In lieu of an abstract, here is a brief excerpt of the content:Women on the Global Market: Irigaray and the Democratic StateNicole Fermon (bio)Best known for her subtle interrogation of philosophy and psychoanalysis, Luce Irigaray clearly also conducts a dialogue with the political, proposing that women’s erasure from culture and society invalidates all economies, sexual or political. Because woman has disappeared both figuratively and literally from society [see Sen, “More Than 100 Million Women Are Missing”], Irigaray conceives (...) the contemporary ethical project as a recall to difference rather than equality, to difference between women and men—that is, sexual difference. She characterizes relations between men and women as market relations in which women are commodities, objects, but never subjects of exchange, objects to men but not to themselves: women do not belong to themselves but exist “to keep relationships among men running smoothly” [TS 192]. Women under these conditions require imaginative ways to reconfigure the self, to subvert the melancholy and regression of masculinist economies and envisage a future in which women would not be ashamed of the feminine, would experience it as a positivity worth emulating.Irigaray contends that after the gains of egalitarian politics are carefully examined, the inclusion of women in the political arena has failed to take into account women’s distinct and different position from men, and from each other, as well as perpetuating the fiction of the “neutral” citizen, the ahistorical individual citizen of the nation-state. It is that fiction Irigaray dispels in her critique of liberal democratic politics and its creation, “citizens who are neuter in regard to familial singularity, its laws, and necessary sexual difference” [SG 112] in order to benefit the State and its laws. The subject is male; the citizen is neuter. Who is the female citizen in contemporary society? What is the ethical elaboration of the contractual relations between women and men, and between sexed individuals and the community? How do women imagine a distinct set of rights and responsibilities based on self-definition and autonomy, given the particular strictures of contemporary politics—that is, the market-driven, antidemocratic nature of the current economic national and global forces? Irigaray suggests that “the return of women to collective work, to public places, to social relations, demands linguistic mutations” and profound transformations, an embodied imagination with force and agency in civil life [TD 65].Irigaray warns that if civil and political participation is construed in overly narrow terms, if focus is on economic or judicial “circuits” alone, we overlook the symbolic organization of power—women risk losing “everything without even being acknowledged” [TD 56]. Instead an interval of recognition can expand the political to include the concerns and activities of real women, lest silence imply consent to sexual neutrality, or more likely, to women’s obliteration under men’s interests and concerns. Women’s insistence on self-definition and wage labor, on love and justly remunerated work, [End Page 120] testifies to the obduracy of women’s difference, one that is not likely to disappear. The patriarchal family is still the legal norm, even when certain exceptions are made, while enduring questions regarding women’s health and children’s physical welfare as priorities beyond market considerations are consigned to legislative obfuscation, still a political afterthought. Instead, in the US the liberal state removes the slender welfare net specific to women and children, Aid to Families with Dependent Children, and fails to provide medical coverage to those who are among the most vulnerable of its citizens. Women without access to the legal protection of sex-neutral citizenship, poor working women without language (the money for an effective “mouthpiece” to represent their distress in a court of law), are further disempowered by liberal politics’ insistence on sexual neutrality—that is, on repression or amnesia regarding the lived experiences of women.Sexual difference is key to any project of self-definition by women. Irigaray insists on the sexual nature of this self-definition, not solely for its obvious procreative necessity, but because the natural world is a source of renewal and fecundity which requires attentive interrogation and respect [SG 15]. This rebirth seems alien to the structure of male politics, which instead seem to provoke disasters (Bhopal, Chernobyl, or the current runaway... (shrink)

Feminist scholars have been critical of the expectations placed upon mothers to accomplish a perfect version of motherhood, but have often failed to interrogate the values about normalcy and disability imbedded in modern mothering ideologies. Mothers with disabilities are well positioned to expose the underlying beliefs about normalcy with which all mothers must contend. Drawing from interviews and focus groups conducted with mothers who have physical and sensory disabilities, I explore Deaf/disabled women’s experiences negotiating the scientific motherhood regime. Illuminating (...) a paradox, I argue these women are labeled “risky mothers” under scientific motherhood, which prizes the management of risk and the prevention of disability. Yet, these mothers are simultaneously rendered invisible by inaccessible and inflexible medical practices, and by a consumer market of expert advice which prescribes that mothers inhabit a typical body. These women’s experiences illuminate the normalcy project as a central tenet of scientific motherhood. (shrink)

Gender-based inequalities constrain women’s ability to participate in efforts to enhance agricultural production and reduce poverty and food insecurity. To resolve this, development organizations have targeted women and more recently “mainstreamed” gender within their agricultural aid programs. Through an analysis of agricultural-related development aid, we examine whether funded agricultural projects have increasingly targeted women and/or gender. Our results show that the number of agricultural aid projects and the dollar amounts targeting women/gender increased between 1978 and 2003. (...) However, the increase was modest and, as a percentage of all agricultural development aid, has declined since the late 1990s. Significantly, this decline occurs at a time when there are an increasing number of women engaged in agriculture. Our findings suggest that the rhetoric of gender mainstreaming outstrips efforts to develop projects aimed at women and gender inequality and that the concept may be being used to legitimize a decline in focusing explicitly on women. (shrink)

ABSTRACTThis article examines the way in which some biomedical ethicists have constructed sexually transmitted AIDS as a significant threat to women's health. We demonstrate that the familiar claim that‘women are the fastest growing group'— whether of HIV‐infected or of AIDS patients — is misleading because it obscures the distinction between proportional rate of growth and absolute increase. Feminist ethicists have suggested that misogyny of a male dominated health care system has led to underreporting of women (...) AIDS cases in order to support these feminists’claim of AIDS being a real threat to women's health. Given the apparent rarity of tertiary transmissions of AIDS, the assertion that most or even many women are at significant risk for AIDS seem wrong. Particularly disturbing in this campaign is the fact that the theme of‘risky sex’has been extended all the way to lesbians, even though their risk to acquire AIDS sexually is non‐existent to minuscule. We argue that actual harm is done to women by this exaggeration of their risk of contracting AIDS sexually. The scare has led to misappropriations of scarce health care funds. AIDS disproportionately affects women who inject drugs, and who suffer other diseases, poverty and malnutrition. It would have been better to concentrate health care efforts in this area instead of‘educating’women not at risk for AIDS how to prevent the acquisition of this disease. Unjustifiable AIDS anxiety has been created in women and has resulted in millions of unnecessary HIV‐tests, and many broken relationships. This anxiety has inevitably reduced the pleasure of having sex for many women. We reject the kind of‘victim ideology’that lies at the heart of this strategy which has, unfortunately, been supported by a number of influential feminist ethicists. (shrink)

This article examines the way in which some biomedical ethicists have constructed sexually transmitted AIDS as a significant threat to women's health. We demonstrate that the familiar claim that‘women are the fastest growing group'— whether of HIV-infected or of AIDS patients — is misleading because it obscures the distinction between proportional rate of growth and absolute increase. Feminist ethicists have suggested that misogyny of a male dominated health care system has led to underreporting of women (...) AIDS cases in order to support these feminists’claim of AIDS being a real threat to women's health. Given the apparent rarity of tertiary transmissions of AIDS, the assertion that most or even many women are at significant risk for AIDS seem wrong. Particularly disturbing in this campaign is the fact that the theme of‘risky sex’has been extended all the way to lesbians, even though their risk to acquire AIDS sexually is non-existent to minuscule. We argue that actual harm is done to women by this exaggeration of their risk of contracting AIDS sexually. The scare has led to misappropriations of scarce health care funds. AIDS disproportionately affects women who inject drugs, and who suffer other diseases, poverty and malnutrition. It would have been better to concentrate health care efforts in this area instead of‘educating’women not at risk for AIDS how to prevent the acquisition of this disease. Unjustifiable AIDS anxiety has been created in women and has resulted in millions of unnecessary HIV-tests, and many broken relationships. This anxiety has inevitably reduced the pleasure of having sex for many women. We reject the kind of‘victim ideology’that lies at the heart of this strategy which has, unfortunately, been supported by a number of influential feminist ethicists. (shrink)

This article examines the way in which some biomedical ethicists have constructed sexually transmitted AIDS as a significant threat to women's health. We demonstrate that the familiar claim that‘women are the fastest growing group'— whether of HIV‐infected or of AIDS patients — is misleading because it obscures the distinction between proportional rate of growth and absolute increase. Feminist ethicists have suggested that misogyny of a male dominated health care system has led to underreporting of women (...) AIDS cases in order to support these feminists’claim of AIDS being a real threat to women's health. Given the apparent rarity of tertiary transmissions of AIDS, the assertion that most or even many women are at significant risk for AIDS seem wrong. Particularly disturbing in this campaign is the fact that the theme of‘risky sex’has been extended all the way to lesbians, even though their risk to acquire AIDS sexually is non‐existent to minuscule. We argue that actual harm is done to women by this exaggeration of their risk of contracting AIDS sexually. The scare has led to misappropriations of scarce health care funds. AIDS disproportionately affects women who inject drugs, and who suffer other diseases, poverty and malnutrition. It would have been better to concentrate health care efforts in this area instead of‘educating’women not at risk for AIDS how to prevent the acquisition of this disease. Unjustifiable AIDS anxiety has been created in women and has resulted in millions of unnecessary HIV‐tests, and many broken relationships. This anxiety has inevitably reduced the pleasure of having sex for many women. We reject the kind of‘victim ideology’that lies at the heart of this strategy which has, unfortunately, been supported by a number of influential feminist ethicists. (shrink)

