Sexual and gender politics inform relational expectations surrounding sexual experiences of Peruvian transgender women (TW) and men who have sex with men (MSM). We used the framework of sexual role strain, or incongruence between preferred sexual role and actual sexual practices, to explore potential conflicts between personally articulated identities and externally defined norms of gender and sexuality and its potential to increase HIV/STI risk. Cross-sectional individual- and dyad-level data from 766 TW and MSM in Lima, Peru were used to assess the partnership contexts within which insertive anal intercourse was practiced despite receptive role preference (receptive role strain), and receptive anal intercourse practiced despite insertive role preference (insertive role strain). Sexual role strain for TW was more common with non-primary partners, while for MSM it occurred more frequently in the context of a primary partnership. Receptive role strain was more prevalent for TW with unknown HIV status (reference: without HIV) or pre-sex drug use (reference: no pre-sex drug use). For homosexual MSM, receptive role strain was more prevalent during condomless anal intercourse (reference: condom-protected) and with receptive or versatile partners (reference: insertive). Among heterosexual or bisexual MSM, insertive role strain was more prevalent with insertive or versatile partners (reference: receptive), and less prevalent with casual partners (reference: primary). Our findings suggest TW and MSM experience different vulnerabilities during sexual role negotiation with different partner-types. Future studies should explore the impact of sexual role strain on condom use agency, HIV/STI risk, and discordances between public and private presentations of gender and sexual orientation. / National Institutes of Health / Revisión por pares

In response to Irish philosopher Richard Kearney’s recent proposal of a post-metaphysical re-imagination of God, the thesis asks how we may begin to reimagine the Christ-event, post-metaphysically. Specifically, it investigates the implications of such post-metaphysical thought for the theological categories of hamartiology and soteriology. Methodologically, the thesis proceeds from hermeneutical re-readings of biblical narratives and traditions. Via an archaeology of the biblical yetser, the concept of imagination is offered as a way to re-imagine sin and salvation. The Eden narrative is read within its ancient Near Eastern context, and the narratives of the Annunciation and Transfiguration also receives special mention, as well as the window that Song of Songs opens on the metaphor of the desire of God. What results from this approach is, first, yet another deconstruction of the Augustinian formulation of original sin, as well as an eschatological reinterpretation of the Christ event in terms of the messianic Kingdom of God. Christ, who submits his yetser to the will of the Father in an act of worshipful surrender, becomes the perfect embodiment of the Word of God to a humanity whose yetser is perpetually put in service of itself in an act of idolatry. The enabling of the Kingdom of God in Jesus, who embodies the human telos, captures the human imagination and transfigures humanity through the existential experience of transcendence which breaks into its concrete reality through the Christ-event and its retelling. In this way, realised eschatology is possibilised through the imagination. Christ as prototype of the divinely intended telos of humanity becomes an existential possibility via the transfiguration, enacted by the imagination. This enables humanity to become co-creators with God of a new creation, symbolised by God’s messianic Kingdom of love and justice. / Thesis (PhD)--University of Pretoria, 2016. / University of Pretoria Postgraduate bursary / Dogmatics and Christian Ethics / PhD / Unrestricted

The purpose of this thesis is to scope the literature to understand how people who use injection drug (PWIDs) experience access to hepatitis C (HCV) testing and diagnosis. The design was a scoping review methodology, guided by Arksey and O’Malley, JBI, and PRISMA-ScR guidelines. A search was conducted through seven electronic databases using a peer-reviewed search strategy. Five studies were yielded through two-level screenings. The extracted data were synthesized using conventional data analysis and reported using tables and narrative summaries. Four categories were found: Awareness and Knowledge, Stigma, Healthcare Service, and Psychological Responses. The studies were conducted in Australia, UK, and US published between 2014 to 2018. A total of 19 participant characteristics were extracted to contextualize their experiences. The World Health Organization’s definition of accessibility should be defined through the guidance of the constructed truths of the individuals in the current context. The lack of demographic data and connection to client quotes further exacerbates the inequities among the population through overlooking their intragroup identities.

