系性问题。 [ABSTRACT FROM AUTHOR]

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This paper reports on a study of the effects of the sexual, racial and status identity on health and health seeking behavior among a cohort of African American men. Focus groups and structured interviews were conducted to explore the attitudes of a cohort of African American men about their masculinity and its relationship to their health related behaviors. Their narratives indicate that being sexually active is an important component of masculinity. Both younger and older members of the cohort described their use, intended use, and avoidance of sexual activity as a health behavior to preserve a masculine identity. They stated that avoidance would be especially necessary if they were faced with an “incurable” medical diagnosis that could interfere with the freedom of their sexual activities. A diagnosis of HIV/AIDS, for example, was information they said they would avoid by not being tested for AIDS. Evaluating this behavior within the framework of hegemonic masculinity suggests that the behavior is irrational. To remedy this, the paper considers leading theories of gender and masculinity, including “hyper” and hegemonic masculinity and attempts—with the aid of the men’s narratives about masculinity—to formulate a notion of masculinity with greater relevance to African American men. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The twentieth century has witnessed an epidemic of metaphors in our attempt to make sense of sexuality and sexual health. This paper explores some of those constructs in order to gain insights into how we think, and ultimately how we practice. While many metaphors come from the wider culture, our health care institutions are a product of that same culture and we cannot help but be influenced by them and use the metaphors ourselves (Plummer 1995). In this paper, we will examine the use of notions of contamination, transmission and contagion to describe non-infectious social phenomena such as homosexuality and homophobia. Social constructionism discusses sexuality and gender, not as essential characteristics, but as socially produced, reproduced and transmitted, with the latter's symbolic similarity to infection transmission. However, while non-hegemonic expressions of gender and sexuality are viewed through these metaphors, the hegemonic variations remain unproblematised. As such, the unproblematised hegemonic representations are more likely to be viewed by the public as bearing essential qualities. [ABSTRACT FROM AUTHOR]

This paper documents the reframing at the start of the twenty-first century of the historical debate on ethics and demography, both in terms of greater emphasis on individual rights, as opposed to the previous emphasis on the public good, and through the inclusion of a variety of new dimensions—in particular, sexuality. This shift is intrinsically related to the emergence and impact of social movements—feminists, gay and lesbian organizations, and HIV/AIDS-related initiatives— that became increasingly interconnected globally and were able to diffuse a public discourse concerning sexuality. Despite clear achievements in addressing sexuality and HIV/AIDS issues within a human rights frame, the conceptualization of ethical dimensions relating to demographic change and sexuality is not fully completed. This paper re-examines the recent and conflictive evolution of the global debate linking sexuality and human rights, identifies unresolved conceptual problems, and explores the implications of these new policy trends for demographic thinking. [ABSTRACT FROM AUTHOR]

Care for AIDS orphans in southern Africa is frequently characterized as a “crisis”, where kin-based networks of care are thought to be on the edge of collapse. Yet these care networks, though strained by AIDS, are still the primary mechanisms for orphan care, in large part because of the essential role grandmothers play in responding to the needs of orphans. Ongoing demographic shifts as a result of HIV/AIDS and an increasingly feminized labor market continue to disrupt and alter networks of care for orphans and vulnerable children. This paper examines the emergence of a small but growing number of male caregivers who are responding to the needs of the extended family. While these men are still few in number, the strength of gendered ideologies of female care means that this group of men is socially, if not statistically significant. Men continue to be considered caregivers of last resort, but their care will close a small but growing gap that threatens to undermine kin-based networks of care in Lesotho and across the region. The adaptation of gender roles reinforces the strength and resilience of kinship networks even when working against deeply entrenched ideas about gendered division of domestic labor. [ABSTRACT FROM PUBLISHER]

Despite batteries of interventions to change the dynamics of HIV in South African communities, increasing HIV prevalence suggests that much more needs to be done to stem the tides of infection. Issues of language and communication around HIV/AIDS in particular merit more attention. One aspect of the efficacy of HIV/AIDS discourses is the question of what extent they may serve to (inadvertently) reproduce sexual practices and mores inimical to HIV/AIDS prevention. This paper conducts a chronotopic and multimodal analysis of a popular South African campaign ‘Brothers for Life’ from this perspective. The campaign is an attempt to promote ‘new’ role models for South African men in order to get to grips with one of the most serious factors behind the spread of HIV/AIDS, namely male violence against women and children. The analysis suggests that past ideals of masculinity continue to find resonance in masculinities of the present, although framed, mediated and reindexicalized in late modern discourses of consumerism. Thus foundational assumptions on figurations of masculinity and male sexuality appear to remain largely consistent across generations.

