Gender, sexuality, and HIV/AIDS: the what, the why, and the how.

The focus of Geeta Rao Gupta's plenary presentation of 12 July 2000 at the XIII International AIDS Conference is on the what, why, and how of gender, sexuality, and HIV/AIDS. Dr Rao Gupta discusses the factors associated with women's vulnerability to HIV; and the ways in which unequal power balance in gender relations increases not only women's, but also men's, vulnerability to HIV-despite, or rather because of, their greater power. She then addresses the question of how one is to overcome the seemingly insurmountable barriers of gender and sexual inequality. How can we change the cultural norms that create damaging, even fatal, gender disparities and roles? According to Dr Rao Gupta, an important first step is to recognize, understand, and publicly discuss the ways in which the power imbalance in gender and sexuality fuels the epidemic. She provides examples of sensitive, transformative, and empowering approaches to gender and sexuality and concludes that, in the final analysis, reducing the imbalance in power between women and men requires policies that are designed to empower women--policies that aim to decrease the gender gap in education, improve women's access to economic resources, increase women's political participation, and protect women from violence.

Correlation of the growth fraction, nucleolar organizer region counts and epidermal growth factor receptor with histomorphological prognostic criteria in breast cancer.

A total of 60 cases of breast cancer were studied to find the correlation between newer parameters of prognosis viz growth fraction (GF), nucleolar organizer region (AgNOR) counts and epidermal growth factor receptor (EGFR) positivity with the various histomorphological factors such as tumour size, nuclear grade, histological grade and mitoses. Growth fraction measured by Ki67 monoclonal antibody varied from 3.6 to 73.7 percent. AgNOR counts ranged from 1.2 to 16.9 dots per tumour cell nucleus with a mean of 6.26 dots. EGFR positivity was seen in 66.7% of cases. Ki67 score correlated with all prognostic variables studied except the presence of axillary metastases. AgNOR counts correlated with size of tumour, axillary lymph-node metastases and Ki67 score but no correlation was seen with histologic or nuclear grade. EGFR positivity correlated strongly with size of the tumour and weakly with Ki67 score, AgNOR counts and mitoses.

Summary of track D: social science: research, policy and action.

SCOPE: This review summarizes the main issues discussed during Track D, which examined the societal impact of HIV/AIDS, and responses to the epidemic by individuals, families, communities and societies worldwide. Micro- and macrolevel issues addressed included the development, implementation and evaluation of programmes for prevention and care; policy development and implementation; structural issues such as the impact of gender relations, development and migration on the development of the epidemic; and the social and economic impact of HIV/AIDS on affected societies and communities. RECURRENT THEMES: Presentations provided strong evidence that peer-led, community-based programmes offer particularly effective ways of working, and that participatory research involving affected communities provides useful results for the design and evaluation of programmes and policies. This is the case across settings, issues, populations and countries. FUTURE DIRECTIONS: Emerging needs include how best to ensure sustainability of national and international responses, how best to scale up successful interventions for wider reach, and how best to work with systematically marginalized, neglected groups and populations. Research priorities include the characterization of the multiple determinants of HIV-related vulnerability, and the evaluation of interventions that take these complex determinants as their starting point. A more coherent and strategic response requires less separation between the different constituencies involved in AIDS work, and the more sustained involvement of people living with HIV/AIDS themselves.

Gender and HIV / AIDS: transforming prevention programs.

PIP: The Women and AIDS Research Program (International Center for Research on Women) has identified a series of obstacles to preventing HIV infection among women, including social norms that mandate female ignorance about sexual matters, women's economic dependence on men, widespread acceptance of male promiscuity, and violence against women. Most AIDS prevention programs fail to challenge these contextual determinants and continue to focus on the promotion of condom use among men. Recommendations to empower women and improve their status are dismissed as long-term measures outside the domain of AIDS prevention. Feasible, however, is the modification of existing AIDS prevention programs to ensure they are gender-sensitive. This would mean measures such as providing services at times that are convenient to women and integrating services to reduce waiting and travelling times. To address the contextual issues at the root of women's vulnerability to HIV, AIDS prevention programs can link up with economic interventions such as credit programs, agricultural extension services, and women's cooperatives. Moreover, AIDS programs can provide HIV-infected women with social support through group educational sessions or counseling. Finally, because improvements in women's socioeconomic status are essential for the success of all AIDS prevention, program managers should be in the forefront of broader struggles to enact policy changes to eliminate gender-based discrimination and inequality.^ieng

Male-female inequalities result in submission to high-risk sex in many societies. Special report: women and HIV.

PIP: The prevalence of HIV infection is increasing in women throughout the world, and the four basic prevention recommendations depend upon people having control over their sexual relations. In many societies, however, women have no control over their sexuality or over their partners' sex behavior. In areas which have been badly hurt by economic recession, many women and girls find economic refuge in "sexual networking," or exchanging sexual favors for money, gifts, and protection. Women with no economic independence also feel constrained to adopt whatever behavior is necessary to protect their marital status, including overlooking their partner's infidelities. The idealization of virginity in many cultures means that women and girls are deliberately kept in ignorance of basic reproductive and anatomical facts. Virgins are also prized by older men attempting to avoid contacting HIV infections (of course, these men may already be infected). Motherhood also has an elevated status, and no method of HIV prevention is available which also allows conception to occur. A cultural emphasis on male sexual pleasure also increases a woman's risk of infection as women adopt practices such as "dry sex" and anal intercourse and as women suffer from forced sex. The following policies and programs would reduce women's vulnerability to HIV infection: 1) improving women's status; 2) supporting the development of a female-controlled preventive technology; 3) increasing availability and accessibility of sexually transmitted disease services; 4) increasing women's knowledge of their bodies and of sexuality as well as their skills in negotiating safer sexual behaviors with their partners; and 5) promoting sexual and family responsibility among adolescent boys and men.^ieng

Women's lives and sex: implications for AIDS prevention.

Preliminary findings from the Women and AIDS program, a research grants program of the International Center for Research on Women in Washington, D.C. that supports 17 studies in developing countries worldwide, provide a glimpse into the complex interaction between women's social and economic status and risk of HIV infection. In many settings, the cultural norms that demand sexual fidelity and docile and acquiescent sexual behavior among women permit--and sometimes even encourage--early sexual experimentation, multiple partnerships, and aggressive and dominating sexual behavior among men. Drawing upon the finding from the program, the paper analyzes how such cultural norms, together with women's social and economic dependency, can limit a woman's ability to negotiate safer sex with her partner; restrict her access to information and knowledge about her body; force her to sometimes barter sex for survival; increase her vulnerability to physical violence in sexual interaction; and compromise her self-esteem. The findings highlight the limitations of the current HIV/AIDS prevention strategy for reducing women's risk of HIV, and underline the urgency for an approach to prevention that is grounded in the realities of women's lives and sexual experiences--an approach that recognizes the relationship between the dynamics of gender relations, sexual behavior, and HIV risk.

Cytokinins in seeds of pumpkin.

Extracts of seeds of pumpkin (Cucurbita pepo Linn.) contain three chromatographically distinguishable cytokinins which are held on Dowex 50-W and are extractable by ethanol and n-butanol. Two of the active factors are precipitable by silver nitrate at acidic pH. The chromatographic behavior and the spectral characteristics of one of these cytokinins are similar to those of zeatin. However, the R(F) values of the other two active compounds do not match with those of any of the known natural cytokinins.