In feminist analyses of HIV/aids and heterosexuality it is often suggested that the constitution of sexual difference and gender concerns the specific image of heterosexual women's bodies. Such understandings of power and embodiment are especially at play in analyses of safer-(hetero)sex advertisements where the object of the condom is considered to represent a diseased female body. But while the object of the condom in AIDS heterosexual culture is generally understood to concern a female `other' and in addition a (...) disappearing male body, in this article I call into question this understanding of the condom. Specifically, through an analysis of AIDS research findings on safer heterosex practise, I suggest that the object of the condom concerns not sexed female bodies but a heterosexual masculine self-identity. (shrink)

The paper aims to provide evidence on consistent condom use dynamics among sex workers in Central America between 1997 and 2000, and to examine the most important predictors of use behaviour important for policy and programme interventions in the region. Data on 3500 sex workers, 1500 from 1997 and 2000 from the year 2000, were analysed. The samples represented sex workers in low socioeconomic neighbourhoods who met their clients at known sex establishments or by the roadside. Sex workers were (...) more likely to have used condoms consistently in 2000 than in 1997 (Odds Ratio (OR)=1·4, p[less-than-or-equal]0·05). Sex workers who discussed condoms with their partners or lovers used them consistently with all clients more than those who did not (OR=1·3, p[less-than-or-equal]0·10). Knowledge of condom advantages had a positive influence on consistent use. Sex workers who reported using condoms to prevent pregnancy or STDs used them consistently with all clients more than those who did not (OR=1·2, and 1·3 respectively, p[less-than-or-equal]0·10). The source of condoms is an important predictor of consistent condom use. Sex workers who bought condoms from health establishments or from brothels used them consistently more than those who did not (both OR=1·3, p[less-than-or-equal]0·10, and p[less-than-or-equal]0·05, respectively). Self-efficacy had a positive effect on consistent condom use. Sex workers who reported that they would use condoms even if clients offered to pay more for unprotected sex used them consistently with all clients more than those who did not (OR=1·8, p[less-than-or-equal]0·001). The findings suggest that having condom skill is positively related to condom use. Sex workers who had all four skills used condoms more consistently than those who had none (OR=1·6, p[less-than-or-equal]0·01). In order to increase consistent condom use and avert more incidences of HIV/AIDS and other STIs, programme interventions need to use the most efficient way to provide quality information, and provide repeated training on condom negotiation and use skills to sex workers. (shrink)

Since the 1980s Catholic moralists have discussed whether the use of condoms to prevent the transmission of the virus that causes AIDS is morally permissible. In 2004 Rev. Martin Rhonheimer argued that the use of condoms by HIV-discordant married couples, although not prudent or advisable, was nevertheless not intrinsically wrong. Many other Catholic moralists strongly disagreed with him. This paper analyzes both sides of the argument and concludes that the practice is not morally permissible even for an infertile married couple (...) because the use of a non-perforated condom, by preventing male ejaculation into the vagina, deprives the act of its essential ordination to procreation. National Catholic Bioethics Quarterly 15.1 : 91–105. (shrink)

Male to male unprotected anal sex is the main route of HIV transmission in Australia. The Australian Study of Health and Relationships, a large, representative population survey of sexual health behaviors, found that six percent of males in the general population have engaged in homosexual activity. These findings were consistent with studies in Europeand North America. Condoms have been shown to reduce the transmission of HIV in the community. Barriers to the use of condoms include access,stigma,and cost? Nevertheless, increased (...) class='Hi'>condom use has been reported among homosexual males, sex workers and injecting drug users although recent declines in condom use among homosexuals has presented new challenges in HIV prevention.The prevalence of male to male sexual activity may be higher in prison than in the general population. Sexual activity in prison can be consensual and non-consensual involving both homosexual / bisexual and heterosexual men. (shrink)

