Commercial sex work, survival sex, sexual violence and HIV/AIDS prevention in Arumeru District, Arusha region Of Tanzania

Objective: To examine the knowledge and practices about HIV/AIDS among female Tanzanian commercial sex workers (CSWs) and assess the contextual dynamics that prevent safer sexual behaviours.

Method: The study used mixed methods and was implemented in two phases. Phase one assessed the knowledge and practices about HIV/AIDS among CSWs. Data were obtained with 54 CSWs, who were selected by using a snowball sampling approach. Semi-structured, face-to-face interviews with the CSWs were undertaken to allow the research participants to describe and discuss their lived realities as they perceive and experience them. In phase two, three discrete focus group discussions, each comprising 6-10 women, were carried out with 26 of the 54 CSWs who were interviewed in phase one.

Results: There was exploitation and inequity in the women's lives due to the multiple and overlapping oppressions of poverty and patriarchy. Sexual violence was framed, legitimised and reinforced by structural and cultural inequities. Such exploitation impacted not only on CSWs' lives as sex workers, but on their previous and/or simultaneous lives as mothers, wives, girlfriends and daughters. The women practised ‘survival sex’ as CSWs and/or sexual partners of men, and experienced sexual violence from their clients/partners. This violence was either culturally legitimised within a patriarchal framework or manifested itself as ‘displaced aggressive sex’ by men experiencing marginalisation in socio-economic spheres.

The Role of TAFE as an Equity Pathway to Social Inclusion, Employment, and to University : a submission from The Deakin University Social Work/Gordon TAFE Community Services Work, Geelong Based Project Team

Executive Summary

The Deakin University Social Work/Gordon TAFE Community Services Work Geelong Based Project Team (the Project Team) was assisted by Higher Education Partnership and Participation funding made available through Deakin University Participation and Partnerships Program (DUPPP) to carry out research and project work in 2012/13.

In the following submission to the House of Representatives Inquiry into the role of Technical and Further Education (TAFE) system and its operation, this Project Team seeks to establish a case for:

1. Funding to enable TAFE to continue as:

a) an equity pathway to social inclusion, employment, and to university, particularly in regional areas.
b) an integral complement to the University education sector to deliver on the ambitious objectives of the Federal Government’s widening participation agenda, as a mechanism to deliver the skills, knowledge and workforce needed now, and in the future, in the Australian economy.
2. Increased resources for separate and joint sector development
a) Publicly funded TAFEs need funding to be restored and increased to enable them to maintain the high quality education they provide and to maintain their successful work in supporting communities, regions and disadvantaged individuals to gain skills, training and employment.
b) Universities need increased funding to increase staffing levels and therefore free up teaching staff to spend the necessary time to develop relationships with and provide support to students. This is important for the achieving the goals of the widening participation agenda of increasing access without increasing attrition at the same time.
c) TAFEs and Universities need funding to do the work required to further develop and formalise diploma-degree pathways so that disadvantaged individuals can exit into employment at the diploma level or be supported in an efficient and seamless way to undertake further study.
3. Active use of localised and nuanced partnership approaches by education institutions. This includes:
• Cross teaching by TAFEs and Universities in courses that can be articulated, such as professional practice diplomas and degrees
• Programs negotiated and designed according to the needs of students in each location. TAFEs and Universities need resources in order to do this work
• Focus on regional centres where there is a particular opportunity for government to make an impact on TAFE pathways to employment and/or further education
• Workforce development in regional areas due to new industries is a particular area of need
4. Recognise and capitalise on the complementary and symbiotic nature of each sector’s skills, strengths and capacities.
The submission responds to the second, third and fifth points of the Terms of Reference of the Inquiry and is based on the research work carried out by the Project Team in 2012/13.

We provide evidence of Gordon TAFE in Geelong working as an equity mechanism in the particular case of the welfare/ community services diploma to social work degree pathway. The project team considers that there is a strong case for additional resourcing of TAFE to enable it to continue what it does well. TAFE is the key training and education sectorthe ‘education and social hub’that can successfully attract, retain, and graduate people who may not otherwise access education due to one or more combinations of:

1. having a low SES current or past background;
2. living in regional areas;
3. receiving interrupted primary and secondary education;
4. having disabilities;
5. being sole parents;
6. being from refugee backgrounds;
7. having English as an additional language/culture;
8. retrenchment from employment in dying industries;
9. short, medium and long term unemployment;
10. past and/or current caring roles;
11. marriage/relationship breakdowns;
12. domestic violence;
13. gender, class, age, race/ethnicity and dis/ability discriminations; and
14. socialised expectations and fears.

The recommendations in this submission are based on research findings about important similarities and differences between Gordon TAFE welfare and Deakin University social work students in Geelong, and their respective institutional organisations and contexts. The two institutions employ a repertoire of diverse administrative, teaching, learning and support approaches to meet different mission goals, requirements and needs.

