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Women and AIDS in Zimbabwe: the making of an epidemic.

As the AIDS epidemic in Africa assumes major proportions, the need to understand the social context in which heterosexual transmission occurs takes on urgent importance. In this article we explore how the intersection of traditional culture with the colonial legacy and present-day political economy has influenced family structure and sexual relations, and particularly the social position of women. Drawing on Zimbabwe's historical experience, we show how land expropriation, rural impoverishment, and the forcible introduction of male migrant labor fostered new patterns of sexual relations, characterized by multiple partners. Traditional patriarchal values reinterpreted in European law resulted in further subjugation of women as even limited rights to ownership were withdrawn. For many women, sexual relations with men, either within marriage (for the majority) or outside, become inextricably linked to economic and social survival. In this setting, all sexually transmitted diseases became rampant, including genital ulcer, which facilitates transmission of the human immunodeficiency virus (HIV). Intervention programs to halt the spread of AIDS need to take into the account the epidemic's historical roots and social nature. For example, efforts to reduce risk of HIV transmission should seek to expand women's limited options, both technically (e.g., by providing alternatives to condoms) and socially (e.g., by promoting employment).

Acquired Immunodeficiency Syndrome↗

Health and health care of employed women and homemakers: family factors.

Women's increasing participation in the labor force has resulted from availability of fertility control, changed attitudes toward family size, a strong demand for occupations traditionally filled by women, and other factors. Despite many social changes, employed women continue to be concentrated in lower-income pursuits and frequently have major responsibility for the household. This paper is drawn from a study that explored the association of occupation and home responsibilities with the health of employed women and men and compared them with female homemakers. It also examined variations in the use of physician and hospital services. The principal data source was the National Health Interview Survey tapes for 1975-77. Nurturant role responsibilities were derived from records of members of the index adult's household. This paper reports on comparisons of employed women with homemakers using multiple regression analysis, and also on direct comparisons of the three work-sex groups. Study findings suggest that better health is associated with desired, positive roles such as marriage and married parenthood. Worse health is associated with unwelcome role expansions such as single parenthood, child disability, having a sick spouse and marital dissolution. Effects vary by both sex and work status. It is suggested that it is not the number of activities that may be burdensome to women's health but inability to choose one's roles and organize one's resources to meet their demands.

Absenteeism↗

The link between marital conflict and child adjustment: parent-child conflict and perceived attachments as mediators, potentiators, and mitigators of risk.

Parent-child conflict and perceived attachments to parents were examined as predictors, mediators, and moderators in the marital conflict-child adjustment connection in a sample of older children and young adolescents. After controlling for marital conflict, parent-child conflict predicted additional unique variance mainly for children's externalizing problems, and attachments to parents accounted for unique variance in children's externalizing and internalizing problems. Moderation effects illustrated that a higher level of parent-child conflict was a vulnerability factor, whereas a secure attachment was a protective factor, for behavior problems associated with marital conflict. Mediation effects were also evident and supported the proposition that parent-child conflict and attachment to parents mostly are partial mediators of effects in the marital conflict-child outcomes link. The findings illustrate the aggregation, potentiation, and amelioration of risk for adjustment problems associated with marital conflict, and highlight the importance of assessing multiple systems within the family.

Child↗

Longitudinal prediction of marital discord from premarital expressions of affect.

Theoretical and empirical analyses suggest that affective features of dyadic communication bear importantly on relationship satisfaction. A circumplex model that originated in research on the structure of affect was first replicated using data from premarital problem-solving discussions. Negativity, Positivity, and Disengagement emerged as the three primary factors. Multiple regression analyses, controlling for premarital relationship satisfaction, showed affective Disengagement at premarriage to be negatively associated with marital satisfaction at 18 (n = 84) and 30 (n = 72) months after marriage. Negativity of premarital affective expression correlated negatively with premarital satisfaction (n = 88) but not with postmarital satisfaction. Two variables formed by combining affect factors contributed to the prediction of 30-month marital satisfaction. Elements associated with current marital satisfaction appear to differ from those associated with later marital satisfaction.

Adult↗

Concurrent sexual partnerships among women in the United States.

