1
|
Pezaro S, Pendleton J, van der Waal R, LaChance Adams S, Santos MJDS, Bainbridge A, Istha K, Maeder Z, Gilmore J, Webster J, Lai-Boyd B, Brennan AM, Newnham E. Gender-inclusive language in midwifery and perinatal services: A guide and argument for justice. Birth 2024. [PMID: 38822631 DOI: 10.1111/birt.12844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 03/04/2024] [Accepted: 05/02/2024] [Indexed: 06/03/2024]
Abstract
Effective communication in relation to pregnancy and birth is crucial to quality care. A recent focus in reproductive healthcare on "sexed language" reflects an ideology of unchangeable sex binary and fear of erasure, from both cisgender women and the profession of midwifery. In this paper, we highlight how privileging sexed language causes harm to all who birth-including pregnant trans, gender diverse, and non-binary people-and is, therefore, unethical and incompatible with the principles of midwifery. We show how this argument, which conflates midwifery with essentialist thinking, is unstable, and perpetuates and misappropriates midwifery's marginalized status. We also explore how sex and gender essentialism can be understood as colonialist, heteropatriarchal, and universalist, and therefore, reinforcing of these harmful principles. Midwifery has both the opportunity and duty to uphold reproductive justice. Midwifery can be a leader in the decolonization of childbirth and in defending the rights of all childbearing people, the majority of whom are cisgender women. As the systemwide use of inclusive language is central to this commitment, we offer guidance in relation to how inclusive language in perinatal and midwifery services may be realized.
Collapse
Affiliation(s)
- Sally Pezaro
- Research Centre for Healthcare and Communities, Coventry University, Coventry, UK
- The University of Notre Dame, Fremantle, Western Australia, Australia
| | - John Pendleton
- Research Centre for Healthcare and Communities, Coventry University, Coventry, UK
- Faculty of Health, Education, & Society, University of Northampton, Northampton, UK
| | - Rodante van der Waal
- Care Ethics Department, University for Humanistic Studies, Utrecht, The Netherlands
- Independent Midwife, Bristol, UK
| | - Sarah LaChance Adams
- The Florida Blue Center for Ethics, University of North Florida, Jacksonville, Florida, USA
| | - Mario J D S Santos
- Department of Sociology, Universidade da Beira Interior, Covilhã, Portugal
- Iscte - Instituto Universitário de Lisboa, CIES-IUL, Lisbon, Portugal
| | - Ash Bainbridge
- Three Counties School of Nursing and Midwifery, University of Worcester, Worcester, UK
| | | | | | - John Gilmore
- School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | | | - Bunty Lai-Boyd
- Three Counties School of Nursing and Midwifery, University of Worcester, Worcester, UK
| | | | - Elizabeth Newnham
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
| |
Collapse
|
2
|
Crooks N, Sosina W, Debra A, Sanker-Panchal K, Okafor A, Coleman D, Barrie R. 'Protecting your body and loving yourself': strategies Black male caregivers use to protect Black girls sexuality in the USA. CULTURE, HEALTH & SEXUALITY 2024:1-17. [PMID: 38779906 DOI: 10.1080/13691058.2024.2355206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 05/10/2024] [Indexed: 05/25/2024]
Abstract
Black girls in the USA face disproportionate rates of sexually transmitted infections (STIs), HIV, and sexual violence, prompting research into the sociocultural factors such as adultification, race and gender discrimination, and stereotyped messaging, impacting Black girls' sexual development. While existing literature finds that Black female caregivers utilise protective strategies to mitigate potential harm to Black girls, little is known about the role of Black male caregivers. This qualitative study employed the Becoming a Sexual Black Woman framework and one-on-one interviews to examine how 30 Black male caregivers of girls conceptualised parental protection and elated strategies. The thematic analysis revealed key themes of: Being a Provider, Being a Present Role Model, Protecting Black Girls' Bodies, Limiting Exposure to Stereotyped Messages, and Providing Emotional Protection. Black male caregivers navigated traditional gendered expectations and limited resources while utilising parental strategies that reflected patriarchal, sometimes misogynistic, and non-patriarchal ideals and norms. The study highlights the attitudes and beliefs of Black male caregivers regarding protecting Black girls from sexual violence and other related adverse outcomes. The findings offer insights for family-based interventions and programmes that empower Black girls to support their sexual development and health in the USA.
