Rural/Urban Residence,Migration, HIV/AIDS,and Safe Sex Practices among Men in Zimbabwe*

Abstract The AIDS epidemic was initially thought to be primarily an urban phenomenon. However, migration between rural and urban areas has resulted in the spread of the virus to all segments of the population. Prevention efforts continue to focus on the ABCs of AIDS, namely, abstinence among young adults, being faithful within a monogamous relationship, and/or using condoms at each sexual encounter. We examine the effects of residence, migration status, and selected social and demographic variables on the use of these three practices among men in Zimbabwe, a nation experiencing one of the highest HIV/AIDS prevalence rates in the world. Both residence and migration status were found to be significantly related to safe sex practices. Knowledge of a source with easy access to condoms was the strongest predictor of this behavior. Knowledge of prevention methods and experience with persons with AIDS also exerted significant effects, although not always in the manner hypothesized. Possible reasons for the findings and implications for policy are discussed.     

Conceptualizations of Heterosexual Anal Sex and HIV Risk in Five East African Communities

Heterosexual anal sex is underresearched and little understood, particularly in the African context. Existing prevalence data indicate that heterosexual anal sex is a widespread practice, yet little is known about the way in which it is conceptualized and understood. Describing findings from qualitative research conducted in Kenya, Tanzania, and Uganda, we shed light on conceptualizations of heterosexual anal sex and its relation to human immunodeficiency virus (HIV). These findings suggest that penile-anal sex is practiced by men and women in Africa for a range of reasons, including virginity maintenance, contraception, fulfillment of male pleasure, relationship security, menstruation, in the presence of vaginal complications, financial gain, fidelity, and prestige. Despite anal sex being the most efficient way to transmit HIV sexually, there is widespread lack of knowledge about its risks. These findings describe the ways in which anal sex is conceptualized in five East African communities, highlighting how penile-anal intercourse is often not considered “sex” and how the omission of anal sex in safe-sex messaging is interpreted as meaning that anal sex is safe. In light of its frequency and risks, greater attention must be paid to heterosexual anal sex in Africa to ensure a comprehensive approach to HIV prevention.     

American High School Students’ Perceptions of Determinants of Life Satisfaction

Life satisfaction can be assessed either globally or with regard to satisfaction with specific domains of life. The latter multidimensional approach presumes science has delineated with confidence the specific domains most relevant to evaluating whether the criteria for a good life have been met. This paper shares results of a qualitative study of the perceived determinants of life satisfaction among 30 high school students who were diverse in terms of mental health; 6–10 participants were classified as complete mental health, vulnerable, symptomatic but content, or troubled at two time points separated by a year. Thematic analyses of transcribed individual interviews suggested eight themes that capture the domains of life adolescents perceive influence their happiness. These themes are compared and contrasted to domains included in existing multi-dimensional measures of youth life satisfaction. The factors likely to be particularly salient to students with different levels of mental health are noted.

     

Examining the association between Medicaid coverage and preterm births using 2010–2013 National Vital Statistics Birth Data

Reducing the number of preterm births is a high public health priority in the U.S. Preterm birth, affecting an estimated 380,000 infants annually, is a leading cause of infant mortality and morbidity and is associated with individual and systemic characteristics. Preterm birth is estimated to cost society $26 billion annually. Despite an elevated financial burden caused by preterm birth, very little is known about who bears these costs. This study seeks to understand the relationship between Medicaid and private insurance payment for preterm birth, using multiple years of vital statistics data, which for the first time since 2010 include information on payment source. The nationwide data cover births that occur in all settings, including non-hospital settings, and many maternal characteristics not available in other datasets, improving upon previous analyses. These data can be used to promote better Medicaid coverage of interventions known to be effective in reducing preterm births.     

Responding to child deaths: the work of Australia's Victorian Child Death Review Committee

The Victorian Child Death Review Committee (VCDRC) in Australia is a multidisciplinary Ministerial Advisory Committee established to review the deaths of children either currently child protection clients or known to the statutory child protection system. The Committee provides advice about each child death as well as insights into what are the surrounding patterns and issues. Key to this role is examining the contribution of the service sectors to the protection of children and the routine practices that are in place to respond to children and vulnerability. This paper provides a snapshot of the cases referred to the VCDRC and the key messages for practice drawn from them. What emerges is that often the threshold for when statutory child protection services must be involved in child and family matters can be ambiguous and that agreement about intervention, the level and nature of need or risk, and when cumulative harm and neglect require statutory responses are not always shared between agencies. It is clear that the lack of common frameworks about what constitutes child protection intervention challenges services. It is recommended that there be and used agreed definitions and frameworks to ensure shared understandings and collaborative responses across the service and legal systems.     

Mission Rivalry: Use and Preservation Conflicts in National Parks Policy

The purpose of this study is to explore the conflict between use and preservation in national parks policy as seen through the mission statement of the National Parks Service. The histories of the national parks were qualitatively coded in order to further explore this controversy, or what we have termed “mission rivalry”.     

在公共服务递送中运营共同生产：服务蓝图的贡献

本文认为,公共服务应从以产品为主导的逻辑转向服务途径。通过采取服务导向,公共服务递送的经验性、组织间和系统性,以及作为共同生产者的服务使用者角色,将一同被考虑。论文将通过服务蓝图的应用,解释共同生产如何操作。并介绍了高等教育中的一个案例。在这一案例中,蓝图的创建将师生汇聚在一起,专注于学生入学的设计,从而改善学生体验,并支持共同生产。