Biomedical subjects
Publications and source records attributed to S Kippax.
Preventing sexual transmission is the key to containing the HIV epidemic, and the key to prevention is in the positive promotion of safer sexual behaviours: using condoms and avoiding unprotected penetrative sex. Doctors can play a vital public health role by providing frank advice.
The discursive construction of HIV/AIDS associates deviance and disease. Women living with HIV/AIDS, in particular, have been positioned as a source or potential source of infection, and have attracted guilt and blame: in becoming 'disease' they have failed in their appropriate roles as carers and nurturers, responsible for the next generation. Based on in-depth interviews with 27 women living with HIV/AIDS this paper focuses on three ways of positioning HIV positive women: through discrimination on the part of medical professionals; through internalisation of stigmatisation; and through multiple stigmatisation of women who are or have been illicit drug users or sex workers. The implications of stigmatisation are discussed in relation to accessing health care and support.
This study investigated trends in HIV knowledge and endorsement of social avoidance of people who might be infected with HIV. The respondents (n = 7387) were self-identified heterosexual students. Most of them (n = 6500) were first-year behavioural or biological sciences students from annual surveys (1988-1995) at Macquarie University. The others (n = 887) were from four biennial (1987-1993) random samples of all students below 30 years of age at the University of Sydney. Students at both campuses completed self-administered questionnaires. Nine items were used to compute Partner Distinction Scale scores which indicated whether students had accurate knowledge that HIV may be transmitted through specific sexual practices with either casual or regular partners. Eleven items contributed to a Social Avoidance Scale. At Macquarie, male students had more accurate knowledge than female students, [F(1, 6024) = 9.20, p < 0.003], but at Sydney there were no significant sex differences in knowledge. Male students endorsed greater social avoidance at both Macquarie, [F(1, 6421) = 195.57, p < 0.00005], and Sydney, [F(1, 881) = 32.41, p < 0.00005]. Multiple linear regression on social avoidance revealed a significant reduction in social avoidance over time, with more rapid decrease among male students. Whereas less social avoidance was partly attributable to better knowledge over time, it is concluded that the improved social climate towards those most affected by HIV is mainly due to a shift in cultural norms.
From 1988 to 1994, first-year students in a large introductory class at Macquarie University completed a questionnaire regarding sexual practice, knowledge of transmission of human immunodeficiency virus (HIV) and understandings of safe sex. Data from 18- and 19-year-old students were analysed to examine changes over time among recent school leavers. Approximately 58 per cent were sexually experienced, young men were more experienced than young women, and both had more experience with regular than with casual partners. The number of partners did not vary over the years, most respondents having had one or two partners. Changes over time were found with respect to condom use, particularly with regular partners. The percentage using condoms "always' with casual partners was greater, having increased to around 60 per cent. Accuracy of knowledge relating to safety of sexual practices with casual and with regular partners increased over time, particularly with respect to regular partners. While both accuracy of knowledge and safety of practice increased with time, there was no relationship between these two variables in any one year. The findings suggest that there has been normative change with regard to condom use and that this has occurred within a reasonably static and unchanging set of sexual practices. Sex education appears to be one of the factors contributing to this change.
The focus of the paper is the predictors of unprotected anal intercourse with casual partners among a national Australian sample of homosexually active men. We interviewed by telephone 2583 homosexually active men (sex with a man within the last five years) about their sexual practice, type of sexual partners, human immunodeficiency virus (HIV) test status, attachment to the gay community, knowledge of HIV and acquired immune deficiency syndrome (AIDS) and a range of demographic variables. Logistic regression analyses were used to distinguish men who practised unprotected anal intercourse with casual partners from those who practised safe sex with casual partners. Men who practised unprotected anal intercourse with casual partners were less likely to have a regular male sexual partner than men who practised safe sex with their casual partners. They were less likely to be tertiary educated, more likely to be employed in trade and manual occupations and to live in Tasmania and the Northern Territory. They were less likely to be culturally or politically attached to the gay community. Knowledge of HIV/AIDS also distinguished the men: men with an accurate knowledge of HIV transmission were less likely to engage in unprotected anal intercourse with their casual partners. Several other variables, including age and HIV test status, did not distinguish those who practised safe sex with casual partners from those who practised unprotected anal intercourse with casual partners.
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OBJECTIVE: TO assess the maintenance of safe sexual practice. (We use the term 'safe' sex throughout the paper, since 'safe' is the term adopted by the Australian National Committee on AIDS). DESIGN: Maintenance was assessed by comparing sexual behaviour with both regular and casual partners reported in a 1986/1987 survey (time 1) with behaviour reported in a second survey in 1991 (time 2). METHOD: The 145 homosexually active participants were a non-clinical sample recruited in 1986/1987 by advertisement and followed-up in 1991. A structured questionnaire was administered at both times. Items included questions about the nature of the men's sexual relationships and their sexual practices. RESULTS: Our findings indicate that the majority of men had sustained safe sex practices. HIV prevention strategies adopted included condom use, avoidance of anal intercourse and negotiated safety (i.e., the negotiated practice of unprotected anal intercourse within regular partnerships of concordant serostatus). CONCLUSIONS: Negotiated safety is not the same as relapse.
A study was conducted to examine burnout and associated factors in the nursing care of AIDS patients in the hospital setting. Oncology nurses served as a comparison group and 64 subjects completed the Maslach Burnout Inventory. Although nurses working in the area of Oncology suffered burnout with greater frequency, nurses working in the area of AIDS showed greater intensity of burnout after adjustment for frequency of burnout. The study identified hospital differences in burnout scores, lending support to the environmental model of burnout proposed by Maslach. Male nurses were as likely to suffer burnout as female nurses. Having previously worked in other stressful areas did not influence burnout scores. On the other hand nurses who had worked in a particular unit for a greater length of time were more likely to suffer burnout, and age significantly influenced burnout inversely.
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