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The Internet is a promising medium to strengthen participation in Human Immunodeficiency Virus (HIV) prevention among young men who have sex with men (YMSM). This study engaged YMSM from Bali in codesigning online HIV prevention using a series of participatory action research focus groups. Further, this research utilized Habermasian critical theory of communicative action to interpret the findings. This was framed around the current mismatch between HIV prevention, the "systemworld", and the lived reality, or "lifeworld", of YMSM in Bali. Using a model of intervention called "So Us", YMSM aspired to HIV prevention which reflects their identity, language, and interaction style.

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The current paper provides a critical review of food environments' literature, with a focus on the metaphoric typology that has been developed over recent decades. This has tended to focus understandably on harmful food environments using well-known metaphors: that of food deserts, food swamps and food mirages. The purpose of the review was to consider the current typology in relation to what constitutes healthy food environments, and the implications for population groups in low socioeconomic environments who are often disadvantaged by current food systems and unhealthy food environments. The paper posits a new term, alongside the notion of the food oasis, that of food havens. Oasis indicates a small place of plenty in a setting of scarcity. Haven extends the boundaries of plenty in society by positing places and settings of refuge and safety, even sanctuary from which health and well-being can be attained and supported. We argue for focusing on creating such sustainable food environments so as to proliferate and promote examples of what needs to be done urgently in the fight to transform global food environments for the health of people particularly those that are vulnerable and the planet. Elements of the food haven as proposed in this paper have been drawn from indigenous perspectives-these include Maori and Pacific worldviews. Future research should consider what food environments might look like in different contexts and how we might move away from food swamps and deserts to food oases and havens; and utilize these positive motifs to go further in creating whole sustainable food environments encompassing all of society.

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The health of Pacific people is known to be at risk because of the onset of non-communicable diseases (NCDs), such as diabetes. The scale of the problem requires innovative approaches to bring about change. One such approach is the development of a sustainable food system in combination with the leadership of Pacific youth. This study sought to engage Pacific youth as part of the solution to reducing NCDs through social enterprise and championing of sustainable food systems. Four young Fijian vegetable and fruit entrepreneurs shared their stories as part of a participatory action research of Talanoa/storytelling, with social media workshops, networking and promotional opportunities. Findings revealed that youth entrepreneurs are passionate about food and health, family and tradition; some are already food influencers and champions and they are keen to grow their businesses. Yet, there is limited support for small business development with a social purpose and youth-led campaigns. The study indicates a growing potential to develop local youth-led social entrepreneurship and innovation to address NCDs in exciting new ways. There is an urgent need to support innovation interventions to advocate for sustainable food systems for the Pacific, that promote positive human health needs and address, more broadly, climate change effects.

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New Zealand is currently facing an obesity and non communicable diseases (NCDs) epidemic. Recent studies have largely attributed these health issues to insufficient food and low-quality diets that cause micronutrient deficiencies. Improving healthy diets requires broader thinking and collaboration, particularly around maintaining sustainable food systems, which signifies a shift from individualistic/behavioural approaches in health promotion. This paper aims to extend solutions addressing increasing rates of obesity and diet-related NCDs in New Zealand while considering diet and human health in concurrence with sustainability. In particular, the three pillars of sustainability-economic, environmental, and social-will be considered, alongside application of a food systems approach to analysing the epidemic and policy developments in New Zealand. Given its proximity to smaller Pacific islands in the region, New Zealand is in a unique position to work multisectorally and be a leader in considering food system approaches to tackling obesity and NCDs in the Pacific.

