Exclusion of HIV-positive people with disabilities in the media

This current issue piece aims to address the harmful exclusion of people with disabilities in the Iranian media. In a case study, this author collected news related to statistics of HIV-positive people covered by popular news websites written in the Persian language between June 2011 and June 2012. Within the analysed electronic texts, no reference was made to the number of HIV-positive people with disabilities. Under the rubric of critical discourse analysis, one can argue that this lack of representation may also be linked to a more general level of discourse that constitutes the marginalization of people with disabilities. This damaging exclusion both legitimizes and reproduces the ideology that people with disabilities are social minorities who can be excluded to the benefit of powerful people. This current issue piece also discusses the potential negative consequences of excluding HIV-positive people with disabilities from the discourse of HIV/AIDS in the media. Ultimately, the conceivable reasons for the Iranian government failure or refusal to publish the statistics of HIV-positive people with disabilities will be provided. Studies from various countries could shed more light on the exclusion of HIV-positive people with disabilities in the media and the interplay between HIV/AIDS and disability issues.     

Similarities in the Sexual Behavior and HIV Risk Factors of Colombian,Dominican, Mexican,and Puerto Rican MSM Residing in New York City

Abstract

In a sample of Colombian, Dominican, Mexican, and Puerto Rican men who have sex with men (MSM) (n = 307) living in New York City, we contrasted sexual behavior and a number of variables related to it. The four groups were consistently similar in terms of frequency of partnership types (men with lovers, one-night-stands, other partners), monogamy, types of sexual behaviors with men and women, number of occasions of different behaviors, condom use during sex, and history of childhood sexual abuse. The four groups also had similar scores in most of the psychosocial variables usually related to condom use. These similarities validate the clustering of these four populations under a common category (Latino or Hispanic) for reporting and prevention purposes. This does not imply, however, that small scale interventions tailored to the specific cultural nuances of different national groups may not have an added strength. In the few cases where intraethnic differences were found, Mexican MSM were more likely than men in the other groups to receive ejaculate both in the rectum and in the mouth. These differences were not accounted for by the other variables examined and requires further investigation.     

Monitoring and evaluating transition and sustainability of donor-funded programs: Reflections on the Avahan experience

PurposeIn low and middle-income countries, programs funded and implemented by international donors frequently transition to local funding and management, yet such processes are rarely evaluated. We reflect upon experience evaluating the transition of a large scale HIV/AIDS prevention program in India, known as Avahan, in order to draw lessons about transition evaluation approaches and implementation challenges.ResultsIn terms of conceptualizing the transition theory, the evaluation team identified tensions between the idea of institutionalizing key features of the Avahan program, and ensuring program flexibility to promote sustainability. The transition was planned in three rounds allowing for adaptations to transition intervention and program design during the transition period. The assessment team found it important to track these changes in order to understand which strategies and contextual features supported transition. A mixed methods evaluation was employed, combining semi-structured surveys of transitioning entities (conducted pre and post transition), with longitudinal case studies. Qualitative data helped explain quantitative findings. Measures of transition readiness appeared robust, but we were uncertain of the robustness of institutionalization measures. Finally, challenges to the implementation of such an evaluation are discussed.ConclusionsGiven the scarceness of transition evaluations, the lessons from this evaluation may have widespread relevance.     

Lesbian Blood Drives as Community-Building Activism in the 1980s

As gay men began voluntarily withdrawing from blood donation in the early 1980s, lesbians in community with gay men in several U.S. cities organized drives to replenish the blood supply. These drives were sometimes the continuation of previously established drives by gay–lesbian organizations or faith communities, sometimes new initiatives in response to HIV/AIDS. However, after the initial publicity, mention of lesbian blood drives in print is both scarce and brief. Focusing on drives organized from 1983 to 1992 by a group known as San Diego Blood Sisters, this article is an initial step in documenting lesbian blood drives to inform and enrich conversations about histories of responses to HIV/AIDS, theoretical discussions of how community connections in the lesbian, gay, bisexual, transgender, and queer spectrum are enacted and understood, and emerging research on intersections of gender and sexuality as they are expressed through blood donorship.     

