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Bedi S, Strachan R, Zehbe I. Awareness of human papillomavirus infection among Indigenous males in North America and Oceania: a Scoping Review. Cancer Causes Control 2024; 35:437-449. [PMID: 37831275 DOI: 10.1007/s10552-023-01804-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 09/15/2023] [Indexed: 10/14/2023]
Abstract
PURPOSE Human papillomavirus (HPV) is the most commonly transmitted sexually transmitted infection. HPV infections have been on the rise among males, especially in the form of oropharyngeal cancer. Despite this, there is a gap in healthcare guidelines to increase HPV vaccine administration among males. In this study, we focus on the Indigenous population of North America and Oceania to determine existing barriers resulting in low HPV vaccination rates among the population. METHOD We surveyed peer-reviewed literature on the awareness of HPV infection among Indigenous males in North America and Oceania. Using keywords HPV plus male, men or boy, and ethnical filters such as Indigenous, Aboriginal or First Nations, we retrieved 54 articles based on titles, of which 15 were included after reading the abstracts. RESULTS Reported HPV awareness was generally low in Indigenous males in North America, with no peer-reviewed data from Oceania. The lower understanding by males compared to females was largely attributable to misconceptions about HPV-related diseases, their transmission, and prevention. Lack of awareness and concern toward the risk of contracting HPV infection in Indigenous males suggests an impediment in disseminating health information about this cancer-causing virus. CONCLUSION Culturally sensitive education, with emphasis on Indigenous males, is needed to improve this group's HPV knowledge. Researchers should also engage meaningfully with Indigenous communities by building rapport to achieve a positive change in attitude.
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Affiliation(s)
- Simran Bedi
- Biology Department, Lakehead University, Thunder Bay, ON, P7B5E1, Canada.
| | - Robert Strachan
- Biology Department, Lakehead University, Thunder Bay, ON, P7B5E1, Canada
- Probe Development and Biomarker Exploration, Thunder Bay Regional Research Institute, Thunder Bay, ON, Canada
| | - Ingeborg Zehbe
- Biology Department, Lakehead University, Thunder Bay, ON, P7B5E1, Canada
- Probe Development and Biomarker Exploration, Thunder Bay Regional Research Institute, Thunder Bay, ON, Canada
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2
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Hackett L, Biderman M, Doria N, Courville J, Bogner E, Spencer R, Miller D, McMillan J, Numer M. A rapid review of Indigenous boys' and men's sexual health in Canada. CULTURE, HEALTH & SEXUALITY 2021; 23:705-721. [PMID: 32223538 DOI: 10.1080/13691058.2020.1722856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 01/24/2020] [Indexed: 06/10/2023]
Abstract
Indigenous boys and men in Canada face adverse social and structural circumstances that affect their ability to achieve and maintain sexual health. Research about Indigenous sexual health, however, is largely limited to matters relating to women and statistics on sexually transmitted infections. A rapid review of research was conducted to determine what is currently known about Indigenous boys' and men's sexual health in Canada. Given the prevalence of research documenting quantitative disparities, the current review included qualitative research only. Thirteen included studies explored a wide range of topics relating to sexual health and an overarching intersection between social conditions and individual health outcomes was observed. The results of this review reveal significant gaps in the literature relating to the holistic sexual health of Indigenous boys and men and highlight important domains of sexual health to consider in future research. Findings suggest that sexual health programmes that promote traditional Indigenous knowledge and intergenerational relationships may be effective for promoting sexual health among Indigenous boys and men.
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Affiliation(s)
- Lisa Hackett
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Maya Biderman
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Nicole Doria
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Julien Courville
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Emma Bogner
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Rebecca Spencer
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | | | - Jane McMillan
- Department of Anthropology, St. Francis Xavier University, Antigonish, NS, Canada
| | - Matthew Numer
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
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3
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Predictors of Sexually Transmitted Infection Positivity Among Substance-Using Native American Adults. Sex Transm Dis 2021; 47:211-216. [PMID: 31923137 DOI: 10.1097/olq.0000000000001129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sexually transmitted infections (STIs) are a public health crisis with Native Americans suffering a high burden of disease. Studies across gender and racial/ethnic groups have found varying risk factors associated with STI positivity. Understanding how risk factors are associated with STI positivity can help design interventions for those most at risk. METHODS Participants were Native American binge substance using adults enrolled in a randomized controlled trial evaluating a brief intervention to increase STI screening and reduce sexual risk-taking behaviors. Participants completed a self-report assessment at baseline that included questions about sexual risk factors and STI testing behaviors and diagnosis. This analysis includes those who had ever completed an STI test at baseline. Bivariate and multivariate analyses using logistical regression were utilized to identify associations between risk factors and past STI diagnosis. RESULTS A total of 193 people were included in the analysis. Over half (50.6%) of the participants had ever been diagnosed with an STI. Risk behaviors varied by gender. More women with a self-reported history of STI reported having sex with someone they thought had an STI, past experience of physical/sexual violence, and having passed out from drinking. Men with a self-reported history of STI were more likely to report past marijuana and other drug use. Among women with a self-reported history of STI, having sex with someone they thought had an STI was associated with STI positivity, whereas other drug use was associated with STI positivity among men with a self-reported history of STI. CONCLUSIONS Findings provide information for those working to reduce STIs in Native Communities to better identify and design programs for those at highest risk for STIs. Additional studies examining gender dynamics and sexual risk taking among native adults are warranted.
