Internalized Homophobia,HIV Knowledge,and HIV/AIDS Personal Responsibility Beliefs: Correlates of HIV/AIDS Discrimination among MSM in the Context of Institutionalized Stigma

ABSTRACT

There exists a paucity of research on the psychosocial risk factors of HIV/AIDS among men who have sex with men (MSM) in settings where they are stigmatized or face prosecution. The present study investigates discrimination against people living with HIV (PLHIV), internalized homophobia, HIV/AIDS personal responsibility beliefs and HIV knowledge in a purposive sample of 106 self-identified MSM obtained through a web-based survey disseminated by two voluntary welfare organizations. Results indicate that internalized homophobia is positively associated with discrimination against PLHIV. Internalized homophobia also substantially mediates the effect of HIV/AIDS personal responsibility beliefs on discrimination against PLHIV, highlighting the confounded nature of HIV/AIDS and homosexual stigma in a setting where stigma is deep-rooted and institutionalized. Internalized homophobia may thus serve as a barrier to the effectiveness of HIV prevention efforts among MSM in Singapore.     

“You Have to Keep Yourself Hidden”: Perspectives From Malaysian Malay-Muslim Men Who Have Sex With Men on Policy,Network, Community,and Individual Influences on HIV Risk

ABSTRACT

Malay-Muslim men who have sex with men (MSM) are marginalized and hidden in Malaysia, a predominantly Muslim country in southeast Asia. We explored the policy, network, community, and individual factors related to HIV infection among Malay-Muslim MSM through 26 in-depth interviews and one focus group discussion (n = 5) conducted in Kuala Lumpur and Kota Bharu between October 2013 and January 2014. As religion plays an important role in their lives, participants viewed homosexuality as a sin. Low risk perception and misconceptions about HIV/AIDS were common, and most participants expressed reluctance to consult a doctor unless they had symptoms. Additionally, buying condoms was embarrassing and anxiety-producing. Fear of discrimination by health care providers and community hindered participants from disclosing sexual behaviors and accessing health services. Homophobic comments and policies by the government and religious leaders were concerns of participants. A safe and enabling environment is needed to reduce HIV risks among Malay-Muslim MSM.     

“Requestioning” AIDS: An Ethical Reflection From 1993 to Today

ABSTRACT

This article serves as one of the supplementary pieces of this special issue on “Mapping Queer Bioethics,” in which we take a solipsistic turn to “map” the Journal of Homosexuality itself. Here, the author examines the first feature-length article to address the relationship between HIV status and homosexuality. Lingering on both the temporal gap between the dawn of AIDS in American discourse and its inclusion in this journal, the author asks us to consider (in hindsight) such a delay bearing in mind queer theoretical projects of the present such as gay shame, stigma, and queer biopolitics.     

Socioeconomic status, sexual behavior, and differential AIDS mortality: evidence from Côte d’Ivoire

Lack of knowledge about differential AIDS mortality seriously hampers the study of the economic impact of AIDS in developing countries. We derive HIV infection risk differentials by age, education, and other microeconomic characteristics using the Ivorian Demographic and Health Survey. Our model is based on econometrically estimated equations using commonly available variables, therefore it can be used whenever such a survey is available but there is no representative information about HIV infection by socioeconomic group. For instance, we found that educated people have a higher risk of HIV infection, because they are more likely to have several sexual partners. However, this effect is partly offset by a higher probability of condom use relative to less educated people. The identification of the socioeconomic characteristics of low and high risk groups seems indispensable to set up adequate AIDS prevention and therapy policies in developing countries.

Knowledge and Attitudes About HIV/AIDS Among Community-Living Older Women: Reexamining Issues of Age and Gender

ABSTRACT

Although older women face unique risks related to HIV/AIDS, little empirical data is available regarding HIV/AIDS among women over the age of 65. In the present study, 160 community-living older women and men completed questionnaires regarding knowledge and attitudes about HIV/AIDS. Findings showed that although older women were less likely to talk to their physician about HIV than men, they maintained greater knowledge and generally dispelled myths about viral transmission. However, most older women believed that HIV/AIDS had limited personal relevance, possessed virtually no knowledge of age and gender specific risk factors, and professed HIV-associated stigma. These findings highlight the need for gender and age specific prevention programs.     

