52 research outputs found

    American Myths, Legends, and Tall Tales: An Encyclopedia of American Folklore

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    Folklore has been a part of American culture for as long as humans have inhabited North America, and increasingly formed an intrinsic part of American culture as diverse peoples from Europe, Africa, Asia, and Oceania arrived. In modern times, folklore and tall tales experienced a rejuvenation with the emergence of urban legends and the growing popularity of science fiction and conspiracy theories, with mass media such as comic books, television, and films contributing to the retelling of old myths. This multi-volume encyclopedia will teach readers the central myths and legends that have formed American culture since its earliest years of settlement. Its entries provide a fascinating glimpse into the collective American imagination over the past 400 years through the stories that have shaped it. [From the Publisher]https://cupola.gettysburg.edu/books/1095/thumbnail.jp

    Accessing methadone within Moldovan prisons: Prejudice and myths amplified by peers.

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    BACKGROUND: The volatile HIV epidemic in Moldova, driven primarily by people who inject drugs (PWIDs), is concentrated in prisons. Although internationally recommended opioid agonist therapy (OAT) is available in Moldovan prisons, coverage remains inadequate and expansion efforts have failed to meet national and international goals. METHODS: To better understand why eligible prisoners are reluctant to initiate OAT, we surveyed recently released prisoners who met criteria for opioid dependence and compared those who had and had not been enrolled in within-prison OAT (N=56) using standardized scales on OAT knowledge and attitudes as well as within-prison harassment experiences. RESULTS: Knowledge about OAT was similar between both groups, but this knowledge and myths about OAT had independent and opposite direct effects on OAT attitudes. Those who were enrolled in OAT in prison were significantly more likely to perceive it as an effective form of treatment and had more tolerable attitudes toward OAT but were also more likely to have been bullied and to express concerns about their personal safety. Prisoners who had not been enrolled in OAT were more likely to endorse negative myths about methadone; only one person among them intended to receive OAT in the future. CONCLUSION: In Moldovan prisons, OAT enrollment and treatment continuation are influenced by ideological biases and myths that are largely formed, amplified, and reinforced behaviorally in restricted prison settings. Future interventions that expand OAT in prisons should target individual-level ideological prejudices and myths, as well as the prison environment.<br/

    Drivers of HIV self-testing among female sex workers: Findings from a multi-state study in Malaysia

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    BackgroundAlthough research on HIV self-testing (HIVST) has rapidly increased, few studies have explored HIVST uptake in female sex workers (FSW), and none in Malaysia. Therefore, we endeavored to assess the willingness to use HIVST in this at-risk, vulnerable population.MethodsA cross-sectional survey study was conducted among 113 HIV-negative Malaysian FSW in 2017. Participants were recruited using advertisements on social media, flyers, and direct referrals from community-based organizations. Data were collected using self-administered surveys. Multivariable logistic regression was used to identify correlates of willingness to use HIVST.ResultsNearly a third of participants (30.1%) reported they would be willing to use HIVST. Multivariable analyses adjusting for Malay ethnicity, stable housing, living in Kuala Lumpur (KL), years in sex work, age of first sex work, childhood sexual assault, history of HIV testing, and previously in prison indicated that living in KL [adjusted odds ratio (aOR) = 5.214, p = 0.0137] was associated with a greater willingness to use HIVST. In contrast, having stable housing (aOR = 0.100, p = 0.0064) was negatively associated with willingness to use HIVST.ConclusionsOur results indicate that HIVST may potentially enhance the uptake of HIV testing among FSWs living in an urban environment and experiencing unstable housing, but an overall willingness to use HIVST is low. These findings highlight the need for efforts to increase awareness of HIVST among FSWs and additional research on the effective implementation of HIVST for FSW

    Acceptability of a microfinance-based empowerment intervention for transgender and cisgender women sex workers in Greater Kuala Lumpur, Malaysia