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Gabster A, Mayaud P, Pascale JM, Cislaghi B. Gender norms and sexual behaviours among Indigenous youth of the Comarca Ngäbe-Buglé, Panama. CULTURE, HEALTH & SEXUALITY 2020; 22:1032-1046. [PMID: 31429382 DOI: 10.1080/13691058.2019.1648873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 07/23/2019] [Indexed: 06/10/2023]
Abstract
The Comarca Ngäbe-Buglé, an administratively autonomous Indigenous region in western Panama, is home to a significant population rural Indigenous people of Ngäbe and Buglé ethnicity. HIV prevalence in the Comarca is two times higher than the national average, and the great majority of cases are concentrated in young men. Yet, there is little data regarding socio-cultural and sexual behaviour factors that may drive this high prevalence. Understanding such factors would enable the development of relevant prevention interventions. We conducted a qualitative study between January and March 2018, consisting of 20 semi-structured interviews with male and female young people aged 14-19 years, complemented with ethnographic observations of one month's duration each in two communities within the Comarca, to identify potential factors that could increase risk of HIV and other sexually transmitted infections (STIs). We suggest that interventions to prevent HIV and other STIs should focus on increasing open communication between sex partners, especially with respect to condom use, as well as facilitating people-driven change in gender norms that are harmful to both young women and young men.
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Affiliation(s)
- Amanda Gabster
- Departamento de Genómica y Proteómica, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama, Panama
- Faculty of Infectious and Tropical Diseases, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Philippe Mayaud
- Faculty of Infectious and Tropical Diseases, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Juan Miguel Pascale
- Departamento de Genómica y Proteómica, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama, Panama
- Facultad de Medicina, Universidad de Panamá, Panama, Panama
| | - Beniamino Cislaghi
- Faculty of Infectious and Tropical Diseases, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
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Fetner T, Dion M, Heath M, Andrejek N, Newell SL, Stick M. Condom use in penile-vaginal intercourse among Canadian adults: Results from the sex in Canada survey. PLoS One 2020; 15:e0228981. [PMID: 32078662 PMCID: PMC7032697 DOI: 10.1371/journal.pone.0228981] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 01/28/2020] [Indexed: 11/18/2022] Open
Abstract
PURPOSE This paper examines condom use in penile-vaginal sexual intercourse among adults in Canada. DATA AND METHOD The Sex in Canada survey is a national survey of Canadian adults, ages 18+ (N = 2,303). The online survey used quota-based population sample matching of 2016 census targets for gender, age, region, language, visible minority status, and education level. We report general patterns of self-reported condom use, as well as results from zero-inflated negative binomial regression models on the relationship between condom use and social location, relationship status, and sexual health. RESULTS Condom use varies by gender, age, education, visible minority status, and relationship status. Use of condoms is related to the perception of risk of being diagnosed with a sexually transmitted infection in the next six months and to the experience of receiving lessons in condom use. No significant associations were found between condom use and region, rural/urban residence, income, or religion. Among men, but not women, condom use is associated with language preference, past diagnosis with a sexually transmitted infection, and self-reported sexual health. CONCLUSION Canadian adults report using a condom in approximately 30% of their sexual encounters involving penile-vaginal sex. Condom use is highest among young adults. Single people use condoms more often than people with marital or common-law partners. Condom use is higher among those with higher levels of education, among people belonging to visible minorities relative to white people, and for men relative to women. People who think they are likely to be diagnosed with a sexually transmitted infection in the next six months are more likely to use condoms than those who do not.
