Modelling coseismic displacements during the 1997 Umbria-Marche earthquake (central Italy)

We propose a dislocation model for the two normal faulting earthquakes that struck the central Apennines (Umbria-Marche, Italy) on 1997 September 26 at 00:33 (Mw 5.7) and 09:40 GMT (Mw 6.0). We fit coseismic horizontal and vertical displacements resulting from GPS measurements at several monuments of the IGMI (Istituto Geografico Militare Italiano) by means of a dislocation model in an elastic, homogeneous, isotropic half-space. Our best-fitting model consists of two normal faults whose mechanisms and seismic moments have been taken from CMT solutions; it is consistent with other seismological and geophysical observations. The first fault, which is 6 km long and 7 km wide, ruptured during the 00:33 event with a unilateral rupture towards the SE and an average slip of 27 cm. The second fault is 12 km long and 10 km wide, and ruptured during the 09:40 event with a nearly unilateral rupture towards the NW. Slip distribution on this second fault is non-uniform and is concentrated in its SE portion (maximum slip is 65 cm), where rupture initiated. The 00:33 fault is deeper than the 09:40 one: the top of the first rupture is deeper than 1.7 km; the top of the second is 0.6 km deep. In order to interpret the observed epicentral subsidence we have also considered the contributions of two further moderate-magnitude earthquakes that occurred on 1997 October 3 (Mw 5.2) and 6 (Mw 5.4), immediately before the GPS survey, and were located very close to the 09:40 event of September 26. We compare the pattern of vertical displacements resulting from our forward modelling of GPS data with that derived from SAR interferograms: the fit to SAR data is very good, confirming the reliability of the proposed dislocation model

"Now we are in a different time; various bad diseases have come." understanding men's acceptability of male circumcision for HIV prevention in a moderate prevalence setting

Background: Adult male surgical circumcision (MC) has been shown to reduce HIV acquisition in men and is recommended by the WHO for inclusion in comprehensive national HIV prevention programs in high prevalence settings. Only limited research to date has been conducted in countries experiencing moderate burden epidemics, where the acceptability, operational feasibility and potential epidemiological impact of MC remain unclear. Methods. A multi-method qualitative research study was conducted at four sites in Papua New Guinea (PNG), with 24 focus group discussions and 65 in-depth interviews carried out among 276 men. Results: The majority of men were in favour of MC being introduced for HIV prevention in PNG and considered improved genital hygiene, enhanced sexual pleasure and culturally appropriateness key factors in the acceptability of a future intervention. A minority of men were against the introduction of MC, primarily due to concerns regarding sexual risk compensation and that the intervention went against prevailing cultural and religious beliefs. Conclusion: This is one of the first community-based MC acceptability studies conducted in a moderate prevalence setting outside of Africa. Research findings from this study suggest that a future MC program for HIV prevention would be widely accepted by men in PNG

Making meaning out of objects : self, connectedness and belonging among sexuality diverse men and transgender women in Papua New Guinea

Objects in our everyday lives range from the mundane to the highly significant and can be understood and interpreted in various ways. In a Pacific society such as Papua New Guinea, making meaning out of objects and storytelling provides great insight into (our) culture. However, much of the attention given to material culture historically and culturally in Papua New Guinea is directed at documenting objects from the past, and often the objects possessed by cis-gender men. Much less attention has been given to the material culture of individuals and communities of sexuality diverse men and transgender women in Papua New Guinea. As part of a life history study among sexuality diverse men and transgender women in Papua New Guinea this chapter explores meanings of objects significant to these people. These non-human objects, sometimes reflecting significant people and relationships, speak to kinship and family, identity and self-courage, justice and human rights, providing new insights into the lives of Papua New Guineans, frequently framed via discourses of risk

Gender diversity among 'boys' in Papua New Guinea : memories of sameness and difference in early childhood

Childhood is a time when children begin to constitute themselves as gendered subjects largely according to social norms that are rigidly framed within dominant discourses of heteronormative binary gender. This paper is based on the life histories of 42 sexuality and gender diverse adult men and transgender women conducted in PNG. Findings offer insight into the ways in which boys transgressed gender norms through dress, play, work within the home and in dance. We argue that gender transgression in childhood is not a contemporary phenomena and such childhood experiences of boys in PNG should be recognised as part of the country's rich cultural diversity

Ambiguous bodies, uncertain diseases: knowledge of cervical cancer in Papua New Guinea

Objectives: Within their local realities, people experience and interpret disease in diverse ways that do not necessarily correlate or converge with Western biomedical interventions. In the high cervical cancer burden setting of Papua New Guinea, understanding how people experience and interpret cervical cancer is necessary for effective intervention. Drawing on work by Street on the production of unstable biomedical knowledge, we explored how ambiguity and uncertainty, coupled with cultural taboos and linguistic limitations, affect what and how people ‘know’ about women’s reproductive organs and their associated disease. Design: A qualitative research approach was used to explore and understand how people in PNG articulate matters of health and disease as they relate to cervical cancer and HPV infection. Specifically, how unstable biomedical knowledge is produced and sustained. We employed a mixed-methods approach in collecting data from 208 (147 women) participants between 2011 and 2012 across 3 provinces in PNG. Results: We found that knowledge and awareness about cervical cancer were poor. Five thematic areas emerged in our analysis, which included the gendered knowledge of women’s reproductive health, the burden of cervical cancer in the community and the role (or limitation) of language. We further identified four ways in which ambiguity and uncertainty operate on both sociocultural and biological levels, and in the intersection between to produce unstable biomedical knowledge. These included poor knowledge of where the cervix is located and the uncertainty or unreliability of (lay) diagnoses of disease. Conclusion: Local understandings of cervical cancer reflected the limitations of Tok Pisin as a lingua franca as well as the wider uncertain biomedical environment where diagnoses are assembled and shared. There is a clear need to improve understanding of the female reproductive organs in order that people, women in particular, can be better informed about cervical cancer and ultimately better receptive to intervention strategies

