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Papers by Eric Mykhalovskiy

Research paper thumbnail of Hegemonic Masculinity and the Experience of Prostate Cancer: A Narrative Approach

Journal of Aging and Identity, 2002

Prostate cancer is a major health problem—one that inevitably challenges men's notions about them... more Prostate cancer is a major health problem—one that inevitably challenges men's notions about themselves and their expressions of masculinity. As part of a larger study investigating linkages between masculinity and prostate cancer, this article focuses on the narratives of three men with prostate cancer—all of whom shed light on contemporary forms of hegemonic masculinity. Multiple interviews were conducted with study participants, capturing experiencesboth prior to and following cancer diagnosis. Analysis of individual narratives showed how social factors such as work and family influenced (and were influenced by) men's experiences with illness. All three men were forced to renegotiate their performances of masculinity—with this renegotiation mostly occurring within the parameters of performance consistent with hegemonic masculinity. However, there was also some evidence of shifts into new socialterritory and new expressions of masculinity. In contrast to more traditional, trait-based approaches to studying men's experiences, a narrative approach allows social scientists to do justice to the temporal realities and contextual complexities of men's lives. Men will be better understood as more attention is paid to the actual shape of individual lives.

Research paper thumbnail of From compliance to medication practice: Exploring the health work of people living with HIV/AIDS

Research paper thumbnail of Beyond buzzwords: toward a community-based model of the integration of HIV treatment and prevention

Aids Care-psychological and Socio-medical Aspects of Aids/hiv, 2009

Propelled by increased global access to Highly Active Anti-Retroviral Therapies, the integration ... more Propelled by increased global access to Highly Active Anti-Retroviral Therapies, the integration of HIV treatment and prevention has emerged as an important organizing concept of pandemic response. Despite its potential significance for community-based AIDS organizations (CBAOs) little research on integration has been done from a community-based perspective. This paper responds to that gap in the literature. With a view to moving what can be an abstract concept to the level of concrete practice, we offer a community-based model of the integration of HIV treatment and prevention. The model is based on research conducted in 2006Á2007 with front-line staff from CBAOs across Canada carried out in partnership with the Canadian AIDS Treatment Information Exchange. The model is grounded in three central dimensions of a community-based perspective on integration deriving from our research: the phenomenological primacy of front-line service work, a comprehensive notion of treatment and prevention, and the importance of social context. The model is intended as a conceptual resource that can assist CBAOs in formulating practical responses to new demands for integrated service provision.

Research paper thumbnail of Conceptualizing the integration of HIV treatment and prevention: findings from a process evaluation of a community-based, national capacity-building intervention

International Journal of Public Health, 2009

Objective: This paper responds to a gap in knowledge about the conceptualization of integration i... more Objective: This paper responds to a gap in knowledge about the conceptualization of integration in community-based AIDS organizations (CBAOs). Methods: A community-based process evaluation was conducted of a national intervention, developed by the Canadian AIDS Treatment Information Exchange (CATIE), to enhance treatment information provision in CBAOs and encourage its integration with prevention services. Our study involved 13 interviews with intervention participants in 6 CBAOs across Canada, CATIE staff, and funders, as well as a 25-person verification exercise. Results: Intervention participants conceptualized integration as linking front-line HIV treatment, health promotion and prevention services, emphasizing mediation between scientific and lay knowledge, the political context of integration and the role of social determinants in clients’ health and access to services. Challenges to integration include high staff turnover and inflexible funding structures. Complex health education related to the relationship between viral load and HIV transmission is a critical area of integrated service delivery. Conclusion: Study findings help distinguish a community-based concept of HIV-related integration from alternative uses of the term while pointing out key tensions associated with efforts to integrate HIV prevention and treatment in a community-based context.

Research paper thumbnail of XVII International AIDS Conference: From Evidence to Action - Social, behavioural and economic science and policy and political science

Journal of The International Aids Society, 2009

AIDS 2008 firmly established stigma and discrimination as fundamental priorities in the push for ... more AIDS 2008 firmly established stigma and discrimination as fundamental priorities in the push for universal access to HIV prevention, treatment, care and support. Conference sessions and discussions reinforced the tangible negative effects of stigma on national legislation and policies. A strong theme throughout the conference was the need to replace prevention interventions that focus exclusively on individual behaviour change or biomedical prevention interventions with "combination prevention" approaches that address both individual and structural factors that increase vulnerability to HIV infection. Several high-level sessions addressed various aspects of the debate over "vertical" (disease-specific) versus "horizontal" (health systems) funding. The majority of evidence presented at the conference suggests that HIV investments strengthen health systems through the establishment of clinical and laboratory infrastructure, strengthened supply and procurement systems, improvements in health care worker training, and increased community engagement. Human rights were a focal point at the conference; several presentations emphasized the importance of securing human rights to achieve universal access goals, including workplace discrimination, travel restrictions, gender inequality, and the criminalization of homosexuality, drug use, sex work, and HIV transmission and/or exposure.

