Targeting vulnerable populations : a synthetic review on alcohol use and risky sexual behaviour among migrant populations

Background: Research has demonstrated a link between alcohol use and risky sexual behaviour among different types of migrant populations. Therefore, research investigating risk factors associated with alcohol consumption among them is a public health priority. This review aimed to explore the intersection between migration, alcohol consumption and risky sexual behaviour. Methods: This article is a synthetic review of empirical studies on the association of alcohol and high-risk sexual behaviour among different types of the migrant populations, focusing on measurable outcomes generated from quantitative data. A descriptive analysis generated from global and situational studies was used to interpret the reviewed research and to discuss critically the factors that drive migrants to engage in alcohol consumption and high-risk behaviour. Results: This review found out that there is a significant and positive association between global and situational alcohol use and several outcomes of risky sexual behaviour among different types of migrant populations. This association was however mainly observed at high quantities and frequencies of alcohol use, mainly among male migrants, and was often tied to a specific situation or context, for instance the type of sexual partner, the level of mobility and to environmental factors such as living arrangements and entertainment venues. Conclusions: The study supports previous research that alcohol use is associated with risky sexual behaviour among different types of migrant populations. Therefore, future interventions should target mobile, male migrant heavy drinkers. Additional research is needed using more event-level and longitudinal methodologies that overcome prior methodological limitations

Unpacking the dynamics of double stigma : how the HIV-TB co-epidemic alters TB stigma and its management among healthcare workers

Background HIV and tuberculosis (TB) are intricably interlinked in South Africa. The social aspects of this co-epidemic remain relatively unexplored. More specifically, no research has quantitatively explored the double stigma associated with HIV and TB in this context, and more specifically the impact of the co-epidemic on [1] the stigmatisation of TB and [2] the TB stigma mangement strategy of covering (i.e. the use of TB as a cover for having HIV). The current study aims to address this research gap by disentangling the complex mechanisms related to HIV-TB stigma. Methods Using Structural Equation Modelling (SEM), data of 882 health care workers (HCWs) in the Free State province, South Africa, are analysed to investigate the link between the stigmatization of HIV and TB and the stigma management by those affected. The current study focuses on health care workers (HCWs), as both TB and HIV have a severe impact on this professional group. Results The results demonstrate that the perceived link between the epidemics is significantly associated with double HIV-TB stigmatization. Furthermore, the link between the illnesses and the double stigma are driving the stigmatization of TB. Finally, the link between HIV and TB as well as the stigmatization of both diseases by colleagues are associated with an increased use of covering as a stigma management strategy. Conclusions This is the first quantitative study disentagling the mediating role of double stigma in the context of the co-epidemic as well as the impact of the co-epidemic on the social connotations of TB. The results stress the need for an integrated approach in the fight against HIV and TB recognizing the intertwined nature of the co-epidemic, not only in medical-clinical terms, but also in its social consequences

Reducing HIV- and TB-Stigma among healthcare co-workers in South Africa: Results of a cluster randomised trial.

RATIONALE: The HIV and TB co-epidemic has a severe impact on the South African healthcare workforce and health system. HIV- and TB- stigma directed from healthcare workers (HCWs) towards colleagues not only has a negative impact on the mental health and well-being of the HCWs, but has been identified as a barrier to their own health-seeking behaviour. It also increases the strain on the health system due to absenteeism. OBJECTIVE: This cluster-randomised trial tested an intervention to reduce HIV- and TB-stigma among HCWs. The intervention, based on the theory of Diffusion of Innovations consisted of training healthcare workers as change agents in a Social and Behavioural Change Communication workshop to help them change stigmatising attitudes in the workplace. This was supported by a social marketing campaign. METHODS: Eight hospitals in the Free State province were randomised into intervention and control group in a stratified study design. 652 respondents randomly drawn from the hospitals were surveyed on aspects of HIV and TB stigma once in 2016 and again in 2018. Since the study only used four hospitals per intervention arm, cluster-based summaries were compared when analysing the intervention effect, using the nonparametric Mann-Whitney test. To explore how the intervention worked, 24 qualitative focus groups were conducted following the intervention. RESULTS: The quantitative test did not show a significant intervention effect on stigma between intervention and control groups. Qualitative evidence reported new awareness and changed behaviour related to HIV- and TB-stigma among individual HCWs, but a combination of factors including strong social hierarchies in the workplace and the down-scaling of the original version of the intervention seemed to reduce the impact. Conclusion The findings did not indicate a significant intervention effect, but show the potential of using HCWs as change agents to reduce HIV and TB stigma in their local communities

Sjunkande födelsetal, en fråga om attityder : En undersökning av 26 europeiska länder

Undersökningens syfte är att undersöka huruvida det finns ett samband mellan traditionella könsnormer samt inställningen till det egna landets familjepolitik, och landets totala fertilitetsnivå. Uppsatsen har en kvantitativ ansats med analyser baserade på data från European Social Survey samt Eurostat och undersöker 26 europeiska länder. Den teoretiska bakgrunden belyser hur mönstret i de totala fertilitetsnivåerna har förändrats till de nivåer som uppvisas i Europa idag. Vidare beskrivs hur könsrollsattityder och familjepolicys kan kopplas till födelsetal. Av den teoretiska bakgrunden framkommer vikten av att kunna kombinera barn med förvärvsarbete som en nyckelaspekt. Framförallt ses barnomsorg som något som minskar kvinnors alternativkostnader avsevärt vad gäller att kunna kombinera dessa två. För att göra resultatet överskådligt organiseras resultatet efter välfärdstypologier. Resultatet visar att det finns ett negativt samband mellan traditionella könsrollsattityder och totala fertilitetsnivåer. Detta innebär att det i länder där individer i högre grad anser att kvinnor bär huvudansvar för barn och familj och där män ses som huvudförsörjare, finns en lägre total fertilitetsnivå.  Vidare framkommer även ett positivt samband mellan att vara nöjd med familjerelaterade sociala förmåner samt befintlig barnomsorg och totala fertilitetsnivåer. Resultatet tyder således på att länder där individer är nöjda med befintliga sociala förmåner och där individer är nöjda med den tillgängliga barnomsorgen, har en högre total fertilitetsnivå.

Stakeholder Perspectives on the Needs of Children of Prisoners in Europe

Children of imprisoned parents have been identified as a particularly vulnerable group of children. Despite being an under-recognised and under-researched group, these children come into contact with a wide variety of professional groups and other stakeholders. From a wider study on the mental health, well-being and resilience of children of imprisoned parents, this paper presents findings from 122 stakeholder consultations in England,Germany, Romania, and Sweden. Despite significant differences in prison systems and service provision, common issues were raised across the four countries. Prominent themes included: restrictions on regular contact with the imprisoned parent posing a threat to even strong parent-child relationships; the adverse emotional and social impact and the potential long-term consequences; stigma and secrecy; a lack of information; and issues surrounding availability of support services (although examples of good practice emerged, particularly from NGOs). There is a need for a reduction in the stigma that often prevents children and their families from accessing available services, greater awareness of the vulnerabilities of children of prisoners at policy level, a more equitable distribution of service provision development of good practice models and more professional training