New drug use among agricultural workers.

Research on drug use onset rarely examines the spatial dimensions of onset, owing to a literature that is overwhelming from urban areas of an industrialized country (United States). Narrative interviews from drug-using agricultural workers in contrast reveal another side of drug use onset, where influence of familiarity with place becomes evident, despite the expectation that the novelty and/or adventure within a lifestyle of seasonal employment and migratory labor that requires overnight accommodations on-the-season is likely to push/pull one into the first use of a new drug or the first drug that an individual has ever used.

From parallel to intersecting narratives in cases of sexual assault.

Restorative justice alternatives to criminal justice are designed to balance the needs of victims, offenders, families, friends, and the community at large to achieve social justice, repair of victims, and deterrence of crime. In the model we evaluated from RESTORE (Responsibility and Equity for Sexual Transgressions Offering a Restorative Experience), each offender and victim received individual services and met in guided conferencing to mutually determine reparative actions for the offender. At the exit meeting, the offender, as the responsible person, read a written apology to the survivor/victim. In this article, we analyze the expression of empathy in the apology, in which the initial mitigation of responsibility in early documents was replaced by acknowledgment of harm to the survivor/victim and acceptance of responsibility for the assault. Those accused of felony rape and those targeting a visible person in cases of misdemeanor indecent exposure expressed greater regret and remorse than offenders of indecent exposure with an indeterminate victim.

"Alcohol is something that been with us like a common cold": community perceptions of American Indian drinking.

This study examined tribal members' perspectives on alcohol, risk factors, consequences, and community responses. Focus groups were conducted with five American Indian tribes between 1997 and 2001. Participants were knowledgeable of the cultural lives of their reservation communities. Although there was agreement regarding the pervasiveness of heavy drinking, participants reported different opinions about the meaning of alcohol and appropriate intervention strategies. Three dilemmas were identified, suggesting that community ambivalence may serve as a barrier to reducing problem drinking. Implications, limitations, and future research directions are discussed. The study was funded by the National Institute on Alcohol Abuse and Alcoholism.

Identity and resilience among persons with HIV: a rural African American experience.

In this article, the author contrasts the disruption model proposed by Becker (1997) against the life trajectories of two persons who used and sold drugs; considers the impact of engagement and discontinuation of substance use on their respective lives; and examines the process of life reorganization they put into motion after testing positive for HIV. Their departure from the world of drugs removed each from an unwanted lifestyle, facilitated the process of building resilience against the social adversity they faced in relation to their seropositivity, assisted them with securing care and services through institutional mechanisms, and generated a forum for new ideas on family continuity versus the ideal of individualism that grounds mainstream society. A process of identity reaffirmation further deepened their understanding of themselves as African Americans in the southern United States.

Determinants of survival for Native American adults with HIV infection.

Few if any Native American/Alaska Native (NA/AN) people have been included in highly active antiretroviral therapy (HAART) treatment trials or epidemiologic studies, leaving little data on which to be assured of the efficacy of HAART in this unique population. This study aims to evaluate the impact of HAART and review determinants of survival in a cohort of NA/AN persons receiving treatment for HIV in a real life clinical setting. A retrospective chart review of 235 HIV-infected Native Americans receiving services at an urban medical center operated by the Indian Health Service from January 1, 1981 through June 30, 2004 was conducted, providing 782.7 person-years of follow-up. The main outcome measures were time from study entry and from incident AIDS diagnosis to death. Death rates fell from 18.4 (13.3-25.4) per 100 person-years in the period prior to 1998 to 6.4 (4.6-8.8) per 100 person-years in the years 1998-2004, (RR 0.35, p < 0.0001). Factors associated with the greatest reduction in risk of death from time of study entry were current use of HAART, HR 0.13 (0.06-0.30, p < 0.001), and CD4 count >/=200 at entry, HR 0.16 (0.08-0.35, p < 0.001). Current use of HAART was the strongest predictor of survival from time of AIDS diagnosis, HR 0.11 (0.05-0.25, p < 0.001). The use of HAART therapy and CD4 count were primary predictors of survival. Earlier diagnosis and access to effective medical treatment will be key factors in reducing disparities in health brought about by HIV infection in Native American/Alaska Native communities.

After-rape among three populations in the Southwest: a time of mourning, a time for recovery.

Narrative analysis of open-ended interviews with 62 female survivors of rape from three populations in the Southwest (Native American, Mexican American, Anglo) uncovered commonalities and dissimilarities in women's description of their experience of afterrape (rape survival). Although all three groups reported experiences that confirm aspects of prior analyses of reactions to rape, the narrative analysis highlights variations in reactions to rape across the three groups. These variations, and more established commonalities, provide baseline material for strengthening primary and secondary interventions for women who have experienced sexual violence.

