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This paper used Bayesian Hierarchical Models, particularly the usual Poisson-Gamma model and the Poisson-Gamma model with Covariates in estimating the relative risk of HIV prevalence in Ilocos Region instead of using the Standardized Incidence Ratio (SIR) which is a frequentist approach. The study in the relative risk of HIV prevalence is significant due to its present nature of being incurable. The use of Poisson distribution as likelihood in relative risk estimation is appropriate because HIV prevalence is independent, that is, when the infection occurs, it does not affect the probability of another infection occurring in the same area. The appropriateness of Gamma distribution as the prior distribution is due to the fact Poisson and Gamma distributions are from the same family of distributions. Covariates are considered in this study to possibly improve the precision of results and to prohibit alternative explanations for the results due to the population of sexually active males and the number of diagnosed tuberculosis patients per municipality or city. It is confirmed that the application of Bayesian Poisson-Gamma and Poisson-Gamma with Covariates hierarchical models exhibit more stable HIV relative risk estimates and shrinkage when compared to SIR. There is no implication of a significant difference between the two Bayesian Hierarchical Models after the application of Deviance Information Criterion (DIC). It is recommended when applying the Poisson-Gamma model with Covariates to consider other fixed effects related to HIV prevalence to further improve the model. Lastly, the Bayesian Hierarchical Models presented in this paper can be utilized in estimating the posterior relative risk of other rare or infectious diseases. [ABSTRACT FROM AUTHOR]

This paper investigates the factor analysis of HIV transmission through mobile heterosexual population. The analysis of qualitative properties of the dynamics are done. In a continuous dynamical system involving various parameters, it is possible that a small change in a parameter has tremendous impact on the solution of the system. The bifurcation analysis is to study a dynamical system with respect to the trajectory represented by system, the occurrence of an equilibrium points and the stability properties of the equilibrium point, when changes occur in a certain parameter. The behavior of the system of heterosexual affected population is examined by means of bifurcation analysis. The robustness of the dynamics is also analyzed by hyperbolic equilibrium point. [ABSTRACT FROM AUTHOR]

HIV/AIDS is an infectious disease caused by the infection of HIV (Human Immunodeficiency Virus) virus that decrease the immune system by attacking and damaging CD4 cells which are types of white blood cells (lymphocytes). The decreasing of immune system due to HIV virus then causes damage to AIDS (Acquired Immunodeficiency Syndrome). People with HIV virus infection can take an ARV (Anti Retroviral Therapy) treatment. ARV treatment is an effort that can be done to reduce the HIV viruses inside the body and can extend life time before the disease turn into AIDS. In this paper, a mathematical model of the spread of HIV/AIDS with education and treatment will be discussed. Furthermore, a numerical simulation and sensitivity analysis of basic reproductive numbers will be discussed to determine the parameters which havethe most effect on the spread of HIV/AIDS disease. In the mathematical model of the spread of HIV/AIDS with education and treatment, the most influential parameters is the rate of transmission of susceptible individuals caused by an undiagnosed HIV virus individual and the level of success of education given to susceptible individuals as an effort to prevent the spread of HIV viruses. [ABSTRACT FROM AUTHOR]

TB and HIV infection have the effect of deeply on assault the immune system, since they can afford to weaken host immune respone through a mechanism that has not been fully understood. HIV co-infection is the stongest risk factor for progression of M. tuberculosis to active TB disease in HIV individuals ,as well as TB has been accelerated to progression HIV infection. In this paper we create a model of transmission co-infection TB in HIV community, dynamic system with ten compartments built in here . Dynamic analysis in this paper mentioned ranging from disease free equilibrium conditions, endemic equilibrium conditions , basic reproduction ratio, stability analysis and numerical simulation. Basic reproductive ratio were obtained from spectral radius the next generation matrix of the model. Numerical simulations are built to justify the results of the analysis and to see the changes in the dynamics of the population in each compartment. The sensitivity analysis indicates that the parameters affecting the population dynamics of TB in people with HIV infection is parameters rate of progression of individuals from the exposed TB class to the active TB, treatment rate of exposed TB individuals, treatment rate of infectious (active TB) individuals and probability of transmission of TB infection from an infective to a susceptible per contact per unit time. We can conclude that growing number of infections carried by infectious TB in people with HIV infection can lead to increased spread of disease or increase in endemic conditions. [ABSTRACT FROM AUTHOR]

Tuberculosis links up with HIV/AIDS at any stage of total infection period. Today HIV and TB are the leading causes of death due to infectious disease. We analyse HIV/AIDS and TB coinfection model in this paper. The HIV/AIDS and TB coinfection model is divided into two sub models like HIV sub model and TB sub model and the total population is divided into ten compartments. We investigate the basic reproduction number, disease free equilibrium point and the endemic equilibrium point of the model. The HIV only model is locally asymptotically stable in case of disease free equilibrium when basic reproduction number is less than unity and locally asymptotically stable in case of endemic equilibrium when the basic reproduction number is greater than unity. The TB only model is locally asymptotically stable in case of disease free equilibrium when basic reproduction number is less than unity and locally asymptotically stable in case of endemic equilibrium when the basic reproduction number is greater than unity. The numerical simulations of this model show the behavior of dynamics of co-infections of HIV and TB for different values of contract rate for which we can understand the prevalence of progression of individual to AIDS stage. [ABSTRACT FROM AUTHOR]

