dance4life is a globally active organization within the fields of HIV, sexual and reproductive health and rights (SRHR) and the Millennium Development Goals, specifically aiming to establish a social youth movement consisting of 1 million agents4change by 2014. The central mission of dance4life is to power a movement that creates change at global and community level by taking action to improve young people’s SRHR, and in particular, improving access to sexuality education and youth-friendly services, and to challenge stigma and discrimination and break down taboos that surround sexuality, especially focusing on HIV and AIDS. KIT was invited to partner with dance4life on an impact assessment of dance4life’s work, with a focus on mixed methods and the involvement of the young people themselves. The assessment took place in two countries: Uganda and Russia. A pilot study was undertaken in the Netherlands to test the qualitative research instruments.
Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980–2017 and forecast these estimates to 2030 for 195 countries and territories.
We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package—a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce age-sex-specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections.
Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87–2·04) and has since decreased to 0·95 million deaths (0·91–1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79–3·67) and since then have gradually decreased to 1·94 million (1·63–2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8–39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets.
Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact.
Background Most new HIV infections among people who inject drugs (PWID) in eastern Europe and central Asia occur in Russia, where PWID have a high risk of overdose. In Russia, use of opioid agonist therapy (OAT) is prohibited, and coverage of needle and syringe programmes (NSPs) and antiretroviral therapy (ART) is poor. We aimed to assess the effects that scaling up harm reduction (ie, use of OAT and coverage of NSPs) and use of ART might have on HIV incidence and the frequency of fatal overdoses among PWID in two cities in the Ural Federal District and Siberian Federal District, where the prevalence of HIV is high or increasing in PWID. Methods In this modelling study, we developed a dynamic deterministic model that simulated transmission of HIV through injection drug use and sex among PWID. We calibrated this model to HIV prevalence data among PWID in two Russian cities: Omsk (which has high but increasing prevalence of HIV among PWID) and Ekaterinburg (which has very high but stable prevalence of HIV). The source data were from research studies supported by the Global Fund to Fight AIDS, Tuberculosis, and Malaria and US Centers for Disease Control and Prevention and surveillance studies from WHO and regional AIDS centres. We modelled the effects of no intervention scale-up (no use of harm reduction measures and 30% of HIV-positive PWID receiving ART) versus combinations of scaling up of OAT, receipt of high coverage of NSPs, and use of ART on the incidence of HIV infections, mortality from HIV, and the frequency of fatal overdoses from 2018 to 2028. Findings Without intervention, HIV prevalence among PWID in Omsk could increase from 30% in 2018 to 36% (2·5–97·5 percentile interval 22–52) in 2028 and remain high in Ekaterinburg, estimated at 60% (57–67) in 2028. Scaling up OAT to 50% coverage for a duration of 2 years could prevent 35% of HIV infections and 19% of deaths associated with HIV in Omsk and 20% (11–29) of HIV infections and 10% (4–14) of deaths associated with HIV in Ekaterinburg. Further, this scaling up could prevent 33% of overdose deaths over the next 10 years. Scaling up of NSPs and OAT to 50% coverage and tripling recruitment to ART (reaching about 65% of HIV-positive PWID) could prevent 58% (46–69) of HIV infections and 45% (36–54) of deaths associated with HIV in Omsk and 38% (26–50) of HIV infections and 32% (23–41) of deaths associated with HIV in Ekaterinburg by 2028.
2016 marked the next phase of the protracted social crisis. Economic instability and tension in the international political arena ensured the maintenance of affective reactions in the social environment, thereby providing opportunities for media controllers to build manipulative schemes. The most widespread form of affective reactions is moral panics.
In 2016 media controllers made an attempt to construct a moral panic, presenting the problem of HIV spread as an epidemic. Using the tools of symbolization and exaggeration, journalists complicated the phenomenon familiar to the public, interpreting it as a forerunner of a social catastrophe. Thus, the HIV epidemic has become the basis for the production of the second-order moral panic, cultivated on social grounds, prearranged by a prior wave of the events of social reality.
According to the results of the study it is concluded that there are two media strategies: inspiring moral panic and its containment. The example of constructing a moral panic concerning the HIV epidemic by LIFE has demonstrated the fallacy of the chosen strategy, since due to the lack of media tandem this phenomenon has not caused long-term affective reactions in the social environment. The main federal channels (for example, First Channel) promoted the need for HIV prevention. The rhetoric of regional channels (STRC “Orenburg”, TRK “TC-Region”) corresponded fully to the strategy of the federal mass media and was focused on the adaptation of HIV-infected people in the society.
To conclude, the spread of HIV in Russian cities has reached a critical level in 2016 and it has been defined as a real social problem that requires consolidated solutions on the part of the society and the state. The increase of public awareness and knowledge – millions of people across the country get interested in their HIV status (only in the Urals the number of people who tested for HIV has increased by 3%) can be considered as a constructive consequence of this problem coverage by federal and regional mass media.
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.
This article is talking about state management and cultural policy, their nature and content in term of the new tendency - development of postindustrial society. It mentioned here, that at the moment cultural policy is the base of regional political activity and that regions can get strong competitive advantage if they are able to implement cultural policy successfully. All these trends can produce elements of new economic development.