The Supervision of Known Sex Offenders in the Community: Monitoring Progress and Providing Feedback

Case management is the process by which most known sex offenders who live in the community are currently supervised. However, by itself, case management has been shown to have only a modest impact on rates of re-offending, and it is only when case work and/or treatment sessions are introduced, that the benefits become apparent. This paper considers how routinely collecting and feeding back standardized data about client progress towards supervisory goals can be integrated into the offender supervision and case management process. Based on methods that have been shown to be associated with enhanced outcomes in mental health, it is suggested that the implementation of feedback approaches have the potential to both enhance the case management process and improve the effectiveness of those policies which require it.

Professional views on the management of sex offenders in the community

Sex offender registration and community notification schemes form an increasingly important part of public policy relevant to the management of known sex offenders in the community. Critics of these policies not only point to the lack of empirical evidence that is currently available to support their impact on reoffending, but also the disproportionate and potentially iatrogenic effects that they have on offenders. However, there have been few attempts to understand these issues from the perspective of those practitioners who work on a daily basis with sex offenders in the community. These professionals are uniquely placed to contribute to an understanding of effective risk management and, as such, this article presents an analysis of the perspectives of a group of experienced practitioners and how this practice-based wisdom might inform the development of sex offender public policy.

The impact of community notification on the management of sex offenders in the community : an Australian perspective

Western Australia recently passed legislation that allows information about convicted sex offenders to be disclosed to the general public. After critically appraising the rationale behind community notification, this paper considers its impact on offenders’ reintegration into the community and their subsequent risk of reoffending, its potential deterrent effect and usefulness as a management tool, and implementation issues. This discussion identifies several factors that potentially moderate the effectiveness of community notification schemes and some directions for future research and the development of policy and practices in this area.

Risk assessment with female sex offenders : can women meet the criteria of community protection laws?

Although females represent a small proportion of the sex offender population, they occasionally appear before the courts under the current generation of laws intended to protect the public from high-risk sex offenders. In this context, practitioners are called upon to provide assessment of the risk these women pose for sexual re-offending. The primary issues addressed in this paper are related to the validity of conducting such risk assessments and providing professional opinions as to the risk of further sexual offences that may be committed by female offenders. The approach taken is to summarize briefly the available professional literature regarding female sex offenders, and then to present the findings of the relatively few empirical studies that address sexual recidivism in females. The final section examines the positions taken in the published works of various international experts regarding risk assessment with females, followed by conclusions and recommendations in light of the standards typically prescribed by community protection laws.

Occupational health and safety among commercial sex workers

The concept of occupational health and safety (OHS) for commercial sex workers has rarely been investigated, perhaps because of the often informal nature of the workplace, the associated stigma, and the frequently illegal nature of the activity. We reviewed the literature on health, occupational risks, and safety among commercial sex workers. Cultural and local variations and commonalities were identified. Dimensions of OHS that emerged included legal and policing risks, risks associated with particular business settings such as streets and brothels, violence from clients, mental health risks and protective factors, alcohol and drug use, repetitive strain injuries, sexually transmissible infections, risks associated with particular classes of clients, issues associated with male and transgender commercial sex workers, and issues of risk reduction that in many cases are associated with lack of agency or control, stigma, and legal barriers. We further discuss the impact and potential of OHS interventions for commercial sex workers. The OHS of commercial sex workers covers a range of domains, some potentially modifiable by OHS programs and workplace safety interventions targeted at this population. We argue that commercial sex work should be considered as an occupation overdue for interventions to reduce workplace risks and enhance worker safety.

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.

Nursing work and nursing knowledge : exploring the work of women's health nurses, patterns of power and praxis

