Stigmatization of patients with AIDS : understanding the interrelationships between Thai nurses' attitudes towards HIV/AIDS, drug use and commercial sex

There is currently a scarcity of research on the nature of HIV/AIDS stigma within the Thai health context. This is problematic given the negative role of stigma in hindering the provision of patient care and treatment. This study used a mixed-method approach to investigate the interrelationships between the stigma of HIV/AIDS and the stigmas relating to its various modes of disease transmission including injection drug use (IDU). Twenty interviews were conducted with trainees and qualified nurses from a Bangkok college. Participants were presented with vignettes describing a hypothetical person varying in disease diagnoses (AIDS, leukemia, no disease) and co-characteristics (IDU,  commercial sex (CS), blood transfusion, no co-characteristic). Using a Q-sort task, participants arranged the vignettes along a bipolar scale according to their willingness to interact with the persons, and were asked to explain their decisions. Univariate and multivariate regression analyses showed that IDU, AIDS, and CS were all individually stigmatizing. Strong interactions were found between the stigmas of HIV/AIDS, IDU, and CS. Interview data also showed clear biases toward patients according to their IDU and CS habits. The findings  suggest that addressing these co-stigmas could be vital to the success of efforts aimed at reducing the disease stigma of HIV/AIDS.

Disentangling the stigma of HIV/AIDS from the stigmas of drugs use, commercial sex and commercial blood donation - a factorial survey of medical students in China

Background
HIV/AIDS related stigma interferes with the provision of appropriate care and support for people living with HIV/AIDS. Currently, programs to address the stigma approach it as if it occurs in isolation, separate from the co-stigmas related to the various modes of disease transmission including injection drug use (IDU) and commercial sex (CS). In order to develop better programs to address HIV/AIDS related stigma, the inter-relationship (or 'layering') between HIV/AIDS stigma and the co-stigmas needs to be better understood. This paper describes an experimental study for disentangling the layering of HIV/AIDS related stigmas.

Methods
The study used a factorial survey design. 352 medical students from Guangzhou were presented with four random vignettes each describing a hypothetical male. The vignettes were identical except for the presence of a disease diagnosis (AIDS, leukaemia, or no disease) and a co-characteristic (IDU, CS, commercial blood donation (CBD), blood transfusion or no co-characteristic). After reading each vignette, participants completed a measure of social distance that assessed the level of stigmatising attitudes.

Results
Bivariate and multivariable analyses revealed statistically significant levels of stigma associated with AIDS, IDU, CS and CBD. The layering of stigma was explored using a recently developed technique. Strong interactions between the stigmas of AIDS and the co-characteristics were also found. AIDS was significantly less stigmatising than IDU or CS. Critically, the stigma of AIDS in combination with either the stigmas of IDU or CS was significantly less than the stigma of IDU alone or CS alone.

Conclusion
The findings pose several surprising challenges to conventional beliefs about HIV/AIDS related stigma and stigma interventions that have focused exclusively on the disease stigma. Contrary to the belief that having a co-stigma would add to the intensity of stigma attached to people with HIV/AIDS, the findings indicate the presence of an illness might have a moderating effect on the stigma of certain co-characteristics like IDU. The strong interdependence between the stigmas of HIV/AIDS and the co-stigmas of IDU and CS suggest that reducing the co-stigmas should be an integral part of HIV/AIDS stigma intervention within this context.

Stigmatization of AIDS patients : disentangling Thai nursing students' attitudes towards HIV/AIDS, drug use and commercial sex

This paper analyzes the interrelationships between the stigma of HIV/AIDS stigma and the co-stigmas of commercial sex (CS) and injecting drug use (IDU). Students of a Bangkok nursing college (N = 144) were presented with vignettes describing a person varying in the disease diagnoses (AIDS, leukemia, no disease) and co-characteristics (IDU, CS, blood transfusion, no co-characteristic). For each vignette, participants completed a social distance measure assessing their attitudes towards the hypothetical person portrayed. Multivariate analyses showed strong interactions between the stigmas of AIDS and IDU but not between AIDS and CS. Although AIDS was shown to be stigmatizing in and of itself, it was significantly less stigmatizing than IDU. The findings highlight the need to consider the non-disease-related stigmas associated with HIV as well as the actual stigma of HIV/AIDS in treatment and care settings. Methodological strengths and limitations were evaluated and implications for future research discussed.

Female-perpetrated child sex abuse: definitional and categorisational analysis

A recent series of court cases in Australia in which teachers have been convicted of sexual crimes against children and adolescents has brought to attention the fact that females are capable of, and do commit, such crimes. However, the nature of the crimes does not reflect the range of sexually abusive behaviours females may perpetrate, nor the kinds of women who may engage in such behaviour. We consider definitional problems in identifying female-perpetrated sexual abuse, and note that apart from one attempt to describe the range of sexual abuse perpetrated by mothers, there is little to guide researchers or clinicians in relation to female perpetrated offences more generally. We then consider approaches to categorising female sex offenders, and conclude that, although there a several such approaches that overlap in some ways, a multidimensional approach that combines aspects of each taxonomy may be more useful.

