HIV/AIDS, especially in the context of poverty, results in considerable suffering. The issues surrounding prevention, transmission, and mitigation are complex, but one very important concept sustaining the epidemic is stigma. This article examines the meaning of stigma in the literature and through the experience of people living in a high-prevalence area. An ethnographic study in rural Zimbabwe, where approximately one third of adults are infected, revealed how stigma, suffering, shame, and silence are mutually supporting concepts that challenge health promotion efforts. For a reduction in HIV/AIDS morbidity and mortality rates, there is a need to understand and act on contextual issues such as stigma with increased political and social commitment at local, national, and international levels. Nurses and other health care professionals need to be involved to ensure public policy and local interventions are aimed at enhancing supportive environments and reducing suffering.

After many years of HIV prevention in Zimbabwe, AIDS morbidity and mortality rates continue to rise. This study explores factors facilitating or hindering rural Ndau women's participation in HIV prevention that might influence health promotion programming. Ethnographic methods were used with a sample of 38 females and 10 males. Women's existence is revealed as difficult and oppressive. Their socialization to become workers and mothers occurs within a context of limited voice, subservience, violence, and economic powerlessness, all barriers to HIV prevention. Through analysis of sociocultural and economic factors, it is suggested that cultural beliefs and practices, along with national and international forces, support and sustain gender inequality. For a change in the AIDS crisis, prevention strategies need to be multifaceted, consider people's culture and context, and include gender analysis. It is imperative that nurses working with diverse populations be sensitive to culture while challenging unjust and oppressive systems.

Photovoice, as one method of participatory action research, has been used to better understand local realities and promote health in many countries and with diverse populations. It has been especially effective as a process for women to explore health and contextual issues often related to oppression and marginalization. This article discusses the impact of a photovoice process on a small group of lone mothers carrying out a community health assessment in eastern Canada. According to the women, their level of empowerment increased considerably in the 2 years of the study and their stories of the project's impact provide the evidence.

Between 2005 and 2007, a small group of lone mothers in Moncton, New Brunswick, carried out participatory action research within a university-community agency partnership. Applying the method of photovoice, the women took pictures within their community context on topics that they considered important to their health, health promotion, and quality of life. Eight themes that emerged from the process were represented with pictures and captions and presented in numerous public venues and conferences. Themes included finances, stress, support, personal development, violence and abuse, place, and transportation. The visual images and accompanying captions bring to the public arena the voices of those who are often most affected by public policy but have little, if any, input into its creation. Nurses and other health professionals can play a critical role in working toward gender and economic justice, while accompanying marginalized populations in ways that respect their beliefs, perceptions, and experiences.

This research examined rural and urban women's experiences of gender-based violence in Chimaltenango, Guatemala. Photovoice methodology was used to describe and analyze local realities and vulnerabilities, and ethnographic techniques added cultural and contextual factors. While the initial focus was on intimate partner violence, results showed that violence for women exists from childhood to senior years. Participants noted gaps in services and participated in a public strategy workshop to address these. Challenges and opportunities are presented around the enduring and complex global crisis of gendered violence. Photovoice is a powerful method for organizations to better understand and respond to local issues.