How to Be a Healthy Homosexual: HIV Health Promotion and the Social Regulation of Gay Men in the United Kingdom

ABSTRACT

Primary Objective: Health promotion has arisen as the main response to the problem of HIV prevention among gay men. Using the linked concepts of governmentality and health promotion as a neoliberal disciplinary technology, this article argues that health promotion in the time of AIDS has contributed to new forms of social regulation and governance for gay men. Methods and Procedures: This article presents an analysis of data from a study of U.K. HIV health promotion for gay men (interviews with health promoters and analyses of health promotion materials). Conclusions: This analysis of health promotion is helpful in describing an emerging form of governance dependent on incentive rather than censure (censure, pathology and “cure” are how we traditionally describe the use of medical knowledge in the regulation of homosexuality).     

HIV/AIDS,Social Capital,and Online Social Networks

The prospects for online social networks as sites of information-gathering and affiliation for persons with AIDS and others concerned about HIV/AIDS not only represent the latest development in a trend toward circumventing traditional media and official information sources, but also may offer hope for a revitalization of HIV/AIDS discourse in the public sphere. This article provides an overview of three decades of information-seeking on the pandemic and its social and personal implications, as well as case studies of three examples of social networking surrounding HIV/AIDS. It finds preliminary evidence of the formation of strong and weak ties as described in Social Network Theory and suggests that the online accumulation of social capital by opinion leaders could facilitate dissemination of messages on HIV/AIDS awareness and testing.     

Health and Cultural Determinants of Voluntary HIV Testing and Counseling Among Middle-Aged and Older Latina Women

The rate of cases of HIV/AIDS in older people is increasing; indeed one out of every four people with HIV/AIDS is over age 50. This study describes the correlates of HIV Voluntary Counseling and Testing (VCT) using structural equation modeling techniques for a sample of 135 middle-aged and middle-aged and older Latinas in South Florida. Over 60% of participants had been tested for HIV. Provider endorsement was found to be the strongest predictor of VCT (odds ratio [OR] = 6. 38), followed by having a clinic as a regular source of healthcare (OR = 3.88). Social work implications are provided.     

SHORT REVIEWS

Book reviewed in this article: Richard L. Harris (ED.) Globalization and Development in Latin America. David Henley Fertility, Food and Fever: Population, Economy and Environment in North and Central Sulawesi, 1600–1930. Nie Jing ‐Bao Behind the Silence: Chinese Voices on Abortion. Dudley L. Poston and Michael Micklin (EDS.) Handbook of Population. United Nations Department of Economic and Social Affairs , Population Division World Mortality Report 2005. UN Millennium Project Task Force ON HIV/AIDS, Malaria , TB, and Access to Essential Medicines , Working Group on HIV/AIDS Combating AIDS in the Developing World.     

流动人口行为特征及其空间过程与HIV/AIDS扩散

流动人口的行为特征及其空间过程是HIV/AIDS扩散的重要因素之一,其行为特征的高危性和流动性使流动人口成为HIV/AIDS的易感人群,在其流动的空间过程中与不同类型人口的相互接触,当发生与HIV/AIDS人群的高危行为时,一方面容易使自己感染HIV;另一方面,流动人口成为HIV携带者后与其他人发生高危行为则会成为HIV的传染源之一,其结果是导致了HIV/AIDS在感染者数量和感染空间上的扩散。因而,针对流动人口高危行为特征及其空间过程提出防控HIV/AIDS扩散的对策是可行的。     

Accessibility of health and human services for the HIV-infected

Most research on services for the HIV/AIDS population has focused on primary medical care or on service brokering by advocacy groups. Little research data exist on the extent to which services of programs that do not specialize in HIV/AIDS clients are available to these individuals who often have multiple and multi-dimensional problems. The reported research examines selected data from a sample of 236 medical, behavioral health and social service programs in Miami-Dade County, Florida. A constructed measure of involvement in services for HIV/AIDS clients, pertinent provider program and client characteristics are examined in the context of geo-distributed data on reported AIDS cases and census data. In logistic regression analyses, two aspects of race/– the population in the zip code area served by the program, and the clients or patients seen in the program – were significant in predicting program under-response, defined as level of response relative to cumulative reported AIDS cases from the program's zip code area. The analysis is briefly discussed regarding its relevance and methodological generalizability for HIV/AIDS and related public health policy and applied purposes.     