For most of the 20th century, the condom in the United States was a cheap, useful, but largely unmentionable product. Federal and state statutes prohibited the advertising and open display of condoms, their distribution by mail and across state lines, and their sale for the purpose of birth control; in some states, even owning or using condoms was illegal. By the end of World War I, condoms were increasingly acceptable for the prevention of sexually transmitted disease, but their unique (...) dual function—for disease prevention and contraception—created ongoing ambiguities for sellers, consumers, and distributors as well as for legal, political, health, and moral leaders. Not until the 1970s did condoms emerge from the shadows and join other personal hygiene products on open drugstore and supermarket shelves and in national advertisements. Then came the 1980s and AIDS when, despite the rise of Ronald Reagan, the radical right’s demonization of condoms, and the initial reluctance of condom merchants to market to gay constituencies, the HIV/AIDS epidemic slowly but inexorably propelled the condom to the top of the prevention agenda. The condom’s journey from lewd device to global superstar was fitful, but colorful. The Comstock Act of 1873, prohibiting birth control information and devices, created a vast underground operation—periodically illuminated, however, by arrests, protests, legal proceedings, and media coverage. This essay chronicles one such moment of illumination: the legal battle in the 1920s and 1930s over the legitimacy and legality of the Trojan Brand condom trademark and the unusual series of advertisements produced by the Youngs Rubber Corporation, makers of Trojans, to dramatize the ethical and economic issues of the trademark battle. Culminating in Youngs Rubber Corporation v. C.I. Lee & Co., Inc. , this landmark case in trademark law established the right of the Trojan Brand condom, despite its ambiguous dual function, to the protection of a federal trademark. I seek to show how the Youngs antipiracy ad series illuminates the paradox of visibility by illuminating the paradox of any binary division: to establish the one depends inevitably on invoking or making visible—even if to suppress—the other. This essay is a case study in the negotiation of such a dialectic. (shrink)

This paper examines Irish campaigns for condom access in the early 1990s. Against the backdrop of the AIDS crisis, activists campaigned against a law which would not allow condoms to be sold from ordinary commercial spaces or vending machines, and restricted sale to young people. Advancing a conception of ‘transformative illegality’, we show that illegal action was fundamental to the eventual legalisation of commercial condom sale. However, rather than foregrounding illegal condom sale as a mode of spectacular (...) direct action, we show that tactics of illegal sale in the 1990s built on 20 years of everyday illegal sale within the Irish family planning movement. Everyday illegal sale was a long-term world-making practice, which gradually transformed condoms’ legal meanings, eventually enabling new forms of provocative and irreverent protest. Condoms ‘became legal’ when the state recognised modes of condom sale, gradually built up over many years and publicised in direct action and in the courts. (shrink)

The Theological Consequence is of a more scandalous nature for Catholic ‘insiders’—the literate laity etc.etc.—than is the ‘mere’ ‘Humanist’ one. The pair together can to ‘Evangalisation’ no good at all.The Eminence, who on the BBC programme looks slightly comic. is, when one reflects a very disquieting figure indeed. So: A squib is comic: a serious one is, serious.Note the ‘BBC Panorama’ presentations have been seen in Australia, and so, possibly, in other countries in which this Journal is read.

Safer sex campaigns for heterosexuals have sometimes targeted women in particular to take responsibility for condom use. In this article, the authors question some of the assumptions underlying this strategy, for instance, the assumptions of women's relatively unproblematic relationship with condoms and women's control over condom use. The authors interviewed 14 women about their experiences and views of condoms and of heterosexual relationships more broadly. Using a feminist poststructuralist form of discourse analysis, they examine their accounts in relation (...) to gendered discourses of desire and a coital imperative. They argue that an appreciation of these kinds of discursive influences is important for understanding the complex ways in which women are constrained and enabled to employ condoms for safer heterosex. (shrink)

The response many gay men took to the HIV epidemic in the United States was largely informal, especially given distant state and federal governments. The condom code, a set of informal norms that encouraged the use of condoms, is one instance of this informal response, which was wholly uncoordinated. Yet, it is not clear why these informal norms emerged or why they have since eroded. This paper explores how gay men in particular generated expectations and normative beliefs regarding (...) class='Hi'>condom usage, which helped to establish the condom code as an informal norm. Furthermore, the erosion of the condom code is viewed as a result of changing expectations, which change as bio-medical means of HIV treatment and prevention develop and as online and digital communities facilitate serosorting, all of which provide alternatives to condoms as a means of prevention and their associated informal norms. Future HIV prevention campaigns should recognize the extent to which informal norms coordinate and encourage preventative behavior, as well as how beliefs and expectations alter the informal norms people adopt. (shrink)

Does the position of the Roman Catholic Church on contraception also imply that the usage of condoms by HIV-discordant couples is illicit? A standard argument is to appeal to the doctrine of double effect to condone such usage, but this meets with the objection that there exists an alternative action that brings about the good effect—namely, abstinence. I argue against this objection, because an HIV-discordant couple does not bring about any bad outcome through condom usage—there is no disrespect displayed (...) for the generative function of sex. One might retort that the badness of condom usage consists in thwarting the unitive function of sex. I argue that also this objection cannot be upheld. In conclusion, if there are no in-principle objections against condom usage for HIV-discordant couples, then policies that deny access to condoms to such couples are indefensible. HIV-discordant couples have a right to continue consummating their marriage in a manner that is minimally risky and this right cannot be trumped by utilitarian concerns that the distribution of condoms might increase promiscuity and along with it the HIV infection rate. (shrink)

