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PubMed2006

Specificity in reactive oxidant signaling: think globally, act locally.

Although reactive oxidants have long been stigmatized as unwanted metabolic byproducts, the expression of oxidases specifically functioning to produce these same molecules in a regulated fashion is surprisingly pervasive throughout metazoan and plant evolution. Although the involvement of oxidants in many signaling pathways is well documented, the cellular strategies for conferring pathway specificity to such reactive molecules have remained more recondite. Recent studies now suggest that cells may spatially restrict oxidant production to allow microdomain-specific signaling.

Animals↗
PubMed1996

Racial differences in marriage and childbearing: oral history evidence from the South in the early twentieth century.

Using oral histories collected in 1938 and 1939 in the Southern United States, this article examines how African-Americans and whites viewed marriage and nonmarital childbearing. The authors document distinct racial differences in family norms and the sanctions that supported those norms. Giving birth outside a marital relationship was clearly not the stigmatizing event for African-Americans that it was for whites. The authors also found that African-Americans were more likely than whites to end marriages under similar conditions. These results suggest that debates about contemporary racial differences need to take into account the historical background, both cultural and demographic, of diverse groups.

Black or African American↗
PubMed1999

Fecundity above the Species Level: Ovule Number and Brood Size in the Genisteae (Fabaceae: Papilionoideae).

Per-fruit components of fecundity (ovules per ovary, seeds per fruit, seed : ovule ratio, and patterns of seed maturation within pods) were studied in 33 species of the Genisteae, a legume tribe of mostly Mediterranean shrubs, e.g., Cytisus, Ulex, that also includes more widespread herbs such as Lupinus. Species identity explained most variance in both potential (ovules) and realized (seeds per fruit and seed : ovule ratio) fecundity, and although significant population-specific effects existed, these were relatively small, indicating that estimates of fecundity were not particularly prone to environment-induced changes. Average seed : ovule ratios varied between 20% (for a few species in which fixed rates of embryo abortion result into single seeded pods) and 100% (annuals), but most taxa were in the 40%-60% range. The probability that an ovule near the base of the ovary matured into a seed was significantly lower than the pod average in the majority of species. As indicated by the large size of stigmatic pollen loads, this was unlikely to result from insufficient pollination but rather from preferential embryo abortion. High abortion rates next to pod base occurred in both presumed selfers and obligate outcrossers. Evidence points to relatively stereotyped reproductive ways and high reproductive coherence in the tribe, with major departures from the norm being high seed : ovule ratios exhibited by annual Lupinus (associated with selfing), and low ratios shown by species with single seeded pods (associated with fixed rates of embryo abortion).

Journal Article↗
PubMed1999

Beetle pollination of Philodendron solimoesense (Araceae) in French Guiana.

The pollination of Philodendron solimoesense (subgenus Meconostigma) was studied in four populations of French Guiana. Flowering is asynchronous within each population during July, and the flowering cycle is a 2-d process. Numerous insects visit Philodendron inflorescences, but the main pollinator seems to be Cyclocephala colasi (Scarabaeidae, Dynastinae). The pollination process displays aspects typical of beetle pollination: the production of heat and of a strong odor, the presence of a food reward (stigmatic secretion and sterile male flowers), and the presence of a copulation chamber. Flower heat production is important (ca. 11 degrees C above the ambient air) and may help to volatilize the fragrance. Attraction and choice-test experiments showed that C. colasi is not likely to depend on chemical information (such as pheromone) to localize conspecifics but may rely instead on stimuli produced by the inflorescences in order to meet mating partners.

Journal Article↗
PubMed2001

Concerns of pregnant women about bing tested for HIV: a study in a predominately Mexican-American population.

