Managing the HIV/AIDS Pandemic: Paving a Path into the Future of International Law and Organization

Complex global interdependence continues to influence international legal and political affairs at the close of the twentieth century. As interdependence has tightened, non‐state actors have emerged in many policy areas as key political and service delivery players; often supporting increasingly prioritized human‐centered issues. Analysis of the global management of the HIV/AIDS pandemic suggests that use of international quasi‐legislation can be employed in order to create space within which to manage these changes, thus opening room for discussion about new approaches to meeting the challenges of a changing world.     

Mass screening in low-income populations: the challenges of securing diagnostic and treatment services in a national cancer screening program

Funding for many mass screening programs for low-income and uninsured populations provides resources for screening tests, yet only rarely does it provide coverage for necessary follow-up diagnostic and treatment services. The National Breast and Cervical Cancer Early Detection Program (NBCCEDP), a federally funded initiative that provides cancer screening to low-income uninsured and underinsured women, covers some diagnostic follow-up tests and no treatment services. We conducted in-depth case studies of seven state programs participating in the NBCCEDP to investigate the strategies and approaches being used to secure diagnostic and treatment services. The results suggest that the program relies on a patchwork of resources--at state and local levels--to provide diagnostic and treatment services. This includes a number of components of local safety nets, all of which are unstable and have uncertain futures. Public health disease-screening initiatives need to reconsider the feasibility of continued reliance on case-by-case appeals to the local safety net for diagnostic follow-up and treatment services.     

"A tempest in a cocktail glass": mothers, alcohol, and television, 1977-1996

This article examines the portrayal of pregnancy and alcohol in thirty-six national network evening news broadcasts (ABC, CBS, NBC). Early coverage focused on white, middle-class women, as scientific authorities and government officials warned against drinking during pregnancy. After 1987, however, women who drank during pregnancy were depicted as members of minority groups and as a danger to society. The thematic transition began before warning labels appeared on alcoholic beverages and gained strength from official government efforts to prevent fetal alcohol syndrome. The greatest impetus for the revised discourse, however, was the eruption of a "moral panic" over crack cocaine use. By linking fetal harm to substance abuse, the panic suggested it was in the public's interest to control the behavior of pregnant women.     

FACTORS INFLUENCING GUN CARRYING AMONG YOUNG URBAN MALES OVER THE ADOLESCENT‐YOUNG ADULT LIFE COURSE*

This paper uses data from an ongoing panel study of urban youth to examine the causes and correlates of hidden gun carrying among young urban males. The analysis assesses the changing impact of gang membership, drug sales, and peer gun ownership for protection on gun carrying at nine separate points over the early adolescent to young adult life course. In early adolescence, gang membership is a strong motivation for gun carrying. At somewhat older ages, drug dealing, particularly high drug sales, and illegal peer gun ownership replace gang membership as the primary determinants of illegal gun carrying.     

Transferring Health Technology to South Africa: The Importance of Traditional African Culture

The transfer of new health technology to South Africa is occurring despite the fact that North American and European health care planners and entrepreneurs have a very limited understanding of traditional Black South African cultures which condition the health-related behaviors of the majority of the population. Consequently, relatively few people of African descent in this very diverse nation are, at least initially, benefiting from the new imported medical technology. This study gives an overview of traditional Black medicine in South Africa and, through the presentation of several case studies, discusses its implications for the societal adoption of new health technology received from the United States and other industrialized nations. The example of the successful application of cervical cancer exams in rural and urban clinics of the Eastern Cape is analyzed and institutional mechanisms that support successful transfer are identified.