Global public health
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Global public health · Aug 2016
ReviewA global research synthesis of HIV and STI biobehavioural risks in female-to-male transgender adults.
There is a growing interest in HIV infection and sexually transmitted infection (STI) disease burden and risk among transgender people globally; however, the majority of work has been conducted with male-to-female transgender populations. This research synthesis comprehensively reviews HIV and STI research in female-to-male (FTM) transgender adults. A paucity of research exists about HIV and STIs in FTMs. ⋯ Little is known about the sexual and drug use risk behaviours contributing to HIV and STIs in FTMs. Future directions are suggested, including the need for routine surveillance and monitoring of HIV and STIs globally by transgender identity, more standardised sexual risk assessment measures, targeted data collection in lower- and middle-income countries, and explicit consideration of the rationale for inclusion/exclusion of FTMs in category-based prevention approaches with MSM and transgender people. Implications for research, policy, programming, and interventions are discussed, including the need to address diverse sexual identities, attractions, and behaviours and engage local FTM communities.
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Global public health · Aug 2016
Review'Men who use the Internet to seek sex with men': Rethinking sexuality in the transnational context of HIV prevention.
MISM (i.e. men who use the Internet to seek sex with men) has emerged in public health literature as a population in need of HIV prevention. In this paper, we argue for the importance of rethinking the dominant notions of the MISM category to uncover its ethnocentric and heteronormative bias. To accomplish this, we conducted a historical, epistemological and transnational analysis of social sciences and health research literature (n = 146) published on MISM between 2000 and 2014. ⋯ We argue that the essentialist approach of Western scholarship can homogenise MISM by narrowly referring to behavioural aspects of sexuality, thereby rendering multiple sexualities/desires invisible. Furthermore, we argue that a Eurocentric bias, which underlies the MISM category, may hinder our awareness of the transnational dynamics of sexual minority communities, identities, histories and cultures. We propose the conceptualisation of MISM as hybrid cultural subjects that go beyond transnational and social boundaries, and generate conclusions about the future of the MISM category for HIV prevention and health promotion.
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Global public health · Aug 2016
HIV vulnerability and the erasure of sexual and gender diversity in Abidjan, Côte d'Ivoire.
In the fight against concentrated HIV epidemics, men who have sex with men (MSM) are often framed as a homogeneous population, with little attention paid to sexual and gender diversity and its impact on HIV vulnerability. This article draws on ethnographic research conducted in Abidjan, Côte d'Ivoire among les branchés - a local term encompassing several categories of same-sex desire and practice. In the context of increased HIV prevention programming targeting Ivoirian sexual and gender minorities, such diversity is effectively erased. ⋯ Branchés whose class and/or ethnic backgrounds compound their stigmatised status as sexual and gender minorities also bear the burden of this exclusion. Furthermore, some branchés deploy 'MSM' as a form of self-identification, further complicating who such categories represent. By highlighting the ways in which constructions of gender and sexuality within HIV/AIDS programming obscure complex social realities, I aim to reorient thinking around the development of purposeful HIV programming that engages the complexity of sexual and gender minority experience.
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Global public health · Jan 2016
Stigma, shame and women's limited agency in help-seeking for intimate partner violence.
In Tanzania, 44% of women experience intimate partner violence (IPV) in their lifetime, but the majority never seeks help, and many never tell anyone about their experience. Even among the minority of women who seek support, only 10% access formal services. Our research explored the social and structural barriers that render Tanzanian women unable to exercise agency in this critical domain of their lives. ⋯ Barriers to help-seeking curtail women's agency. Even women who reject IPV as a 'normal' practice are blocked from action by powerful social norms. These constraints deny survivors the support, services and justice they deserve and also perpetuate low reporting and inaccurate estimates of IPV prevalence.
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Within the World Health Organization-International Atomic Energy Agency (WHO-IAEA) collaboration for delivery of technical assistance to its Member States, the National Cancer Control Programme/Plan (NCCP) Core Capacity Self-Assessment Tool has been used to obtain a simple and quick qualitative overview of national cancer control planning and on-going activities. The NCCP tool was applied in 50 Member States, which were classified as low- and middle-income countries in 2012. Results show that half of these countries reported having officially endorsed an NCCP and 42% were in the process of preparing or updating one. ⋯ Contrarily, patient's rehabilitation, psychosocial support, human papilloma virus vaccination, breast cancer screening with mammography and control of occupational carcinogens were noted as being in early development phases. The availability of crucial resources to support interventions was perceived to be the highest in upper middle-income countries. These findings highlight specific areas where WHO, IAEA and partners could strengthen collaboration with countries to leverage on-going interventions and improve availability of resources.