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Syphilis prevention in the United States continues to be an enduring public health challenge. Although syphilis is a curable infection, if left untreated it can result in severe, debilitating and potentially life-threatening complications. Routine screening for syphilis in high-risk populations remains an important prevention and control measure. Research consistently demonstrates the relative advantage of greater testing frequency in at-risk populations such as men who have sex with men (MSM) using both cost-effectiveness analyses and mathematical modeling. Despite this, frequency of screening for syphilis among MSM remains sub-optimal, and failure to screen MSM at recommended intervals may be attributable to clinicians’ perceptions related to syphilis screening in this population. The Theory of Planned Behavior (TPB) may help to elucidate the attitudes, social and professional norms, and perceived behavioral control that providers experience towards syphilis screening. The extent to which these cognitive-behavioral factors facilitate clinicians’ intentions to screening MSM for syphilis has not been previously evaluated. Using the constructs of the TPB, this study developed and validated a new survey tool with a national sample of physicians (n=123) who treat MSM and recruited through a proprietary email list and through passive recruitment on social media and provider Listservs. Results of the survey revealed variability in providers’ attitudes, social norms and perceived behavioral control, and these differed in association with self-reported syphilis screening intention and behavior. The survey was also used to validate a measurement model based on the TPB. This measurement model consisted of four factors: attitudes, social norms, perceived behavioral control and intention. This model was then used in structural equation modeling analysis to simultaneously test the strength of associations between these factors and a self-reported behavioral outcome. Results indicate that attitudes have a significant indirect effect on self-reported screening behavior mediated though intention. Perceived behavioral control was also strongly associated with self-reported behavior, as was intention to screen. By incorporating the TPB into a model of physician behavior, this study provides a framework for interventions targeted at increasing syphilis testing frequency in clinical practice. / Public Health

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Pre-exposure prophylaxis (PrEP) access is increasing in Latin America. We explored PrEP use among Spanish-speaking, Hornet geosocial networking application users from Latin American countries with limited PrEP data via an online survey completed between December 2018 and February 2019. A total of 718 Hornet users from 10 countries were included, of whom 72.1% reported PrEP awareness. Few (5.6%) were currently taking PrEP, though 32.1% intended to take PrEP in the subsequent 6 months. PrEP awareness was lower in 18–25 year olds compared to 26+ (62.4% vs. 75.6%, aOR 0.67, [95% CI 0.46–0.97]), and higher among those living in larger versus smaller cities (74.4% vs. 58.8%, aOR 1.96, [95% CI 1.25–3.07]) or countries with at least partial versus no PrEP policy adoption (79.1% vs. 60.8%, aOR 2.20, [95% CI 1.56–3.12]). Intention to use PrEP was higher among PrEP-eligible respondents (51.8% vs. 29.6%, aOR 2.26, [95% CI 1.26–4.07]) and those recently tested for a sexually transmitted infection (35.4% vs. 25.5%, aOR 1.58, [95% CI 1.01–2.48]). Efforts to expand PrEP use in Latin America should focus on national PrEP policy adoption, and research should explore barriers to awareness and use among young men who have sex with men. / National Institute of Mental Health / Revisión por pares

This study focused on the agency of battered women who kill in Turkey by conducting face- to-face interviews and using news articles covering the stories of three battered women who killed their abusers. Using a feminist poststructuralist theory and intersectionality analysis, the study analysed the patterns surrounding the agency of battered women who kill. Male violence in Turkey continues to be an unresolved problem, which continues to only grow. In the mainstream media and discourse, female victims of male violence tend to be portrayed within the victimhood concept. Thus, it creates an image of a weak, passive woman who does not have an agency. However, battered women who kill tend to conflict with the image of a passive victim. The act of killing does not fit the traditional understanding of femininity. The interview findings showed that battered women who killed their abusers were commonly understood as desperate, weak, and ignorant women. While the act of killing was justified, it was through a justification of an act conducted by someone who lacked agency. The news portrayals supported the findings of the interviews and showed that battered women who kill were justified when the woman was portrayed as a victim who killed specifically while she was being battered and was a mother who killed...

This thesis explores the topic of Canadian-Indigenous battered women who killed their intimate abusers and seeks to better understand these women’s experiences, their treatment within the Canadian criminal justice system, and how BWS was used in their cases. A theoretical framework comprised of Indigenous Feminisms and Intersectionality was used to guide this research study and to shed light on the lived experiences of Indigenous battered women who killed their abusers. Various important Indigenous Feminist theorists such as Dian Million (2013) and Patricia Monture-Angus (1998) were drawn upon as well as advocates for Intersectionality such as Patricia Hill-Collins (2019). A qualitative thematic analysis was performed to create four overarching themes from eight cases where Indigenous battered women killed their intimate abusers.