国际学术交流中的诡道:AIDS病毒发现权之争

关于艾滋病病毒发现权之争的著述在国外已有许多,但国内对这一事件从科学史角度的研究还不多见.本研究试图在艾滋病的最初发现,病源学研究,以及病毒发现之争的起因等方面进行回顾的基础上,对美国科学家和美国政府在这一事件中的一些做法和表现,从美国当代国家科学发展战略观的角度进行解读,并通过历史分析求得有益的启示.     

艾滋病感染信息配偶告知中的伦理问题探析

艾滋病感染者和病人有将感染信息及时告知配偶的义务,但部分感染者和病人会以隐私保护或告知后可能面临困难为由拒绝履行,这是对避免将疾病传播给他人责任的回避,也会造成维护伦理关系名义下对关系的破坏。因而需要允许保密原则的合理例外,赋予医疗卫生机构告知权限。这一赋权带来的受益大于风险,同时也作为感染者和病人自律的制约与补充,以及信息弱势群体权益的保障。在告知举措上,需要注重伦理管理,完善相关政策措施;回应感染者和病人的生活逻辑,采取人性化告知方式;同时告知与宣传并重,减少歧视感染者和病人的舆论环境。

     

Spiritual Wellness for Clients With HIV/AIDS: Review of Counseling Issues

The epidemic of HIV/AIDS has resulted in an increasing population of individuals in need of counseling services: persons living with AIDS, as well as family, friends, and caregivers. The relationship between HIV/AIDS clients' counseling and spiritual issues is demonstrated by a review of salient literature. Three broad themes are used: terminal illness issues such as post-death existence and existential meaning of life, religious disenfranchisement from society or families of origin, and multicultural spiritual and religious issues. Practical recommendations for counselors and research implications are included.     

临床试验的科学性和伦理问题

提出了临床试验中7种不符合伦理的情况,并以实例说明.同时介绍了符合伦理的临床试验的一种新的设计方法--动态设计以及实施动态设计所需要建立的独立数据检查委员会.最后讨论了动态设计的中文译名.     

Stigma and Ostracism Associated with HIV/AIDS: Children Carrying the Secret of Their Mothers' HIV+ Serostatus

Qualitative interviews were conducted with mothers (N = 47) who had disclosed their HIV status to their children. The majority of mothers explicitly told their child not to disclose to other people that she was HIV-positive because they feared repercussions in the way of stigma and ostracism for both themselves and their child. Approximately one-fourth of the mothers identified safe people, to whom their child could discuss her serostatus, such as family members, health care providers, or therapists. The majority of the children respected their mothers' wishes; only four children disclosed to someone after being explicitly told not to do so. A significant number of children expressed concerns about their friends finding out, fearing that they would be ostracized or that it would be assumed they were also infected. In addition, the children did not want others to find out because they wanted to protect their mothers. The burden of keeping the secret of their mothers' serostatus does seem to be a stressor for some of the children.     

Sex-Related HIV/AIDS Prevention Among African American College Students: Issues for Preventive Counseling

This study examined condom use during oral and anal sex among 1,593 African American male and female college undergraduates. Findings suggest a high level of concordance between men and women on several measures. However, female participants were more likely to use condoms during oral and anal sex than were male participants.     

Psychological Distress in Orphan,Vulnerable Children and Non-Vulnerable Children in High Prevalence HIV/AIDS Communities

The degree of psychological distress and access social support is investigated in children (n = 741) living in nine high prevalence HIV/AIDS communities. They comprised (i) vulnerable, maternally-orphaned (n = 319); (ii) vulnerable and not orphaned (n = 276); and (iii) typically developing (n = 146). The following psychometric tests were administered: The Trauma Symptom Checklist for Children (Townsend, 2002); the Reynolds Depression Scale for Children (Reynolds, 1989); and the Social Support Scale (Beale Spencer, Cole, Jones & Phillips Swanson, 1997). Primary caregivers completed the Conners' Parent Rating Scale (Conners, Parker, Sitarenios, & Epstein, 1998) and an Adversity Index (Killian, 2004a) to establish the vulnerability status of each child. The data were analysed to distinguish the groups from each other regarding profiles of distress. The findings suggest that vulnerable children, be they orphaned or not, manifest similar degrees of emotional distress and perceived themselves as unable to access social support. Interventions should address the needs of both orphans and other vulnerable children, without prioritising the needs of orphans over other vulnerable children.     

Listening to the Voices of Children in Early Schooling in the South African Context of HIV/AIDS

This study explored how children in early schooling interpreted their social reality to construct vulnerable childhoods in an HIV/AIDS context. Ten males and ten females between the ages of eight and nine years from low-income families in KwaZulu-Natal participated in the study. In order to raise the voices of the children, a listening framework was created through participatory techniques. Focus group interviews, drawings, story telling and projection techniques were used in the study. The study found that children actively interpreted their social reality through engaging with circumstances that surrounded their lives in an HIV/AIDS context. Child activism is important to HIV/AIDS education.     

The Translation Issues in the Gender Inclusive Controversy

Abstract

The recently published Today's New International Versionhas received some criticism, especially from The Council on Biblical Manhood and Womanhood, which argues that the TNIVhas gone beyond translation to interpretation in order to further feminist causes. The present author argues that the differences between the TNIVand NIVare standard translation issues, highlighting three key points with illustrations, establishing a case for the superiority of “gender inclusive” translations such as the TNIV. A bibliography for study on both sides is included.     