This article examines the way in which some biomedical ethicists have constructed sexually transmitted AIDS as a significant threat to women's health. We demonstrate that the familiar claim that‘women are the fastest growing group'— whether of HIV‐infected or of AIDS patients — is misleading because it obscures the distinction between proportional rate of growth and absolute increase. Feminist ethicists have suggested that misogyny of a male dominated health care system has led to underreporting of women (...) AIDS cases in order to support these feminists’claim of AIDS being a real threat to women's health. Given the apparent rarity of tertiary transmissions of AIDS, the assertion that most or even many women are at significant risk for AIDS seem wrong. Particularly disturbing in this campaign is the fact that the theme of‘risky sex’has been extended all the way to lesbians, even though their risk to acquire AIDS sexually is non‐existent to minuscule. We argue that actual harm is done to women by this exaggeration of their risk of contracting AIDS sexually. The scare has led to misappropriations of scarce health care funds. AIDS disproportionately affects women who inject drugs, and who suffer other diseases, poverty and malnutrition. It would have been better to concentrate health care efforts in this area instead of‘educating’women not at risk for AIDS how to prevent the acquisition of this disease. Unjustifiable AIDS anxiety has been created in women and has resulted in millions of unnecessary HIV‐tests, and many broken relationships. This anxiety has inevitably reduced the pleasure of having sex for many women. We reject the kind of‘victim ideology’that lies at the heart of this strategy which has, unfortunately, been supported by a number of influential feminist ethicists. (shrink)

This article focuses on the ways that sexual risk behaviors are related to race, class, and gender among low-income, culturally diverse women in South Florida. Data concerning sexual risk and gender are presented in terms of race and class variations. Results indicate that, in general, these women have a high degree of knowledge about acquired immune deficiency syndrome, a quite contemporary awareness of women's gendered subordination, and a lack of trust in heterosexual relationships. Attitudes, beliefs, (...) and knowledge, however, are not translated into sexual behaviors with men partners that would reduce their vulnerability to infection with the human immunodeficiency virus. The data indicate that race is a major factor that places women into an underclass position. Consequently, without socioeconomic resources, gendered behaviors have a direct influence on sexual risk. Multivariate analyses indicate that those women who are sex workers are significantly more likely to negotiate safe sex with clients than with main partners. The research not only challenges mainstream thinking about race, class, and gender but also provides overdue information on the vulnerability of women to HIV infection. (shrink)

This essay shows how South African Pentecostal teachings about sexuality, particularly HIV prevention and divorce, constrain women’s real and imagined choices. Institutional Review Board–approved fieldwork revealed the prevalence of wives remaining faithful to unfaithful husbands despite high risks of physical abuse and HIV infection. Maintaining the “ideal” of abstinence and faithfulness, male pastors actively oppose condom use and emphasize that “God hates divorce”. In this essay I engage and resist such hermeneutics. Using scripture as source and norm, I construct (...) an A-B-C-D prevention strategy to enhance women’s freedom: Abstain, Be faithful, use Condoms, or Divorce. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:“Homo-Ness” and the Fear of FemininityPatrick Paul Garlinger (bio)Leo Bersani. Homos. Cambridge: Harvard UP, 1995.Homos is a disturbing book, in the most literal sense of the word, for Leo Bersani’s goal throughout much of his text is precisely to disturb some of the widely accepted precepts of queer theory and gender performativity. As if the title alone were not enough to signal the text’s contestatory tone, the first sentence (...) of the prologue boldly declares that “no one wants to be called a homosexual” [1]. While many scholars might disagree with such an overwhelming generalization (myself included), it nonetheless reminds us that homosexuality continues to occupy an ambiguous position within contemporary society, an ambiguity perhaps most powerfully punctuated by the recent failure of gays and lesbians to secure legal access to the institution of marriage. In the first three chapters, Bersani interrogates topics such as gay identity, AIDS, queer theory, and sadomasochism. In the final chapter, “The Gay Outlaw,” he addresses the literary representation of homosexuality through radical rereadings of Gide, Proust, and Genet. Although no one single thesis coherently unites these chapters, a healthy spirit of suspicion begs the thorny question of what it means to be gay, and in so doing, explores the tenability of identity politics. Rejecting a politics of opposition that would bind our theorizations to the very heteronormative paradigms that they are attempting to resist, Bersani argues instead for ways to “explore the links between a specific sexuality, psychic mobility, and a potentially radical politics” [56].Identity, for Bersani (and other critics following Foucault), is an operation of power, a “disciplinary project” that is a tool at the service of identification and containment [3]. 1 Seen as essentialist, universalizing, or ontological, identity has received a bad rap. Indeed, the notion of a sexual identity as a fixed category invariably fails in its performative capacity to capture the myriad array of sexual acts that a given individual may feel compelled to perform. The failure of identity, however, should not lead to its elimination from our theoretical frameworks, Bersani proposes. He claims instead that the critique of identity in feminist and queer theory is ultimately destructive rather than liberating. At the [End Page 57] source of this dismissal of identity is the fear that visibility will result in “discipline and punishment,” but Bersani argues quite convincingly that this retreat from the domain of the visible colludes with the homophobic goal of eliminating homosexuality. On the other hand, Bersani acknowledges that identity and visibility are not wholly benevolent either: “[o]nce we agreed to be seen, we agreed to be policed” [12]. Visibility allows for domination and even annihilation, a possibility that Bersani considers in his discussion of AIDS, in which visibility can be seen as providing straight America with a front-row seat at the spectacle of gay death [21]. Nevertheless, that is a risk that must be taken. While not proposing a return to regulatory identity categories, Bersani wants to return to a gay specificity to prevent gays and lesbians from “performing” themselves out of existence. Responding to David Halperin and Judith Butler, for example, he argues that the rejection of essentializing identities as a mode of resisting homophobia erases the very agent of that resistance [56]. Fearful that the attacks on the notion of identity in the academy have simply collaborated in the marginalization of homosexuality, Homos attempts to offer “homo-ness” as an “anti-identitarian identity” [101], one that risks the pitfalls of essentialism and simultaneously transcends the limits of sexual orientation.Nowhere is his desire to rethink identity more clear than in his trenchant critique of the dismantling of gender by critics such as Butler, Monique Wittig, and Michael Warner. Suspicious of their deconstructive strategies, he argues that the undoing of the categories of gender inevitably leads to the elimination of homosexuality. The critique of gender in discussions of sexuality endangers any specificity that same-sex sexuality might have. For example, he writes, “‘men’ and ‘women’ in Wittig’s radical argument are political creations designed to give a biological mandate to social arrangements in which one group of human beings oppresses another” [38]. Within the social domain of... (shrink)

School-based sexuality education is a type of sexology directed at specific bodies: `unfinished' adolescent bodies in the process of becoming sexual bodies. This article explores notions of the adolescent `unfinished' body in the context of HIV/aids education for young people. Drawing on empirical research carried out in Australian secondary schools, we look at the concepts of the project of the self and reflexivity as they are articulated by young people in their evaluation of HIV/aids education. The open (...) character of self identity and the reflexively monitored nature of the body were emphasized by the young people in their attempted construction of intimacy and sexuality. The discourses of openness and trust and the reliance on both `expert' and `experiential' knowledges were evident in the ways in which they dealt with the risk of HIV/aids. The article concludes with a discussion of the implications of these data for the theorizing of risk and reflexivity. (shrink)

Ample research links mothers’ postpartum depression (PPD) to adverse interactions with their infants. However, most studies relied on general population samples, whereas a substantial number of women are at elevated depression risk. The purpose of this study was to describe mothers’ interactions with their 6- and 12-month-old infants among women at elevated risk, although with a range of symptom severity. We also identified higher-order factors that best characterized the interactions and tested longitudinal consistency of these factors (...) from 6 to 12 months of infant age. We leveraged data from eight projects across the United States (n = 647), using standardized depression measures and an adaptation of the NICHD Mother-Infant Interaction Scales. Overall, these depression-vulnerable mothers showed high levels of sensitivity and positive regard and low levels of intrusiveness, detachment, and negative regard with their infants. Factor analyses of maternal behaviors identified two overarching factors—“positive engagement” and “negative intrusiveness” that were comparable at 6 and 12 months of infant age. Mothers’ ability to regulate depressed mood was a key behavior that defined “positive engagement” in factor loadings. An exceptionally strong loading of intrusiveness on the second factor suggested its central importance for women at elevated depression risk. Mothers with severe depressive symptoms had significantly more “negative intrusiveness” and less “positive engagement” with their 6-month-old infants than women with moderate or fewer depressive symptoms, suggesting a potential tipping point at which symptoms may interfere with the quality of care. Results provide the foundation for further research into predictors and moderators of women’s interactions with their infant among women at elevated risk for PPD. They also indicate a need for evidence-based interventions that can support more severely depressed women in providing optimal care. (shrink)

