TB STIGMA – MEASUREMENT GUIDANCE

TB is the most deadly infectious disease in the world, and stigma continues to play a significant role in worsening the epidemic. Stigma and discrimination not only stop people from seeking care but also make it more difficult for those on treatment to continue, both of which make the disease more difficult to treat in the long-term and mean those infected are more likely to transmit the disease to those around them. TB Stigma – Measurement Guidance is a manual to help generate enough information about stigma issues to design and monitor and evaluate efforts to reduce TB stigma. It can help in planning TB stigma baseline measurements and monitoring trends to capture the outcomes of TB stigma reduction efforts. This manual is designed for health workers, professional or management staff, people who advocate for those with TB, and all who need to understand and respond to TB stigma

Rape Beyond Crime

Public health experts agree that sexual violence constitutes a significant public health issue. Yet criminal law dominates rape law almost completely, with public health law playing at best a small supporting role. Recent civil law developments, such as university disciplinary proceedings, similarly fixate on how best to find and penalize perpetrators. As a result, rape law continues to spin its wheels in the same arguments and obstacles. This Article argues that, without broader cultural changes, criminal law faces a double bind: rape laws will either be ineffective or neglect the importance of individual culpability. Public health law provides more promising terrain for rape prevention because it is a strong legal framework that can engage the complex causes of rape, including the social norms that promote sexual aggression. While criminal law can only punish bad behavior, public health interventions can use the more effective prevention strategy of promoting positive behaviors and relationships. They can also address the myriad sexual behaviors and social determinants that increase the risk of rape but are outside the scope of criminal law. Perhaps most importantly, public health law relies on evidence-based interventions and the expertise of public health authorities to ensure that laws and policies are effective. Transforming rape law in this way provides a framework for legal feminism to undertake the unmet challenge of “theorizing yes,” that is, moving beyond how to protect women’s right to refuse sex and toward promoting and exploring positive models of sex. Criminal law is simply incapable of meeting this challenge because it concerns only what sex should not be. A public health framework can give the law a richer role in addressing the full spectrum of sexual attitudes and behaviors

Social determinants of HIV infection among men who have sex with men in the Philippines

Since 2007, the number of prevalent HIV cases in the Philippines has been growing exponentially each year. In 2014, 84% of the new cases were attributed to sexual transmission by men who have sex with men (MSM). To provide insight on this rising epidemic, social determinants of HIV infection among MSM were analyzed using a social ecological model, consisting of individual, network, community, and public policy levels. The following determinants were found most relevant to MSM in the Philippines: (1) individual: genital ulcer disease, number of male partners, injection drug use (IDU) and non-IDU substance abuse; (2) network: receptive and unprotected anal sex, and social media usage; (3) community: the lack of access to preventive services, VCT and ART, and stigma; (4) public policy: homophobia, condom availability, and sexual health education. Stigma was found to interact with multiple determinants at every level. Condom use was found to be a key determinant to target for expansion. Using health belief model constructs, barriers to self-efficacious behavior might be identified for future interventions. Lastly, individual, network, and community levels might be the most feasible in HIV prevention for MSM until attitudes toward MSM and condom use change at the societal level

When Terrorism Threatens Health: How Far are Limitations on Personal and Ecomonic Liberties Justified

The government is engaged in a homeland-security project to safeguard the population\u27s health from potential terrorist attacks. This project is politically charged because it affords the state enhanced powers to restrict personal and economic liberties. Just as governmental powers relating to intelligence, law enforcement, and criminal justice curtail individual interests, so too do public health powers

Paths Forward for the Global Water, Sanitation, and Hygiene (WASH) Sector

The report summarizes key challenges and recommendations discussed at an event entitled "Paths Forward for the Global Water, Sanitation, and Hygiene (WASH) Sector" hosted by the Global Water Futures Project at the Center for Strategic and International Studies (CSIS). The series of discussions focused on ways to catalyze and strengthen efforts to address international WASH problems. The sessions aimed to develop a set of actionable recommendations to improve the outcomes of global WASH programs and to increase the capacity of the U.S.-based public and private sectors to engage in program activities related to global WASH challenges. Each session examined a key challenge facing the water, sanitation, and hygiene sector. Roundtables focused on the following themes: "Building the Momentum for WASH Awareness," "Growing the Resource Base for WASH Efforts," "Making Our WASH Investments Count," and "Breaking the WASH Silo.