Doing Childhoods in the Context of HIV and AIDS: Young Children in Early Schooling Speak

This study investigated children's experiences and understandings of the HIV/AIDS pandemic. Grade 3 children (n=31) from the province of KwaZulu-Natal aged between 8–11 years were participants in the study. Data were collected through a four-stage focus group process including activities such as diagrammatic mapping, drawing, timelines, projective techniques and ranking exercises. The findings suggest that the meanings children make about HIV and AIDS are contextual and situational. Moreover, the contexts in which children live act as power sites where struggles over meaning and meaning making occur.     

Gender as an Obstacle in HIV/AIDS Prevention: Considerations for the Development of HIV/AIDS Prevention Efforts for Male-to-Female Transgenders

SUMMARY

Social discourses regarding gender are responsible for molding people's cognitions, perceptions, behaviors, and interactions with others. Approaching and understanding gender socialization is an important strategy that must be included in the development of HIV/AIDS prevention intervention efforts targeting male-to-female (MTF) transgender people.

This paper represents an effort to identify the influence of gender construction among a group of MTF transgenders in Puerto Rico. Using combined methodology, authors examined results from a questionnaire and in-depth interviews with a convenience sample of MTF transgenders living in the San Juan metropolitan area.

Quantitative analysis demonstrated that this sample is composed of young, unemployed, and undereducated population. Many participated in the sex industry. Participants reported need for basic health and social services and alienation from social networks. Qualitative analysis confirmed their traditional social construction of the “feminine.” Their discourse underlines their need to reinforce their identity by the construction of a female self which undermines their possibilities for negotiating safer sex, as happens to most females in Latino societies.

Social vulnerability, institutional exclusion, and gender construction issues are obstacles for the HIV prevention efforts among these communities.     

Relations of Power in Different Spaces: An Exploration of the Schooling Experiences of Children in an HIV/AIDS Context

In this article we explore how the concept of relations of power in different spaces plays out in the lives of school children living in an HIV/AIDS context, and how processes of inclusion and exclusion are associated with particular spaces. The article uses Foucault's (2000) identification of four distinct relations of power to argue that within different school spaces we find economic, political, judicial and epistemological relations of power that are embedded in the way children experience reality. The study was conducted in five primary schools, three secondary schools, one early Childhood Education (ECD) centre, a special school and their communities in the province of KwaZulu Natal. Participants were teachers, learners, out of school youth, and members of community organisations working in the district. Data collection methods included individual and focus group interviews. Within the focus group interviews various participatory research techniques were used, including ranking exercises, projective activities, transect walk, body mapping, photo voice. The findings in the study revealed three complex and contradictory schooling spaces: policy space, curriculum space, and safe spaces in which learners' schooling lives are played out. The study showed that space is fundamental in the exercise of power as revealed in the exclusionary and inclusionary ways in which children experienced their schooling lives.     

Intentions to Care for Children Orphaned by HIV/AIDS: A Test of the Theory of Planned Behavior

HIV/AIDS has added an unparalleled number of children to South Africa's orphan population. The theory of planned behavior (TPB) was used to investigate the decision-making processes of potential substitute caregivers of children orphaned by AIDS. Existing foster and adoptive parents ( n  = 175) completed a self-report postal survey. Of the sample, 76.0% reported willingness to care for an HIV-negative child and 62.2% an HIV-positive child. Analyses of the theory's components reveal contradictory and disappointing results. While the theory is most useful in conceptualizing the factors that bear on fostering and adoption, the current study suggests that the TPB is limited in its ability to address the complexity of decisions that attend fostering and adoption of children orphaned by HIV/AIDS.     

Communicating HIV/AIDS Through African American Churches in North Carolina: Implications and Recommendations for HIV/AIDS Faith-Based Programs

This study explores HIV/AIDS communication strategies among church leaders at predominately African American churches in a metropolitan city and surrounding areas in North Carolina. The church leaders contacted for the study are members of an interfaith-based HIV/AIDS program. The researchers used semi-standardized interviews to explore how church leaders address HIV/AIDS in the church. The findings indicate that the seven church leaders who participated in the study use a variety of communication channels to disseminate HIV/AIDS information for congregants and their surrounding communities, which include both interpersonal and mass media.     

随机临床试验中伦理问题的探讨

随着我国的药物临床试验过程逐渐完善,药物临床试验水平不断提高,但伦理学方面并不十分完善.临床研究者和受试者应该明确自己的权益和义务,并在药物随机临床试验中,使受试者的权益得到更好的保护.本文论述并总结了药物临床试验中出现的问题,并提出了改进措施.     

Development of the HIV/AIDS Stress Scale

Development of a self-report measure of stress specific to HIV/AIDS is needed to advance our understanding of the role of stress in adaptation to HIV/AIDS; hence, the aim of this study was the development of the HIV/AIDS Stress Scale. A total of 132 homosexual/bisexual men with HIV/AIDS were interviewed and completed the HIV/AIDS Stress Scale and measures of coping strategies, appraisal, social support and adjustment (global distress, depression, social adjustment, number of HIV symptoms, and subjective health status) at three time points. Thirty-nine primary caregivers were interviewed and completed measures of stress and adjustment. Exploratory factor analyses of the HIV/AIDS Stress Scale items revealed three factors: Social, Instrumental and Emotional/Existential Stress. Factors had adequate internal reliabilities and were stable over 12 months. Construct validation data are consistent with recent stress/coping research that links higher levels of stress with more HIV symptoms, reliance on emotion-focused coping, lower social support, poorer levels of adjustment and higher levels of caregiver stress. Results extend this research by revealing new differential relations between various stress dimensions and stress/coping variables. Convergent validation data suggest that the HIV/AIDS Stress Scale shares conceptual similarity with threat appraisal, and differs from controllability and challenge appraisals. The HIV/AIDS Stress Scale shows potential for the elucidation of the role of stress in coping and adaptation to HIV/AIDS and disease progression in both research and clinical applications.