Highlights Participatory system dynamics modeling helps improve the HIV service system to reduce the epidemic. We engaged local stakeholders to critique their HIV service system using system dynamics modeling. Participants showed enhanced communication and consensus about systems understanding and solutions.

Intensive sociometric network data were collected from a typical respondent driven sample (RDS) of 528 people who inject drugs residing in Hartford, Connecticut in 2012-2013. This rich dataset enabled us to analyze a large number of unobserved network nodes and ties for the purpose of assessing common assumptions underlying RDS estimators. Results show that several assumptions central to RDS estimators, such as random selection, enrollment probability proportional to degree, and recruitment occurring over recruiter's network ties, were violated. These problems stem from an overly simplistic conceptualization of peer recruitment processes and dynamics. We found nearly half of participants were recruited via coupon redistribution on the street. Non-uniform patterns occurred in multiple recruitment stages related to both recruiter behavior (choosing and reaching alters, passing coupons, etc.) and recruit behavior (accepting/rejecting coupons, failing to enter study, passing coupons to others). Some factors associated with these patterns were also associated with HIV risk.

Child sexual abuse (CSA) can be defined as sexual contact with a child or adolescent that occurs because of coercion or force or within the context of a relationship that is exploitative because of an age difference or caretaking responsibility (Finkelhor, 1992). A broad range of sexual activities may be involved in abuse, from "noncontact" offenses (e.g., voyeurism) to acts of varying physical intrusiveness (e.g., from fondling to intercourse; Walker, Bonner, & Kaufman, 1988). Legal definitions vary from state to state but often include similar elements. Criminal charges are determined based on the ages of the victim and the offender, the victim-offender relationship, the type of sexual act perpetrated, and the frequency of the abuse. Although adult males represent the largest group of child sexual offenders, estimatesThe authors express their thanks to colleagues who were willing to provide prevention information as well as comments on a draft of this chapter:

Background This paper examines peer recruitment dynamics through respondent driven sampling (RDS) with a sample of injection drug users in Hartford, CT to understand the strategies participants use to recruit peers into a study and the extent to which these strategies may introduce risks above the ethical limit despite safeguards in RDS. Methods Out of 526 injection drug users who participated in a mixed-method RDS methodology evaluation study, a nested sample of 61 participants completed an in-depth semi-structured interview at a 2-month follow-up to explore their experiences with the recruitment process. Results Findings revealed that participants used a variety of strategies to recruit peers, ranging from one-time interactions to more persistent strategies to encourage participation (e.g., selecting peers that can easily be found and contacted later, following up with peers to remind them of their appointment, accompanying peers to the study site, etc). Some participants described the more persistent strategies as helpful, while some others experienced these strategies as minor peer pressure, creating a feeling of obligation to participate. Narratives revealed that overall, the probability of experiencing study-related risks remains relatively low for most participants; however, a disconcerting finding was that higher study-related risks (e.g., relationship conflict, loss of relationship, physical fights, violence) were seen for recruits who participated but switched coupons or for recruits who decided not to participate in the study and did not return the coupon to the recruiter. Conclusions Findings indicate that peer recruitment practices in RDS generally pose minimal risk, but that peer recruitment may occasionally exceed the ethical limit, and that enhanced safeguards for studies using peer recruitment methods are recommended. Suggestions for possible enhancements are described.

In this article, the author will utilize her fieldnotes and videotaped interviews to reconstruct and reflect on her experiences and some of the ethical dilemmas she faced as a community partner in participatory action research with a self-governed homeless encampment called Dignity Village. The author's yearlong facilitation utilized a democratic, collaborative, and inclusive process. Following the final stages of the research, an abrupt shift of power occurred in the community. She explores questions about her involvement in this power shift and whether the change was problematic or healthy for the community.

It is well known that concerns about sexual risk tend to decline among people in intimate relationships where there is established commitment and trust. In the context of relationships at increased risk for HIV transmission, interactions involving disclosure and partner responsiveness are key to maintaining intimacy and physical safety. This paper explores concepts of risk and sexual intimacy articulated by a community sample of 30 people living with HIV and their intimate relationship partners. Data revealed the shifts in intimate relationship dynamics upon the disclosure of an HIV diagnosis, the importance of intimacy in the context of managing one or both partners' HIV care and responses to new advances in HIV prophylaxis. Findings suggest that participants' experiences of self-disclosure and partner responsiveness most often resulted in an increased sense of protectiveness from and for partners. This suggests that health-promoting messaging should be adapted to be more relevant to intimate couple communication and mutual support.

Social science researchers have long stressed the importance of a more publically relevant and accessible science. Nevertheless, significant barriers remain within the academy, such as processes for peer review, promotion, and awarding of degrees, which discourage the use of nontraditional dissemination techniques that support a more public ethnography. Concerns over scientific rigor, best practices, and methods for disseminating ethnographic research to public audiences may act as some of the barriers, among others. The purpose of this article is to discuss challenges in doing and disseminating collaborative ethnography to public audiences while still operating within the constraints of the academy. By sharing this experience, my intent is to stimulate debate and scholarship around assessing the quality of public ethnography using less traditional modes of reporting, such as video, and to encourage changes in peer review and institutional practices to more effectively support quality and dialogic dissemination of public ethnography that aims to bring together both academic and public audiences to address issues of great public significance.

We explore ethical issues faced by investigators as they conduct research as part of a peer-delivered HIV/AIDS risk reduction program for injection drug users (IDUs). Staff and participant experiences in peer-delivered interventions among IDUs have come under scrutiny by ethics researchers because of their potential to inadvertently and negatively impact participant rehabilitation due to continued engagement with drug-using networks during the course of outreach. This study explores whether enhanced communication of participant concerns and experiences with clinic and research staff helps to reduce inadvertent malfeasance in peer-delivered drug treatment interventions. Results contribute to the development of patient support infrastructure in peer-delivered risk reduction programs involving IDUs.