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Baeza MJ, De Santis JP, Cianelli R, Metheny N, Villegas N. Bearing (Aguantando) With Intimate Partner Violence: A Grounded Theory Study of Self-Silencing Among Hispanic Women Who Experienced Intimate Partner Violence. QUALITATIVE HEALTH RESEARCH 2024; 34:662-675. [PMID: 38236009 DOI: 10.1177/10497323231225144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Hispanic women who experience intimate partner violence (IPV) face unique disparities. They have poorer health outcomes and are less likely to seek help than their non-Hispanic counterparts. When women remain in relationships where IPV occurs and refuse to disclose or seek treatment, they may resort to self-silencing, which can also worsen health outcomes. The purpose of this study was to develop a theory that explains how self-silencing evolves among Hispanic women who experience IPV. Participants were recruited from two research studies focused on Hispanic women's health, and from snowball sampling, which involved referrals by previously registered participants. Data were collected via Zoom® and included individual interviews. A total of 25 women participated in this study. Analysis followed constructive grounded theory levels of analysis described by Charmaz and constant comparative methods described by Glaser and Strauss. A grounded theory entitled Bearing (Aguantando) With Intimate Partner Violence emerged from the data. The theory explains the main strategy Hispanic women use to deal with violence while remaining in a relationship where IPV occurs. The theory is constructed of four categories with subcategories. The results of this study provide an initial framework to understand the self-silencing process among Hispanic women who experience IPV. In addition, this study identifies different levels of interventions that can be useful for researchers and healthcare providers to promote Hispanic women's ability to become empowered, use their voices, and seek help.
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Affiliation(s)
- María José Baeza
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
- Escuela de Enfermería, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Joseph P De Santis
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Rosina Cianelli
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
- Escuela de Enfermería, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nicholas Metheny
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Natalia Villegas
- The University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, NC, USA
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2
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Abstract
Self-silencing describes the phenomenon of "loss of voice." A clear and comprehensive definition of self-silencing is relevant for nursing research and practice to promote a better understanding of detrimental health outcomes that may result from self-silencing. This concept analysis used a modified version of Walker & Avant's method to identify attributes, antecedents, and consequences of self-silencing. Self-silencing has psychological and sociocultural dimensions that may result in negative health consequences. Directions for research, practice, and policy are included.
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Affiliation(s)
- Maria Jose Baeza
- School of Nursing & Health Studies, University of Miami, Coral Gables, Florida, USA.,Escuela de Enfermería, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Joseph P De Santis
- School of Nursing & Health Studies, University of Miami, Coral Gables, Florida, USA
| | - Rosina Cianelli
- School of Nursing & Health Studies, University of Miami, Coral Gables, Florida, USA.,Escuela de Enfermería, Pontificia Universidad Católica de Chile, Santiago, Chile
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Propiedades psicométricas del Massachusetts General Hospital-Sexual Functioning Questionnaire en personas mayores. Rev Int Androl 2022; 20:170-177. [DOI: 10.1016/j.androl.2020.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 11/20/2020] [Accepted: 12/06/2020] [Indexed: 11/21/2022]
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4
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Morton C, Habib S, Morris J. What women want: the effect of health agency advertising on patient-doctor communication. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2021. [DOI: 10.1108/ijphm-07-2020-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this study is to investigate the relationship between women’s sexual health agency and their intent to initiate communications with their doctors. The research questions examined the effect sexual health agency has on patient-doctor communication, women’s emotional responses to health advertisements encouraging patient communication with their doctors, attitude toward the message and behavioral intentions after exposure to the advertising message.
Design/methodology/approach
An experimental design was implemented via an online questionnaire instrument to test the differences between younger-aged women (25 to 45 years) and mature-aged women (46 to 70 years). It was observed that 188 women who reported their status as single and sexually active in the past 12 months were exposed to a health advertisement that encouraged patient-doctor communication. Analyses were conducted to compare between-group measures on sexual health agency, emotional response and attitude toward the ad and behavioral intention.
Findings
No statistical difference existed between younger and older women. In general, women expect their doctor to lead conversations about sexual health but are positively reinforced by health messages that encourage their assertiveness as patients.
Research limitations/implications
The small sample size also may have limited the study’s potential to evaluate differences between age segments. Future research should explore this further.
