Embedded Systems: The Case of HIV/AIDS Nonprofit Organizations in New York City

In this paper the notion of an embedded system is developed as an analytic model to examine how state–nonprofit relations develop and become differentiated, using the case of HIV/AIDS nonprofit organizations. Drawing on extensive fieldwork among three prominent HIV/AIDS nonprofit organizations in New York City, this paper shows how the kinds of relationships these nonprofit organizations are likely to form with state agencies are based on their embeddedness in the state–nonprofit system of relations. Three forms of embeddedness are distinguished according to the type and regularity of state–nonprofit contact—direct, outsider, and mediating. Importantly, it is shown how the configuration of relations within which an organization is embedded determines many of the organization's constraints and opportunities.     

From Acute Palliation to Chronic Care: Using the Narratives of Two Gay Caregivers to Explore Experiences of Providing HIV Support Across Sociohistorical Contexts

Despite the longstanding shift in conceptualizing HIV/AIDS as a site of chronic care, versus one of acute palliation, few attempts have been made to examine caregiving in the context of this change. This study constitutes a preliminary attempt at exploring the evolving nature of HIV/AIDS caregiving among sexual minorities, primarily by comparing the narratives of two partnered caregivers of HIV-positive gay men whose stories are located in disparate sociohistorical contexts. Whereas one caregiver provided support during an era in which HIV/AIDS was primarily conceptualized as acutely life-limiting, the other did so in the contemporary period of chronic HIV care. Although similarities are noted across the stories, distinctions are also apparent in how the caregivers encounter expressions of homophobia and HIV stigma, and negotiate these realities distinctly as a function of sociohistorical context. In particular, despite the salience of these systemic barriers across the two narratives, these expressions of marginalization appear to occur more routinely and indefinitely in the context of chronic care. This article concludes with implications of the study's findings on theory, research, policy, and practice.     

Health Care innovation and children in poverty: lived experiences of caregivers of children with disabilities in a medicaid-serving ACO

This paper reports the results of a qualitative study of caregivers of children with disabilities enrolled in a Medicaid-serving accountable care organization (ACO). The state of Ohio mandated ACO enrollment for Medicaid-eligible children with disabilities in 34 of 88 counties effective July 2013. Research participants were queried in focus groups and individual interviews about their children’s care experiences and care coordination after enrollment. Most told researchers that they themselves are their children’s care coordinators, and many indicated that resource scarcity is a more pressing problem than fragmented care. Data analysis identified a theme of scarcity and four categories of insufficiency that made caregiver efforts on behalf of their children more difficult: a lack of health services under managed care, resource constraints on other agencies and programs for which families were eligible, a lack of financial support, and a lack of family support. A conceptual framework places ACO care coordination among more upstream factors and identifies ways in which ACOs serving Medicaid populations may wish to address the social determinants of the well-being of children with disabilities. Implications for future research are discussed.     

Strengthening the Capacity of Grandparents in Providing Care to Young Children Affected by HIV/AIDS

Abstract

Action for Children (AFC) is a non-governmental organization founded and registered with the government of Uganda in 1998 to rescue children from immediate danger and to advocate for their rights. AFC is working on a three-year pilot project entitled the Grandparents Action Support Project (GAS), designed and implemented to strengthen the capacity of grandparents providing care to HIV/AIDS orphans and vulnerable children under the age of eight, and to improve the overall welfare of the families taking care of these children. After only seven months, an interim program evaluation revealed that several effective innovative and pragmatic community-based strategies have been developed and implemented by participants. The Project has had a multiplier effect in participating communities in that ‘non-Project’ families are copying and learning from GAS Project homes. Challenges and future expansion of the Project are described.     

Donor withdrawal and local civil society organizations: An analysis of the HIV/AIDS sector in Vietnam

The impact of international donor arrival on local civil society organizations (CSOs) is well researched. Less well understood is how local CSOs react and adapt to donor withdrawal. This article explores this phenomenon in the context of the HIV/AIDS sector in Vietnam. Using data from government, donor and CSO sources in Vietnam, it examines how current and planned cuts in donor funding, including donor exit, impact local CSO agency and effectiveness. It finds that while donor withdrawal may reduce CSO capacity and independence, it can also prompt local innovations that—if successful—may improve CSOs’ responsiveness to local stakeholders.     

A Calmly Disruptive Insider: The Case of an Institutionalized Advocacy Organization at Work

Through a case study of a leading service provider organization in Philadelphia, this paper explores the advocacy work of a publicly funded, professionalized, institutionalized nonprofit organization. In this article I relate how in the spring of 2002, staff at the organization responded to a recurring political issue: local business groups were again calling for official action against “aggressive panhandlers” in the downtown district. I use ethnographic and historical data to show that the organization’s institutionalization and ties to the public sector have allowed staff to develop resources and skills for being both contentious claim-makers and influential actors in the institutional political arena.

