Forced Migration and HIV/AIDS Risks in Angola

This study examines HIV/AIDS-related knowledge, attitudes, and behaviour of forced migrants in Luanda, Angola by comparing them with those of voluntary migrants and long-time city residents. The study uses data from a survey of 1081 men and women conducted in 2004 in two suburban municipalities of Luanda. One of the municipalities has a large share and the other a small share of the forced migrant population. The analysis detects differences between forced migrants and the other groups in HIV/AIDS-related knowledge and attitudes, but these differences are explained away by the demographic characteristics and socio-economic disadvantages of forced migrants. With respect to behaviour, we find that regardless of other characteristics forced migrant men are more likely to engage in practices that may lead to increased HIV risks than long-time male city dwellers. The differences between forced and voluntary male migrants show the same tendency but are not statistically significant. While women overall are less likely to engage in potentially risky practices than men, differences among women in the three migration-status groups are not as pronounced as among men.     

Redefining Sex and Intimacy: The Sexual Self-Images,Outlooks, and Relationships of Gay Men Living with HIV/AIDS

This paper examines how gay men living with HIV disease come to terms with the profound sexual implications of their illness. Based on interviews with 25 gay men diagnosed with HIV/AIDS, this paper highlights (a) the disruptions that these men experience in their sexual feelings and self-images as a result of their illness; (b) the challenges they encounter in negotiating and sustaining sexual relationships; (c) the declines they experience in their sexual attractiveness, desire, and capacities as their illness advances; and (d) the changed meanings they give to sex and self as they come to terms with the erotic implications of their illness and try to preserve valued, intimate identities. In focusing on these themes, this paper offers an “insider's view” into key dimensions of the moral experience of gay men with HIV/AIDS. It also illustrates how the moral experience of these men shifts over the course of their illness, especially in response to the changes and challenges that arise in their intimate relationships and subcultural networks. On a broader, analytic level, this paper addresses a research question that has been neglected in previous studies of the experience of illness—that is, how does serious illness affect the sexuality of diagnosed individuals, particularly their construction of sexual and intimate identities? Through examining this question, this paper contributes to and extends the growing interactionist literature on the consequences of illness for self.     

Hypersexual Behavior and HIV Sex Risk among Young Gay and Bisexual Men

Hypersexual behavior has been identified as a sexual risk correlate among gay and bisexual men (GBM). The Hypersexual Behavior Inventory (HBI) has been shown to be a reliable and valid measure of hypersexual behavior in clinical populations, yet it has not been used to assess hypersexual behavior in nonclinical samples. We examined the psychometric properties of the HBI with survey data recorded between December 2009 and March 2010 in a sample of young men (N = 366, M = 21.46 years old, SD = 1.95) who self-identified as gay (89%) or bisexual (11%) and assessed its association with unprotected receptive anal intercourse (URAI) partners and occasions. Using cross-sectional data of single, sexually active young GBM (YGBM), we used confirmatory factor analyses to test the HBI's three-factor structure. Using negative binomial regressions, we then tested the association between the HBI subscales and sexual risk. After accounting for covariates, we found that sexual control was a risk factor for URAI partners and occasions, and coping was found to be a protective factor for URAI occasions. In light of our findings, we discuss the importance of reexamining the theoretical assumptions of hypersexual behavior and propose HIV prevention strategies that may reduce young GBM's vulnerability to HIV infection.     

Marital Aspirations,Sexual Behaviors,and HIV/AIDS in Rural Malawi

We explore how marital aspirations are related to the sexual behaviors of adolescents and young adults in Malawi, where HIV/AIDS prevalence among adults exceeds 10%. We also consider whether the specter of AIDS is shaping ideals about marriage. By combining survey data (N = 1,087) and in‐depth interviews (N = 133) with young Malawians from the Malawi Diffusion and Ideational Change Project, we show that looking for and finding a suitable spouse are linked to sexual behaviors and, thus, HIV risks. Moreover, concerns about contracting HIV are closely tied to the ideal characteristics of a future spouse. Our findings draw long‐overdue attention to the importance of marital aspirations in understanding adolescent sexual behaviors and risks in the era of AIDS.     