More than 90% of pediatric acquired immune deficiency syndrome (AIDS) cases are due to mother-to-child (vertical) transmission. Medical intervention can reduce the risk of vertical transmission human immunodeficiency virus (HIV) from 25% to less than 8%. However, studies have suggested that approximately one-fourth of women may refuse HIV testing as part of routine prenatal care. The purpose of this study was to identify concerns that pregnant women might have that would impact their decision to undergo HIV testing in pregnancy. The study is a cross-sectional survey of 413 pregnant women in south Texas. A survey questionnaire was used to assess reasons why subjects might avoid HIV testing and to assess their risks for HIV infection. The reasons for not wanting HIV testing grouped around four themes: (1) fear of being stigmatized as sexually promiscuous or as an injecting drug user; (2) denial about the possibility of being infected; (3) fatalism; and (4) of rejection leading to loss of emotional and financial support. Overall, 15% of subjects who had not been previously tested (5% of all subjects) indicated that they would refuse HIV testing, a rate which is below rates of 20%-24% in previous studies. The lower rate of refusal for HIV testing in our study may reflect a downward trend nationally in the rate of refusal for prenatal testing. Many women have concerns about HIV testing, although these concerns may not necessarily prevent them from undergoing testing. Physicians and policy makers need to be aware of women's concerns and fears when implementing HIV testing policies.

Adult↗
PubMed2001

AIDS in India: incidence, prevalence, and prevention,.

With 3.7 million human immunodeficiency virus (HIV)-positive in India, many predict that this nation of 1 billion people will soon see infection rates soar if successful prevention programs are not implemented. The majority of infections occur through sexual contact, with blood banks, intravenous drug use, and mother-to-child transmission also spreading the virus. Those in India who are HIV-positive are highly stigmatized and often have difficulty finding physicians who are willing to treat them. Nongovernment organizations provide various services, including physician referrals and legal help for those who are HIV-positive and programs to raise awareness and education. Although the Government of India has designed various programs to help prevent the further spread of HIV, lack of funding and poor regulatory systems are further barriers to their implementation. India is also at war with poverty, illiteracy, and gender inequality, all of which make the fight against acquired immune deficiency syndrome (AIDS) a more difficult battle. India's AIDS control strategy must take these issues into account in order to design successful programs to prevent infection rates from multiplying rapidly.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Telling the stories of people with AIDS in rural Haiti.

For 20 years, Hospital Albert Schweitzer (HAS) in Haiti's Artibonite Valley has struggled with the evolving acquired immune deficiency syndrome (AIDS) epidemic. Initial efforts to confront the disease met numerous obstacles including denial, stigmatization, powerlessness, and mistrust. Over time, HAS and local community organizations developed a new approach to the AIDS problem. The first step in this approach flowed from the founding principle of HAS: Reverence for Life; hospital staff and community leaders provided hospice care to people dying of AIDS. Caring for people with AIDS and hearing the stories of people with AIDS quickly generated sympathy and a personal sense of vulnerability among community leaders and created a desire for community human immunodeficiency virus (HIV) education and prevention. Using the stories of people with AIDS as a basis, a community education program was launched. More than 1,000 church leaders, voodoo priests, and schoolteachers were trained. The majority of these leaders returned to their communities and started creative and unexpected initiatives to confront the AIDS problem.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Lipodystrophy syndrome and self-assessment of well-being and physical appearance in HIV-positive patients.

The lipodystrophy syndrome (LDS) is a growing problem in human immunodeficiency virus (HIV)-positive patients treated with highly active antiretroviral therapy (HAART). It is characterized by alterations of body composition and metabolic abnormalities. The goal of the study was to investigate attitudes toward health condition, well-being, and individual appearance in relation to LDS. Outpatients between July and October 2000 in an HIV-specialized unit at the University Hospital of Düsseldorf, Germany, underwent clinical evaluation and received a standardized written questionnaire. Of 389 patients eligible for analysis, 313 patients returned completed questionnaires (response rate, 80.5%). LDS was observed in 37.7%; the predominant manifestation was lipoatrophy of the face (32.9%). Individuals with and without LDS did not differ significantly in their attitude to the quality of their health condition and the amount of disturbance of their well-being by HIV infection. Participants with LDS felt recognizable as HIV-positive by physical appearance in 30.1%, compared to 18.3% in patients without LDS (p = 0.027). This difference became more pronounced after adjustment for gender, age, stage of disease, CD4 cell count, and duration of HAART (odds ratio, 2.04, 95%-confidence interval [CI] 1.09-3.84). In conclusion, LDS does not seem to disturb the general attitude toward health condition and well-being. However, patients presenting with lipodystrophy are about twice as likely to feel recognizable as HIV-positive by their physical appearance. LDS may thus be perceived as a characteristic mark of being HIV-positive by affected persons. A stigmatizing effect and social disadvantages may be the consequences.