Collapse
Affiliation(s)
- Natasha Crooks
- College of Nursing, University of IL Chicago, Chicago, IL, USA
| | - Wuraola Sosina
- Department of Clinical Psychology, Adler University, Chicago, IL, USA
| | - Alyssa Debra
- College of Medicine, University of Illinois Chicago, Chicago, IL, USA
| | | | - Annette Okafor
- College of Medicine, University of Illinois Chicago, Chicago, IL, USA
| | - Diamond Coleman
- College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | | |
Collapse
|
3
|
Thorpe S, Hargons CN, Malone N, Iyiewuare P, Jester JK, Stevens-Watkins D. An Interpretative Phenomenological Analysis of Black Women's Meaning and Experiences of Sexual Anxiety. JOURNAL OF SEX RESEARCH 2024; 61:614-628. [PMID: 36534478 DOI: 10.1080/00224499.2022.2156449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Sexual anxiety can activate the stress response cycle during sex, compromising a woman's ability to experience sexual pleasure. Black women face additional cultural and contextual factors, such as hypersexualization, partner scarcity, and higher rates of sexual trauma that may increase the magnitude, frequency, and odds of experiencing sexual anxiety. However, limited research has explored this phenomenon among Black women. Thus, we sought to qualitatively explore how N = 25 premenopausal Black women living in the southern United States make meaning of experiences with sexual anxiety. We analyzed the interview data using an interpretive phenomenological approach. Three components of the phenomenon of sexual anxiety were gleaned: 1) causes of sexual anxiety, 2) characteristics of sexual anxiety, and 3) coping strategies. Each component included three to six elements of meaning making. For these Black women, causes of sexual anxiety included fears of sexual pain, partner unfamiliarity, previous traumas, mental health concerns, and intersecting socio-structural factors. Characteristics of sexual anxiety included mental, somatic, and emotional elements. Coping strategies included having a reassuring and supportive sex partner, supporting themselves with affirmations and mindfulness, attending therapy, and using substances. Through reflection about their perceived causes of, experienced characteristics of, and intentional coping with sexual anxiety, meanings were co-constructed through an intersectional frame. Implications for intersectionality-informed interventions and suggestions for mental health professionals and partners are discussed.
Collapse
Affiliation(s)
- Shemeka Thorpe
- Department of Kinesiology & Health Promotion, University of Kentucky
| | - Candice N Hargons
- Department of Educational, School, and Counseling Psychology, University of Kentucky
| | - Natalie Malone
- Department of Educational, School, and Counseling Psychology, University of Kentucky
| | | | - Jasmine K Jester
- Department of Educational, School, and Counseling Psychology, University of Kentucky
| | | |
Collapse
|
4
|
Martino RM, Roberts SR, Maheux AJ, Stout CD, Choukas-Bradley S. The Role of Feminism and Gender in Endorsement of Hookup Culture among Emerging Adults. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1621-1632. [PMID: 38561481 DOI: 10.1007/s10508-024-02841-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/14/2024] [Accepted: 02/20/2024] [Indexed: 04/04/2024]
Abstract
Hookup culture has transformed the sexual behavior of emerging adults. Feminism, a movement that has advocated for liberating women from sexual repression, may be associated with hookup endorsement attitudes. This study explores the associations among multiple dimensions of feminism, gender, and hookup culture endorsement. Participants included 318 emerging adults (46% women; Mage = 22.2 years; 51% White, 27% Asian, 5% Hispanic/Latinx, 9% Black, 1% Middle Eastern, 1% American Indian, 6% Multiracial) from five Anglophone countries (62% U.S., 23% United Kingdom, 9% Canada, 5% Australia, 1% New Zealand), who completed the Feminist Beliefs and Behavior Scale and Endorsement of Hookup Culture Index via an anonymous, online survey. Participants were categorized according to their feminist identity label (feminist, non-feminist) and feminist belief system (hold feminist beliefs, hold non-feminist beliefs). A series of ANCOVAs was conducted, revealing that women who identified as feminist and/or held feminist beliefs reported significantly higher endorsement of hookup culture compared to non-feminist women with non-feminist beliefs. Neither dimension of feminism predicted hookup culture endorsement in men. When comparing feminist-identifying women and men, the gender disparity in hookup culture endorsement was eliminated. Together, these findings highlight how social movements, such as feminism, may be associated with young women's attitudes towards hookups, and may ultimately shape their sexual experiences.
