'You are not yourself': exploring masculinities among heterosexual African men living with HIV in London.

It is now clear that gender is an essential factor shaping the narratives of men as well as women. However, there have been few studies of the daily lives or sexual activities of heterosexual men. Hence, strategies developed to prevent the spread of the HIV virus are rarely based on detailed knowledge of the men whose behaviours they are intended to change; this is especially evident in the developing world where the epidemic is most severe. Nor do we know very much about those men who have already been diagnosed as HIV positive. Around 13 million men are now living with HIV of whom around 96% are in low or middle income countries. Migrants from developing countries also make up the majority of positive people in a number of developed countries. In the UK, for example, heterosexual activity is now responsible for about half of all new HIV diagnoses with the majority of those involved being of African origin. But almost nothing is known about the ways in which different constructions of masculinity affect their experiences of illness. This study used qualitative methods to explore the experiences of a sample of black African men who defined themselves as heterosexual and were receiving treatment for HIV and/or AIDS in London. It explored their feelings, their needs, their hopes and their desires as they negotiated their lives in the diaspora.

Challenges in researching life with HIV/AIDS: an intersectional analysis of black African migrants in London.

Most social science research on HIV has focused on prevention. The arrival of new therapies generated more studies on life with HIV. However most have been carried out in developed world contexts. Much less is known about the vast majority of those living with HIV and dying from AIDS. If this gap is to be filled, more qualitative research will be needed on affected individuals in the developing world and also among migrants who have left developing countries to live in the diaspora. It will also be essential to explore the lives of individuals from the same communities who may experience HIV in very different ways as a result of their gender and/or sexuality. This paper presents findings from three studies of Black African migrants living with HIV in London. It uses an intersectional approach to examine the similarities and the differences between the experiences of heterosexual women, heterosexual men and gay and/or bisexual men. The article highlights the importance of research of this kind both for providing the evidence base for context-specific policy development and also for making better conceptual and theoretical sense of the impact of HIV on individuals and their lives.

'I count myself as being in a different world': African gay and bisexual men living with HIV in London. An exploratory study.

The experiences of men from African backgrounds living with HIV who are gay/bisexual have so far been overlooked in the research on HIV in the UK. Little is known about the ways that HIV impacts on this population. We report on an exploratory qualitative study with 8 gay/bisexual men from 7 different African countries living with HIV in London, based on in depth semi structured interviews and a thematic analysis. HIV testing and diagnosis, disclosure to others, social and sexual networks, sexual relationships and practices, use of health services and coping mechanisms emerged as key themes. Men with insecure residency status in the UK and those without work had additional challenges to meet. Men described the constant juggling required to balance the complex and sometimes contradictory realities of life as a gay/bisexual man, an African and an HIV positive person. Actual and perceived stigma was a key barrier to accessing appropriate practical and emotional support from families, social network or religious organisations.

Sex, gender and blindness: a new framework for equity.

Four-fifths of all blind or vision impaired people live in middle-income and low-income countries with the African region and parts of Asia and the Middle East bearing the heaviest burden. At the same time, we know that around two thirds of all blind people in the world are female. Hence, the poorest (and usually the oldest) women are most likely to have their lives limited by visual impairment. While recent strategies have focussed on international variations in eye health, very few have paid attention to the gender differences that are an inextricable element in these inequalities. This review will explore possible explanations for the advantage of men in the exercise of one of the most basic of human senses. It will show that this cannot be understood through the use of a biomedical approach alone. Broader social perspectives will also be needed in order to create an appropriate knowledge base for tackling global inequalities in blindness.

The odd couple: using biomedical and intersectional approaches to address health inequities.

BACKGROUND: Better understanding and addressing health inequities is a growing global priority. OBJECTIVE: In this paper, we contribute to the literature examining complex relationships between biological and social dimensions in the field of health inequalities. Specifically, we explore the potential of intersectionality to advance current approaches to socio-biological entwinements. DESIGN: We provide a brief overview of current approaches to combining both biological and social factors in a single study, and then investigate the contributions of an intersectional framework to such work. RESULTS: We offer a number of concrete examples of how intersectionality has been used empirically to bring both biological and social factors together in the areas of HIV, post-traumatic stress disorder, female genital circumcision/mutilation/cutting, and cardiovascular disease. CONCLUSION: We argue that an intersectional approach can further research that integrates biological and social aspects of human lives and human health and ultimately generate better and more precise evidence for effective policies and practices aimed at tackling health inequities.

Understanding women, health, and social change: the case of South Korea.

Since the 1960s, South Korea has experienced rapid economic development and an improvement in the health of its population. During this period there have been marked increases in women's educational and occupational opportunities. But despite these improvements, women still suffer higher levels of gender discrimination than their counterparts in many other countries at similar stages of development. Most dramatically, there are still high levels of sex-selective abortion. Women have lower socioeconomic status than men, and their lives are markedly restricted by the cultural values associated with Confucianism. This article explores the effects of these factors on women's health. Despite their greater longevity, South Korean women still report higher rates of morbidity and distress than men. This can be compared with the "gender paradox" in health reported in many developed countries during the 1970s and 1980s. More detailed research is needed on the factors influencing the health of South Korean women and on related trends in other newly industrializing Asian societies.

'My fear is to fall in love again...' how HIV-positive African women survive in London.

Many studies are now documenting the circumstances of people living with HIV/AIDS in different parts of the world. We know an increasing amount about the experiences of women who make up the majority of those infected in countries in sub-Saharan Africa. However, very few researchers have examined the lives of female migrants from the region living with HIV. This article begins to fill that gap by exploring the situation of 62 women from different parts of Africa receiving treatment from the National Health Service in London. It is based on a qualitative study carried out between 2001 and 2002 using semi-structured interviews. The analysis explores the ways in which the women's lives are shaped in complex ways by their sex and gender, by their status as migrants and by their seropositivity. It examines the nature of their survival strategies, focusing mainly on the management of information, the use of health services and the importance of spirituality in their lives. The article concludes by highlighting the paradox whereby these women have access to treatment that would be unavailable in their own countries but their survival depends on them remaining in a country which few regard as 'home'.

Sex and gender: the challenges for epidemiologists.

Gender issues are now receiving more attention on global and national health agendas. However, the evidence base for policy and practice in this area remains limited and conceptual confusion is still common. This article reviews the challenges facing epidemiologists and other researchers who aim to make their work more "gender sensitive." It begins by exploring the concepts of biological "sex" and social "gender" and assesses their implications for the health of both women and men. It then reviews a range of strategies for mainstreaming sex and gender into health research. The article concludes with brief comments on the links between gender equity and wider equality concerns.