In this study, we elaborate connections among gender, structure, and practice to suggest how social structural relations shape social sexual practice and, in the process, reshape gender relations. Using survey data from a study of a community mobilization intervention, we investigate the connection between institutional arrangements and condom use practice in sexual encounters with commercial clients and intimate partners among 410 women engaged in sex trade in a semiurban town in southern India. Multinomial logistic regression analysis uncovers the effects (...) of 16 measures of gendered structural relations in three contexts—livelihood resources, household circumstances, and community mobilization intervention priorities. We compare women who practice either consistent or inconsistent condom use with both clients and partners with a reference group of women who practice consistent condom use with clients but not with partners. Results reveal the importance of household and community relations for consistent safer sex practice over and above the organization of sex trade. Our analysis advances gender theory in two interrelated ways: We contribute to gender theorizing in the implementation of health interventions, and to gender change more generally by thinking through possibilities emerging from recursive influences between reordered institutional configurations and altered expectations in interaction. (shrink)

The most popular form of reversible contraception in the United States is the female-controlled hormonal birth control pill. Consequently, scholars and lay people have typically assumed that women take primary responsibility for contraceptive decision making in relationships. Although many studies have shown that men exert strong influence in couple’s contraceptive decisions in developing countries, very few studies have considered the gendered dynamic of contraceptive decision making in developed societies. This study uses in-depth interviews with 30 American opposite-sex couples to show (...) that contraceptive responsibility in long-term relationships in the United States often conforms to a gendered division of labor, with women primarily in charge. A substantial minority of men in this study were highly committed contraceptors. However, the social framing of contraception as being primarily in women’s “sphere,” and the technological constraints on their participation, made even these men reluctant to discuss contraception with their women partners. (shrink)

Ong, Caroline There was once a strong belief amongst global HIV/AIDS organisations that the key to the prevention of the sexual transmission of HIV was condom use. Other measures such as abstinence and being loyal to one partner were seen as beneficial, but secondary. Thirty years later, the evidence is mounting that behavioural change is much more effective in halting the spread of HIV than condoms.

HIV/AIDS prevention campaigns have been overshadowed by conflicting, competing, and contradictory views between those who support condom use as a last resort and those who are against it for fear of promoting sexual immorality. We argue that abstinence and faithfulness to one partner are the best available moral solutions to the HIV/AIDS pandemic. Of course, deontologists may argue that condom use might appear useful and effective in controlling HIV/AIDS; however, not everything that is useful is always good. In (...) principle, all schools of thought and faith seem to agree on the question of faithfulness for married couples and abstinence for those who are not married. But they differ on condom use. On the ground, the situation is far more complex. We simply lack a single, entirely reliable way to resolve all disagreements regarding HIV/AIDS prevention strategies. (shrink)

Condom use among college men in the United States is notoriously erratic, yet we know little about these men’s approaches to other contraceptives. In this paper, accounts from 44 men attending a university in the western United States reveal men’s reliance on culturally situated ideas about gender, social class, race, and age in assessing the risk of pregnancy and STI acquisition in sexual encounters with women. Men reason that race- and class-privileged college women are STI-free, responsible for contraception, and (...) will pursue abortion services if necessary. Since men expect women will take responsibility, they often stay silent about condoms and other contraceptives in sexual encounters—a process we term “strategic silence.” Men’s strategic silence helps uphold local constructions of hegemonic masculinity that prioritize men’s sexual desires and protects these constructions by subtly shifting contraceptive and sexual health responsibility onto women. Our analysis demonstrates the importance of men’s expectations of women for upholding constructions of hegemonic masculinity, which legitimate gender inequality in intimacy and are related to men’s underestimation of the risks associated with condom-free sex. (shrink)

The human immunodeficiency virus since its genesis has continued to affect a large number of the population in the African region and has caused exponential deaths. At the same time, new infections have been reported in South Africa. However, religion as a vehicle of change through the institution of the church has been acting on the contrary, since it discourages the use of condoms and moralising the pelvic area in its characterisation against the commandment of God. Such a perspective has (...) largely been drawn from the Christian doctrine. We argue that in its condemnation and moralisation of the virus, the church, through its pastors, engaged in biblical discourse.Contribution: The article applies a qualitative phenomenological approach and system theory as theoretical lenses. Furthermore, the article locates the study within Christian communities located in Thulamela Municipality, Limpopo province. It proposes Christian practices that can be useful in combating the virus. (shrink)

