Environmental Change,Risky Sexual Behavior,and the HIV/AIDS Pandemic: Linkages Through Livelihoods in Rural Haiti

Local natural resources are central to rural livelihoods across much of the developing world. Such “natural capital” represents one of several types of assets available to households as they craft livelihood strategies. In order to explore the potential for environmental scarcity and change to contribute to perpetuation of the HIV/AIDS pandemic, we examine the association between declining natural capital and engaging in risky sexual behaviors, as potentially another livelihood strategy. Such an association has been demonstrated in Kenya and Tanzania, through the fish-for-sex trade. To explore the possibility of this connection within rural Haitian livelihoods we use Demographic and Health Survey data, with a focus on rural women, combined with vegetation measures generated from satellite imagery. We find that lack of condom use in recent sexual encounters is associated with local environmental scarcity—controlling for respondent age, education, religion and knowledge of AIDS preventive measures. The results suggest that explicit consideration of the environmental dimensions of HIV/AIDS may be of relevance in scholarship examining factors shaping the pandemic.     

Introducing the female condom to drug users in Brazil

Brazil is currently the number two country in the world for reported cases of AIDS, and the rate of heterosexually acquired cases is on the rise. Moreover, because of the changing focus of the epidemic, the ratio of male to female cases dropped from 28 : 1 in 1984 to 2.7 : 1 in 1997. While women's risk of infection continues to grow, there is evidence to suggest that traditional approaches to HIV risk reduction have not effectively addressed women's special needs. Within such a setting this study sought to introduce drug-involved women to the female condom – a female-controlled method of protection from HIV. As part of a larger HIV/AIDS intervention study targeting low-income, cocaine users, the primary aim of this initiative was to assess the level of acceptability of this new device among women at high-risk for HIV infection in Rio de Janeiro, Brazil. In conjunction with individual pre-test HIV prevention counseling, clients participated in a detailed education/demonstration session with the female condom. Women were asked to try the female condom with their partners and to report their experiences at two points of contact. Outcome data indicate that a sizable proportion (71.1%) of the sexually active women used the female condom during vaginal sex on one or more occasions. In addition, many women continued to use the female condom as a method of risk reduction over the three-month follow-up period. These data suggest that the female condom can have an important role in HIV prevention efforts in Brazil.     

A gender comparison of HIV and drug use across the rural-urban continuum

Despite the central role of women drug users in escalating AIDS statistics, there is still a limited number of studies that examine the roles of gender and drug use type in HIV seroprevalence. This lacuna in the research literature has led to significant gaps in researchers' understanding of how and to what extent women may differ in their drug-using and HIV risk behaviors compared to their better-studied male counterparts. This study, derived from a sample of 3,555 out-of-treatment drug users residing in three South Florida urban and rural communities, attempts to compare the drug usage and needle and sexual risk behaviors of male and female drug users that put them at risk for HIV infection. The overall seropositivity rate for women drug users was 26.5% compared to 19.5% for their male counterparts. Results of multivariate analyses indicate that females compared to males were 1.4 times more likely to be HIV seropositive. Risk behaviors associated with this elevated seropositivity include living arrangements, homeless status, drug use, sexual trading behaviors, and history of STDs. Furthermore, there was a strong linear relationship between drug use type and HIV seroprevalence among women drug users. Compared to those who were neither crack smokers nor injectors of illicit drugs, those who were crack smokers only were 2 times more likely to be HIV seropositive, while those who were both crack smokers and injectors were 5 times more likely to be HIV seropositive, and those who were injectors only were 6 times more likely to be HIV seropositive. These findings indicate that among women, drug abuse and its associated risk behaviors, increase the vulnerability of this population for HIV and thus render them an extremely important priority population on which to focus HIV prevention and public health efforts and programs.     