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BACKGROUND: Participation is an accepted means of increasing the effectiveness of public health programs, and as such, it is considered an important component of HIV interventions targeting at-risk youth. The situation of young women sex workers in Thailand is alarming on many fronts, including that of HIV risk. As a result, HIV programs in Thailand are the key interventions undertaken in relation to young women sex workers' health. A small-scale study used semistructured interviews to explore the participation reports of five young women sex workers, as well as the related views of two community support workers, who lived and worked in Bangkok, Thailand. DISCUSSION: This study is considered in the light of current research on - as well as new opportunities and challenges offered for - participation by vulnerable groups in the context of digital society. Thematic analysis of the interview data identified barriers to participation, including the illegality of sex work, fear, and lack of trust of the authorities, as well as widespread social stigma. Such barriers resulted in young women seeking anonymity. Yet, promisingly, young women positioned themselves as experts; they are involved in peer education and are supportive of greater involvement in HIV programs, such as further educational initiatives and collective actions. CONCLUSION: There is a need for a more empowerment-oriented participation practice positioning young women sex workers as expert educators and codecision makers within a model of participation that is also accountable, such as including young women as members of program boards. Beyond current norms, there are new opportunities emerging because of the increasing availability of smartphone/Internet technology. These can support activist and codesign participation by young women sex workers in HIV programs. However, any developments in participation must maximize opportunities carefully, taking into consideration the difficult social environment faced by young women sex workers as well as the need for strategies to address illegality and stigma.

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BACKGROUND: Stigma, voicelessness, and legislative and rights barriers, coupled with top-down decision making, are the common experiences of vulnerable youth populations that limit their opportunities to participate in vital health promotion efforts such as HIV prevention. OBJECTIVE: To consider new opportunities arising from a digital society for youth to creatively shape HIV prevention. METHODS: Drawing on research with vulnerable youth in Busoga, Uganda; Bulawayo, Zimbabwe; Bangkok, Thailand; and Bali, Indonesia, we explore current youth participation, in theory and practice, while considering new opportunities arising from a digital society for youth to creatively shape HIV prevention. RESULTS: Collaborative commons and prosumer models are defined as people employing new technology to codesign toward a common goal. Within the context of a diminishing role of the traditional institution and the rise of digitized networks, such models offer exciting new directions for youth as electronic health promotion prosumers to participate in difficult challenges such as HIV prevention in the 21st century. CONCLUSIONS: It is time for institutions to embrace such opportunities, especially in areas where access to technology is widening, while continuing to champion youth and advocate for supportive social environments.

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This paper describes a study which explored the lives of young Ugandan women through their voices, and related the findings to HIV prevention paradigms. The research was conducted in the context of the continuing vulnerability of young Ugandan women to HIV; reflected in disproportionately high prevalence compared to young men. The participants of the study were 15 young women aged 15-19 years, from Busoga Region in Eastern Uganda. Given the focus on young women's voices within norms of gender inequality, a narrative methodology was used as a safe space for participants to speak about their lives, expanding on research experiences with young people. The methods used included drawing; written stories and drama; aspirational writing and diary keeping. Forty-eight narratives, in image and word form, represented everyday experiences in young women's lives, as well as difficult experiences of inequality and resistance. Young women portrayed considerable social barriers to empowerment, and a challenging environment of poverty and educational limitations. Young women's representations were analysed using a gender empowerment and positive sexuality framework. The resulting analysis was then critically applied to HIV prevention paradigms. Evidence from the study showed that prevailing HIV prevention paradigms reinforce the difficulties faced by young women in their sexual lives. This research adds to calls for alternative and wider approaches to HIV prevention, underpinned by gender empowerment. Alternative approaches need to build young African women's voices in the spaces of homes, schools and communities. It is vital, however, that such efforts are embedded in more radical change leading to social environments receptive to the needs of young women.

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This article reviews the relationships between government and church health providers within sub-Saharan Africa with a particular focus on East and Southern Africa. This is of particular interest at this time, given the changing configuration of the health sector in many countries as a result of health sector reform policies. The article provides a historical overview of the development and emerging role of the church health services within this changing environment. The factors affecting the relationship between the government and church sector are identified. These include differences in objectives, types of service provided, and the organizational culture and management styles. The paper then explores key issues seen to affect the future pattern of relationships including the changing scene, and identifies different models for relationships and implications for key actors including the Ministry of Health, church health agencies and coordinating bodies. The article concludes that church health services will continue to play a key role in health care in sub-Saharan Africa; however, there are challenges facing them and both parties need to develop a response to these.

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