DOCSLIB.ORG

Drug Injection and HIV/AIDS in Asia

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Drug Injection and HIV/AIDS in Asia MAP Report 2005 Drug Injection and HIV/AIDS in Asia Drug injection is a strong driver of HIV The purpose of this booklet is twofold: also describes how those points should infection in Asia, notably parts of 1. to summarize what researchers have inform HIV prevention strategies. China, Indonesia and Vietnam, where learned about the epidemiology of the steepest recent rises in HIV infec- HIV/AIDS within Asian IDU networks; This is one of a series of three tions are seen among injecting drug and, programming-themed booklets based users (IDUs). HIV prevalence rates in 2. to discuss the programmatic impli- on AIDS in Asia: Face the Facts. The some IDU populations are extremely cations of those findings. other two are MAP Report 2005: Male- high, and the sexual behaviour of IDUs Male Sex and HIV/AIDS in Asia and MAP can provide a gateway for HIV to The central epidemiological issues Report 2005: Sex Work and HIV/AIDS in spread among non-injectors. were presented in detail in AIDS in Asia: Asia. Taken together, they provide Face the Facts, a report issued by the insight into how to respond to the It is essential for HIV prevention inter- Monitoring the AIDS Pandemic (MAP) behaviours driving the spread of HIV in ventions to take into account the Network in 2004. This publication Asia’s most at-risk populations. complexity of the relationship between follows up by highlighting points that drug injection and HIV transmission. relate specifically to drug injection. It Acknowledgments he members of the Monitoring the AIDS Pandemic Network (The TMAP Network), the grouping responsible for this report, are listed in Appendix 1. The MAP Network would like to thank several people who are not currently network members but who have contributed actively to this report. These people include: Jeanine Bardon, Myat Htoo Razak, Parvez Sazzad Mallick, Elizabeth Pisani, Kelly Safreed Harmon, Ganrawi Winitdhama, and Nigoon Jitthai. The MAP Network would also like to thank the govern- ments of Asia and their development partners for generously sharing national HIV and behavioural surveillance data for this report. A number of institutions support the MAP Network financially, including contributors to the preparation and printing of this report. They include: UNAIDS; WHO; and the Japanese Foundation for AIDS Prevention and, Ministry of Health, Labor and Welfare, Japan. Their support does not imply that they endorse the contents of this report. The text and graphics of the report are based on AIDS in Asia: Face the Facts, a report issued by the Monitoring the AIDS Pandemic (MAP) Network in 2004, prepared by Elizabeth Pisani and Tim Brown. Drug Injection and HIV/AIDS in Asia The Map Reports 2005 Drug Injection and HIV/AIDS in Asia 1 Contents Drug injection and AIDS in Asia: a summary 3 1. Introduction 4 2. How injecting drug use fuels Asian AIDS epidemics 6 A. Sharing of injecting equipment 6 Why high viraemia equals high risk of HIV infection 6 The knowledge-behavior disconnect 7 B. The sexual behaviour of injecting drug users 8 Selling sex to buy drugs: a lethal combination 8 The other side of the coin: drug injectors buying sex 9 C. Confinement and incarceration 10 D. The relationship between HIV and other problems facing IDUs 10 3. From research to practice: translating the evidence into strategies for reducing HIV transmission in IDU networks 11 A. Changing behaviour around the sharing of injecting equipment 11 B. Preventing sexual transmission of HIV in IDU networks 12 C. Meeting the needs of IDUs in jails, prisons and other confined settings 12 D. HIV prevention in the context of other problems facing IDUs 13 4. Protecting IDUs and other community members from HIV/AIDS by engaging them in prevention and care efforts 15 Appendix 1: Members of the Monitoring the AIDS Pandemic Network 16 Appendix 2: Sources used in this report 17 Notes about sources Because this document refers to data with great frequency, the sourcing of each individual data point cited would be impractical. The sources for surveillance data are consolidated in a list in Appendix 2. Any data point that is not individually sourced, or that is sourced to “national surveillance records” or “behavioural surveillance,” comes from the sources on that list. Data from stand-alone studies rather than from repeated surveillance efforts are individually referenced in endnotes that appear in Appendix 2. Sources for all figures are provided in Appendix 2. 