ABSTRACT Chemsex is a phenomenon in which typically gay, bisexual, trans, queer, and/or related communities of men take psychoactive drugs while having sex, often without a condom. The practice can lead to increased rates of HIV transmission, sexual assault, and in extreme cases murder. GBTQ+ men are already a stigmatised group so those who engage in chemsex face multiple stigmas. This study examines the ways that two types of media report on chemsex while negotiating these stigmas. We take a (...) large data set of newspaper articles written for the general British public and a smaller data set of magazines aimed at GBTQ+ men to examine how chemsex is represented in the media. We find that the mainstream press focus on extreme criminal cases involving chemsex, while the media aimed at GBTQ+ men focus on counselling services and discuss chemsex in relation to gay culture. Chemsex is unlikely to go away, and so we address how information about it is conveyed in different media and call for more research in this area. (shrink)

BackgroundInformed consent as stipulated in regulatory human research guidelines requires volunteers to be well-informed about what will happen to them in a trial. However, researchers may be faced with the challenge of how to ensure that a volunteer agreeing to take part in a clinical trial is truly informed. This study aimed to find out volunteers’ comprehension of informed consent and voluntary participation in Human Immunodeficiency Virus (HIV) clinical trials during the registration cohort.MethodsWe conducted a qualitative study among volunteers who (...) were enrolled in the registration cohort of HIV clinical trials in Dar es Salaam, Tanzania. A purposive sampling strategy was used to obtain twenty study participants. The data were collected between June and September 2020 using a semi-structured interview guide. In-depth interviews were used to collect the data to obtain deep insights of the individual study participants on the comprehension of informed consent and participation in the clinical trial. A thematic analysis approach was used to analyze the data. Themes and subthemes were supported by the quotes from the participants.ResultsVolunteers described comprehension of informed consent from different perspectives. They reported that various components of the informed consent such as study procedure, confidentiality, risk and benefits were grasped during engagement meetings. Furthermore, the volunteers’ decision to participate in the registration cohort was voluntary. However, trial aspects such as health insurance, free condoms, and medical checkups could have indirectly influenced their reluctance to withdraw from the study.ConclusionEngagement meetings may increase the comprehension of informed consent among potential participants for HIV clinical trials. However, trial incentives may influence participation, and thus future research should focus on the challenges of giving incentives in the study. This will ensure comprehension and voluntary participation in the context of HIV clinical trials. (shrink)

The ethics of safe sex in the gay community has, for many years, been focused on debates surrounding the responsibility regarding the use of condoms to prevent HIV transmission, once the only tool available. With the development of Truvada as a pre-exposure prophylaxis for HIV, for the first time in the history of the HIV/AIDS epidemic there is the potential to significantly reduce the risk of HIV transmission during sex without the use of condoms. The introduction of PrEP necessitates a (...) renewed discussion about the politics and ethics of safe sex for men who have sex with men. We present the arguments of authors who hold radically opposite positions with regard to the ethics of condom use by gay men, but who currently both criticize the use of PrEP. We offer a critique of their arguments and advance the position that the use of PrEP, even without condoms, can be acceptable and part of a safe sex ethics framework for MSM. (shrink)

Deception sometimes results in nonconsensual sex. A recent body of literature diagnoses such violations as invalidating consent: the agreement is not morally transformative, which is why the sexual contact is a rights violation. We pursue a different explanation for the wrongs in question: there is valid consent, but it is not consent to the sex act that happened. Semantic conventions play a key role in distinguishing deceptions that result in nonconsensual sex (like stealth condom removal) from those that don’t (...) (like white lies). Our framework is also applicable to more controversial cases, like those implicated in so-called “gender fraud” complaints. (shrink)

Consumers often feel embarrassed when buying products like condoms, hemorrhoid cream, and beriberi cream in crowded pharmacies. There is an interesting phenomenon in life: Some beriberi creams use the images of a “real foot”, while others use the images of a “cartoon foot.” Imagine if a young woman needed to go to a retail store for beriberi cream that would embarrass her, she would choose a “real foot image” or a “cartoon foot image” beriberi cream? It has been shown that (...) the embarrassment of these products has a strong negative impact on consumer buying behavior. Previous researches have explored how changing packaging elements of embarrassing products can effectively reduce consumer embarrassment. However, few have examined the impact of different image types of embarrassing product packaging with embarrassment. Therefore, this research explores the effect of image types on consumers’ willingness to purchase embarrassing products and reveals the mechanisms of the underlying effects. The results show that natural images can lead to lower purchase intention of embarrassing products when the advertisement uses first-person pronouns due to the mediating role played by negative body imagery. However, there is no significant difference in purchase intention between different image types in the third-person pronouns. Finally, this paper discusses its contributions and limitations. (shrink)