The Prospect for the Future of Continuing Care Retirement Communities in New York State

No abstract available for this article.     

Challenges and Opportunities in HIV/AIDS Counseling: A Case of Jharkhand

The study highlights the challenges and opportunities in HIV/AIDS counseling. The major challenges are recruiting the right individuals and their capacity building and retention. The finding shows that most of the counselors are not befitting in terms of qualification and experience besides motivation, remuneration, and other issues. The study suggests that to ensure the effective counseling to reverse the epidemic, it is important to focus on such issues through appropriate policy interventions.     

The assessment of sexual practices relevant to the transmission of AIDS: A global perspective

Despite global similarities between the immunologic and pathogenic properties of HIV infection, there are substantial cultural and geographical variations in the transmission dynamics of HIV infection/AIDS. In the United States and Europe, for example, HIV infection/AIDS is predominantly evident among homosexual men and intravenous drug abusers. However, in Central Africa, the data indicate that HIV infections/AIDS is heterosexually acquired. Thus, the purpose of the present paper is to suggest some basic strategies and raise some critical issues for collecting data on sexual practices relevant to the transmission of HIV infection/AIDS throughout the world. Topics include assessment strategies, language and meta‐language, cross‐cultural and intra‐cultural comparability, general methodological issues, and constraints for the assessment of anal intercourse.     

Formal and Informal Community Care to Older Adults: Comparative Analysis of the United States and Great Britain

Support to frail elders is of international and growing importance. This article compared receipt of assistance with ADL limitations, home health help, any assistance received, and unmet needs in functionally impaired individuals aged 70 years old or older in the United States (n = 1847, 80% women, M _age = 80 years) and Great Britain (n = 1203, 57% women, M _age = 78 years). Informal and formal assistance levels were higher in Great Britain, and rates of unmet need did not differ across ADL domains measured. Receipt of formal and informal care were associated positively, which is consistent with both supplementary and complementary perspectives on the formal-informal care interface. Few individuals in either country received formal services alone. Results suggest that community-based formal support does not substitute for family help. Implications for family and economic policy are discussed.     

Divided and Drifting: Interactionism and the Neglect of Social Organizational Analyses in Organization Studies

The analysis of organizational phenomena within interactionism has become bifurcated between social organizational analyses and organizational ethnographies. This division has had the effect of allowing organizational ethnographies to more readily contribute to organization studies while marginalizing studies of social organization. The historical conditioning of this development and current evidence for this case is demonstrated through an analysis of the existing literature from the past thirteen years of interactionist organizational research. To end the continued neglect of social organizational analyses in the interdisciplinary field of organization studies the article concludes by suggesting a number of possible inspirations for promoting future research.     

Patches of grief and rage: Visitor responses to the NAMES project AIDS Memorial Quilt

This paper presents an analysis of comments written on signature square panels of the NAMES Project AIDS Memorial Quilt. In our paper we explore how collective memory regarding AIDS deaths emerges from conflict among members of vernacular, mainstream and official culture. The cultural contest waged over how individuals who have died from AIDS-related illnesses will be remembered in society fits within the realm of the sociology of collective memory. Visitor responses to the Quilt illustrate that as a form of commemoration the Quilt is interpreted as a therapeutic device and a political tool. Like other memorials, especially those for which there is social disdain or conflict (e.g., the Vietnam Veteran's Memorial), signature square comments provide an alternative conception of public memory. The fact that the Quilt is used to symbolically commemorate the dead, providing an outlet for collective grieving and inspiring social action, is what makes it an important sociological phenomenon. In our paper we put forward a conception of the politics of collective memory that extends previous work in this area. In doing so this paper contributes to an emerging understanding of public commemoration and to the debate over how different segments of society are to be remembered.     

Co-Production in the Context of Finnish Social Services and Health Care: A Challenge and a Possibility for a New Kind of Democracy

Alongside the ongoing renewal process of the Finnish welfare state, the role of the citizens is also revisited. So far the attention has mainly focused on how the responsibility for service provision is shared between the public sector and the service users, while the role of public services as a part of the democratic system has been more or less ignored. Based on the results from a 3-year participatory action research project called KAMPA, this article will discuss if the development of co-production in the context of public welfare services shows the way forward toward a new kind of society where democracy is an inseparable part of the structures and procedures of the service provision. The data gathered during the project (textual material, interviews, notes from meetings, and observation diaries) are analyzed using thematic analysis. The results show that while legislation and official policies strongly highlight the participation of citizens and service users, there are still many obstacles to overcome at both the attitudinal and practical level. The development of co-production and arenas of a new kind of democracy requires continuity in the attempts and recognition of the achievements, but it also has the potential to demonstrate the way in which a new more lively democratic society can come true in practice.     