This article’s central aim is to debunk the overly simplified, paradigmatic, and essentialist description of certain types of Muslim sexuality, arguing that such essentialist characterization of Muslims ignores the nonunique social determinants (poverty, education, and sociostructural exclusions) of HIV/aids risk in an increasingly globalized world. To support this argument, we rely on a thematic and comparative analysis. A reoccurring theme in this project is that issues of public health, human rights, justice, and social empowerment are inextricably intertwined. (...) Having established a conceptual framework linking health and human rights, we use a comparative analysis of the cases of Iran, Indonesia, and Bangladesh in an attempt to single out similarities and differences among these cases. All these cases hold a majority Muslim population (at 98%, 86%, and 89%, respectively) and are also representative of the two primary strands of Islam: Shi’a and Sunni. Additionally, each of these states has signed the Declaration of Commitment on HIV/aids and reports the progress of their HIV/aids treatment and prevention efforts to United Nations Program on HIV/aids, the United Nations organization tasked with monitoring and combating the spread of HIV/aids. (shrink)

Primary research on HIV/AIDS in India has predominantly focused on known risk groups such as sex workers, STI clinic attendees and long-distance truck drivers, and has largely been undertaken in urban areas. There is evidence of HIV spreading to rural areas but very little is known about the context of the infection or about issues relating to health and social impact on people living with HIV/AIDS. In-depth interviews with nineteen men and women infected with HIV who (...) live in rural areas were used to collect experiences of testing and treatment, the social impacts of living with HIV and differential impacts on women and men. Eight focus group discussions with groups drawn from the general population in the four villages were used to provide an analysis of community level views about HIV/AIDS. While men reported contracting HIV from sex workers in the cities, women considered their husbands to be the source of their infection. Correct knowledge about HIV transmission co-existed with misconceptions. Men and women tested for HIV reported inadequate counselling and sought treatment from traditional healers as well as professionals. Owing to the general pattern of husbands being the first to contract HIV women faced a substantial burden, with few resources remaining for their own or their children’s care after meeting the needs of sick husbands. Stigma and social isolation following widowhood were common, with an enforced return to the natal home. Implications for potential educational and service interventions are discussed within the context of gender and social relations. (shrink)

In 1992, the Walloon Region modified its investment incentive legislation. The new legislation applies the notion of SME to any business employing up to 250 people and which turnover does not exceed 20 million ECU, and replaces the former interest subsidies and capital premiums by a grant calculated as a percentage of investment. According to the size of the business, the activity sector and the area, the maximum aid may vary from 13 to 21 %. The grant total percentage is (...) calculated by summing up the percentage of aid obtained for five criteria under which job creation is by far the most important. The new legislation gives a partial answer to traditional criticisms against investment incentives. First of all it aims at reducing the risk of accelerated substitution of capital for Labour. Besides, it simplifies adminsitrative procedures and reduces the "sprinkling". It should also reduce the risk of inefficient allocation of resources thatarises when grants go to loss-making entreprises. But the question of whether investment incentives actually increase the level of investment remains largely unanswered. Evidence suggests that investment incentives might have contributed to attract foreign investments hut have little impact on thelevel of domestic investment. Nevertheless, as far as SMEs are concerned, public grants might contribute to increased investment not by reducing the cost or increasing the profitability of the project but rather by increasing the means available in the business. (shrink)

As its title is meant to suggest, this paper is a reply to Sir Tim Lankester’s article “International Aid: Experience, Prospects and the Moral Case”, published in the World Economics last year 1 . Therefore, I would like to begin by expressing my gratitude for the author’s responsiveness to my interest and queries in the area of development economics. The main point of Sir Lankester’s article was, I believe, to strengthen the case for international aid by showing first, that it (...) was not just a theoretical matter 2 and second, that its efficiency was not a self-evident fait accompli, but a still-to-achieve objective, entirely contingent upon human and institutional factors such as the will, interests, and past experience of donors, as well as the system of governance and existing policies from the recipient countries. Moreover, the human factor is actually two-fold, in the sense that one can focus either on the external part engaged in the aid mission – the donor –, or on the internal one – the recipient. Sir Tim Lankester looks into what motivates the former, whereas I intend to unpack the life-experience of the latter, for I strongly believe that what ultimately decides the success or failure of development projects has more to do with understanding their life situation, than with the actual quantum of aid. Although the two cases grounded on the above-mentioned claims may seem completely separated in Tim Lankester’s article for he allocates distinct sections to them, I have reasons to believe that they are not only inter-connected, but also deeply inter-dependent, which is crucial for the kind of existentialist scenario that I intend to outline here. In order to prove this, I am going to combine two sets of argumentative tools: one will be logical, the other – empirical. The former will help us address the issues at stake in Tim Lankester’s moral case, and find ways of strengthening it; the latter will help reminding the real goal of this attempt – which is to improve the prospects of aid missions in real-life scenarios, rather than in theory. The first, rather theoretical section will consist of an extended analysis of the moral case that Sir Lankester started to build. The focus will be not only on the supposedly fruitful aspects of social justice theories, but also on their potential risks; both heroes and villains will emerge from the analysis, and new leads will be discovered. The main criterion for testing whatever findings will remain the pragmatic one: questioning their implications on the life-experiences of the poor. The other approach that I have mentioned will consist of providing a description of life in a particular community, which I have known and learnt from. In this case, the ‘empirical’ obviously means more than just the use of examples – which can be invented, or refined: it actually involves relying on a set of personal experiences and convictions, thereby testifying in – rather than just advocating – the case for aid and development projects, under discussion here. Again, the purpose will be not so much to prove that my claim has the sort of objective validity that a theoretician would normally seek to achieve, as to enforce it by whatever relevant testimonies – be them contextual, perhaps even biased; in this case, the ‘biased’ aspect consists of using an example derived from lifeexperiences in a particular developing country: my own. And it is exactly what I regard as the strength of it; indeed, I would not be writing this, had I not learnt that lesson. (shrink)

Lack of supportive workplaces may be depriving babies and mothers of the health advantages of breastfeeding. This citizen science pilot project set out to engage women in photographing and sharing information on the available facilities for breastfeeding and expressing and storing breastmilk in Australian workplaces. While some useful insights were gained, the project failed in the sense that 234 people ‘liked’ the project Facebook page set up to recruit participants, but only nine photographs were submitted. The (...) heaviest loss of participation occurred after the ethics committee requirements were explained, in particular, the requirement for employer consent to take a photograph, or alternatively, for a participant to agree to bear the risk of taking a photo without permission. The ethics committee also made stipulations about the formality of language to be used. Thus, the project’s potential role as an enabler for health action was neutered. We argue that the ethics requirements worked contrary to our purpose and possibly acted to reinforce the powerlessness some women experience at work. (shrink)

Although the category “race” fails as a postulated natural kind, racial, ethnic, national, linguistic, religious, and other group designations might nonetheless be considered projectible insofar as they support inductive inferences in biomedicine. This article investigates what it might mean for group concepts in population genetics and genomics to be projectible and whether the projectibility of such predicates licenses the representation of their corresponding classes as natural kinds according to currently prevailing projectibility-based accounts of natural kinds. The article draws on a (...) case study from cancer genetics, specifically, breast cancer risk in Ashkenazi Jewish women. (shrink)

Because of risks of essentialism and homogenization, feminist theorists frequently avoid making precise ontological claims, especially in regard to specifying bodily connections and differences among women. However well-intentioned, this trend may actually run counter to the spirit of intersectionality by shifting feminists' attention away from embodiment, fostering oppressor-centric theories, and obscuring privilege within feminism. What feminism needs is not to turn from ontological specificity altogether, but to engage a new kind of ontological project that can account for the (...) material complexity of social space in the twenty-first century. Taking inspiration from the phenomenological concept of flesh as well as ecofeminism and María Lugones's theory of the colonial/modern gender system, this essay argues that our own flesh is related to that of others through lines of intercorporeal relations that collectively form topographies of flesh. When we attend to those material relationships present in a particular locality at a point in time, we are able to recognize topographical aggregates of beings that can serve as a basis for this new feminist ontology. An example from Toni Morrison's Beloved involving a human woman and a nonhuman one is used as a paradigm for thinking ontological connection and difference at the same time. (shrink)

Asian American women demonstrate higher rates of disordered eating than other women of color and comparable rates to European American women. Research suggests that leading sociocultural predictors, namely pressures for thinness and thin-ideal internalization, are predictive of disordered eating in Asian American women; however, no known studies have tested the intersection of sociocultural and culture-specific variables (e.g., ethnic identity, biculturalism, acculturative stress) to further elucidate disordered eating risk in this vulnerable, understudied group. Accordingly, this (...) class='Hi'>project used path analysis to simultaneously examine the role of sociocultural and culture-specific effects on disordered eating in Asian American college women (N = 430). Self-report measures assessing disordered eating, sociocultural (pressures for thinness; thin-ideal internalization) and culture-specific (ethnic identity, biculturalism, acculturative stress) variables revealed that a number of sociocultural and culture-specific factors are predictive of disordered eating. Consistent with prior research, heightened perceived pressures for thinness and thin-ideal internalization were predictive of disordered eating, and thin-ideal internalization partially mediated the relationship between pressures for thinness and disordered eating. Acculturative stress predicted disordered eating and fully accounted for the inverse relationship between biculturalism and disordered eating. Overall, findings highlighted the salience of sociocultural predictors for disordered eating in Asian American women and identified biculturalism and acculturative stress as culture-specific contributors that may uniquely impact vulnerability to disordered eating in Asian American women. Thus, the combined consideration of sociocultural and culture-specific factors may be important in disordered eating research and in the development of individualized treatment plans for Asian American women. (shrink)

