Doug Henry

Evidence of hiv transmission risk in barebacking men-who-have-sex-with-men: Cases from the internet

SUMMARY The purpose of this ethnographic study was to conduct an exploratory research investigation examining the phenomenon of bare-backing among men-who-have-sex-with-men (MSM) on the Internet. The researchers selected a case sample of 100 MSM advertisers on an Internet bareback sex site to assess HIV transmission risk as related to HIV serostatus, partner selection, and sexual risk-taking. The data suggest that while intentionally seeking to transmit or contract HIV was extremely rare, a small proportion of advertisers appeared to be relatively indifferent to HIV transmission. However, the great majority of advertisers for bareback sex appeared to practice “sero-sorting” or sero-concordant behavior by HIV status with potential sexual partners as a strategy to minimize HIV transmission risk.

Understanding Patient Responses to Insomnia

To better gain insight into patient responses to insomnia, we take a medical anthropologically informed approach to patient beliefs and behaviors, particularly those related to self-diagnosis, management, help-seeking, and self-treatment of insomnia. We conducted 24 in-depth qualitative interviews in which participants were asked their beliefs about the origin of their insomnia, its anticipated course, their evaluation of symptoms, their responses, and their expectations surrounding treatment. Important and novel data were generated about patient beliefs and behaviors related to problem sleeping. Patients identified barriers to treatment, particularly those contextualized within a general social stigma and personal isolation, in which their problems sleeping were not taken seriously. The interview format was particularly conducive to making patients comfortable discussing the personal changes they made to their medically prescribed treatment plans, or supplanting their medical therapy with some kind of complimentary and alternative medicine (CAM) therapy. These are important issues in the long term management of chronic insomnia. We underscore concern about the need to evaluate the efficacy of therapies that so many people with insomnia are driven to try.

Correlates and Racial/Ethnic Differences in Bareback Sex Among Men Who Have Sex with Men with Unknown or Negative HIV Serostatus

Men who have sex with men (MSM), particularly racial/ethnic minority MSM, are disproportionately affected by HIV in the United States and Texas. Bareback sex or condomless anal intercourse (CAI) can be a high HIV risk behavior. Despite this, a majority of MSM continues to engage in barebacking. Research suggests racial/ethnic differences in barebacking exist; however, these conclusions remain unclear due to insufficient sample sizes to compare racial/ethnic groups. Our cross-sectional correlational design explores barebacking correlates (substance use during sex, safe sex fatigue, and optimistic HIV treatment beliefs) within and between racial/ethnic groups among 366 MSM. Regression models are significant for Latino and African-American MSM alone and for all MSM combined, though not significant for European-American and Other Race/Ethnicity MSM alone. Our findings suggest motivations and behaviors underlying barebacking among MSM vary by racial/ethnic membership with clinical implications for informing culturally sensitive HIV interventions and prevention programs for target racial/ethnic groups.ResumenEn los Estados Unidos de América y en el estado de Texas, los hombres que tienen sexo con hombres (HSH), en especial aquellos que forman parte de minorías raciales/étnicas, son afectados desproporcionadamente por el VIH. El sexo anal “bareback” o sin condón puede ser un riesgo para contraer VIH. Aun así, una gran mayoría de los HSH continúan teniendo sexo sin condón. Previas investigaciones sugieren que existen diferencias raciales/étnicas en cuanto al sexo anal sin condón, pero las conclusiones de estos estudios no son claras debido al insuficiente tamaño de las muestras de cada grupo racial/étnico. Nuestro estudio transversal con diseño correlacional explora varios correlatos (uso de sustancias durante el sexo, fatiga de tener sexo seguro, y creencias optimistas del tratamiento para el VIH) dentro y entre grupos raciales/étnicos entre 366 HSH. Los modelos de regresión son significantivos para los HSH Latinos y Afro-Americanos y para todos los grupos de HSH combinados, pero no son significantivos para los HSH Europeo-Americanos o HSH de otros grupos raciales/étnicos. Nuestros resultados sugieren que puede haber motivos o comportamientos subyacentes por los cuales tener sexo sin condón varía dependiendo del grupo racial/étnico, lo cual tiene implicaciones clínicas para desarrollar intervenciones y programas de prevención de VIH enfocados a minorías raciales/étnicas.

Conflict, Diamonds and the Political Economy of Instability in Africa

Abstract There are countries in Africa that form the hub of global diamond production, yet instead of always being a major asset, diamonds can become a major source of catastrophe. Using Sierra Leone, Angola and the Democratic Republic of Congo as examples, this paper explores the impact conflict diamonds have had on the lives of the people and the destabilization of these countries. A political economy conceptual framework is used since factors such as political history and economy of a country, corruption, greed and the ignorance of the West, all contribute to the trade of illicit diamonds. The findings suggest that African countries and Western countries share the blame for the trade in conflict diamonds and the grim repercussions facing some African countries.

Borders and Healers: Brokering Therapeutic Resources in Southeast Africa (review)

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