Drug use,prostitution and the prevalence of AIDS: An analysis using census tracts

This paper reports on preliminary efforts to study at the census tract level the reciprocal relationships between AIDS and street crime, particularly prostitution and drug offenses and the prevalence of AIDS. The Los Angeles County Department of Public Health provided the number of reported AIDS cases by census tract. The data on reported crimes and arrests, organized by reporting districts, came primarily from the Los Angeles County Sheriff's Department and the Los Angeles City Police Department. Although this strategy needs replication and extension, the present findings suggest that sexual orientation, drug use and prostitution are useful risk variables at the census track level.     

Improving ascertainment of risk factors for HIV infection: results of a group-randomized evaluation

To allow appropriate allocation of prevention and care funding, HIV/AIDS surveillance data must include risk factor information, currently available for less than 70% of cases reported in the United States. The authors evaluated an intervention consisting of provider training and materials to improve risk factor reporting. Facilities were matched prior to randomization to intervention or control, and generalized linear mixed models were used to test for an intervention effect. Twenty-one percent of cases from intervention facilities and 33.4% from control facilities (p = .09) were reported without any risk factor information. The pre-post difference (20.7% for intervention and 36.0% for control) was not significant among HIV cases (p = .11) nor among AIDS cases (p = .12; 21.3% for intervention and 31.1% for control). The methods the authors' evaluated may need to be combined with other approaches and/or alternative classification schemes to significantly reduce the percentage of cases reported to surveillance without risk factor information.     

Negative Consequences

Abstract

This article reports the results of a qualitative study of self-identified HIV-Negative gay/bisexual men living in urban gay communities. The study explored the effects of living through nearly two decades of the AIDS pandemic. Most researchers have focused on those who are HIV-Positive. Those whose serostatus is HIV-Negative are rarely included, but are greatly affected by this disease. An increasing number of these men, especially younger men, are seroconverting. Forty-seven gay men returned a questionnaire asking about feelings on being HIV-Negative, dealing with grief, sexual practices, and relationship and caregiver issues. Many HIV-Negative gay men reported psychological problems such as depression and unresolved grief. Therapists and AIDS prevention educators need to attend to the special needs of this overlooked population.     

Agricultural change and the rise of the British strawberry industry, 1920–2009

Little research has been conducted on structural change within the UK horticultural sector. This paper examines long-term changes, over a 90-year period, in one particular part of the UK horticultural sector: strawberries. It follows its growth from being a minor crop in 1920 to becoming the biggest grossing horticultural crop in 2009. Using a combination of long-term continuous datasets of agricultural statistics and primary data gathered from a behavioural study of the sector, three distinct phases of change are identified. The last phase, in particular, witnessed the biggest changes with the introduction of protected cultivation, the industrialisation of strawberry production and the divergence of practices and marketing methods leading to the formation of two distinct farm types. This industrialisation removed the geographical disadvantage of Scotland relative to England, encouraging growth of the Scottish strawberry industry and a spatial shift in the main production centres. Supermarkets have played a dominant role in the market for fresh strawberries and their importance in driving change is of high significance.     

Sex,drugs and matrices: Mathematical prediction of HIV infection

The purpose of this paper is to consider a very simple model of the AIDS epidemic. This model illustrates how the spread of AIDS can be affected by parameters whose values, at the present time, are very imprecise or unknown. Of particular interest are the data related to sexual encounters and practices, data which are often unreliable or ambiguous. In this regard, the present model also suggests that the epidemiology of AIDS is particularly sensitive to the limitations in the assessment of sexuality/drug‐related behavior. Using a system of elementary differential equations, the present paper illustrates (using 3 examples) that depending upon the value of critical parameters, one could predict either very rapid increases of seropositivity or a decreasing rate of seropositivi‐ty. Thus, in order to diminish the ambiguity, it becomes crucial to make careful estimates of the sexual “interaction” coefficients, along with all other parameters, to insure that reasonable predictions can be made.     

A Broadened Horizon: The Value of International Social Work Internships

Globalization demands that social work educators initiate educational programs that promote understanding of global problems and country‐specific interventions to address transnational problems. Moreover, the global movement of peoples means that social workers must be increasingly adept at working with different cultural groups. This paper outlines an international social work internship jointly sponsored by San Diego State University and Thammasat University in Bangkok, Thailand. The internship program sought to expose students to social work and social welfare practices different than those in the United States and to the impact of problems such as AIDS and child abuse in a different culture. Moreover, the internship program focused on cultural learning and promoted the development of ethnorelativism, a perspective that incorporates another culture's world view. The paper outlines the creation of the internships, student activities and learning, and skills gained.     

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.     

