The risk of HIV infection looms large among male, female, and transgender sex workers in India. Several individual, sociocultural, and structural-environmental factors enhance the risk of HIV infection among sex workers by restricting their ability to engage in safer sexual practices with clients and/or intimate partners. While most HIV prevention programs and research focus on visible groups of women sex workers operating from brothels (Pardasani, 2005) and traditional sex workers, for example, Devadasis (Orchard, 2007); there is a whole subgroup of the sex worker population that remains invisible within HIV prevention programs, such as the male, female, and transgender sex workers operating from non-brothel-based settings. This paper provides an overview of the different types and contexts of sex work prevalent in Indian society, discusses the factors that increase a sex worker’s risk of HIV infection, describes the varied approaches to HIV prevention adopted by the existing HIV prevention programs for sex workers, discusses the limitations of the HIV prevention programs, and concludes with implications for social work practice and education.
The past two decades have witnessed a surge in the growth of initiatives and funding to weave physical and behavioral health care, particularly with identification of the high costs incurred by their comorbidity. In response, a robust body of evidence now demonstrates the effectiveness of what is referred to as collaborative care. A wide range of models transverse the developmental lifespan, diagnostic categories, plus practice settings (e.g., primary care, specialty medical care, community-based health centers, clinics, and schools). This article will discuss the foundational elements of collaborative care, including the broad sweep of associated definitions and related concepts. Contemporary models will be reviewed along with identified contextual topics for practice. Special focus will be placed on the diverse implications collaborative care poses for the health and behavioral health workforce, especially social workers.
Jessica M. Black
Sleep is required for healthy and adaptive neurobehavioral and psychosocial functioning throughout the life course. Sleep is restorative, facilitates memory consolidation, improves immune function, and regulates emotional responses. Sleep deprivation, whether due to sleep disorders or other life conditions and transitions, is a significant risk factor for negative developmental outcomes at all stages in the life course. This article adheres to the biopsychosocial model to review current research describing the benefits of adequate sleep and ways in which insufficient sleep, as determined by developmental needs throughout the life course, can undercut healthy development. Particular attention is paid to social issues of relevance to social workers, with a closing discussion of policy and implications for future work within the field.
Shaun M. Eack
Mental health research is the study of the causes and correlates of mental health and illness, approaches to improve mental well-being, and the delivery of effective mental health services to those in need. Social workers have been leading researchers in each of these areas of inquiry, and this article provides an overview of the broad field of mental health research, with particular emphasis on the contributions of social work. A biopsychosocial review of research on the correlates of mental health and illness is provided, followed by a synthesis of studies examining pharmacological and psychosocial approaches to improving mental health. Research on mental health services is then presented, with a focus on studies seeking to improve access to quality care and reduce service disparities. Key directions for future mental health research include identifying specific causal predictors of mental illness, improving existing treatments, and disseminating advances to the community.
Linda P. Darrell
The perspective of end-of-life care has changed over the years. People are living longer, fuller lives due to advanced medical care and technology along with an increased interest in healthier lifestyles. The focus of end-of-life care has expanded to include accidental and sudden, unexpected death, chronic illness, anticipated death from longevity, and illnesses impacting children. An expanded perspective of end-of-life care must account for the challenges and changes of service delivery within a multi-cultural 21st-century milieu. The significance of advanced medical technology and improved lifestyles is an important component of a primary multidisciplinary assessment to understand the impact of such a life-altering occurrence as end-of-life care. Equally as important is a culturally inclusive perspective to accommodate the significance of longevity due to improved lifestyles, advanced medical technology, ethnicity, spirituality, and racial awareness. This article will explore the multiple concerns surrounding end-of-life care issues from an expansive worldview.
Meredith Stensland, Sara Sanders, and Marla Berg-Weger
Advance care planning (ACP) is the process of determining and documenting desired wishes for the end of one’s life. Referred to by such terms as end-of-life planning, advance (health) directives, and living wills, ACP is a relatively new concept within our society, having emerged as a social, political, and ethical issue in the United States only since the 1960s. Researchers and legislators have been challenged in their efforts to examine healthcare decision-making and design appropriate policy to guide practice. This article will define ACP, provide an overview of the history and evolution of the process and the associated legal and ethical issues, and describe the process with three specific populations. In addition, it examines the role of the social work profession in working with individuals and families on planning for the end of one’s life.
Jessica M. Black
Although it was once widely held that development through toddlerhood was the only significant time of tremendous brain growth, findings from neuroscience have identified adolescence as a second significant period of brain-based changes. Profound modification of brain structure, function, and connectivity, paired with heightened sensitivity to environment, places adolescence both as a heightened period of risk and importantly as a time of tremendous opportunity. These findings are of key relevance for social-work policy and practice, for they speak to the ways in which the adolescent brain both is vulnerable to adverse conditions and remains responsive to positive environmental input such as interventions that support recovery and resilience.
QingYing Ji and Anao Zhang
This article offers an overview of medical social work development in Shanghai, China. The Chinese definition of medical social work is introduced, and its development in Shanghai is described. Both from a history and policy perspective, this article outlines the three stages of medical social work development in Shanghai chronologically while introducing relevant national policies for medical social work at each stage. Lessons learned from the past are summarized and reviewed. Finally, future directions for further development are discussed.
Vivian Jackson and Wendy Jones
The revised NASW Standards and Indicators for Cultural Competence in Social Work Practice (2015) requires social workers to “provide and advocate for effective communication with clients of all cultural groups, including people of limited English proficiency or low literacy skills, people who are blind or have low vision, people who are deaf or hard of hearing, and people with disabilities” (p. 43). This article focuses on one component of this standard—literacy, specifically health literacy. It presents a summary overview of health literacy and its implications for social work practice. It also presents the history of the concept and provides various definitions and types of health literacy as described in the literature. The authors describe the association between health literacy levels of the population, the intricacies of health systems, and their impact on health outcomes. The negative impact for marginalized populations including persons with limited English proficiency and immigrants and refugees—a major focus of the social work profession—signals the need for action at multiple levels. The authors explore a multifaceted approach to health literacy at the clinical, organizational, and policy levels with reference to the role of the social work profession.
Home health care is professional medical and non-medical care delivered in the home (home refers to a private residence, an assisted living facility, or a group home) to assist ill, injured, or disabled seniors or adults remain safely at home for as long as possible. As the population ages, and the numbers of Baby Boomers age 85 and older increases, it is likely that there will be a growing need for long-term care, including home health care. In this article, the role of social work in home health care is reviewed as it is impacted by sources of payment and demographic characteristics of home care users. Social work assessment and intervention in home health care is also discussed with a focus on effective referral practices.