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Affiliation(s)
- Tina Fetner
- Sociology, McMaster University, Hamilton, Ontario, Canada
| | - Michelle Dion
- Political Science, McMaster University, Hamilton, Ontario, Canada
| | - Melanie Heath
- Sociology, McMaster University, Hamilton, Ontario, Canada
| | | | - Sarah L. Newell
- Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Max Stick
- Sociology, McMaster University, Hamilton, Ontario, Canada
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6
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James-Hawkins L, Dalessandro C, Sennott C. Conflicting contraceptive norms for men: equal responsibility versus women's bodily autonomy. CULTURE, HEALTH & SEXUALITY 2019; 21:263-277. [PMID: 29764310 DOI: 10.1080/13691058.2018.1464209] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 04/09/2018] [Indexed: 06/08/2023]
Abstract
Most research investigating how men and women in heterosexual relationships negotiate contraceptive use focuses on the women's point of view. Using a sample of 44 interviews with men attending a western US university, this study examines norms governing men's participation in contraceptive use and pregnancy prevention and their responses to those norms. The paper demonstrates how competing norms around sexual health decision-making and women's bodily autonomy contribute to unintended outcomes that undermine young people's quest for egalitarian sexual relationships. While men largely agree that responsibility for sexual health decision-making should be shared with women, they also believe that women should have power over their own bodies and sexual health. However, the coexistence of these two competing norms - which call for both equal responsibility in decision-making and women's bodily autonomy - results in a disconnect between men saying that sexual health decision-making should be equal, but not always participating equally. Thus, men largely give contraceptive decision-making power over to women, putting the burden of pregnancy prevention onto women and letting men off the hook. It is concluded that men's negotiation of these competing norms reinforces unequal power and inequality in sexual relationships.
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Affiliation(s)
| | - Cristen Dalessandro
- b Department of Sociology , University of Colorado Boulder , Boulder , CO , USA
| | - Christie Sennott
- c Department of Sociology , Purdue University , West Lafayette , IN , USA
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7
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Jacques-Aviñó C, García de Olalla P, González Antelo A, Fernández Quevedo M, Romaní O, Caylà JA. The theory of masculinity in studies on HIV. A systematic review. Glob Public Health 2018; 14:601-620. [PMID: 29972098 DOI: 10.1080/17441692.2018.1493133] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This study aimed to describe the methodological characteristics of publications on HIV and masculinity, to identify possible information gaps and determine the main thematic areas. A systematic review was conducted of gender, masculinity, HIV infection and other sexually-transmitted infections in original articles published between 1992 and 2015. Original studies published from Pubmed and Scopus were included. A total of 303 articles were identified, of which 187 were selected. Most of the studies were qualitative and the most widely used technique was the interview. Twenty-nine-point five percent of studies were performed in South Africa, 20.8% in the USA, and 3.2% in Europe. Fifteen percent of the studies were performed in heterosexuals, 12.8% in men who have sex with men, and 60% did not specify the sexual orientation of the population. Eight thematic areas were defined, the most frequent being sexuality and risk behaviours, defined by men's need to demonstrate they were sexually active and a breadwinner. Most studies on HIV and masculinity show a gender bias by not specifying the sexual identity of the population. Studies should consider diversity in sexual and cultural identity in different contexts, including in Europe, to carry out more effective HIV interventions from a masculinity perspective.
