AIDS in China

Most recent official statistics indicate that there was a cumulative total of 133 AIDS cases in mainland China through the end of October 1996 and 5157 people infected with HIV. Official statistics also indicate continuing increases in recent years in the number of people with AIDS and people infected with HIV, and that the incidence of infection is growing in China. HIV has been found to have been transmitted in China through IV drug use, sexual activities, from mother to child, and through transfusions and the use of blood products. Important risk factors for the spread of HIV in China include high population density, a considerable transient population, drug use, prostitution, blood transfusion, the improper sterilization of medical instruments in rural areas, changes in people's sexual attitudes and behaviors, and lack of information on safe sex. The Chinese government reports having taken considerable steps to check the spread of HIV/AIDS and supports communication and education as an essential tool in the fight against the epidemic. Life expectancies in China's provinces and municipalities are listed.     

The spread of HIV into the general population of the USA: A simulation

The spread of HIV from injection drug users and male homosexuals into the general US population is simulated, using survey data on sexual behavior. We estimate that approximately 150,000 persons are currently infected with HIV through heterosexual transmission, the majority of whom are female partners of drug-using or bisexual men. The estimated number of AIDS cases generated by the model is close to the CDC statistics for males, but much higher for females. We conclude that prevention efforts should be targeted towards these high risk groups rather than the general population.Abbreviations IDU injection drug users - NORC National Opinion Research Center; Chicago - STD sexually-transmitted disease     

Sexual risk-taking in the slums of Nairobi,Kenya, 1993-8

Relatively less attention has been paid to reproductive health problems facing deprived urban residents than to those facing rural residents in the sub-Saharan Africa. This is probably because the majority of Africans live in rural areas, where they are presumed to have poorer medical, educational, and other social services. Yet, the unprecedented rate of urbanization and the accompanying disproportionate growth in the proportion of poor city residents pose new challenges for health care in the region. This study examines differences in sexual behaviour between slum residents and non-slum residents in Nairobi city. The results show that slum residents start sexual intercourse at earlier ages, have more sexual partners, and are less likely than other city residents to know of or adopt preventive measures against contracting HIV/AIDS. The findings highlight the need to treat slum residents as a sub-population uniquely vulnerable to reproductive health problems and to expend more resources in slum settings.     

Sexual risk-taking in the slums of Nairobi,Kenya, 1993-98

Relatively less attention has been paid to reproductive health problems facing deprived urban residents than to those facing rural residents in sub-Saharan Africa. This is probably because the majority of Africans live in rural areas, where they are presumed to have poorer medical, educational, and other social services. Yet, the unprecedented rate of urbanization and the accompanying disproportionate growth in the proportion of poor city residents pose new challenges for health care in the region. This study examines differences in sexual behaviour between slum residents and non-slum residents in Nairobi city. The results show that slum residents start sexual intercourse at earlier ages, have more sexual partners, and are less likely than other city residents to know of or adopt preventive measures against contracting HIV/AIDS. The findings highlight the need to treat slum residents as a subpopulation uniquely vulnerable to reproductive health problems, and to expend more resources in slum settings.     

Sexual Behavior in China: Trends and Comparisons

Dramatic political, economic, and social changes in China over the past several decades have been accompanied by much discussion in popular media and among academics of a fundamental transformation in Chinese sexual behavior. Several studies have examined current Chinese sexual behavior but have been limited to particular provinces or cities and have been based on non‐random samples. The potential threat of a generalized HIV epidemic in China highlights the dearth of population‐based information on current patterns of sexual behavior that could help design better intervention strategies and prevent misguided ones. This article uses data from the first national probability survey of adult sexual behavior in China completed during 1999–2000, along with a historical and literature review, to address three key questions: 1) Has there been a revolution in sexual behavior in China? 2) Is China unique compared to other countries in these transformations? 3) What are the implications of these findings for China's risk of a generalized HIV epidemic?     

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。     

Disease risk and fertility: evidence from the HIV/AIDS pandemic

A fundamental question about human behavior is whether fertility responds to disease risk. The standard economic theory of household fertility decision-making generates ambiguous predictions, and the response has large implications for human welfare. We examine the fertility response to the HIV/AIDS pandemic using national household survey data from 14 sub-Saharan African countries. Instrumental variable (IV) estimates using distance to the origin of the pandemic suggest that HIV/AIDS has increased the total fertility rate (TFR) and the number of surviving children. These results rekindle the debate about the fertility response to disease risk, particularly the HIV/AIDS pandemic, and highlight the question of whether the HIV/AIDS pandemic has reduced GDP per capita.     

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.     

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     

Gender differences in substance use and initiation of sexual activity

Even though widespread efforts have focused on educating young adults about HIV and AIDS, many individuals continue to engage in behaviors that place them at risk. These behaviors include frequent experimentation with alcohol and other drugs prior to sex, engaging in sexual activity with different partners, and inconsistent safe sex practices (Butcher et al. 1991). The combination of these risky behaviors causes increased concern about the spread of HIV among those of college age. This study focused on two behaviors by examining the relationship between substance use during adolescence and early initiation of sexual activity in a sample of 950 subjects aged 19–21 in a mid-sized southern city. Results indicate that early use of alcohol and marijuana relates to earlier initiation of sexual activity and subsequent risky sexual behavior among young adults. Also, gender differences were observed for frequent users of marijuana and alcohol with males engaging in riskier sexual practices. Recommendations for interventions are made.     

