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Sex work has undergone a change, with the rise of the internet economy with more ‘middle class’ sex workers coming into the industry. In this paper, I explore the social status hierarchy within online direct-contact commercial sex work in New Zealand. I draw on findings from an in-depth qualitative investigation of online sex work, undertaken between 2017 and 2018. I took a participatory approach, working closely with NZPC – Aotearoa New Zealand Sex Workers’ Collective to provide an understanding of two interrelated issues: the role web platforms play in shaping the social status of sex workers who advertise for clients online; and how sex workers brand and market themselves online. The findings suggest that sex workers strive to represent themselves as authentic in their marketing to enhance social status. Furthermore, the web platform on which over 90% of indoor sex workers in New Zealand advertise has embedded a status system among sex workers through the advertising packages they offer. Social status has thus become the most powerful marketing tool indoor direct-contact sex workers have to stand out from their competitors and attract sufficient clients to make a liveable income.

Sex work is decriminalised in Aotearoa New Zealand and so brothels are deemed a 'businesses like any other' in the eyes of the law. We interviewed 14 brothel operators in this study to understand whether they were able to run their 'business like any other'. Similar to any other business owners, local authorities require brothel operators to run their businesses in accordance with the local district plan. Institutions such as banks and insurance companies, however, have policies which discriminate against brothel owners, and this presents a barrier to running their business like any other. Brothels continue to be seen as discreditable businesses in a decriminalised context and brothel operators internalise this stigma. More effort is needed to reduce stigma and discriminatory practices. The inclusion of the prevention of discrimination on the basis of occupation in New Zealand's Human Rights Act should be the first step. This could better allow brothel operators to run their business like any other in the 'mainstream' economy.

Children’s community nutrition environments are an important contributor to childhood obesity rates worldwide. This study aimed to measure the type of food outlets on children’s journeys to or from school, children’s food purchasing and consumption, and to determine differences by ethnicity and socioeconomic status. In this New Zealand study, we analysed photographic images of the journey to or from school from a sample of 147 children aged 11–13 years who wore an Autographer camera which recorded images every 7 s. A total of 444 journeys to or from school were included in the analysis. Camera images captured food outlets in 48% of journeys that had a component of active travel and 20% of journeys by vehicle. Children who used active travel modes had greater odds of exposure to unhealthy food outlets than children who used motorised modes; odds ratio 4.2 (95% CI 1.2–14.4). There were 82 instances of food purchases recorded, 84.1% of which were for discretionary foods. Of the 73 food and drink consumption occasions, 94.5% were for discretionary food or drink. Children on their journeys to or from school are frequently exposed to unhealthy food outlets. Policy interventions are recommended to limit the availability of unhealthy food outlets on school routes.

PurposeIn Aotearoa New Zealand, Health Education is socio-critical in orientation and is offered as a subject that can offer credits towards the national secondary school qualification. The purpose of this paper is to explore the learning experiences of people who studied Health Education to the final level of secondary schooling in Aotearoa New Zealand. The authors focus specifically on how the subject is taught; or the pedagogical practices that are “put to work” in the Health Education learning environment.Design/methodology/approachUsing in-depth interviews as the authors’ method of data production, they experiment with a post-qualitative approach to analysis while traversing the theoretical terrain of new materialism. In doing so, they explicate the non-human and human elements that are arranged in a pedagogical assemblage – and explore what these elements can do.FindingsThe authors found that an array of pedagogical practices were put to work in the senior secondary school Health Education classroom: Student-centred approaches, a non-judgemental and energetic tone to teaching, deployment of human and non-human resources, and students connecting with the community. The authors argue that these practices open up possibilities for a critical Health Education.Practical implicationsThis research addresses an empirical gap in the literature by focusing on Health Education in the senior secondary levels of schooling. The findings in this paper may provide readers who are Health Education teachers with ideas that could be of material use to them in their teaching practice. In terms of implications for researchers, the authors demonstrate how putting “new” theory and methodological approaches to work in the area of school-based Health Education can produce novel ways of thinking about the subject and what it can do.Originality/valueThe shifting nature of the pedagogical assemblage can ignite new ways of thinking about teaching practice in the Health Education classroom and the capacities that result for learners. In combination with a post-qualitative approach to analysis, the paper provides a novel approach to exploring Health Education.

