ВИЧ/СПИД в Европе - 2013
This book studies the role of civil society organisations in the fight against HIV/AIDS in Russia. The book investigates civil society organizations’ contribution to social change and civil society development in post-Soviet Russia, and thus situates a specific type of civil society actors into a broader socio-political context and questions their ability to represent civic interests, particularly in the field of social policy-making and health.
Prior to 2010, medical care for people living with HIV/AIDS was provided at an outpatient facility near the center of St. Petersburg. Since then, HIV specialty clinics have been established in more outlying regions of the city. The study examined the effect of this decentralization of HIV care on patients' satisfaction with care in clinics of St. Petersburg, Russia. We conducted a cross-sectional study with 418 HIV-positive patients receiving care at the St. Petersburg AIDS Center or at District Infectious Disease Departments (centralized and decentralized models, respectively). Face-to-face interviews included questions about psychosocial characteristics, patient's satisfaction with care, and clinic-related patient experience. Abstraction of medical records provided information on patients' viral load. To compare centralized and decentralized models of care delivery, we performed bivariate and multivariate analysis. Clients of District Infectious Disease Departments spent less time in lines and traveling to reach the clinic, and they had stronger relationships with their doctor. The overall satisfaction with care was high, with 86% of the sample reporting high level of satisfaction. Nevertheless, satisfaction with care was strongly and positively associated with the decentralized model of care and Patient-Doctor Relationship Score. Patient experience elements such as waiting time, travel time, and number of services used were not significant factors related to satisfaction. Given the positive association of satisfaction with decentralized service delivery, it is worth exploring decentralization as one way of improving healthcare services for people living with HIV/AIDS.
With the rapid growth of online social network sites (SNS), the issue of health-related online communities and its social and behavioral outcomes has become increasingly popular in Internet studies and sociology of health and medicine. This paper presents the results of the empirical study investigating the structure of the 'friendship' networks and participants' communicative activity within 15 online groups on VK.com SNS. In this pilot study we seek to trace the relation between declared aims (social functions) and structure of online groups devoted to the HIV/AIDS theme. First, we propose a classification of online HIV-related groups according to their declared purposes and actual social functions. The most widespread group types on VK.com SNS are HIV activists, HIV-infected dating groups, AIDS denialists movement groups, online pages of offline organizations and social support groups. Second, we identify and describe several patterns of network structure and user behavior occurring among these groups. We distinguish five types of community structure: tight crowd, polarized crowd, stratified structure, clustered network and disintegrated structure. Finally, we find and interpret the relation between the purposes and functions, on the one hand, and network structure of online communities, on the other. Tight crowd networks mainly occur in dating groups for HIV-infected persons and, and links in them are determined by users' gender (either homogeneous or heterogeneous ties prevail). Stratified structure is related to HIV activists and especially to AIDS denialists movement groups. The crucial factor of network formation for this pattern is participation in public discussion within a group. Active users form a cohesive community while passive users stay isolated or connected with just a few active users. Our findings are consistent with some previous research on communication network structures on other social media platforms.
Purpose: This is the first empirical study of the effectiveness of the international volunteer program “dance4life” in Russia. The program addresses taboos, stigma, discrimination, HIV/AIDS prevention, promoting Sexual Reproductive Health and Rights (SRHR), healthy lifestyle among adolescents/youth. The program uses the “edutainment” model that allows involving youth more meaningfully through music, dance and youth icons. Educated volunteers provide schoolchildren with comprehensive information on SRHR and organize practical application of the life and leadership skills. The program cycle ends with rewarding celebration event for children involved.
Methods: Qualitative and quantitative methods were used. The qualitative research involved youth aged 13-19 (20 interviews, 6 focus groups), teachers (8 interviews), volunteer team members (8 interviews), and program managers in 4 regions (5 interviews). In quantitative research 105 respondents took part, of which 48% were 13-16 year old, 44% - 17-19, 8% - 20-23, both boys and girls.
Findings: Young people’s participation in dance4life had significant positive impact on perception of SRHR and knowledge level; it changed some misconceptions about HIV/AIDS and helped develop social and healthy lifestyle skills. The program contributed to the growth of voluntary activity and organizational skills of youth. Perception of SRHR by teachers positively changed due to their participation in the program.
Limitations: The limitations of the quantitative research sample (N = 105) does not allow us to disaggregate the data by region or by gender. These limitations were minimized by choosing relatively comparable socio-economic status of the 4 regions and through quota sampling in equal proportions for boys and girls. This study was conducted for the first time, so it is not possible to draw conclusions about the impact of the program in the long run.
Practical implications: The short implementation period allows for the dissemination of information and training to large numbers without much funding.
Social implications: The dance4life approach uses a special way of providing information on SRHR to youth, which rouses their interest and is perceived as relevant and important. Program participants use this information themselves and share it with their friends, parents and other adults.
Originality: The dance4life program is unique for Russia, there is no regular sexual education in Russian schools. School programs are rarely evaluated with the methods used in this study.
Several approaches to the concept of fatherhood present in Western sociological tradition are analyzed and compared: biological determinism, social constructivism and biosocial theory. The problematics of fatherhood and men’s parental practices is marginalized in modern Russian social research devoted to family and this fact makes the traditional inequality in family relations, when the father’s role is considered secondary compared to that of mother, even stronger. However, in Western critical men’s studies several stages can be outlined: the development of “sex roles” paradigm (biological determinism), the emergence of the hegemonic masculinity concept, inter-disciplinary stage (biosocial theory). According to the approach of biological determinism, the role of a father is that of the patriarch, he continues the family line and serves as a model for his ascendants. Social constructivism looks into man’s functions in the family from the point of view of masculine pressure and establishing hegemony over a woman and children. Biosocial theory aims to unite the biological determinacy of fatherhood with social, cultural and personal context. It is shown that these approaches are directly connected with the level of the society development, marriage and family perceptions, the level of egality of gender order.