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Affiliation(s)
- Constanza Jacques-Aviñó
- a Servicio de Epidemiología , Agència de Salud Pública de Barcelona , Barcelona , Spain.,b Universitat Rovira i Virgili (URV) , Tarragona , Spain
| | - Patricia García de Olalla
- a Servicio de Epidemiología , Agència de Salud Pública de Barcelona , Barcelona , Spain.,c Epidemiología y Salud Pública , CIBER , Spain
| | - Alicia González Antelo
- d Servicio Medicina Preventiva y Epidemiología , Hospital Vall d'Hebrón , Barcelona , Spain
| | | | - Oriol Romaní
- c Epidemiología y Salud Pública , CIBER , Spain.,e Medical Anthropology Research Center (MARC- URV) , Tarragona , Spain
| | - Joan A Caylà
- a Servicio de Epidemiología , Agència de Salud Pública de Barcelona , Barcelona , Spain.,c Epidemiología y Salud Pública , CIBER , Spain
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8
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Psaki SR, Ayivi-Guedehoussou N, Halperin DT. Leveraging changing gender norms to address concurrency: focus group findings from South African university students. Sex Health 2016; 10:369-76. [PMID: 23809883 DOI: 10.1071/sh12209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2012] [Accepted: 04/25/2013] [Indexed: 01/09/2023]
Abstract
UNLABELLED Background This study aims to complement recent research on sexual concurrency in South Africa by providing a deeper understanding of women's roles and motivations for engaging in and accepting their partners' concurrency. Our goal is to inform the implementation of more effective interventions that embrace the powerful role that women can play in healthy sexual decision-making in consensual relationships. METHODS We conducted 12 focus groups with male and female students at the University of KwaZulu-Natal. Drawing on a subset of those focus groups, we examined the gender norms underpinning the apparently widespread acceptance of concurrent sexual partnerships. Our analysis focusses on women's attitudes and behaviours towards concurrency - from both men's and women's perspectives - with a goal of identifying opportunities to engage women as agents of change in sexual partnership patterns in their communities. RESULTS Our findings indicate that: (1) concurrent sexual partnerships were the norm among male students and increasingly common among female students; (2) material gain and changes in women's perceptions of their roles and power in relationships were the primary female motives for concurrency; (3) peer pressure, a perceived innate need and a fear of being alone were the primary male motives for concurrency; (4) women often know that their partners are cheating and stay with them because they believe they are the most important partner, for financial reasons, or because they worry they will not find another partner. CONCLUSIONS HIV prevention interventions in populations where concurrency is common would benefit from emphasising women's role and power in taking greater control of their own sexual decision-making in consensual and nonviolent relationships.
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Affiliation(s)
- Stephanie R Psaki
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health,Baltimore, MD 21205, USA
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9
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Fleming PJ, DiClemente RJ, Barrington C. Masculinity and HIV: Dimensions of Masculine Norms that Contribute to Men's HIV-Related Sexual Behaviors. AIDS Behav 2016; 20:788-98. [PMID: 26696261 PMCID: PMC4799765 DOI: 10.1007/s10461-015-1264-y] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Numerous studies have documented a relationship between masculine norms and men's HIV-related sexual behaviors, but intervening upon this relationship requires a nuanced understanding of the specific aspects of masculine norms that shape men's sexual behaviors. We integrate theories on masculinities with empirical HIV research to identify specific dimensions of masculine norms that influence men's HIV-related sexual behaviors. We identify three major dimensions of masculine norms that shape men's sexual behavior: (1) uncontrollable male sex drive, (2) capacity to perform sexually, and (3) power over others. While the existing literature does help explain the relationship between masculine norms and men's sexual behaviors several gaps remain including: a recognition of context-specific masculinities, an interrogation of the positive influences of masculinity, adoption of an intersectional approach, assessment of changes in norms and behaviors over time, and rigorous evaluations of gender-transformative approaches. Addressing these gaps in future research may optimize prevention efforts.
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Affiliation(s)
- Paul J Fleming
- Division of Global Public Health, University of California, San Diego, 9500 Gilman Drive MC 0507, La Jolla, CA, 92093, USA.
| | - Ralph J DiClemente
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA, USA
- Center for AIDS Research, Prevention Sciences & Epidemiology Core, Atlanta, GA, USA
| | - Clare Barrington
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Strömbäck M, Wiklund M, Salander Renberg E, Malmgren-Olsson EB. Gender-sensitive and youth-friendly physiotherapy: Steps toward a stress management intervention for girls and young women. Physiother Theory Pract 2016; 32:20-33. [DOI: 10.3109/09593985.2015.1075639] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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11
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Jamal F, Bonell C, Wooder K, Blake S. Let's talk about sex: gender norms and sexual health in English schools. Sex Health 2015; 12:1-3. [PMID: 25730511 DOI: 10.1071/sh15010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 02/10/2015] [Indexed: 11/23/2022]
Abstract
The sexual health of young people in England is an urgent public health concern. While interventions to address young people's sexual health have focussed on knowledge, skills and contraception access, amazingly none in the UK has explicitly addressed the effects of the social hierarchies of gender and gendered behavioural ideals that shape young people's sexual expectations, attitudes and behaviour. The lack of attention to gender is a persistent gap in health research, practice and policy. A rigorous evaluation of such an intervention package would go some way to building an evidence base for challenging gender norms, which appear to be strongly associated with adverse sexual health outcomes.