2 Drug Injection and HIV/AIDS in Asia The Map Reports 2005 Drug injection and HIV/AIDS in Asia: a summary Sharing injecting equipment is a very efficient way immediately obvious risks posed by HIV may of passing on HIV. Because of this, HIV prevalence seem less significant to them. Ensuring can rise rapidly among IDUs who share needles adequately scaled programmes to help drug users and syringes. In many Asian settings, needle and get off of and stay off of drugs is an important syringe sharing are very common. This clearly HIV prevention and care strategy in Asia. contributes to the very high levels of HIV in some Treatment and detoxification programmes for IDU populations. Even where the numbers of IDUs could be expanded and better utilized people injecting drugs are relatively small, their as settings for providing HIV prevention contribution to the overall HIV epidemic in a interventions, as well as medical care and country can be considerable. This is because IDUs treatment. Prisons are also settings where more may also pass on HIV infection sexually, creating a could be done regarding HIV prevention and “critical mass” of infections within sexual networks. care for IDUs. In a number of Asian countries, HIV From there, HIV can spread out more widely. prevalence among IDUs is already high. Hence, the provision of HIV treatment and prevention Major areas of concern that should guide HIV services to HIV-positive drug users is essential for prevention strategies targeting IDU networks effective national responses. include: (1) the sharing of injecting equipment; (2) the sexual behaviour of IDUs; (3) the confinement The major risk behaviours for HIV in Asia, injecting and incarceration of IDUs; and, (4) the relationship drug use, the buying and selling of sex and male- between HIV and other issues facing IDUs. male sex, are by no means mutually exclusive. In every Asian country where data are collected, drug All the scientific evidence suggests that large- injectors report more sexual activity, including scale programmes providing substitutes for sex between men, than other population groups, injected drugs and increasing access to clean and much of that sex is commercial, both bought needles and syringes will reduce new HIV infections and sold. Reducing risky sex among drug users among injectors. While these programmes often is a critical component of effective national HIV remain controversial politically, there are now programmes. good examples to suggest that they can be effective in Asian settings. For example, there was Modelling shows that in situations where HIV has a dramatic decrease in needle-sharing among remained low for years despite low condom use, IDUs when a needle and syringe exchange a sharp rise in HIV infection among drug injectors programme was started in Bangladesh. However, could “kick-start” an HIV epidemic that may in the vast majority of settings, programmes are otherwise have taken many decades to develop. not at a large enough scale to slow the spread of This is why it is essential to provide prevention the HIV/AIDS epidemic. Furthermore, access to services to IDUs before drug use-related HIV clean needles and syringes is often not enough, transmission begins to increase. for example, in several countries, injectors say Reducing HIV transmission in IDU networks that the real problem is being subjected to fines, will require stronger collaborations among arrest and imprisonment. If a country is serious communities, health workers, law enforcement about tackling HIV among IDUs, it must ensure workers, decision makers and drug users. All that drug users can safely access and utilize HIV stakeholders should be encouraged to recognize risk reduction services. that drug use-related HIV/AIDS is a global Another formidable obstacle to reducing HIV challenge requiring everyone to work together on transmission among IDUs is the presence of the same goal—reducing the impact of the HIV/ competing risks in their lives. Many drug injectors AIDS epidemic worldwide. report episodes of drug overdose and suicide attempts, and they also may be targeted for physical violence and at risk for various health problems. Compared to all of this, the less The Map Reports 2005 Drug Injection and HIV/AIDS in Asia 3 1.Introduction Is HIV a Bigger Problem in the Sex Industry or in Drug-Using Populations? A needle that contains HIV-infected blood The groups with the highest HIV infection rates can introduce the virus directly into the in Asia are injecting drug users (IDUs). So why do bloodstream. Consequently, needle-sharing experts emphasize the role of commercial sex between infected and uninfected people is as one of the major drivers of HIV epidemics in one of the most efficient ways of spreading HIV. Asia? Because of the significance of the absolute Drug injection is emerging as the strongest numbers of people engaging in both types of initial driver of HIV infection in many parts of behaviours. In general, IDUs are more likely to be Asia, and the steepest recent rises in numbers infected with HIV than sex workers or their clients. of HIV infections are seen among IDUs. Parts of But because the overall numbers of people buying China, Indonesia and Vietnam have seen HIV and selling sex are much larger than the numbers infection rates take off among drug injectors in of people injecting drugs in most settings, more recent years.
