The second session had camera instruction. The third session had each participant given a camera and they were instructed to "(t)ake pictures of the challenges and solution in addressing HIV and AIDS" (Mitchell et al., 2005). The fourth session saw the photos developed and asked small groups to compare and contrast their pictures by creating posters. The authors draw on previous research on photo-voice techniques, as well as memory and photography and self-representation through photography.
In the end, the authors' qualitative research concluded that although many projects use photography to give voice to participants, it is especially significant in the giving a voice to community health workers and teachers in rural South African communities. In these remote areas, the communities do not have to wait for researchers to provide them answers, instead they are able to take action themselves and give a visible face to the HIV and AIDS plight (Mitchell et al., 2005). Through the creative use of photography, these communities can express themselves in entirely new ways.
Critical Analysis of the Article:
This article was incredibly moving and illustrated a non-conventional approach to communicating. The premise of the research, how best to give healthcare workers and teachers a voice in the plight against AIDS and HIV reaches beyond the medical and scientific issues involved in this topic and touches on the psychological and sociological issues as well. The authors effectively call attention to the need for putting faces with the HIV and AIDS epidemic, as well as the need to give critical people involved in the community a way to express their own unique opinions on the topic. For this alone, the article was useful.
However, further research needs to be conducted. The methodological premise of the value of photo-voice is sound, but it would be interesting to see this article followed up with the effectiveness specifically in rural South African communities, and specifically regarding the HIV and AIDS plight. Although healthcare workers and teachers may have found photography useful in expressing their thoughts and feelings about the challenges and solutions surrounding the epidemic, it would be interesting to learn if their voices were heard by the greater community.
Yoshikawa, H., Wilson, P., Hsueh, J., Rosman, E., et al. (2003 Sept) What front-line CBO staff can tell us about culturally anchored theories of behavior change in HIV prevention for Asian/Pacific islanders. American Journal of Community Psychology, 32(1/2). Retrieved November 17, 2006, from ProQuest database.
Summary of the Article:
Yoshikawa et al.'s (2003) qualitative research was reported in this article. The researchers noted that there are "(f)ew rigorously tested primary prevention programs (that) have been developed to prevent HIV infection among immigrant communities in the United States (due to) the lack of culturally specific behavioral theories that can inform HIV prevention for immigrant communities in the United States." The researchers' goal was to develop these behavioral theories for specifically the Asian/Pacific Islanders (A/PIs) immigrant communities.
Although A/PIs in general appear to be at a lower risk of contracting HIV, certain A/PIs subgroups are at an increased risk.
These include young gay A/PI males, who have a higher incidence of HIV infection than White gay males. In addition, the authors cited a recent study that found that between 21 and 53% of AP/I males that have sex with men self-reported having unprotected anal intercourse within the last 6 months (Yoshikawa et al., 2003).
Since the purpose of the study was to inform both researchers and practitioner audiences, the researchers chose a methodology that not only allowed for assessment and description of theories of change, but also one that would create practical and immediately useful information for those at CBOs. An empowerment evaluation approach was undertaken and with the assistance of a CBO participant staff, the study was conceptualized, and the measures to be used and data analysis procedures were developed. In the end, it was discovered that one way to address a taboo topic, with A/PIs, such as HIV and AIDS< was to pair it with a positive cultural symbol. They also determined that "diffusion of innovation processes are more efficient under conditions that address the particular meanings of sex and HIV / AIDS in A/PI cultures" (Yoshikawa et al., 2003). In addition, the researchers presented risk factors that were inherent to the contraction of HIV. These included: retention of cultural values from their home country that stigmatized protected sex, perceived low levels of risk for contracting the disease, length of U.S. residence, and education levels. Lastly, Yoshikawa at al. surmised that processes at the social network, behavior setting, and community levels, that are directed towards cultural preferences and attitudes, specifically for A/PI populations, are currently lacking in the American HIV prevention programs.
Critical Analysis of the Article:
Yoshikawa et al.'s (2003) research is instrumental in helping correct the severely lacking amount of culturally specific behavioral theory regarding immigrant communities and HIV prevention in the United States.
Their findings were contrary to mainstream practice of one-size-fits-all prevention programs. Their qualitative research helps fill that void. In addition, they brought to light the fact that American HIV prevention programs are not geared towards the cultural preferences and attitudes of immigrant populations, specifically A/PIs.
Future qualitative and quantitative research is needed to explore the predictors of HIV risk among A/PI populations, in order "to expand the data base on culturally anchored theories suitable for HIV prevention. In addition, quasiexperimental and experimental evaluation of culturally anchored strategies such as the ones reported by the peer educators in this study is urgently needed" (Yoshikawa et al., 2003).
In addition, this research should be repeated but with a greater diversity of participants. The researchers sample was based on a group of peer educators from a community-based AIDS service organizations serving A/PI communities in a Northeastern city. A more geographical diverse study would either confirm or draw question to this research. In addition, the current study was a small sample size of only 35 participants. A greater sample size would again provide more validity to the findings.
Weitz, A., Reddy, P., Van Den Borne, H., Kok, G., & Pietersen, J. (2003 May). Determinants of multi-partner behaviour of male patients with sexually transmitted diseases in South Africa: Implications for interventions. International Journal of Men's Health, 2(2). Retrieved November 17, 2006, from Academic OneFile database.
Summary of the Article:
The article presents quantitative research results regarding multi-partner behavior among patients with STDs in Cape Town, South Africa. Two thousand two-hundred thirty-three male patients with STDs were given a structured interviewer-administered questionnaire. The questions that were asked centered on personal determinants such as: biodemographics, the patient's general knowledge regarding STDs, their beliefs and attitudes about STDs, and perceptions regarding HIV risk. In addition, normative determinants were explored "including social norms regarding gender role beliefs about refusing sex and condom use behaviour as well as perceptions of self-efficacy in using condoms" (Weitz, Van Den Borne, Kok, & Pietersen, 2003).
A logistic regression analysis was utilized to identify the significant predictors of multiple partner behavior. The data identified a strong linkage between mult-partner behavior and male gender constructs that value sexual prowess and the belief that men cannot refuse sex because their sexual desire is uncontrollable. Previous experience with an STD was also found to be linked to multi-partner behavior, centered on the belief that having an STD is synonymous with sexual prowess. Disturbingly, there was no significant relationship discovered between the number of sexual partners and condom use behaviors, which would help prevent the spread of STDs and specifically HIV and AIDS.
Negative attitudes about condom use was a factor in this. In the end, "(t)he findings suggest that the real challenge for preventive behavioural change lies in addressing gendered beliefs that emerged as significant predictors of multiple sex partner behaviour. These deep-seated beliefs touch the very core of what it constitutes to be a man and a woman within the Southern African context" (Weitz, Van Den Borne, Kok, & Pietersen, 2003).
Critical Analysis of the Article:
The article explored a significant facet of the struggle against HIV and AIDS.
Multi-partner behavior is a critical issue concerning the spread of the disease.
Their research sampling, although geographically specific, included such a large participant group that produced great insight into the prevailing belief system amongst the participants. One of the more interesting findings was the specific beliefs behind the negative attitudes towards condom use. It was discovered that many of the participants expressed negative attitudes due to cultural beliefs that believed condom use to be a waste of sperm as it limited the continuation of the clan name, and that it was bad because it was 'like masturbation' and not 'flesh to flesh'. In addition some believed that condom use would cause a man to lose his virility (Weitz, Van Den Borne, Kok, & Pietersen, 2003). These unique insights into the cultural biases of South African males are critical to developing behavioral change intervention programs.