Contraceptive prevalence is a key variable estimated from Demographic and Health Surveys. But the prevalence estimated from reports of husbands differs widely from that estimated for wives. In this research, using data from six Demographic and Health Surveys of sub-Saharan Africa, reports from spouses in monogamous couples with no other reported sex partners in the recent period are examined. Agreement ranged from 47% to 82%, but among couples in which one or both reported use, the category represented less than half (...) in all nations except Zimbabwe. Husbands generally had higher reports of condoms, periodic abstinence and pills but fewer reports of the IUD, injections and female sterilization. Either discussion of family planning with the spouse and/or higher socioeconomic status was associated with agreement in most of the surveys. Ambiguities in the survey question regarding current use need to be reduced, perhaps with an added probe question for non-permanent methods. (shrink)

Having sold more than 100 million records worldwide, KISS has come to be one of the best selling bands of all-time. From their over-the-top stage personas and theatrics to their eclectic merchandising endeavors that span from condoms to caskets, KISS has lived up to their famous tagline as “the hottest band in the world.” This chapter analyzes the band—and the brand—that is KISS through the lenses of the philosophies of Friedrich Nietzsche and Mikhail Bakhtin. KISS’s music can be properly understood (...) as an embodiment of what Nietzsche calls the Dionysian in The Birth of Tragedy. As opposed to the measured and calm restraint that is found in Apollonian music, Dionysian music praises the raw, instinctual and the libidinous aspects of life. Songs like “Shout it Out Loud” that embrace the party life and songs like “I Was Made For Lovin’ You” that celebrate sex are exemplars of the Dionysian. KISS, however, is much more than their music. KISS brings to life what Bakhtin refers to as carnival wherein ordinary social conventions are turned upside down and a freer, unrestricted, and playful world emerges that proclaims the joyful relativity of all order and structure. The KISS Kondom, which is marketed as a condom that offers “Love Gun Protection,” demonstrates the levity that often accompanies Bakhtinian carnival, as does the KISS Kasket, a coffin licensed by the band that dons the famous KISS logo and pictures of the band members in their iconic make-up. By manifesting carnival, KISS taps into what Bakhtin refers to as the latent sides of human nature that otherwise remain hidden and thereby teach us all to lighten up a bit. While most of us can’t “rock and roll all nite and party every day,” KISS reminds us that the sometimes sterile status quo needs to be loosened up every once in a while and swapped out for a more playful world. (shrink)

The reasons for judgment by the Supreme Court of Canada on the appeal in Mabior (2012 SCC 47) fail to address or resolve a number of significant questions. The reasons acknowledge the fundamental role of sexual consent in protecting sexual autonomy, equality, and human dignity, but do not use the law of consent as a tool to assist the Court in crafting a fresh approach to the issue on appeal. Instead the Court adopts the same general approach to analysis of (...) the elements of aggravated sexual assault committed by fraud it used in 1998 in Cuerrier. Fifteen years later, it should be possible to re-conceptualize the problem in a more straightforward manner that reflects Charter values, fundamental common law principles, recent developments in sexual assault law, and the limitations and uncertainties of current HIV treatment and diagnosis. -/- Ironically, the two pronged legal test ultimately proposed by the Court -- non-disclosure of HIV-positive status and a “realistic possibility of transmission,” is likely to give false confidence to individuals who adhere to a regime of anti-retroviral treatment, use good quality latex condoms, and routinely conceal their HIV-positive status from their sexual partners. Research shows that HIV viral loads fluctuate widely in response to a myriad of factors. An inevitable consequence of reliance on the Mabior test will be accused who are shocked to find themselves charged under s. 273, charges that would not apply had they disclosed their HIV-positive status to their sexual partner(s). There are further practical consequences. Non-disclosure will tend to increase the risk of transmission because non-HIV-positive sexual partner(s) will not fully appreciate the actual hazards of improper condom use. As a direct result, careless sexual practices will be more common. And finally, the decision will not contribute to reducing the social stigma that haunts the lives of those who are HIV-positive -- even those who are skilled at deceit. That stigma will not be reduced or eliminated by a ruling that can be seen as tacitly validating stigmatization and fear by appearing to permit infected individuals to pretend they are not HIV-positive when they know or suspect this to be false. Deceit harms the human dignity of the deceived and deceiver alike, and does nothing to build authentic social trust and cohesion. For all these reasons, the problem on appeal in Mabior requires a different approach. This article proposes one. (shrink)