Load more

Recommended publications
  • Get Laid, Get Paid, Get High, Survive
    Get Laid, Get Paid, Get High, Survive An analytical and personal response to Elizabeth Pisani's deconstruction of HIV and AIDS Simone LeClaire SOC407: Contemporary Theory Dr. Lee Garth Vigilant March 7, 2012 LeClaire 1 The Wisdom of Whores: Bureaucrats, Brothels, and the Business of AIDS explores the phenomenon of HIV and AIDS through the enduringly personal account of epidemiologist Elizabeth Pisani. Pisani's voice weaves itself energetically through what could easily become an overwhelming amount of meaningless statistics and numbers—but instead remains a compelling and eye-opening illustration of her own experience and knowledge of the global problem of HIV and AIDS, including all kinds of the personal, social, and political complications linked to the issue. Thus, here is an powerful example of standpoint epistemology, which is an approach that, according to Dorothy Smith, "first, places sociologists where we are actually situated...and second, makes our direct embodied experience of the everyday world the primary ground of our knowledge". (1974) In other words, this first-person account is based on Pisani's own experience, and she is careful to record the context and shortcomings of that experience throughout the entirety of her account. Pisani sets the tone of her book by immediately identifying her career as "sex and drugs", and then gives a brief introduction of how she moved through a degree in Chinese, a bout of investigative journalism, and a public health education, to eventually become involved with epidemiology and specifically HIV research. The main issue that she immediately saw within the field was a gap between knowledge, and communication or action.
    [Show full text]
  • Universal Health Coverage UNIVERSAL HEALTH COVERAGE
    September 2019 A collection published by The Harvard Global Health Institute and The BMJ Universal health coverage UNIVERSAL HEALTH COVERAGE EDITORIAL 1 Delivering on the promise of universal health coverage Ashish Jha, Fiona Godlee, Kamran Abbasi ANALYSIS 2 Rethinking assumptions about delivery of healthcare: implications for universal health coverage September 2019 EDITORIAL OFFICES Jishnu Das, Liana Woskie, Ruma Rajbhandari, Kamran Abbasi, Ashish Jha The Editor, The BMJ BMA House, Tavistock Square 7 Climate change threatens the achievement of effective universal healthcare London, UK, WC1H 9JR Email: [email protected] Renee N Salas, Ashish K Jha Tel: + 44 (0) 20 7387 4410 Fax: + 44 (0) 20 7383 6418 BMJ - Beijing 13 Achieving universal health coverage for mental disorders A1203 Tian Yuan Gang Center Vikram Patel, Shekhar Saxena East 3rd Ring North Road Chaoyang District 16 Motivating provision of high quality care: it is not all about the money Beijing 100027 China Mylène Lagarde, Luis Huicho, Irene Papanicolas Telephone: +86 (10) 5722 7209 BMJ - Hoboken BMJ Publishing Inc 21 Overcoming distrust to deliver universal health coverage: lessons from Ebola Two Hudson Place Liana R Woskie, Mosoka P Fallah Hoboken, NJ 07030 Tel: 1- 855-458-0579 email [email protected] 26 Global health security and universal health coverage: from a marriage of convenience BMJ - Mumbai 102, Navkar Chamber, A Wing to a strategic, effective partnership Marol, Andheri - Kurla Road Andheri (East) Mumbai 400059 Clare Wenham, Rebecca Katz, Charles Birungi, Lisa Boden,
    [Show full text]
  • In the Eye of the Beholder: to Make Global Health Estimates Useful, Make Them More Socially Robust
    Global Health Action æ CURRENT DEBATE In the eye of the beholder: to make global health estimates useful, make them more socially robust Elizabeth Pisani1* and Maarten Kok2 1The Policy Institute, King’s College London, London, UK; 2Institute for Health Policy and Management, Erasmus University, Rotterdam, Netherlands A plethora of new development goals and funding institutions have greatly increased the demand for internationally comparable health estimates in recent years and have brought important new players into the field of health estimate production. These changes have rekindled debates about the validity and legitimacy of global health estimates. This paper draws on country case studies and personal experience to support our opinion that the production and use of estimates are deeply embedded in specific social, economic, political, and ideational contexts, which