Practical implications
The study provides evidence that sexual health advertising can reinforce women’s intent to initiate conversations with doctors regardless of age.
Social implications
Health communications can bolster women’s sexual health agency and improve patient-initiated conversations with doctors.
Originality/value
The study is the first to explore advertising messaging’s potential for applying health agency as a communication strategy for encouraging sexual health communications between women and their doctors.
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Bassett SM, Brody LR, Jack DC, Weber KM, Cohen MH, Clark TM, Dale SK, Moskowitz JT. Feasibility and Acceptability of a Program to Promote Positive Affect, Well-Being and Gender Empowerment in Black Women Living with HIV. AIDS Behav 2021; 25:1737-1750. [PMID: 33389322 PMCID: PMC7778488 DOI: 10.1007/s10461-020-03103-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 12/28/2022]
Abstract
While programs and interventions intended to increase positive affect among people living with HIV (PLWH) and other chronic diseases have been associated with improved health outcomes, including decreased depression, programs have not been tailored specifically for Black women. We tailored a program designed to increase positive affect and to decrease depressive symptoms in PLWH to a group format for Black WLWH. We also added skills to increase gender empowerment. We then tested the acceptability and feasibility of this program with 8 Black WLWH. The program was acceptable and relatively feasible, as assessed by women’s participation and feedback about program clarity and helpfulness, which women rated above 9 on a 10-point scale. A few women suggested that optimal delivery point for some skills taught would be shortly after HIV diagnosis. A proof-of-concept program intended to bolster positive emotions and gender empowerment and decrease depression can be tailored for Black WLWH and is relatively feasible and acceptable. A randomized controlled trial is needed to assess the preliminary efficacy of this program on positive affect, depression, and other health outcomes for WLWH.
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Affiliation(s)
- S M Bassett
- Medical Social Sciences, Northwestern University, Chicago, IL, USA.
| | - L R Brody
- Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | - D C Jack
- Fairhaven College of Interdisciplinary Studies, Western Washington University, Bellingham, WA, USA
| | - K M Weber
- Cook County Health and Hektoen Institute of Medicine, Chicago, IL, USA
| | - M H Cohen
- Department of Medicine, Rush University and Stroger Hospital of Cook County, Chicago, IL, USA
| | - T M Clark
- Cook County Health and Hektoen Institute of Medicine, Chicago, IL, USA
| | - S K Dale
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - J T Moskowitz
- Medical Social Sciences, Northwestern University, Chicago, IL, USA
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Moore MP, Javier SJ, Maxwell ML, Dunn CE, Belgrave FZ. "You put yourself at risk to keep the relationship:" African American women's perspectives on womanhood, relationships, sex and HIV. CULTURE, HEALTH & SEXUALITY 2020; 24:1-16. [PMID: 32964793 DOI: 10.1080/13691058.2020.1815240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 08/23/2020] [Indexed: 06/11/2023]
Abstract
Recent trends indicate that HIV and STI infection rates are rising among adults over the age of 50, and African American women have the highest rates of HIV infection across racial and ethnic groups of women in the USA. Limited research has examined factors that contribute to HIV risk among older African American women. The current study used Collins' Black Feminist Thought to examine and understand attitudes and perceptions around HIV and sexual risk behaviours among African American women aged 50 years and older. Participants were recruited from two faith-based organisations in the mid-Atlantic region of the USA. Overarching themes and subthemes included those of expectations among African American women (carry yourself as you were raised, and carry a big burden), risk factors (not at risk, sexual networks and loneliness) and protective factors (maintaining high standards and education). Findings from this study have implications for the development of future HIV prevention programmes involving older African American women, who have largely been overlooked by past and ongoing HIV prevention trials and safer sex promotion efforts.
