Stigma,AIDS, and HIV Prevention in Africa: Reports from Community Organizations Providing Prevention Services

ABSTRACT

The AIDS epidemic in Africa remains a serious health crisis. Nongovernmental organizations (NGOs) in Africa play a critical role in the delivery of HIV prevention services. An important barrier to their HIV prevention efforts is stigma directed at persons living with HIV/AIDS. In order to understand how stigma affects HIV prevention programming, we conducted in-depth qualitative interviews with NGO directors in 29 African countries. Qualitative analytic approaches were used to identify key themes. Substantial discrimination and stigmatization of HIV-positive persons was reported. HIV-positive women were particularly likely to suffer negative social and economic consequences. The stigma associated with HIV interfered with disclosure of HIV status, risk-reduction behaviors, and HIV testing, creating significant barriers to HIV prevention efforts.

Interventions to reduce AIDS-related stigma in Africa are urgently needed. Reducing the burden of stigma is critical to fighting the epidemic in Africa and could play an important role in global HIV reduction.     

Four contexts of institutional oppression: Examining the experiences of Blacks in education,criminal justice and child welfare

ABSTRACT

Institutions are key sites of oppression. Institutional oppression is defined as the mistreatment of people of a particular group that is enforced by society and its institutions. It is a system of invisible barriers that emerge from institutional laws, customs and practices, thus producing inequities for particular groups across race, gender and class. Woven together, the web of institutional oppression is vast, cumulative and multi-faceted, including both overt and covert discriminatory practices and behaviors. Based in a critical review of the literature, the authors of this article introduce and describe four characteristics of institutional oppression that specifically impact the lives of Black Americans. Furthermore, we provide a case vignette that illustrates these characteristics of oppression. The article concludes with recommendations on dismantling institutional oppression and highlights the roles that social workers can play in collaboration with educators and other professionals.     

Cultural integration through shared learning among resettled Bhutanese women

ABSTRACT

The multidimensional needs of recently resettled refugees have been well documented and range from elevated rates of mental illness and health care challenges to difficulties accessing resources due to language and literacy barriers. These factors are largely responsible for the challenges resettled refugees face in acquiring and maintaining stable employment. It is possible that achieving financial stability through steady employment and purposeful money management may alleviate some stressors associated with the resettlement process, though research in this area that is specific to refugees is in its infancy. What is clear, however, is that a traditional approach to mental health treatment (i.e., therapy in a traditional office setting) may lack effectiveness because of the lack of attention to extraneous stressors such as poverty, transportation, and language and literacy challenges that impact resettled refugees. The purpose of this study was to qualitatively assess the impact of a group-based financial education course and social enterprise on the self-reported mental health (i.e., post-traumatic stress symptoms, depression, anxiety, and somatization) of Bhutanese refugee women resettled in the United States. The study also sought to evaluate the acceptability and overall satisfaction with various components of the intervention. This qualitative study was a follow-up to a larger quantitative study that included 65 Bhutanese women who were resettled to the southwestern United States by a large resettlement agency. The results of this study offer insights into the lived experiences of Bhutanese refugees in the United States, particularly related to cultural integration bolstered by group-based education and shared learning opportunities.     

Workplace flexibility: a model of change

The inception of When Work Works – a theoretical- and research-based model of change in promoting effective and flexible workplaces – dates back to the confluence of a number of factors in the early 1990s. One decade later, this ‘perfect storm’ of factors led to the creation of When Work Works, and two decades later, to this critical assessment of the foundation for and results of this model of change. When Work Works has used partnerships with nationwide business organizations with community chapters in combination with media coverage, educational events, the creation of tools and materials and grassroots methods to communicate well-researched information to employers that show workplace flexibility is not just a favor or perk for employees but can be a powerful strategy for promoting better outcomes for both employers and employees. The program has been responsible for implementing a rigorous award and providing numerous community-based recognition and educational events on workplace effectiveness and flexibility around the country and for assisting many employers to effectively create more flexible and effective workplaces. When Work Works has been designed around eight key principles for creating change on a national level. This paper presents the context in which When Work Works evolved, a detailed discussion of the eight principles of Families and Work Institute's model of change, its results and lessons other organizations may wish to apply in their own change initiatives.     