vary at different levels of the global health architecture. Broadly, most global health estimates tend to be made far from the localities where the data upon which they are based are collected and where the results of estimation processes must ultimately be used if they are to make a difference to the health of individuals. Internationally standardised indicators are necessary, but they are no substitute for data that meet local needs and that fit with local ideas of what is credible and useful Á in other words, data that are both technically and socially robust for those who make key decisions about health. We suggest that greater engagement of local actors (and local data) in the formulation, communication, and interpretation of health estimates would increase the likelihood that these data will be used by those most able to translate them into health gains for the longer term.
    [Show full text]
  • Multi-Media Campaign Exposure Effects on Knowledge and Use of Condoms for STI and HIV/AIDS Prevention in Uganda
    Carolina Population Center University of North Carolina at Chapel Hill 123 W. Franklin Street Multi-media campaign exposure effects on Chapel Hill, NC 27516 knowledge and use of condoms for STI and Phone: 919-966-7482 HIV/AIDS prevention in Uganda Fax: 919-966-2391 [email protected] www.cpc.unc.edu/measure Ruth Bessinger, Charles Katende, Neeru Gupta Collaborating Partners: Macro International Inc. May 2003 11785 Beltsville Drive Suite 300 Calverton, MD 20705-3119 Phone: 301-572-0200 Fax: 301-572-0999 [email protected] John Snow Research and Training Institute 1616 N. Ft. Myer Drive 11th Floor Arlington, VA 22209 Phone: 703-528-7474 Fax: 703-528-7480 [email protected] Tulane University 1440 Canal Street Suite 2200 New Orleans, LA 70112 Phone: 504-584-3655 Fax: 504-584-3653 [email protected] Funding Agency: Center for Population, Health and Nutrition U.S. Agency for International Development Washington, DC 20523-3600 Phone: 202-712-4959 WP-03-66 The research upon which this paper is based was sponsored by the MEASURE Evaluation Project with support from the United States Agency for International Development (USAID) under Contract No. HRN-A-00-97-00018-00. The working paper series is made possible by support from USAID under the terms of Cooperative Agreement HRN-A-00-97-00018-00. The opinions expressed are those of the authors, and do not necessarily reflect the views of USAID. The working papers in this series are produced by the MEASURE Evaluation Project in order to speed the dissemination of information from research studies. Most working papers currently are under review or are awaiting journal publication at a later date.
    [Show full text]
  • Round Table Table
    RoundRound table table Sharing health data: good intentions are not enough Elizabeth Pisania & Carla AbouZahrb Abstract Epidemiologists and public health researchers are moving very slowly in the data sharing revolution, and agencies that maintain global health databases are reluctant to share data too. Once investments in infrastructure have been made, recycling and combining data provide access to maximum knowledge for minimal additional cost. By refusing to share data, researchers are slowing progress towards reducing illness and death and are denying a public good to taxpayers who support most of the research. Funders of public health research are beginning to call for change and developing data sharing policies. However they are not yet adequately addressing the obstacles that underpin the failure to share data. These include professional structures that reward publication of analysis but not of data, and funding streams and career paths that continue to undervalue critical data management work. Practical issues need to be sorted out too: how and where should data be stored for the long term, who will control access, and who will pay for those services? Existing metadata standards need to be extended to cope with health data. These obstacles have been known for some time; most can be overcome in the field of public health just as they have been overcome in other fields. However no institution has taken the lead in defining a work plan and carving up the tasks and the bill. In this round table paper, we suggest goals for data sharing and a work plan for reaching them, and challenge respondents to move beyond well intentioned but largely aspirational data sharing plans.
