Why do People Disclose their HIV Status? Qualitative Evidence from a Group of Activist Women in Khayelitsha

Abstract

This study explores the bio-psychosocial context of HIV/AIDS in which eleven HIV-positive activist women from Khayelitsha negotiated the process of disclosing their HIV-positive status to significant others, specifically biological household members. The study is based on the narratives of a group of HIV-positive peer-educators in Cape Town, South Africa. The results suggest that community perceptions of HIV/AIDS are shaped by a wide variety of factors particular to the socio-cultural and political context of HIV/AIDS in South Africa. The process and outcomes of disclosure to others occurs within this shifting web of meanings, and in turn, reshapes them as people respond to the person who has just disclosed. Eight out of the eleven women disclosed to a close biological household member as these significant-others provided, or had the potential to provide, the appropriate support. Six of the eleven participants disclosed during the symptomatic phases of HIV/AIDS, while five were asymptomatic at the time. Four of the five who disclosed when asymptomatic were diagnosed while pregnant and had never experienced severe opportunistic infections. Additionally, these same four disclosed some time after diagnosis (nine months > t < two years). Of the six who disclosed in a state of ill-health, five disclosed immediately after diagnosis in order to access health-related social support. At this time, concerns regarding health and mortality superseded fears of rejection and discrimination due to AIDS-related stigma. The perceived potential benefits (social and health-related support) outweighed the perceived risks (stigmatisation and discrimination). When participants had never experienced serious illness, they disclosed in order to educate loved-ones, gain emotional support or challenge false popular perceptions of HIV/AIDS.     

The Interpretation of Line of Regard by Prelingually Deaf Children

The ability of 5- to 12-year-old deaf children to utilise and interpret another person's visual line of regard (where the eyes are looking) was studied in four experiments using cartoon faces. The children had little difficulty in determining whether or not a face was looking directly at them. They had more difficulty, however, with more complex tasks requiring them to infer mental states of desire and intention from line of regard and to ignore line of regard when it was inappropriate to attend to this cue. Deaf children raised in a hearing environment appear to have more difficulty with these more complex tasks than hearing children. The results are discussed in terms of the special difficulties facing some deaf children in the development of skills involving utilisation of line of regard and the implications for the development of joint attentional behaviour, theory of mind and dyadic social interaction in deaf and hearing children.     

Can social workers and police be partners when dealing with bikie-gang related domestic violence and sexual assault?

Welfare and criminal justice systems manifest different goals, cultures, values and working methods. In Australia, the welfare sector has a culture of empowerment and concern for victims’ rights, within which social workers focus on social justice and social change. In contrast, the criminal justice sector (police) is patriarchal and para-military in structure, focusing on enforcing and maintaining community order and safety. These differences can create tension when social workers and police need to work as partners in response to violence against women, in particular violence against women from bikie gangs. This article addresses the issue of partnerships between social workers and police when working with abused bikie-gang women. It presents the findings of recent research into social work practice with such women in South Australia, in conjunction with a brief exploration of the international literature on social work and police cultures, and partnerships. It concludes that whilst there is a great need for genuine collaboration and partnership between social workers and police in the complex context of domestic violence with links to organised crime, the cultures and mandates of these different professions make this difficult.     

A response to M. Stone: 'How not to measure the efficiency of public services (and how one might)'

Summary.  This is a response to Stone's criticisms of the Spottiswoode report to the UK Treasury which was responding to the Treasury's request for improved methods to evaluate the efficiency and productivity of the 43 police districts in England and Wales. The Spottiswoode report recommended uses of data envelopment analysis (DEA) and stochastic frontier analysis (SFA), which Stone critiqued en route to proposing an alternative approach. Here we note some of the most serious errors in his criticism and inaccurate portrayals of DEA and SFA. Most of our attention is devoted to DEA, and to Stone's recommended alternative approach without much attention to SFA, partly because of his abbreviated discussion of the latter. In our response we attempt to be constructive as well as critical by showing how Stone's proposed approach can be joined to DEA to expand his proposal beyond limitations in his formulations.