Reaching Men who have Sex with Men in Australia. An Overview of AIDS Education: Community Intervention and Community Attachment Strategies

This paper outlines the principles underlying the Australian AIDS strategy and offers an explanation for its success in reducing the spread of the human immunodeficiency virus (HIV) among homosexual and bisexual men in Australia's gay communities. A brief outline of the AIDS education activities offered by the gay-community AIDS organisations is followed by results from the Social Aspects of the Prevention of AIDS (SAPA) research project based at Macquarie University. This research confirms the importance of the community-intervention strategies utilised by gay AIDS organisations. The paper then assesses progress in the development of community-attachment strategies for men who have sex with men but who are not attached to organised gay communities.     

Sexual Orientation and Sex in Women's Lives: Conceptual and Methodological Issues

Use of such categorical terms as heterosexual, bisexual, and lesbian is widespread, yet research indicates that sexuality is a multidimensional phenomenon. Sexual behavior, identity, and desire are not highly intercorrelated for women, and this has implications for new ways of conceptualizing sexual orientation. Furthermore, the multifaceted nature of sexual orientation has implications for conceptualizing sexual activity and sexual desire for women. Some methodological issues are presented for future research on female sexual orientation, including a better understanding of gender and a more multifaceted approach to sexual orientation.     

The Changing Focus of Child Maltreatment Research and Practice Within Psychology

Professions functionally define a field by the types of behaviors or circumstances to which they direct their attention and efforts. For psychology and mental health professionals concerned with child maltreatment, child sexual abuse has been the dominant interest over the past two decades and has been virtually synonymous with child maltreatment within psychology. This is discrepant from the broader scope of child maltreatment, as seen both in child welfare populations and in the general population. In child welfare, sexual abuse is an important but nonetheless relatively less frequent issue. Child neglect and physical abuse dominate child welfare caseloads, and historically always have. The disconnect between the interests of mental health professionals and child welfare appears to be waning, both in terms of dialogue within psychology and apportioning of research resources. This article examines what this emerging change may mean for practice and research in terms of the changing nature of populations involved, different types and locations of services, different roles and new multidisciplinary alliances.     

SOURCES OF INFORMATION ABOUT HIV/AIDS,TRUST OF SOURCES AND PERCEIVED RISK OF INFECTION

The relationship between sources of information about AIDS/HIV, trust of the sources, how informed about AIDS people thought they were, and perceived risk to self and others were examined using three samples. One included young heterosexual students (113 females and 91 males), while the others included slightly older heterosexuals (74 females and 73 males) and homosexuals (82 males) from the general community. Homosexual men were the only group who trusted the same sources from which they received the most information (eg gay publications and AIDS organisations). Heterosexuals trusted expert sources the most, but the students received most information from magazines aimed at their peer groups and the heterosexuals in the community sample received most information from the print media. For the students, perceived personal risk was influenced most by perceived risk to male friends and people with the same sexual practices, whereas for the community samples it was influenced most by perceived risk to people with the same practices. The results suggest a strong peer influence on perceptions of personal risk of HIV infection.     

The Economic and Gender Consequences of South Africa's Home‐based Care Policy

South Africa's approach to care provision in the era of HIV/AIDS is home‐ and community‐based care, but in reality care for ill people in the home is provided on an unpaid basis, predominantly by women. But how much do they spend on this care work, in time and money? And what economic consequences does this policy have, particularly for poorer women? This article is based on findings from a study that focuses on unpaid care provision within the home for those in late‐stage HIV/AIDS in KwaZulu‐Natal, South Africa, and specifically on the costs of such provision. The findings show that female caregivers are bearing the bulk of the costs of care provision for ill people within the home on an unpaid basis. Home‐based care is cost‐effective for the provincial government but not for unpaid caregivers who are subsidizing the provincial economy. While hospital care for people with HIV/AIDS has been capped, home‐based care services have not been increased to a commensurate level. Unpaid caregivers and ill people within the home are largely disconnected from the health system. The analysis clearly shows that the home‐based care policy is not resulting in appropriate or sufficient support for these individuals in need and needs to be revised.     

Older Latina Women and HIV/AIDS: An Examination of Sexuality and Culture as they Relate to Risk and Protective Factors

Older Latina women are one of the least studied American demographic groups with regard to social, health, or sexual behavior. This could leave social workers and other geriatric professionals unprepared for dealing with HIV/AIDS in this population. Currently, older Latina women are one of the fastest growing groups of new AIDS cases. Twenty percent of all women ever diagnosed with the disease are Latina and 5.5% of Latinas infected with the virus are older. The number of diagnosed infections is increasing in older women, including Latinas, in spite of recent declines in infection rates with younger populations. There are also a potentially large number of cases that go misdiagnosed or undiagnosed.

