The contribution of HIV to fertility decline in rural Zimbabwe, 1985-2000

HIV-related sub-fertility has been reported for those populations in sub-Saharan Africa in which contraceptive use is low. We use data from a retrospective survey in rural Zimbabwe and multivariate logistic regression models to show that recent birth rates and current pregnancy rates are also lower among HIV-positive women than among HIV-negative women in those African populations where contraceptive use is high. The fertility reduction is smaller than where contraceptive use is low because age at first sexual intercourse is later and birth rates at older ages are already low. Nevertheless, total fertility is approximately 8.5 per cent lower and HIV-associated sub-fertility may account for as much as one-quarter of fertility decline in Zimbabwe since the late 1980s. Mechanisms for HIV-associated sub-fertility in rural Zimbabwe include more frequent widowhood and divorce, reduced coital frequency, increased amenorrhoea, and possibly, pelvic inflammatory disease. Miscarriage appears to be a less important factor than elsewhere possibly because syphilis is rare.     

The effects of high HIV prevalence on orphanhood and living arrangements of children in Malawi, Tanzania, and South Africa

Using longitudinal data from three demographic surveillance systems (DSS) and a retrospective cohort study, we estimate levels and trends in the prevalence and incidence of orphanhood in South Africa, Tanzania, and Malawi in the period 1988-2004. The prevalence of maternal, paternal, and double orphans rose in all three populations. In South Africa - where the HIV epidemic started later, has been very severe, and has not yet stabilized - the incidence of orphanhood among children is double that of the other populations. The living arrangements of children vary considerably between the populations, particularly in relation to fathers. Patterns of marriage, migration, and adult mortality influence the living and care arrangements of orphans and non-orphans. DSS data provide new insights into the impact of adult mortality on children, challenging several widely held assumptions. For example, we find no evidence that the prevalence of child-headed households is significant or has increased in the three study areas.     

Environmental and policy change to support healthy aging

Given the growing evidence of the influence of the environment on older adult health, the need to design and implement effective environmental policy around healthy and vital aging is urgent. This article describes issues amenable to improvement through policy change, evidence supporting specific policy approaches and outcomes, and promising strategies for implementing those approaches. Key areas of focus are neighborhood design and safety, housing, transportation, and mobility. Strategies to build capacity for policy change are also addressed. Our goals are to foster greater attention to environmental change in support of healthy aging and to illuminate directions for policy change.     

Environmental and Policy Change to Support Healthy Aging

Given the growing evidence of the influence of the environment on older adult health, the need to design and implement effective environmental policy around healthy and vital aging is urgent. This article describes issues amenable to improvement through policy change, evidence supporting specific policy approaches and outcomes, and promising strategies for implementing those approaches. Key areas of focus are neighborhood design and safety, housing, transportation, and mobility. Strategies to build capacity for policy change are also addressed. Our goals are to foster greater attention to environmental change in support of healthy aging and to illuminate directions for policy change.     

Self-regulation in older Thai women with self-reported knee osteoarthritis: A path analysis

Abstract

This study aimed at testing factors influencing coping behavior and health status among older women with knee osteoarthritis. A total of 274 participants completed questionnaires. Model testing revealed that self-efficacy was the most powerful predictor of coping behavior. Illness representation had a significant direct and indirect effect on health status and was a better predictor of health status than were the other variables. Understanding the complex relationships among study variables should help to tailor future interventions to better address the symptoms of osteoarthritis and to promote optimal health in older Thai women who report knee osteoarthritis.     

A Critical Reflection on Researching Black Muslim Women’s Lives Post‐September 11th

This paper consists of a critical reflection of a research study carried out by a white researcher documenting black Muslim women’s experiences of victimisation and the management of their personal safety. It is argued that whilst some aspects of the researcher’s subjectivity can be linked to marginalised, outsider positions, which helped to produce oppositional knowledge, other aspects of her self‐identity served to maintain and re‐produce dominant racial and cultural discourses and power relations.