Discussing sex at work can be a costly business: Translating the science, language and law behind M v A & U (2007) QADT 8...

On 16 March 2007, in the matter of M v A & U [2007] QADT 8, the Anti-Discrimination Tribunal of Queensland found that a complaint of discrimination in the supply of goods and services had been made out by the complainant on two grounds: her female sex and lawful sexual activity. The decision would have been quite unremarkable except that ‘M’, as the complainant was known for the purposes of the hearing, is a woman of difference, one who had unusually arrived at her legal female state by completing the sex reassignment process now more commonly described as ‘sex affirmation’.

This article seeks to elaborate on the language and law of transsexualism used by the Tribunal. Its aim is to enhance practitioners’ understanding of the legal and social issues peculiar to those who affirm a sex opposite that first assigned to them so that those practitioners may better interpret the law to their clients. As the instant decision shows, the failure by an employer to take reasonable steps to avoid infringing the Anti-Discrimination Act 1991 (Qld), either on its own part or by the actions of its employees, can prove a costly business indeed.

The author offers a brief synopsis of the current medical viewpoint regarding transsexualism and reviews recent Australian legal developments in the jurisprudence. She reminds practitioners that the Anti-Discrimination Act 1991 (Qld) has since been further strengthened by the inclusion of ‘gender identity’ as a protected attribute, and concludes by proposing the existence of a heightened duty on the part of practitioners to ensure business clients are aware of the full extent of their legal obligations to not discriminate against employees or clients.

Sex and the surgeon's knife: the family court's dilemma...informed constent and the specter of iatrogenic harm to children with intersex characteristics

The article focuses on the opinion of the Australian High Court on the doctrine of informed consent and the judicial reasoning including the supporting medical evidence in sex assignment cases. The author explains that the remaining credible basis for the jurisdiction assumed by the Family Court in such cases rests in the inability of parents as guardians to give their informed consent to irreversible surgical procedures.

Temporal dynamics of oocyte development, plasma sex steroids and somatic energy reserves during seasonal ovarian maturation in captive Murray cod Maccullochella peelii peellii

The temporal dynamics of oocyte growth, plasma sex steroids and somatic energy stores were examined during a 12 month ovarian maturation cycle in captive Murray cod Maccullochella peelii peelii under simulated natural photothermal conditions. Ovarian function was found to be relatively uninhibited in captivity, with the exception that post-vitellogenic follicles failed to undergo final maturation, resulting in widespread pre-ovulatory atresia. Seasonal patterns of oocyte growth were characterised by cortical alveoli accumulation in March, deposition of lipids in April, and vitellogenesis between May and September. Two distinct batches of vitellogenic oocytes were found in Murray cod ovaries, indicating a capacity for multiple spawns. Plasma profiles of 17β-oestradiol and testosterone were both highly variable during the maturation period suggesting that multiple roles exist for these steroids during different stages of oocyte growth. Condition factor, liver size and visceral fat stores were all found to increase prior to, or during the peak phase of vitellogenic growth. Murray cod appear to strategically utilise episodes of high feeding activity to accrue energy reserves early in the reproductive cycle prior to its deployment during periods of rapid ovarian growth.

How is gender-based violence covered in the sporting news? An account of the Australian Football League sex scandal

Despite the significant amount of feminist and sociological research devoted to the question of sexual harassment and assault in sport, there has been little accompanying exploration of how the media discuss gender-based violence by sportsmen. This study examines the narratives of gendered behaviour that emerge in stories about Australian rules footballers and violence against women in the sport sections of two major Australian newspapers. As the audience for sport news is primarily male, the way that sexual misconduct by footballers is reported in this section of the newspaper provides an important dimension in theorising how media institutions influence public discourse and understandings of gender.

Gendered (s)explorations among same-sex attracted young people in Australia

This paper seeks to import a more complex understanding of gendered subjectivity into discussions of young people and homosexuality, and is based on an Australian national survey (n=749) of same-sex attracted youth (SSAY) aged between 14 and 21. Results revealed significant gender differences with regard to patterns of sexual attraction, behaviour and identity labels among participants. For the young men in the study, there was more congruence between feelings of gender a-typicality, same-sex attractions and same-sex behaviours. Overall, young women displayed more fluidity with regard to their sexual feelings, behaviours and identities. Young women were more likely to be engaged in private explorations of lesbianism, concurrent with participation in heterosexual sex and relationships. Young women were also grappling with more limited and emotionally risky opportunities for sex with other girls who were already known to them as friends. The invisibility of lesbianism as an identity or practice led to confusion about what feelings meant for the future in the arena of lived experience. The paper concludes that more research is needed into the impact of gender on the development of young people's experiences of homosexuality, particularly the manner in which invisibility and lack of social acceptance of a full spectrum of sexual diversity may disadvantage young women's emotional health and well-being.