In the United States, sexual contact remains the primary mode of human immunodeficiency virus (HIV) transmission-despite more than two decades of safe sex public health campaigns. Social research, however, has demonstrated the need to be especially attentive to contextual factors that influence the social and sexual interactions of HIV-infected persons in order to understand the nature of HIV disease transmission. The purpose of this paper is to explore sociodemographic, health-related, and substance use correlates that affect the sexual health of HIV-positive men. Our paper uses baseline and 12-month follow-up data of a 24-month prospective cohort study entitled, "Predictors of Outcomes in HIV-Infected Men." We operationalize sexual health using four indicators: having sex in the past month, sexual quality, sexual drive, and sexual function. Bivariate analyses reveal moderately strong, positive correlations between each of these variables. Income, the presence of a domestic partner, and moderate alcohol use consistently exhibit positive associations with sexual health indicators; acquiring HIV via homosexual contact and depression are negatively related to sexual health indicators. We discuss the implications of our findings by drawing on recent literature and conclude by offering suggestions for future research on the correlates of sexual health among HIV-infected persons. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

This paper examines AIDS mortality outcomes by race. It pays particular attention to the mortality outcomes of whites in comparison to blacks. Using the AIDS Public Information Data Set, we examine whether minority groups are more likely to be reported as dead than whites. We also examine whether there are differences between cities as we exaimine Atlanta, Chicago, Los Angeles, New York City, and Washington DC. The results of the paper show a conflicting picture. While blacks are over-represented as HIV and AIDS cases in comparison to whites, they are less likely to die in comparison to whites. Whether this is a result of the limitations of the data set or because blacks are better off than whites is unclear. [ABSTRACT FROM AUTHOR]

The emergence of HAART as a standard of care for the treatment of HIV infection has been coupled by growing social scientific interest in the decision-making practices of people living with HIV. Established approaches to decision-making tend to rely on highly rational, individualized conceptions of human action. As such, they fail to fully represent the complexities of how actual people with HIV enter into relation with HAART. In response to this problem, this paper develops an analysis of how people come to take HAART as a social, relational and embodied process. The paper draws on the results of an institutional ethnographic study conducted in and around Toronto, Canada that involved individual and focus group interviews with 79 people living with HIV (57men and 22 women). Drawing on participants? narratives of their "health work" the paper explores two features of the social character of coming to be on HAART. First, it examines the temporal dimensions of coming to take treatment, emphasizing the work people do to ?make? and ?take time? to decide about HAART. Second, it explores how the process of coming to take medications relies on how people actively construct hybrid medico-experiential knowledge about the body and HIV treatment. The paper closes by raising practical implications for supporting the health work of people living with HIV that are suggested by the study?s findings. [ABSTRACT FROM AUTHOR]

All evidence to date indicates that African Americans and Latinos are disproportionately affected by the HIV/AIDS epidemic in the United States. The primary mode of transmission and risk factor is men who have sex with men (MSM). Within the MSM of color population, there are a significant number of men who have sex with both men and with women (MSM/W), yet who do not identify as bisexual or gay. Due to its hidden nature, this sub-population of MSM faces much greater HIV risk. This paper presents data and findings from a Rapid Assessment and Response Evaluation (RARE) project conducted in San Diego with a multi-ethnic sample of MSM and MSM/W. The paper addresses limitations in HIV prevention efforts by discussing the connections between and impact of 1) contextual structural and cultural factors; 2) individual psychological and demographic characteristics of MSM and MSM/W of color, and 3) prevention strategies targeting MSM of color. The role of negative cultural attitudes about sex and HIV/AIDS, self-esteem, substance use and lack of general knowledge about HIV/AIDS and HIV interventions are explored. The paper concludes by making programmatic and policy recommendations to improve HIV prevention efforts for MSM and MSM/W of color. [ABSTRACT FROM AUTHOR]

This paper examines the discourses employed by gay and bisexual men who have abandoned the practice of safe sex, and who have, over time, developed a language of responsibility to account for it. Relying on interviews with gay and bisexual men in Toronto with recent, and sometimes extensive, personal histories of unprotected sex, it is the contention of this paper that barebacking discourse displays a remarkable consistency with the leading, contemporary strands of moral reasoning circulating in advanced industrial societies today. [ABSTRACT FROM AUTHOR]

This paper articulates features of family life and the context and circumstances that predispose individual members to risk behaviours associated with the spread of HIV infection and AIDS in Botswana. The paper argues that core family members are ushered into a socially impractical, emotionally burdensome and simply problematic family life in which substantial and effective common residence among its core members is difficult to achieve. As many workers are deployed and redeployed away from their families, they become trapped in a cycle of events that contribute to undermining the family as a viable social institution capable of sustaining desirable social values and behaviours that could contribute to the prevention of the spread of HIV. The separation of family members and the opportunity to develop and maintain multiple partners predispose individuals to behaviours that have serious consequences for the stability of family life, and the safety of sexual activity. The critical factors that lead to the spread of HIV and AIDS are primarily socio-economic and structural. Focusing attention merely on behavioural change cannot halt the epidemic. [ABSTRACT FROM AUTHOR]

This paper proposes a broad notion of access to health care, one that goes beyond entitlement to a doctor's services to examine how aspects of the doctor-patient relationship and the medical consultation can function as barriers to health care. Using data from a Canadian study into the health work of people living with HIV/AIDS (PHAs), the paper examines issues of health care delivery from the perspective of PHAs who looked after their health and consulted doctors from positions of social and economic vulnerability. The emphasis is on identifying various barriers to access and the "best practices" that diminish or eliminate them. [ABSTRACT FROM AUTHOR]