Collapse
Affiliation(s)
- Rachel M Martino
- Department of Psychology, Harvard University, 33 Kirkland St., Cambridge, MA, 02138, USA.
| | | | - Anne J Maheux
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Claire D Stout
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | | |
Collapse
|
5
|
Wesche R, Toman M, Grafsky EL, Gupta S, Tarantino MR. Developing an Inclusive Model of Young Heterosexual and Sexual Minority Women's Sexual Decision-Making. JOURNAL OF SEX RESEARCH 2024:1-15. [PMID: 38687300 DOI: 10.1080/00224499.2024.2320260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Efforts to improve sexual health outcomes among young cisgender women require in-depth understanding of how women with diverse sexual identities make decisions about their sexual health. We conducted semi-structured interviews with 31 young cisgender women with diverse sexual identities and histories (age range 18-29 (M = 23.32); 81% White; 29% bisexual, 26% heterosexual, 16% lesbian, 13% queer, 10% pansexual, 3% gay, 3% demisexual) about their decision-making surrounding sexual risk reduction. By conducting thematic analysis, we found that, regardless of partner sex or gender, women adapted sexual health strategies based on how much commitment, trust, and communication existed in their relationships. Because heteronormative structural influences limited access to information and safer sex options, women had to rely on trust and communication more with other women and partners with vaginas, compared to men and partners with penises. Women did not consider safer sex strategies with partners with vaginas (e.g. hand washing) risk-reduction techniques; instead, they considered them general hygiene or a way to take care of a partner. We propose that an inclusive model of young women's sexual decision-making should: (a) highlight the influence of relationships; (b) frame prevention in terms of overall health instead of pregnancy and STIs; and (c) acknowledge that structural factors, such as heteronormativity and sex-negativity, constrain women's decisions.
Collapse
Affiliation(s)
- Rose Wesche
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University
| | - Madelyn Toman
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University
| | - Erika L Grafsky
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University
| | - Shivangi Gupta
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University
| | - Mari R Tarantino
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University
| |
Collapse
|
6
|
Tarantino MR, Wesche R. Queering Cisgender LGB+ Women's Sexual Health Scripts. JOURNAL OF SEX RESEARCH 2024:1-13. [PMID: 38446103 DOI: 10.1080/00224499.2024.2323742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
The invisibility of lesbian, gay, and bisexual (LGB+) women in sexual health research is of particular concern when it comes to understanding and supporting their sexual health practices. We conducted a qualitative secondary analysis of sexual health decision-making interviews among 22 LGB+ cisgender women who ranged in age from 20 to 26 (M = 23.1 years, SD = 1.8 years). Participants were mostly bisexual (n = 9), White (n = 13), and all reported at least some college education. Results showed that LGB+ women both reify and push against heteronormativity in their sexual partnerships. By queering definitions of "sex" beyond heterosexual intercourse, leaning into trust as a foundation of new sexual partnerships, and promoting accessible and realistic hygienic strategies for STI prevention, LGB+ women queer, or reimagine, new sexual scripts. These results highlight the need for relationship and sexual health scholars to direct focus toward the promotion of holistic sexual and relationship education and research which reflects LGB+ women's various sexual desires, goals and needs. Understanding LGB+ women's sexual scripts and health outcomes will ensure that this population continues to be validated and supported by clinicians, researchers, and educators.