BACKGROUND: The marked racial disparity in sexually transmitted infection (STI) rates in the United States remains inadequately explained. One important factor may be concurrent sexual partnerships (relationships that overlap in time), which can transmit STIs more rapidly through a population than does sequential monogamy. METHODS: To determine prevalence, distribution, and correlates of U.S. women's involvement in concurrent partnerships, we analyzed sexual partnership data reported by the 10,847 women, age 15-44 years, in the 1995 National Survey of Family Growth. Overlapping sexual partnership dates were determined by computer program and visual review of the data. RESULTS: Prevalence of concurrent partnerships since January 1991 was 12% overall. Prevalence was lowest among currently married respondents (4%) and highest among those who were formerly married (22%), never married (19%), in the lowest income stratum (17%), age 18-24 years when interviewed (23%), or who first had sexual intercourse at age 12 or 13 (35%). Prevalence was 21% among blacks, 11% among whites, 8% among Hispanics, and 6% among Asian American and Pacific Islanders. Multiple logistic analysis substantially weakened the relationship between concurrency and black race (OR = 1.2; 95% CI = 1.1-1.4). CONCLUSIONS: Marital status in particular is strongly related to concurrency; thus, lower marriage rates among blacks and the associated higher concurrency of sexual partners may contribute to racial disparities in STI rates.

Adolescent↗

Understanding betrayals in marriage: a synthesized model of forgiveness.

Forgiveness is an issue that is problematic for many couples, particularly those in marital therapy. However, little attention has been paid to this construct in the psychological literature. The purpose of this article is to describe a synthesized model of forgiveness using constructs from multiple theories, including forgiveness, trauma recovery, cognitive-behavioral, family systems, and insight-oriented theories. Forgiveness is conceptualized as a process consisting of three stages, each of which has cognitive, behavioral, and affective components. Furthermore, these stages seem to parallel a person's natural response to traumatic stress. First, there is a response to the initial impact; second, there is an attempt to give the event some kind of meaning, or put it into context; and finally, the person begins to move forward and readjust. Forgiveness is conceptualized as attaining: (a) a realistic, nondistorted, balanced view of the relationship; (b) a release from being controlled by negative affect toward the participating partner; and (c) a lessened desire to punish the participating partner. Implications for marital therapy also are discussed.

Adaptation, Psychological↗

[A case of multiple cerebellar hemangioblastomas with congenital deafness, juvenile diabetes mellitus and retinal angioma].

It has already been noted that hemangioblastoma is occasionally complicated with various diseases, especially retinal angioma, cysts of kidney and/or pancreas, vascular disorders, and furthermore about 10% of hemangioblastoma are multiple. The authors report here a case of multiple cerebellar hemangioblastomas accompanied with congenital deafness, juvenile diabetes mellitus and retinal angioma. The patient, a 38-year-old man who complained of disturbance of consciousness, headache and vomiting, admitted to our hospital on October 6, 1982. He was born in consanguineous marriage family and his elder sister was also suffered from congenital deafness and juvenile diabetes mellitus, but no angiomas. CT and angiography showed a left side cystic and a right side small cerebellar lesions with remarkable ventricular enlargement. Ventriculo-peritoneal shunt and suboccipital craniectomy & removal of the tumors were performed on October 6, and November 8, 1982 succeedingly. From a point of view of hereditary occurrence, the authors investigated these complicated lesions recognized in this patient. It revealed that this case did not belong to any other categories of hereditary syndromes which were already reported and so authors considered that this was an extremely rare condition. Moreover, in case of multiple hemangiomas, cerebral angiography could be a more useful method than CT scan to detect multiplicity of the lesions in the posterior fossa.

Adult↗

Widowhood and depressive symptoms among older Chinese: do gender and source of support make a difference?

In this study, we examined the effects of gender and pre-bereavement social support from three different sources (spouse, adult children, and friends) on widowhood adjustment among older adults in China. Hypotheses were developed by integrating the literature in the West and the cultural context of China. Data came from a panel survey, conducted in 1991 (baseline) and 1994 (follow-up), of a probability sample of older persons in Wuhan, China. For the present analysis, only those who were married with children at baseline were selected (N = 1,263). About 10% of the sample experienced spousal death between the two measurement points. Multiple regression analyses suggest that widowhood had a negative mental health consequence for older Chinese. Social support from adult children buffered the deleterious effect of widowhood, whereas spousal support during the marriage increased one's vulnerability. Support from friends was not found to have a significant effect. Gender difference in the effect of widowhood was also not evident. In this study, we have extended bereavement and social support research to a developing nation, with some findings similar to and some different from studies in Western developed nations.

Adaptation, Psychological↗

Dynamic patterns of time use in adolescence.