Circuit parties are weekend long dance events ostensibly designed to raise money for HIV non-profit organizations. They are disproportionately attended by HIV-positive gay men relative to most other gay social settings. For attendees, circuit parties have many functions, of which a major one is to find sexual partners. In this sexually charged and drug-prevalent setting, the risk of HIV transmission is high. Indeed, past literature points to the strong correlation between drug use (e.g., ecstasy, G, K, crystal) and unsafe sexual practices at and immediately following parties and its contribution towards HIV serotransmission. We review this literature, but it is sparse. Thus, another purpose of this paper is to propose a research agenda for studying the connections between circuit parties, drug use, sexual behavior, and HIV transmission. Since the literature is still small, this paper also proposes a research agenda around 1. intervention studies designed to promote safer sex practices at the parties, 2. explanatory studies of the social-psychological and pharmacological factors that mediate between attending a party and unsafe sexual practices, 3. ethnographic studies of the culture of circuit parties, and 4. surveys that describe the population of attendees and how it might be changing. [ABSTRACT FROM AUTHOR]

A foundation for rigorous focus group research includes a well-defined sampling plan and carefully constructed recruiting procedures. Focus group-related literature has not provided in-depth discussions about these processes and how researchers can accomplish them. This paper tackles these issues by examining the experiences of the "Targeting Mass Media Campaigns for HIV Prevention" Project during the sampling and recruiting phases of the focus group portion of the study. The paper notes key principles behind building a theoretically based sampling plan that reflects the major goals of the research. This plan serves as a foundation for recruiting activities that must identify eligible respondents with a reasonable investment of labor time and funding. The paper examines several different recruiting methods employed by the Project and discusses the advantages and disadvantages of each. In conclusion, it offers eleven "lessons" learned that can provide guidance for health communication researchers engaged in focus group research. [ABSTRACT FROM AUTHOR]

In this study, we have analyzed Hepatitis B virus to find out the analytical solutions for reducing the HBV infection. We also found the analytical solutions using Homotopy Perturbation Method (HPM) to find out the solution of nonlinear ordinary differential equation systems. SEICR models have been used to control the viral infections. Thus, we concentrated on examining the dynamics of Hepatitis B viral infection and how it must be controlled by vaccination and treatment method. The exactness and effectiveness of two methods has been analyzed by solvable ordinary differential equation systems. We mainly concentrated on steady controls for both vaccination and treatment. Finally, this paper depicts the analytical results which show that optimal combination of vaccination and treatment that will be the most useful way to control Hepatitis B virus infection. [ABSTRACT FROM AUTHOR]

Protein is an important part of the organism. Proteins must interact with others to perform its functions properly. One of the interactions between proteins is the interactions between HIV-1 proteins and human proteins. Although HIV-1 and human proteins interact, we need to do depth analysis because some of the HIV-1 proteins do not interact with human proteins. Bicluster is the method which used to observe this interaction. Bicluster can groups interactions by rows and columns, so we can analyze it easier. The local search framework based on pairs operation algorithm called POLS algorithm. POLS algorithm is one of many algorithms to find a bicluster, it uses a balanced biclique approach. The algorithm is good for binary data because the initial step of the algorithm is to find local bicluster. The purpose of finding local bicluster is to make sure whether a bicluster can be found or not. In this paper, we use the POLS algorithm to find local bicluster on data interactions protein between HIV-1 and human. We divided the data into two types. The first data is HIV positive and the second is HIV negative. In HIV positive, the local bicluster consists of protein asp, envelope surface glycoprotein gp120, BECN1, and IFNG. In HIV negative, we found the local bicluster consist of protein envelope surface glycoprotein gp120, envelope surface glycoprotein gp160, ICAM1, and ICAM3. [ABSTRACT FROM AUTHOR]

When people living with HIV in the U.S. pick up a prescription at a pharmacy, they are confronted with a shocking price tag. The annual "list price" of an HIV regimen in the U.S. is approximately $25,000. However, though patients are confronted with this price tag when, few insurers, including federal payers such as Medicaid and the AIDS Drug Assistance Program pay this "list price". This paper addresses the social production of knowledge about pharmaceutical prices through historical case studies of three controversies over HIV/AIDS treatment costs in the U.S. I first provide a brief history of the U.S. Orphan Drug Act (ODA). While the ODA was intended to create incentives for the development of unprofitable drugs for the treatment of rare diseases such AIDSrelated pneumonia, today, almost 40% of all drugs approved by the FDA receive the orphan designation. Rare disease is big business. Second, I briefly describe the debates about the costs of AIDS that led up to the passage of the Ryan White Care Act in 1990. I track the ways that financialization of biomedicine has reshaped U.S. HIV/AIDS treatment prices and payment. In the wake of the U.S. FDA approval of Highly-Active Antiretroviral Treatment (HAART), HIV treatment advocates took a different approach to controversies about costs. Their "rebate advocacy" leveraged industry-standard practices to decrease the payment price of HAART and extend access for a narrow group of HIV positive people. Finally, I address Turing Pharmaceuticals 2016 decision to increase the list price of a treatment for an AIDSdefining infection by 5000% and subsequent pricing transparency interventions, including California's Proposition 61. I argue that rebated advocacy and confidentially-negotiated rebates as pragmatic strategies to control pharmaceutical costs has eschewed fundamental questions about profit, cost and value in biomedical markets. [ABSTRACT FROM AUTHOR]

