Sex, violence and HIV on the inside: cultures of violence, denial, gender inequality and homophobia negatively influence the health outcomes of those in closed settings

Kelly‐Hanku, Angela; Kawage, Thomas; Vallely, Andrew; Mek, Agnes; Mathers, Bradley

doi:10.1080/13691058.2015.1020877

Cited by 11 publications

(17 citation statements)

References 26 publications

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“…But in doing so, we do not seek to dismiss or downplay Papua New Guinean women and girls' experiences of inequality and violence, or the role that gender norms plays in its perpetration. Indeed, several authors of this article have documented the impact of harmful masculinities on violence against women (and men) (Kelly-Hanku, Aeno et al 2016;Kelly-Hanku, Kawage et al 2015). Aggressive forms of masculinity were also noted among some men in our study.…”

Section: Introductionsupporting

confidence: 68%

Caring Masculinities in the Context of HIV Serodiscordant Relationships in Papua New Guinea

Mitchell¹,

Kelly‐Hanku

Mek

et al. 2019

Men and Masculinities

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Globally, there is limited research exploring the positive role men play in reducing HIV vulnerability or in the care and support of women living with HIV. This paper draws on interviews conducted with men and women in heterosexual HIV serodiscordant relationships as part of a longitudinal qualitative study exploring the social aspects of biomedicine among serodiscordant couples in two high HIV-burden areas in Papua New Guinea (PNG). Findings highlight that some HIV negative men in heterosexual relationships are resisting hegemonic masculine norms they see as harmful and are embracing caring masculine identities as they seek to support their HIV-positive wives. We suggest that understandings of masculinity in the context of the HIV epidemic in PNG should be broadened from simplistic discourses and representations of men as largely uncaring and violent to incorporate deeper understanding of how men can and are embracing caring masculinities.

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Section: Introductionsupporting

confidence: 68%

Caring Masculinities in the Context of HIV Serodiscordant Relationships in Papua New Guinea

Mitchell¹,

Kelly‐Hanku

Mek

et al. 2019

Men and Masculinities

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“…Overall, women are at a higher risk of transmission than men, i.e., 1.1% vs. 0.7% [2]. The role of women in controlling the spread of HIV is also of particular interest due to vertical (mother to child) transmission [5,6] and the positive correlation between genderbased violence and increased risk of HIV transmission, particularly considering the high prevalence of violence against women and children in PNG [4,[7][8][9][10]. The UNAIDS 90-90-90 targets stated that by 2020, 90% of people living with HIV would be aware of their status, 90% of those diagnosed with HIV would be on appropriate antiretroviral treatment, and 90% of those on treatment would demonstrate viral suppression [11].…”

Section: Introductionmentioning

confidence: 99%

Media Exposure, Behavioural Risk Factors and HIV Testing among Women of Reproductive Age in Papua New Guinea: A Cross-Sectional Study

Adegboye

Ezechukwu²,

Woodall

et al. 2022

TropicalMed

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Background: Reproductive health remains a major health concern in developing countries such as Papua New Guinea (PNG). The prevalence of human immunodeficiency virus (HIV) in PNG is the highest in the Southern Pacific region, with women having a higher risk of contracting the infection. Hence, there have been several policies aimed at mitigating the spread of the disease. One of these policies include the use of mass media as a health promotion tool to educate the population on the risk of the disease. Therefore, this study aimed at investigating the association of mass media to HIV testing among women. Methods: Data were obtained from the PNG Demographic and Health Survey (DHS) of 2019. A total of 15,005 reproductive-age women was included in this analysis. Results: The results showed that women with low (aOR = 1.63, 95% CI: 1.39, 1.90) and high (aOR = 1.53, 95% CI: 1.36, 1.72) media exposure were more likely to undertake HIV testing compared to those with no media exposure. Compared to no education, women with incomplete primary (aOR = 1.22, 95% CI: 1.06, 1.40), complete primary (aOR = 1.56, 95% CI: 1.30, 1.87), incomplete secondary (aOR = 2.18, 95% CI: 1.85, 2.58), complete secondary (aOR= 2.33, 95% CI: 1.77, 3.09) and higher (aOR = 3.38, 95% CI: 2.57, 4.46) education were more likely to undertake HIV testing. Compared to women with the poorest wealth index, women with richer indexes were more likely to undertake HIV testing. Women living in rural areas were less likely to undertake HIV testing (aOR = 0.72, 95% CI: 0.63, 0.82). However, marital status, knowledge of transmission and religion were not associated with HIV testing. Conclusion: In conclusion, this study provides strong evidence that mass media exposure increases the likelihood of HIV testing in women of reproductive age in PNG. Mass media campaigns would serve as a cost-effective health promotion tool against the spread of disease.