Adapting the jury trial for program evaluation: A report of an experience

A portion of the graduate program in clinical community psychology at SUNY Buffalo was subjected to a jury trial as a form of program evaluation. The theory of the trial as evaluation, the problems of implementation, and a posttrial evaluation are discussed. The trial, while time-consuming, especially in its pretrial phases, has the potential for presenting a dramatic picture of a program through the medium of human testimony. The jury was able to arrive at clear decisions on questions put to it, with a high degree of confidence. Decision makers accepted some of the jury's conclusions, and subjective evidence suggests that many of the controversial issues which generated the trial were resolved for the group by the procedure. The posttrial evaluation revealed limitations, such as evidence which was not presented at the trial. The experience proved useful for purposes of interdisciplinary education, providing another lens through which the evaluation problem could be viewed.     

Walk the Walk but Don't Talk the Talk: The Strategic Use of Color‐Blind Ideology in an Interracial Social Movement Organization

In this study, I examine the strategies interracial organizations use in the twenty‐first century, where color‐blind ideology dominates. Much theoretical work on racism examines how it has evolved during different historical periods, but this work does not address how these changing forms of racism affect social movement organizations, particularly those on the left. While the literature on color‐blind ideology has examined how it is expressed by African Americans and European Americans separately, my work investigates how color‐blind ideology operates when European Americans and people of color are working together in the same organizational setting. Studies of social movements have examined how organizational culture affects strategies but have neglected how external racist culture and color‐blind ideology impacts organizational strategies. Findings from 3 years of ethnographic data collected on an interracial social movement organization and its corresponding coalition suggest that activists in interracial organizations use racism evasiveness strategically to maintain solidarity. I conceptualize racism evasiveness as the action resulting from color‐blind ideology within a larger system of racism. While activists perceive advantages to these strategies, there are also long‐term negative consequences. Without explicitly naming and addressing racism, progressive organizations may be limited in their ability to challenge systemic racism.     

Designing an Ageless Social Community: Adapting a New Urbanist Social Core to Suit Baby Boomers in Later Life

ABSTRACT

Since 90% of older adults prefer aging in place (Wang, Shepley, & Rodiek, 2012), it is important that neighborhood design supports successful aging. Beyond basic needs, research indicates quality interaction is associated with positive health and well-being benefits, particularly for older adults. In this, design supporting social relationships plays an essential role. This study's purpose was to identify New Urbanist neighborhood and social space design attributes supporting older residents' physiological and social needs. This case study used keyword-in-context analysis with focus group interview data to identify domains supporting social interaction for residents aging in place including: location factors, social factors, design factors, and programmatic factors.     

Civil Society Transformed: International Aid to New Political Parties in the Czech Republic and Slovakia

VOLUNTAS: International Journal of Voluntary and Nonprofit Organizations - How do international nonprofit organizations influence political party formation in new democracies? Despite recent...     

The logic of protection: narratives of HIV/AIDS in the UN Security Council

ABSTRACT

When HIV/AIDS was first addressed by the UN Security Council in 2000, it was seen as the culmination of a successful securitization process and a pivotal moment for introducing human security. However, concern for the epidemic was paired with problems in including a nonmilitary issue on the Security Council’s agenda and the fear that peacekeepers were vectors of HIV. Reports of peacekeepers being involved in sexual exploitation and abuse added to these problems. This article aims to understand how gender has informed the efforts to address these issues and to rehabilitate peacekeeping forces and the Security Council from the legitimacy challenges that arose in this context. The article argues that including nonmilitary issues on the Security Council agenda requires adjustment to fit a war/peace logic. Drawing on feminist theories on security and protection, the analysis shows that the security narrative on HIV/AIDS did not form a coherent protection logic until the 2011 reformulation, when HIV/AIDS was constructed as part of the problem of wartime rape. This reformulation is interpreted as an appropriation of gender equality to reproduce a military security doctrine.     

When Freedom is Not an Endless Meeting: A New Look at Efficiency in Consensus‐Based Decision Making

It is axiomatic among scholars of participatory democracy that consensus‐based decision making is inefficient, yet no study has systematically assessed that claim. This article examines the efficiency of consensus decision making in 12 social movement groups from the German autonomous and nonviolence movements. Data were analyzed from 62 semistructured interviews regarding how long it took each group to make a typical decision and what types of decisions were the easiest and most difficult to make. A measure of inclusiveness was included to determine whether efficiency was attained by silencing dissent. Most decisions were made in less than two hours. Factors were identified that distinguished more and less efficient groups.     

Explaining the Gender Gap in Help to Parents: The Importance of Employment

Although it is well established that adult daughters spend more time giving assistance to their parents than do sons, the sources of this gender gap are not well understood. This paper asks: To what extent can this gap be explained by structural variation, especially the different rates of employment and kinds of jobs that women and men tend to hold? Using data from the National Survey of Families and Households (N = 7,350), the paper shows that both employment status and job characteristics, especially wages and self‐employment, are important factors in explaining the gender gap in the help given to parents, and that these operate similarly for women and men.