    [Show full text]
  • Amnesty International Group 22 Pasadena/Caltech News Volume XXIII Number 8, August 2015
    Amnesty International Group 22 Pasadena/Caltech News Volume XXIII Number 8, August 2015 UPCOMING EVENTS Next Rights Readers PLEASE NOTE: WE ARE NOT HAVING meeting: THURSDAY MONTHLY MEETINGS FOR JULY AND AUGUST. Meetings will resume Sunday, Sept. 20, on September 24. 6:30 PM Tuesday, September 8, 7:30 PM. Letter Vroman’s Bookstore writing meeting at Caltech Athenaeum, corner 695 E. Colorado, of Hill and California in Pasadena. In the Pasadena summer we meet outdoors at the “Rath al Fresco,” on the lawn behind the building. This Indonesia Etc.: informal gathering is a great way for Exploring the newcomers to get acquainted with Amnesty. Improbable Nation Sunday, September 20, 6:30 PM. Rights By Elizabeth Pisani Readers Human Rights Book Discussion group. This month we read “Indonesia Etc.: BOOK REVIEW Exploring the Improbable Nation” by [The New York Times Sunday Book Review] Elizabeth Pisani. By JOSHUA KURLANTZICK AUG. 1, 2014 COORDINATOR’S CORNER This year, three of the world’s largest Hi everyone democracies are holding national elections -- vast polls spread over several days and School started last week (the early start thousands of miles of territory, involving more calendar) and we are up and running with Tdap than a billion voters. Two of these elections have (vaccine required for 7th grade entry)! So far our attracted intense media coverage, or will. India’s region is in the lead with 96% of 7th graders in national elections, which took place in May, compliance! swept out of office the long-ruling Congress Party and handed government of a rising Hope you all had a nice summer.
    [Show full text]
  • Responding to HIV/AIDS in the East Asia and Pacific Region a Strategy Note for the World Bank
    HNP DISCUSSION PAPER Public Disclosure Authorized Responding to HIV/AIDS in the East Asia and Pacific Region About this series... This series is produced by the Health, Nutrition, and Population Family (HNP) of the World Bank’s Human Development Network. The papers in this series aim to provide a vehicle for publishing preliminary and unpolished results on HNP topics to encourage discussion and Public Disclosure Authorized A Strategy Note for the World Bank debate. The findings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, to its affiliated organizations or to members of its Board of Executive Directors or the countries they represent. Citation and the use of material presented in this series should take into account this provisional character. For free copies of papers in this series please contact the individual authors whose name appears on the paper. East Asia and Pacific Human Development Sector Unit Enquiries about the series and submissions should be made directly to the Editor in The World Bank Chief Alexander S. Preker ([email protected]) or HNP Advisory Service ([email protected], tel 202 473-2256, fax 202 522-3234). For more information, see also www.worldbank.org/hnppublications. The Economics of Tobacco Control sub-series is produced jointly with the Tobacco Free Initiative of the World Health Organization. The findings, interpretations and conclusions expressed in this paper are entirely those of the authors and should not be attributed in any Public Disclosure Authorized manner to the World Health Organization or to the World Bank, their affiliated organizations or members of their Executive Boards or the countries they represent.