Decriminalisation is arguably essential to protecting the human rights of sex workers. Nonetheless, there are suggestions that decriminalisation has less influence on sex workers&rsquo, experiences of working than many assume. This paper explores management practices in brothels in the context of decriminalisation in New Zealand, focusing on sex workers&rsquo, employment status, managerial control and agency. We interviewed 14 brothel operators and 17 brothel-based sex workers in this study. The findings suggest that there remain challenges for sex workers in that brothel operators treated them as employees rather than independent contractors. Brothel operators retained control over shift times and pricing of services, and working conditions were unclear. Most sex workers understood their rights, but when operators impinged on their rights, it was often more expedient to move place of work than make an official complaint. However, decriminalisation did have a meaningful impact on the way sex workers negotiated potentially exploitative dimensions of brothel-based work. Decriminalisation has provided the context where it is possible for sex workers to experience safer and more supportive work environments than they otherwise might, where they can (and sometimes do) contest managerial control.

Introduction: Food environments shape food behaviours and are implicated in rising rates of obesity worldwide. Measurement of people’s interactions with food stores is important to advance understanding of the associations between the food environment and in-store behaviour. This paper describes a new method, Food Store Environment Examination (FoodSee) to measure people’s interaction with the food store environment in a feasibility study focused on convenience stores and children. Methods: One hundred and sixty-eight randomly selected children (aged 11–13 years) recruited from 16 randomly selected schools in Wellington, New Zealand, used wearable cameras for 4 days that recorded images every 7 s. The study was conducted from July 2014 to June 2015. All images of convenience stores and service stations, and a sample of images from supermarkets, were evaluated to determine the feasibility of assessing food availability and marketing. The outcomes of interest assessed were: food product availability, placement, packaging, branding, price promotion, purchases and consumption. Results: Thirty-seven children (22%) visited a convenience store or service station at least once during the study period. In total, there were 65 visits to 34 different stores. Seven hundred and nineteen images revealed the in-store environment. Of those, 86.1% were usable and able to be analysed for the outcomes of interest. Conclusions: The FoodSee methodology provides a promising new method to study people’s interaction with the in-store food environment. The evidence generated will be valuable in understanding and improving the food store environment within which people shop, and will contribute to efforts to address obesity globally.

Stigma attached to sex workers' occupation, sometimes disparagingly referred to as 'prostitution' or 'whore' stigma, is a fundamental challenge for people in sex work. Yet sex workers are not powerless when confronting occupational stigma. We employed thematic analysis with data from in-person interviews conducted in 2012-13 with a diverse sample of 218 adult sex workers in Canada. Our participants perceived a high degree of occupational stigma, which they responded to and managed using four main strategies. First, some participants internalised negative discourses about their sex work and accepted their discredited status. Second, many controlled access to information about themselves, consciously keeping knowledge of their occupation from most people while sharing it with trusted others. Third, some participants rejected society's negative view of their occupation. Finally, some attempted to reduce the personal impact of stigma by reframing sex work to emphasise its positive and empowering elements. Participants often strategically responded to stigma contingent on the situated contexts of their work and personal life. We discuss these findings in relation to the existing knowledge base about stigma attached to sex workers' occupation as well as how these findings may direct future research on stigma strategies.

BackgroundThe United Nations Convention on the Rights of the Child confirms a child’s right to adequate food, and to the highest attainable standard of health. For indigenous children, these rights are also recognised in the UN Declaration on the Rights of Indigenous Peoples. However, Indigenous children endure higher rates of obesity and related health conditions than non-indigenous children, including in Aotearoa New Zealand (NZ). For indigenous tamariki (Māori children) in NZ, high levels of obesity are interconnected with high rates of food insecurity. Therefore there is a need for action. This study aimed to investigate policy options that would safeguard the rights of indigenous children to healthy food. We explored with key stakeholder’s policy options to ensure the rights of indigenous children to healthy food, through a case study of the rights of tamariki.MethodsInterviews were conducted with 15 key stakeholders, with experience in research, development or delivery of policies to safeguard the rights of tamariki to healthy food. Iterative thematic analysis of the transcripts identified both deductive themes informed by Kaupapa Māori theory and literature on rights-based approaches and inductive themes from the interviews.ResultsThe analysis suggests that to ensure the right to adequate food and to healthy food availability for tamariki, there needs to be: a comprehensive policy response that supports children’s rights; an end to child poverty; food provision and food policy in schools; local government policy to promote healthy food availability; and stronger Māori voices and values in decision-making.ConclusionsThe right to food for indigenous children, is linked to political and economic systems that are an outcome of colonisation. A decolonising approach where Māori voices and values are central within NZ policies and policy-making processes is needed. Given the importance of food to health, a broad policy approach from the NZ government to ensure the right to adequate food is urgent. This includes economic policies to end child poverty and specific strategies such as food provision and food policy in schools. The role of Iwi (tribes) and local governments needs to be further explored if we are to improve the right to adequate food within regions of NZ.