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    Introduction: Cisgender and transgender woman sex workers (CWSWs and TWSWs, respectively) are key populations in Malaysia with higher HIV‐prevalence than that of the general population. Given the impact economic instability can have on HIV transmission in these populations, novel HIV prevention interventions that reduce poverty may reduce HIV incidence and improve linkage and retention to care for those already living with HIV. We examine the feasibility of a microfinance‐based HIV prevention intervention among CWSW and TWSWs in Greater Kuala Lumpur, Malaysia. Methods: We conducted 35 in‐depth interviews to examine the acceptability of a microfinance‐based HIV prevention intervention, focusing on: (1) participants’ readiness to engage in other occupations and the types of jobs in which they were interested in; (2) their level of interest in the components of the potential intervention, including training on financial literacy and vocational education; and (3) possible barriers and facilitators to the successful completion of the intervention. Using grounded theory as a framework of analysis, transcripts were analysed through Nvivo 11. Results: Participants were on average 41 years old, slightly less than half (48%) were married, and more than half (52%) identified as Muslim. Participants express high motivation to seek employment in other professions as they perceived sex work as not a “proper job” with opportunities for career growth but rather as a short‐term option offering an unstable form of income. Participants wanted to develop their own small enterprise. Most participants expressed a high level of interest in microfinance intervention and training to enable them to enter a new profession. Possible barriers to intervention participation included time, stigma, and a lack of resources. Conclusion: Findings indicate that a microfinance intervention is acceptable and desirable for CWSWs and TWSWs in urban Malaysian contexts as participants reported that they were ready to engage in alternative forms of income generation

    Pre-incarceration police harassment, drug addiction and HIV risk behaviours among prisoners in Kyrgyzstan and Azerbaijan: results from a nationally representative cross-sectional study

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    Introduction: The expanding HIV epidemic in Azerbaijan and Kyrgyzstan is concentrated among people who inject drugs (PWID), who comprise a third of prisoners there. Detention of PWID is common but its impact on health has not been previously studied in the region. We aimed to understand the relationship between official and unofficial (police harassment) detention of PWID and HIV risk behaviours. Methods: In a nationally representative cross-sectional study, soon-to-be released prisoners in Kyrgyzstan (N=368) and Azerbaijan (N=510) completed standardized health assessment surveys. After identifying correlated variables through bivariate testing, we built multi-group path models with pre-incarceration official and unofficial detention as exogenous variables and pre-incarceration composite HIV risk as an endogenous variable, controlling for potential confounders and estimating indirect effects. Results: Overall, 463 (51%) prisoners reported at least one detention in the year before incarceration with an average of 1.3 detentions in that period. Unofficial detentions (13%) were less common than official detentions (41%). Optimal model fit was achieved (X2=5.83, p=0.44; Goodness of Fit Index (GFI) GFI=0.99; Comparative Fit Index (CFI) CFI=1.00; Root Mean Square Error of Approximation (RMSEA) RMSEA=0.00; PCLOSE=0.98) when unofficial detention had an indirect effect on HIV risk, mediated by drug addiction severity, with more detentions associated with higher addiction severity, which in turn correlated with increased HIV risk. The final model explained 35% of the variance in the outcome. The effect was maintained for both countries, but stronger for Kyrgyzstan. The model also holds for Kyrgyzstan using unique data on within-prison drug injection as the outcome, which was frequent in prisoners there. Conclusions: Detention by police is a strong correlate of addiction severity, which mediates its effect on HIV risk behaviour. This pattern suggests that police may target drug users and that such harassment may result in an increase in HIV risk-taking behaviours, primarily because of the continued drug use within prisons. These findings highlight the important negative role that police play in the HIV epidemic response and point to the urgent need for interventions to reduce police harassment, in parallel with interventions to reduce HIV transmission within and outside of prison

    Childhood Gender Nonconformity, Parent-Child Relationships, and the Development of Internalized Homophobia in Gay Men