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Affiliation(s)
- Melanie P Moore
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Sarah J Javier
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, CA, USA
- Center for Primary Care & Outcomes Research, Stanford School of Medicine, Stanford, CA, USA
| | - Morgan L Maxwell
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Population Health Sciences Department, Virginia Tech University, Blacksburg, VA, USA
| | - Chelsie E Dunn
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Faye Z Belgrave
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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Odlum M, Black D, Yoon S, Maher C, Lawrence S, Osborne J. Exploring HIV concern in a population of Dominican American women midlife and older. BMC Public Health 2019; 19:1429. [PMID: 31672141 PMCID: PMC6824013 DOI: 10.1186/s12889-019-7810-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 10/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The feminization and ethnic diversification of HIV infection, has resulted in a call for gender- and culture-specific prevention strategies for at-risk groups including Latinos in the United States. The steadily changing demographic profile of the AIDS epidemic challenges prevention strategies to remain relevant and up-to-date, particularly in populations of women midlife and older where an understanding of risk remains under explored. As the CDC requests country-specific HIV risk profiles for Latino communities in the US, understanding the socio-economic, behavioral and personal risk reasons of HIV risk for older Dominican women is critical for prevention. METHODS We conducted focus group discussions informed by the Theory of Gender and Power (TGP). The three constructs of the TGP: 1) Affective influences/social norms; 2) Gender-specific norms and. 3) Power and Authority guided the thematic analysis and identified themes that described the socio-cultural and contextual reasons that that contribute to perceptions of HIV risk. RESULTS Sixty Dominican American women ages 57-73 participated in our focus group discussions. Sexual Division of Labour: 1) Economic Dependence; 2) Financial Need and 3) Education and Empowerment. Sexual Division of Power: 4) HIV Risk and 5) Relationship Dynamics. Cathexis: Affective Influences/Social Norms: 6) HIV/AIDS Knowledge and 7) Prevention and Testing. Importantly, participants were concerned about partner fidelity when visiting the Dominican Republic, as the country accounts for the second highest HIV rates in the Caribbean. CONCLUSIONS Our results confirm previous findings about perceptions of HIV risk and provide additional insight into aging-related aspects of HIV risk for Latino women midlife and older.
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Affiliation(s)
- Michelle Odlum
- Columbia University School of Nursing, 560 W 168 St, New York, NY, 10032, USA.
| | - Danielle Black
- Columbia University School of Nursing, 560 W 168 St, New York, NY, 10032, USA
| | - Sunmoo Yoon
- Columbia University Medical Center, New York, NY, 10032, USA
| | - Cassidy Maher
- Columbia University Mailman School of Public Health, 722 W 168th Street, New York, NY, 10032, USA
| | - Steven Lawrence
- Columbia University Mailman School of Public Health, 722 W 168th Street, New York, NY, 10032, USA
| | - Jennel Osborne
- Columbia University School of Nursing, 560 W 168 St, New York, NY, 10032, USA
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Self-silencing in school: failures in student autonomy and teacher-student relatedness. SOCIAL PSYCHOLOGY OF EDUCATION 2019. [DOI: 10.1007/s11218-019-09511-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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9
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Jacobs RJ, Kane M, Sklar EM. Psychosocial and Behavioral Correlates of Internalized Homonegativity in Midlife and Older Gay and Bisexual Men. J Appl Gerontol 2019; 39:527-535. [DOI: 10.1177/0733464819843057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study investigated psychosocial and demographic variables that might influence internalized homonegativity (IH) in midlife and older gay and bisexual men (GBM). Data were collected from 802 community-dwelling GBM aged 40 to 94 years ( M = 54.8) through an anonymous questionnaire that assessed levels of IH, coping self-efficacy, self-silencing, and other characteristics. Multivariate logistic regression analysis successfully explained 22% of the variance in predicting IH, which was significantly related to coping self-efficacy, self-silencing, gay community volunteering, partnership status, and race, F = 59.74, p < .001. IH scores were highest in participants who were single, had lower education levels, were non-White, were less involved in gay community volunteering, experienced less coping self-efficacy, and reported higher levels of self-silencing behaviors. These data underscore the need for more tailored programming approaches for midlife and older GBM, focusing on underlying factors contributing to IH that include skill-building to increase coping self-efficacy, community involvement, and decrease self-silencing behaviors in this overlooked population.