A dynamic theory of fidelity networks with an application to the spread of HIV/AIDS

We study the dynamic stability of fidelity networks, which are networks that form in a mating economy of agents of two types (say men and women), where each agent desires direct links with opposite type agents, while engaging in multiple partnerships is considered an act of infidelity. Infidelity is punished more severely for women than for men. We consider two stochastic processes in which agents form and sever links over time based on the reward from doing so, but may also take non-beneficial actions with small probability. In the first process, an agent who invests more time in a relationship makes it stronger and harder to break by his/her partner; in the second, such an agent is perceived as weak. Under the first process, only egalitarian pairwise stable networks (in which all agents have the same number of partners) are visited in the long run, while under the second, only anti-egalitarian pairwise stable networks (in which all women are matched to a small number of men) are. Next, we apply these results to find that under the first process, HIV/AIDS is equally prevalent among men and women, while under the second, women bear a greater burden. The key message is that anti-female discrimination does not necessarily lead to higher HIV/AIDS prevalence among women in the short run, but it does in the long run.fidelity networks; anti-female discrimination; stochastic stability; HIV/AIDS; union formation models

Project sanitarium:playing tuberculosis to its end game

Interdisciplinary and collaborative projects between industry and academia provide exceptional opportunities for learning. Project Sanitarium is a serious game for Windows PC and Tablet which aims to embed learning about tuberculosis (TB) through the player taking on the role of a doctor and solving cases across the globe. The project developed as a collaboration between staff and undergraduate students at the School of Arts, Media and Computer Games at Abertay University working with academics and researchers from the Infection Group at the University of St Andrews. The project also engaged industry partners Microsoft and DeltaDNA. The project aimed to educate students through a workplace simulation pedagogical model, encourage public engagement at events and through news coverage and lastly to prototype whether games could be used to simulate a virtual clinical trial. The project was embedded in the Abertay undergraduate programme where students are presented with real world problems to solve through design and technology. The result was a serious game prototype that utilized game design techniques and technology to demystify and educate players about the diagnosis and treatment of one of the world’s oldest and deadliest diseases, TB. Project Sanitarium aims to not only educate the player, but allows the player to become a part of a simulated drug trial that could potentially help create new treatments in the fight against TB. The game incorporates a mathematical model that is based on data from real-world drug trials. The interdisciplinary pedagogical model provides undergraduates with workplace simulation, wider industry collaboration and access to academic expertise to solve challenging and complex problems

AIDS Educ Prev

In the Caribbean region, HIV prevalence is high among key population (KP) groups, such as sex workers and men who have sex with men. However, there is a lack of high-quality, population-level data estimating HIV prevalence and population sizes of KPs. The President's Emergency Plan for AIDS Relief has funded and completed five bio-behavioral surveillance (BBS) surveys using respondent-driven sampling methodology to target KP in the English-speaking Caribbean region. We describe the experience of implementing bio-behavioral surveys in the Caribbean region and document the context, processes, successes, and challenges, and make recommendations for future survey implementation. Successes include the provision of estimates of nationally representative HIV data and KP size estimates to improve HIV programming and provision of tools for routinization of BBS. Challenges include small KP sizes, the legal context, and the cost and speed of implementation. Future bio-behavioral surveys should include well-planned formative assessments and stakeholder involvement.CC999999/Intramural CDC HHS/United States2019-04-12T00:00:00Z30966768PMC64613626144vault:3189

Self-study modules on tuberculosis

The Self-Study Modules on Tuberculosis are a series of educational modules designed to provide information about TB in a self-study format. The series consists of a total of nine modules that are separated into two courses. The first course, Modules 1-5, provides basic information on TB. The second course, Modules 6-9, provides more specific TB programmatic information.Detecting and responding to TB outbreaks are among the important challenges public health programs face today in eliminating TB. Delays in detecting TB cases, and delayed or incomplete contact investigations, can lead to TB outbreaks.Despite many similarities between contact investigations and outbreaks in how public health programs manage cases and contacts, the overall response needed for outbreaks is much more complex. Health departments may find it difficult to respond quickly and effectively to TB outbreaks.The techniques used to detect and respond to TB outbreaks are guided by knowledge of the transmission and pathogenesis of M. tuberculosis and by the principles of effective contact investigations. Thus, in order to understand how to detect and respond effectively to a TB outbreak, it is important to have a good understanding of these concepts, which are presented in Module 1: Transmission and Pathogenesis of Tuberculosis and Module 8, Contact Investigations for Tuberculosis.Background -- New terms -- Introduction to TB outbreak detection and response -- Systematic approach to TB outbreak response -- Special circumstances in TB outbreak -- Detection and response -- Additional resources -- Answers to study questions -- Case study answers.Health EducationInfectious Diseas