Collapse
Affiliation(s)
- Mari R Tarantino
- Human Development and Family Science, Virginia Polytechnic Institute and State University
| | - Rose Wesche
- Human Development and Family Science, Virginia Polytechnic Institute and State University
| |
Collapse
|
7
|
Bond KT, Radix AE. Sexual Health and Well-Being: A Framework to Guide Care. Med Clin North Am 2024; 108:241-255. [PMID: 38331477 DOI: 10.1016/j.mcna.2023.10.001] [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] [Indexed: 02/10/2024]
Abstract
Although the acceptance of sex positivity centering pleasure and justice has grown, clinical and public health strategies for sexually transmitted infection management have remained focused on risk and adverse outcomes. To promote sex-positive health care practice in clinical settings and beyond, health care practitioners should use an integrated, patient-centered approach to sexual health. These strategies include initiating discussions, continued sexual health education, providing informative material for patients, and knowledge of different communication strategies. Patient-provider interactions might be enhanced by using such methods.
Collapse
Affiliation(s)
- Keosha T Bond
- Department of Community Health and Social Medicine, CUNY School of Medicine, 160 Convent Avenue, Harris Hall, New York, NY 10031, USA; Center for Interdisciplinary Research on AIDS at Yale University, Yale University School of Public Health, 135 College Street, Suite 200, New Haven, CT 06510-2483, USA.
| | - Asa E Radix
- Center for Interdisciplinary Research on AIDS at Yale University, Yale University School of Public Health, 135 College Street, Suite 200, New Haven, CT 06510-2483, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, USA
| |
Collapse
|
8
|
Wetzel GM, Sanchez DT, Gesselman AN, Adams OR, Campbell JT, Garcia JR. Exploring the Orgasm Gap Across Racial/Ethnic Groups: A Descriptive Analysis. JOURNAL OF SEX RESEARCH 2024:1-10. [PMID: 38329940 DOI: 10.1080/00224499.2024.2308044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Orgasm gaps between heterosexual men and women, and for women across sexual orientations, are well-established in research. However, no large-scale assessments of orgasm frequency by race/ethnicity exist. Here, we analyzed 10 years of cross-sectional Singles in America survey data between 2011 and 2021 to investigate the orgasm gap at the intersection of gender and racial/ethnic identity (i.e. White, Black, Hispanic/Latino, and Asian) for heterosexual participants (N = 27,347). White and Hispanic/Latino men reported greater orgasm frequency than Black and Asian men. Hispanic/Latino women reported the greatest orgasm frequency, and Asian women reported the lowest, with White and Black women's frequencies in between. The orgasm gap between men and women was largest for White (d = 0.89) and Asian (d = 0.86) groups, although Asian participants reported a lower orgasm frequency than White participants overall. The orgasm gap was smaller for Hispanic/Latino participants (d = 0.66), because Hispanic/Latino women reported a greater orgasm frequency than other racial/ethnic groups of women. The orgasm gap was smaller for Black participants (d = 0.61), because Black men reported a lower orgasm frequency than some other racial/ethnic groups of men. This descriptive study serves as an important starting point for future research on orgasm experiences across racial/ethnic groups.
Collapse
Affiliation(s)
| | | | | | - Olivia R Adams
- The Kinsey Institute, Indiana University
- Department of Gender, Women's, and Sexuality Studies, University of Florida
| | | | - Justin R Garcia
- The Kinsey Institute, Indiana University
- Department of Gender Studies, Indiana University
| |
Collapse
|
9
|
Wade RM, Piasecki M. Whose Role is It Anyway? Sexual Racism and Sexual Positioning Among Young Sexual Minority Black Men. JOURNAL OF SEX RESEARCH 2024:1-12. [PMID: 38270958 DOI: 10.1080/00224499.2024.2305823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Racialized Sexual Discrimination (RSD), also referred to as "sexual racism," is widely reported among young sexual minority Black men (YSMBM). Though RSD is driven in part by sexual scripts and racial stereotypes, little is known about YSMBM's experiences with RSD with respect to their sexual positioning roles. Using data from a cross-sectional web-survey of YSMBM (N = 726), a multivariate Kruskal Wallis test was conducted comparing YSMBM who identified as mostly bottom, versatile, or mostly top, on the degree to which they were affected by four RSD experiences, as well as the frequency with which they encountered these experiences. Men identifying as mostly bottom reported significantly stronger negative reactions to same-race rejection and encountering sexual role assumptions than men identifying as mostly top. Men identifying as versatile encountered same-race rejection significantly more frequently than men identifying as mostly top. Men identifying as mostly bottom encountered White superiority significantly more frequently than men identifying as mostly top. RSD may impact YSMBM differentially based on sexual position. These findings may have implications for culturally competent clinical practice, as well as analytic implications (e.g., estimating more complex statistical models) for sexual racism research, which remains an important yet underexamined field in the health sciences.