AIDS in the Native Hawaiian Community

Native Hawaiians are at high risk for several health disorders and experience multiple socioeconomic problems. Infection rates for AIDS in this population are increasing and, when viewed in context of their overall poor health profile, are clearly indicators for concern. This article discusses the ramifications of AIDS in the native Hawaiian community by examining the knowledge and lifestyle practices of 26 native Hawaiians in Hawaii, and by identifying recommendations that may lead to the development of culturally responsive social services.     

Family farms in the Scottish borders: a practical definition by hill sheep farmers

The theme of this paper is the family farm and the problems of defining it. The approach taken is to recognize the difference between theoretical definitional practices of sociologists and anthropologists, on the one hand, and everyday definitional practices of family farmers on the other. The former focus upon observable behaviour and/or quantitative measures that are used to construct an analytical concept with precise boundaries; the latter are not interested in defining the boundaries of the concept of the family farm but in understanding the nature and operations of their family farms so that they can reproduce them in their everyday activities. They attend to what is most central and ideal to the family farm and this is the basis of their concept of the family farm. Through an ethnographic account of hill sheep farms in the Scottish borderlands, the paper argues that the essence of family farms is a consubstantial relation between family and farm such that the distinct existence and form of both partake of or become united in a common substance that is transmitted over generations. The analysis highlights the economic and social interdependence of family and farm, the process by which the farm becomes embodied through family labour, the strategies adopted by the family to ensure the transfer of the farm to the following generation, and the use of a genetic metaphor to transpose a legal relation between family and farm into a consubstantial one.     

New ways of believing or belonging: is religion giving way to spirituality?1

In this article, the presence of alternative spirituality and practices within the general culture and their relationship to institutional religion are examined using national survey data collected as part of the 2001 Scottish Social Attitudes Survey. Alternative practices are found to divide into two groups of interests: concerns with personal well-being and interest in divination. Better-educated women are much more likely to engage with holistic practices associated with well-being; a minority of younger, less well-educated women are more likely to have found horoscopes, astrology, fortune-telling and tarot 'important in their lives'. Churchgoers find divination antithetical to religion while the use and salience of a range of holistic practices is as acceptable among churchgoers as it is among non-attenders and the secular (once allowance has been made for the connections between putatively alternative practices, gender, age and education). This underscores a focus on personal well-being rather than alternative spirituality in the consumption of holistic products and practices within the general culture. The study findings are used to assess claims for a spiritual revolution in modern Britain.     

Risk behaviors and perceptions of AIDS among street injection drug users

Standardized survey interviews (n = 325) and guided in-depth interviews (n = 22) were conducted with injection drug users (IDUs) in Long Beach, California, to document drug usage and injection patterns, sexual practices, perceived risk of HIV infection, sources of health information, and knowledge and attitudes about AIDS. Most IDUs reported sharing needles (87.9%), and a large minority reported regular sterilization of needles/syringes (40.3%). Lower rates of needle sharing were reported among cocaine users than among heroin and speedball users. HIV seroprevalence was 5.7 percent (11/194). Sexually active female (60.7%) and male (20.5%) IDUs reported exchanging sex for money or drugs. Overall, 48.3 percent of IDUs reported having made changes in their injection practices and one-third reported modifying their sexual behavior in order to avoid HIV infection. Differences in drug use, sexual practices, and drug treatment history were found with regard to gender, ethnicity, age, and type of drug injected. Implications of findings for the development of AIDS risk-reduction programs are presented.     

Psychological Adaptation and Adjustment to Acquired Immune Deficiency Syndrome

Early reports of the psychological ramifications of acquired immune deficiency syndrome (AIDS) emerged shortly after the first incidence of the isease was officially reported in this country in 1981. These preliminary reports were based on clinical observations and anecdotal information which showed that the psychological reactions of AIDS patients were similar to those stages of death and dying described by Kubler-Ross (1969) although they appeared to be intensified and compounded by other issues related to the stigmatized status of most carriers of this disease. Two specific models of the staging of these psychological reactions are outlined. The psychological problems most commonly requiring therapeutic intervention are discussed with attention paid to the importance of distinguishing between those whose etiology is functional versus organic. The suspected pathogenesis, symptomatology and progression of the most common form of organic neurological disorder associated with AIDS, AIDS dementia complex, is summarized. Finally, a model of integrated treatment for the psychological aspects of adaptation to AIDS is described.     

Implications of increased infectivity in early-stage HIV infection. Application of a Bernoulli-process model of HIV transmission

Recent reports suggest that the infectivity of sexually transmitted HIV (i.e., the probability of transmission on a single sexual contact) may be up to 1,000 times greater during the first few months of infection than during the long asymptomatic period that precedes the development of AIDS. Assuming the validity of this estimate, a simple Bernoulli-process model of HIV transmission indicates that, in some cases, the expected number of secondary infections is greater for the brief period of primary infection than for the much longer asymptomatic phase. The implications of these findings for current HIV/AIDS prevention practices are analyzed with particular attention to the role of condom use in preventing HIV transmission.     