Prevalence of and Factors Associated with Oral Sex Among Rural and Urban Malawian Men

ABSTRACT

Objectives: Despite medical evidence that female-to-male oral sex (fellatio) carries a lower risk for HIV transmission than unprotected vaginal intercourse, little research exists on the practice of fellatio in Africa. The objective of this study was to document the prevalence of oral sex in Malawi, and to provide the first evidence on factors associated with the practice in sub-Saharan Africa. Methods: We used two samples of men from Malawi—one rural and one urban—to examine the prevalence of oral sex, as well as factors that were associated with the knowledge and practice of oral sex. Results: While 97% of the rural sample and 87% of the urban sample reported having had vaginal sex, just 2% and 12%, respectively, said they had ever received oral sex. Only half of the rural sample, and less than three quarters of the urban sample, reported having heard of oral sex. Education, exposure to newspapers and television, and condom use significantly predicted oral sex knowledge after controlling for other confounding factors, while exposure to radio did not. Conclusions: The large gap between sexual activity and oral sex prevalence suggests that fellatio should be taken into consideration as a potential component of an HIV prevention strategy, but further quantitative and qualitative research that includes women as well as men is needed to understand potential benefits and drawbacks.     

Predictors of HIV Sexual Risk Behavior Among Men Who Have Sex with Men,Men Who Have Sex with Men and Women,and Transgender Women

ABSTRACT

Men who have sex with men, men who have sex with men and women, and transgender women are at high risk for HIV infection. This study seeks to clarify which known HIV risk factors (partner type, sex location, serodiscordance, multiple sex partners, substance use during sex) contribute to engagement in high-risk (unprotected receptive anal) sex in each population. Data collected from June 2005 through June 2008 indicate all three populations display different HIV sexual risk profiles. The data suggest that HIV-prevention interventions should be individually tailored to address the specific needs of these three highly vulnerable and impacted populations.     

HIV/AIDS Projects with and for Gay Men in Northern Thailand

Abstract

In this paper I look at three HIV/AIDS projects which were run by and for gay men, transsexuals and men who have sex with men (MSM) in northern Thailand in the early 1990s. These three projects were very different in format and in context, ranging from a rural village AIDS association to an urban drag beauty contest. The projects were located in settings as different as gay bars and cruising areas, shopping malls and rural villages. Aspects of the three Thai projects have important implications for those working in HIV/AIDS prevention and in the care and support of people living with HIV/AIDS (PLWHAs) across cultures, particularly in relation to education, outreach and counselling programs.     

An impact evaluation of student teacher training in HIV/AIDS education in Zimbabwe

Zimbabwe introduced a nation-wide program to teach AIDS education in 1994. This paper evaluates changes in student teachers' level of knowledge about transmission, symptoms and prevention of STDs and HIV/AIDS; their attitude towards persons living with AIDS; and their sensitivity to the impact of the epidemic and to discussing and teaching about these issues. There was an increase in knowledge of HIV prevention and in teachers' ability to discuss reproductive health and sexual issues. However, as students were exposed to other HIV material outside the programme, not all of this change is due to the programme. Course attendance needed to be enforced and the curriculum needed to be updated with student participation. Peer educators and participatory techniques are needed to get students to internalise positive attitudes and behaviour. The education materials need to address the lack of female empowerment in making decisions and negotiating for safer sex.     

