Living with Uncertainty: Acting in the Best Interests of Women

A recent multi-country study on hormonal contraceptives (HC) and HIV acquisition and transmission among African HIV-serodiscordant couples reported a statistically significant doubling of risk for HIV acquisition among women as well as transmission from women to men for injectable contraceptives. Together with a prior cohort study on African women seeking health services, these data are the strongest yet to appear on the HC-HIV risk. This paper will briefly review the Heffron study strengths and relevant biological and epidemiologic evidence; address the futility of further trials; and propose instead an alternative framework for next steps. The weight of the evidence calls for a discontinuation of progestin-dominant methods. We propose here five types of productive activities: (1) scaling injectable hormones down and out of the contraceptive mix; (2) strengthening and introducing public health strategies with proven potential to reduce HIV spread; (3) providing maximal choice to reduce unplanned pregnancy, starting with quality sexuality education through to safe abortion access; (4) expanding provider training, end-user counseling and access to male and female barriers, with a special renewed focus on female condom; (5) initiating a serious research agenda to determine anti-STI/HIV potential of the contraceptive cervical cap. Trusting women to make informed choices is critical to achieve real progress in dual protection.

The Validity of Broad and Narrow Personality Traits For Predicting Job Performance: The Differential Effects of Time

Research into the dynamicity of job performance criteria has found evidence suggesting the presence of rank-order changes to job performance scores across time as well as intraindividual trajectories in job performance scores across time. These findings have influenced a large body of research into (a) the dynamicity of validities of individual differences predictors of job performance and (b) the relationship between individual differences predictors of job performance and intraindividual trajectories of job performance. In the present dissertation, I addressed these issues within the context of the Five Factor Model of personality. The Five Factor Model is arranged hierarchically, with five broad higher-order factors subsuming a number of more narrowly tailored personality facets. Research has debated the relative merits of broad versus narrow traits for predicting job performance, but the entire body of research has addressed the issue from a static perspective -- by examining the relative magnitude of validities of global factors versus their facets. While research along these lines has been enlightening, theoretical perspectives suggest that the validities of global factors versus their facets may differ in their stability across time. Thus, research is needed to not only compare the relative magnitude of validities of global factors versus their facets at a single point in time, but also to compare the relative stability of validities of global factors versus their facets across time. Also necessary to advance cumulative knowledge concerning intraindividual performance trajectories is research into broad vs. narrow traits for predicting such trajectories. In the present dissertation, I addressed these issues using a four-year longitudinal design. The results indicated that the validities of global conscientiousness were stable across time, while the validities of conscientiousness facets were more likely to fluctuate. However, the validities of emotional stability and extraversion facets were no more likely to fluctuate across time than those of the factors. Finally, while some personality factors and facets predicted performance intercepts (i.e., performance at the first measurement occasion), my results failed to indicate a significant effect of any personality variable on performance growth. Implications for research and practice are discussed.