滇西某大型筑路工地流动人口艾滋病风险分析

本研究采用定性与定量相结合的方法对滇西某大型道路建设工地流动人口的艾滋病风险进行调研与分析,该工地流动人口所面临的主要艾滋病风险是高危商业性性行为。深入调研发现,因其特殊的行业特征,工地流动人口中形成了对商业性性行为默许、容忍、合理化的氛围,对于所面临的艾滋病风险存在侥幸心理,各职业人群由于知识、社会经济处境不同,其与艾滋病相关的高危行为有明显差异。基于研究发现,本文对流动人口艾滋病预防干预实践、艾滋病预防研究的社会人文视角及未来研究方向等提出了讨论和建议。     

中国老年艾滋病的流行状况分析

艾滋病在中国的迅速流行已是不争的事实,但是人们普遍认为“艾滋病是年轻人的病”。调查资料显示,50岁及以上的老年艾滋病病毒感染者报告人数已达到全国感染者的1/10,并呈快速增长趋势。老年感染人群的主要感染渠道以既往有偿献血感染为主。老年艾滋病病毒(HIV)感染者和艾滋病(AIDS)病人增多无论对家庭还是对社会均产生严重的后果,在艾滋病预防和控制战役中,老年是一个不可忽略的人群,应引起高度重视。     

Theory-Based Policy Development for HIV Prevention in Racial/Ethnic Minority Midlife and Older Women

ABSTRACT

In 2008, there were more than a million persons with HIV/AIDS in the United States. The CDC (2007) estimates that 15% of persons with HIV/AIDS are over age 50. At greater risk are women of color. Most intervention efforts have focused on intrapersonal aspects of an individual and his or her sexual-risk behaviors, with little or no attention directed toward interpersonal and socioenvironmental considerations of risk and prevention. This paper considers the limitations of current national policies relating to HIV prevention in minority populations, especially among midlife and older women of color. In particular, this paper examines risk and prevention policies in light of ecological perspectives, social capital, and dialogical theories.     

Community Cleavages: Gay and Bisexual Men’s Perceptions of Gay and Mainstream Community Acceptance in the Post-AIDS,Post-Rights Era

Changes in gay and bisexual men’s connectedness to the gay community are related to the declining public visibility of HIV/AIDS and greater acceptance for homosexuality and bisexuality in mainstream society. Little work, however, has focused on perceived acceptance for subgroups within the gay community or broader society. Using interviews (n = 20) and a survey (n = 202) of gay and bisexual men in a mid-sized Canadian city, we find perceived hierarchies of acceptance for the various subgroups as well as an age effect wherein middle-aged men perceive the least acceptance for all groups. These differences are linked with the uneven impact of social, political, and institutional changes relevant to gay and bisexual men in Canada.     

Destabilizing Science From the Right: The Rhetoric of Heterosexual Victimhood in the World Health Organization's 2008 HIV/AIDS Controversy

This article examines the 2008 World Health Organization/Joint United Nations Program on HIV/AIDS controversy through original reports and media coverage. Analysis reveals that discourse rhetorically exonerates heterosexuals from HIV/AIDS while reifying homophobic and morally righteous ideology about HIV/AIDS and homosexuality. Discourses of “fraudulent science,” “heterosexual absence,” and reverse victimization destabilize meaning of HIV/AIDS and heterosexuality. “AIDS,” “heterosexuality,” and even victimhood and minority status were destabilized and resignified in a rhetoric that benefited from its status as science even as it rendered past science suspect as ideological.     

Stigma and Salvation: Advertising HIV Awareness in New York City: A Case Study

Popular culture representations and negotiations of HIV/AIDS have fluctuated over the last several decades, and awareness of the illness and its causes has grown due to better education and extensive cultural dialogue. The following examines two contemporary HIV/AIDS public health campaigns in the New York City area. Although there have been limited improvements in the portrayals of HIV-positive individuals, advertising focused on HIV awareness still does not directly address prevention. These two campaigns encourage two distinct messages; one that reinforces the stigma attached to HIV/AIDS and one that promises salvation.     

基于文化作用机制分析的艾滋病预防控制对策研究——以云南为例

艾滋病的流行与扩散受多种因素的影响与制约,其中文化因素起着潜在的但效应极强的影响作用。通过分析文化与艾滋病流行扩散的相互关系,以及云南艾滋病亚文化的形成和发展,对云南艾滋病流行扩散的文化作用机制进行了分析．提出了基于文化作用机制的云南艾滋病预防控制对策,将文化因素融入到艾滋病的防治中,对于提高艾滋病的防治成效将起到积极的促进作用。     

“The String of This One Story”: Erotica,HIV, and the Construction of Safe Sex in Gay Male Popular Memory

Recalibrating the critical consideration of popular memory, this essay rehabilitates the erotic narrative as an object of critical study and as a political practice via an examination of John Preston's (1985b) print collection, Hot Living: Erotic Stories About Safer Sex. It considers this collection as a use of the erotic genre to produce a popular memory within its reading community to support safer sex practices in the “Age of AIDS.” It examines this collection as a communitarian project that articulates a new erotic rhetoric in response to HIV and considers its individual epistemological and epidemiological implications.