Adult↗
PubMed2003

Rape among incarcerated men: sex, coercion and STDs.

Male inmates fear being raped most of all. Criminologists have yet to reach consensus on the prevalence of male inmate-on-inmate rape. The leading prevalence studies found that 7-12% of the responding male inmates had been raped an average of nine times. With a national jail and prison population of 2 million at mid-year 2002, the United States likely exposes tens of thousands of male inmates to rape, and consequently, to HIV/AIDS and other sexually transmitted diseases (STDs). The release of inmates from jails and prisons-estimated at 11.5 million persons in 1998-transforms the consequences of male rape from a correctional matter into a public health crisis. The quest for dominance and control over other inmates-not sexual release-best explains male custodial rape. Prison sexual predators are typically heterosexual. Their victims, however, involuntarily assume female roles in the prison sexual system. Moreover, they experience stigmatization by inmates and staff as well as physical and mental trauma. Civil rights litigation on behalf of victims rarely succeeds and damage awards are usually small. In 2003, Congress provided $13 million for the study and prevention of rape in jails and prisons. Preventing custodial rape and treating its victims will require a sustained commitment by government.

HIV Infections↗
PubMed1998

Low versus high prevalence of AIDS: effect on nursing students' attitudes and knowledge.

The purpose of this study was to compare AIDS knowledge and attitudes of baccalaureate nursing students living in a state with a high prevalence of AIDS and those who resided in a state with a low prevalence of AIDS. Students from the high-prevalence state had significantly higher AIDS knowledge scores than did students from the low-prevalence state. However, overall, respondents from the low-prevalence state viewed the person living with AIDS with more accepting attitudes than did the respondents from the high-prevalence state. Students in the high-prevalence state interacted with persons living with AIDS (PLWA) primarily through professional contact. In contrast, students in the low-prevalence state identified both personal and professional contact with PLWA as their most significant interactions. Personal experience of nursing students appears to be a key to decreasing stigmatization of PLWA.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Partner notification as a prevention strategy: a social system perspective.

Provider referral and contact referral are two established means to provide notification of contagious, but treatable diseases, as has been done for tuberculosis and sexually transmitted diseases (e.g., syphilis). Because AIDS is at this time an incurable disease, programs of notification have proved highly controversial. The author examines recent adjustments to the New York State public health law regarding HIV/AIDS notification mechanisms. A literature review supports further discussion of ethical and partner notification issues as they bear on the perception and objections of various constituencies, stigmatization, and principles of confidentiality. Both U.S. and Swedish strategies to partner notification are outlined as well as why these schemes may not be interchangeable based on culture differences; points for general improvement are drawn from this comparison. A social system perspective based on the social functions of adaptation, goal attainment, integration, and latency (pattern maintenance) is introduced as a means to address the barriers inherent in HIV/AIDS notification programs and to enhance counseling programs--the objective being that knowledge and understanding of the patient's culture and social context can give providers additional tools with which to stop the spread of HIV/AIDS and bring people to treatment earlier.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Heterosexual anal intercourse: prevalence, cultural factors, and HIV infection and other health risks, Part I.

