Crafting Communities: Promoting Inclusion,Empowerment, and Learning between Older Women

Abstract

While social policy and planning documents are replete with ominous warnings about the cost of an ageing population, this article tells a different story about the productive and self-sustaining networks that exist among older women in the community who do craftwork. From our research conducted in Victoria, Australia during 2007–2008 we discovered a resilient and committed group of older women quietly and steadily contributing to community fundraising, building social networks, and providing learning opportunities to each other in diverse ways. Through our conversations with nine craftswomen we have been able to articulate clear links between the theory and models commonly espoused in the community development literature and the life-enriching practices used in organising informal community craft group activities. From our interviews with the older women we provide evidence of sustained participation, the generation of social capital, and the fostering of life-long learning. While none of the women we spoke to were trained in community development and did not use language commonly associated with feminist ideology, the relationship between the informal group work with principles of empowerment and self-efficacy were unmistakeable. We conclude with a discussion of the implications of our findings for critical social work practice.     

Youth-Driven HIV Prevention Programmes in South Africa: Social Capital,Empowerment and Conscientisation

Abstract

The community-level attributes of two youth HIV prevention initiatives in a single community are examined using the concepts of social capital, empowerment and critical consciousness. The school-based peer education programme and youth-initiated public clinic ‘add-on’ facility for the treatment of adolescent sexually transmitted diseases had differing experiences in terms of implementation, community acceptance, sustainability and achieving their goals. By examining the role of conscientization, networks for accessing resources and power, and community acceptability of adolescent HIV prevention, this paper describes the differing experiences of these two programmes. The paper indicates the need for true adolescent agency in challenging the social constructions of adolescent HIV risk at the social and community levels.     

Changing Directions in HIV Prevention: The Move Toward a Psychosocial Model

ABSTRACT

Although some HIV prevention programs have been successful in helping gay and bisexual men change their sexual behaviors, rates of HIV infection continue to increase. In an attempt to address this problem, social workers need to move beyond traditional HIV prevention approaches to a psychosocial model of HIV prevention. Based on the work of previous researchers, this approach assumes that a combination of individual, psychological, and social factors contribute to risky sex in gay and bisexual men. Because social workers are trained to view problems from a psychosocial framework, they are already in a position to develop programs incorporating the psychosocial model. This article examines the psychosocial model of HIV prevention and the various psychosocial factors that may contribute to high-risk sexual behavior and concludes with examples of prevention research that have already incorporated the model.     

An Approach to Community Outreach Practice in the 21st Century

ABSTRACT

This article presents the findings of a study about knowledge, attitudes and beliefs about AIDS held by older Hispanic adults. Members of the convenience sample provided responses that identify concerns about effective practice in outeach and information provision to older adults with regard to risky sexual practices. Intervention to prevent the spread of HIV/AIDS among older adults needs to be culturally competent and to be attuned to social practices, traditions, community concerns, and generational perspectives with regard to serious health problems related to sexual behavior. The sample composition was primarily Hispanic (97.4%); Catholic, (92.1%) and female (84.2%) with a mean age of 73.7 years. Approximately 28.2% of those surveyed stated that they felt that AIDS was an important problem for older adults. The majority, (76.3%) were aware of locations where health information and services were available if AIDS were a problem. Even though the majority indicated knowledge that AIDS is spread through sexual intercourse, more than one third, (36.8%) thought that sexually active adults 55 and over never use condoms. A discussion of the implications for disease prevention programs and community practice is presented emphasizing the importance of empowerment strategies in health promotion programs and the strengthening of multidisciplinary collaborative efforts to effect positive community health changes.     

Interventions to Developing Community Partnerships for HIV Prevention Planning

Abstract

Since 1985 the Centers for Disease Control and Prevention (CDC) have entered into a series of cooperative agreements with the states and territories of the United States to fund human immunodeficiency virus (HIV) prevention activities. In 1994, the CDC mandate shifted from using a central entity to plan HIV prevention programs throughout its jurisdictions to fostering partnerships among a central state or territorial agency, health departments in local counties, and community-based organizations. This article discusses and applies a model developed by social workers to facilitate HIV prevention community planning at the local level. The model used to facilitate community planning emphasizes the use of the social principles of empowerment, self-determination, ownership, and inclusion to foster the development of community-relevant HIV prevention plans. This approach resulted in the completion of a successful HIV prevention plan, and application for continuing and supplemental funds ($6.6 million and $1.2 million respectively) from the CDC for HIV prevention efforts, the continued use of the model in HIV prevention planning, and the ability to use the principles of the model as a basis for providing future technical assistance in community planning.     