Patterns of time use are tangible representations of individual identity and the meaning of age groups in the life course. How do young people allocate their time to multiple domains of involvement, including the school, workplace, family, and peer group? Drawing on longitudinal data from the Youth Development Study (N = 1,010), a person-centered analytic strategy was used to describe configurations of time use through the high school years. Over half of the students were engaged in many domains, although a substantial percentage of students focused their time on one or two domains outside the school. Students who were highly engaged in multiple domains tended to remain so across grade levels, whereas students focused on one or two domains frequently changed their commitments. Plans for school, grade point average, future orientations that emphasize marriage and good citizenship, and gender significantly predicted time-use patterns. These findings elucidate connections among school, work, and other contexts through the high school years.

Adolescent↗

Meckel Gruber syndrome: occurrence in non-consanguineous marriages.

Meckel Gruber syndrome is an uncommon, lethal, autosomal recessive disorder, associated consistently with polycystic kidneys, posterior encephalocoele and polydactly. We report three cases in non-consanguineous marriages, suggesting that the single gene defect occurs more commonly in non-consanguineous marriages than mutant genes associated with other autosomal recessive disorders that are usually related with consanguineous marriages. The usefulness of prenatal diagnosis is discussed.

Abnormalities, Multiple↗

Mental health, work, and gender.

Women have significantly higher prevalence rates than men for many mental disorders, particularly affective disorders. Married women are more at risk for mental ill-health than single women or married men. The detrimental effects of marriage on mental health appear to relate to the contexts of role performances and the reduction in opportunities in paid employment. This review examines the influence of women's paid and unpaid domestic work and roles on mental health. Many studies show positive effects of paid employment on mental health, and multiple roles have been found to have beneficial rather than adverse effects on mental health. However, husbands' negative attitudes to women's paid employment, with resultant marital conflict, and husbands' lack of participation in child care may erode these potential beneficial effects.

Adult↗

Equipping couples with the tools to cope with predictable and unpredictable crisis events: the PREP Program.

The current article focuses on the application of crisis intervention principles to primary prevention programs for marital distress. The Prevention and Relationship Enhancement Program (PREP) is a universal, empirically-supported preventative intervention program that teaches couples skills that decrease relationship risk factors and increase protective factors. These skills, mainly conflict resolution and communication skills, serve to protect relationships from the negative impact of both normative transitional crises (e.g., marriage) and other non-predictive crises. PREP emphasizes the development and maintenance of intimacy, commitment, and friendship in the relationship, which not only protects couples from the negative ramifications of crisis events, but may also decrease the chance of such crises happening in the first place. Research has shown that PREP significantly decreases multiple indicators of marital distress as much as four years after participation in the program in both clinical and community settings. PREP has also been shown to increase marital satisfaction.

Adaptation, Psychological↗

Study on relationship between carbon disulfide exposure and symptoms and signs of nervous system in workers.

The relationship between carbon disulfide (CS2) and the symptoms and signs of nervous system in rayon workers was investigated. In a cross sectional study of CS2-exposed workers from the viscose industry and controls, data on neurological symptoms and clinical neurological examination were evaluated. The exposed subjects includes 326 workers and 105 workers from the same factory, without exposure to CS2 or to any other neurotoxic agents, served as controls. The median exposure to CS2(8 h time weighted) in the low-level exposure group was 4.6 mg/m3, and 18.3 mg/m3 in high-level exposure group. Non-conditional multiple logistic regression analysis was employed for evaluating statistical differences by using SAS software. In the analysis, age, sex, work time, body mass index (BMI), smoking and drinking habits, educational background and marriage status were controlled. The odds ratio (OR) significantly increased of some symptoms in workers exposed to CS2 at levels below 10 mg/m3, as compared to controls. The dose-effect relationship between the exposure to CS2 and the symptoms of nervous system was demonstrated. In terms of neurological parameters, no other abnormal change but that in temperature sensitivity was observed in workers exposed to CS2. In conclusion, the influence of low level CS2 on nervous system of workers should not be ignored.

Carbon Disulfide↗

Attitudes to sex and sexual behaviour in rural Matabeleland, Zimbabwe.