Studies of heterosexual HIV transmission have consistently found anal intercourse to be a highly predictive risk factor for seroconversion. Yet most AIDS prevention messages targeted at heterosexuals, presumably influenced by cultural taboos against acknowledging this sexual practice, continue to emphasize vaginal and, increasingly, oral sex transmission. The health risks of anal sex appear to be severely underestimated by a substantial proportion of sexually active women and men in North and Latin America as well as parts of South Asia, Africa, and other regions. Among heterosexuals reported rates of condom use are nearly universally lower for anal than for vaginal intercourse. This review examines anal sex among the general population, including its prevalence in various world regions, related sociocultural factors, and other associated health problems including anorectal STDs, Hepatitis B infection, and HPV-related anal cancer in women. U.S. survey and other data suggest that, in terms of absolute numbers, approximately seven times more women than homosexual men engage in unprotected receptive anal intercourse. Research among higher risk subpopulations, including bisexual men, injecting drug users, female sex workers, inner-city adolescents, and serodiscordant heterosexual couples, indicates that persons particularly at risk of being infected by or transmitting HIV are also more likely to practice anal sex. Considering this finding, along with the much greater efficiency for HIV infection as well as lower rates of condom usage, a significant proportion of heterosexual transmission in some populations is due to anal intercourse. This typically stigmatized and hidden sexual practice must be given greater emphasis in AIDS/STD prevention, women's care, and other health promotion programs.

Adolescent↗
PubMed2005

Knowledge, attitudes, behaviors, and perceptions of risk related to HIV/AIDS among Chinese university students in Hunan, China.

The purpose of this paper is to describe HIV/AIDS knowledge, attitudes, and perceptions and identify personal risk behaviors among undergraduate students in China. A descriptive, cross-sectional survey of 1326 students between ages 17 through 28 was conducted in 2002. Results indicated that students held considerable misconceptions about HIV transmission by casual contact and needle sharing as well as stigmatizing attitudes about injection drug use, homosexuality and HIV-positive women who bear children. Results indicated that 14% of Chinese university students are sexually active and risk behaviors tended to increase with age. Additionally, 24% of the students considered themselves to be at moderate to very high risk of contracting HIV and 40% of sexually active students never used condoms. Therefore, it is important to design HIV prevention strategies that target university students in China.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Prevalence and correlates of HIV serostatus disclosure: a prospective study among HIV-infected postparturient women in Barbados.

This study was undertaken to determine the prevalence of self-disclosure of HIV status among the postparturient HIV-infected women and to describe the correlates of disclosure in this population. Subjects for this study include all known HIV-infected postparturient women in Barbados who delivered during 1997 through 2004. Sociodemographic data are routinely collected from all HIV-infected postparturient women. Data on disclosure were collected through one-to-one interview of the consenting women included in this study. One hundred thirtynine women were studied. Forty women (28.8%) had self-disclosed their HIV status to other people including their current sex partner. Among women who did not disclose their HIV status to anybody, 30 (30%) gave fear of stigmatization as the reason for nondisclosure, while 23 (23%) did not disclose their status as they feared abnormal reaction from their current sex partner and possible violence directed at them. Women who had disclosed their HIV status were more likely to use condoms during all sexual encounters, less likely to have had subsequent pregnancy from a different sex partner, were more likely to have a partner who had been tested for HIV, and were themselves more likely to be attending the centralized HIV clinic for follow-up and care compared to those who did not disclose. A substantial proportion of HIV-infected postparturient women never disclosed their result to a partner or a close relative. Lack of disclosure may have limited their ability to engage in preventive behaviors or to obtain the necessary emotional support for coping with their serostatus or illness.

Adult↗
PubMed2006

Routine testing for HIV in the United States: the intersection between recommendations and practice.

The purpose of this study was to examine the current practices of family practice (FP) providers and their allied staff with regard to routine HIV testing in Rhode Island (RI) and Mississippi (MS). Anonymous experimenter-derived surveys were mailed to both groups of providers in 2002. The questionnaire contained five questions about their current practices and attitudes toward HIV testing as well as patient demographics. Five hundred twenty-one questionnaires were sent to American Academy of Family Practitioners (AAFP) members in RI and MS and to FPs with listings in the phone book in RI. The response rate was 52% in RI and 41% in MS. The vast majority of providers (93%) tested their high-risk patients for HIV, but less tested pregnant (57%) and other sexually active (37%) patients. The FPs in this survey wanted HIV testing to be done in the primary care setting, yet only 7% recommended HIV testing to their sexually active patients aged 18-50 in the previous year. In order not to stigmatize any specific risk group, nor to miss any patients who are unable to be identified as being "at high risk," routine testing in the primary care setting should be encouraged.