This paper examines the emergence of HIV in Leopold's Congo, its global proliferation and cultural construction. It argues that imperialism and slavery are implicated in the emergence of the HIV virus, in the radical reshaping of the geography along the Congo River Basin. It then traces the relationship between the virus and four ethnographic subjects as case studies from across the globe to understand HIV's multifarious becoming and how it defies easy categorization through materialist or constructivist theories of culture. The first subject is Pan troglodytes troglodytes, a chimpanzee, and the original source of the virus. The second is T, a 21 year-old gay man who dreams of becoming viral. Our third case examines the emergence of HIV through consideration of Michel Foucault's theory of biopower. Finally, we turn to Ursula an HIV+ woman from Botswana who used her serostatus to claim political asylum. The interaction of the virus with each one of these subjects challenges easy apprehension by either constructivism or materialism challenging the theoretical boundaries of culture. The ethnographic case studies are used to refine Foucault's theory of biopower and biopolitics as a theory with the capacity for interpreting global emergence of a virus and its culture. [ABSTRACT FROM AUTHOR]

HIV can infect cells via cell-to-cell and virus-to-cell transmissions. These two types of transmission may occur in a combined way and enable viral spread. In this paper we investigate the importance of these two transmission modes. We show that cell-to-cell transmission plays an important role on the HIV dynamics during antiretroviral therapy as well. A pharmacokinetics model is employed to estimate the drug efficacies. We consider different drugs, drug regimens, and emergence of drug resistance. Under these scenarios, we numerically investigate the effect of these two transmission modes on the antiviral response, showing their importance on the HIV dynamics and treatment. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to explore the possibility of changing negative impressions of people with AIDS in the sociology classroom. A foundations course in sociology was the basis for this exploration. The goals of the course were to develop the sociological imagination; develop critical thinking skills; better understand the role of theory and methods in critical thinking and the sociological imagination; apply the sociological imagination, critical thinking, and theory and methods to real-world issues; and develop scholarly writing techniques and oral presentation skills in the discipline of sociology. The real-world exemplar used in the course was HIV/AIDS. This paper examines the problem of HIV/AIDS stigma; describes efforts to change classroom attitudes toward marginalized groups; discusses the application of these methods in the course in question; and shares results of an attempt to change impressions of people with HIV/AIDS in a particular sociology classroom. Using data across four semesters (N=160), significant changes in impressions about people with AIDS were found. Significantly more positive and humanizing impressions were found at the end of the semester compared with the beginning of the semester. Implications of these findings for teaching and learning are discussed. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

This paper presents an approach to optimise rough set partition sizes using various optimisation techniques. Three optimisation techniques are implemented to perform the granularisation process, namely, genetic algorithm (GA), hill climbing (HC) and simulated annealing (SA). These optimisation methods maximise the classification accuracy of the rough sets. The proposed rough set partition method is tested on a set of demographic properties of individuals obtained from the South African antenatal survey. The three techniques are compared in terms of their computational time, accuracy and number of rules produced when applied to the Human Immunodeficiency Virus (HIV) data set. The optimised methods results are compared to a well known non-optimised discretisation method, equal-width-bin partitioning (EWB). The accuracies achieved after optimising the partitions using GA, HC and SA are 66.89%, 65.84% and 65.48% respectively, compared to the accuracy of EWB of 59.86%. In addition to rough sets providing the plausabilities of the estimated HIV status, they also provide the linguistic rules describing how the demographic parameters drive the risk of HIV. [ABSTRACT FROM AUTHOR]

This paper explores the gendered dimension of HIV stigma within the particular social context of India. Building up on the multiple status contingencies of women in India based on class, caste or geographical location, women's lived experiences with HIV is not the same. Using John Braithwaite's "Shaming Theory" and Pierre Bourdieu's notion of "Cultural Capital" this paper introduces the gendered, culture and community aspects of lived experiences of HIV within a local milieu, therefore providing foundation for fundamental analogies and contrasts with the global parlance for future research. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

Current discussions of clinical trials in the developing world seldom focus on the individual motivations of local physicians and the impact upon clinical research. Using ethnographic fieldwork of a developing world HIV clinic, this paper focuses on the rationales given by clinic physicians to provide post-study care for patients in the form of a clinical trial. This paper demonstrates that local physicians express common logics of evidence based medicine, generalizability, and biological plausibility when evaluating clinical trials. In addition, institutional familiarity with the clinical trial and physician desire to maintain high status position drove the decision to use the clinical trial form. This has important implications for informed consent. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

A new health concern has emerged in homosexual communities, the bug chasing phenomenon. Little is known about the attitudes and propensities of the men who bug chase, save for their most conspicuous behavior, an active desire to voluntarily contract HIV. This paper exposes these unknown attributes through analyzing how Chasers advertise and self-present. Drawn from a barebacking website, three-hundred online advertisements created by gay men were analyzed. As predicted, a group of Bug Chasers could be identified within the ads that differed from Barebackers in their preference for a serodiscordant partner and a willingness to engage in risky behaviors. As anticipated, two subgroups were found within the bug chasing profiles, those who were fluke and those who were serial chasers. Overall, the data indicated that Bug Chasers were more likely than Barebackers to market themselves as sexual subordinates, engage in passive sexual fetishes and advertise membership to the Crystal Meth culture. ..PAT.-Conference Proceeding [ABSTRACT FROM AUTHOR]

This paper reports on the results of a quasi-experiment that tests the effectiveness of the Prevention Options for Positives (POP) intervention. The experiment tests for the outcomes of group sessions combined with individual level counseling vs. individual level counseling only. The results indicate that the group and individual level interventions combined have a greater impact on risk reduction behaviors than the individual level only sessions. Knowledge about HIV is relatively high, and there was little change across groups. The POP intervention influenced the relative importance of various referent groups, but normative beliefs were not impacted. ..PAT.-Conference Proceeding [ABSTRACT FROM AUTHOR]