The majority of women's health nurses in this study work in generalist community health centres. They have developed their praxis within the philosophy and policies of the broader women's health movement and primary health care principles in Australia. The fundamental assumption underlying this study is that women's health nurses possess a unique body of knowledge and clinical wisdom that has not been previously documented and explored. The epistemological base from which these nurses' operate offers important insights into the substantive issues that create and continually shape the practice world of nurses and their clients. Whether this represents a (re)construction of the dominant forms of health care service delivery for women is examined in this study. The study specifically aims at exploring the practice issues and experience of women's health service provision by women's health nurses in the context of the provision of cervical cancer screening services. In mapping this particular group of nurses practice, it sets out to examine the professional and theoretical issues in contemporary nursing and women's health care. In critically analysing the powerful discourses that shape and reshape nursing work, the study raises the concern that previous analyses of pursing work tend to universalise the structural and social subordination of nurses and nursing knowledge. This universalism is most often based on examples of midwifery and nursing work in hospital settings, and subsequently, because of these conceptualisations, all of nursing is too often deemed as a dependent occupation, with little agency, and is analysed as always in relation to medicine, to hospitals, to other knowledge forms. Denoting certain discourses as dominant proposes a relationship of power and knowledge and the thesis argues that all work relations and practices in health are structured by certain power/knowledge relations. This analysis reveals that there IX are many competing and complimentary power/knowledge relations that structure nursing, but that nursing, and in particular women's health nurses, also challenge the power/knowledge relations around them. Through examining theories of power and knowledge the analysis, argues that theoretical eclecticism is necessary to address the complex and varied nature of nursing work. In particular it identifies that postmodern and radical feminist theorising provide the most appropriate framework to further analyse and interpret the work of women's health nurses. Fundamental to the position argued in this thesis is a feminist perspective. This position creates important theoretical and methodological links throughout the whole study. Feminist methodology was employed to guide the design, the collection and the analysis. Intrinsic to this process was the use of the 'voices' of women's health nurses as the basis for theorising. The 'voices' of these nurses are highlighted in the chapters as italicised bold script. A constant companion along the way in examining women's health nurses' work, was the reflexivity with feminist research processes, the theoretical discussions and their 'voices'. Capturing and analysing descriptive accounts of nursing praxis is seen in this thesis as providing a way to theorise about nursing work. This methodology is able to demonstrate the knowledge forms embedded in clinical nursing praxis. Three conceptual threads emerge throughout the discussions: one focuses on nursing praxis as a distinct process, with its own distinct epistemological base rather than in relation to 'other' knowledge forms; another describes the medical restriction and opposition as experienced by this group of nurses, but also of their resistance to medical opposition. The third theme apparent from the interviews, and which was conceptualised as beyond resistance, was the description of the alternative discourses evident in nursing work, and this focused on notions of being a professional and on autonomous nursing praxis. This study concludes that rather than accepting the totalising discourses about nursing there are examples within nursing of resistance—both ideologically and X in practice—to these dominant discourses. Women's health nurses represent an important model of women's health service delivery, an analysis of which can contribute to critically reflecting on the 'paradigm of oppression' cited in nursing and about nursing more generally. Reflecting on women's health service delivery also has relevance in today's policy environment, where structural shifts in Commonwealth/State funding arrangements in community based care, may undermine women's health programs. In summary this study identifies three important propositions for nursing: • nursing praxis can reconstruct traditional models of health care; • nursing praxis is powerful and able to 'resist' dominant discourses; and • nursing praxis can be transformative. Joining feminist perspectives and alternative analyses of power provides a pluralistic and emancipatory politics for viewing, describing and analysing 'other' nursing work. At the micro sites of power and knowledge relations—in the everyday practice worlds of nurses, of negotiation and renegotiation, of work on the margins and at the centre—women's health nurses' praxis operates as a positive, productive and reconstructive force in health care.

Hyper-community detection in the blogosphere

Most existing work on learning community structure in social network is graph-based whose links among the members are often represented as an adjacency matrix, encoding direct pairwise associations between members. In this paper, we propose a method to group online communities in blogosphere based on the topics learnt from the content blogged. We then consider a different type of online community formulation - the sentiment-based grouping of online communities. The problem of sentiment-based clustering for community structure discovery is rich with many interesting open aspects to be explored. We propose a novel approach for addressing hyper-community detection based on users' sentiment. We employ a nonparametric clustering to automatically discover hidden hyper-communities and present the results obtained from a large dataset.

Client self-assessment in community aged care: A comparative study involving older Australians and their case managers

Self-assessment of support needs is a relatively new and under-researched phenomenon in domiciliary aged care. This article outlines the results of a comparative study focusing on whether a self-assessment approach assists clients to identify support needs and the degree to which self-assessed needs differ from an assessment conducted by community care professionals. A total of 48 older people and their case managers completed a needs assessment tool. Twenty-two semi-structured interviews were used to ascertain older people’s views and preferences regarding the self-assessment process. The study suggests that while a co-assessment approach as outlined in this article has the potential to assist older people to gain a better understanding of their care needs as well as the assessment process and its ramifications, client self-assessment should be seen as part of a co-assessment process involving care professionals. Such a co-assessment process allows older people to gain a better understanding of their support needs and the wider community aged care context. The article suggests that a co-assessment process involving both clients and care professionals contains features that have the capacity to enhance domiciliary aged care.

Community aged care case managers transitioning to consumer directed care: more than procedural change required

Consumer directed care (CDC) is increasing in community aged care. However, limited information is available to successfully transition social workers and other case managers to their new role. This paper reports on a case study of six senior case managers who supervised staff in three Australian community-aged care agencies as they transitioned from agency directed care to consumer directed care. A change management framework was used to analyse the qualitative data collected in 12 semistructured interviews. A key finding is that changes in values, attitudes, and organisational culture are needed before staff can fully implement CDC principles of service user self-determination, empowerment, and choice. Process changes needed to assist staff transition to CDC are: using a change management strategy that maximises certainty; monitoring and responding to feelings of anxiety through ongoing consultations; and providing ongoing education and support in group sessions.

Blue army : paramilitary policing in Australia

Examination of how Victoria's Special Operations Group and their tactics have contributed to the extraordinary number of police shootings in Victoria. Looks at how these tactics have been passed on to the ordinary police. Based on author's research into the paramilitarisation of the police. Exposes the risks of allowing Australia's police forces to move away from their original charter of keeping the peace with the use of minimum force. Author lectures in Police Studies at Deakin University. She has represented the families of several men shot and killed by police in the late 1980s in her work as a community lawyer.