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Torres-Obregon R, Onofre-Rodríguez DJ, Sierra JC, Granados R, Garza-Elizondo ME, Benavides-Torres RA. Factores interpersonales como predictores de la autoestima sexual en mujeres del noreste de México. Rev Int Androl 2019; 17:55-59. [DOI: 10.1016/j.androl.2018.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 12/28/2017] [Accepted: 03/05/2018] [Indexed: 11/29/2022]
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Ramírez-Ortiz D, Rojas P, Sánchez M, Cano MÁ, De La Rosa M. Associations of Self-Silencing and Egalitarian Attitudes with HIV Prevention Behaviors Among Latina Immigrant Farmworkers. J Immigr Minor Health 2019; 21:430-433. [PMID: 30030668 PMCID: PMC6607899 DOI: 10.1007/s10903-018-0773-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Latinas in farmworker communities are at particularly higher risk for human immunodeficiency virus (HIV) due to the vulnerable circumstances they experience. However, little is known about the factors influencing HIV prevention behaviors in this population. The aim of this study was to examine the associations of self-silencing behaviors and egalitarian attitudes toward women in relation to three HIV prevention behaviors: self-efficacy for HIV prevention, intentions to negotiate safe sex, and HIV-related knowledge. This study is a cross-sectional analysis that used hierarchical multiple regression models to examine these previously mentioned associations, among Latina immigrant farmworkers from Miami-Dade County, Florida (n = 232). Findings indicated that self-silencing behaviors were adversely associated with the three HIV preventive behaviors whereas egalitarian attitudes were positively associated. Findings from this study may help to advance the understanding of sociocultural determinants of HIV prevention behaviors among Latina immigrants.
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Affiliation(s)
- Daisy Ramírez-Ortiz
- Department of Epidemiology, Florida International University, Miami, FL, USA
| | - Patria Rojas
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL, USA.
- Department of Health Promotion and Disease Prevention, Florida International University, Miami, FL, USA.
| | - Mariana Sánchez
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL, USA
- Department of Health Promotion and Disease Prevention, Florida International University, Miami, FL, USA
| | - Miguel Ángel Cano
- Department of Epidemiology, Florida International University, Miami, FL, USA
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL, USA
| | - Mario De La Rosa
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL, USA
- Department of Health Promotion and Disease Prevention, Florida International University, Miami, FL, USA
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Stokes LR, Brody LR. Self-Silencing, but Not Sexual Relationship Power Associated with Condom Use for Black College-Aged Women. Behav Sci (Basel) 2019; 9:E13. [PMID: 30696006 PMCID: PMC6406997 DOI: 10.3390/bs9020013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 01/23/2019] [Accepted: 01/26/2019] [Indexed: 11/23/2022] Open
Abstract
Black adolescent and young adult women in the United States experience a disproportionately higher rate of HIV infections than White and Hispanic adolescent and young adult women. Heterosexual sexual activity is the main route of infection for women, regardless of race or ethnicity. We examined two potential barriers to reducing Black adolescent and young adult women's HIV risk: high levels of self-silencing and low levels of sexual relationship power. Data were collected on a small convenience sample of sexually active Black college-aged women (N = 57, Mage = 19.6, SD = 1.4) who answered questions about their current or most recent dating relationship. We found that higher levels of self-silencing were significantly related to lower condom use frequency and to a lower likelihood of reporting condom use at last sex. No significant associations were found between sexual relationship power and condom use (frequency or at last sex). Data from this study suggest that self-silencing, which involves putting the needs of others ahead of one's own in order to avoid conflict in relationships, is an important variable to consider when examining potential risk factors for sexually transmitted HIV among Black college-aged women. Implications for future studies on HIV risk are reviewed.
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Affiliation(s)
| | - Leslie R Brody
- Department of Psychological & Brain Sciences, Boston University, Boston, MA 02215, USA.
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Cianelli R, Villegas N. Social Determinants of Health for HIV Among Hispanic Women. HISPANIC HEALTH CARE INTERNATIONAL 2018; 14:4-9. [PMID: 27257185 DOI: 10.1177/1540415316629672] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bezerra VP, Serra MAP, Cabral IPP, Moreira MASP, de Almeida SA, de Araujo Patrício ACF. [Preventive practices in the elderly and vulnerability to HIV]. ACTA ACUST UNITED AC 2016; 36:70-6. [PMID: 26735761 DOI: 10.1590/1983-1447.2015.04.44787] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 08/18/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To know the vulnerability of the elderly to the HIV infection in the context of preventive practices. METHOD Exploratory qualitative study, lead from December 2012 to May 2013, with 37 nursing Coexistence Groups in João Pessoa--Paraiba. The Focus Group was elected as the research technique, and the empirical material obtained was subjected to a Content Analysis Technique, thematic modality. RESULTS The elderly recognize the importance of preventive practices, but they face difficulties in its use when their emotional relationships with their partners do not favor preventive behavior, resulting in vulnerability. The elderly showed the population groups most vulnerable to HIV and do not recognize themselves as such. CONCLUSION The complexity of the various contexts experienced by the elderlies of this study indicate the need for more research that allows advances in the understanding of subjectivity imposed in relations that underlie the aging process and the experience of sexuality in this age group.