Collapse
Affiliation(s)
- Ryan M Wade
- School of Social Work, University of Illinois at Urbana-Champaign
| | | |
Collapse
|
10
|
Wade JM, Parker S, Kirkpatrick S, Yarell E. Black Women's Sexual Communication: Retrospective Accounts of Messages from Male and Female Family Members. JOURNAL OF FAMILY COMMUNICATION 2023; 23:241-257. [PMID: 38312846 PMCID: PMC10836148 DOI: 10.1080/15267431.2023.2237489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 07/05/2023] [Indexed: 02/06/2024]
Abstract
The study used Black feminist theory and methods to examine messages about the composition of, and potential differences in the sexual health that Black women received from male and female loved ones. Black feminist theory grounded the study by ensuring Black women were involved in research team composition, design, recruitment, and data analysis. Our inductive thematic analysis of focus group data from 24 Black women revealed seven themes: Indirect Communication, Absence of Communication, Messages to Shield, and Prepare from male figures. The themes from female figures included: Absence of Communication, Open Communication, and Empowerment, Pleasure, and Judgment-Free Communication. A seventh theme that connected across gender focused on Objectification and Gender Stereotypes. Findings of the study suggest that there is a need for greater focus on improving family communication about sex for Black women and the need to center communication that empowers Black women to engage in healthy sexual practices.
Collapse
Affiliation(s)
- Jeannette M Wade
- Department of Social Work and Sociology, University of North Carolina at Greensboro. Department of Human Health Sciences
| | - Sharon Parker
- Department of Social Work and Sociology, North Carolina Agricultural and Technical State University
| | | | - Erynn Yarell
- North Carolina Agricultural and Technical State University
| |
Collapse
|
11
|
Fredriksen-Goldsen K. Blueprint for Future Research Advancing the Study of Sexuality, Gender, and Equity in Later Life: Lessons Learned From Aging With Pride, The National Health, Aging, and Sexuality/Gender Study (NHAS). THE GERONTOLOGIST 2023; 63:373-381. [PMID: 36254775 PMCID: PMC9960017 DOI: 10.1093/geront/gnac146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Indexed: 11/12/2022] Open
Abstract
While interest in sexuality\research is growing, in the past, it has been largely invisible in gerontology. By exploring the full range and dimensions of sexuality and their interrelationships with multiple factors, this article presents conceptual, substantive, and methodological advances for the field of sexuality in later life. Based on the Sexual Equity Framework, an extension of the Health Equity Promotion Model, this article highlights the heterogeneity and intersectionality of sexuality across the life course, examining how historical and contemporary contexts frame key dimensions of sexuality at multiple levels (intrapersonal, interpersonal, sociocultural, and structural) and their relationship with sexual quality of life. Utilizing findings from Aging with Pride: National Health, Aging and Sexuality/Gender Study, the heterogeneity and intersectionality of age, gender, race, and ethnicity are critical to understanding sexuality and its dimensions in later life. Many adults experience changes in sexual and gender identities over time. Affirming sexual and gender identities, social connections, and health-promoting behaviors are positively associated with sexual quality of life, while sexual stigma and marginalization have adverse consequences. The study of sexuality needs to be fully integrated into gerontology. The Sexual Equity Framework explicates the potential deleterious effect of historical and contemporary structures on sexuality as well the important roles of affirmation, agency, and resilience among older adults, and recognizes the important role of human rights to advance sexual quality of life. Important directions for future research, practices, and policies are outlined.
