editor's choice

AMERICAN JOURNAL OF PUBLIC HEALTH EDITOR-IN-CHIEF DEPUTY EDITOR FEATURE EDITOR IMAGE EDITOR ASSOCIATE EDITORS

EDITOR’S CHOICE Tackling Violence and HIV/AIDS: Global Health Imperatives The epidemics of violence and HIV overlap and intersect in complex ways and are similarly relevant to women, men, children, adolescents, transsexual, and transgender populations. Everywhere in the world, violence and HIV, individually and collectively, raise significant public health and human rights concerns. For each, our interest is in not only prevention but also care and treatment. Each brings into play not just the ways in which services are delivered, but larger questions around societal relations, gender, sexuality, and ultimately human rights. As policy and programmatic trends are often justified, although not systematically informed, by evidence ostensibly derived from peer-reviewed publications, the types of studies being conducted, where studies are taking place, and which populations are studied takes on critical significance. The articles in this issue of the Journal contribute to the discourse around these important areas of work by providing new evidence for action, not only about violence and about HIV but also about issues affecting their intersections in the United States and around the globe. This work is particularly timely in the current climate, as resources dwindle and researchers, policymakers, and public health workers alike grapple to find the most effective ways to address these intersecting epidemics. Working in HIV is well recognized as politically fraught with questions around approaches, funding, and priorities dominating discussion. Work in the area of violence is no less complicated, raising a host of politicized issues with respect to fundamentals, such as defining what actually constitutes individual and systemic violence and importantly where attention and resources should go. Within the realm of violence, understood to encompass economic, gender-based, physical, psychological, sexual, social, and structural violence, debates are fierce as to where priorities should lie and importantly who should decide areas for action. Why is it important to consider both HIV and violence as global health imperatives? It is first to raise awareness that these are topics of

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global relevance and magnitude that impact people’s health and lives in considerable ways. Second, HIV and violence are of concern everywhere in the world and affect all social classes, genders, cultures, and communities. And third, this naming may exert a powerful influence on the actions of researchers and the public health community within and across nation states, as well as for governments, civil society, and private entities. Determining that these are global health issues affects how and where research should be done, how responses are to be constructed, and ultimately how political and financial power should be brought to bear. The impacts of HIV and violence are reciprocal and compounding. Studies linking violence and HIV are heavily skewed toward examining violence as a risk factor for acquiring HIV, with few analyzing HIV as a risk factor for experiencing violence. Fewer still examine the perpetuating cycle between violence and HIV. Research and actions at the intersections of violence and HIV are expanding, but more understanding is needed of the complexities of these intersections across country contexts, in different environments, and among different population groups. Attention to locally defined constructs of gender, sexuality, and human rights represent significant opportunities for advancing understanding of how these epidemics are linked and how they can be jointly addressed. We must think locally and act globally. Research along with structural and communitybased interventions should urgently address the key drivers of both epidemics and aim to change societal norms to create safer living environments. This is a tall order, but one that we all, as members of the global health community, are well poised to take on––and cannot afford to shy away from. j Sofia Gruskin Associate Editor, AJPH

Mary E. Northridge, PhD, MPH Farzana Kapadia, PhD Gabriel N. Stover, MPA Aleisha Kropf Mary T. Bassett, MD, MPH Felipe Gonza´lez Castro, PhD, MSW Michael R. Greenberg, PhD Sofia Gruskin, JD, MIA Said Ibrahim, MD, MPH Robert J. Kim-Farley, MD, MPH Stewart J. Landers, JD, MCP Stella M. Yu, ScD, MPH ASSOCIATE EDITOR FOR STATISTICS AND EVALUATION Roger Vaughan, DrPH, MS INTERNATIONAL ASSOCIATE EDITORS Kenneth Rochel de Camargo Jr, MD, PhD (Rio de Janeiro, Brazil) Daniel Tarantola, MD (Sydney, Australia) DEPARTMENT EDITORS Leslie Beitsch, MD, JD Government, Politics, and Law Elizabeth Fee, PhD, and Theodore M. Brown, PhD Images of Health Public Health Then and Now Voices From the Past Bernard M. Dickens, PhD, LLD, FRSC Health Policy and Ethics Forum Kenneth R. McLeroy, PhD, and Deborah Holtzman, PhD, MSW Framing Health Matters EDITORIAL BOARD Hector Balcazar, PhD (2011), Chair Bobbie Berkowitz, PhD, RN (2011) Jermane Bond, PhD (2013) Linda Chan, PhD (2013) Bonnie Duran, DrPH (2011) Roy Grant, MA (2013) Alice M. Horowitz, PhD, MA (2012) Cassandra L. Joubert, ScD (2012) Moriah McGrath (2012), Student Louise-Anne McNutt, PhD (2013) Brian Saylor, PhD, MPH (2013) David H. Wegman, MD, MSc (2011) Lynne S. Wilcox, MD, MPH (2012) Jeffrey R. Wilson, PhD, MS (2012) STAFF Georges C. Benjamin, MD Executive Director/Publisher Nina Tristani, Publications Director Brian Selzer, Manager of Production Ashell Alston, Director of Advertising Teena Lucas, Production Coordinator Michael Henry, Associate Production Editor (Sr) Maya Ribault, Associate Production Editor (Jr) Ellie D’Sa, Graphic Designer Vivian Tinsley, Subscriptions Coordinator FREELANCE STAFF Greg Edmondson, Michelle Quirk, Gretchen Becker, Trish Weisman, Gary Norton, Jennifer Holmes, Brent Winter, Eileen Wolfberg, Kelly Burch, Alisa Guerzon, Copyeditors Chris Filiatreau, Sarah Cook, Nestor Ashbery, Proofreaders Vanessa Sifford, Michele Pryor, Graphic Designers

doi:10.2105/AJPH.2011.300255

American Journal of Public Health | June 2011, Vol 101, No. 6