Research paper thumbnail of XVII International AIDS Conference: From Evidence to Action - Social, behavioural and economic science and policy and political science

Journal of The International Aids Society, 2009

AIDS 2008 firmly established stigma and discrimination as fundamental priorities in the push for ... more AIDS 2008 firmly established stigma and discrimination as fundamental priorities in the push for universal access to HIV prevention, treatment, care and support. Conference sessions and discussions reinforced the tangible negative effects of stigma on national legislation and policies. A strong theme throughout the conference was the need to replace prevention interventions that focus exclusively on individual behaviour change or biomedical prevention interventions with "combination prevention" approaches that address both individual and structural factors that increase vulnerability to HIV infection. Several high-level sessions addressed various aspects of the debate over "vertical" (disease-specific) versus "horizontal" (health systems) funding. The majority of evidence presented at the conference suggests that HIV investments strengthen health systems through the establishment of clinical and laboratory infrastructure, strengthened supply and procurement systems, improvements in health care worker training, and increased community engagement. Human rights were a focal point at the conference; several presentations emphasized the importance of securing human rights to achieve universal access goals, including workplace discrimination, travel restrictions, gender inequality, and the criminalization of homosexuality, drug use, sex work, and HIV transmission and/or exposure.

Research paper thumbnail of XVII International AIDS Conference: From Evidence to Action - Social, behavioural and economic science and policy and political science

Journal of The International Aids Society, 2009

AIDS 2008 firmly established stigma and discrimination as fundamental priorities in the push for ... more AIDS 2008 firmly established stigma and discrimination as fundamental priorities in the push for universal access to HIV prevention, treatment, care and support. Conference sessions and discussions reinforced the tangible negative effects of stigma on national legislation and policies. A strong theme throughout the conference was the need to replace prevention interventions that focus exclusively on individual behaviour change or biomedical prevention interventions with "combination prevention" approaches that address both individual and structural factors that increase vulnerability to HIV infection. Several high-level sessions addressed various aspects of the debate over "vertical" (disease-specific) versus "horizontal" (health systems) funding. The majority of evidence presented at the conference suggests that HIV investments strengthen health systems through the establishment of clinical and laboratory infrastructure, strengthened supply and procurement systems, improvements in health care worker training, and increased community engagement. Human rights were a focal point at the conference; several presentations emphasized the importance of securing human rights to achieve universal access goals, including workplace discrimination, travel restrictions, gender inequality, and the criminalization of homosexuality, drug use, sex work, and HIV transmission and/or exposure.

Research paper thumbnail of Hegemonic Masculinity and the Experience of Prostate Cancer: A Narrative Approach

Journal of Aging and Identity, 2002

Prostate cancer is a major health problem—one that inevitably challenges men's notions about them... more Prostate cancer is a major health problem—one that inevitably challenges men's notions about themselves and their expressions of masculinity. As part of a larger study investigating linkages between masculinity and prostate cancer, this article focuses on the narratives of three men with prostate cancer—all of whom shed light on contemporary forms of hegemonic masculinity. Multiple interviews were conducted with study participants, capturing experiencesboth prior to and following cancer diagnosis. Analysis of individual narratives showed how social factors such as work and family influenced (and were influenced by) men's experiences with illness. All three men were forced to renegotiate their performances of masculinity—with this renegotiation mostly occurring within the parameters of performance consistent with hegemonic masculinity. However, there was also some evidence of shifts into new socialterritory and new expressions of masculinity. In contrast to more traditional, trait-based approaches to studying men's experiences, a narrative approach allows social scientists to do justice to the temporal realities and contextual complexities of men's lives. Men will be better understood as more attention is paid to the actual shape of individual lives.

Research paper thumbnail of From compliance to medication practice: Exploring the health work of people living with HIV/AIDS

Research paper thumbnail of Beyond buzzwords: toward a community-based model of the integration of HIV treatment and prevention

Aids Care-psychological and Socio-medical Aspects of Aids/hiv, 2009

Propelled by increased global access to Highly Active Anti-Retroviral Therapies, the integration ... more Propelled by increased global access to Highly Active Anti-Retroviral Therapies, the integration of HIV treatment and prevention has emerged as an important organizing concept of pandemic response. Despite its potential significance for community-based AIDS organizations (CBAOs) little research on integration has been done from a community-based perspective. This paper responds to that gap in the literature. With a view to moving what can be an abstract concept to the level of concrete practice, we offer a community-based model of the integration of HIV treatment and prevention. The model is based on research conducted in 2006Á2007 with front-line staff from CBAOs across Canada carried out in partnership with the Canadian AIDS Treatment Information Exchange. The model is grounded in three central dimensions of a community-based perspective on integration deriving from our research: the phenomenological primacy of front-line service work, a comprehensive notion of treatment and prevention, and the importance of social context. The model is intended as a conceptual resource that can assist CBAOs in formulating practical responses to new demands for integrated service provision.