Sex-role traits and the comorbidity of symptoms of disordered eating and problem drinking

The symptoms of problem drinking and disordered eating were studied independently in relation to sex-role traits and also for evidence of comorbidity in a student sample of 217 women. The participants completed surveys that assessed positive and negative sex-role traits, reported drinking levels, alcohol dependence, problem drinking, bulimic symptoms, dietary restraint, and drive for thinness. Eating symptoms were related to both the negative and positive traits of Femininity, but self-descriptions involving negative traits (passivity, dependence, unassertiveness, etc.) showed the strongest relationship. High scores on identification with the traits typically labelled as Masculinity were related to drinking but there was an important difference between drinking per se (which was related to Positive Masculinity) and drinking found to be associated with drinking problems, which was related to Negative Masculinity (aggression, showing-off, rudeness, etc.). Feminine traits were also related to drinking. Low identification with the traits of Negative Femininity was associated with non-problem drinking, whereas low identification with the traits of Positive Femininity were associated with problem-related drinking. Young women who displayed comorbid symptoms described themselves by a high identification with the traits of both Negative Masculinity and Negative Femininity. It was argued that comorbidity reveals a more extreme form of the sex-role conflict previously described in relation to disordered control over both eating and drinking when considered independently.

Knowledge, risk perceptions and condom usage in male sex workers from three Australian cities

The study identifies factors associated with knowledge and perception of risk of HIV/AIDS, as well as attitudes to and usage of condoms by a sample of male sex workers (MSW). One hundred and eighty-five male sex workers completed a self-reported questionnaire, including knowledge about HIV transmission, attitudes to condom use and perceptions and personal susceptibility to HIV and sexually transmitted infection (STI) risk, and a two-week diary recording use of condom during commercial sex encounters. The findings reveal that condom use was found in 77.7% of the encounters with clients and the majority of the respondents perceived themselves to be at no risk for HIV because of sex work. Independent sex workers from Melbourne and workers who owned their place of residence used condoms in a significant lower proportion. Generally speaking, knowledge about the risks associated with AIDS was high, with respondents showing lower knowledge about the risks associated with unprotected receptive or active oral sex. Participants held a positive attitude to condom use; most considered the provisions of condoms to be their responsibility rather than clients; and they were more worried about contracting an STI than HIV. Those who scored higher on the knowledge scale had more positive attitudes to condom use and those who had a more positive attitude to condom use recorded a perceived lower risk of contracting STI but not HIV. The study discusses the relevance of these findings for public health risk reduction and sexual health education campaigns.

Alcohol and drug use in Australian male sex workers: its relationship to the safety outcome of the sex encounter

This paper describes the self-reporting patterns of alcohol and drug consumption among male sex workers (MSWs) in three Australian cities during commercial sex encounters, and examines to what extent alcohol and drugs are used and whether this is related to the safe/unsafe outcome of the commercial sex encounter. One hundred and eighty-six MSWs from Brisbane, Sydney and Melbourne completed a diary following each commercial sex encounter over a two-week period. MSWs reported 2,087 commercial sex encounters during the study period. Alcohol or drug consumption was reported in 50.5% of the encounters.

Homophobia and the production of shame: young people and same sex attraction

Research among same-sex attracted young people in Western cultures has described a minority group of adolescents whose sexuality is negated by the significant institutions and people in their lives. Very often, there is a silence in the family and at school about same-sex sexuality and when a young person's homosexuality is suspected or disclosed s/he suffers from denial, discrimination and abuse. Not surprisingly, living in hostile environments leaves such young people at high-risk of drug abuse, depression and suicide. This paper describes some of the ways young people resist being positioned in these negative ways. Using autobiographical stories from 200 same-sex attracted young Australians, we document the discursive field of sexuality in which these young people struggle to construct positive identities. Young people were well aware of dominant discourses which characterized homosexuality as 'evil, diseased and unnatural'. Yet they use different strategies to fault, deflect and discount these negative understandings and to highlight other discourse which positions them positively.

Primary sex ratio bias in an endangered cooperatively breeding bird, the Black-eared Miner, and its implications for conservation

The aim of our study was to investigate primary and adult sex ratios in the cooperatively breeding black-eared miner, Manorina melanotis. We used genetic methods to determine the sex of all birds. Observations were made to quantify differences in helping behaviour between the sexes. As in other miners, Manorina spp., non-breeding males provided most of the help in raising young. Male and female nestlings did not differ significantly in weight, suggesting that both sexes are equally costly to produce. Like other miners, the adult sex ratio in black-eared miners is male-biased (64.4%). However, unlike its congeners, the black-eared miner’s primary sex ratio was strongly biased toward females (62.5%). This suggests that females suffer higher juvenile mortality than males. Our study illustrates how understanding sex ratios is both of theoretical interest and relevant to biological conservation.