社会性别化的风险、经历与反应——对美国妇女与艾滋病的探讨

艾滋病目前已成为美国一个严重的社会问题和大众健康问题。妇女从 2 0世纪 80年代在边缘徘徊 ,到 90年代已陷入了该危机的“震中”。本文将从女权主义的视野来审视这场社会性别化的传染病 ,即把社会性别当作主要变量来考察它同种族、族裔、阶级、性取向以及文化等诸因素的交叉互动 ,并从纷繁复杂的艾滋病现象和文献中梳理出妇女与艾滋病关系上的社会性别差异。文章最后将提出若干可资借鉴并值得我们警觉的建议     

Sexuality and HIV/AIDS: An Exploration of Older Heterosexual Women's Knowledge Levels

Sexuality research tends to ignore older populations, and little is known about older women's sexual health knowledge. To fill this research gap, 186 Canadian heterosexual women 50 years and older were surveyed about their knowledge regarding sexuality and HIV/AIDS. Respondents had moderate levels of overall knowledge of sexual health and aging, correctly answering, on average, 60% of the 35 questions. They had lower levels of HIV/AIDS knowledge, correctly answering just over 50% of the 25 questions. Results indicate the need for social awareness and education in this group regarding both general sexual health later in life and HIV/AIDS.     

Demarcating forest, containing disease: land and HIV/AIDS in southern Zambia

The ongoing HIV/AIDS pandemic in southern Africa continues to manifest itself in unexpected ways. While the consequences of the disease appear straightforward in some aspects—e.g., medical, labor, cost—in other respects the repercussions, while large, are nonetheless highly nuanced and can be counterintuitive. This paper reports on the intersection of HIV/AIDS, migration, livelihood adaptation, land tenure, and forest conservation, to outline how adaptation to the pandemic has reworked significant aspects of land tenure to result in increased forest conservation in southern Zambia in the near to medium-term. The research uses a combination of ethnography, case studies, household survey and spatial analyses and finds that HIV/AIDS is used in customary legal settings to enhance land access. We also draw links to practical and theoretical implications of the relationship between HIV/AIDS, land tenure, and deforestation in Sub-Saharan Africa.     

Using innovation to address HIV, AIDS, and environment links: intervention case studies from Zimbabwe, Uganda, and Malawi

This article presents three cross-cutting intervention case studies that address HIV, AIDS, and natural resources management in an integrated manner through innovative programming in Zimbabwe, Uganda, and Malawi. In Zimbabwe, a religious-based non-governmental group and two community organizations work together to build skills of HIV- and AIDS-vulnerable children in rural areas to meet dietary and income needs, while using natural resources sustainably. In Uganda, various government agencies and NGO actors work together to improve the food security of HIV-affected households at the national, district, sub-district, and village levels. Finally, in Malawi, a conservation organization incorporates HIV and AIDS awareness and programming into its operations and projects. Each case study presents pioneering approaches to simultaneously addressing the pressures on conservation initiatives, food security/agricultural production, income generation/livelihoods, and social and health care systems. They also provide lessons for expanding interventions and partnerships.     

Rethinking the African AIDS Epidemic

Half the AIDS victims in the world are in East and Southern Africa, where adult HIV sero‐prevalence was 11.4 percent by the end of 1997 and over 25 percent in two countries of Southern Africa. HIV/AIDS infection is not the result of ignorance, as nearly everyone has sufficient knowledge about AIDS and how it is transmitted. The high levels of AIDS arise from the failure of African political and religious leaders to recognize social and sexual reality. The means for containing and conquering the epidemic are already known, and could prove effective if the leadership could be induced to adopt them. The lack of individual behavioral change and of the implementation of effective government policy has roots in attitudes to death and a silence about the epidemic arising from beliefs about its nature and the timing of death. International responsibility may have to be taken before the needed effective policies are put in place.     

Injecting and Rejecting,Framing and Failing

This paper seeks to examine how female subjectivities are privileged by Canadian human papillomavirus (HPV) vaccination discourse and, in turn, how homosexual male subjectivities are displaced. Employing a Critical Discourse Analysis approach, I analyze selected HPV vaccination (HPVV) promotional materials, and depict the discursive strategies which privilege and exclude gendered subjectivities. My critical analysis is influenced by feminist linguistic works that seek to uncover the discursive constructions around sexuality, gender and identity, and the discursive strategies used to communicate ideas about sexual health risks and responsible citizenship. In addition, I adopt feminist theories of knowledge and power to rethink the discursive representations of some bodies and subjectivities as normal, and Others as unintelligible within HPVV discourse in today's neoliberal time.     