Photo ID 279661800 © Sidewaypics|Dreamstime.com ABSTRACT Decolonization is complex, vast, and the subject of an ongoing academic debate. While the many efforts to decolonize or dismantle the vestiges of colonialism that remain are laudable, they can also reinforce what they seek to end. For decolonization to be impactful, it must be done with epistemic and cultural humility, requiring decolonial scholars, project leaders, and well-meaning people to be more sensitive to those impacted by colonization and not regularly included in the (...) discourse. INTRODUCTION Decolonization is complex. To successfully achieve decolonization, projects should incorporate the voices of those subjugated or silenced. Including such voices requires sincerely exploring who has been affected by colonialism or neocolonialism and how, as well as cultural sensitivity. In its basic use, decolonization refers to countries under colonial rule gaining independence or freedom from forms of subjugation. Additionally, scholars use the term to refer to efforts to dismantle neocolonialism and vestiges of colonialism. The process includes de-silencing subjugated voices.[1] I use decolonization in the latter way to refer to countries with technical independence. While arguably colonization ended formally with independence from colonizing powers, neocolonialism is the indirect, informal, and sometimes subtle control of the people, their economy, and political life despite formal independence from colonizing authorities. I conceptualize neocolonialism as a system that involves direct and involuntary control of another’s political, economic, or social life, impacting their worldview and ways of encountering the world. Decolonization may target actions, places, or systems like health care or AI to overcome the ills of colonialism and neocolonialism. It also may target knowledge and require rethinking how people develop their knowledge base. For example, if people grew up seeing an outside colonizer as superior, they would need to change their knowledge of superiority. Decolonization may target power, for example, changing who owns and distributes COVID-19 vaccines and who distributors exclude in the distribution of vaccines. Decolonization could require looking at those disempowered in the distribution process. Additionally, decolonization may target autonomy of persons by freeing people, ensuring human and individual rights, and respecting cultural traditions. Decolonization projects that try to de-silence by including the voices of those affected by colonialism and neocolonialism must examine inclusiveness in the context of the culture of the subrogated individuals. Examples of decolonization projects include making datasets inclusive of diverse peoples and places, returning to traditional food and eating practices, making sure hospitals in developing countries are led by locals and respectful of cultural traditions, returning unethically obtained artefacts or objects. Another project would be laying the groundwork for equality in formerly colonized countries to ensure that business ownership, education, and financial success will flow fairly to those previously victimized by colonization. Summarily, there are many strategies for decolonizing. However, it is worth asking whether the strategies have risks that undermine the goal of decolonization. I. Understanding Decolonization Discourses Many fields, from AI to politics, economics, health care, aviation, and academia, discuss decolonization. The content of the discourse on decolonization depends on the region and field discussing it. Rather than just reporting on decolonization, the discussions may be calls to action. For example, decolonization discourses reflect activism for cognitive justice, such as equal consideration of Indian or African knowledge systems in global health discourses.[2] In politics and political science, some scholars frame decolonization as an anti-western, anti-colonial movement by Africans to emancipate Africa/ns from subjugation or shift the continent to postcolonialism and post-neo-colonialism. This framing walls off non-African participants and may undermine their capacity to benefit the conversation.[3] There are other political scientists who actively support decolonization and see it as a field of activism in support of anyone and countries where colonization harmed people and development.[4] The point is that two ways of conceptualizing decolonization in politics and political science are discernible. One conceptualization is less inclusive since it alienates scholars and professionals from Western, high-income, or developed countries. The other is more inclusive. In humanitarian studies, including philosophy, some decolonization articles and conversations are efforts to end the destructive force of colonization. They focus on either the form, such as ecocide, genocide, and many others, or the geographic location, such as Africa, Asia, Latin America, and Oceania.[5] Finally, the feelings one brings into this conversation can adversely impact how one engages in them and who they listen to or are willing to hear from. For example, anger, rage, bitterness, and hatred are emotions that are not uncommon in spaces of decolonization conversations. Decolonization conversations that originate from a place of negativity risk deepening the psychological state of victimhood and prevent people from disrupting constructively or critically engaging in the conversation.[6] II. Understanding Decolonization Strategies Decolonization strategies mainly aim to de-silence victims of domination or subjugation. People have proposed many strategies for decolonizing. These strategies may be informed by what the target is for decolonization. Decolonization can target power relations in global health. For example, during the COVID-19 pandemic, public health organizations noted the power imbalance in vaccine distribution. Decolonization could involve de-silencing those affected by neocolonialism to bring about a more balanced distribution of power and a more fair distribution of the vaccine. By analyzing who was adversely impacted by the distribution and who ought to wield power, those engaged in decolonizing advocated for positive change and equitable power relations. Equally, when being is the target of decolonization, the language of unlearning or relearning and mental decolonization take centre stage in the decolonization discourse. For example, the quest to decolonize colonized minds aims to demythologize African inferiority and Western superiority. Demythologizing African inferiority enables those engaged in the decolonization discourse to cultivate and foster African agency.[7] Finally, when knowledge production is the target of decolonization, scholars use inclusion and cognitive justice. For example, they try to alter the knowledge that underlies global health ethics.[8] “[D]decolonizing researchers aim to respectfully understand and integrate theory from Other(ed) perspectives, while also critically examining the underlying assumptions that inform their Western research framework.”[9] One common strategy that scholars use in decolonization is inclusion. It is worth asking, does including people who have been subrogated foster decolonization? Whether that is effective depends on whether included people are more heard or whether the strategies to include them create new forms of silencing. III. Inclusion and the Quest to Decolonize Evaluating how effective inclusion is in the quest to de-silence subjugated voices is important. First, inclusive strategies are not neutral. They are epistemically situated. This situatedness constrains meaning-making in different ways: how and what questions are asked, how social roles are constructed, organized or assigned, and who is admitted to the room where these conversations occur.[10] Inclusion strategies may reinforce (unchallenged) assumptions. For example, to address prejudices and stereotypes in global health images, Arsenii Alenichev and his colleagues[11] successfully inverted “one stereotypical global health image” by prompting a generative AI to produce “an image of a traditional Indian or African healer healing a White Child.” Although there were some problems with the image of the White child, this innovation is a significant, useful effort to de-embed or strip global health images of problematic pictures that mythologize White superiority and Black inferiority. Yet it is possible that using categories like traditional Indian or African reinforces unchallenged assumptions, raising key questions regarding how language and words create new stereotypes. It is common to define traditional as non-conventional, unorthodox, and informal. Yet studies continue to reveal that non-scientifically appraised healing approaches in India or Africa are not only effective but also real, meaningful, fundamental, and primary care-seeking behaviours in many communities in these regions.[12] Suppose inclusive strategies are not un-situated. These conversations may be had within the structures, language, and spaces built by or connected to colonialism. The spaces, language, places, and structures in which these conversations occur can limit who can participate and how they participate. Importantly, some conditions are not conducive to participation as equals. The allocated time for the discussion could also constrain how individuals express themselves. It is unclear who is ultimately heard. Furthermore, epistemic situatedness of inclusion can impact decolonization conversations when participants are beneficiaries of, products of, and trained by structures and systems they seek to dismantle. To enhance the decolonization project and its goals, a pressing task is to unveil and question how the circumstances may inhibit activism. If the vestiges of colonialism continue to structure the decolonization discourse invisibly, the vestiges may undermine decolonization. For example, a public health discussion that includes white Western doctors and Western pharmaceutical executives in Africa may have many local Africans at the table but could still effectively devalue their input based on built-in assumptions and biases that are vestiges of colonialism. Second, exclusion and inclusion are also not binary. Individuals may experience exclusion, even while included (the phenomenon called internal exclusion). In other words, inclusion can fail to be substantial or become a means of enhancing optics, “a way of (un)consciously weakening the radical claims being pursued.”[13] For example, in South Africa, many institutions have made significant efforts to diversify their faculties due to the promulgation of the Employment Equity Act 55.[14] The act requires South African institutions to implement employment equity that redresses the history of harmful discrimination in the country. The act further requires transforming departments and institutional administrations. Although many recognize and support the need to transform departments in South Africa, the rhetoric of transformation departs sharply from the lived experiences.[15] This misalignment between the plan and practice is evident in the underrepresentation of black people and females in senior management teams, professorships in many universities and health departments, and positions of power in some South African institutions. Those selected in the transformation of the departments have also complained of being overworked. The burden of extra work undermines their ability to develop agency and voice in the space they now occupy or fulfil key requirements that have implications for their career trajectory.[16] This is called the minority tax. Notably, "the minority tax… is the burden of extra responsibilities [placed] on faculty of colour to achieve diversity and inclusion and contributes to attrition and impedes academic promotion."[17] One challenge for decolonializing projects will be for decolonial scholars and those selected for decolonization objectives to have the humility to decline invitations, requests, roles, and platforms for which they are either unqualified or lack the capacity to fulfil. At its heart, decolonization strategies must empower those included rather than weaken them. Finally, inclusion can lead to a phenomenon known as elite capture.[18] Elite capture occurs when socially advantaged individuals in a group monopolize or exploit activism to their own benefit at the expense of the larger, struggling group. Elite capture weakens decolonization efforts from within, revealing that those likely to benefit from global inclusive efforts are those who fulfil globally constructed standards, those “already present in the room.” There is no better strategy to weaken decolonial movements than weakening the project from within by strategically positioning individuals who share physical properties with the victims of exclusion and silencing but intellectually, behaviourally, psychologically, and emotionally share more common ground with the colonizer. Such insiders may be unaware they are furthering neocolonial conditions rather than decolonizing. In relation to decolonization, particularly in global health, elite capture reveals that those whose voices are loudest in the room are not necessarily those more impacted by colonialism. They may benefit more from reinforcing colonialism. Opportunism weakens meaningful activism from within, preventing good initiatives and strategies from having their intended impact or taking substantive root.[19] This paper cannot do justice to elite capture, but it is worth noting its negative impacts. IV. Improving the Impact of Decolonization To end neo-colonialism, it is important to understand how it manifests and what to do at each level. Beyond the academic discourse, many tangible efforts exist to decolonize through de-silencing. Examples of these efforts include the ME2 movement that seeks to centre the concerns and experiences of sexually abused or harassed victims in the public discourse. At the funding level, many grant-awarding agencies like Wellcome Trust have dedicated huge budgets to studies that help them understand how they may have perpetrated colonialism or neocolonialism and what they can do differently going forward.[20] In South Africa, promulgating the Employment Equity Act 55 was a tangible attempt to entrench decolonization concerns in a country's regulatory framework. Yet, these decolonization efforts could fail to be substantive if they do not reflect cultural sensitivity. Two key components of cultural sensitivity are worth highlighting here: epistemic and cultural humility. Epistemic humility is an intellectual virtue described as knowing one’s limitations and the limitations of the learning methods employed. At its simplest, it is the ability to admit when one is wrong. Cultural humility includes genuine attempts to learn about and embrace other cultures. Epistemic and cultural humility are signs of academic excellence and strength. Epistemic and cultural humility seriously acknowledge how the state of our knowledge, cognitive limitations, experiences, and backgrounds, while constraining us, also invite us to listen, learn, grow, and change. The limitations-owing account of epistemic and cultural humility suggests that “a person who is aware of her cognitive limitations and owns them is much better positioned to achieve such epistemic goods as true beliefs and understanding than someone who… simply has insight into the epistemic status of her beliefs.”[21] Epistemic and cultural humility may help prevent decolonization projects that unintentionally reinforce what they seek to dismantle. Epistemic humility calls on decolonizers to defer tasks for which they are not qualified to suitably qualified persons. Beyond this, humility supports brave scholarship that imagines and reimagines how featuring the same voices, faces, and perspectives possibly introduces new forms of domination or silencing. Cultural knowledge can lead to a more intentional way of seeking out the right people or a more diverse group than those frequently featured in decolonization conversations. This would give others more opportunities to navigate these spaces and should do so in ways that are familiar to them. One ought to be more sensitive to those who would ordinarily not be included in these conversations. Unless we radically and boldly reimagine these discussions, we risk alienating those most negatively impacted by neocolonialism. CONCLUSION Decolonization conversations are complex and the subject of academic debate. The strategies employed to decolonize can harm or help the victims of neo-colonialism. Inclusion of previously silenced individuals may not be enough to overcome the vestiges of colonialism, leading to a false inclusion, where those included feel excluded or contribute in ways reflecting their own biases and circumstances. Inclusion of an elite or people who do not truly represent the subjugated can lead to elite capture. For decolonization strategies to be impactful, for example, in the context of global health, project leaders and participants must engage in conversations employing epistemic and cultural humility. In many ways, epistemic and cultural humility can help us demythologize our assumptions of any cultural superiority or cognitive authority, allowing for diverse voices, cultures, and perspectives to emerge without domination. - [1] Caesar Atuire & Olivia Rutazibwa. 2021. An African Reading of the Covid-19 Pandemic and the Stakes of Decolonization. An African Reading of the Covid-19 Pandemic and the Stakes of Decolonization [Online]. Available from: https://law.yale.edu/yls-today/news/african-reading-covid-19-pandemic-and-stakes-decolonization [Accessed July 29, 2021 2021]. [2] Bridget Pratt & Jantina De Vries 2023. Where is knowledge from the Global South? An account of epistemic justice for a global bioethics. Journal of Medical Ethics, medethics-2022-108291. [3] Anye-Nkwenti Nyamnjoh 2023. Is decolonisation Africanisation? The politics of belonging in the truly African university. Social Dynamics, 1-20. [4] Rianna Oelofsen 2015. Decolonisation of the African mind and intellectual landscape. Phronimon, 16, 130-146. [5] Caesar Atuire & Olivia Rutazibwa. 2021. An African Reading of the Covid-19 Pandemic and the Stakes of Decolonization. An African Reading of the Covid-19 Pandemic and the Stakes of Decolonization [Online]. Available from: https://law.yale.edu/yls-today/news/african-reading-covid-19-pandemic-and-stakes-decolonization [Accessed July 29, 2021 2021]. [6] Pedro Alexis Tabensky 2008. The Postcolonial Heart of African Philosophy. South African Journal of Philosophy, 27, 285-295. [7] Nicholas M. Creary 2012. African Intellectuals and Decolonization, Ohio, Ohio University Press. [8] Bridget Pratt & Jantina De Vries 2023. Where is knowledge from the Global South? An account of epistemic justice for a global bioethics. Journal of Medical Ethics, medethics-2022-108291. [9] Vivetha Thambinathan & Elizabeth Anne Kinsella 2021. Decolonizing Methodologies in Qualitative Research: Creating Spaces for Transformative Praxis. International Journal of Qualitative Methods, 20, 16094069211014766. [10] Abimbola Seye 2023. Knowledge from the global South is in the global South. Journal of Medical Ethics, 49, 337. [11] A. Alenichev, P. Kingori & K. P. Grietens 2023. Reflections before the storm: the AI reproduction of biased imagery in global health visuals. Lancet Glob Health. [12] Jonathan K. Burns & Andrew Tomita 2015. Traditional and religious healers in the pathway to care for people with mental disorders in Africa: a systematic review and meta-analysis. Social Psychiatry and Psychiatric Epidemiology, 50, 867-877. [13] Anye-Nkwenti Nyamnjoh & Cornelius Ewuoso 2023. What type of inclusion does epistemic injustice require? Journal of Medical Ethics, jme-2023-109091. [14] 1998. Employment Equity Act. In: GOVERNMENT, S. A. (ed.) 19370. [15] Dina Zoe Belluigi & Gladman Thondhlana 2019. ‘Why mouth all the pieties?’ Black and women academics’ revelations about discourses of ‘transformation’ at an historically white South African university. Higher Education, 78, 947-963. [16] Juliet Ramohai & Khomotso Marumo 2016. Women in Senior Positions in South African Higher Education: A Reflection on Voice and Agency. 231, 135-157. [17] J. Trejo 2020. The burden of service for faculty of color to achieve diversity and inclusion: the minority tax. Mol Biol Cell, 31, 2752-2754. [18] Olufemi Taiwo 2020. Being-in-the-Room Privilege: Elite Capture and Epistemic Deference. The Philosopher, 108, 7. [19] Margarita Kurbatova & Elena Kagan 2016. Opportunism of University Lecturers As a Way to Adaptate the External Control Activities Strengthening. Journal of Institutional Studies, 8, 116-136. [20] Jeremy Farrar. 2022. An update on Wellcome's anti-racist programme. An update on Wellcome's anti-racist programme [Online]. Available from: https://wellcome.org/news/update-wellcomes-anti-racism-programme [Accessed August 10, 2022 2022]. [21] Katherine Dormandy 2018. Does Epistemic Humility Threaten Religious Beliefs? Journal of Psychology and Theology, 46, 292-304. (shrink)