This essay shows how South African Pentecostal teachings about sexuality, particularly HIV prevention and divorce, constrain women’s real and imagined choices. Institutional Review Board–approved fieldwork revealed the prevalence of wives remaining faithful to unfaithful husbands despite high risks of physical abuse and HIV infection. Maintaining the “ideal” of abstinence and faithfulness, male pastors actively oppose condom use and emphasize that “God hates divorce”. In this essay I engage and resist such hermeneutics. Using scripture as source and norm, I construct (...) an A-B-C-D prevention strategy to enhance women’s freedom: Abstain, Be faithful, use Condoms, or Divorce. (shrink)

In Brazil, induced abortion in adolescents has been frequent in less-advantaged socioeconomic classes, and the vulnerability of these adolescents has not been addressed. Given this context, the present study sought to investigate the relationship between the practice of abortion and vulnerability in adolescents. This was a descriptive cross-sectional study of 201 adolescents who completed a structured questionnaire that allowed the analysis of variables with respect to intent to abort. The profile of the pregnant adolescents in the sample studied was the (...) following: average age, 16.1 years; stable partner; mulatas; did not use condoms during sexual relations; precocious with respect to their first sexual relations; and did not plan the pregnancy. According to the classification of the World Health Organization, 81.59% of the subjects‘ abortions were known to be induced. Twenty-one were vulnerable to induced abortion; of these, 13 reported forced sexual intercourse, of whom 8 reported that they had suffered associated violence. These results indicate that sexual violence and unwanted pregnancy subject adolescents to a context of greater vulnerability to induced abortion. Thus, it is suggested that this relationship should be considered from the perspective of bioethics and human rights, but always respecting the cultural values of the society in which the adolescents live, as well as their human dignity. (shrink)

Male partner involvement in the prevention of mother-to-child transmission of human immunodeficiency virus is considered as one of the priority interventions in reducing paediatric HIV. However, there is neither a standard definition nor measurement for MPI in PMTCT. The study explored meanings of MPI in PMTCT programmes in Zimbabwe. Eight focus group discussions were conducted with men and women aged 18 years and above. Seven key informants from health institutions and organisations providing PMTCT services were interviewed. Eight in-depth interviews were (...) conducted with pregnant women at two public health facilities. Thematic analysis was used for data analysis. Five major themes were identified which facilitated our understanding of MPI. Male partner involvement was referred to as participation of male partners in HIV couple counselling and testing. Acceptance of condom use during pregnancy and breastfeeding was deemed vital as this prevents HIV transmission. Male partners were expected to have knowledge of administering antiretroviral drugs to an HIV-exposed child. Provision of financial support was another form of male involvement commonly expected during antenatal and postnatal periods. Faithfulness in marriage was a major theme that was highlighted, especially by respondents in marital relationships. Male partner presence in PMTCT community educational sessions was also considered. However, the provision of male-oriented educational programmes was identified as poor. The study suggested a definition for MPI in PMTCT in Zimbabwe. The merit of this definition was that it took a holistic approach to include activities beyond antenatal activities and HIV testing. Future research should explore how public health institutions could create male-oriented health services within PMTCT programmes, as this has the potential of increasing men’s involvement in PMTCT of HIV.Contribution: This article contributed to the knowledge on how world views, which is shaped by culture and religion, influenced the formation of meanings on MPI PMTCT programmes. (shrink)

This paper seeks to clarify the proximate end. A distinction is made between the definition of an act and the identification of an act. The principle of objectified circumstances is postulated which, without expanding beyond the proximate end, gives due weight to both the perspective of the acting person and the context within which an act occurs. POC is used to help discern the object contained within the proximate end. It is applied to the issues of euthanasia, lying, mutilation, and (...) the controversy between Martin Rhonheimer and Janet Smith concerning the use of condoms for HIV protection. The challenge of angelism is addressed. The paper argues that the object, located exclusively in the proximate end, can be understood in a way that is sensitive to both traditionalist and proportionalist schools of thought. POC opens up an avenue of thought for fresh dialogue concerning the identification of the moral object. (shrink)

Twenty-four U.S. states have enacted HIV exposure laws that prohibit HIV-positive persons from engaging in sexual activities with partners to whom they have not disclosed their HIV-status. From a public health perspective, HIV serostatus exposure laws can be viewed as structural interventions that seek to limit the spread of HIV by acting at the policy level. A central premise of these laws is that informed partners are more likely to protect themselves by declining sex, by substituting less risky activities for (...) higher-risk ones, or by using condoms, than are uninformed partners. However, the effectiveness of these laws at preventing HIV transmission is not known.There is little standardization among existing HIV exposure laws, which vary substantially with respect to the sexual activities that are prohibited without prior serostatus disclosure. Among the strictest laws are those in Arkansas, Michigan, New Jersey, and Ohio which mandate disclosure prior to almost any type of sexual contact. (shrink)