Decriminalisation recognises sex work as work; it provides opportunities for promoting the health of sex workers and therefore goes a long way to addressing health and human rights inequities for this sector of the population. This chapter focuses on three scenarios (among many) where decriminalisation of sex work in New Zealand has been successful in promoting sex workers’ health, safety, and wellbeing and, in so doing, provides a blueprint for best practice in working with sex workers.Although services for sex workers are available in many countries, they tend to focus on street-based sex workers, who are perceived as the most vulnerable and thus most in need. A decriminalised context provides greater access to peer support (Harcourt 2010), which is much better positioned to address the complex needs of all sex workers. It also allows for sex workers to engage with others in the community for more effective policy as well as service provision (O’Neill and Pitcher, Sex work matters: exploring money, power and intimacy in the sex industry, Zed Books, London, 2010). In this chapter, we discuss: How access to police has been improved for sex workers who wish to report sexual assault How decriminalisation has enabled interagency collaboration when working with sex workers who have concerns about practices within certain brothels How new sex workers access information on safe practices in a decriminalised environment We use the research literature from New Zealand and elsewhere to expand on the real-life stories of the engagement between New Zealand Prostitutes Collective and sex workers, agencies, and individuals to illustrate the three scenarios.

Food availability refers to the adequacy of the supply of healthy food. It is a key concern for the wellbeing of tamariki Māori today. A narrative literature review methodology was applied to examine the literature and identify influences that enable the availability of healthy food for tamariki. Findings were synthesised and analysed using the Oranga Mokopuna framework—a rights-based approach grounded in tikanga Māori. Factors enabling healthy food availability for tamariki involve the fulfilment of their rights to (a) an environment that enables access to traditional foods and food practices, (b) be involved in decisions about their food environment, (c) the right to adequate food and (d) the highest attainable standard of health (and within this) to be protected from food marketing. There is limited evidence that the New Zealand government is meeting these obligations to tamariki. Thus, the right to healthy food needs to urgently be embedded across legislation, policy and practices.

Street-based sex workers are part of the community in which they work – some live close to where they work and most contribute to the economy of the community through patronage of cafes, service stations and other shops. Yet they are marginalised and stigmatised and are seldom seen as community members by business owners and residents within that community. This chapter draws on interviews with street-based sex workers, residents, Council representatives and outreach workers in two cities in New Zealand. It discusses the spaces within these two cities where street-based sex work is (and is not) accepted by others in the community, as well as how the tensions within these spaces have been addressed. The chapter argues for a community engagement process to relieve community tensions rather than regulatory approaches, which too often have unintended consequences.

While sex work is decriminalised in New Zealand and is ostensibly recognised as work, section 19 of the Prostitution Reform Act (PRA) 2003 prohibits temporary migrants from working as sex workers, and migrant sex workers face the threat of deportation if exposed. Section 19 of the PRA stemmed from concern amongst some politicians that decriminalisation could encourage trafficking into the sex industry. This chapter draws on the findings of two qualitative studies: one with migrant sex workers on their experiences, and the other with permanent resident sex workers. Both studies point to the deleterious impacts section 19 has had on migrant sex workers, putting them in a position where they are vulnerable to exploitation. It is argued in this chapter that there is no evidence of trafficking for sex work into New Zealand and that the repeal of Section 19 would be more conducive to protecting migrant sex workers from exploitation and ensuring that the PRA provides appropriate protection to all sex workers.

