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Biomedical subjects

Sofia Gruskin

Publications and source records attributed to Sofia Gruskin.

At least 19 recordsLinked to original sources
PubMed2006

Orphan care in Botswana's working households: growing responsibilities in the absence of adequate support.

OBJECTIVES: Botswana has one of the world's highest HIV-prevalence rates and the world's highest percentages of orphaned children among its population. We assessed the ability of income-earning households in Botswana to adequately care for orphans. METHODS: We used data from the Botswana Family Health Needs Study (2002), a sample of 1033 working adults with caregiving responsibilities who used public services, to assess whether households with orphan-care responsibilities encountered financial and other difficulties. Thirty-seven percent of respondents provided orphan care, usually to extended family members. We applied logistic regression models to determine the factors associated with experiencing problems related to orphan caregiving. RESULTS: Nearly half of working households with orphan-care responsibilities reported experiencing financial and other difficulties because of orphan care. Issues of concern included caring for multiple orphans, caring for sick adults and orphans simultaneously, receiving no assistance, and low income. CONCLUSIONS: The orphan crisis is impoverishing even working households, where caregivers lack sufficient resources to provide basic needs. Neither the public sector nor communities provide adequate safety nets. International assistance is critical to build capacity within the social welfare infrastructure and to fund community-level activities that support households. Lessons from Botswana's orphan crisis can provide valuable insights to policymakers throughout sub-Saharan Africa.

Adolescent↗
PubMed2005

The impact of a police drug crackdown on drug injectors' ability to practice harm reduction: a qualitative study.

This paper employs qualitative methods to explore the ramifications of a police drug crackdown on drug injectors' ability to practice harm reduction. Between August and December 2000, we conducted open-ended interviews with 40 illicit-drug-injecting residents of a New York City police precinct undergoing a crackdown. Interview topics included participants' experiences with police in the precinct and their drug use practices. Grounded theory methods were used to analyze resulting transcripts. Because place emerged as a salient analytic category, we also drew on elements of social geography to interpret results. The analysis suggests that particular crackdown tactics, notably frequent police searches of participants' bodies and elevated surveillance of the precinct's public spaces, reconfigured participants' experiences of their bodies and the public spaces comprising the precinct in ways that adversely affected their capacity to engage in harm reduction. Frequent police searches, for example, discouraged participants from carrying the injection equipment they needed to ensure that they could inject with a sterile syringe. Constant monitoring of local public spaces made it difficult for homeless women and men to inject safely. Simultaneously, participants expressed support for police actions that reduced public drug activity. Given these findings, we recommend the implementation of strategies, designed by partnerships of community groups and governmental and non-governmental organizations, which reduce public drug activity without imperiling injectors' health. Possible strategies include improving access to treatment and establishing safe injection spaces.

Adolescent↗
PubMed2004

Characterizing perceived police violence: implications for public health.

Despite growing recognition of violence's health consequences and the World Health Organization's recent classification of police officers' excessive use of force as a form of violence, public health investigators have produced scant research characterizing police-perpetrated abuse. Using qualitative data from a study of a police drug crackdown in 2000 in 1 New York City police precinct, we explored 40 injection drug using and 25 non-drug using precinct residents' perceptions of and experiences with police-perpetrated abuse. Participants, particularly injection drug users and non-drug using men, reported police physical, psychological, and sexual violence and neglect; they often associated this abuse with crackdown-related tactics and perceived officer prejudice. We recommend that public health research address the prevalence, nature, and public health implications of police violence.

Adult↗
PubMed2004

Bangkok 2004. Current issues and concerns in HIV testing: a health and human rights approach.

In the rush to scale up HIV testing, partially justified by the fact that treatment is becoming more widely available, the long-held view that testing must be voluntary, and that it must be accompanied by pre- and post-test counselling, is being increasingly questioned. However, as long as stigma, discrimination, and unequal access to care and treatment continue, the individual informed decision to take an HIV test must remain an integral step in medical practice. In this article, based on her presentation at an oral abstract session of the XV International AIDS Conference in Bangkok on 14 July 2004, Sofia Gruskin describes the developments that have led some people to question voluntary testing and counselling (VTC); outlines the factors that need to be considered in analyzing whether a proposed HIV testing strategy is effective in both health and human rights terms; calls for clarity in the use of terms such as "routine testing," "opting in," and "opting out"; and provides a list of considerations that must be addressed for any scaling up of HIV testing to be successful.

AIDS Serodiagnosis↗
PubMed2003

Poverty, equity, human rights and health.