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Affiliation(s)
- Farah Jamal
- University College London, UCL Institute of Education, 18 Woburn Square, London, WC1H 0NR, UK
| | - Chris Bonell
- University College London, UCL Institute of Education, 18 Woburn Square, London, WC1H 0NR, UK
| | - Kai Wooder
- Brook, 50 Featherstone Street, London, EC1Y 8RT, UK
| | - Simon Blake
- Brook, 50 Featherstone Street, London, EC1Y 8RT, UK
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12
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Oliver V, Flicker S, Danforth J, Konsmo E, Wilson C, Jackson R, Restoule JP, Prentice T, Larkin J, Mitchell C. 'Women are supposed to be the leaders': intersections of gender, race and colonisation in HIV prevention with Indigenous young people. CULTURE, HEALTH & SEXUALITY 2015; 17:906-919. [PMID: 25702802 DOI: 10.1080/13691058.2015.1009170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Focusing on gender, race and colonialism, this paper foregrounds the voices of Indigenous young people, their histories of oppression, their legacies of resistance and the continuing strengths rooted in Indigenous peoples, their cultures and their communities. Exploring the relationship between gender and colonialism, the paper speaks to the lived realities of young people from Indigenous communities across Canada. Over 85 young people participated in six different Indigenous community workshops to create artistic pieces that explored the connections between HIV, individual risk and structural inequalities. In the course of the research, Indigenous young people, and young Indigenous women in particular, talked about how gender intersects with race and colonisation to create experiences that are, at times, especially difficult for them. In this paper, young people discuss the ways in which colonialism has demeaned women's roles and degraded women's sexuality, and how continuing cultural erasure and assimilationist policies impact on their lives and on their bodies.
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Affiliation(s)
- Vanessa Oliver
- a Youth and Children's Studies, Wilfrid Laurier University , Brantford , ON , Canada
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13
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Kennedy DP, Brown RA, Morrison P, Vie L, Ryan GW, Tucker JS. Risk evaluations and condom use decisions of homeless youth: a multi-level qualitative investigation. BMC Public Health 2015; 15:62. [PMID: 25636862 PMCID: PMC4324882 DOI: 10.1186/s12889-015-1419-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 01/14/2015] [Indexed: 11/17/2022] Open
Abstract
Background Homeless youth are at higher risk for sexually transmitted infections and unwanted pregnancy than non-homeless youth. However, little is known about how they evaluate risk within the context of their sexual relationships. It is important to understand homeless youths' condom use decisions in light of their sexual relationships because condom use decisions are influenced by relationship dynamics in addition to individual attitudes and event circumstances. It is also important to understand how relationship level factors, sexual event circumstances, and individual characteristics compare and intersect. Methods To explore these issues, we conducted semi-structured interviews with 37 homeless youth in Los Angeles County in 2011 concerning their recent sexual relationships and analyzed the data using systematic methods of team-based qualitative data analysis. Results We identified themes of risk-related evaluations and decisions at the relationship/partner, event, and individual level. We also identified three different risk profiles that emerged from analyzing how different levels of risk intersected across individual respondents. The three profiles included 1) Risk Takers, who consistently engage in risk and have low concern about consequences of risk behavior, 2) Risk Avoiders, who consistently show high concern about protection and consistently avoid risk, and 3) Risk Reactors, those who are inconsistent in their concerns about risk and protection and mainly take risks in reaction to relationship and event circumstances. Conclusions Interventions targeting homeless youth should reflect multiple levels of risk behavior and evaluation in order to address the diversity of risk profiles. Relationship/partner-, event-, and individual-level factors are all important but have different levels of importance for different homeless youth. Interventions should be tailored to address the most important factor contributing to homeless youth reproductive needs. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1419-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- David P Kennedy
- RAND Health, RAND Corporation, P.O. Box 2138, 1776 Main Street, Santa Monica, CA, 90407, USA.
| | - Ryan A Brown
- RAND Health, RAND Corporation, P.O. Box 2138, 1776 Main Street, Santa Monica, CA, 90407, USA.
| | - Penelope Morrison
- The RAND-University of Pittsburgh Health Institute, Pittsburgh, PA, USA.
| | - Loryana Vie
- The Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA. .,The Department of Psychology, University of California, Riverside, CA, USA.
| | - Gery W Ryan
- RAND Health, RAND Corporation, P.O. Box 2138, 1776 Main Street, Santa Monica, CA, 90407, USA.
| | - Joan S Tucker
- RAND Health, RAND Corporation, P.O. Box 2138, 1776 Main Street, Santa Monica, CA, 90407, USA.