Collapse
|
12
|
Dunn CE, Hood KB, Hall CJ. Do gendered racial microaggressions influence the relationship between body appreciation and Black emerging adult women's condom use behaviors? JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 36595584 DOI: 10.1080/07448481.2022.2155055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 06/19/2022] [Accepted: 09/19/2022] [Indexed: 06/17/2023]
Abstract
Background: Sexual protective behaviors, such as consistent condom use and intention, are important preventative measures against the transmission of HIV/AIDS and sexually transmitted infections. Current sexual health research has yet to explore the interaction between contextual factors, such as gendered racial microaggressions, and the role of personal factors (i.e., body appreciation) on Black women's sexual risk and protective behaviors in the United States. Guided by objectification theory, we hypothesized that sexually objectifying gendered racial microaggressions moderated the body appreciation and condom use behaviors relationship. Participants: The current study consisted of 114 Black emerging adult women in the southern United States. Results: Results showed significant interactions between the frequency of sexually objectifying gendered racial microaggressions and body appreciation on consistent condom use and condom use intention. Conclusion: Overall, these findings suggested the need for sexual health researchers and interventionists to further explore the influence of gendered racial microaggressions and body appreciation on condom use behaviors.
Collapse
Affiliation(s)
- Chelsie E Dunn
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Kristina B Hood
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Calvin J Hall
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| |
Collapse
|
13
|
Leblanc NM, St. Vil NM, Bond KT, Mitchell JW, Juarez AC, Lambert F, Muheriwa SR, McMahon J. Dimensions of Sexual Health Conversations among U.S. Black Heterosexual Couples. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:588. [PMID: 36612908 PMCID: PMC9819242 DOI: 10.3390/ijerph20010588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
Sexual health communication is an important feature of healthy intimate relationships; however, some couples may avoid discussing difficult matters (e.g., HIV/STI testing, sexual satisfaction) to minimize interpersonal conflict. From October 2018 to May 2019 in New York State, we conducted a multi-method descriptive pilot study to characterize Black heterosexual couples' (N = 28) sexual health conversations. Partners individually completed an online sexual health/relationship survey before engaging in-person for a joint dyadic qualitative in-depth interview. Quantitative descriptive statistics demonstrated that most absolute score differences among couple's preferences for sexual health outcomes, communal coping and sexual relationship power were mainly small, but greatest regarding extra-dyadic sexual behaviors. A qualitative descriptive approach discerned, motivation and norms for sexual health conversations, and communication patterns. Thematic and content analysis revealed two central themes: initiating and sustaining sexual health conversations, and leveraging features of the couples to promote sexual health. Integrated findings indicate that couples possess varied communication patterns that operate with motivations for sexual health conversations toward subsequent sexual health promotion. Equitable and skewed communication patterns emerged as relationship assets that can be leveraged to optimize sexual health. There is also opportunity for future work to address communication regarding extra-dyadic behavior and preferences. Asset-based considerations are discussed.