Combining employment and parenthood: A longitudinal study of intentions of Dutch young adults

This paper examines the intentions of Dutch males and females with regard to combining paid employment and parenthood. Four models of how couples combine these roles are distinguished. Panel data from a representative survey among Dutch young adults show that the traditional model (the female takes care of the children and the male works full-time) is becoming less popular, whereas the supplementary model (the female takes care of the children and supplements the labor force participation of the male), and the egalitarian model (both partners share paid labor more or less equally) are becoming more popular. The no-child model is preferred by about 10% of the respondents. A multivariate analysis shows that both job characteristics, like the flexibility of working hours, and gender role attitudes are important predictors of intentions with regard to combining family and work roles.     

Altruistic and contractual remittances between male and female migrants and households in rural Thailand

Past research has questioned the extent to which remittances are altruistic behaviors versus payments in a contractual relationship between households and migrants. This article explores altruistic and contractual patterns of remittances using a gendered approach. On the basis of results with various levels of significance in regression models, male and female migrants from Nang Rong, Thailand, behave both altruistically and contractually. However, women and migrants from poorer households behave more altruistically, while men and migrants from richer households behave more contractually. These results point to the need for further research and theory development to explain heterogeneities in migrants' behavior.     

AIDS and kitchen gardens: insights from a village in Western Kenya

In rural Africa, indigenous farming and natural resource management systems exemplified by kitchen gardens are being reshaped by the HIV/AIDS epidemic and its negative impacts (illness, stigma and mortality, and economic costs) and positive opportunities (organizational responses to the epidemic). Subtle changes in crops and farm techniques can be traced to these diverse influences of HIV+ infection, illness, mortality, widowhood, foster child care, and AIDS support groups, as well as the organizations, ideas, and flow of funding from outside. These findings draw on original field data: a village census, in-depth interviews with gardeners, and group discussions in a village in Bungoma District (in 2005 and 2007). This part of western Kenya is a typical small-farm zone that has faced a moderate HIV/AIDS epidemic since the 1990s, following decades of demographic, environmental, technological, and institutional changes. Implications of this case study for further research on HIV/AIDS and on micro-level population–environment change suggest that households are useful but imperfect analytical units and are best seen as part of complex social networks, shaping connections to markets. These important “mediating institutions” link AIDS as a demographic and economic force with environmental outcomes in cultivated landscapes.     

Mitigating an elephantine epidemic: gendered space for HIV/AIDS outreach through Namibian conservancies

As the reach of HIV/AIDS continues to devastate communities and create potential pressures on natural resources, conservation organizations have increasingly become involved in education and outreach to address the disease. This paper’s purpose is to investigate how increasing HIV infection rates and AIDS deaths relate to community-based conservation and livelihood strategies in the Caprivi Region of northeastern Namibia, and demonstrate that conservation organizations can play a unique role in combating the disease. As the epidemic is more widespread in the Caprivi than in any other region of the country, local organizations such as Integrated Rural Development and Nature Conservation (IRDNC) are responding to the disease by integrating it into conservation work. IRDNC’s efforts reflect a particular focus on gender, including changes in the way that HIV/AIDS is discussed in local communities, strategies to promote access to testing and care, and bringing to light the experiences of individuals and families struggling with HIV/AIDS. This approach shows that there are benefits to be gained from approaching HIV/AIDS mitigation through familiar, existing structures such as those of community conservancies in Namibia—especially the ability to circumvent heavy local stigma. Using data collected through participant observation and participatory discussions, this paper demonstrates that conservation programs can positively affect people with HIV/AIDS, highlighting the importance of mainstreaming outreach efforts that address the particular localized manifestations of the disease in the context of natural resource management.     

24/7 SM slavery

This study describes the nature of 24/7 SM slavery as practiced within the SM (sadomasochistic) community. These SM participants, who attempt to live full-time in owner-slave roles, represent a small proportion of those with SM interests. SM slaves have not been studied systematically to determine if and how they differ from other SM practitioners. An online questionnaire was used to obtain responses from individuals who self-identified as slaves. A total of 146 respondents participated, 53% female and 47% male, ranging in age from 18 to 72. We explored the depth of their relationships, how well they approximated "slavery," and how their relationships were structured to maintain distinct roles. Data showed that in long-term SM slave relationships, a power differential exists which extends beyond time-limited SM or sexual interactions. Owners and slaves often use common, daily life experiences or situations, such as the completion of household chores, money management, and morning or evening routines, to distinguish and maintain their respective roles. In addition, contrary to the perception of total submission, results revealed that slaves exercise free will when it is in their best interests to do so. These relationships were long-lasting and satisfying to the respondents.     

