The cost of science : knowledge and ethics in the HIV pre-exposure prophylaxis trials.

Over the past decade AIDS research has turned toward the use of pharmacology in HIV prevention, including pre-exposure prophylaxis (PrEP): the use of HIV medication as a means of preventing HIV acquisition in those who do not have it. This paper explores the contradictory reasons offered in support of PrEP-to empower women, to provide another risk-reduction option for gay men-as the context for understanding the social meaning of the experimental trials that appear to show that PrEP works in gay men and heterosexual couples but not single women. The PrEP debates reveal the different ideas about "demedicalization" in the earlier gay health and women's health movements and highlight the relationship between health activism and critique of research ethics in the context of a global pharmaceutical market.

Negotiating "home" and "care" among the HIV+ homeless: an ethnographic case study of home care nursing habitus.

The authors combine field work among home care nurses working in an impoverished urban neighbourhood with analysis of changing models of service provision. They explore the concepts of"home" and "care" for the homeless and marginally housed as features of a home care nursing "habitus" in the face of conflicting professional and institutional approaches to HIV care. While the nurses' innovative practice is a result of the failure of existing models to meet the needs of multi-diagnosis patients, it is also influenced by the drive to increase adherence to antiretroviral regimens as a means of slowing the spread of HIV at the population level. The authors describe the nurses' negotiated practice and use Pierre Bourdieu's notion of habitus to theorize about their ability to meet competing demands.

Mapping stairwell accessibility in Vancouver's downtown core.

BACKGROUND: The increase in obesity is due in part to changes in the environment that affect behaviours such as physical activity. Stairwells in buildings present an opportunity to increase physical activity in the workplace. We characterized the stairwell accessibility in business buildings in the downtown core of Vancouver. METHODS: Characteristics of the stairwells in business buildings with two or more floors were obtained. Stairwells were characterized based on their visibility from the main entrance, signage, presence of physical door, and interior lighting and space. Building completion year was obtained from the Vancouver City Hall. RESULTS: A total of 138 buildings in the pre-designated area were eligible for characterization. Due to security concerns, only 123 were assessed. Of those assessed, 54% had stairwells visible from the main entrance, 33% had locked doors and only 18% had signs on the stairwell doors. Of the 83 stairwells that were accessible, 54% and 36% were considered brightly lit and spacious enough for two people, respectively. Only 11% of the buildings studied had accessible stairwells that met all of our accessibility criteria. More recently built buildings tended to have a higher proportion of locked stairwell doors; otherwise, building completion year was not associated with any of the accessibility criteria. INTERPRETATION: Based on their environmental characteristics, very few buildings were set up in a way that encouraged stair use. For the work environment to be conducive to increased physical activity, building policy will need to consider the implications of design on activity patterns.