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Affiliation(s)
- Valéria Peixoto Bezerra
- Department of Clinical Nursing, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brasil
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Pilowsky DJ, Wu LT. Sexual risk behaviors and HIV risk among Americans aged 50 years or older: a review. Subst Abuse Rehabil 2015; 6:51-60. [PMID: 25960684 PMCID: PMC4410899 DOI: 10.2147/sar.s78808] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Although HIV-related sexual risk behaviors have been studied extensively in adolescents and young adults, there is limited information about these behaviors among older Americans, which make up a growing segment of the US population and an understudied population. This review of the literature dealing with sexual behaviors that increase the risk of becoming HIV-infected found a low prevalence of condom use among older adults, even when not in a long-term relationship with a single partner. A seminal study by Schick et al published in 2010 reported that the prevalence of condom use at last intercourse was highest among those aged 50–59 years (24.3%; 95% confidence interval, 15.6–35.8) and declined with age, with a 17.1% prevalence among those aged 60–69 years (17.1%; 95% confidence interval, 7.3–34.2). Studies have shown that older Americans may underestimate their risk of becoming HIV-infected. Substance use also increases the risk for sexual risk behaviors, and studies have indicated that the prevalence of substance use among older adults has increased in the past decade. As is the case with younger adults, the prevalence of HIV infections is elevated among ethnic minorities, drug users (eg, injection drug users), and men who have sex with men. When infected, older adults are likely to be diagnosed with HIV-related medical disorders later in the course of illness compared with their younger counterparts. Physicians are less likely to discuss sexual risk behaviors with older adults and to test them for HIV compared with younger adults. Thus, it is important to educate clinicians about sexual risk behaviors in the older age group and to design preventive interventions specifically designed for older adults.
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Affiliation(s)
- Daniel J Pilowsky
- Columbia University Medical Center, Department of Epidemiology, Mailman School of Public Health New York City, NY, USA ; Division of Epidemiology, New York State Psychiatric Institute, New York City, NY, USA
| | - Li-Tzy Wu
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA ; Center for Child and Family Policy, Duke University, Durham, NC, USA
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Peleg-Sagy T, Shahar G. Female Medical Students' (Silencing the) Self: Effects on Depression and Dyadic/Sexual Dissatisfaction. SELF AND IDENTITY 2015. [DOI: 10.1080/15298868.2015.1008031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Smith TK, Larson EL. HIV sexual risk behavior in older black women: a systematic review. Womens Health Issues 2015; 25:63-72. [PMID: 25442363 PMCID: PMC4275320 DOI: 10.1016/j.whi.2014.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 08/27/2014] [Accepted: 09/05/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Human immunodeficiency virus (HIV) is a major public health concern in the United States, particularly among older Black women who comprise approximately 40% of the newly diagnosed cases among women. This systematic review sought to answer the research question: What are the sexual practices in older Black women associated with HIV risk? METHODS CINAHL, PubMed, MEDLINE, and Web of Knowledge electronic databases were searched for English-language research studies published between 2003 and 2013 that focused on the HIV sexual risk practices of Black women over the age of 50. Using PRISMA guidelines, two reviewers independently reviewed and appraised the quality of relevant articles; agreement of select studies was achieved by consensus. RESULTS Among the 3,167 articles surveyed, 9 met inclusion criteria. The majority (88%) were quantitative, observational studies. All nine articles addressed at least one of three factors that contribute to HIV sexual risk: Behavioral (inconsistent condom use and multiple sexual partners), psychological (risk perception, depression/stress, trauma, and self-esteem issues), and social factors (economics, education, and drugs/alcohol use). Outcome measures varied across studies. CONCLUSION Although this systematic review appraised few studies, findings suggest that many older Black women are engaged in HIV risk-taking practices. Clinicians and researchers need to be aware of the HIV risk practices of older Black women to improve health outcomes through education, effective communication and risk appraisal.