Collapse
Affiliation(s)
| | - Noelle M. St. Vil
- School of Social Work, University at Buffalo, Buffalo, NY 14215, USA
| | - Keosha T. Bond
- School of Medicine, City University of New York, New York, NY 10031, USA
| | - Jason W. Mitchell
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33174, USA
| | - Adrian C. Juarez
- School of Nursing, University of Texas Medical Branch, Galveston, TX 77550, USA
| | - Faith Lambert
- School of Nursing, University of Rochester, Rochester, NY 14642, USA
| | | | - James McMahon
- School of Nursing, University of Rochester, Rochester, NY 14642, USA
| |
Collapse
|
14
|
Willie TC, Knight D, Baral SD, Chan PA, Kershaw T, Mayer KH, Stockman JK, Adimora AA, Monger M, Mena LA, Philllips KA, Nunn A. Where's the "Everyday Black Woman"? An intersectional qualitative analysis of Black Women's decision-making regarding HIV pre-exposure prophylaxis (PrEP) in Mississippi. BMC Public Health 2022; 22:1604. [PMID: 35999528 PMCID: PMC9396836 DOI: 10.1186/s12889-022-13999-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 08/11/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Black cisgender women in the U.S. South bear a disproportionate burden of HIV compared to cisgender women in other racial and ethnic groups and in any other part of the US. Critical to decreasing new HIV infections is the improved delivery of pre-exposure prophylaxis (PrEP) for Black cisgender women as it remains underutilized in 2021. Informed by intersectionality, the study sought to characterize the sociostructural influences on Black cisgender women's deliberations about PrEP within the context of interlocking systems of oppression including racism, sexism, and classism. METHODS Six focus groups were conducted with 37 Black women residing in Jackson, Mississippi. This sample was purposively recruited to include Black cisgender women who were eligible for PrEP but had never received a PrEP prescription. RESULTS Six themes were identified as concerns during PrEP deliberation among Black women: 1) limited PrEP awareness, 2) low perceived HIV risk, 3) concerns about side effects, 4) concerns about costs, 5) limited marketing, and 6) distrust in the healthcare system. Three themes were identified as facilitators during PrEP deliberations: 1) women's empowerment and advocacy, 2) need for increased PrEP-specific education, and 3) the positive influence of PrEP-engaged women's testimonials. Black women shared a limited awareness of PrEP exacerbated by the lack of Black women-specific marketing. Opportunities to support Black women-specific social marketing could increase awareness and knowledge regarding PrEP's benefits and costs. Black women also shared their concerns about discrimination in healthcare and distrust, but they felt that these barriers may be addressed by patient testimonials from PrEP-engaged Black women, empowerment strategies, and directly addressing provider biases. CONCLUSIONS An effective response to PrEP implementation among Black women in the South requires developing programs to center the needs of Black women and carry out active strategies that prioritize peer advocacy while reinforcing positive and mitigating negative influences from broader social and historical contexts.
Collapse
Affiliation(s)
- Tiara C Willie
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA.
| | - Deja Knight
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Stefan D Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Philip A Chan
- Department of Medicine, Brown University, 222 Richmond St, Providence, RI, 02903, USA
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06510, USA
| | - Kenneth H Mayer
- Harvard Medical School and Harvard T H Chan School of Public Health, Harvard University, 25 Shattuck St, Boston, MA, 02115, USA
| | - Jamila K Stockman
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Adaora A Adimora
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, 170 Rosenau Hall, CB#7400, 135 Dauer Drive, Chapel Hill, NC, 27599-7400, USA
| | - Mauda Monger
- MLM Center for Health Education and Equity Consulting Services, 123-A Hwy 80 East #258, Clinton, MS, 39056, USA
| | - Leandro A Mena
- Department of Medicine, University of Mississippi Medical Center, 2500 N State St, Jackson, MS, 39216, USA
| | - Karlye A Philllips
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA
| | - Amy Nunn
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, 121 S Main St, Providence, RI, 02903, USA
| |
Collapse
|
15
|
Leblanc NM, Mitchell JW, Bond KT, Juarez Cuellar A, Vil NMS, McMahon J. Perspectives on a Couples-Based, e-Health HIV Prevention Toolkit Intervention: A Qualitative Dyadic Study with Black, Heterosexual Couples in New York State. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2625-2640. [PMID: 35639220 PMCID: PMC10688541 DOI: 10.1007/s10508-021-02270-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 12/11/2021] [Accepted: 12/17/2021] [Indexed: 05/11/2023]
Abstract
Web-based technology provides an unparalleled opportunity to increase access and uptake of couples-based HIV prevention interventions. e-Health HIV prevention interventions for US Black heterosexual couples have largely been understudied. To address this gap, we applied the Assessment Phase of the ADAPT-ITT Framework to investigate Black heterosexual couples' perspectives on an existing e-Health, couples-based HIV prevention intervention. Applying a qualitative descriptive approach, joint dyadic interviews were conducted with 28 Black heterosexual couples from three jurisdictions in New York State. Content dyadic analysis revealed three descriptive categories: perspectives of the toolkit intervention (sub-codes: perceived relevance, reactions to core components), recommendations to enhance intervention relevancy (sub-codes: tailoring to relationship type, adding new content), and lasting intervention considerations (sub-codes: toolkit usability and language use). Overall, couples found the toolkit intervention content and usability acceptable and reflected on its potential to build sexual and relationship health. Couples recommended to enhance toolkit adaptability for varied couple's motivation and types re-consider terms like sexual agreements, and include content to facilitate communication regarding sensitive topics (e.g., childhood sexual trauma, co-parenting, family planning) and other issues that may have more relevance to the experience of US Black persons (i.e., wealth building).