At the end of 2003, nearly a million Zambians were estimated to be living with HIV. In the Copperbelt region of Zambia, where this study took place, it is estimated that 26% of the adult population is HIV positive. To make matters worse, HIV/AIDS is heavily stigmatized and thus the topic remains interpersonally taboo. Although few may be talking about it, media messages about HIV and AIDS are plentiful. The pandemic proportions of this disease along with the stigma surrounding it has created a climate in which interpersonal networks fail, leaving many Zambians dependent on media for HIV/AIDS information. Media System Dependency Theory predicts that media exposure has a greater impact on those who are more dependent on media. This paper examines a test of the theory among a sample of 285 working men (75.4%) and women (24.6%) in the Copperbelt region. Specifically, I examine whether being dependent on media for information about HIV/AIDS prevention results in attitudes more supportive of condom use when newspaper exposure increases. Results support MSD theory predictions. Implications are discussed. ..PAT.-Conference Proceeding [ABSTRACT FROM AUTHOR]

This research is based on a sample of 283 young adult recurrent users of the drug, Ecstasy (i.e., MDMA). Study participants were recruited in the Atlanta, Georgia metropolitan area between August 2002 and August 2004 using a targeted sampling and ethnographic mapping approach. Street outreach was used to identify and recruit participants, who completed two-hour interviews. The purposes of this paper are to (1) examine the extent to which young adult ecstasy users recently reported having had multiple sex partners and (2) identify the factors predictive of engaging in this HIV risk practice. Potential predictors included a wide array of demographic characteristics, numerous background and experiences measures, childhood maltreatment experiences, substance use/abuse variables, and several measures assessing psychological and psychosocial functioning.Results revealed that nearly one-third of the study participants had had more than one sex partner during the preceding month with sexual protection rates tending to be very low. Multivariate logistic regression analysis revealed seven predictors associated with an increased likelihood of having had more than one sex partner: (1) being nonCaucasian, (2) knowing someone who was HIV-positive, (3) younger age of first sexual experience, (4) using Ecstasy for its touch-enhancing qualities, (5) higher self-esteem, (6) handling disagreements more dysfunctionally, and (7) not being involved in a romantic relationship. The HIV prevention- and intervention-related implications of these findings are discussed. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

The over-50 older adult population consistently comprises about 15% of the U.S. AIDS population; this figure is expected to increase substantially within the next few years due to rising HIV infections among this age group. HIV infection in this population is increasingly due to heterosexual transmission, with an overall increase of 94% in over-50 men and 107% in over-50 women since 1991 (www.about.com 2006); however, this age group is the least likely to be tested for HIV or seek education about prevention tactics and services. In this paper (which is part of a larger dissertation project which focuses on the Midwest--specifically Kansas, Missouri, Iowa and Nebraska's HIV/AIDS polices), I propose that the growing HIV/AIDS rate in the over-50 population is due to the failure of health promotion efforts to reach older adults; as a result of this policy failure, the infection rate among older adults will continue to increase. State HIV/AIDS directors and other officials involved with public health promotion influence public policy and financial resource distributions and help to target older adults with prevention information. Despite this potential to affect HIV/AIDS health outcomes, health workers have been slow to respond to the infection of older adults. My research will inform state-level policymakers and implementing agencies about an important and overlooked segment of the population with significant and growing HIV infection. This research has the potential to improve public health policy, public health, and reduce the cost of HIV/AIDS-related health care in the Midwest and the nation. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

Malawi is one of the countries most affected by the HIV/AIDS epidemic. It is the eighth hardest hit in the world, with an estimated prevalence rate of 14.2% at the end of 2003 (Population Reference Bureau, 2004). HIV/AIDS is the leading cause of death among adults aged 20-49 (Malawi Global Fund Coordinating Committee, 2002), and estimates indicate that the crude death rate would be cut in half in the absence of HIV/AIDS (US Bureau of Census, 2002). AIDS morbidity and mortality are expected to have a large economic impact in Malawi since they reduce the time that adults can spend on income generating activities. However, due to a lack of data, no study has addressed this issue yet. In this paper, we utilize quantitative and qualitative data collected by Malawi Diffusion and Ideational Change Project to analyze the impact of HIV morbidity and AIDS-related mortality on time allocation decisions for rural Malawians. We find that the main impact of HIV/AIDS-related mortality and morbidity at the household level is to induce diversification of income sources, with women reallocating their time from work-intensive (typically farming and heavy chores) to cash-generating tasks. As men's time allocation is unresponsive to the same shocks, overall agricultural output might fall as a consequence of HIV/AIDS-relates morbidity and mortality. This has serious implications for food security in Malawian households, where food consumption is the dominant category of household expenditure and the majority of food consumption is from home-produced items. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

While processes of hybridization are common to all post-colonial societies, I believe that South Africa's uniquely ambivalent historical-social position within the global capitalist world system where it straddles both first- and third-worldness, and its ambiguous volleying between neo-liberalism and Afrocentrism, produces a uniquely polyvocal discursive field in which myriad discourses compete for ultimate legitimacy and claims on the 'solution' of AIDS. This paper analyzes three dominant institutionalized discourses that are foremost players in the contentious symbolic struggle raging in post-apartheid South Africa over the meaning of HIV/AIDS. By exploring the controversial rhetoric and policies of Thabo Mbeki's denialism, the vociferous and fierce battle fought by AIDS activists for the accessibility and affordability of anti-retrovirals, and the ambiguous position into which the profession and culture of traditional healing have been cornered, this presentation intends to use the case of South Africa to expose the stakes involved for post-colonial nations attempting to secure new national imaginations and identities and therefore control their own conditions of hybridity in a world that is both contesting national borders and succumbing to the rule of neoliberalism and an American Empire. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