Increasing rates of childhood obesity worldwide has focused attention on the obesogenic food environment. This paper reports an analysis of children&rsquo, s interactions with food in convenience stores. Kids&rsquo, Cam was a cross-sectional study conducted from July 2014 to June 2015 in New Zealand in which 168 randomly selected children aged 11&ndash, 14 years old wore a wearable camera for a 4&ndash, day period. In this ancillary study, images from children who visited a convenience store were manually coded for food and drink availability. Twenty-two percent of children (n = 37) visited convenience stores on 62 occasions during the 4-day data collection period. Noncore items dominated the food and drinks available to children at a rate of 8.3 to 1 (means were 300 noncore and 36 core, respectively). The food and drinks marketed in-store were overwhelmingly noncore and promoted using accessible placement, price offers, product packaging, and signage. Most of the 70 items purchased by children were noncore foods or drinks (94.6%), and all of the purchased food or drink subsequently consumed was noncore. This research highlights convenience stores as a key source of unhealthy food and drink for children, and policies are needed to reduce the role of convenience stores in the obesogenic food environment.

The development of antiretroviral (ARV) drugs to treat HIV has turned what was once a death sentence into a chronic disorder. However, a focus on absence of disease in the form of an undetectable viral load and the dismissal of the so-called "cosmetic" complications of the disease ignores perceptions of health and well-being of those living with HIV. Facial lipoatrophy is a stigmatising side effect of treatment for HIV as it betrays the presence of the virus within the body. The study took a longitudinal qualitative approach, interviewing 11 people twice over a period of 1 year on their experience of living with HIV. Two participants were given cameras and asked to take photos which represented what it was like for them to live with this condition and were interviewed four times at four monthly intervals. This paper looks at one man's struggle to conceal or veil his facial lipoatrophy. His story is presented in the form of "selfies" and extracts from in-depth interviews. It tells of an emotional (ongoing) journey of frustration, anger, excitement, depression and resignation which had a profound effect on his sense of social and psychological well-being. This suggests a more holistic approach to treating people living with HIV is needed. While an undetectable viral load is indeed vital, it should not be seen as the only essential outcome of treatment.

Young people in statutory care and protection interact with social workers, who hold potential to provide a supportive adult role in their lives. Many however, run away at an early age and end up on the street trading sex for money or other favours. There is potential to improve outcomes for young people in care if the relationship between young people and their social workers is better addressed. This paper uses data from a qualitative study of 14 young people who traded sex and who had experienced interactions with social workers. A thematic analysis identified three themes: the rigidity of social work practice; contesting the family situation; and resisting the at-risk label. We argue that to have any impact on outcomes for young people in care, social workers need to prioritise relationship-building above the need to conform to organizational protocols and guidelines. Such guidelines assist the social worker in assessing whether family situations pose high risk for a young person, but the “at-risk” label is contested by young people, which results in a lack of trust and a barrier to relationship building.

Sexual and Reproductive Health Rights are fundamental human rights. Previous studies on gender and sexuality in displacement settings have often focused on sexual and gender-based violence and the reproductive health problems of women while underplaying their needs for sexual expression, pleasure and procreation. This paper examines the influence of conflict and displacement on gender relations, sexuality and natality of internally displaced women in Nigeria. It draws on data from a larger study in which focus group discussions and in-depth interviews were used to explore 52 women's gendered experiences with Boko Haram insurgency and displacement. A critical thematic analysis of data revealed that the women's relationships with their men were complex and ambiguous, characterised by both tensions and solidarity. The women saw their men as partners in their struggle against multi-level oppression, including the structural barriers that undermine their mutual sexual expressions and pleasure, as well as their desire to procreate and repopulate their decimated ancestral communities. We recommend collaborative efforts to promote and protect the Sexual and Reproductive Health Rights of displaced women which includes building physical structures and living conditions that promote healthy, safe and pleasurable sexual expressions, and socio-political structures that create access to the long term social security.