Medical history has so far paid hardly any attention to the longue durée, a history in which, according to Braudel, 'all change is slow'. It is therefore one of the challenges of the emerging field of the social history of medicine to work audaciously across time as well as across space. An interesting subject, for example, is the history of contraception. Throughout history, there has been almost nothing people have worried about more than having sex without fear of consequence. At (...) first sight, the story of contraception seems to be one of progress, from the Ancient Egyptian crocodile-dung pessary to the modern-day condom and contraceptive pill. A closer look, however, shows a pattern of remarkable continuities in the reproductive behaviour of men and women over the last two thousand years. In this paper, I shall attempt to show why traditional male-dominated contraceptive methods still linger on despite the sexual revolution brought about by the invention of the 'pill' in the late 1950s. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Invisible ChildrenMaureen KelleyИсчезаю в весне,в толпе,в лужах,в синеве.И не ищите.Мне так хорошо...I fade into spring,or into a crowd,or into a puddle,sometimes into the blue.There's no sense in looking for me.I feel fine...—¾"Absentee" by Arvo Mets"You have to go through Lesha to get to Danil," Alexandra told me. Lesha was a small but unmoving dog with matted hair and a fierce growl. The dog was pressed against the little (...) boy, who looked no more than three or four years old. Alexandra later told me he was eight. Danil was wearing a Spider Man shirt that was four sizes too big and came down to his feet and mismatched sandals. He was huddled against his dog not only for security but warmth. His tiny arm circled Lesha's neck and he looked at me with a mix of curiosity and caution. I knelt and put my hand out for Lesha to smell me. Apparently I didn't pass the smell test. The dog didn't budge from his post. We stood like that for a long time, at the base of the steps to the shelter. I tried the few Russian words I had learned while visiting as a volunteer. The dog didn't understand my broken Russian, or pretended not to, but I managed to get a shy smile from Danil.Alexandra, a nurse volunteer at the shelter, eventually mediated the standoff by giving Lesha, the dog, a cookie. I introduced myself to the little boy. And just like that, he leaned up against me and put both arms around my legs. It didn't matter that I was a stranger, and a stranger who spoke terrible Russian. "Spidey" was an affectionate little guy. He gripped my hand while Alexandra led us up the steps and Lesha followed close behind. Inside was a small room, warm and full of color. One wall was covered in kids' drawings. Another had public health posters in Russian, some with instructions for condom use, others on literacy. There were about fifteen kids in the shelter that afternoon. The young ones were drawing pictures at a low table. Two teenage boys were hunched over a small TV playing a video game. There was only one teenage girl, Irina. She was cooing at the little kid's drawings, showing one girl how to draw a princess. Alexandra said quietly to me, "Most of the teenage girls are only here in the morning. The rest are back at work right now." I found out later "back at work" meant on the streets as sex workers. This city was frequented by businessmen and itinerant workers heading to the factories or lumber mills in the North. The best money for homeless girls was in prostitution. Danil unwrapped himself from me and ran over to the two older boys playing video games. One put his controller down long enough to pull Danil into his lap. The three boys stared intently as Super Mario hopped from mushroom to magic cloud, golden coins spinning above his cartoon head.To the right of the main room was a closet-sized office for the shelter director, Anya, a pediatrician who donated her time to running the shelter for homeless and orphaned youth living on the streets. Alexandra and I stood in the doorway waiting for Anya to finish a phone conversation. Her desk was covered in papers. Behind her were photos of the kids who had "graduated" from the streets. There were cards and letters pinned to a cork board. When [End Page E4] she finished, Anya greeted us with bear hugs and showed us to the clinic area. Next to her office was a small bathroom with a shower and tub. She explained that bath days were on Wednesdays. Around back, with a separate entrance was the small clinic space. The outside metal door had a sliding window that you see at some nightclubs. They ran a needle exchange program out of that door. It was funded for street youth, but from time to time they would get adult addicts. Anya was adamant that this side of the clinic remain separate from the central space for the children. In reality the distance... (shrink)