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    Prior research has consistently shown a clear relationship to exist between gender nonconforming behavior, defined as those behaviors, traits, interests, and/or self-perceptions which are stereotypically associated with persons of the other sex in childhood, and the development of a homosexual orientation in adulthood. Researchers have also found GNB in childhood, particularly among boys, to be associated with several negative developmental outcomes for gay men, including lower self-esteem, poor family relations, increased suicidality, attachment anxiety in romantic relationships, and narcissistic symptomatology. Despite these findings, no study has investigated the relationship between childhood GNB and internalized homophobia, a construct shown to be highly associated with low self-esteem in gay men. Furthermore, scholars have theorized and, to a limited extent, revealed the mediating role of relationships with parents on the association between GNB and maladjustment in adulthood. As such, the present thesis had two primary objectives: (a) determine the relationship between childhood GNB and adult internalized homophobia, and (b) assess whether parental relationship quality has a moderating and/or mediating effect between childhood GNB and adult internalized homophobia in gay men. Data did not support a relationship between GNB and internalized homophobia or parental relationship quality. Further analysis of the data indicated a strong inverse relationship between disclosure of sexual orientation to parents and internalized homophobia, suggesting that communication about one\u27s stigmatizing identity, particularly with family members, may help buffer the adverse effects of internalized homophobia. Results, limitations, and directions for future research are also discussed

    Burden of infectious diseases, substance use disorders, and mental illness among Ukrainian prisoners transitioning to the community.

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    The epidemics of incarceration, substance use disorders (SUDs), and infectious diseases are inextricably intertwined, especially in the Former Soviet Union (FSU). Few objective data documenting this relationship regionally are available. We therefore conducted a comprehensive, representative country-wide prison health survey in Ukraine, where one of the world's most volatile HIV epidemics persists, in order to address HIV prevention and treatment needs.A nation-wide, multi-site randomly sampled biobehavioral health survey was conducted in four Ukrainian regions in 13 prisons among individuals being released within six months. After consent, participants underwent standardized health assessment surveys and serological testing for HIV, viral hepatitis, and syphilis.Of the 402 participants (mean age = 31.9 years), 20.1% were female. Prevalence of HIV, HCV, HBV, and syphilis was 19.4% (95% CI = 15.5%-23.3%), 60.2% (95% CI = 55.1%-65.4%), 5.2% (95% CI = 3.3%-7.2%), and 10% (95% CI = 7.4%-13.2%), respectively, with regional differences observed; HIV prevalence in the south was 28.6%. Among the 78 HIV-infected inmates, 50.7% were unaware of their HIV status and 44 (56.4%) had CD4<350 cells/mL, of which only five (11%) antiretroviral-eligible inmates were receiving it. Nearly half of the participants (48.7%) reported pre-incarcertion drug injection, primarily of opioids, yet multiple substance use (31.6%) and alcohol use disorders (56.6%) were common and 40.3% met screening criteria for depression.This is the only such representative health study of prisoners in the FSU. This study has important implications for regional prevention and treatment because, unlike elsewhere, there is no recent evidence for reduction in HIV incidence and mortality in the region. The prevalence of infectious diseases and SUDs is high among this sample of prisoners transitioning to the community. It is critical to address pre- and post-release prevention and treatment needs with the development of linkage programs for the continuity of care in the community after release

    Correlates of recent HIV testing among transgender women in Greater Kuala Lumpur, Malaysia

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    Purpose: In Malaysia, an estimated 9.7%-12.4% of transgender women (TW) are HIV positive, with higher estimates among those engaged in sex work. According to the 90-90-90 Joint United Nations Programme on HIV/AIDS strategy, HIV testing is the first crucial step in curbing the HIV epidemic. This study examines correlates of recent HIV testing among TW in Greater Kuala Lumpur, Malaysia. Methods: TW (N = 199) in Greater Kuala Lumpur completed a survey on healthcare access and utilization, including HIV testing history. Bivariate logistic regression and penalized multivariate logistic regression were used to explore correlates of HIV testing in the last 12 months. Results: Overall, 41.7% of TW reported having ever been tested for HIV. Among participants who were HIV negative or not sure of their HIV status (n = 187), only 18.7% (n = 35) had been tested for HIV in the last 12 months. The multivariate analysis indicated that having a primary care provider (PCP), being 26-40 years of age, and having higher mental health functioning were positively associated with recent HIV testing. Active amphetamine use and previous depression diagnosis were also associated with recent HIV testing. Conclusion: HIV testing is the first step in linking individuals to prevention and treatment interventions. Our findings suggest that having a PCP can improve engagement in HIV testing. Moreover, PCPs can serve as a valuable link to HIV treatment and prevention services. Current interventions that target social and behavioral risk factors for HIV, on their own, may be insufficient at engaging all HIV-vulnerable TW
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