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Chambers LA, Wilson MG, Rueda S, Gogolishvili D, Shi MQ, Rourke SB. Evidence informing the intersection of HIV, aging and health: a scoping review. AIDS Behav 2014; 18:661-75. [PMID: 24185708 DOI: 10.1007/s10461-013-0627-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The growing number of people over age 50 with HIV requires research, policy, and practice to develop a more comprehensive understanding of the health consequences of HIV in older individuals. We conducted a scoping review of peer-reviewed and grey literature published since 1996 to explore the impacts of aging on the health of older people with HIV (50 years or older). We included 209 studies (two systematic reviews, 174 quantitative studies, 28 qualitative studies, and five mixed methods studies). Health topics addressed include: HIV- and aging-related comorbidities, disease progression, neurocognitive functioning, mental health conditions, psychological well-being, social supports, stigma, antiretroviral adherence, health care utilization/access, and sexual risk behaviour. We recommend that future research takes a broader view of health, looks at aging from a strength-based perspective and examines the issue using diverse perspectives (i.e., geographic location, multiple methods, time of diagnosis, time on antiretroviral therapy (ART), demographic diversity).
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Affiliation(s)
- Lori A Chambers
- Ontario HIV Treatment Network, 1300 Yonge St., Suite 600, Toronto, ON, M4T 1X3, Canada
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19
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De Santis JP, Patsdaughter CA. The dangerous intersection of violence and HIV infection. J Assoc Nurses AIDS Care 2014; 25:S1-4. [PMID: 24387901 DOI: 10.1016/j.jana.2013.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 10/22/2013] [Indexed: 11/18/2022]
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DeMarco RF, Lanier LR. The Concept of “Silencing the Self” in Low-Income, Aging, HIV-Infected African American Women: A 10-Year Community-Based Participatory Program of Research With Results. J Assoc Nurses AIDS Care 2014; 25:112-22. [DOI: 10.1016/j.jana.2012.12.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Accepted: 12/03/2012] [Indexed: 11/26/2022]
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Cianelli R, Villegas N, Lawson S, Ferrer L, Kaelber L, Peragallo N, Yaya A. Unique factors that place older Hispanic women at risk for HIV: intimate partner violence, machismo, and marianismo. J Assoc Nurses AIDS Care 2013; 24:341-54. [PMID: 23790277 DOI: 10.1016/j.jana.2013.01.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 01/15/2013] [Indexed: 11/25/2022]
Abstract
Hispanic women who are 50 years of age and older have been shown to be at increased risk of acquiring HIV infection due to age and culturally related issues. The purpose of our study was to investigate factors that increase HIV risk among older Hispanic women (OHW) as a basis for development or adaptation of an age and culturally tailored intervention designed to prevent HIV-related risk behaviors. We used a qualitative descriptive approach. Five focus groups were conducted in Miami, Florida, with 50 participants. Focus group discussions centered around eight major themes: intimate partner violence (IPV), perimenopausal-postmenopausal-related biological changes, cultural factors that interfere with HIV prevention, emotional and psychological changes, HIV knowledge, HIV risk perception, HIV risk behaviors, and HIV testing. Findings from our study stressed the importance of nurses' roles in educating OHW regarding IPV and HIV prevention.