Sero‐Discordant Couples in Five African Countries: Implications for Prevention Strategies

Most analyses of the determinants of HIV infection are performed at the individual level. The recent Demographic and Health Surveys, which include results from HIV tests, allow the study of HIV infection at the level of the cohabiting couple. This article exploits this feature of the data for Burkina Faso, Cameroon, Ghana, Kenya, and Tanzania. The analysis yields two findings about the dynamics of the HIV/AIDS epidemic that have important implications for policy. First, at least two‐thirds of the infected couples are sero‐discordant, that is, only one of the two partners is infected. This implies scope for prevention efforts among infected couples. Second, among 30–40 percent of the infected couples only the woman is infected. This is at odds with levels of self‐reported extramarital sex by women and with the common perception that unfaithful men are the main link between high‐risk groups and the general population. These findings are confirmed by tests of robustness. These results indicate that extramarital sexual activity among women in union is a substantial source of vulnerability to HIV that should be, as much as male extramarital activity, targeted by prevention efforts.     

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.     

Trend Analysis of Medical Publications About LGBT Persons: 1950–2007

Although there are currently at least 6 million lesbian, gay, bisexual, and transgender (LGBT) persons in the United States, there are no prior studies analyzing how this group is represented in the medical literature. An examination of published LGBT topics over a 57-year period was performed using OvidSP. A total of 21,728 publications was analyzed for topic using information from the title, keywords, subject headings, and abstracts. Several trends became apparent. The largest proportion of LGBT publications (31.78%) was devoted to HIV/AIDS and other sexually transmitted infections (STIs), yet there was an overall lack of emphasis on general health topics or common causes of mortality. Further analysis showed that if publications on HIV/AIDS or STIs addressed sexual orientation, they were more likely to be about LGBT persons than heterosexuals. Overall, the volume and range of medical publications on LGBT persons may not be reflective of the health care needs of this population.     

Trend analysis of medical publications about LGBT persons: 1950-2007

Although there are currently at least 6 million lesbian, gay, bisexual, and transgender (LGBT) persons in the United States, there are no prior studies analyzing how this group is represented in the medical literature. An examination of published LGBT topics over a 57-year period was performed using OvidSP. A total of 21,728 publications was analyzed for topic using information from the title, keywords, subject headings, and abstracts. Several trends became apparent. The largest proportion of LGBT publications (31.78%) was devoted to HIV/AIDS and other sexually transmitted infections (STIs), yet there was an overall lack of emphasis on general health topics or common causes of mortality. Further analysis showed that if publications on HIV/AIDS or STIs addressed sexual orientation, they were more likely to be about LGBT persons than heterosexuals. Overall, the volume and range of medical publications on LGBT persons may not be reflective of the health care needs of this population.     

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.     

Social networks, perceptions of risk, and changing attitudes towards HIV/AIDS: new evidence from a longitudinal study using fixed-effects analysis

The study presented here is an investigation of the importance of social interactions to perceptions of the risk of AIDS, and explores spousal communication about the AIDS epidemic in rural Malawi. A fixed-effects analysis based on longitudinal data collected in 1998 and 2001 shows that social interactions on the subject of HIV/AIDS have significant and substantial effects on respondents' perceptions of the risk of HIV/AIDS, even after controlling for unobserved factors that affect the selection of social networks. These effects are more complex than previously thought. The dominant mechanisms--social learning and social influence--are found to vary by sex and by region, because of regional variations in the marriage pattern and the resulting implications for the formation of local social networks. The conclusion of the study is that rather than fostering denial and inaction, social interactions are an important vector of change in the face of the HIV/AIDS epidemic.     

The integration of support for HIV and AIDS and livelihood security: district level institutional analysis in southern Africa

Livelihood insecurity, HIV and AIDS, and environmental change, including high climate variability, have negatively impacted the southern African region for the last decade. It is increasingly evident that there is a complex interplay of factors shaping rural livelihoods at various scales. Recognition of the varied impacts of HIV and AIDS has led to development of a conceptual framework that utilises the ‘AIDS Timeline’ or ‘Programming Matrix’, which enables differential intervention strategies to be adopted depending on the dominant impacts and trends on livelihoods. This paper presents this approach and links it to case study material from two districts in Malawi and South Africa. The evidence suggests that although there are some areas where HIV and AIDS are mainstreamed into livelihood security interventions, this is not sufficient, as holistic environmental and social approaches are not adopted. This paper reflects on the fieldwork findings to link to the AIDS Timeline in support of appropriate interventions. At the same time, we highlight the urgency in addressing the meso-scale and adopting a holistic framework that addresses livelihood security from a range of angles, including the implications for the chronically ill, interactions with environment and the capacity to implement change.     

吸毒人群对艾滋病防治的接纳现状与影响因素

近年来我国已经把吸毒人群作为艾滋病防治的重要干预对象之一,然而现状不容乐观,吸毒人群传播艾滋病的风险远未得到有效控制。探讨影响吸毒人群对艾滋病防治措施的认同和接纳的因素,以便为完善艾滋病防治措施提供新的思路。研究表明,吸毒人群的认知水平、社会支持、政策保障、人生态度等因素对其接纳艾滋病防治措施有影响。只有将吸毒人群视为弱势群体予以增权和关爱,以"合作"的社会政策导向和"平等"的社会工作价值介入,从其需求入手开展务实多样的防治措施,才有可能真正改变吸毒人群的观念与行为,从而获得艾滋病防治的良效。     

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.