Mass media, stigma, and disclosure of HIV test results: multilevel analysis in the Eastern Cape, South Africa.

In this article, we examine the role of mass media and interpersonal communication in affecting knowledge of HIV/AIDS, reducing stigma, using condoms, and increasing the likelihood of disclosing HIV test results to sexual partners and family members. Data from a 2002 household survey in the Eastern Cape Province of South Africa are used to measure levels of stigma, interpersonal communication, willingness to disclosure HIV test results and condom use. We use a multilevel framework that accounts for the social context in which individuals access information, gauge social norms, and make decisions about the costs and benefits of HIV testing and disclosure. The results provide support for the positive effects of both media exposure and informal social networks on ideational factors, namely changes in knowledge and stigma, which lead to behavior change. Consistent with common models of health communication dynamics, these latter factors dominate decisions regarding disclosure of HIV test results and condom use.

Utilization of voluntary counseling and testing services in the Eastern Cape, South Africa.

This analysis uses data from a population-based household survey and a government clinic survey in the Eastern Cape Province of South Africa to examine attitudes towards voluntary counseling and testing (VCT) services, patterns of utilization of VCT services and the relationships between HIV/AIDS-related stigma, VCT service availability and quality and the use of VCT. The household survey data are linked with clinic-level data to assess the impact of expanded VCT services and access to rapid testing on the likelihood of being tested in rural areas and on HIV/AIDS stigma. Our analysis finds that while overall use of VCT services is low, utilization of VCT services is positively associated with age, education, socioeconomic status, proximity to clinics, availability of rapid testing and outreach services and lower levels of HIV/AIDS stigma. Importantly, the effects of stigma appear considerably stronger for females, while men are more heavily influenced by the characteristics of the VCT services themselves.

Price elasticities of demand for curative health care with control for sample selectivity on endogenous illness: an analysis for Sri Lanka.

Estimation of demand for health care with samples of only the ill may bias estimates. Additionally, the lack of exogenous information, especially distance, about the alternative care providers causes omitted variable problems. This paper alleviates both problems through geographic mapping of facility information to individuals, combined with joint estimation of illness (health production) and health care demand. The joint estimation full sample demand results are compared to those from one equation estimation for only the ill sample. The results indicate that the selectivity problem is significant, but that for this sample the magnitude of the bias on the price coefficient is small.

Selection of an instrument to measure the physical activity of elderly people in rural areas.

Physical activity is an important factor in the care of adults 65 years and older who have had a cardiac event. Valid and reliable measurement is critical to nursing assessment, screening, and ongoing evaluation. This article describes the process used to evaluate the quality, including the reliability and validity, of a physical activity instrument for use in a rural population. The sample consisted of 32 adults who had participated in one of four rural cardiac rehabilitation programs. The Physical Activity Scale for the Elderly (PASE), which was selected for this study, was found to be reliable. Experts judged the content to be appropriate and valid for older adults living in rural areas. Perceived health was positively related to physical activity (r = 0.31, p = .08). The PASE was found to be marginally valid. Although further investigation of the instrument's construct validity is warranted, the use of such physical activity surveys has potential clinical relevance for the rehabilitation of older adults from diverse geographic and cultural backgrounds.

Relationship of cardiac size to maximal oxygen uptake and body size in men and women.

It has been suggested in previous studies that the difference in endurance performance between males and females is related to gender-specific differences in cardiac function. Other studies have not equated males and females for physical condition, and this may have contributed to the findings. The purpose of this study was to determine the extent to which the difference in VO2max in groups of similarly trained males and females was explained by gender differences in cardiac size, fat-free weight (FFW) and hemoglobin concentration [( Hb]). Measurements of VO2max, FFW, [Hb] and cardiac size (LVM) were made on 19 males and 20 females comparable in age and cardiorespiratory capacity. The difference between men and women in LVM accounted for 68.3% of the gender difference in VO2max, and the combination of LVM and FFW accounted for 98.7% of the gender-related difference in VO2max. It was concluded that the gender difference in LVM accounts for a majority of the difference in VO2max in males and females, with other aspects of body size accounting for nearly all the remaining difference. The gender difference in heart size primarily reflects the smaller overall dimensions of women.

Metabolic and Circulatory Responses to Running During Pregnancy.

In brief: The authors measured metabolic and circulatory responses to a monthly ten-minute submaximal treadmill run at 6 mph in a 32-year-old pregnant runner. Ventilation, oxygen uptake, heart rate, and respiratory exchange ratio during steady-state running all increased substantially as the pregnancy progressed. The increase in oxygen uptake was directly proportional to the weight gained, but the heart rate, ventilation, and respiratory exchange ratio were not. The authors concluded that running becomes more stressful as pregnancy proceeds, and they recommend progressively decreasing running speed.