Transferring a University-Led HIV/AIDS Prevention Initiative to a Community Agency

Summary

Given the urgent need for HIV/AIDS interventions that will reverse current infection trends among urban minority youth, identifying effective and socially relevant approaches is of primary concern. HIV/AIDS prevention initiatives that are housed in, and led by, communities may address the limits of laboratory-based inquiry for this complex and socially-situated health issue. In this article, we describe the process of moving a researcherled, HIV/AIDS prevention research program—the Collaborative HIV/AIDS Adolescent Mental Health Project (CHAMP)—from a university laboratory to a community mental health agency with the goal of strengthening program access, effectiveness, and sustainability over time. We outline the framework, timeline, and responsibilities involved in moving the program, research, and technology from its original university base to a local community agency. From the challenges faced and lessons learned during this complex transfer process, we hope to enhance understanding of ways in which we can narrow the gap between academic and community leadership of HIV/AIDS prevention research.     

A Model of Heterosexual Adaptive Relationship Functioning in South Africa: Implications for HIV Prevention Interventions

Abstract

Objectives: Couple-based HIV prevention efforts are an important HIV prevention strategy in South Africa but there is a lack of understanding as to what constitutes healthy relationships in South African sociodisadvantaged communities. Methods: To address this, 8 focus group discussions were conducted with 27 men and 23 Black African women living in a large disadvantaged community in Cape Town, South Africa. Results: A model of adaptive relationship functioning is put forth, which involves four primary relationship components that emerged as central to healthy relationships: active relationship building, emotional support/display, communication, and problem-solving. Conclusions: The results of this study can inform couple-based HIV prevention efforts.     

Gendered Economic,Social, and Cultural Challenges to HIV/AIDS Prevention and Intervention for Chinese Women

ABSTRACT

China is experiencing the most rapidly expanding HIV prevalence in the world, with the percentage of Chinese women living with HIV/AIDS also increasing significantly. Chinese women's risk of HIV infection is heavily influenced by patriarchal cultural beliefs, Confucian doctrines, and rapid social and economic changes in China. Chinese women generally have a low level of awareness of HIV/AIDS. With inherent inferior social status and economic disadvantage, their vulnerability to HIV infection is heightened by adverse impacts of massive rural-to-urban migration, explosion of the commercial sex industry, and prevalence of gender-based violence. In order to target HIV/AIDS prevention and treatment programs for Chinese women, their specific needs and gendered obstacles must be addressed and tackled. These include strategies that aim to fight against poverty, improve education, enhance HIV/AIDS awareness, facilitate new life-skills acquisition and behavior change, make available woman-centered services for testing and treatment of HIV, and eradicate gender-based discrimination and violence. There is also an urgent need to further develop various public health infrastructure in China, especially in remote and rural areas. The pool of gender experts in China should also be expanded to conduct a thorough gender analysis and design a national response to address the evolving HIV/AIDS epidemic in Chinese women.     

Difference in Condom Use Among Sexually Active Males at Historically Black Colleges and Universities

Black men who have sex with men (MSM) and black men who have sex with both men and women (MSMW) may not perceive themselves to be part of the larger gay community and hence may not heed prevention messages aimed at the community. Objective and Participants: To better understand the participants behaviors, the authors examined differences in condom use between black MSM/W (including MSM and MSMW) and men who have sex with women (MSW) at historically black colleges and universities (HBCUs). Methods: A paper-and-pencil questionnaire survey investigated sexual behaviors of 1,865 freshmen from 35 HBCUs during the 2001-2002 school year. Results: MSM/W were about 0.37 times less likely to always use condoms compared with MSW (adjusted odds ratio = 0.63, 95% confidence interval = 0.42-0.95). Sexual behavior, age at survey, total family income, and religion were also associated with condom use. Conclusions: These findings offer new directions for sexually transmitted disease and HIV prevention aimed at a highly marginalized population that remains at high risk for infection.     