The perpetual decline of Zimbabwe’s socio-economic situation can be found in the country legalising prostitution, which it used to regard as an act of criminality. This legalisation promoted the trade from being an offense to a lifestyle and from being an act of immorality to a profession. Prostitutes were also advanced from being social outcasts to commercial sex workers. Although the law appeared to financially empower prostitutes, its negative impact is seen in the level it dehumanises teen girls as they (...) turn themselves into sex objects. Cases of school dropouts among teen girls and human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are some of the evidences of the negative impact of prostitution, caused by their belief that ‘unprotected sex pays more’. The location of the study was Epworth Booster in Harare, Zimbabwe. Using an African feminist theology framework, this article aims to analyse how women’s theology can be used as a panacea to restore dignity and hunhu-ism to the teen girls whose bodies have been exposed to abuse by their purported fathers. The article uses both unstructured and focus group interviews to collect data from three health personnel and 10 teen girls, respectively. The article grapples with the fact that the legalisation of prostitution in Zimbabwe seriously affected both the social and religious life of teen girls as they risk their lives in order to earn a living, and African feminist theology should be applied to defend these vulnerable girls.Contribution: In the context of socio-economic depletion and laws that suppress women in the name of empowering them, rereading and application of women’s theology should protect women and offer them a future with hope. (shrink)

Summary Recent research has highlighted the risk of HIV infection for married teenage women compared with their unmarried counterparts (Clark, 2004). This study assesses whether a relationship exists, for women who have completed their adolescence (age 20–29 years), between HIV status with age at first marriage and the length of time between first sex and first marriage. Multivariate analysis utilizing the nationally representative 2004 Cameroon Demographic and Health Survey shows that late-marrying women and those with a (...) longer period of pre-marital sex have the highest risk of HIV. Although women in urban areas overall marry later than their rural counterparts, the positive relationship between age at marriage and HIV risk is stronger in rural areas. The higher wealth status and greater number of lifetime sexual partners of late-marrying women contribute to their higher HIV risk. Given that the age at first marriage and the gap between first marriage and first sex have increased in recent years, focusing preventive efforts on late-marrying women will be of much importance in reducing HIV prevalence among females. (shrink)