Background: There is no accepted best practice for optimizing tertiary student knowledge, perceptions, and skills to care for sexual and gender diverse groups. The objective of this research was to synthesize the relevant literature regarding effective curricular initiatives designed to enhance tertiary level student knowledge, perceptions, and skills to care for sexual and gender diverse populations.Methods: A modified Critical Interpretive Synthesis using a systematic search strategy was conducted in 2015. This method was chosen to synthesize the relevant qualitative and quantitative literature as it allows for the depth and breadth of information to be captured and new constructs to be illuminated. Databases searched include AMED, CINAHL EBM Reviews, ERIC, Ovid MEDLINE, Ovid Nursing Database, PsychInfo, and Google Scholar. Results: Thirty-one articles were included in this review. Curricular initiatives ranging from discrete to multimodal approaches have been implemented. Successful initiatives included discrete sessions with time for processing, and multi-modal strategies. Multi-modal approaches that encouraged awareness of one’s lens and privilege in conjunction with facilitated communication seemed the most effective.Conclusions: The literature is limited to the evaluation of explicit curricula. The wider cultural competence literature offers further insight by highlighting the importance of broad and embedded forces including social influences, the institutional climate, and the implicit, or hidden, curriculum. A combined interpretation of the complementary cultural competence and sexual and gender diversity literature provides a novel understanding of the optimal content and context for the delivery of a successful curricular initiative.

Social work practice with sex workers in New Zealand occurs within a context of decriminalization since the passing of the Prostitution Reform Act (PRA) in 2003. This article presents the findings of a qualitative study focused on social workers’ perceptions of sex work/ers, the PRA, and its influence on practice with individuals in the sex industry. The findings suggest that social workers hold nuanced perspectives on sex work. While decriminalization creates opportunities that support social work practice with sex workers, challenges to antioppressive, critical social work remain, even within the context of decriminalization.

Despite international efforts, stigma is still a significant issue for people living with HIV/AIDS (PLWHA). This paper explores the stigma encountered in health interactions, focusing on strategies PLWHA use to manage and reduce it. It is hoped that our findings will improve future interactions by contributing towards a more understanding practitioner-patient relationship. The data have been drawn from a small qualitative study conducted in Christchurch, New Zealand. Fourteen participants took part in semi-structured face-to-face interviews in 2013 and 11 of these participants were then interviewed again in 2014. Codes and themes were developed through inductive thematic analysis of the interview transcripts. Our findings identified that whilst the majority of participants had positive experiences, nearly all had faced stigma during their health interactions. Most of these encounters were due to healthcare workers holding exaggerated fears of transmission or not maintaining confidentiality and privacy. The main way that participants managed this stigma was through seeking control in their interactions. This overarching strategy could be further divided into three key themes: selective disclosure of their HIV status, self-advocacy and developing their HIV knowledge. We discuss these findings in the context of the current literature, comparing our results to strategies that have been previously identified in social settings.

Although some sex workers are forced to work because of personal circumstances,12 most of the sex workers I have interviewed over the past 20 years are adamant that that they chose sex work because it suited their needs. They enjoy their work—they just want their human rights to be respected and have the same access to justice as any …

This chapter examines the role of the media in the context of the implementation of the 2003 Prostitution Reform Act (PRA). It determines whether the media coverage of the PRA reinforced existing moral discourses of sex work or developed original ones within the new policy context. To determine the role played by the media, a content analysis of the print-media reporting on the PRA is provided. The chapter also explores messages communicated in and by the print media in New Zealand from 2003 to 2006. It furthermore employs a qualitative analysis of in-depth interviews with 58 sex workers concerning their media-coverage experiences. The main emphasis of the chapter is on the moral discourses of sex work, which dominated print media in spite of the media's attempts to maintain a neutral stand on prostitution. Reporting that focused on the morality of prostitution was particularly acknowledged by the sex workers, and was believed to be a tool for the reinforcement of the existing stigmatisation of sex work. Apart from highlighting the type of media reporting that reinforced stigmatisation, the chapter also highlights the manner in which sex workers resisted dominant discourses in their everyday practices.

The paper uses 2006 survey data to examine sex workers' safety in the post-decriminalised sex industry in New Zealand. We use probit analysis to examine institutional and individual factors that affect the likelihood of sex workers experiencing physical and sexual violence, theft and threats by clients. We find that alcohol and/or drug dependency more than doubles the risk of violence across the three sectors within the industry. After controlling for individual factors, including alcohol and drug use, we find no significant sectorial differences for the probability of violence, while the street sector has more theft and threats than the other sectors.