Those concerned with poverty and health have sometimes viewed equity and human rights as abstract concepts with little practical application, and links between health, equity and human rights have not been examined systematically. Examination of the concepts of poverty, equity, and human rights in relation to health and to each other demonstrates that they are closely linked conceptually and operationally and that each provides valuable, unique guidance for health institutions' work. Equity and human rights perspectives can contribute concretely to health institutions' efforts to tackle poverty and health, and focusing on poverty is essential to operationalizing those commitments. Both equity and human rights principles dictate the necessity to strive for equal opportunity for health for groups of people who have suffered marginalization or discrimination. Health institutions can deal with poverty and health within a framework encompassing equity and human rights concerns in five general ways: (1) institutionalizing the systematic and routine application of equity and human rights perspectives to all health sector actions; (2) strengthening and extending the public health functions, other than health care, that create the conditions necessary for health; (3) implementing equitable health care financing, which should help reduce poverty while increasing access for the poor; (4) ensuring that health services respond effectively to the major causes of preventable ill-health among the poor and disadvantaged; and (5) monitoring, advocating and taking action to address the potential health equity and human rights implications of policies in all sectors affecting health, not only the health sector.

Health Services Accessibility↗
PubMed2003

Vulnerability to HIV/STIs among rural women from migrant communities in Nepal: a health and human rights framework.

Human rights norms and standards can be applied to health issues as an analytical tool and as a framework to identify and shape interventions to reduce the impact of ill-health and improve the lives of individuals and populations. This article discusses how migration, health status, gender-based discrimination and access to education have an impact on HIV/STI vulnerability among rural women from migrant communities in Nepal. It is based on data from a clinic-based HIV/STI prevalence study with 900 women aged 15-49 from two rural communities in Kailali district, Western Nepal, and existing legal and policy data. Existing efforts to address HIV/STI vulnerability and risk in this population focus primarily on risk-taking behaviour and risk-generating situations, and largely fail to address contextual issues that create and facilitate risky behaviour and situations. Respecting, protecting and fulfilling the rights of individuals can reduce vulnerability to HIV/STI infection. Greater emphasis must be given to addressing the gender discrimination embedded in Nepalese culture, the acute lack of access to health care and education in rural areas, and the precarious economic, legal and social circumstances facing many migrants and their families.

Adult↗
PubMed2003

The UNGASS Declaration of Commitment on HIV/AIDS: one year later.

This article is one of a series commissioned to mark the tenth anniversary of the Canadian HIV/AIDS Legal Network. It offers a critical assessment of the impact of the UNGASS Declaration of Commitment on national HIV/AIDS strategies and programs in relation to human rights one year after its adoption. The article reviews the process leading up to the Declaration and describes the limitations of the Declaration's explicit and implicit recognition of human rights. It summarizes information provided by countries one year later to the Secretary-General and to UNAIDS on their progress in meeting the goals and targets of the Declaration, particularly with regard to human rights. It comments on what we can learn from this about countries' recognition of the centrality of promoting and protecting human rights. Finally, it suggests ways to monitor more effectively and comprehensively the implementation of a human rights-based response to the HIV/AIDS epidemic.

Canada↗
PubMed2002

Time, place, and consciousness: three dimensions of meaning for US institutional review boards.

In the past few years, US federal agencies governing research with human subjects and institutional review boards have taken a higher-profile path than ever before, both at home and internationally. This trend carries profound significance for US-based institutions and has implications also for the rest of the world. What does this critical moment of heightened federal scrutiny mean for the workings of US institutional review boards? We examined board activity across 3 dimensions: time, place, and consciousness. We conclude that although institutions in all areas of biomedical and social science research are adapting their practices, the field of public health is especially well positioned to adapt to, and succeed in, new efforts to ensure protection of human research subjects.

Academic Medical Centers↗
PubMed1998

Children confronting HIV/AIDS: charting the confluence of rights and health.

From a child rights perspective, HIV/AIDS serves to illuminate how cultural norms and legal precepts facilitate or constrain the protection of the child from HIV infection and from its individual and collective impacts. Recognition of human rights in the design, implementation, and evaluation of governmental policy can point the way toward actions which are not only necessary but, in public health terms, most effective. This article summarizes the three situations -- children infected, affected, and vulnerable -- and three levels of governmental obliations -- to respect, protect, and fulfill rights -- which should be considered when identifying children's specific needs and rights in the context of HIV/AIDS. The article then proposes a method to analyze systematically the confluence between HIV/AIDS and children's rights, creating opportunities for a synergy between those involved in HIV/AIDS prevention, care, and research, and others engaged to the promotion and protection of the rights of the child.

Acquired Immunodeficiency Syndrome↗