Constructions of ‘vulnerability’ in comparative perspective: Scottish protection policies and the trouble with ‘adults at risk’

This paper places Scottish adult support and protection (ASP) policy in the context of debates about the nature of ‘vulnerability’ and its usefulness as a defining concept in law and social policy. It examines the construction of ‘adults at risk’ in ASP policy, using a comparison with the construction of children in Scottish child protection policy, on the one hand, and women in Scottish domestic abuse policy, on the other, to illuminate the nature of the vulnerability that ASP considers itself to be addressing. It then problematises this construction, drawing both on the social model of disability and on an ethic of care. It concludes that current ASP policy remains underpinned by unhelpful assumptions about disabled people, older people and people with mental or physical health problems. A more inclusive understanding of vulnerability would be more empowering to these people and others, in policies concerned with mistreatment and abuse.     

An Approach to Community Outreach Practice in the 21st Century

ABSTRACT

This article presents the findings of a study about knowledge, attitudes and beliefs about AIDS held by older Hispanic adults. Members of the convenience sample provided responses that identify concerns about effective practice in outeach and information provision to older adults with regard to risky sexual practices. Intervention to prevent the spread of HIV/AIDS among older adults needs to be culturally competent and to be attuned to social practices, traditions, community concerns, and generational perspectives with regard to serious health problems related to sexual behavior. The sample composition was primarily Hispanic (97.4%); Catholic, (92.1%) and female (84.2%) with a mean age of 73.7 years. Approximately 28.2% of those surveyed stated that they felt that AIDS was an important problem for older adults. The majority, (76.3%) were aware of locations where health information and services were available if AIDS were a problem. Even though the majority indicated knowledge that AIDS is spread through sexual intercourse, more than one third, (36.8%) thought that sexually active adults 55 and over never use condoms. A discussion of the implications for disease prevention programs and community practice is presented emphasizing the importance of empowerment strategies in health promotion programs and the strengthening of multidisciplinary collaborative efforts to effect positive community health changes.     

Between skepticism and empowerment: the experiences of peer research assistants in HIV/AIDS,housing and homelessness community‐based research

People living with HIV/AIDS (PHAs) in Canada are a highly researched population, yet their inclusion in the research process is minimal. Community‐based research (CBR) has become a recognized tool for addressing issues of power and exclusion within researcher/community relationships by inviting the community's equitable involvement as research partners. Within the context of HIV/AIDS research, this includes a commitment to the Greater Involvement of People Living with HIV/AIDS (GIPA) at all stages of the research process. One way of adopting GIPA principles within CBR is through providing employment, research training, and capacity building opportunities for PHAs as peer research assistants (PRAs). Drawing on data from two in‐depth focus groups with seven PRAs from the Positive Spaces, Healthy Places: Community‐based Research Study, this paper will highlight important methodological practices for academic and community‐based researchers who are working with and supporting PRAs.     

College Students and HIV/AIDS: A Comparison of Nontraditional and Traditional Student Perspectives

Objective and Participants The authors compared nontraditional college students' knowledge and perceptions of HIV/AIDS and sexual practices with previously reported results about traditional students. Methods Nontraditional students completed an online survey with questions based on national HIV/AIDS surveys. Traditional students completed the same survey with paper and pencil. Results Overall, the authors found more similarities than differences between the 2 groups. The findings support previous research that suggests that although college students are knowledgeable about HIV and its risks, they express little personal concern about becoming infected. The authors also discuss how apparent differences between nontraditional and traditional students regarding personal concern about becoming infected, relationship status, and information sources may influence the development of effective prevention strategies geared toward nontraditional college students. Conclusions Institutional leaders need to adapt to these differences, and researchers should undertake additional studies to clarify these differences so that college students may be more effectively educated about HIV/AIDS and encouraged to get tested.     

THE ORGANIZATIONAL CAREER OF GANG STATISTICS: The Politics of Policing Gangs

This article examines the way in which the construction of a "gang" problem and the resulting "gang statistics" in a particular community, referred to as Bigcity, are related to the local political context and the police accommodation of political interests. In particular, the political accountability of the police impacts on police recordkeeping practices and the statistics regarding "gangs" that those records generate. The organizational career of gang statistics, from the citizen's call to the police response and subsequent recordwork, is examined in order to demonstrate how the recordkeeping practices of the police bureaucracy facilitate the social construction of the "gang" problem. Field research data, including calls to the police, ride-along observations, and interviews, illustrate how the politicization of the "gang" problem impacts on police recordkeeping and the social construction of "gang statistics.'Given that the current concern about the nationwide growth of gangs is based on such statistics and that gang suppression efforts call for enhancing and sharing gang databases, the role of police practices in shaping gang statistics is an important issue.