Effects of sociodemographic factors,stage of illness,and perceived stigma on the identification of a support person among women with HIV infection

Addressing the lack of research on the social distribution of social support and research on the social experience of women with HIV infection, this article examines how sociodemographic factors, stage of illness, and perceived stigma affected the identification of a supportive social relationship among HIV‐infected women. Data were collected from women with HIV disease living in the state of Georgia. Logistic regression analysis indicates that after taking account of other factors, marital status, rural‐urban residency, stage of illness, and stigmatization were significant predictors of whether the women identified a support person. Single status and rural residency had negative effects on the outcome. Those who were at the advanced stage of illness were less likely than those at the asymptomatic stage to identify a supportive relationship. Contrary to our expectation, stigmatization had positive effects on the outcome. Implications and limitations of the analysis are discussed, followed by directions for future research.     

Club Drug Use,Sexual Behavior,and HIV Risk Among Community and Internet Samples of Hispanic MSM: Implications for Clinicians

ABSTRACT

Hispanic men who have sex with men (MSM) are at high risk of HIV infection. This study reports on the club drug use and sexual behaviors of two distinct samples (community and Internet) of Hispanic MSM living in the AIDS epicenter of Miami-Dade County. Both samples reported high rates of unprotected anal sex and high numbers of sex partners; rates of club drug use (cocaine, ecstasy, methamphetamines, GHB, amyl nitrites, and Viagra) were also high. Recent use of club drugs was associated with both unprotected receptive and insertive anal sex in the Internet sample, but not in the community sample. Implications for social work practice are discussed.     

The Impact of AIDS on Intergenerational Relationships in Africa

Abstract

This paper describes die impact of AIDS on intergenerational relationships in Africa (especially Sub-Saharan Africa). The AIDS infection in Sub-Saharan Africa has expanded astronomically with up to 18.5 million living with the disease. Young adults between the ages of 14 and 49 are most likely to be infected. In the countries of Sub-Saharan Africa, three levels of HIV/AIDS infection among adults can be identified-hardest hit, high, and moderate. This ranges from 3.6% for moderate level to 35.8% for the hardest hit. The situation has changed the youth population profile and has numerous quality of life implications for young people, older adults, and a multi-dimensional impact on community life.

With the adverse socioeconomic and psychological effect of AIDS, interactions between members of the different generations are made difficult-relationships are becoming more of a burden than a mutual source of satisfaction. Children and young adults are losing their parents and mentors, and sometimes have to take care of their infected and dying parents at a very early stage in life. The older population is now losing its social and economic support, which hitherto, they have drawn from their adult children, and at the same time, they are assuming a new caregiving role to either their infected and affected children or grandchildren, or both.

Hope exists if the trend is checked by AIDS prevention efforts with examples drawn from countries like Uganda, Senegal, and Nigeria. But since there are some victims already, efforts should be made to help them cope with the stress and adverse effects of the disease. Governmental policies should also aim at assisting victims and volunteers financially. As part of the strategy, intergenerational relationships at family, organizational and community levels should be strengthened. Reinforcing the value of being one's “brother's keeper” both as individuals and groups/organizations is crucial at this time of crisis.     

Green grey hairs: A life course perspective on environmental engagement

ABSTRACT

Older adults provide a long view of understanding environmental engagement from their early beginnings to their current community activities. This study draws on interviews with self-described environmentalists and follows a life course analysis that employs social work values and practice skills as they work towards environmental justice in their Midwestern communities. We conclude that the older adults of this second generation of environmentalists offer valuable lessons for social workers with regard to environmental justice, while at the same time contributing insights into older adult volunteering and addressing the challenge of a generational gap in participation in their community organizations.     