New Zealanders have traditionally been 'wired' by a cultural preoccupation with fairness and the need for everyone to be able to have a 'fair go'. In an interesting comparison of the history of New Zealand (NZ) and the United States of America, Fischer wrote, amongst other things, of the issue of women's rights. The principle of fairness set the scene for the introduction of the Prostitution Reform Bill to parliament, but it was not enough to sustain its passage through the three readings. In a neoliberal environment like NZ, in which government seeks to deregulate and achieve government from a distance, emphasis is put on self-regulation and self-surveillance. Ultimately, the neoliberal argument of freedom of choice, the sex workers' rights and feminist positions of the right of women to choose, and the harm minimisation argument of protecting women who choose to work in the sex industry were all framed as issues of fairness.

New Zealand was the first country to decriminalize sex work. This article provides a reflective commentary on decriminalization, its implementation and its impacts in New Zealand. New Zealand Prostitutes’ Collective (NZPC) was the key player in getting decriminalization on the policy agenda and their effective networking played an essential role to the successful campaign for legislative change. There were contentious clauses within the Prostitution Reform Act (PRA) which were of concern to NZPC and others. However, the research which informed the review of the Act has shown that decriminalization has been successful in making the industry safer and improving the human rights of sex workers within all sectors of the industry. The PRA provides several protections for sex workers, which means that their human rights and citizenship can be safeguarded. Yet there has been little movement towards decriminalization in other countries and reluctance by some to draw on New Zealand’s experience. Indeed, it cannot be claimed that decriminalization will be experienced in the same way in other countries. New Zealand is a small island with a population of just over four million and movement across its borders is more restricted than countries that are part of the European Union. Nevertheless, other countries may find the arguments used to get legislative change in New Zealand useful within their own context.

Living with human immunodeficiency virus (HIV) in the industrialised world has for over a decade been conceptualised as living with a chronic illness. People living with HIV now are amongst the first to live and age with the virus. Drawing on a qualitative longitudinal study in a low-incidence area in a low-incidence country, this paper investigates the nuanced ways that people negotiate this condition. While it has been argued that HIV is a condition like any other chronic disease, our thematic analysis reveals some similarities and particularities around living with the condition. In comparing themselves to others with the condition, high levels of diversity of experience were identified that extended well beyond length of time from diagnosis. In comparing their illness with other illnesses, the location, for example, of their specialist service within a clinic for those with acute sexually transmitted diseases was identified as problematic. The work involved in maintaining a coherent sense of self in the face of existing and shifting challenges as a result of their infection was a second strong theme. The final theme involved flux and flex work in the ways people sought to gain and maintain control over various aspects of their lives. All of these experiences are mediated by place; that is the experience is not the same as that of those who live where there is a much higher incidence of infection. The work involved in negotiating this condition in low-incidence environments deserves more attention, but aspects of these findings are significant in higher incidence contexts as well; in particular, passivity in face of infection as one ages and the potential for medication refusal as a means of maintaining control over life and death.

This article explores the movement of sex workers between sectors of the sex industry in New Zealand's decriminalised environment and motivations for working in these different venues. We argue for contextual, risk environment approaches to understanding risks associated with the different sectors and how these risks might influence the movement of sex workers between sectors. By doing so we also address arguments made by policy makers in different countries, with different ways of regulating sex work, for the eradication of the street-based sector of the sex industry. The findings are drawn from a survey of 772 sex workers and in-depth qualitative interviews with 58 sex workers in New Zealand. Findings suggest there is a growing private sector but little change in the size of the street-based sector following decriminalisation. Street-based sex workers argue the need to maximise earnings and that this is only possible from the street environment. They are prepared to make the trade-off of more money for ...

In contemporary times, evidence-based medicine is used as the basis for clinical decision-making. For a great number of diseases, surveillance guidelines, which are informed by evidence-based medicine, have been drawn up with much input from specialists in their relevant fields. However, these guidelines are implemented in general practice where different rationalities are brought to bear on clinical decision-making. This qualitative study interviewed both specialists and General Practitioners in New Zealand about their use of surveillance guidelines for colorectal cancer. Tension between both groups of medical professionals was apparent with regard to referral practices, with specialists advocating a rational approach to risk. However, the socio-cultural context within which General Practitioners' clinical decision-making takes place demands a more reflexive process. This paper argues the need to explore power within medical practice as the devolution of power to one group, specialists, who are construct...