Experience of Older Gay and Bisexual Men Living with HIV/AIDS

Although HIV/AIDS definitely impacts gay and bisexual men of all ages, the impact on people in their later years has not been actively investigated. This exploratory study obtained detailed narratives from 14 adults between the ages of 51-72, all of whom were infected with HIV. Ten of the participants were potentially infected through male to male sexual contact. The subjects reported living with HIV for substantial periods with an average of 13 years of life since diagnosis, estimating a duration of HIV seropositivity from 1-20 years. Most had significant health problems, which may be related to aging, in addition to a number of HIV-related symptoms. They expressed community identification as people living with HIV; some were highly identified as gay men, while other were closeted or in denial regarding their same-sex activity. Half felt to some extent bisexual, and described relationships with wives or other women. Although many participants maintained active social lives, others expressed feelings of loneliness and isolation. This group was minimally active sexually and several of the participants expressed reservations about safer sex, especially condom usage. A strong theme was the sense of having lived a full life, which may help the individual cope with his diagnosis. The findings suggest the need to examine the diversity among older gay and bisexual men living with HIV, how these experiences vary by race and ethnicity, and identification of issues related to prevention and services.     

Social,Relational and Network Determinants of Unprotected Anal Sex and HIV Testing Among Men Who Have Sex with Men in Beirut,Lebanon

Objectives: We examined the social, relational and network determinants of condom use and HIV testing among men who have sex with men (MSM) in Beirut. Methods: Two-hundred thirteen men were recruited via respondent driven sampling and administered a survey. Results: Sixty-four percent reported unprotected anal intercourse (UAI), including 23% who had UAI with unknown HIV status partners (UAIU); 62% of participants had tested for HIV. In multivariate analysis, being in a relationship was associated with UAI and HIV testing; lower condom self-efficacy was associated with UAIU and HIV testing; gay discrimination was associated with UAIU; MSM disclosure was associated with UAI, UAIU and HIV testing; and network centralization was associated with HIV testing. Conclusions: Multi-level social factors influence sexual health in MSM.     

Rural HIV/AIDS Social Services for Gays and Lesbians

Abstract

The HIV pandemic persists into its second decade, with an untoward toll on rural gays which continues to generate suffering and loss. Rural HIV infections are increasing, and the unique problems of health and social services represent new challenges. Professional social services that would overcome barriers to care for rural gays and lesbians have been historically inadequate or non-existent. The HIV pandemic shows that services for HIV diseases must become part of efforts to strengthen the care delivery services for all in rural America, especially by fostering the power and resiliency of gays and lesbians. The empowerment of rural gays, bisexuals, lesbians and transgendered persons assumes that basic differences occur between those in rural and urban areas, and health and social services must build upon the unique strengths of these diverse groups.     

Sex education and HIV/AIDS: political conflict and legal resolution

Throughout the last decade sex education has been a site of intense political struggle. This article identifies how the legal regulation of sex education operates in such a way as to incorporate conflicting discursive problematisations of HIV/AIDS and childhood sexuality through the construction of distinct categories within the sex education curriculum and the legitimisation of distinct roles for parents, teachers and health professionals within those categories. In particular it seeks to explain why sex education in schools fails at present to be a primary source of information about HIV/AIDS for young people and, consequently, identifies the urgent need for new guidance from the Department of Education and Employment.     

Rural Migration,Rapid Growth,and Fear of Crime*

Abstract Although much research on rural “boomtowns” explores differences between rapid‐growth communities and more stable communities, it is logical to consider that residents within rural boomtowns experience community transitions in different ways. We examine a specific outcome, fear of crime, across three categories of community residents with different migration histories: lifetime residents, migrants who joined the boomtown community during its period of rapid growth, and post‐boom period migrants. This perspective is particularly interesting, given the likelihood that these three different categories of residents have had substantially different community experiences. Making use of survey data from two intermountain West communities that represent resource‐dependent transitions during the 1970s and 1980s (Evanston, Wyoming and Delta, Utah), we find that boom migrants express greater fear of crime than longer‐term residents or post‐boom migrants. The findings suggest that the longer‐term decline in fear of crime in “post‐boom” periods is not equal among residents.     