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Brown S. 'They think it's all up to the girls': gender, risk and responsibility for contraception. CULTURE, HEALTH & SEXUALITY 2015; 17:312-25. [PMID: 25270238 DOI: 10.1080/13691058.2014.950983] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Much research suggests that attitudes towards responsibility for use of contraception amongst young people are strongly gendered. However, decision making, if 'decisions' happen at all, is bound up with notions of hegemonic masculine and feminine roles as well as factors concerning relationship status. Data from two earlier qualitative studies were re-analysed with an emphasis on findings related to gender and responsibility for use of contraception. The first study investigated unintended conceptions amongst 16-20-year-old women. Interviews focused on knowledge and views about contraception, sex education and sexual health services. The second study involved focus groups with two groups of 14-18-year-old men to explore their views on sex education, sexual health and contraception. Almost all the young women said that young men viewed contraception as 'not their job'. In contrast, the young men thought that responsibility should be shared. The key issue, however, related to relationship status, with decision-making being shared in long-term relationships. There are some gender differences in accounting for decisions about use of contraception, however the key issue revolves around relationship status.
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Affiliation(s)
- Sally Brown
- a School of Medicine, Pharmacy and Health, Durham University , Durham , UK
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15
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Perceived Level of Relationship Commitment, Sexual Risk Taking and Condom Use Among American Indian Men. J Immigr Minor Health 2014; 17:1078-85. [DOI: 10.1007/s10903-014-0058-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Buston K, Parkes A, Wight D. High and low contraceptive use amongst young male offenders: a qualitative interview study. ACTA ACUST UNITED AC 2014; 40:248-53. [PMID: 24736230 PMCID: PMC4173989 DOI: 10.1136/jfprhc-2013-100696] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objectives There are high rates of fatherhood and sexually transmitted infections (STIs) among young incarcerated men. Here we focus on a sample of men incarcerated in a Scottish Young Offender Institution, analysing their accounts of their contraceptive use. Those who report low or no use of contraception are compared with those who report high use. Methods Semi-structured interviews with 40 young male offenders, aged 16–21 years. Participants were purposively sampled using answers from a questionnaire administered to 67 inmates. Data from those men (n=31) reporting either high (n=14) or low/no use (n=17) of contraception are analysed here. Results Low users emphasise their desire for pleasure and appear fatalistic about both pregnancy and disease prevention. High users report a strong desire to protect themselves and their ‘manliness’ by using condoms to avoid the risk of STIs and, to a lesser extent, pregnancy. Both sets of men present themselves in a traditionally masculine way, with high users emphasising power, authority and self-control to justify their non-risk-taking contraceptive behaviour. Conclusions The masculine narrative regarding self-protection, utilised by the high users, may be an effective method of intervention with potential and actual low users. Conventional masculinity valorises risk-taking but if particular forms of risk avoidance – condom use – can be legitimised as confirming one's masculinity it may be possible to persuade low users to adopt them. The opportunity to work with young men whilst incarcerated should be grasped.
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Affiliation(s)
- Katie Buston
- Senior Investigator Scientist, MRC Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Alison Parkes
- Senior Investigator Scientist, MRC Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Danny Wight
- Programme Leader, MRC Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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17
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Strömbäck M, Malmgren-Olsson EB, Wiklund M. 'Girls need to strengthen each other as a group': experiences from a gender-sensitive stress management intervention by youth-friendly Swedish health services--a qualitative study. BMC Public Health 2013; 13:907. [PMID: 24083344 PMCID: PMC3850732 DOI: 10.1186/1471-2458-13-907] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 09/30/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental health problems among young people, and girls and young women in particular, are a well-known health problem. Such gendered mental health patterns are also seen in conjunction with stress-related problems, such as anxiety and depression and psychosomatic complaints. Thus, intervention models tailored to the health care situation experienced by young women within a gendered and sociocultural context are needed. This qualitative study aims to illuminate young women's experiences of participating in a body-based, gender-sensitive stress management group intervention by youth-friendly health services in northern Sweden. METHODS A physiotherapeutic body-based, health-promoting, gender-sensitive stress management intervention was created by youth-friendly Swedish health services. The stress management courses (n = 7) consisted of eight sessions, each lasting about two hours, and were led by the physiotherapist at the youth centre. The content in the intervention had a gender-sensitive approach, combining reflective discussions; short general lectures on, for example, stress and pressures related to body ideals; and physiotherapeutic methods, including body awareness and relaxation. Follow-up interviews were carried out with 32 young women (17-25 years of age) after they had completed the intervention. The data were analysed with qualitative content analysis. RESULTS The overall results of our interview analysis suggest that the stress management course we evaluated facilitated 'a space for gendered and embodied empowerment in a hectic life', implying that it both contributed to a sense of individual growth and allowed participants to unburden themselves of stress problems within a trustful and supportive context. Participants' narrated experiences of 'finding a social oasis to challenge gendered expectations', 'being bodily empowered', and 'altering gendered positions and stance to life' point to empowering processes of change that allowed them to cope with distress, despite sometimes continuously stressful life situations. This intervention also decreased stress-related symptoms such as anxiousness, restlessness, muscle tension, aches and pains, fatigue, and impaired sleep. CONCLUSIONS The participants' experiences of the intervention as a safe and exploratory space for gendered collective understanding and embodied empowerment further indicates the need to develop gender-sensitive interventions to reduce individualisation of health problems and instead encourage spaces for collective support, action, and change.