It is anticipated that a colorectal cancer (CRC) screening programme will be introduced in New Zealand making it the first screening programme in this country to include both males and females. In-depth interviews were carried out with 80 participants (53 females and 27 males) about their knowledge and attitudes to screening programmes in general, as well as their understanding and perceptions of CRC screening in particular. The study highlighted the perceived marginalization of men’s health with a sense that women had advocated for, and therefore monopolized, screening while men’s health had been left unattended. There were also perceptions of women’s responsibility for ensuring men’s access to health services. There are arguments that such perceptions disempower or ‘infantalize’ men which have no long term benefits. While health is perceived as being a feminine matter, it may be difficult to encourage men to engage in preventative behaviours, such as taking up the offer of screening. This article also highlights the heterogeneity of men, where different performances of masculinities were presented. A stereotypical ‘staunch’ or ‘macho image’ discourse was evident in some of the interviews where much emphasis was on maintaining and controlling bodily boundaries. Letting the barrier of embodied ‘staunchness’ down to access health services is a threat to identity. What is required for successful implementation of the CRC screening programme is a normalization of men’s health help-seeking, taking into account the fact that men are not homogenous. Studies in relation to men’s health need to attend to cultural diversity which is likely to present a challenge to individualism. Critical studies of men would be enhanced by more engagement with the work of black male scholars.

Public health focuses on ensuring the conditions in which people can be healthy. It is a societal approach to protecting and promoting the health of population groups. Our aim is to tackle societal conditions that create inequalities so that people can lead healthier lives. At the core of public health is the principle of social justice, and inequalities in health are seen as a human rights or social justice issue. Social justice for sex workers did not exist in New Zealand until 2003, when they were decriminalised with the passing of the Prostitution Reform Act. Robust research has shown that when sex workers or their activities are criminalised their health and safety is severely compromised,12345678910111213 and this was …

In 2003, New Zealand decriminalised sex work through the enactment of the Prostitution Reform Act. Many opponents to this legislation predicted that there would be increasing numbers of people entering sex work, especially in the street-based sector. The debates within the New Zealand media following the legislation were predominantly moralistic and there were calls for the recriminalisation of the street-based sector. This study estimated the number of sex workers post-decriminalisation in five locations in New Zealand: the three main cities in which sex work takes place as well as two smaller cities. These estimations were compared to existing estimations prior to and at the time of decriminalisation. The research suggests that the Prostitution Reform Act has had little impact on the number of people working in the sex industry.

There have been many debates in the literature about the extended transition to adulthood many young people are experiencing in late modern times. However, not all young people make this prolonged transition and, for some, resources within their family and community networks are insufficient to enable an extended transition into stable, independent adult roles. The findings presented in this paper are drawn from a large participatory research project investigating the impact of decriminalisation on the health and safety practices of sex workers in New Zealand. This paper utilises the talk of 17 street-based sex workers who entered the industry under the age of 18 years, as well as using data from a survey of 772 sex workers in New Zealand. For young people entering the industry prior to the age of 18, the period of adolescence was short-lived and their inability to gain support through either their family or the government meant that they opted to work in the sex industry to survive. Unsupported transitio...

Traditionally, school‐based sex education has provided information‐based programmes, with the assumption that young people make rational decisions with regard to the use of condoms. However, these programmes fail to take into account contextual issues and developing subjectivities. This paper presents the talk of 42 young people from a New Zealand secondary school who were questioned in‐depth about the sex education programme they had received. They discussed a programme that concentrated on the ‘dangers’ and ‘risks’ of sexual intercourse and that failed to enhance negotiation skills or take into account the contexts in which sex occurred for many young people. Although participants were well aware of the public health discourses of the importance of condom use, the implications of putting these discourses into practice held the potential for ‘risks’ of a greater magnitude in the reality of their everyday life. The ‘risk’ to reputation and subjectivity overrode any ‘risks’ that may have occurred through n...