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Affiliation(s)
- Rosina Cianelli
- School of Nursing and Health Studies, University of Miami, Florida, USA
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22
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"A man's gonna do what a man wants to do": African American and Hispanic women's perceptions about heterosexual relationships: a qualitative study. BMC WOMENS HEALTH 2013; 13:27. [PMID: 23705954 PMCID: PMC3666901 DOI: 10.1186/1472-6874-13-27] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 05/21/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND HIV prevention efforts have given limited attention to the relational schemas and scripts of adult heterosexual women. These broader schemas and scripts of romantic and other sexual liaisons, partner selection, relationship dynamics, and power negotiations may help to better understand facilitators and barriers to HIV risk-reduction practices. METHODS We conducted exploratory qualitative interviews with 60 HIV-uninfected heterosexual African-American women from rural counties in North Carolina and Alabama, and Hispanic women from an urban county in southern Florida. Data were collected for relationship expectations; relationship experiences, and relationship power and decision-making. Interview transcripts underwent computer-assisted thematic analysis. RESULTS Participants had a median age of 34 years (range 18-59), 34% were married or living as married, 39% earned an annual income of $12,000 or less, 12% held less than a high school education, and 54% were employed. Among the Hispanic women, 95% were foreign born. We identified two overarching relationship themes: contradictions between relationship expectations and desires and life circumstances that negated such ideals, and relationship challenges. Within the contradictions theme, we discovered six subthemes: a good man is hard to find; sex can be currency used to secure desired outcomes; compromises and allowances for cheating, irresponsible, and disrespectful behavior; redefining dating; sex just happens; needing relationship validation. The challenges theme centered on two subthemes: uncertainties and miscommunication, and relationship power negotiation. Gender differences in relationship intentions and desires as well as communication styles, the importance of emotional and financial support, and the potential for relationships to provide disappointment were present in all subthemes. In examining HIV risk perceptions, participants largely held that risk for HIV-infection and the need to take precautions were problems of women who differed from them (i.e., abuse drugs, are promiscuous, exchange sex). CONCLUSION Underlying women's relational schemas was a belief that relationship priorities differed for men and women. Consequently, expectations and allowances for partner infidelity and negligent behaviors were incorporated into their scripts. Moreover, scripts endorsed women's use of sex as currency in relationship formation and endurance, and did not emphasize HIV risk. Both couple- and gender-specific group-level interventions are needed to deconstruct (breakdown) and reconstruct (rewrite) relationship scripts.
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Ross P, Humble ÁM, Blum I. Sexuality and HIV/AIDS: An Exploration of Older Heterosexual Women's Knowledge Levels. J Women Aging 2013; 25:165-82. [DOI: 10.1080/08952841.2013.760366] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Rodrigues DADL, Praça NDS. Mulheres com idade igual ou superior a 50 anos: ações preventivas da infecção pelo HIV. Rev Gaucha Enferm 2010; 31:321-7. [DOI: 10.1590/s1983-14472010000200017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Trata-se de pesquisa qualitativa que buscou verificar a adoção de ações preventivas da transmissão do HIV por mulheres com idade igual ou superior a 50 anos, moradoras em uma comunidade de baixa renda e atendidas pelo Programa Saúde da Família, no Município de São Paulo. Adotou-se como referencial teórico a Antropologia Médica e, para o tratamento dos dados, o Discurso do Sujeito Coletivo. Foram entrevistadas 13 mulheres e são apresentados três discursos: valorizando a prevenção; invisibilidade do HIV/aids; e rejeição à adesão ao preservativo. A análise mostrou que o grupo não se percebia em risco à infecção pela via sexual devido à confiança na fidelidade do parceiro. O eventual uso do preservativo foi atribuído somente à curiosidade. As ações preventivas adotadas carecem de embasamento científico. Os resultados alertam para a necessidade do planejamento e da implementação de intervenções culturalmente embasadas direcionadas ao segmento estudado.
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25
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Abstract
HIV-related stigma has been identified as a barrier to HIV testing and prevention efforts internationally and nationally. Although the prevalence of HIV/AIDS is rapidly increasing in women aged 50 and older, little is known about the HIV-stigmatizing behaviors in this underserved population. In this exploratory analysis we investigated the influence of self esteem, sensation seeking, self silencing, and sexual assertiveness on the HIV-stigmatizing behaviors in 572 women aged 50 to 93. The variables considered in this analysis included subscales for the variables self silencing (Externalized Self Perception, Care as Self Sacrifice, Silencing the Self, Divided Self) and sexual assertiveness (Information Communication, Initiation, Refusal). Contributing predictive variables in the final model included: Self esteem (beta = -.190, t = -4.487, p = .000), Care as Self-Sacrifice (beta = .125, t = 2.714, p = .007), and Silencing the Self (beta = .164, t = 3.290, p = .001). Initiation (beta = .108, t = -2.619, p = .009) and Refusal (beta = -.091, t = -2.154, p = .032). Implications for social work and health perception regarding HIV prevention in midlife and older women are considered. Development of age- and gender-appropriate strategies assisting women in addressing HIV-stigma and related influences are addressed.
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Affiliation(s)
- Robin J Jacobs
- Department of Preventive Medicine and Department of Psychiatry and Behavioral Medicine, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida 33314, USA.
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