    [Show full text]
  • Culture, Health & Sexuality the Wisdom of Whores: Bureaucrats
    This article was downloaded by: [Australian National University Library] On: 22 June 2010 Access details: Access Details: [subscription number 907447645] Publisher Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37- 41 Mortimer Street, London W1T 3JH, UK Culture, Health & Sexuality Publication details, including instructions for authors and subscription information: http://www.informaworld.com/smpp/title~content=t713693164 The wisdom of whores: bureaucrats, brothels and the business of AIDS, by Elizabeth Pisani Christine Stewarta a Gender Relations Centre, Australian National University, To cite this Article Stewart, Christine(2009) 'The wisdom of whores: bureaucrats, brothels and the business of AIDS, by Elizabeth Pisani', Culture, Health & Sexuality, 11: 7, 743 — 745 To link to this Article: DOI: 10.1080/13691050903052829 URL: http://dx.doi.org/10.1080/13691050903052829 PLEASE SCROLL DOWN FOR ARTICLE Full terms and conditions of use: http://www.informaworld.com/terms-and-conditions-of-access.pdf This article may be used for research, teaching and private study purposes. Any substantial or systematic reproduction, re-distribution, re-selling, loan or sub-licensing, systematic supply or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material.
    [Show full text]
  • Antimicrobial Resistance: What Does Medicine Quality Have to Do with It?
    Antimicrobial resistance: What does medicine quality have to do with it? Medicine seller in Eastern Indonesia. Photo: Elizabeth Pisani Paper prepared by Dr. Elizabeth Pisani, Visiting Senior Research Fellow, Policy Institute, King's College London and Director of Ternyata Ltd. for the Review on Antimicrobial Resistance. September 22, 2015. Antimicrobial Resistance and Medicine Quality. Pisani for AMR Review, November 2015 2 Table of Contents Table of Contents 2 Introduction 3 Methods 4 Poor quality medicines: what are they? 4 The contribution of poor quality medicine to AMR 7 Reduced delivery of API 9 Increased concentrations of pathogens 9 Unprotected partner medicines 10 Physician behaviour 10 Quantifying problem of poor quality medicine and its contribution to resistance 12 What proportion of antimicrobial medicines are poor quality? 15 Random surveys of medicines at point of sale 17 Published studies based on "convenience" samples 20 Reporting systems based on pharmacovigilance 21 Reports based on market intelligence and seizures 22 Need for a systematic surveillance system 22 Cost to legitimate pharmaceutical enterprises 23 Testing equipment 24 Tests for the expected level of active ingredient: field level 25 Tests for the expected level of active ingredient: lab level 27 Tests for bioavailability 28 Knowing which products to test 29 Regulatory landscape 30 Recommended responses 35 1 Learn more about medicine quality 35 2 Focus on manufacturing standards 36 3 Reduce the risk of degradation 38 4 Increase detection of poor quality medicines in the field 38 Conclusion 39 Acknowledgments 39 Bibliography 40 Antimicrobial Resistance and Medicine Quality. Pisani for AMR Review, November 2015 3 Introduction Pathogens are most likely to become resistant to treatment when they encounter drugs at sub-therapeutic levels.
    [Show full text]
  • AIDS in Asia: Face the Facts
    AIDS in Asia: Face the facts Acknowledgements The members of the Monitoring the AIDS Pandemic (MAP) Network, the grouping responsible for this report, are listed in Appen- dix 1. The MAP Network would like to thank several people who are not currently network members but who have contributed actively to this report. These people include: Jeanine Bardon, Robert Bennoun, Laxmi Bilas Acharya, Txema Calleja, Cheng Hehe, Cheng Feng, Don DeJarlais, Kimberley Fox, Chris Green, Sara Hersey, Robert Kelly, Lu Fan, Ian Macleod, Parvez Sazzad Mallick, Guy Morineau, Mitra Motamedi, Joyce Neil, Nguyen Thi Thanh Thuy, Graham Nielsen, Wiwat Peerapatana-pokin, Wiwat Rojanapithayakorn, Keith Sabin, Frits van Griensven, Wang Bin, Sharon Weir, Dewa Wirawan. The MAP Network would also like to thank the governments of Asia and their development partners for generously sharing national HIV and behavioural surveillance data for this report. A number of institutions support the MAP Network financially, including contribution to the preparation and printing of this report. They include UNAIDS, WHO, UNICEF, the Japanese Foundation for AIDS Prevention, the United States Agency for International Development, Family Health International and the U.S. Centre for Disease Control and Prevention. Their support does not imply that they endorse the contents of this report. The text and graphics of the report were prepared by Elizabeth Pisani. Tim Brown prepared Chapters 5 and 6. Hein Marais edited the text. Ganrawi Winitdhama and Karen Stanecki provided invaluable support throughout. AIDS in Asia:Executive The MAP Report Summary Chapter 1 1 Executive Summary AIDS in Asia: The MAP Report Executive The Asia-Pacific region is home to 60% of the 1 Recent, sharp rises in HIV among people world’s population and to 19% of the men, with identifiable risky behaviours Summary women and children living with HIV in 2004.
