Examining the functions of women's violence: Accommodation, resistance, and enforcement of gender inequality.

The present study contributes to the literature on the consequences of social inequality through a qualitative examination of the social functions and meanings of violence in the lives of 20 marginalized women. All of the women in the sample were at some point court involved and were victims, as well as perpetrators, of violence. Findings indicate a need to expand the extant theory to address enforcement (i.e., strengthening) of status level, social inequities (e.g., gendered power disparities), adding to the accommodation/resistance paradigm. Consistent with scholarship conceptualizing violence as contextual and gender as a socio-structural variable, results support the need to better understand the ways in which contexts of gendered inequality - and inequality in general - may promote processes through which survivors of violence accommodate, resist, and enforce oppression. Implications for research and practice related to social inequality are discussed.

First field evaluation of the optimized CE marked Abbott protocol for HIV RNA testing on dried blood spot in a routine clinical setting in Vietnam.

BACKGROUND: Viral load (VL) monitoring of HIV-infected patients in decentralized areas is limited due to logistic constraints. Dried Blood Spots (DBS) offer the opportunity to collect samples in remote area which can be easily transferred and tested at a central laboratory. The MOVIDA (Monitoring Of Viral load In Decentralized Area) project evaluated the performance of VL measurements on DBS using the new CE marked optimized Abbott protocol. METHODS: HIV-1 infected adults from three outpatient clinics in Hanoi (Vietnam) were enrolled into the study between 1 March and 13 April 2017. VL was measured on DBS using the optimized protocol provided by the manufacturer and compared to plasma VL as reference method on the Abbott m2000rt RealTime HIV-1 platform. Sensitivity was defined as the ability for DBS samples to correctly identify VL failure at the threshold of 1000 copies/mL of plasma, while specificity represented the ability to identify patients with a plasma HIV-RNA VL of <1000 copies/mL. RESULTS: A total of 203 patients were enrolled in the study, of which 152 (75%) were male. Median age was 38 [inter quartile range: 34-43] years. Of these patients, 37 were untreated, 38 on ART for <6 months and 117 were on ART for ≥6 months. A strong correlation between VL results in plasma and from DBS was observed (ρ = 0.95; p<0.001). Plasma VL was ≥1000 copies/mL in 71 patients. The sensitivity of DBS was 90.1% (95% confidence interval [CI]: 80.7-95.9) and the specificity was 96.2% (95% CI: 91.4-98.8). CONCLUSIONS: The new optimized Abbott DBS protocol performed well in this study, meeting the WHO performance criteria for the use of DBS for HIV VL monitoring. Scaling up VL monitoring using DBS can be used to reach the last 90 in the UNAIDS targets of 90-90-90 to help end the AIDS epidemics. However, sensitivity remains the main challenge for manufacturers to prevent maintaining patients in virological failure on inefficient ART.