This article also addresses risk and protective factors related to gender roles, traditional Latino family values, religion, socioeconomic factors, health, and health care, with special attention to the triple jeopardy faced by this population by virtue of being female, seniors, and minorities. The article concludes with recommendations for the development of culturally competent practices with older Latinas and the development of a research agenda to better understand their risk-related and health-seeking behavior.     

Gay Men's Knowledge of HIV Transmission and ‘Safe’ Sex: A Question of Accuracy

The study described in this paper is part of a project assessing the impact of the HIV epidemic on 535 men who have sex with men. These men were surveyed about their knowledge of HIV, their sexual practices, other issues concerning the transmission of HIV, and AIDS. This paper focuses on these men's beliefs about HIV transmission, their perceptions of the safety of a number of sexual and social practices, and the factors influencing these perceptions. The findings indicate, in general, that the men surveyed were moderately well informed about HIV transmission. Some twenty percent of the men were well-informed about both ‘safe’ and ‘unsafe’ sexual practices, a small number were ill-informed and the remainder, the majority, were well-informed about some aspects and ill-informed about others. The data suggest that information from the mainstream and gay press is not only differentially available but that information is processed and interpreted by the men in different ways. Variables which influence the manner in which information is interpreted are place of residence (locale), awareness of gay community posters and pamphlets, and the men's sexual practice; these are associated with cautiousness or rashness in the men's judgments of safety and risk.     

Employment Exits and the Race Gap in Young Women's Employment*

Objective. A race gap in employment that disadvantages young African‐American women has emerged for the first time in U.S. history. This article addresses the extent to which race differences in employment entry, exits, or both are responsible for the gap. Methods. The article relies on event‐history analysis using NLSY data. Results. Analyses show that differences in rates of exit, not entry, explain the race gap. Factors encouraging higher exit rates among African‐American than white women include lower AFQT scores and greater numbers of children. Conclusion. These findings raise questions about the utility of focusing on employment processes at the point of employment entry, at least for processes involving young women. The importance of exits in understanding race differences in women's employment calls attention to processes within firms that present barriers to African‐American women.     

UNDERSTANDING THE CONTEXT OF RISK PRACTICES AMONG INJECTING DRUG USERS: IMPLICATIONS FOR HEPATITIS C PREVENTION

‘Risk’ is central to recent sociological studies of health and related behaviour, particularly in discourses about HIV/AIDS and hepatitis C (HCV). While epidemiological survey predominates over qualitative investigation in HCV risk reduction, it is necessary to move beyond individual‐level characteristics to gain a fuller understanding of the social context of risk. This paper investigates the context of HCV‐related risk behaviour among injecting drug users (IDUs) and discusses the behavioural and social determinants of risk practices. Data from 336 IDUs completing a self‐administered questionnaire were analysed. The data show that needle‐sharing practices are often integral to long‐standing relationships, particularly sexual ones. The level of drug dependency, trust relationships between partners and misconceptions about HCV transmission have been demonstrated to be associated with risk behaviour. Logistic factors, such as poor access to injecting equipment, limited hours of operation, and fear of police were given as barriers to safer injecting. Given the progression of the HCV epidemic, prevention campaigns should aim at risk reduction rather than risk elimination.     

Understanding how globalisation and restructuring affect women's lives: implications for comparative policy analysis

Globalisation and neo–liberal restructuring have transformed social policy and social services in many countries over the past two decades. Among the various impacts on different societies, one commonality is that many of the costs of restructuring are being picked up by women. In the last decade, feminist scholars have developed a critique of the effects of restructuring on the public and private lives of women, effects which are conspicuously absent from many discussions of restructuring. This article presents several conceptual ingredients for a framework that can facilitate a comparative understanding of restructuring and its effects on women at both global and local levels. Canada and China are used to illustrate the utility of such an approach to comparative policy analysis. The article contributes to a growing body of feminist literature on changing regimes of citizenship. It adds to the scholarship on comparative policy analysis by developing a research approach that is grounded in the experiences of women and is attentive to global and local politics. We argue that understanding just how restructuring affects different groups of women is essential for developing analyses that can cross national boundaries and challenge policies that reproduce conditions that oppress women.     

SexualPrejudice and Gender: Do Heterosexuals' Attitudes Toward Lesbians and Gay Men Differ?