Adoption of the Millennium Development Goals triggered much discussion among donor states, multilateral institutions, and developing countries towards changing dysfunctional patterns of interaction that seemed to put the MDGs at risk from their inception. Initially in these high-level discussions, accountability was understood in a state-centric way, primarily as accountability to donors. This needed to be modified with the shift towards developing-country ownership of development strategies and programs. Yet an even greater change was in store when civil society organizations were (...) included in the discussions, since their focus was on accountability to project-affected persons and communities. Hence a new and irreducible conception of accountability came on stage. I characterize this as accountability to the subjects of development and show how it is required and justified by development ethics, based on values of agency and justifiability. This results in a dual standard for accountability: reducing stakeholders’ vulnerability to harmful and inequitable outcomes, and ensuring the justifiability of development projects to affected persons and communities. (shrink)

The onset of the electronics-based information revolution will augur changes in the sociological perceptions of 'suitable careers' for women. This phenomenon is particularly evident in rural Appalachia. A planned, systematic delivery system was designed, developed, and implemented by Southwest Virginia Community College to introduce women to the challenges and possibilities of technical careers. This was accomplished through a gradualized phase-in to Technological Literacy, followed by in-depth involvement, culminating in an industrial internship experience. A special curriculum was designed to (...) ease the transition of the women, most of whom were homemakers, into the fast-paced mainstream of the academic environment. Duration of the introductory segment was one academic quarter. All project participants were clustered in a peer group, led by the project director, a trained counselor. In addition to a central course on Career Directions for Women, the program design emphasized Industrial Dynamics, the variety of uses possible with "user-friendly" microcomputers, Computer-Assisted Drafting, Electronics Instrumentation, Mathematics and Communications. Field experiences and visits to area industries were integrated into the program plan, as were visits from women who had achieved success in technical careers. Particular efforts were made to arrange for visits by the limited number of women alumni from the college's technical programs. Students were then mainstreamed into a regular program in Electronics or Computer Aided Drafting in the intermediate segment. Students are given a closer look at the industrial sector in the final segment. An examination of the social structure in Appalachian Virginia is presented, together with an albeit tentative prediction of the implications for female wage earners in this highly traditional region, so dependent heretofore on coal mining. Finally, the concept of whether this effort will lead to evolution, rather than revolution, is discussed. While covering a somewhat homogeneous and unique population cluster, the action blueprint outlined can be applied to other population groups in the U.S. and abroad. (shrink)

Recent global advances in available technology to prevent mother-to-child HIV transmission necessitate a rethinking of contemporary and previous ethical debates on HIV testing as a means to preventing vertical transmission. In this paper, we will provide an ethical analysis of HIV-testing strategies of pregnant women. First, we argue that provider-initiated opt-out HIV testing seems to be the most effective HIV test strategy. The flip-side of an opt-out strategy is that it may end up as involuntary testing in a clinical (...) setting. We analyse this ethical puzzle from a novel perspective, taking into account the moral importance of certain hypothetical preferences of the child, as well as the moral importance of certain actual preferences of the mother. Finally, we balance the conflicting concerns and try to arrive at an ethically sound solution to this dilemma. Our aim is to introduce a novel perspective from which to analyse testing strategies, and to explore the implications and possible benefits of our proposal. The conclusion from our analysis is that policies that recommend provider-initiated opt-out HIV testing of pregnant mothers, with a risk of becoming involuntary testing in a clinical setting, are acceptable. The rationale behind this is that the increased availability of very effective and inexpensive life-saving drugs makes the ethical problems raised by the possible intrusiveness of HIV testing less important than the child's hypothetical preferences to be born healthy. Health care providers, therefore, have a duty to offer both opt-out HIV testing and available PMTCT (preventing mother-to-child transmission) interventions. (shrink)

In 1999, Médecins Sans Frontières set out to explore and demonstrate the feasibility of preventing and treating HIV/AIDS in a so-called resource-poor, economically and socially disadvantaged setting. The first MSF mission to incorporate antiretroviral treatment into its HIV-AIDS-oriented medical program was undertaken in Bangkok. The second project was launched in Khayelitsha where MSF has been providing ARV treatment for persons with HIV/AIDS since May 2001. Khayelitsha is an enclave of some 500,000 inhabitants, most of whom live (...) in corrugated-iron shacks, without running water or electricity. Unemployment is extremely high; crime and violence are rampant. The general prevalence of HIV/AIDS is 26%, measured among pregnant women. The tuberculosis incidence rate is one of the world's highest for open-space sites. Unsurprisingly, TB/HIV coinfection is very high too: 63% of those with TB are also infected with HIV. (shrink)

Behavior change is the only available means of curtailing new HIV infections in South Africa. This study investigated the relationship between sexual risk taking and attitudes to AIDS precautions. The participants were about 25% white, about 30% colored/mixed blood and 45% black in their second year in polytechnics (413 females and 402 males). Participants responded to the 40-item HIV-related knowledge, attitudes and behaviors. Data indicated that young women showed more positive attitudes to AIDS precautions than young (...) men (reflecting in part the stereotypic negative attitudes of young men toward condoms). In general, most males and females were found to have less knowledge about HIV transmission and less favorable attitudes toward safe sex behavior than their counterparts in the west. Also young men with more partners expressed more fatalistic attitudes toward AIDS. The possibility that a finergrained multivariate analysis of attitudes to AIDS and safe-sex behaviour is something that needs to be taken seriously in future research, however. (shrink)

Urban agriculture is an important source of food and income throughout Africa. The majority of cultivators on the continent are women who use urban agriculture to provide for their family. Much research on urban agriculture in Africa focuses on the material benefits of urban agriculture for women, but a smaller body of literature considers its social and psychological empowering effects. The present study seeks to contribute to this debate by looking at the ways in which urban agriculture empowers (...) women on the Cape Flats, a region of Cape Town where urban agriculture is supported by nongovernmental organisations. Based on interviews with cultivators, the findings show that NGO-run urban agriculture projects not only aid food security, but also help women to develop supportive networks that unlock benefits across the personal, social and economic spectrum. (shrink)

This paper investigates the effect of female representation on the board of directors on corporate response to stakeholders’ demands for increased public reporting about climate change-related risks. We rely on the Carbon Disclosure Project as a sustainability initiative supported by institutional investors. Greenhouse gas emissions measurement and its disclosure to investors can be thought of as a first step toward addressing climate change issues and reducing the firm’s carbon footprint. Based on a sample of publicly listed Canadian firms over (...) the period 2008–2014, we find that the likelihood of voluntary climate change disclosure increases with women percentage on boards. We also find evidence that supports critical mass theory with regard to board gender diversity. These findings reinforce initiatives being undertaken around the world to promote gender diversity in corporate governance while demonstrating board effectiveness in stakeholder management. (shrink)

As COVID-19 keeps impacting the world, its impact is felt differently by people of different sexes and genders. International guidelines and research on gender inequalities and women’s rights during the pandemic have been published. However, data from Taiwan is lacking. This study aims to fill the gap to increase our knowledge regarding this issue and provide policy recommendations. This study is part of a more extensive project in response to the fourth state report concerning the implementation of the (...) Convention on the Elimination of All Forms of Discrimination against Women in Taiwan in 2022. We have drawn on the guidelines and documents published by the United Nations human rights bodies, conducted interviews with advocacy and professional practitioners, and hosted a study group comprising students and teachers from the National Taiwan University College of Public Health to supplement the interview data. The data were analyzed thematically. The results include five themes: (1) particular health risks to carers (primarily women); (2) COVID-related measures’ impact on women’s health and health behaviors; (3) highly gendered psychological maladjustment; (4) increase in gender-based violence and domestic violence; and (5) mental health inequities and intersectionality. The study has global implications for societies of similar sociopolitical contexts and developmental statuses. To truly live up to the standard of CEDAW and other international human rights principles, we ask that central and local government be more aware of these lived experiences and adjust their policies accordingly, accounting for gender sensitivity. (shrink)