    [Show full text]
  • Rethinking Hiv Stigma: Locating Intersectionality and Agency in the Experience of Social Exclusion
    RETHINKING HIV STIGMA: LOCATING INTERSECTIONALITY AND AGENCY IN THE EXPERIENCE OF SOCIAL EXCLUSION by Nevia Pavletic A Thesis Submitted to the Graduate Faculty of George Mason University in Partial Fulfillment of The Requirements for the Degree of Master of Arts Anthropology Committee: ___________________________________________ Director ___________________________________________ ___________________________________________ ___________________________________________ Department Chairperson ___________________________________________ Dean, College of Humanities and Social Sciences Date: _____________________________________ Summer Semester 2015 George Mason University Fairfax, VA Rethinking HIV Stigma: Locating Intersectionality and Agency in the Experience of Social Exclusion A Thesis submitted in partial fulfillment of the requirements for the degree of Master of Arts at George Mason University by Nevia Pavletic Bachelor of Arts University of Maryland, College Park, 2009 Director: Cortney Hughes Rinker, Professor Department of Sociology and Anthropology Summer Semester 2015 George Mason University Fairfax, VA DEDICATION I dedicate this thesis to my parents, Jadranka and Zivko, for their unconditional love and support. ii ACKNOWLEDGEMENTS I would like to thank all those who have helped me, either directly or indirectly, with this thesis. You know who you are. This thesis would not have been possible without your support and encouragement. I am also grateful for anthropology—a discipline that I entered into by pure happenstance but with which I fell in love rather quickly. Anthropology, you have encouraged me to be curious and creative, to think outside of the box, and you have challenged me to reflect more deeply on the intricacies of life and our shared human experience. I am lucky to have found my academic “home” in you. I only wish that we had found each other sooner.
    [Show full text]
  • A Study of Current Policies, Practices and Infrastructure Supporting the Sharing of Data to Prevent and Respond to Epidemic and Pandemic Threats
    January 2018 A study of current policies, practices and infrastructure supporting the sharing of data to prevent and respond to epidemic and pandemic threats Elizabeth Pisani, Amrita Ghataure, Laura Merson Summary: Data sharing in public health emergencies: Wellcome/GloPID-R ii Executive summary Introduction Discussions around sharing public health research data have been running for close to a decade, and yet when the Ebola epidemic hit West Africa in 2014, data sharing remained the exception, not the norm. In response, the GloPID-R consortium of research funders commissioned a study to take stock of current data sharing practices involving research on pathogens with pandemic potential. The study catalogued different data sharing practices, and investigated the governance and curation standards of the most frequently used platforms and mechanisms. In addition, it sought to identify specific areas of support or investment which could lead to more effective sharing of data to prevent or limit future epidemics. Methods The study proceeded in three phases: a search for shared data, interviews with investigators, and a review of policies and statements about data sharing. We began by searching the academic literature, trials registries and research repositories for papers and data related to 12 pathogens named by the WHO as of priority concern because of their epidemic or pandemic potential. Chikungunya, Crimean Congo Haemorrhagic Fever (CCHF), Ebola, Lassa Fever, Marburg, Middle East Respiratory Syndrome Coronavirus (MERS-CoV), Severe Acute Respiratory Syndrome (SARS), Nipah, Rift Valley Fever (RVF), Severe Fever with Thrombocytopenia Syndrome (SFTS), Zika. For biomedical research involving these pathogens in humans, animals, in vitro and in silico, we sought to access the data underlying each paper, including through a short, on-line survey sent to 110 corresponding authors.
    [Show full text]