HIV Testing Among Heterosexual Young Adults: The Influence of Partners' Risk Behaviors and Relationship Dynamics

Using relational theory and survey data from the Toledo Adolescent Relationships Study (n = 665), this article examined whether individuals were tested for HIV while intimately involved in a current or recent heterosexual relationship. The analyses included the respondent's and partner's sexual risk factors (non-exclusivity and lifetime number of partners), relational variables, prior testing, and demographic characteristics. It was found that 39% of respondents had an HIV test while involved in their current or most recent sexual relationship, and women (47%), compared with men (29%), were significantly more likely to have been tested. Whereas some predictors operated similarly (number of sex partners and pressured to have sex), others displayed significant gender differences (partner's sexual exclusivity, sexual communication difficulties, and pregnancy), particularly related to women's testing behaviors. Excerpts from qualitative interviews with male respondents suggested that some relational dynamics, not well reflected in relational theory, played a role in their testing. Results highlight the need to consider gendered dynamics when targeting young adults for routine HIV testing.     

The history of SHSAAMc: Student Health Services at Academic Medical Centers

This article presents an historical review of the organization known as Student Health Services at Academic Medical Centers (SHSAAMc). The authors discuss characteristics of health service directors as well as the history of meetings, discussion, and leadership. The focus of the group is the healthcare needs of health professions students at academic medical centers.     

Indirect measures of child mortality: Overview and application to Brazil, 1980

Mortality rates in the early childhood years are valuable indicators of a population's standard of living, especially in high mortality countries in the developing world. This study summarizes the logic of indirect techniques of mortality estimation, and applies the methods to sample data from the 1980 census of Brazil. The results for metropolitan areas show that children in affluent households have an average expectation of life that is around ten years higher compared to the children of the poor. Multivariate analysis using the mortality ratio proposed by Trussell and Preston found that mother's education was the most important determinant of child mortality, followed by the effects of running water in the house, father's schooling, membership in the social security system and region of the country. Given the potential usefulness of the indirect methods to a wide range of researchers outside of the field of demography, the study presents detailed examples of the computational steps required of the various techniques.     

Gender and Employment Restructuring in British National Health Service Manual Work

While managerial initiatives to cut costs through increased labour flexibility are widespread, we have limited knowledge of the micro-politics of gender and contemporary restructuring at the local level: of the processes and dynamics through which flexibility and other initiatives reconstitute or transform gendered patterns of work and advantage in specific workplaces. This case study, based upon extensive interviewing, observation, and examination of documentary materials, examines the gender implications of several different types of restructuring initiatives in three types of manual work at two hospitals in an NHS Trust. On the whole, it finds that restructuring created more continuity than change in gendered patterns of work and advantage in the two sites. The case study suggests, first, that employment restructuring incorporates elements of structural, institutional and interactive gendering; managers use women's subordination in the workplace and labour markets to achieve their objectives, and male workers actively resist loss of their advantages. Second, it suggests that competitive tendering exercises have a disproportionately negative impact upon women workers, while functional flexibility initiatives are somewhat more positive. Third, the case study suggests union resistance to restructuring is limited and particularly circumscribed in relation to restructuring of women's jobs.     

Persistence and desistance in heavy cannabis use: the role of identity,agency, and life events

Many cannabis users ‘mature out’ of their drug use, and factors of cannabis use cessation have been identified. However, very little in-depth knowledge is available about the mechanisms underlying this phenomenon. Criminological studies have gained interesting insights in desistance from crime, yet these perspectives are rarely used in drug research. This qualitative, three-year longitudinal study explored the processes involved in desistance from frequent cannabis use for young adults. Using a narrative approach, desisters (frequent users who successfully quit their cannabis use) and persisters (frequent users with a persistent desire and unsuccessful attempts to quit) were compared. In the course of the study, desisters mainly exhibited increasing agency and goal setting, established strategies to achieve these goals, and could envision another self. Desistance was generally induced by life events that became turning points. Persisters experienced largely similar events, but lacked goals and strategies and held external factors responsible for their life course and failed quit attempts. Identity change is at the core of desistance from frequent cannabis use, and the meaning-giving to life events and experiences is essential. Agency is a necessary ingredient for desistance, develops over time and through action, and leads to a new drug-free identity with desistance in turn increasing agency.     

Personal agency in the stress process

Stress researchers have typically controlled for the role of personal agency, or self-selection, in the stress process, rather than examining it. People in better mental health (those with high levels of coping resources and low levels of distress or disorder) should be more likely to exercise agency. Such individuals should, through problem-solving efforts and purposeful acts, experience fewer negative controllable events and more positive controllable events in their lives and be able to transform or compensate for stressors that they cannot avoid or eliminate. These agentic processes may account for the stress-buffering effects of coping resources; and, because coping resources are unequally distributed by social status, these processes should further help to explain how status differences in mental health are maintained and amplified over time.