Background: Adolescence is a period with physical, psychological, biological, intellectual, and social changes in which there is usually little perception of risk. COVID-19 has generated constant situations of change and uncertainty worldwide. During the pandemic, the acquisition of preventive behaviors has been relevant. Various studies carried out with adults associate risk perception and the implementation of preventive behaviors with knowledge about the COVID-19 and with age, but there are not many studies with adolescents. Therefore, the objective is to (...) validate, in Spanish, the questionnaire of the knowledge, attitudes, risk perceptions, and practices of adolescents toward the pandemic, and analyze it according to sociodemographic characteristics.Method: This study was a descriptive cross-sectional study, which included adolescents between the ages of 12–18. First, a translation and a back-translation of the questionnaire were performed. The questionnaire was presented in several high schools chosen by convenience sampling and following a non-probabilistic snowball sampling. Reliability and validity analyses were then carried out and the relationships between the different sociodemographic variables were analyzed.Results: The reliability of the questionnaire is acceptable. Knowledge was higher in women, and in those with a higher level of education; and were lower in those who lived in smaller towns, as well as in those who had a member of their family receiving financial aid. In terms of attitudes and risk perceptions, younger adolescents had higher scores, and those who had a member of their family receiving financial aid, lower.Conclusion: The questionnaire is a reliable tool in the Spanish adolescent population. Knowledge was influenced by gender, place of residence, level of education, and financial aid. Attitudes and risk perceptions were influenced by age and financial aid. For practices, no predictors were found. In general, adolescents scored lower on knowledge about COVID-19, but they scored higher on COVID-19 safety practices. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Broken Bodies and Healing Communities: The Challenge of HIV and AIDS in the South African ContextEmily Reimer-BarryBroken Bodies and Healing Communities: The Challenge of HIV and AIDS in the South African Context Edited by Neville Richardson Pietermaritzburg, South Africa: Cluster Publications, 2009. 209 pp. $12.00.The township of Mpophomeni, like many communities in South Africa, has been tragically devastated by HIV/AIDS. Christian churches in the region (...) have responded to this ongoing crisis in a variety of ways. In this collection of essays, edited by Neville Richardson, a team of international scholars from various subfields has combined ethnography and qualitative research with theology, with the goal of understanding how Christian churches have responded to the needs of the people of Mpophomeni. This book is the result of a two-year collaborative research project. The title of the book alerts the reader to two major themes of the unfolding narrative: the reality of brokenness, suffering, and sin (individual, interpersonal, social, and ecclesial) and the goal of healing (again, individual, interpersonal, social, and ecclesial). The ten chapters, individually authored, are divided thematically into three sections: Part 1, “Healing and Community: Perspectives from Zulu Culture and Religion”; Part 2, “Caring, Healing and Faith Communities”; and Part 3, “Caring and Community: Training in a Hospital Setting.” As perhaps expected, the authors’ conclusions remain ambivalent. James R. Cochrane explains: “Religion per se is not innocent of breaking bodies, which should always stand as a warning to us. But religion per se is also the source of healing; indeed, in some ways it is all about healing or wholeness, in relation to the sacred” (115). Churches in Mpophomeni have been “protective spaces” (11), “bridging communities” (91), and “broken bodies” that remember and re-member “the broken body of Jesus” (145–51). But communities are also in flux (101) and are sources of discourse that stigmatizes and shames (172).The book presents clearly argued and compelling essays that work independently and could be read or adopted for class as individual essays. The authors approach some of the same difficult questions from different vantage points, methodological foundations, and subdisciplines. For example, in the first two chapters Sidsel Roalkvam and Jone Salomonsen describe the many social problems in Mpophomeni, including poverty, unemployment, gender inequalities, sexual violence, drug and alcohol addiction, and criminal violence. But their [End Page 225] ethnographic research uncovers some of the rituals of healing that help the community to cope, including the practice of communal “strong prayer” (11–15), and uMemulo rite of passage for girls (23–37).However, I wish there were more coherent conversation between the authors of each individual essay. While Richardson explains that the research was collaborative “not only in terms of interaction between the researchers and the community but also among the researchers themselves” (ix), this collaboration between the researchers is not obvious to the reader in the final format of the book. Perhaps another book format would have more fruitfully conveyed this collaborative stance (for example, the inclusion of responses to each chapter or the addition of a roundtable discussion chapter or coauthored chapters).The ethnographic data presented in the third section is particularly rich and challenging for theology, but the authors could have spent more time unpacking, contextualizing, and analyzing the included quotations from patient–chaplain conversations. If, for example, the story of a thirty-three-year-old HIV+ man who allegedly raped a fifteen-year-old girl to give her “a good lesson for her life” so that she will not dress provocatively is “very characteristic of the material” in the study (203–5), much more needs to be said to explain how pastoral care interventions can address the stated “gender inequalities and the drastically different roles of men and women resulting in the vulnerable position of women” (206).The book is a must-read for scholars working on HIV/AIDS and Christian ethics. It could also provide supplemental readings for an undergraduate or graduate course in this area. [End Page 226]Emily Reimer-BarryUniversity of San DiegoCopyright © 2012 Society of Christian Ethics... (shrink)

In Brazil, every study involving human beings is required to produce an informed consent form that must be signed by study participants: this is stated in Resolution 196/96. 1 Consent must be obtained through a specific structured process. Objective: To present the opinions of women regarding how the process of obtaining informed consent should be conducted when women are invited to participate in studies on contraceptive methods. Subjects and Methods: Eight focus groups were conducted, involving a total of (...) 51 women living in the metropolitan region of Campinas. The women involved in the study were either participating in a clinical trial in the area of women's health or had participated in such a trial in the previous 12 months. A thematic guide was used to conduct the focus group discussions; the discussions were recorded, transcribed and a thematic analysis performed. Results: In general, the person who invites a woman to participate in a study should be a member of the research team but not the principal investigator. Information relating to the study should be given orally and in writing, both individually and in the group setting. Study volunteers should be informed about, among other things, the risks, possible side effects and discomforts, including long-term effects. The use of audiovisual aids to provide information was suggested. Conclusion: The process for obtaining informed consent was seen as a means of establishing a relationship between the volunteers and the investigator/research team. The information that the study participants expected to be given coincides with the requirements established under Resolution 196/96. The use of audiovisual aids would improve understanding of the information provided. (shrink)

Tests for hereditary predispositions to breast and ovarian cancer have figured among the first medical applications of the new knowledge gleaned from the Human Genome Project. These applications have set off heated debates on general issues such as intellectual property rights. The genetic diagnosis of breast cancer risks, and the management of women “at risk” has nevertheless developed following highly localized paths. There are major differences in the organization of testing, uses of genetic tests, and the follow (...) up of patients. This article studies testing practices and ways of managing breast cancer risk in France and compares them with those in the United States and United Kingdom. It shows how the complex interaction between global and local factors shapes the multiple meanings assumed by the phrase cancer risk. (shrink)

Martínková et al provide an overview of a tendency to use gender terms in key sports contexts, including eligibility criteria and testing, where gender is unintended. They argue that to avoid conceptual confusion and aid clarity, we should disentangle gender and sex, acknowledging that often gender talk should be interpreted as talk of sex. One of their recommendations is that the labels of competitive categories ‘women’s’/’men’s’ should change to ‘female’/’male’. I first make their argument against gendered labelling more precise (...) by showing that important yet neglected moral and practical reasons support their abandonment. I then argue that in the case of WA regulations, those moral reasons also cut against Martínková et al.’s relabelling proposal ‘female’/’male’. I sketch a testosterone-based proposal which circumvents the problem and which WA itself should accept. More generally, I argue we should be more mindful of the risk that competitive category labels unnecessarily harm athletes. (shrink)

Biologists are faced two questions which are new in their fields. How far to go in genetical research? How should new findings be applied?Theoretically, the answers are not so difficult to find. Research should not be halted or even slowed down. On which basis should we limit knowledge, it would even be on topics such as cancer, AIDS, ageing,…, a crime against humanity not to develop research. Also theoretically, findings would be applied for the good of humanity and for (...) a better health. But, negative consequences can, however, be expected if applications of research, and research itself, serves interests of private companies or of individuals. We cannot deny the advantages of the HGP which are considerable indeed in discovering, isolating, describing, sequencing genes, using in genie therapy,…, developing a better predictive medicine.But rules, and probably laws, will have to be developed to protect the confidentiality of genetical information, the risk being present that insurance companies or employers would use it to discriminate the individuals. People can not be defined only by their genomes. Individuals or populations cannot be stigmatised or ostracised by their genes. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Protecting Human Research SubjectsThe Office for Protection from Research RisksJoan Paine Porter (bio)The office for Protection from Research Risks (OPRR), located within the National Institutes of Health, has two divisions: Human Subject Protections and Animal Welfare. This article will address the overall responsibilities and current projects relating to human subject protections.OPRR implements the Department of Health and Human Services' (HHS) regulations for the protection of human subjects (45 CFR (...) 46 (1991)). These regulations fulfill the responsibilities set forth in the Public Health Service (PHS) Act with regard to institutional review boards (IRB) and other protections for human subjects involved in biomedical and behavioral research conducted or supported by HHS. The PHS Act also mandates a program to clarify ethical issues in biomedical research involving human subjects and to address violations of the rights of human subjects of research (P.L. 99-158 (1985)).OPRR staff negotiate assurances of compliance with institutions conducting Federally-supported research involving human subjects. The assurances describe the policies and procedures each institution will follow to fulfill the requirements of the regulations, including specific IRB composition and functions.In addition, OPRR cosponsors with the Food and Drug Administration and awardee institutions a series of regional workshops that address human subject protections issues. These are attended by IRB members, institutional officials, research investigators, and others involved with human subject protections.Current ActivitiesNumerous activities are underway in OPRR. The following describes only a few of the initiatives and studies aimed at helping develop policies and procedures to protect human subjects of research."Points to Consider" DocumentsOPRR is currently working with the National Center for Human Genome Research (NCHGR) to develop a "points to consider" document for IRBs and others involved in large genetic pedigree studies. Many questions have emerged [End Page 279] on topics such as how subjects should be recruited, with whom information should be shared about others in the family, social risks of disclosure in employment and insurance, the circumstances and timing of informing subjects about study results, and involvement of children. OPRR and NCHGR hope to assemble a group this fall to review and refine the points that are now being developed jointly. A conference in South Carolina organized by the American Association for Advancement in the Sciences entitled "Project on the Ethical and Legal Implications of Genetic Testing," helped generate advice, and identified some of the more controversial issues in design and conduct of genetic research that involves large groups of family members.Another "points to consider" effort concerns enrollment of women and minorities in research. The PHS has established a policy that members of these groups must be included in research projects unless there are valid scientific justifications for their exclusion which can be made on a project by project basis (ADAMHA/NIH Policy 1990; NIH/ADAMHA Policy 1990). OPRR has commissioned several scholarly papers to help in developing "points to consider" for IRBs as they balance issues of equitable selection of subjects and protection of these selected individuals. Concerns about enrolling women of childbearing age in research that may be harmful to a fetus, and liability issues frequently dominate discussion in this area. The papers will address ethical, legal, and statistical aspects of enrollment of minorities and women as well as provide a description of various practices and roles of IRBs in addressing goals of fair selection of participants and appropriate protections.OPRR is also working with the PHS Panel on Women, Adolescents and Children to produce a document, also in the form of "points to consider" guidance, concerning enrollment of children who are wards of the state in HIV-related research. Subpart D of the regulations for the protection of human subjects (45 CFR 46) specifically addresses research involving children who are wards of the state, including the special protections that must be provided. State and local officials who have authority to enroll foster care children in research have indicated a desire to obtain advice in this area.The IRB GuidebookA major project that is now being completed under contract to the Poynter Center at Indiana University is the IRB Guidebook. It will revise and expand the current IRB Guidebook produced in the 1980s... (shrink)