Research on the religion and HIV risk in SSA has suggested that membership in certain religious sub-groups, as well as regular participation in religious services, may be associated with lower levels of HIV risk due by reducing high-risk behaviors among members of these groups. Less is known, however, about the ways in which religion may motivate actual AIDS-related behavior change. The following paper explores the relationship between a variety of religious beliefs and practices and HIV-related behavior modification among rural Malawians using survey data collected in 2004. We find that members of certain denominations, in particular Catholic and Muslims, are most likely to report having altered their sexual behavior in order to avoid AIDS. While attendance at religious services is negatively associated with reporting having made any sexual behavior changes, identification as Born Again for Christians or having made Tauba for Muslims is positively associated with reporting having made such changes. Interpreted within a theoretical framework that emphasizes how individuals use culture strategically to achieve desired ends (or, in the case of HIV, avoid them), these findings further the exploration of the relationship between religion and AIDS in SSA, addressing the likely mechanisms by which religion may influence HIV transmission in this context. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

Science is both a source of and a limit on medical authority. This paper examines three important organizational tasks where the relative authority of science and medicine is in question: the conduct of clinical research, the interpretation of scientific research and the translation of science into rules for clinical care. Each of these areas of medical work is governed by a more or less explicit hierarchy of evidence. These hierarchies rank the relative legitimacy of different kinds of evidence. The formal and informal location of science in these hierarchies varies. Generally, the farther away from the production of scientific findings and the complexities of clinical care, the more likely science is likely to sit atop the evidentiary hierarchy. My primary case for analysis is infectious disease with an emphasis on HIV/AIDS. The study draws on data collected through participant observation, interviews, and document analysis. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

In this paper, we identify the perceived motivations, deterrents, and strategies of prevention talked about (and sometimes acted upon) in rural Malawi, a poor country in southern Africa with the 8th highest HIV prevalence rate in the world. We further identify the social situations and contexts in which these expressed views and actions occur. In using data from a unique set of ethnographic field journals from an ongoing study in rural Malawi--in which conversations about AIDS as they occur in their natural settings are recorded by local "journalists", we find that contrary to typical expectations that local people will be motivated by fear of death and implement strategies of prevention prescribed by typical, individually-focused prevention programs, Malawians often draw on a combination of these factors which heavily depend on social context. Implications for both sociology and AIDS policy are discussed. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

In a context where the transmission of HIV largely operates via heterosexual contact and where no cure or vaccine is available, behavioral change is crucial for containing the epidemic. Most often it is abstinence, faithfulness and condom use that receive attention in this context. In contrast, this paper treats marriage as a resource by means of which individuals steer away from exposure to HIV; either via mechanisms of positive (partner choice) or negative selection (divorce of an adulterous spouse). The evidence for these hypotheses is sought in retrospectively reported marriage histories and panel data. Results indicate that these practices gathered momentum in the period that the threat of AIDS increased and that they possibly contributed to keeping HIV prevalence rates in check. Even though both sexes strategize in a similar fashion, women appear disadvantaged to do so: men are not only more likely to be unfaithful but also in a better position in to penalize infidelity with divorce. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

Scholars and policy experts have devoted increasing attention to the role of gender equality in the spread of HIV. This human rights approach asserts that the marginal social location and low status of women in many societies explains their weakening ability to protect themselves from the virus. Many prior studies point to the relationship between gender, poverty, high-risk behavior, and the transmission of HIV. The expectation is that countries with relatively high levels of gender equality should have a lower prevalence of HIV. While this hypothesis may be true for much of the developing world, it is not true for sub-Saharan Africa. In fact, the analysis presented in this paper suggests the opposite: that gender equality correlates with higher HIV prevalence among adult women in sub-Saharan Africa. I argue that this positive relationship can be understood by integrating macro- and micro-level data, examining how the structural conditions of gender inequalities influence the spread of HIV through individual decision making about sexual activity. Approaching the question in this way, I identify three main factors that explain the concurrent rise in gender equality and HIV prevalence in sub-Saharan Africa: The sexual vulnerability of young women in the region; The link between increasing gender equality, economic growth, income inequality and the material conditions for high-risk situations; Relationships between older men and younger women. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

Women with HIV need an array of comprehensive medical and psychosocial services but often encounter a number of socio-cultural barriers when seeking services for themselves and their families. Factors such as lack of transportation, not knowing what services exist, mothering responsibilities, or fearing disclosure of their status may prevent women from obtaining needed services. To examine the nature of such obstacles, ten focus groups and a self administered survey were conducted as part of an exploratory project to assess the needs of HIV positive women in Indiana. A small group of women with HIV (N=60) and their care coordination providers (N=90) were assessed as to, 1) the kinds of supportive and care services women need regardless of whether these needs were currently met, 2) the nature of barriers women encounter when seeking services, and 3) the kinds of solutions they felt would reduce some of these barriers and improve service utilization. This paper examines each of these areas separately and concludes with suggested recommendations from the study for improvements to the HIV and non-HIV service delivery system. [ABSTRACT FROM AUTHOR]

This paper examines the sources of reproductive and sexual health information recognized by young adults in the Republic of Armenia. How accessible are existing information channels, such as the media, peers, family and medical professions to young women? Do either knowledge levels or sexual decision making vary by the channel of information? Armenia experienced large scale campaigns concerning reporductive and sexual health in the 1990s, well into the HIV pandemic. Finding indicate that while such programs increased media access to issues relating to sexual and reporductive health, young women remain reliance upon peer networks for sexual information. Further, peer networks appear to provide less effective information transmission. Expanding the importance of alternative information channels, and improving the efficacy of peer channels is discussed. [ABSTRACT FROM AUTHOR]