Research paper thumbnail of Conceptualizing the integration of HIV treatment and prevention: findings from a process evaluation of a community-based, national capacity-building intervention

International Journal of Public Health, 2009

Objective: This paper responds to a gap in knowledge about the conceptualization of integration i... more Objective: This paper responds to a gap in knowledge about the conceptualization of integration in community-based AIDS organizations (CBAOs). Methods: A community-based process evaluation was conducted of a national intervention, developed by the Canadian AIDS Treatment Information Exchange (CATIE), to enhance treatment information provision in CBAOs and encourage its integration with prevention services. Our study involved 13 interviews with intervention participants in 6 CBAOs across Canada, CATIE staff, and funders, as well as a 25-person verification exercise. Results: Intervention participants conceptualized integration as linking front-line HIV treatment, health promotion and prevention services, emphasizing mediation between scientific and lay knowledge, the political context of integration and the role of social determinants in clients’ health and access to services. Challenges to integration include high staff turnover and inflexible funding structures. Complex health education related to the relationship between viral load and HIV transmission is a critical area of integrated service delivery. Conclusion: Study findings help distinguish a community-based concept of HIV-related integration from alternative uses of the term while pointing out key tensions associated with efforts to integrate HIV prevention and treatment in a community-based context.

Research paper thumbnail of XVII International AIDS Conference: From Evidence to Action - Social, behavioural and economic science and policy and political science

Journal of The International Aids Society, 2009

AIDS 2008 firmly established stigma and discrimination as fundamental priorities in the push for ... more AIDS 2008 firmly established stigma and discrimination as fundamental priorities in the push for universal access to HIV prevention, treatment, care and support. Conference sessions and discussions reinforced the tangible negative effects of stigma on national legislation and policies. A strong theme throughout the conference was the need to replace prevention interventions that focus exclusively on individual behaviour change or biomedical prevention interventions with "combination prevention" approaches that address both individual and structural factors that increase vulnerability to HIV infection. Several high-level sessions addressed various aspects of the debate over "vertical" (disease-specific) versus "horizontal" (health systems) funding. The majority of evidence presented at the conference suggests that HIV investments strengthen health systems through the establishment of clinical and laboratory infrastructure, strengthened supply and procurement systems, improvements in health care worker training, and increased community engagement. Human rights were a focal point at the conference; several presentations emphasized the importance of securing human rights to achieve universal access goals, including workplace discrimination, travel restrictions, gender inequality, and the criminalization of homosexuality, drug use, sex work, and HIV transmission and/or exposure.

Research paper thumbnail of XVII International AIDS Conference: From Evidence to Action - Social, behavioural and economic science and policy and political science

Journal of The International Aids Society, 2009

AIDS 2008 firmly established stigma and discrimination as fundamental priorities in the push for ... more AIDS 2008 firmly established stigma and discrimination as fundamental priorities in the push for universal access to HIV prevention, treatment, care and support. Conference sessions and discussions reinforced the tangible negative effects of stigma on national legislation and policies. A strong theme throughout the conference was the need to replace prevention interventions that focus exclusively on individual behaviour change or biomedical prevention interventions with "combination prevention" approaches that address both individual and structural factors that increase vulnerability to HIV infection. Several high-level sessions addressed various aspects of the debate over "vertical" (disease-specific) versus "horizontal" (health systems) funding. The majority of evidence presented at the conference suggests that HIV investments strengthen health systems through the establishment of clinical and laboratory infrastructure, strengthened supply and procurement systems, improvements in health care worker training, and increased community engagement. Human rights were a focal point at the conference; several presentations emphasized the importance of securing human rights to achieve universal access goals, including workplace discrimination, travel restrictions, gender inequality, and the criminalization of homosexuality, drug use, sex work, and HIV transmission and/or exposure.

Research paper thumbnail of XVII International AIDS Conference: From Evidence to Action - Social, behavioural and economic science and policy and political science

Journal of The International Aids Society, 2009

AIDS 2008 firmly established stigma and discrimination as fundamental priorities in the push for ... more AIDS 2008 firmly established stigma and discrimination as fundamental priorities in the push for universal access to HIV prevention, treatment, care and support. Conference sessions and discussions reinforced the tangible negative effects of stigma on national legislation and policies. A strong theme throughout the conference was the need to replace prevention interventions that focus exclusively on individual behaviour change or biomedical prevention interventions with "combination prevention" approaches that address both individual and structural factors that increase vulnerability to HIV infection. Several high-level sessions addressed various aspects of the debate over "vertical" (disease-specific) versus "horizontal" (health systems) funding. The majority of evidence presented at the conference suggests that HIV investments strengthen health systems through the establishment of clinical and laboratory infrastructure, strengthened supply and procurement systems, improvements in health care worker training, and increased community engagement. Human rights were a focal point at the conference; several presentations emphasized the importance of securing human rights to achieve universal access goals, including workplace discrimination, travel restrictions, gender inequality, and the criminalization of homosexuality, drug use, sex work, and HIV transmission and/or exposure.