Though HIV prevention campaigns in Zimbabwe have increased public awareness of HIV, they have not meaningfully changed sexual behaviour. Possibly these campaigns are based on wrong assumptions about sexual behaviour. By means of 111 structured interviews with hospital patients, secondary school students and teachers, and 11 focus group discussions with traditional healers, midwives, village community workers, secondary school students and teachers, and commercial sex workers in a rural district of Matabeleland in Zimbabwe, this low-budget study explores attitudes towards sex and sexual behaviour in order to define more appropriate health education messages. Results indicate that traditional sex education no longer takes place and that communication between sexual partners is limited. The almost ubiquitous expectation of women to get rewards for sex outside marriage motivates mostly single women out of economic necessity to meet the male demand for sexual partners, which is created by large scale migrant labour and men's professed 'biological' need for multiple partners. Types of sexual behaviour other than penetrative vaginal sex are uncommon and considered deviant. Safe sex messages from the West therefore are inappropriate in the Zimbabwean context. Recommendations are given to restore traditional communication about sexual matters across generations and to urge sexual partners to discuss sex. Women who, for economic reasons, engage in casual sex should at least learn to negotiate the use of condoms. Men seriously need to reconsider their attitudes to sex and sexual practices in view of the high HIV sero-prevalence. Faithfulness, rather than multiple sexual contacts, should become a reason to boast.

Adolescent↗

Osteogenesis imperfecta with arthrogryposis multiplex congenita (Bruck syndrome)--evidence for possible autosomal recessive inheritance.

We report a son and a daughter of a first cousin Pakistani marriage who both have osteogenesis imperfecta and the son in addition has arthrogryposis multiplex congenita. Bruck [(1897): Dtsch Med Wochenschr 23: 152-155] first reported the case of a boy who had multiple fractures and joint ankylosis, subsequently only one sibship with three affected cases and seven sporadic cases have been reported to our knowledge. On the basis of consanguinity this suggests that the association of osteogenesis imperfecta and arthrogryposis multiplex congenita is inherited in this family as an autosomal recessive condition with variable expression.

Arthrogryposis↗

High immune responsiveness in a family with multiple paraproteinaemia and autoimmune thyroid disease.

Immune responsiveness was investigated in a family comprising 12 first- and second-degree relatives, one of whom had kappa-myelomatosis, one IgA-lambda paraproteinaemia, two Graves' disease and a further two thyroid antibodies without disease. Relatives by marriage served as controls. Parameters of immune capacity studied were the humoral and cellular immune response to haemocyanin of Helix pomatia (HPH), dinitrochlorobenzene (DNCB) skin reactivity and in vitro lymphocyte proliferation capacity to phytohaemagglutinin (PHA). Mean antibody titres to HPH were higher in the family than in the control group in all main Ig classes and IgG subclasses after primary and secondary immunization, and the difference was statistically significant for IgG, IgG2 and IgG4 titres. This could not have been predicted from the (normal) serum Ig levels in this family. In vitro lymphocyte proliferation capacity to HPH after primary and secondary immunization was also significantly increased. DNCB skin reactivity also tended to be high in the family, whereas PHA-induced lymphocyte proliferation was normal. These findings support the idea that myelomatosis clusters in families with immune dysregulation.

Adult↗

Orchid-fungus fidelity: a marriage meant to last?

The characteristics of plant-mycorrhizae associations are known to vary in both time and space, but the ecological consequences of variation in the dynamics of plant-fungus interactions are poorly understood. For example, do plants associate with single fungi or multiple fungi simultaneously, and do the associations persist through a plant's lifetime or do plants support a succession of different fungi? We investigated these and other questions related to plant-fungus interactions in Goodyera pubescens, an evergreen terrestrial orchid of the eastern United States, that interacts with closely related fungi in the genus Tulasnella. Unlike the mycorrhizal associations of other plants, orchid-mycorrhizal associations only benefit the orchid, based on current evidence. Many terrestrial orchids have been found to associate with specific groups of fungi. This characteristic could potentially limit orchids to relatively narrow ranges of environmental conditions and may be a contributing factor in the decline of many orchids in the face of changing environmental conditions. We found that G. pubescens protocorms (developing embryos prior to leaf production) and adults associated with only one fungal individual at a time. The orchid-fungus association persists for years, but during a drought period that was associated with the death of many plants, surviving plants were able to switch to new fungal individuals. These results suggest that G. pubescens interacts with the same fungal partner during periods of modest environmental variation but is able to switch to a different fungal partner. We hypothesize that the ability to switch fungi allows G. pubescens to survive more extreme environmental perturbations. However, laboratory experiments suggest that switching fungi has potential costs, as it increases the risk of mortality, especially for smaller individuals. Our findings indicate that it is unlikely that switching fungi is a common way to improve tolerance of less severe environmental fluctuations and disturbances. These findings may have important implications for plant responses to severe climatic events or to more gradual environmental changes such as global warming.

DNA, Fungal↗