This paper investigates how the emotional tenor and content of ACT UP's internal debates and conflicts—what might be termed their emotional undercurrents—contributed to the breakdown in feelings of solidarity within the group, and eventually to ACT UP's decline. I explore the how of the breakdown in solidarity by investigating the emotional elements of the conflicts, unarticulated and submerged as they sometimes were. More specifically, I investigate how moralizing rhetoric that induced guilt and shame among members of the group shaped ACT UP's internal conflicts and structured their impact on the organization's viability. An investigation into the emotional undercurrents of ACT UP's internal conflicts helps to explain both their intensity and why those conflicts irreparably fractured the movement. Analyzing the emotional hues of ACT UP's internal debates and conflicts also provides insight into more general processes of solidarity formation and fracturing, assisting our studies of similar dynamics in other movements. And in a more activist vein, an investigation of the emotional workings of ACT UP's internal conflicts, of the emotions that underlay them and that were evoked by them, might furnish us with ideas about how such conflicts could be navigated in other movements to head off some of the bitterness and acrimony that both characterized and contributed to ACT UP's decline. [ABSTRACT FROM AUTHOR]

One of the greatest at-risk groups for HIV-infection is military personnel in Africa. Extended periods away from spouses and committed sexual partners, high stress environments, disposal income and mobility create a combination of pressures and opportunity that expose military personnel to high-risk situations. In East Africa, the nations of Tanzania and Kenya have launched aggressive campaigns among their military to address the critical health problem of HIV and AIDS. In this paper we explain the military effort in Kenya to influence military personnel through an entertainment-education film and document some of the results of this effort. We also discuss the lessons health educators and government leaders have learned through theses experiences and the implications of these experiences on future entertainment-education theory and research. [ABSTRACT FROM AUTHOR]

The emergence of HIV/AIDS expertise in medicine is an understudied aspect of the rise of HIV/AIDS as a public health issue. HIV/AIDS specialization is empirically and theoretically interesting because it has coincided with widespread changes in the organization of healthcare including the evidence-based medicine, cost-effectiveness and quality of care movements. This paper examines the emergence of HIV expertise paying special attention to processes of standardization and classification. [ABSTRACT FROM AUTHOR]

Perceptions of HIV/AIDS in the early 1980s, for those who were interested in it at all, were shaped predominately by scant scientific data. Community organizing initially followed the criteria established by the Centers for Disease Control and Prevention (CDC), generating new organizational efforts for each new crisis area only after it was officially identified. Later, as the community groups gained experience and expertise, they began to define the contours of the problem themselves, and to export their definitions and priorities to the public health sector. The purpose of this paper is to examine the interorganizational conditions that allowed a community of political outsiders to define the agenda in a policy domain that required both community and state participation. [ABSTRACT FROM AUTHOR]

Most research about HIV among gay youth focuses on HIV risk behaviors. Many of the studies of gay youth are also driven by a deficit model of development. Scholars have argued that such deficit models may be contributing to their stigmatization while ignoring their resiliency (Savin-Williams, 2001). This paper focuses attention on a subset of the sexual stories told by young gay men interviewed as part of the ?Sexual Stores? project. The ?Sexual Stories? project was a qualitative inquiry into the lives of forty (twenty white and twenty Latino) young gay men between the ages of 18 and 24. Participants in this study were drawn using a snowball sampling procedure within each ethnic group. The interviewer employed a semi-structured interview method of data collection. The particular focus of this manuscript is to analyze how the interviews collected allow for examinations of safe sex accounts told by the young gay men. The authors illustrate, in qualitative detail, the young gay men?s experiences of sex education at school and the stories they tell about crafting their sexual lives. The text also provides recommendations for meaningful and relevant HIV prevention sex education guided by ?gay-boy? talk. [ABSTRACT FROM AUTHOR]

Disclosure of one?s HIV status to a potential sexual partner has important HIV prevention implications. This paper qualitatively evaluates the social and sexual contexts that influence disclosure of HIV status among methamphetamine-dependent gay men enrolled in an outpatient drug treatment research program. As part of an open-ended, semi-structured interview, 34 HIV-positive and HIV-negative men discussed how, when, to whom, and under what circumstances they reveal information about their HIV status. The four factors that influence participants? decision to disclose include: (1) an HIV-negative sexual partner?s disclosure; (2) sexual venue (private versus public); (3) primary versus non-primary partner; and (4) the perceived risk of the sexual act. Sexual encounters among the men in this sample often occurred in public environments with non-primary partners, and involved use of illicit substances. In these social and sexual contexts, both HIV-positive and HIV-negative participants believed that it is HIV-negative rather than HIV-positive men who should initiate safer sex dialogue and safer sex practices. Findings are helpful in crafting HIV-prevention interventions targeting substance-using gay men whose sexual practices place them at high-risk for HIV-infection. [ABSTRACT FROM AUTHOR]