Purpose This paper aims to critically assess approaches to sex and gender in the Human Brain Project as a large information and communication technology project case study using intersectionality. Design/methodology/approach The strategy of the HBP is contextualised within the wider context of the representation of women in ICT, and critically reflected upon from an intersectional standpoint. Findings The policy underpinning the approach deployed by the HBP in response to these issues parallels Horizon 2020 wording and emphasises economic (...) outcomes, productivity and value, which aligns with other “equality” initiatives influenced by neoliberalised versions of feminism. Research limitations/implications Limitations include focussing on a single case study, the authors being funded as part of the Ethics and Society Subproject of the HBP, and the limited temporal period under consideration. Social implications The frameworks underpinning the HBP approach to sex and gender issues present risks with regard to the further entrenchment of present disparities in the ICT sector, may fail to acknowledge systemic inequalities and biases and ignore the importance of intersectionality. Shortcomings of the approach employed by the HBP up to March, 2018 included aspects of each of these risks, and replicated problematic understandings of sex, gender and diversity. Originality/value This paper is the first to use an intersectional approach to issues of sex and gender in the context of large-scale ICT research. Its value lies in raising awareness, opening a discursive space and presenting opportunities to consider and reflect upon potential, contextualised intersectional solutions to such issues. (shrink)

This paper uses lines of argument drawn from Amartya Sen's Idea of Justice to support the notion that NGO efforts, far from being oppressive, are helpful and progressive. It cites the work of Lairap‐Fonderson and Chen, and alludes to specific projects. Contrast is made with Rawls, and the paper suggests that more formal theories of justice may not enable us to grapple with our intuitive sense that justice for the poverty stricken involves, at a minimum, both financial progress and forward (...) movement with respect to internal growth. Examples of work done by NGOs in Bangladesh and other places help us to realize that women in these areas often have their own sense of what a more just situation would require—and NGOs and others can work from these conceptions as a point of departure. Part of the conclusion here is that Sen's concept of the just is a step in the right direction. (shrink)

SummaryA number of authors have identified multiple concurrent sexual partnerships by both men and women to lie at the root of the HIV/AIDS epidemic in sub-Saharan Africa. This study applies multilevel models to Demographic and Health Survey data collected during 2003–2008 in 20 sub-Saharan African countries to examine the influence of social and cultural context on involvement with multiple sexual partnerships in the region, above and beyond the effects of individual characteristics. The findings provide support for the ecological (...) argument that health behaviours are shaped and determined by societal conditions, in addition to the effects of individual and household characteristics. Involvement with multiple sex partners is most prevalent in societies in which sexual norms are widely permissive and where polygyny is common. Individual autonomy is substantial and attitudes towards sexuality are more liberal among men and women who live in communities in which sexual norms are widely permissive. Men and women who are most likely to have multiple sex partners in the sub-Saharan region are those who initiated sexual activity earlier and those who have the individual attributes that bring to them more rights and/or decision-making autonomy, but not necessarily more financial resources and economic security. On the other hand, involvement with multiple partners is determined by cultural norms and social change. The findings suggest a number of opportunities for more effective policy and programmatic responses to curb the prevalence of multiple partnerships in sub-Saharan Africa. (shrink)

Alternatives to convenience sampling (CS) are needed for HIV/STI surveillance of most-at-risk populations in Latin America. We compared CS, time space sampling (TSS), and respondent driven sampling (RDS) for recruitment of men who have sex with men (MSM) and transgender women (TW) in Lima, Peru. During concurrent 60-day periods from June-August, 2011, we recruited MSM/TW for epidemiologic surveillance using CS, TSS, and RDS. A total of 748 participants were recruited through CS, 233 through TSS, and 127 through RDS. (...) The TSS sample included the largest proportion of TW (30.7 %) and the lowest percentage of subjects who had previously participated in HIV/STI research (14.9 %). The prevalence of newly diagnosed HIV infection, according to participants' self-reported previous HIV diagnosis, was highest among TSS recruits (17.9 %) compared with RDS (12.6 %) and CS (10.2 %). TSS identified diverse populations of MSM/TW with higher prevalences of HIV/STIs not accessed by other methods. (shrink)

The mother–adult daughter relationship has been highlighted in both the social sciences and the public health literature as an important facet of social support networks, particularly as they pertain to maternal and child health. Evolutionary anthropologists also have shown positive associations between support from maternal grandmothers and various outcomes related to reproductive success; however, many of these studies rely on proximity as a surrogate measure of support. Here I present data from the Puerto Rican Maternal and Infant Health Survey (PRMIHS) (...) comparing geographic proximity of mother and daughter with a self-reported measure of mother-to-daughter support. These two measures were used to predict infant health outcomes as well as various measures of instrumental and emotional aid provided during pregnancy and after birth. Primary support was shown to have a positive effect across the analyses, whereas geographic proximity was associated with an increased risk of infant mortality and low birth weight as well as reduced odds of receiving support. This paradox was then examined using a combination variable that teased out the interactions of maternal support and proximity. Women who were geographically close to their mothers but who did not consider them a primary source of support had increased odds of infant death and low birth weight, and were less likely to receive either tangible or intangible forms of aid, while women whose mothers were both close and primary showed uniformly positive outcomes. These results place the role of propinquity within the larger context of social support and highlight the need for more detailed studies of social support within evolutionary anthropology. (shrink)

Context: Despite much research on informed choice and the individuals’ autonomy in organised medical screening, little is known about the individuals’ decision-making process as expressed in their own words.Objectives: To explore the decision-making process among women invited to a mammography screening programme.Setting: Women living in the counties of Sør- and Nord-Trøndelag, Norway, invited to the first round of the Norwegian Breast Cancer Screening Program in 2003.Methods: Qualitative methods based on eight semistructured focus-group interviews with a total of 69 (...) women aged 50–69 years.Results: The decision to attend mammography screening was not based on the information in the invitation letter and leaflet provided by the NBCSP. They perceived the invitation letter with a prescheduled appointment as if a decision for mammography had already been made. This was experienced as an aid in overcoming the postponements that easily occur in daily lives. The invitation to mammography screening was embraced as an indication of a responsible welfare state, “like a mother taking care.”Conclusion: In a welfare state where governmental institutions are trusted, mass screening for disease is acknowledged by screening participants as a valued expression of paternalism. Trust, gratitude, and convenience were more important factors than information about benefits, harms, and risks when the women made their decisions to attend screening. These elements should be included in the ethical debates on informed choice in preventive medicine. (shrink)

Breastmilk is bought, sold, and donated in a global marketplace, which risks exploiting the women who produce it. In Detroit, black mothers are targeted as paid milk donors; milk from Cambodian and Indian mothers is sold to parents in the United States and Australia; and the International Breast Milk Project sends donated milk from the United States to Africa. Drawing on transnational care work and affect theory, I argue that merely refraining from paying women does not eliminate (...) potentially harmful effects. Addressing the ethical implications of these exchanges requires reconsidering the relationship between gift and commodity and between love and work. (shrink)

Over the past decade AIDS research has turned toward the use of pharmacology in HIV prevention, including pre-exposure prophylaxis (PrEP): the use of HIV medication as a means of preventing HIV acquisition in those who do not have it. This paper explores the contradictory reasons offered in support of PrEP—to empower women, to provide another risk-reduction option for gay men—as the context for understanding the social meaning of the experimental trials that appear to show that PrEP works (...) in gay men and heterosexual couples but not single women. The PrEP debates reveal the different ideas about “demedicalization” in the earlier gay health and women’s health movements and highlight the relationship between health activism and critique of research ethics in the context of a global pharmaceutical market. (shrink)

This paper presents a procedure designed to aid physicians and patients in the process of making medical decisions, and illustrates its implementation to aid pregnant women, who decided to undergo prenatal diagnostic test choose a physician to administer it. The procedure is based on a medical decision-making model of Karni (J Risk Uncertain 39: 1–16, 2009). This model accommodates the possibility that the decision maker’s risk attitudes may vary with her state of health and incorporates other costs, (...) such as pain and inconvenience, associated with alternative treatments. The medical decision problem was chosen for its relative simplicity and the transparency it affords. (shrink)