Visualizing the qualitative: making sense of written comments from an evaluative satisfaction survey.

PURPOSE: Satisfaction surveys are common in the field of health education, as a means of assisting organizations to improve the appropriateness of training materials and the effectiveness of facilitation-presentation. Data can be qualitative of which analysis often become specialized. This technical article aims to reveal whether qualitative survey results can be visualized by presenting them as a Word Cloud. METHODS: Qualitative materials in the form of written comments on an agency-specific satisfaction survey were coded and quantified. The resulting quantitative data were used to convert comments into "input terms" to generate Word Clouds to increase comprehension and accessibility through visualization of the written responses. RESULTS: A three-tier display incorporated a Word Cloud at the top, followed by the corresponding frequency table, and a textual summary of the qualitative data represented by the Word Cloud imagery. This mixed format adheres to recognition that people vary in what format is most effective for assimilating new information. CONCLUSION: The combination of visual representation through Word Clouds complemented by quantified qualitative materials is one means of increasing comprehensibility for a range of stakeholders, who might not be familiar with numerical tables or statistical analyses.

Narrative constructions of sexual violence as told by female rape survivors in three populations of the southwestern United States: scripts of coercion, scripts of consent.

There is a growing literature on the narrative construction of rape as sexual violence. This is puzzling, since, in certain contexts, violence may stifle narrative production. Researchers of atrocities, for example, propose that the experience of recurring terror disrupts narrative cohesion in reporting lived trauma. Genocidal horror occurs in the context of communities and ethnic groups. Our rape survival data from women of three populations in the southwestern United States reflect traumas of sexual violence against women, experienced within everyday lives. From interviews with 62 female rape survivors, we (1) identify narrative conventions and linguistic devices to show how these women structure accounts of sexual assault that reflect their cultural background; (2) contrast scripts of coercion and consent; (3) examine how the way in which these women describe the coercive actions of the perpetrator(s) contradicts the assumptions of legal discourse; and (4) discuss the narrative production of several women in abusive relationships and compare it to the narrative production (or lack thereof) of persons who experience state-engineered terror.

Risk and danger among women-who-prostitute in areas where farmworkers predominate.

Based on ethnographic research in three agricultural settings in Florida, this article examines one aspect of risk and danger for female sex workers, that of interpersonal violence, while considering women's responses to a shifting sex trade in areas where farmworkers live and work. Sex work in agricultural areas varies from urban sex work. Women eschew pimps, ask for backup from local men entrenched in street settings, and canvass a wide spatial area rather than remained fixed in space. Oscillating between periods of capital-deficiency (nonseason) and capital-intensification (harvest), women respond to increasing risk and danger by building a clientele of regular customers, refusing risky transactions and referrals, and creating a local infrastructure of sanctuary. Some women also construct schemes to relieve men of their money. These men typically are farmworkers, whose vulnerability and image of low risk for HIV expands the potential for risk and danger found in these settings.

Taking humor seriously: talking about drinking in Native American focus groups.

Focus groups provide a source of data that highlight community ideas on a topic of interest. How interview data will be utilized varies by project. With this in mind, we identify ways that focus group data from a particular population (Native American) articulate a health issue of individual tribal concern (alcohol consumption). Taking our analytic framework from linguistics, one of the four fields of inquiry in anthropology, we examine format ties and the performance of humor as stylistic features of tribal focus groups and illustrate how linguistic devices can be used in analyzing aspects of adolescent and adult drinking. Focus group data require systematic review and analysis to identify useful findings that can lead to inquiry points to initiate collaborative work with local experts before the data can be developed and configured into effective program initiatives.

Sex workers in agricultural areas: Their drugs, their children.

Most research on female sex workers is urban-based, emphasizing economic necessity and risk-taking. Few authors discuss sex workers and their children. The objective of the present study was to ethnographically explore the influence of street life on childrearing by women involved in sex work in agricultural areas of the southeastern USA. Interviews took place with 38 women. Findings suggest that the sampled women followed the usual paths into substance use. Most began using substances before they began sex work, at which time use escalated to crack-cocaine. Children of 32 of the 34 women who were mothers were living separately from their mothers. None the less, mothers took an interest in children's wellbeing, and many visited them whenever possible. Their principal concern was assuring that children were raised in the best way available. One daughter followed her mother into sex work, and a few older children drank moderately. Several children had experienced abuse from persons other than parents, but the long-term effects of this abuse are unknown.