Are young people in the Philippines taking chances with HIV / AIDS?

The numbers of AIDS cases and HIV infections detected in the Philippines have risen slowly but steadily since the first AIDS case in the country was diagnosed in 1984. By the end of 1995, 234 AIDS cases and 470 HIV infections had been reported to the country's Department of Health. However, given the limited extent to which people have been tested for HIV infection, there are most likely many more cases than reported. The HIV/AIDS epidemic is spreading within the Filipino population. The country's substantial commercial sex trade, reports suggesting that many unmarried young men have sexual intercourse with girlfriends and acquaintances, and IV drug use among a small number of young people are factors which contribute to the potential for a serious HIV/AIDS epidemic in the Philippines. Findings from the 1994 national Young Adult Fertility and Sexuality Study, a household survey covering 10,879 men and women aged 15-24 years in 959 different communities, are presented. Almost all respondents had heard of AIDS, but there was some degree of ignorance and misinformation on the modes of HIV transmission. 13% of all single men reported having had only one sex partner, 10% reported two or more partners, and 3% reported five or more. 98% of sexually active men had heard of condoms, 58% knew that condom use can protect against HIV infection, 23% reported ever having used one, and 4% reported using a condom during the most recent act of sexual intercourse.     

More Than Pop Culture: Depictions of HIV in the Media and the Effect on Viewer's Perception of Risk

When young adults are questioned about where they gain their knowledge of HIV, overwhelmingly popular media (including television) is reported. Thus, the goal of this article is to question how media is used to educate and influence young people's present perceptions of HIV/AIDS. Narrative analysis of popular prime time shows was used focusing on the story lines and characters used to introduce the topic, as well as the myths and facts about HIV. Results presented provide researchers a clearer insight to how popular shows discuss HIV/AIDS while also highlighting the ways Social Cognitive Theory can still be utilized.     

When the Emotions Really Started Kicking In,Which Ended Up Being a Problem: Sex,HIV, and Emotions Among Young Gay and Bisexual Men

Interviews from 10 young gay and bisexual men aged 18 to 29 were examined to explore how young gay and bisexual men make decisions regarding sexual behaviors in the age of AIDS. Three main themes emerged: (a) disconnections between what an individual knows about HIV, their motivations to remain HIV-negative, and their sexual behaviors; (b) a struggle to connect emotionally and intimately with another man; and (c) a power dynamic whereby the individual acts as an autonomous decider in the decision-making process. Participants indicated high levels of HIV knowledge, and were engaged in a struggle to balance emotional experiences with sexual partners in a complex gendered dynamic. Findings from this analysis indicate a need to reexamine the social-cognitive theoretical frameworks that have guided gay men's HIV-prevention efforts, as these frameworks have failed to account for the psychologically complex emotional experiences and gender dynamics that are part of sexual decision making.     

AIDS in China

Although 10,676 people were officially reported to be infected with HIV on China's mainland by the end of June 1998, experts estimate that more than 300,000 Chinese are actually infected with HIV in China. They also believe HIV continues to spread in alarming fashion. Two thirds of reported HIV infection cases live in rural China, and nearly one third of the 301 people diagnosed as having AIDS have died. About 10% of all HIV infections occurred among teenagers under age 19 years old, with most infected through IV drug use. 60% of teens who responded to a survey in 1997 did not possess correct basic knowledge about AIDS, and 21% did not know how to protect themselves from contracting HIV.     

Men together: understanding the gay couple

The present study surveyed male gay couples to determine how their relationships began and were maintained, the types of conflict they experienced, and how the issues of monogamy, sexual behavior and AIDS affected the relationships. Ninety-two couples responded to the survey. The gay bar was the most common initial meeting place and relationships had lasted from less than one to 35 years. Few had had a commitment ceremony, although many reported wanting one if it were available. Most of the close friends of respondents were also gay couples and about two-thirds of family members were supportive of the relationship. The most persistent conflicts centered around finances and relations with family members. Virtually all respondents described their relationships as monogamous, but only about half practiced safe-sex. More attention needs to be given to understanding male couples and to targeting AIDS-prevention messages to them.     

Knowledge and attitudes about HIV/AIDS among community-living older women: reexamining issues of age and gender

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.