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Affiliation(s)
- Maria Strömbäck
- Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
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18
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Kennedy DP, Brown RA, Golinelli D, Wenzel SL, Tucker JS, Wertheimer SR. Masculinity and HIV Risk among Homeless Men in Los Angeles. PSYCHOLOGY OF MEN & MASCULINITY 2013; 14:156-167. [PMID: 23730216 DOI: 10.1037/a0027570] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
HIV continues to be a serious public health problem for men who have sex with women (MSW), especially homeless MSW. Although consideration of gender has improved HIV prevention interventions, most of the research and intervention development has targeted how women's HIV risk is affected by gender roles. The effect of gender roles on MSW has received relatively little attention. Previous studies have shown mixed results when investigating the association between internalization of masculine gender roles and HIV risk. These studies use a variety of scales that measure individual internalization of different aspects of masculinity. However, this ignores the dynamic and culturally constructed nature of gender roles. The current study uses cultural consensus analysis (CCA) to test for the existence of culturally agreed upon masculinity and gender role beliefs among homeless MSW in Los Angeles, as well as the relationship between these beliefs and HIV-related behaviors and attitudes. Interviews included 30 qualitative and 305 structured interviews with homeless MSW in Los Angeles's Skid Row area. Analysis identified culturally relevant aspects of masculinity not represented by existing masculinity scales, primarily related to barriers to relationships with women. Behaviors, attitudes, and knowledge related to HIV were significantly associated with men's level of agreement with the group about masculinity. The findings are discussed in light of implications for MSW HIV intervention development.
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Affiliation(s)
- David P Kennedy
- RAND Health, RAND Corporation, Santa Monica, CA ; University of California, Los Angeles, Center for Health Services and Society, Los Angeles, CA
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19
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Oliffe JL, Chabot C, Knight R, Davis W, Bungay V, Shoveller JA. Women on men's sexual health and sexually transmitted infection testing: a gender relations analysis. SOCIOLOGY OF HEALTH & ILLNESS 2013; 35:1-16. [PMID: 22497206 DOI: 10.1111/j.1467-9566.2012.01470.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Sexual health and sexually transmitted infection (STI) testing is typically portrayed as a women's issue amid men's estrangement from healthcare services. While the underreporting of men's STIs has been linked to masculinities, little is known about how women interpret and respond to heterosexual men's sexual health practices. The findings drawn from this qualitative study of 34 young women reveal how femininities can be complicit in sustaining, as well as being critical of and disrupting masculine discourses that affirm sexual pleasure and resistance to health help-seeking as men's patriarchal privileges. Our analysis revealed three patterns: looking after the man's libido refers to women's emphasised femininity whereby the man's preference for unprotected sex and reticence to be tested for STIs was accommodated. Negotiating the stronger sex refers to ambivalent femininities, in which participants strategically resist, cooperate and comply with men's sexual health practices. Rejecting the patriarchal double standard that celebrates men as 'studs' and subordinates women as 'sluts' for embodying similar sexual practices reflects protest femininities. Overall, the findings reveal that conventional heterosexual gender relations, in which hegemonic masculinity is accommodated by women who align to emphasised femininity, continues to direct many participants' expectations around men's sexual health and STI testing.
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Affiliation(s)
- John L Oliffe
- School of Nursing, University of British Columbia, Vancouver, Canada.