This article explores the question of whether and how heterosexuals' attitudes toward lesbians differ from their attitudes toward gay men. Data from a 1997 national survey are presented to show that heterosexual women generally hold similar attitudes toward gay men and lesbians, whereas heterosexual men are more likely to make distinctions according to gender. Moreover, men's attitudes toward lesbians are susceptible to situational manipulations. Nevertheless, the underlying unity of attitudes toward lesbians and gay men is demonstrated by the fact that they are highly correlated for both heterosexual men and women. It is suggested that heterosexuals' attitudes toward gay people are organized both in terms of minority group politics and personal sexual and gender identity and that attitudes toward lesbians are most likelyto be differentiated from attitudes toward gay men in the latter realm.     

The Cost of Parenthood: Unraveling the Effects of Sexual Orientation and Gender on Income*

Objectives. Prior research has repeatedly shown that parenthood affects employment outcomes; mothers have, on average, lower wages and are less likely to be hired than childless women. Some research indicates that this effect of parenthood on employment outcomes is dependent on sexual orientation. In particular, lesbian mothers might be treated more like childless women by those making employment decisions. This article examines the degree to which the lesbian wage advantage can be explained by lesbians avoiding the motherhood wage penalty experienced by heterosexual women. Methods. Drawing on 2000 U.S. Census data, this issue is first explored via ordinary least squares regression equations that estimate the effect of having a child present in the household on income. The Blinder‐Oaxaca method is then employed to decompose the earnings differential between heterosexual and gay individuals. Results. Results indicate that lesbians appear to experience a motherhood advantage that increases their wages by approximately 20 percent. Further, results support the notion that lesbians receive different returns to the presence of children in the household than do heterosexual women. Approximately 35 percent of the wage differential between lesbians and heterosexual women is attributable to differences in returns to child rearing. Conclusion. These findings have relevance for state and federal anti‐discrimination laws and work/family policies, as they provide further insight into the role that gender, and gender‐based assumptions, play in determining employment outcomes.     

The coupling of rural communities with their economic base: agriculture,localism and the discourse of self-sufficiency

In the context of the changing socio-economic position of agriculture, this paper is concerned with the governmental relations associated with managing the decoupling of society from economy and the ensuing question about how the economic base can be adequately utilised to ensure continued material sustenance for the community. Central to these challenges is the role of social policy in co-ordinating processes of change against society's capacity for change, taking into account the increasing realisation that the both the capacity of the planet and its economies are finite. Localism is increasingly being promoted as a key social strategy which communities can use to address their needs to secure material sustenance. Under this form of localism, communities are required to secure their own socio-economic sustainability by taking an entrepreneurial approach to developing their local assets and resources. Societies are facing questions about the viability of both interventionist and market-based approaches for ensuring the continued sustenance of given communities. But, since localism does not have the capacity effectively to deal with the question of the carrying capacity of the economic or environmental base at a societal level, one must query the extent to which faith can be maintained in localism as an effective strategy for the future.     

Context-contingent decision-making in child protection practice

Research on child protection practice has been concerned mainly with the problem of the maltreating parent. System philosophies and processes and the influences on these, while addressed by some authors, have not received the attention they deserve. Understanding the ways in which child protection practices are constructed offers insights into the equitable or otherwise application of these processes to different groups of parents within our communities. In the study reported here we examine how child protection workers make decisions about removing children and subsequently initiating court proceedings. By focusing our analysis on a particularly vulnerable group of parents, those with intellectual disability, we highlight the ways in which child protection workers carry out their legislative mandate to keep children safe.     

How Social is Social Policy? Fiscal and Market Discourse in North American Welfare States

Long regarded as a 'laggard' among welfare states in advanced industrial countries, the USA may be emerging as a 'leader' in the reformation of social programmes and the relationship between government, the market economy, and civil society. The dissemination and impact of this new orthodoxy is realized, in large part, through discursive practices. Fiscalization and marketization are two processes central to this growing influence of American social policy. Fiscal and market discourse, while not new, have increased in acceptance and influence, and are changing the welfare state from within by altering perceptions of issues, vocabularies used and programme reforms adopted.     

Understanding Women's Sexualities and Sexual Orientations: An Introduction

Researchers and theorists who attempt to generalize about sexuality and sexual orientation in both men and women simultaneously often take male experiences as the norm and ignore unique aspects of women's lives. The purpose of this issue is to focus attention on scientific research and theory about aspects of women's sexualities, with special emphasis on sexual orientation. A new paradigm is presented that recognizes the great diversity of women's erotic experiences and the many sociocultural factors that shape women's sexuality and sexual orientation across the lifespan. This introductory article highlights major themes and provides a brief summary of the articles in the issue. Four central topics are discussed: (1) the complexnature of women's sexualities and sexual orientations; (2) the importance of historical, social, and cultural contexts for adequately understanding women's sexualities; (3) the development of sexual orientation in women; and (4) implications for research and policy.     