Location within social networks is said to be a major determinant of risktaking behaviour among adolescents. This paper examines some of the techniques that can be used, with regard to the specific risk behaviour of smoking. We draw on previous research done in the USA and Scotland using the Negopy software package to examine social networks of adolescents. From this we argue that the different techniques currently used make comparisons of smoking among adolescents problematic and that social network analysis should involve other research techniques to uncover issues which are not illuminated by using a software package alone. These techniques should include the production of sociograms, the use of cluster analysis and the use of qualitative data gained from in-depth interviews or focus group discussions. If health promotion programmes aimed at reducing smoking initiation in adolescents are to be effective, a better understanding of social networks is essential.

In 2003 the Prostitution Reform Act (PRA) was passed in New Zealand which decriminalised all activities associated with sex work.To explore sex workers' utilisation of health services in New Zealand following decriminalisation of sex work and disclosure of their occupation to health professionals.A cross-sectional survey was carried out with 772 sex workers and in-depth interviews were carried out with 58 sex workers in New Zealand.Most sex workers have regular sexual health check-ups and most access their general practitioner (GP) for both general health needs (91.8%) and sexual health needs (41.3%). A quarter of the participants accessed a local sexual health centre for their sexual health needs and just over 15% accessed New Zealand Prostitutes' Collective's (NZPC's) Sexual Health Clinic. Little change was found in disclosure of occupation to health professionals following decriminalisation. Sex workers remain concerned about disclosing their occupation because of perceived stigma attached to their occupation.Most sex workers have regular sexual health check-ups and most access their GP for this service. However, because of on-going perceptions of stigmatisation many do not report their occupation to their GP which may mean that check-ups may not be comprehensive. For this reason, sexual health check-ups performed at NZPC may be preferable to check-ups elsewhere because disclosure of occupation is not an issue.

Objective: Assess differences in personal circumstances, risk exposure and risk-taking among female sex workers in different sectors of the New Zealand sex industry in regard to issues of sexual safety, drug use, violence and coercion. Method: A cross-sectional survey of 303 female sex workers was carried out in Christchurch, New Zealand, May-September 1999. Results: There was evidence of ‘segmentation’: street workers were younger, had started work at a younger age and had less education than indoor workers. More street than indoor workers used money from sex work for drugs and used drugs at work. There was a high level of condom use but little ‘negotiation’ about them with clients. High levels of violent experiences were reported, but street workers reported more, and more extreme forms of, violence than indoor workers. Implications: Although knowledge of condom use and sexual safety appears generally high and women in both sectors report taking the initiative for safer sex, drug use, violence and coercion remain of concern. While sexual safety will need ongoing health promotion and education interventions to support and ensure the uptake of safer sex practice by new workers and prevent any relapse by more experienced workers, issues of violence and coercion also require attention to the power relationships between individuals. Legislation and policy directed at these issues should encourage the control women can exert over their work practice. Reducing exposure to personal risk may require different measures in different sectors.

INTRODUCTION: Effective communication is fundamental to successful health care service delivery, and has a positive impact on access, quality of care, health outcomes, and patient satisfaction. Although there are a growing number of New Zealanders who do not speak English proficiently, underutilisation of trained interpreter services appears to be common in primary health care settings. AIMS: To describe the pattern of interpreter service need and utilisation by general practice services, and to identify key barriers and enabling factors to the use of trained interpreters. METHODS: A mixed methods study was employed. Census and Partnership Health Canterbury Te Kei o Te Waka (PHC) databases were combined, and quantitative analysis used to derive interpreter service need and utilisation patterns. Transcripts of focus groups and interviews from general practitioners, practice nurses and practice administration staff within the PHC were analysed, using qualitative methods to identify barriers and enablers to interpreter service use. RESULTS: For the years 2008–2010, approximately 10 742 consultations per year involved a non-English-speaking patient, yet in only approximately 74.8 (0.7%) consultations per year were interpreter services utilised. Analysis of focus groups and interviews identified four global themes that represented barriers for interpreter service utilisation; namely, practicalities, expectations, knowledge of service, and systems. DISCUSSION: The current use of interpreter services in PHC general practice appears to be significantly less than the need. In order to maximise health outcomes and reduce risk, strategies must be initiated to counter the barriers currently inhibiting interpreter service use, including adopting best practice policies. KEYWORDS: Communication; communication barriers; general practice; primary health care