AIDS Serodiagnosis↗
PubMedDate not supplied

Genetic screening of targeted subpopulations: the role of communal discourse in evaluating sociocultural implications.

Targeting socially identifiable subpopulations for genetic screening entails the risk of stigmatizing them. The potential for such harm should be considered before programs are initiated. There is an emerging consensus that targeted subpopulations should be actively involved in evaluating these risks. A process of communal discourse engages the community in discussions that reflect both public and private sociocultural contexts in which individual decisions about screening will be made. This allows the subpopulation to address the collective implications of testing in a culturally appropriate way. Communal discourse was used to evaluate the collective implications of genetic testing in two Native American communities. We found that private social units were more influential than public units in reaching communal consensus, that local sociocultural issues were of more concern than were general issues such as employment and insurance discrimination, and that heterogeneity within a subpopulation may be just as significant a consideration in designing a targeted screening program as diversity between subpopulations. Heterogeneity is constructed by using a dichotomy between community-specific and biomedical health representations and practices. How genetic screening is socially constructed using a community's existing dichotomy may be central to its success.

Attitude to Health↗
PubMed1998

Asymptomatic Gaucher disease implications for large-scale screening.

Gaucher disease, the most prevalent genetic disorder among Ashkenazi Jews, is characterized by significant phenotypic heterogeneity. Because seven mutations account for more than 96% of the disease alleles in this population, large-scale screening is feasible, and genotyping is commercially available. To date, only 400 Gaucher patients have been diagnosed in Israel, although 2,500 patients are predicted by gene frequency; hence, there is the probability that those uncovered by population screening will prove to be very mild or asymptomatic since these patients have generally escaped medical attention until now. We studied objective and subjective aspects in 68 asymptomatic/very mild patients, followed for a mean of 2.6 years, to assess the implications of identifying many more such patients if large-scale screening were to be implemented. We found there were no medically significant changes in disease severity during follow-up. The patients' subjective reports of their general health status were similar to those of normal subjects, and there were no significant changes in quality of life during follow-up. Our findings suggest that asymptomatic/mild Gaucher patients do not require frequent monitoring; there is no justification for "prophylactic" enzyme therapy in this group, and, hence, no rationale for large-scale screening in the Ashkenazi population. Furthermore, one needs to be concerned with the adverse effects of labeling large numbers of asymptomatic individuals as affected because of the potential for stigmatization and discrimination.

Adolescent↗
PubMed2004

Informing carriers of beta-thalassemia: giving the good news.

This study explored the value of informing beta-thalassaemia carriers of the advantages, as well as the disadvantages of carrier status. Twenty-eight carriers of beta-thalassaemia were interviewed immediately after counselling, and again 2 weeks later. Both interviews included administration of a psychological scale (previously used for cystic fibrosis). Immediately after the first interview the intervention group (n = 18) were informed of the protective effect of the beta-thalassaemia trait against malaria and coronary heart disease. The control group (n = 10) was given the same information after the second interview. The effect of giving the positive information was assessed by comparing participants' scores at the first and second interview. Knowledge of carrier status aroused several negative feelings, including shock, sadness, and anger, but little feeling of stigmatization. Two weeks later, negative feelings were unchanged in the control group, but they were reduced in all members of the intervention group. All members of the intervention group considered it important to inform carriers of the positive aspects as well as the risks associated with carrier status. Carriers of recessive disorders with a known heterozygote advantage should be informed of the advantage. This information has now been incorporated into the comprehensive information system for hemoglobin disorders available at http://www.chime.ucl.ac.uk/ApoGI/.

Adolescent↗