The Socio‐Economic Determinants of HIV/AIDS Infection Rates in Lesotho,Malawi, Swaziland and Zimbabwe

Using data from the Demographic and Health Survey, this article analyses the relationship between HIV status and the socio‐economic and demographic characteristics of adults in Lesotho, Malawi, Swaziland and Zimbabwe. It constructs the risk profile of the average adult, computes the values of age, education and wealth where the estimated probability of infection assumes its highest value, and determines the percentage of adults for whom these three factors are positively correlated with that probability. It finds that in all four countries: (i) the probability of being HIV‐positive is higher for women than for men; (ii) the likelihood of infection is higher for urban than for rural residents; and (iii) there is an inverted‐U relationship between age and HIV status. Also that, unlike gender, rural/urban residence and age, the relationship between the probability of infection and wealth, education and marital status varies by country. The results provide support for country‐specific and more targeted HIV policies and programmes.     

Work status, benefits, and financial resources among people with HIV/AIDS

With the advent of more advanced treatments and therapies, people with HIV/AIDS are experiencing significant improvements in their health, making many of their ongoing employment and career goals more realistic. However, people with HIV/AIDS continue to have major concerns regarding the impact of working on their benefits and entitlements, including apprehensions about potential economic hardships related to loss of financial supports and health insurance coverage. This article focuses on factors related to employment status, sources of health benefits, and entitlements among people with HIV/AIDS. In addition, results of the study demonstrate differences in employment status, benefit types, and the amount of financial support individuals receive based on gender.     

Migration,the Urban Informal Sector,and Earnings in the Philippines*

This study investigates several issues pertaining to the urban informal sector and cityward migration in Philippine cities. The analysis of cross-sectional national demographic data reveals the four major patterns. First, the pattern of migrants' participation in the urban labor market varies greatly between male and female migrants. The widely held notion that migrants tend to enter the urban occupational structure through the informal sector seems to apply mainly to female migrants. Second, the informal sector must not be identified with urban poverty. Our data suggest that informal economies provide a wide range of income opportunities and that there is a great deal of overlap between formal- and informal-sector workers' incomes. Third, the effects of rural background and informal sector involvement seem to vary between Manila and the secondary cities. Fourth, sectoral boundaries do not seem to constitute a significant mobility barrier, but, due to the general lack of occupational mobility opportunities in Philippine cities, only a small proportion of those working in the informal sector are likely, to move out of it.     

Intergenerational Practices and Possibilities Related to the HIV/AIDS Pandemic in Botswana and Nigeria

Abstract

The future of Botswana and Nigeria hangs precariously on the balance of life and death. In recent years, the latter seems to be winning as both countries face the devastation of their middle generation due to the HIV/AIDS pandemic. Neither country can afford to simply watch their populations be depleted at such an alarming rate. This paper seeks to propose how an intergenerational framework might be applied to this situation with the hope that intergenerational policies and approaches might ameliorate this social crisis.     

HIV/AIDS Knowledge Sources and Risk Behavior among Adolescent African American Males: Toward Developing HIV/AIDS Pedagogy

Black male adolescent HIV incidence and prevalence account for a disproportionate number of AIDS cases. Their cultural experiences are significantly different than other sectors of the U.S. population. Among adolescents, they constitute 37 percent of the cases, which is more than double their representation in the general adolescent population. The authors ask where do African American males receive information about HIV/ AIDS.     

Sources of Personal Meaning Among Mexican and Mexican American Men with HIV/AIDS

ABSTRACT

This study examines one particular form of coping, finding personal meaning in the context of HIV, used by Mexican (M) and Mexican American (MA) HIV-positive men. A total of forty M and MA males who have HIV or AIDS was utilized. Individual interviews were conducted and subsequently transcribed and analyzed through content analysis. The areas most often reported by the M and MA respondents as being sources of personal meaning were as follows: relationships with family members, relationships with lovers/spouses and friends, religious beliefs, helping others, and personal growth. Knowledge of such coping resources used by M and MA men with HIV can contribute to the development of ethnic-sensitive social work practices.