Stigma,AIDS, and HIV Prevention in Africa: Reports from Community Organizations Providing Prevention Services

ABSTRACT

The AIDS epidemic in Africa remains a serious health crisis. Nongovernmental organizations (NGOs) in Africa play a critical role in the delivery of HIV prevention services. An important barrier to their HIV prevention efforts is stigma directed at persons living with HIV/AIDS. In order to understand how stigma affects HIV prevention programming, we conducted in-depth qualitative interviews with NGO directors in 29 African countries. Qualitative analytic approaches were used to identify key themes. Substantial discrimination and stigmatization of HIV-positive persons was reported. HIV-positive women were particularly likely to suffer negative social and economic consequences. The stigma associated with HIV interfered with disclosure of HIV status, risk-reduction behaviors, and HIV testing, creating significant barriers to HIV prevention efforts.

Interventions to reduce AIDS-related stigma in Africa are urgently needed. Reducing the burden of stigma is critical to fighting the epidemic in Africa and could play an important role in global HIV reduction.     

HIV Prevention Programs in the Black Church: A Viable Health Promotion Resource for African American Women?

ABSTRACT

Nearly 40 million people worldwide are living with the human immunodeficiency virus (HIV). The Centers for Disease Control report that women account for more than 50% of the existing 40 million HIV/AIDS cases to date. Moreover, African-American women are infected with HIV/AIDS 25 times more often than white women and four times more often than Hispanic women, making HIV/AIDS the leading cause of death for black women ages 25–34. Given the increasing rate of transmission with this population, the purpose of this article was to review the existing literature to investigate the risk factors associated with African-American women with HIV/AIDS and identify an effective method of HIV prevention for them. A discussion of religion and African-Americans in terms of the Black church and its health promotion efforts was also included. The article concludes with a discussion of program elements of HIV prevention programs in the Black church and possible challenges faced for the programs.     

Sex,Drugs, and Love Among the Middle Aged: A Case Study of a Serodiscordant Heterosexual Couple Coping with HIV

ABSTRACT

HIV infection attributable to injection is growing, as is the incidence among heterosexual persons. Some of the people affected are over 50, and we can anticipate a growing number of older people with substance use and HIV as primary concerns. Therefore, we need to know more about the intersections of age, addictions, and HIV. This article uses narrative analysis to examine a research interview with an African-American woman and her African-American HIV-infected male partner in order to gain insight about how a middle-aged serodiscordant drug-affected couple might struggle and succeed in the face of HIV. Implications for social work, policy and research are provided.     

Girl-trafficking,HIV / AIDS,and the position of women in Nepal

This article focuses on trafficking of young Nepalese girls and women. Trafficking is an integral part of the social and economic fabric of Nepal, as in other parts of the world. The practice causes intolerable degradation and suffering for the girls and young women involved, who are treated as a commodity. It presents a risk to their physical and mental health, and in particular to their sexual health. The article examines the connections between coercive sex work and HIV infection, and community and government responses to HIV infection among trafficked sex workers. In particular, it considers the current AIDS prevention and control program in Nepal, and criticizes it from the feminist perspective of the authors, who are a Nepalese nurse who has undertaken academic work in New Zealand related to women's health, and a New Zealand feminist academic, who is also a nurse.     

Getting a picture of the client's world-view: Art-making and subjectivity as evidence

Paintings and drawings can enrich and amplify understanding of dilemmas which may otherwise be limited by reliance on verbal data alone, such as client conversations, interviews and case-notes. In order for social workers to make sense of this additional information, they will need to use their subjective understandings, which because of their very subjectivity need then to be cross-checked with other forms of evidence. This article outlines an approach useful in social work practice with adult clients. It is based on research with a community group of volunteers from the Midlands who chose to join a project exploring midlife and its transitions. It was found that art-making of a particular order, which accentuated sensory exploration, curiosity and experimentation, contributed towards a changed relationship with self and with the external world. Key indicators lay in changes in use of language, choice of art materials and colour.     

Gendered Perceptions of Community Needs and Concerns

Abstract

Acentral tenet of feminism is that women engage in community practice differently than men. This study explores whether gender differences exist in perceptions of community needs, strengths, problems and responsibilities. Also examined are differences within male and female groups along the dimensions of race, location, years at current address and ownership status. This analysis is based on survey responses from 191 residents in one urban community. Contrary to feminist theory, findings reveal strong agreement between men and women. There were, however, numerous differences within gender groups, especially among women. Implications for feminist scholarship, community practice, and social work education are discussed.