Understanding the experiences of African-American churches in the era of AIDS requires a careful examination of race, gender, and sexuality at multiple levels. This paper explores the convergence of racism, sexism, and homophobia in the lives of African-American women and men, and how it shapes church politics and ideologies. One of the churches in the study is the first black church in a metropolitan area of the Pacific coast. Historically and contemporaneously, this church holds political, economic, and social importance for African-Americans in the area. The second church has a more contemporary foundation, created in response to the AIDS epidemic. Beyond a similar predominant African-American base, the two churches differ sharply in most other respects--origin, demographic characteristics of church founders and members, attitude on gender roles, attitude on sexuality, and attitude on HIV/AIDS--contributing to variance in sociopolitical and religious ideologies and, ultimately, variance in attitudes about HIV/AIDS and HIV/AIDS intervention strategies. The current study represents a portion of my ongoing study of how African-American-centered churches are addressing HIV/AIDS in both worship services and outside the church walls. To the best of my knowledge, there is no empirical study that directly compares how churches differently perceive sexuality, gender, and HIV/AIDS-related matters. This current study hopes to fill that void. [ABSTRACT FROM AUTHOR]

Women who use crack cocaine and are at-risk for HIV infection are socially constructed as unfit parents because of the conflict between the roles of mother and drug user in our society. The women in this study reject the public discourse that they prioritize drug use and other high-risk behavior ahead of motherhood. For this paper, the grounded theory method of constant comparison was used to analyze 43 in-depth interviews and field observation notes with crack-using mothers. All of the women participated in a community-based HIV prevention intervention program, and their experiences in changing risky behavior are contextualized in relation to their mothering conditions. The women discussed four types of conditions for mothering including mothers who are currently raising children; mothers who have lost or given up custody; mothers with adult children; and grandmothers who use crack cocaine. A black feminist perspective combined with symbolic interaction guide the analytical framework as a way to extend knowledge about the meaning of HIV risk reduction in the lives of poor African American mothers. This grounded theory analysis compares narratives of women who perceive their role as mother to be both a help and hindrance in HIV prevention. The social typology that emerged from the constant comparison method common in grounded theory was "hopeful" and "hopeless" mothers. In keeping with a black feminist perspective, the findings include structure and agency perspectives and have implications for more effective HIV interventions targeting poor African American mothers who smoke crack cocaine. [ABSTRACT FROM AUTHOR]

The Southeastern U.S. has the highest HIV rates in the nation, including among women. An important correlate of HIV risk in heterosexual women is domestic violence. This paper examines the link between domestic violence and HIV risk in HIV-positive women reporting domestic violence in Alabama, U.S.A. The methods consisted of two focus groups to develop a definition on domestic violence as HIV risk and 25 personal interviews of HIV-positive women for in-depth information on domestic violence and HIV risk. A final focus group was conducted for verification and feedback purposes in accordance with feminist research principles (Reinharz 1992). The theoretical framework used Connell's (1987) concept of cathexis, in which gender inequality is reproduced by "hostile attachments" in dyadic relationships, and also West and Zimmerman's (1987) concept of "doing gender" through domestic violence. The interview data revealed that male partners abused women in highly sexualized ways that included rape, sexual coercion and jealousy, sexual name-calling and sexual threats. The structure of sexual relationships centered on male privilege, including access to other partners for both status and power reasons, while restricting the lives of women they "owned." The study concluded that enforced ownership through rape, violence, isolation, and sexual denigration was a powerful indicator of HIV risk in women. [ABSTRACT FROM AUTHOR]

My focus in this paper is on the relative importance of collective actors--social movements, advocacy groups, health voluntary organizations, and the like--in Canadian as compared with U.S. public health policy making and implementation. In both countries, non-governmental organizations played critical--although differently structured--roles in development and implementation of tobacco-control policies. However, while policies and actions to limit HIV/AIDS in injection drug users originated at the grass-roots in the U.S. (and have been highly localized and often underground), advocacy groups in Canada have (until very recently) played little or no role in this domain; policy responses have been pushed primarily by local public health officials and funded by national, provincial, and local governments. Based on my analysis of these differences, I argue that collective action in response to disease threats is powerfully shaped by state structure (including both political structure and the structure of medical care) and by how the threat, and its actual and/or potential victims, are perceived by policymakers and the public. [ABSTRACT FROM AUTHOR]

Objectives. This study sought to understand the interpersonal, social, and cultural contexts in which behavioral risk for HIV infection occurs among young gay men. Methods. Forty in-depth semi-structured interviews were conducted with white and Latino young gay men (ages 18-24) who were purposively recruited using a snowball sampling procedure. Results. Sexual risk behaviors occurred mainly in two social situations: primary relationships of presumed monogamy and sexual coercion. These young men also reported experiencing very little relevant sex education prior to engaging in sexual risk behaviors. Conclusion. This paper builds on previous knowledge about sexual risk for HIV among young gay men by focusing attention on the social contexts within which risk behaviors are reported. Recommendations are presented for meaningful and relevant HIV prevention interventions. [ABSTRACT FROM AUTHOR]

Injection drug users and men who have sex with men are two populations of great interest to academic researchers and public health officials. The behavior of these hidden populations can affect the spread of many diseases like HIV/AIDS. Unfortunately, current statistical procedures for making estimates about the composition and behavior of these groups are plagued with problems. In this paper, we further develop a new technique called respondent-driven sampling which uses a chain-referral procedure to collect a sample from the target population. Instead of attempting to estimate from the sample directly to the target population, we first make estimates about the social network connecting the target population. Information about this social network is then used to estimate the proportion of the population falling into distinct groups. By not attempting to estimate directly from the sample to the population we avoid many of the known problems with making inference from chain-referral data. We will show that if certain specified assumptions are met, these estimates are asymptotically unbiased. Numerical simulations show that for a sample size of 500 the estimates are, for all practical purposes, unbiased. Respondent-driven sampling could be used to estimate important information like the percentage of men who have sex with men who used a condom in their last encounter or the rate of HIV seroprevalence among drug injectors in a city. [ABSTRACT FROM AUTHOR]