Collapse
Affiliation(s)
- Natalie M Leblanc
- School of Nursing, University of Rochester, 601 Elmwood Ave., Rochester, NY, 14624, USA.
| | - Jason W Mitchell
- Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Keosha T Bond
- City College of New York, CUNY School of Medicine, New York City, NY, USA
| | | | - Noelle M St Vil
- School of Social Work, University at Buffalo, Buffalo, NY, USA
| | - James McMahon
- School of Nursing, University of Rochester, 601 Elmwood Ave., Rochester, NY, 14624, USA
| |
Collapse
|
16
|
Marcantonio TL, Valdez D, Jozkowski KN. Assessing Young Adults' Internal Feelings Related to Refusing Sexual Behavior. JOURNAL OF SEX RESEARCH 2021; 58:1184-1193. [PMID: 34355996 DOI: 10.1080/00224499.2021.1958195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Young people describe refusing sexual activity as difficult or embarrassing; however, what specific internal feelings young adults associate with refusing sexual activity is unclear. We assessed the positive and negative internal feelings related to refusing different sexual behaviors using sentiment analysis. We also examined if positive and negative internal refusal feelings varied by gender and the intersection of gender and racial/ethnic identity. Young adults (n = 574, 481 women, 93 men, M = 19.2, SD = 1.43) from Canada and the U.S. completed an open-ended survey about how they felt about their experiences refusing sexual activity. Using sentiment analysis, responses were coded as either positive or negative and overwhelmingly, feelings associated with refusing sexual activity were identified as negative. Women and women of color reported more negative feelings than men and White women. However, there were some distinct positive feelings noted from young adults (e.g., feeling respected, comfortable). Young adults appear to internalize negative feelings about their refusals which may relate to social and cultural norms. Moving forward, sexual health programs could focus on normalizing and destigmatizing refusals so that young adults do not feel negatively about refusing sexual activity, with a particular emphasis on helping women and women of color to feel confident and empowered in their refusals.
Collapse
Affiliation(s)
- Tiffany L Marcantonio
- Department of Health, Human Performance and Recreation, University of Arkansas Fayetteville
- Kinsey Institute for Research in Sex, Gender, and Reproduction
| | - Danny Valdez
- Department of Applied Health Science, School of Public Health-Bloomington Indiana University
| | | |
Collapse
|
17
|
An Analysis of Sex Practices and Behaviors Among African Americans in Sexually Concurrent and Sexually Exclusive Relationships. J Racial Ethn Health Disparities 2021; 9:1923-1931. [PMID: 34405391 DOI: 10.1007/s40615-021-01130-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/21/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
Historically, sexually concurrent relationships have been associated with increased risk for sexually transmitted infections (STIs), including HIV. Due to socio-structural factors, African Americans (AAs) have higher rates of STIs compared to other racial groups and are more likely to engage in sexually concurrent (SC) relationships. Current research has challenged the assumption that SC is the only risky relationship type, suggesting that both SC and sexually exclusive (SE) relationships are at equal risk of STI and HIV acquisition and that both relationship types should engage in safer sex practices. This study aimed to compare sex practices and behaviors among AA men and women in SC and SE relationships (N = 652). Results demonstrate differences in sexual practices and behaviors between SC and SE men and women. Overall, SC and SE women report condom use with male partners less frequently than SC and SE men. SC men were more likely to report substance use during sex compared to SC and SE women. Pre-exposure prophylaxis (PrEP) use did not differ across groups. SE men were less likely to report STI testing and diagnosis compared to SC women. Findings support the need to focus on culturally and gender-specific safer sex interventions among AAs.
Collapse
|