Perpetration of violence by female sex workers in Papua New Guinea: 'we will crush their bones'

There is a small but important body of literature on female sex workers' (FSWs) violence towards others, but little of that focused on low- and middle-income countries. Drawn from a larger biobehavioural study of FSWs in three cities in Papua New Guinea, we analyse the interviews from 19 FSWs who reported having perpetrated physical violence towards four major groups: (1) ex-husbands; (2) clients; (3) other sex workers and (4) other people (mainly women). Our study demonstrates that FSWs' use of violence arises from a complex set of social, material and gendered circumstances and cannot be addressed in isolation from other aspects of their lives

Confidential, accessible point-of-care sexual health services to support the participation of key populations in biobehavioural surveys: Lessons for Papua New Guinea and other settings where reach of key populations is limited

To achieve the UNAIDS 90-90-90 targets at a national level, many countries must accelerate service coverage among key populations. To do this, key population programs have adopted methods similar to those used in respondent-driven sampling (RDS) to expand reach. A deeper understanding of factors from RDS surveys that enhance health service engagement can improve key population programs. To understand the in-depth lives of key populations, acceptance of expanded point-of-care biological testing and determine drivers of participation in RDS surveys, we conducted semi-structured interviews with 111 key population participants (12–65 years) were purposefully selected from six biobehavioral surveys (BBS) in three cities in Papua New Guinea. Key populations were female sex workers, men who have sex with men, and transgender women. Four reasons motivated individuals to participate in the BBS: peer referrals; private, confidential, and stigma-free study facilities; “one-stop shop” services that provided multiple tests and with same-day results, sexually transmitted infection treatment, and referrals; and the desire to know ones’ health status. Biobehavioral surveys, and programs offering key population services can incorporate the approach we used to facilitate key population engagement in the HIV cascade. © This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication

One size does not fit all: HIV prevalence and correlates of risk for men who have sex with men, transgender women in multiple cities in Papua New Guinea

Background: Biobehavioral data about men who have sex with men (MSM) and transgender women (TGW) in Papua New Guinea (PNG) are limited to those who sell sex. Information about those MSM and TGW who do not sell sex is necessary to guide HIV prevention and treatment efforts. Methods: We conducted respondent-driven sampling (RDS) surveys among MSM and TGW in Port Moresby, Lae, and Mt. Hagen, PNG from in 2016 and 2017. Eligibility criteria was: aged > 12 years, born male, could speak English or Tok Pisin and had oral or anal sex with another person born male in the past 6 months. Participants were interviewed face-to-face and offered rapid HIV testing. Weighted data analysis was conducted using RDS-Analyst (v. 0.62). Results: We enrolled 400 participants in Port Moresby, 352 in Lae, and 111 in Mt. Hagen. In the last six months, 73.2% of MSM/TGW in Port Moresby, 77.9% in Lae, and 75.9% in Mt. Hagen, had a concurrent sexual partnership. Upwards of 70% of MSM/TGW in all three cities had sex with a woman in the same period. Less than half of MSM/TGW had ever tested for HIV. HIV prevalence among MSM/TGW was 8.5% in Port Moresby and 6.9% in Lae. Among participants in Mt. Hagen it was 1.3%. HIV was associated with not having sex with a woman in the last six months and sexually transmitted disease symptoms in the last 12 months in Port Moresby and Lae. In Port Moresby, it was also associated with an uncut foreskin, and in Lae with earning income in the formal sector and being unable to rely on other MSM or TGW to accompany them to healthcare services. Conclusions: The large proportion of MSM and TGW with concurrent sexual partnerships, combined with the low testing coverage, indicates strong potential for the spread of HIV. The different correlates of HIV in Port Moresby and Lae highlight the importance of conducting surveys in multiple locations and using data to develop locally appropriate interventions even within a country

Factors associated with HIV and syphilis infection among female sex workers in three cities in Papua New Guinea: Findings from Kauntim mi tu, a biobehavioral survey

Background: In this paper, factors associated with HIV and syphilis infection in three cities in Papua New Guinea are explored. Methods: Respondent-driven sampling surveys among FSW in Port Moresby, Lae, and Mt. Hagen (2016-17) were conducted. FSW who were aged ≥12 years, who were born female, who spoke English or Tok Pisin and who had sold or exchanged vaginal sex in the past 6 months were eligible to participate. Participants were interviewed face-to-face and offered rapid HIV and syphilis testing. Survey logistic procedures were used to identify factors associated with HIV and syphilis infection, including modern contraception use, physical violence and having a casual male partner. Weighted data analysis was conducted. Results: Overall, 2901 FSW (Port Moresby, 673; Lae, 709; and Mt. Hagen, 709) were enrolled in the study. HIV prevalence was 15.2% in Port Moresby, 11.9% in Lae and 19.6% in Mt. Hagen. Factors associated with HIV varied by city; for example, use of modern contraception in Port Moresby, experiences of physical violence in Lae and ever having tested for HIV in Mt. Hagen. No one variable was associated with HIV in all cities. Prevalence of syphilis infection was 7.1%, 7.0%, and 3.0% in Port Moresby, Lae, and Mt. Hagen, respectively. Factors associated with syphilis infection also varied by city and were only significant in Lae. Conclusion: The different factors associated with HIV and syphilis infection in each city highlight the complex HIV and syphilis epidemics among FSW and the importance of conducting surveys in multiple locations and developing local interventions