令人费解的矛盾数据揭示商业性性行为的三种“解释”

文章通过探讨和解决滇西某高速公路工地艾滋病防治调研中出现的难题,揭示了对于某些公共卫生概念研究者和服务对象之间可能存在重要的认知差异,影响信息获得和干预效果,人类学视角对解决这类问题有重要意义和作用。     

艾滋病防控面临的道德冲突论纲

道德冲突是目前我国艾滋病防控面临诸多难题的一个重要的深层因素。艾滋病防控中的道德冲突主要有三种类型:一是规范性道德冲突,包括政府干预与公民自主、资源稀缺与分配公正、宽容策略与道德标准;二是事实性道德冲突,包括宣教策略的选择分歧、吸毒人员的伦理定性、性工作者的管控难题以及自愿咨询检测困局;三是主体性道德冲突,包括"道德多数"与少数人权利、社会支持与社会歧视、部门合作的主体困境。道德冲突往往使艾滋病防治的相关方面和环节陷入两难的境地。协调这些道德冲突,必须在区分两种不同性质冲突的基础上,坚持相应的道德原则,强化责任伦理,实施宽容策略。     

Data and projections of HIV/AIDS cases in Portugal: an unstoppable epidemic?

The size of the affected population with HIV/AIDS is a vital question asked by healthcare providers. A statistical procedure called Back-calculation has been the most widely used method to answer that question. Recent discussions suggest that this method is gradually becoming less appropriate for reliable incidence and prevalence estimates, as it does not take into account the effect of treatment. In spite of this, in the current paper that method and a worst-case scenario are used to assess the quality of previous projections and obtain new ones. The first problem faced was the need to account for reporting delays, no reporting and underreporting. The adjusted AIDS incidence data were then used to obtain lower bounds on the size of the AIDS epidemic, using the back-calculation methodology. A Weibull and Gamma distribution was considered for the latency period distribution. The EM algorithm was applied to obtain maximum likelihood estimates of the HIV incidence. The density of infection times was parameterized as a step function. The methodology is applied to AIDS incidence in Portugal for four different transmission categories (injecting drug users, heterosexual, homo/bisexual and other) to obtain short-term projections (2002–2005) and an estimate of the minimum size of the epidemic.     

构建医本科艾滋病课程体系的认识与实践

通过开设医本科艾滋病选修课教学实践，了解医学生艾滋病知识状况及需求，探索医本科艾滋病课程教育目标、教学内容、教学方法、教学评价和师资建设，促进艾滋病课程教育在高等医学院校的开展，提高艾滋病教育效果。     

Reaching African-American Men on the “Down Low”: Sampling Hidden Populations: Implications for HIV Prevention

ABSTRACT

Studies on the impact of the HIV epidemic among African-American men who have sex with men (MSM) have largely neglected men who self-identify as heterosexual but engage in same-sex behavior. These men, commonly referred to as men on the “down low,” pose formidable challenges to researchers conducting prevention studies. This article addresses the methodological issues that create limitations in sampling this population. It presents a novel approach to locate and access these men, describes the success in using this approach, and suggests implications for future research employing this sampling approach.     

Human Immunodeficiency Virus (HIV) Seropositive Homeless Men: Behavioral and Social Characteristics

Homeless persons living in US. innercities are at risk for human immunodeficiency virus (HW) infection, but few studies have examined the continued risk behaviors of HIV infected homeless men. We investigated the sexual behavior of 32 homeless men who had tested HIV seropositive. Twenty-five percent of HW positive men reported a history of injection drug use, 34% had sex with men, over 40% had participated in commercial sex, and 59% had been treated for a non-HIV sexually transmitted disease. HIV seropositive men also reported recent sexual behavior, with 62% having sex in the previous month and 50% currently sexually active. Condom use was inconsistent among seropositive men; 44% of vaginal and 50% of anal intercourse occasions in the preceding three months did not involve condoms, and 28% of HW seropositive men did not use a condom during their most recent sexual encounter. Substance use was frequently associated with unprotected sexual behavior among HW seropositive men. Finally, measures of life satisfaction showed that HIV seropositive men were most satisfied with their relationships, mental health, and spiritual well being. These data suggest a need for intensive behavioral.interventions tailored for homeless HW infected men and we recommend that existing substance use treatment and holistic care be incorporated into behavioral interventions for HW infected men.