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20
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Ning A, Wilson K. A research review: exploring the health of Canada's Aboriginal youth. Int J Circumpolar Health 2012; 71:IJCH-71-18497. [PMID: 22973569 PMCID: PMC3427595 DOI: 10.3402/ijch.v71i0.18497] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Revised: 07/20/2012] [Accepted: 07/21/2012] [Indexed: 11/15/2022] Open
Abstract
Objective To compare the current state of health research on Aboriginal and non-Aboriginal youth in Canada. Design A search of published academic literature on Canadian Aboriginal youth health, including a comprehensive review of both non-Aboriginal and Aboriginal youth research, was conducted using MEDLINE and summarized. Methodology A MEDLINE search was conducted for articles published over a 10-year period (2000–2010). The search was limited to research articles pertaining to Canadian youth, using various synonyms for “Canada,” “youth,” and “Aboriginal.” Each article was coded according to 4 broad categories: Aboriginal identity, geographic location, research topic (health determinants, health status, health care), and the 12 key determinants of health proposed by the Public Health Agency of Canada (PHAC). Results Of the 117 articles reviewed, only 34 pertained to Aboriginal youth, while the remaining 83 pertained to non-Aboriginal youth. The results revealed major discrepancies within the current body of research with respect to the geographic representation of Aboriginal youth, with several provinces missing from the literature, including the northern territories. Furthermore, the current research is not reflective of the demographic composition of Aboriginal youth, with an under-representation of Métis and urban Aboriginal youth. Health status of Aboriginal youth has received the most attention, appearing in 79% of the studies reviewed compared with 57% of the non-Aboriginal studies. The number of studies that focus on health determinants and health care is comparable for both groups, with the former accounting for 62 and 64% and the latter comprising 26 and 19% of Aboriginal and non-Aboriginal studies, respectively. However, this review reveals several differences with respect to specific focus on health determinants between the two populations. In non-Aboriginal youth studies, all the 12 key determinants of health of PHAC are explored, whereas in Aboriginal youth studies the health profile remains incomplete and several key determinants and health indicators are neglected. Conclusions The current studies are not reflective of the demographic and geographic profiles of Aboriginal youth in Canada, and they have also failed to provide a comprehensive examination of their unique health needs and concerns compared with studies on non-Aboriginal youth.
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Affiliation(s)
- Ashley Ning
- Department of Geography & Collaborative Program in Aboriginal Health, University of Toronto Mississauga, Mississauga, Canada.
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21
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Mooney-Somers J, Olsen A, Erick W, Scott R, Akee A, Maher L. Young Indigenous Australians' Sexually Transmitted Infection Prevention Practices: A Community-based Participatory Research Project. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2011. [DOI: 10.1002/casp.1134] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - Anna Olsen
- Kirby Institute for Infection and Immunity in Society; University of New South Wales; Sydney; Australia
| | - Wani Erick
- Queensland Health; Townsville; Queensland; Australia
| | - Robert Scott
- Townsville Aboriginal and Islanders Health Service; Townsville; Queensland; Australia
| | - Angie Akee
- Townsville Aboriginal and Islanders Health Service; Townsville; Queensland; Australia
| | - Lisa Maher
- Kirby Institute for Infection and Immunity in Society; University of New South Wales; Sydney; Australia
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22
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Devries KM, Free CJ. Boyfriends and booty calls: sexual partnership patterns among Canadian Aboriginal young people. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2011; 102:13-17. [PMID: 21485961 PMCID: PMC6974215 DOI: 10.1007/bf03404871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Accepted: 08/20/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVES Sexual partnership patterns, forced sex, and condom non-use can contribute to STI risk, but little is known about these patterns among Aboriginal young people despite elevated STI risk in this group. We describe sexual relationship and condom use patterns among Canadian Aboriginal young people, and how these patterns relate to the socio-structural context as experienced by young people. METHODS We use data from in-depth individual interviews conducted in 2004 with 22 young people who reported ever having sex and who self-identified as Aboriginal in British Columbia, Canada. A thematic analysis is presented. RESULTS Young people described a range of partnership patterns, including 'on-off' relationships which could have high rates of partner turnover but could sometimes be viewed as acceptable contexts for pregnancy, precluding condom use. Contextual elements beyond individual control appeared to contribute to these patterns. Migration between geographic locations was linked with risky partnership patterns, especially if it was linked with family instability or substance use problems. CONCLUSION Sexual health interventions for this group must address partnership patterns in addition to promoting condom use. Survey research into 'migration' as a risk factor for STI transmission should consider reasons for migration. Interventions that address both individual level behaviour and the contextual elements that shape behaviour should be developed and tested.
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Affiliation(s)
- Karen M Devries
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
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