What might Normalisation Process Theory bring to policy implementation studies? Learning lessons and uncovering questions through a case study of the profound implementation failure of a new policing policy

Normalisation Process Theory (NPT), used nationally and internationally to explore implementation within health services research, is used for the first time within policing to understand profound policy implementation failure and to generate broader discussion of policy implementation theory. The policy in question (Police to Primary Care [P2PC]) was an intervention designed to notify GPs when women are assessed by police as at high risk of future domestic abuse. Designed to improve interagency communication, it took place amidst radical organisational change. Using qualitative interviews with domestic abuse specialist and frontline officers, this paper addresses how NPT helps to explain the (non)implementation of P2PC, how such an analysis differs from other policy implementation approaches, and what this means for our understandings of policy implementation more broadly. NPT proved useful in understanding mechanisms leading to (non)implementation of the intervention: fuzzy alignment with existing practice, faulty communication of purpose, and inattention to discretionary implementation spaces. It helped us understand why the intervention came to be invisible. Dwarfed by its organisational context, made institutionally hard to read by a lack of formal protocols, and given restricted view to police officers, it was compromised by a failure to instigate systems of organisational learning. More broadly, NPT helped reveal practices intersecting top‐down and bottom‐up implementation theory. The paper concludes by asking how NPT and theories of street‐level bureaucracy might be better used in tandem and, particularly, how this might help explorations of policy implementation where human actors are joined by technological actors in interpreting and making policy in vivo.     

The Gender Dimension of Social Policy Reform in Turkey: Towards Equal Citizenship?

This article discusses the current social policy reform process in Turkey from a gender perspective. Until now, social security and labour regulations have provided women with special benefits and protections. Depending on the particular case, these gender‐specific policies can be interpreted differently – as positive discrimination, satisfying practical gender interests, or as a reinforcement of traditional gender norms and relations, stigmatizing women as a weaker, vulnerable group in need of special protection. Ongoing reform initiatives, however, neutralize most of these long‐lasting gendered policies, either by terminating rights formerly enjoyed only by women or by extending these rights to men as well. The article questions this changing nature of social policy as to whether it promises equal citizenship for women or increases their vulnerability, in the absence of former benefits and without sufficient policy measures for improved capability.     

Theorizing Sexuality, Sexual Abuse and Residential Children's Homes: Adding Gender to the Equation

This article is primarily concerned with emphasizing the importanceof gender in relation to understanding and responding to sexualityand sexual abuse/exploitation issues within residential children’shomes. Initially, past research and inquiry reports are analysedand evaluated, not only in relation to their overall conclusionsand recommendations, but also with regard to their consideration,misrepresentation or omission of gender issues. A theoreticalframework is then drawn up which takes into account historicaldebates and contestations around notions of gender. This illustrateshow gender is frequently conflated or merged with understandingsabout sex and sexuality. This theoretical conceptualizationis then extended to consider the effects of the social constructionof childhood and childhood sexuality, and how sex, gender andsexuality may commonly be represented and understood withinorganizational, public-sphere contexts. Important findings froma recent indepth qualitative research project focused on sexualityissues in children’s homes are then presented thematicallyand through narrative excerpts. These findings are also locatedwithin and made comprehensible in relation to the theoreticalframework previously constructed. The conclusion examines theimplications of the findings presented and their theorization,and briefly evaluates the usefulness of recent policy initiativesintended to improve the care and development of ‘lookedafter’ children.     

Conflicts of interest in academic research: policies, processes, and attitudes

Few studies have examined academic researchers' understandings or attitudes toward conflict of interest policies even though these understandings and attitudes represent a crucial component of both compliance and educational efforts. This study reports the results of a large-scale, cross-sectional survey of research faculty at the nine campuses of the University of California regarding their understandings of and attitudes toward campus conflict of interest policies. We gathered information on their general assessments of investigators with financial ties to industry sponsors and reactions to the process of implementing conflict of interest policies at their respective campuses. We surveyed 1,971 faculty members from the nine-campus University of California system and had 779 responses (39% response rate). The sampled faculty were in the ten departments with the most number of financial disclosures at each campus. We utilized the WebSurveyor software to create a secure, online, 21-item survey. Our study reveals faculty with complex, sometimes contradictory, feelings about academic-industry relationships and highlights perceived gaps in policy and process. Most respondents were concerned about unlimited financial relationships, but a sizable number also viewed campus policies as irrelevant. Some expressed considerable anger over the process of policy implementation, rejecting the policies on the basis of professional and individual self-determination and moral integrity. Our study suggests the need for renewed efforts to encourage awareness of the relevance of conflict of interest policies for all faculty, new efforts to increase understanding of the situational nature of conflicts of interest, and reexamination of the processes of policy implementation at the campus level.