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“…Indeed, HIV diagnosis has been associated with poorer self-reported health outcomes as well as lower engagement in care, including treatment refusal, in patients with HIV. 12,13,14,15 Trust and Therapeutic Alliance In the case, Dr D knows only 3 things with certainty about M and ART: M is not taking ART; M has been reluctant to discuss HIV infection, at least in certain ways; and M is open to "immunity booster pills," whatever that might mean to him. It would be easy for Dr D to assume that M's behaviors stem from low health literacy or mistrust.…”

Section: Clinician Awarenessmentioning

confidence: 99%

How Should Clinicians Respond if Patient HIV Denial Could Exacerbate Racial Health Inequities?

Lahey

2021

AMA Journal of Ethics

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This commentary examines the appropriateness of a clinician's deceiving a patient who will not discuss lifesaving therapy through the lens of solidarity, a key professional ethical value. Clinicians' awareness of social determinants of many patients' increased vulnerability to HIV infection is needed to promote equitable HIV intervention outcomes at both individual and community levels.To claim one AMA PRA Category 1 Credit TM for the CME activity associated with this article, you must do the following: (1) read this article in its entirety, (2) answer at least 80 percent of the quiz questions correctly, and (3) complete an evaluation. The quiz, evaluation, and form for claiming AMA PRA Category 1 Credit TM are available through the AMA Ed Hub TM . Case M is a 56-year-old Black man with human immunodeficiency virus (HIV) who is hospitalized with failure to thrive and dyspnea. Prior to hospitalization, M did not have an infectious disease or a primary care physician, and he was not taking antiretroviral therapy (ART). In the past 20 years, when physicians have tried to speak to M about his HIV diagnosis and benefits of ART, he has said, "I don't have HIV," or "I don't talk about that." M has a CD4+ count of 3 cells/μL. He is diagnosed with Pneumocystis jirovecii pneumonia, norovirus diarrhea, and acquired immune deficiency syndrome (AIDS) wasting syndrome. During hospitalization, his relationships with clinicians worsen; if a clinician mentions HIV, M breaks eye contact, becomes silent, and interacts minimally.An infectious disease specialist, Dr D, visits M to talk about his pneumonia. M consents to antibiotics to treat this infection and appears interested in strengthening his immune system "in other ways," as Dr D suggests. Dr D continues to use M's positive response as an opportunity to motivate M to take ART and is tempted to give M ART without saying it is HIV treatment. She is worried about deceiving M, taking unfair advantage of his lower health literacy, and upsetting him if he discovers that "immunity booster pills" are actually ART. Since low engagement with health care and worse health outcomes are prevalent in some communities of color and sometimes accompanied by

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Sex, violence and HIV on the inside: cultures of violence, denial, gender inequality and homophobia negatively influence the health outcomes of those in closed settings

Cited by 11 publications

References 26 publications

Caring Masculinities in the Context of HIV Serodiscordant Relationships in Papua New Guinea

Caring Masculinities in the Context of HIV Serodiscordant Relationships in Papua New Guinea

Media Exposure, Behavioural Risk Factors and HIV Testing among Women of Reproductive Age in Papua New Guinea: A Cross-Sectional Study

How Should Clinicians Respond if Patient HIV Denial Could Exacerbate Racial Health Inequities?

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