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper reviews the recent literature on HIV in the Caribbean and discusses the challenges faced. HIV incidence in the Caribbean has declined by 49 % in the past decade, coverage of persons living with HIV among those eligible for antiretroviral treatment as per national guidelines was 70 % in 2012, and some countries are meeting the target of virtual elimination of mother-to-child transmission. HIV prevalence in the Caribbean is 1 % with features of both a generalized and concentrated HIV epidemic. HIV prevalence among female sex workers has declined but remains unacceptably high among men who have sex with men. Social and cultural factors, gender norms, and strong stigma associated with HIV and homosexuality contribute to the continued spread of HIV. Caribbean countries and their partners have invested significant resources, creative effort and impressive research in strengthening the HIV response nationally and regionally. However, in order to control the HIV epidemic, leaders at all levels, and the people, must address fundamental structural barriers in society that deny marginalized persons their rights, undermine public health goals, and impede universal access to HIV prevention, treatment, and care. [ABSTRACT FROM AUTHOR]

This paper examines the representations and emotions associated with disclosure and stigma in Pietermaritzburg, KwaZulu-Natal, seven years after the start of the South African government’s ARV roll-out programme on the basis of in-depth oral history interviews of HIV-positive support group members. It argues that the wider availability of ARV treatment, the ensuing reduced fatality rate and the increased number of people, including men, who receive counselling and testing, may mean that HIV/AIDS is less stigmatised and that disclosure has become easier. This does not mean that stigma has disappeared and that the confusion created by competing world-views and belief systems has dissipated. Yet the situation of extreme denial and ideological confusion observed, for example, by Deborah Posel and her colleagues in 2003 and 2004 in the Mpumalanga province seems to have lessened. The interviews hint at the possibility that people living with HIV may have, more than a decade before, a language to express the emotions and feelings associated with HIV/AIDS. They were also found to be more assertive in matters of gender relations. These new attitudes would make disclosure easier and stigma more likely to recede. [ABSTRACT FROM PUBLISHER]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Interventions aiming to promote gender equality are a common feature of global HIV/AIDS policies. To develop effective interventions, it is important to understand how globally established concepts (e.g. ‘gender’) are (re)interpreted and legitimated locally. This paper examines what happens when the concept of ‘gender’ hits the local ground in the context of an internationally funded HIV/AIDS intervention in Cambodia. Interviews with participants reveal that ‘gender’ is itself understood to mean equal rights. Some elements of this concept are rejected as inapplicable in Khmer society, while others are hybridised with existing knowledges. The analysis demonstrates how relational, symbolic and material dimensions of the place into which HIV/AIDS programmes intervene shape not only what ‘sense’ participants make of new knowledge, but also their capacity to use it. Further, the paper argues that to achieve the desired health-enhancing outcomes, international health organisations must avoid essentialising local spaces as static and ‘traditional’; rather, they must attend to and build on the ambiguities of existing knowledges and the changing dynamics of the places they enter. [Copyright &y& Elsevier]

This systematic literature review identified factors associated with sexual risks related to sexually transmitted infections (STI), HIV and other blood-borne viruses (BBV) among women using heroin and other drugs. The search strategy included five databases (PubMed, EMBASE, PsycNET, Web of Science, Scopus), and PsycEXTRA for grey literature. Out of the 12,135 publications screened, 30 peer-reviewed articles were included. Most publications were cross-sectional (n = 25), quantitative (n = 23) and included 11,305 women. Factors identified were: (1) socio-demographics; (2) gender roles and violence against women; (3) substance use; (4) transactional sex; (5) partner characteristics, partner's drug use, and context of sex; (6) preferences, negotiation and availability of condoms; (7) HIV status and STIs; (8) number of sexual partners; (9) love and trust; (10) reproductive health and motherhood; and (11) risk awareness and perception of control. Overall, this review highlights important implications for future research and practice, and provides evidence for developing STI/BBV preventive strategies. [ABSTRACT FROM AUTHOR]

Despite increasing HIV/AIDS rates among married individuals, minimal research has been conducted on how men and women respond to risk in a marriage. This paper examines strategies used by married individuals to combat HIV/AIDS risk against prevailing gender norms. Qualitative data were gathered in four villages of Cabo Delgado province, Mozambique. Group discussions were held with 160 men and women to explore gender norms, HIV/AIDS knowledge and risk determinants. From the group discussions, 29 individuals were selected for further in-depth interviews to explore relationships between gender norms and risk reduction efforts within marriages. Findings illustrate how infidelity and social limitations placed on condom use not only increase HIV/AIDS risk but also entrench gender disparities. Although power differences between genders can make it difficult to negotiate safe sex, men and women are taking measures to reduce perceived HIV/AIDS risk in their marriage. Married men are reconstructing norms and taking responsibility to protect their family from HIV/AIDS by remaining faithful. For women, responses to HIV/AIDS risk in a marriage are more closely related to their ability to generate an income. Financially dependent women tend to leave a risky marriage altogether in contrast to financially autonomous women who will negotiate condom use with their husband. Factors such as experience with a risky partner, the desire to maintain a good social standing, fear of HIV/AIDS acquisition and parental guidance and support influence men and women to reduce perceived HIV/AIDS risk, despite constraining gender norms and power imbalances in a marriage. Nuanced understandings of the ways in which men and women are already taking measures to decrease noted HIV/AIDS risk, despite gender norms that make this a challenge, should be incorporated into localised responses. [ABSTRACT FROM AUTHOR]

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