“Grandma,Tell Me Another Story”: Family Narratives and Their Impact on Young Adult Development

The transmission of family stories provides insight into the personal and emotional lives of individuals, and sharing stories allows older generations to impart wisdom and family values to developing young adults. The current research explored how gender variation in content and perception of family stories differentially affected identity development in young adults. Young adults from a large northeastern private university shared a written family story about a grandparent and described how that story had impacted their values, behaviors, and identity. Three hundred twenty-five stories, from 238 women and 87 men, were qualitatively analyzed. The stories had much greater impact on young adults' values and attitudes than either their identity development or behaviors. Women shared more relationship stories, whereas men most frequently relayed humorous anecdotes. In addition, women indicated stories most often taught them to be appreciative, loving, or courageous, whereas more men shared stories that emphasized having a strong work ethic or being appreciative of and respectful to others. Although family narratives have been shown to help shape the younger generation's individual identity and character, it is important to differentiate between which stories might impact different genders as they seek to discover their own sense of self.     

Time Use and Well-Being in Older Widows: Adaptation and Resilience

Research on widowhood mostly emphasizes negative outcomes, but some studies suggest widows are resilient. This study evaluated the in-depth daily experiences of older widows compared to married women. Participants included 75 widows and 125 married women from the National Study of Daily Experiences II, who completed daily diaries over 8 days. For long-term widows, there were no differences compared to married women in daily and general well-being, and a few differences in time use. Results add to the literature by using daily diary data to illustrate the general resilience of older women many years after the death of a spouse.     

Trauma-Informed Mindfulness-Based Stress Reduction: A Promising New Model for Working with Survivors of Interpersonal Violence

This article addresses the benefits of modifying the Mindfulness-Based Stress Reduction (MBSR) program by Kabat-Zinn for survivors of interpersonal trauma. MBSR, originally designed for those dealing with chronic health conditions, is being offered to individuals with a variety of issues around the country, including people who have histories of surviving interpersonal violence. Discussed here are the psychosocial needs of women who have survived interpersonal trauma and the rationale for creating a phase I trauma-intervention based on the MBSR model. An example of one model of a trauma-informed MBSR intervention developed by the author is presented, as well as a summary of findings derived from a randomized controlled pilot study of the model with a community-based sample of women survivors of interpersonal trauma. Outcomes include statistically and clinically significant improvements in reducing symptoms of posttraumatic stress disorder and depression, as well as decreases in a measure of anxious attachment. Qualitative findings are also summarized.     

The Model Development Dissertation

ABSTRACT

Asset-building programs, such as Individual Development Account (IDA) programs within social service agencies, assist low-income employed clients in building credit, purchasing affordable assets, and gaining wealth. This longitudinal exploratory study examines the credit outcomes of IDA programs to add to the knowledge concerning the effects of IDAs as an asset-building tool. Data were analyzed using a convenience sample of IDA participants and nonparticipants (N = 164), and the results indicated that initial credit score and history are associated with program participation. However, results also suggested that initial credit score is not a meaningful indicator of program completion, time to completion, or type of asset purchased for participants. Those who completed the IDA program within 2 years experienced the highest credit gains. Future research with larger samples is needed to further assess the impact of credit on program participation and completion and on whether credit gains are sustained.     

Exploring the Nature of Same-Sex Relationships

This study explored the relationship structure and experiences of 145 people in the United States, aged 50 and above, in long-term, same-sex relationships. A survey assessed relationship satisfaction and roles, caregiving, shared assets, and relationship protection and support. The ENRICH couple scales revealed high scores in communication, conflict resolution, and couple satisfaction. Most participants had taken steps to protect shared assets and assign legal authority to their partners. Participants expressed differing views regarding marriage. This study reveals distinctions based on gender and age that will inform practice with this population.