Amidst growing global endorsements of new biomedical HIV prevention strategies, ARV-based pre-exposure prophylaxis (ARV PrEP) has garnered considerable attention as a potentially promising prevention strategy. Though it may offer more effective protection for certain at-risk groups than conventional prevention strategies (such as sexual partner reduction, condom use, and prevention of mother-to-child transmission), PrEP is more costly. PrEP requires more ongoing contact between individuals and providers, and a level of surveillance from the health system that is not necessary with other (...) preventive measures. In this sense, it represents a new bio-technology for HIV prevention that poses particular challenges for worldwide implementation, given developing countries’ struggling health systems and incomplete HIV treatment programs. Since the emergence of PrEP has stimulated ethical discussions premised on incomplete knowledge of efficacy and implementation, this paper explores the ethical parameters of a likely scenario for PrEP usage in a single, resource-poor country. We first develop a plausible model for PrEP deployment and utilization based on current PrEP research, while carefully considering the reigning institutional values of feasibility and effectiveness in global health approaches. Drawing on ethnographic research of HIV treatment and prevention approaches in Lesotho, we address ethical questions arising from this scenario of PrEP delivery. Lesotho presents a compelling and emblematic case study of PrEP's potential successes and pitfalls in a developing country, given the country's high HIV prevalence, struggles to achieve universal access to HIV treatment regimes, continued existence of stigma around the epidemic, and difficulties in addressing persistent social inequalities that fuel infections. (shrink)

For me the history of the battle for fundamental values of our civilization began in the mid-1990s. At that time three major conferences took place: the International Conference on Population and Development in Cairo in 1994, the 1995 World Conference on Women in Beijing and the Conference on Human Settlements in Istanbul in 1996. Surprisingly to most governments and international public opinion they became the battlefield of the war of ideas, which was especially significant during the conferences in Cairo and (...) Beijing. The liberal circles fiercely attacked traditional values which constitute the basis of the international order. Among others, it was the right to live and the institutional family which were especially attacked. There was even an attempt to replace the word family with partnership. The Polish delegation for the conference in Cairo was instructed not only to support the idea of strengthening the family as a basic unit of society, but also to insist on accepting the common definition of marriage as a union of a man and women and defend the position that abortion cannot be treated as a method of family planning or birth control. The discussion at the Cairo conference evolved into a battle for the right to kill unborn children as a method of family planning. Among the Holy See and Poland, it was the countries of Latin America and Muslim countries including African Muslim countries that spoke in defence of traditional values. At the Istanbul conference, also thanks to the Polish delegation, the family was acknowledged as a natural subject of housing policy. In the years 1999, 2000 and 2000 three UN special sessions were held: Cairo +5, Beijing +5 and Istanbul +5. The Polish representation played an important role and the instruction for the Cairo delegation was fulfilled and remains valid.Although the documents of UN Special Sessions are not legally binding for the UN member states they are important for UN policy agendas e.g. economic help for third world countries. It is possible to define the problem of famine as a one of the overpopulation and think of sending condoms to the starving as a solution. There is another consequence of such documents and their language: they influence the public opinion and, after some time, they have an impact on rules of law in the UN member states. That consequence indicates the importance of that battle for the quality of life in the contemporary world. (shrink)

Can researchers, interested in novel ways to assess HIV seroprevalence among populations which are otherwise hidden, collect condoms that have been discarded on the ground in a public sex environment and test them for HIV? Does the Code of Federal Regulations address this question, and if not, what areas of research ethics might provide guidance to an IRB considering such a study? These questions arose as part of a preliminary study to test the feasibility of collecting discarded condoms from a (...) public sex environment in Massachusetts, and testing contained semen for HIV. Although the methodology of this study is somewhat unusual, the questions raised are not. Researchers, who wish to use other types of abandoned samples such as discarded syringes, hair or saliva samples, or even excess biological samples, commonly confront similar issues, and the analysis utilized here could guide design and review of other studies. (shrink)

Thomas Lynch, called "a cross between Garrison Keillor and William Butler Yeats" (New York Times), reminds us not only of how we die but also of how we live. "The facts of life and death remain the same. We live and die, we love and grieve, we breed and disappear. And between these existential gravities, we search for meaning, save our memories, leave a record for those who will remember us." So writes Thomas Lynch, poet and funeral director, and author (...) of the highly praised The Undertaking, winner of an American Book Award and finalist for the National Book Award, as he continues to examine the relations between the "literary and mortuary arts." The essays assembled here explore the human condition at the intersection of millennia, beleaguered by choices and changes, encumbered by merger and acquisition, numbed by maths and technologies, in search of the meaning of life and time, our lives and times. Lynch tenders life and times--sextons, muckrakers, clergy, caskets, condoms, loved poems, a hated cat, the mall, Main Street. In an age that seeks to define human experience in retail, high-tech, or pop-psyche terms, these essays speak to the existentials: between being human and ceasing to be, between birth and death, we are bodies in motion and at rest. (shrink)