'It's Not What You Said, It's How You Said It': Perceptions of Condom Proposers by Gender and Strategy

The rules of mature sex: Sexual scripts and the global challenge of rising STIs

Sexual health continues to be a socially complex problem globally with rising rates of sexually transmitted infections (STIs) despite extensive government and health marketing initiatives. In particular, STIs are rising at a greater rate in mature consumers than any other age group with the main reason cited as lack of condom use. The rules around condom use are based on sexual scripts or internalised guidelines and thus a key step in developing social marketing initiatives to increase condom use and address this global challenge is identifying the sexual scripts that motivate and inhibit condom use by mature consumers. Using sexual script theory, this research involves interviews with 24 mature single heterosexual Australian consumers to identify the sexual scripts that can be leveraged in health marketing to address the grand challenge of increasing mature consumer participation in protective sexual health behaviours.

Reframing Sexual Health for Black Girls and Women in HIV/STI Prevention Work: Highlighting the Role of Identity and Interpersonal Relationships

While Black girls and women are disproportionately impacted by sexual health disparities, there continues to be an overwhelming focus on individual risk behaviors within prevention initiatives, which offers a fragmented narrative of the multidimensional nature of risk and plausibly limits effectiveness of prevention programs and attenuates reductions in disparities. Because sexual health is experienced within an individual's beliefs/values, interpersonal relationships, and behaviors and reflects larger social and cultural systems, it is important to critically examine common theories used to inform HIV/STI prevention interventions for Black women and girls. To fill this gap in the literature, we critique two commonly used theories in HIV/STI prevention interventions, namely the social cognitive theory and the theory of gender and power, by highlighting theoretical and practical strengths and weaknesses. We propose research implications that incorporate key strengths of the two theories while adding new concepts grounded in the intersectionality theory. The overall goal is to introduce a more comprehensive conceptual model that is reflective of and applicable to the multidimensional sexual experiences of Black girls and women within the evolving definition of sexual health and behavior.

On the Hunt for Noble Savages: Romance Tourism and Ageing Femininities

Casual sexual encounters are closely wedded to leisure travel, and have received a lot of attention in both theoretical and empirical work. However, the relationship between romance tourism and female ageing remains largely under-researched. This article offers critical insights into the interplay of the successful ageing and sexual relationships abroad of older women travellers. It shows that romance tourism has both positive and negative implications for women’s physical and psychological health and wellbeing. Although exotic escapes help reconnect women with their youthful selves, enhancing a sense of self-confidence and challenging the narrative of decline, casual sex may also generate conflicting feelings once the travel romance is over. This article also encourages the rethinking of the complexities of ageing femininities, sexual activity and health risk in ‘silver’ romance tourism today. Additionally, it argues that the sexual health guidelines and information campaigns should adopt a more multifaceted approach to sexual expressions, and encourage alternative views towards sex and sexuality in later life, in order to not create a rather oppressive ideology among older women.

Are We Blinded by Desire? Relationship Motivation and Sexual Risk-Taking Intentions during Condom Negotiation

Effective condom negotiation skills support better sexual health for both men and women. The current study explored relationship motivation (motivation to establish and maintain long-term romantic relationships), gender, and sexual orientation as factors influencing the condom negotiation process. Participants (177 heterosexual women, 157 heterosexual men, and 106 men who have sex with men) read a vignette describing an encounter with a hypothetical new sexual/romantic partner and responded to embedded items and scales. Stronger relationship motivation predicted increased willingness to have condomless sex among women who perceived greater familiarity with the hypothetical partner. Gender and sexual orientation predicted different preferences for condom insistence strategies. The findings suggest that there are a number of conditions that make it more difficult to recognize risk during a sexual encounter and demonstrate how the process of condom negotiation can be impacted by gender, sexual orientation, and relationship motivation.

Toward the Tailoring of Sexual Health Education Messages for Young Women: A Focus on Tourist Experiences

Perceived anonymity and decreased influence of sexual double standards in tourism provide female travelers with opportunities for sexual experimentation and risk taking. The purpose of this study was (a) to identify the clusters of risk takers among young women based on their perceptions of and motivations for sexual risk taking in tourism and (b) to profile the clusters with respect to the psychological, sexual, demographic, and tourist characteristics. The data were collected through an online survey of 853 women (age in years: M = 23.5, SD = 6.67). Five clusters of sexual risk takers emerged based on their factor-analyzed risk perceptions and motivations. These clusters were interpreted as (a) diversely motivated broad risk perceivers; (b) fun-seeking broad risk perceivers; (c) diversely motivated physical risk perceivers; (d) anonymity- and empowerment-seeking risk disregarders; and (e) unmotivated broad risk perceivers. Women in these clusters differed in their intentions to engage in sexual risk taking in tourism, sensation-seeking propensities, perceptions of tourist characteristics, levels of sexual experience, and demographic backgrounds. Results suggest tailoring sexual health promotion messages based on cluster affiliation, leveraging cluster-specific risk perceptions, motivations, and personal characteristics. This study provides recommendations for individually tailored, context-specific, age-appropriate, and gender-sensitive sexual health education programs.

An event-level examination of successful condom negotiation strategies among young women

This study examines the effect of condom negotiation strategies on condom use and partner type and substance use before sex as moderators of strategy effectiveness. Women reported their daily sexual behavior during the last month. Withholding sex was more strongly associated with condom use when utilized with a non-casual sex partner. Directly requesting condom use was more strongly and using deceptive reasons to influence condom use was less strongly related to condom use during substance use. Results underscore the importance of understanding the contexts in which condom negotiation strategies are successful in order to improve HIV/sexually transmitted infection prevention efforts among women.

'I don't want to be that guy walking in the feminine product aisle': a Photovoice exploration of college men's perceptions of safer sex responsibility

Incidence and prevalence of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) and other sexually transmitted infections (STIs) continue to increase among young heterosexual men and women in the United States. Although research studies examine the reasons why these young people are not engaging in safe sex behavior, many have not explored factors beyond individual behaviors. Much of the current research focuses on young women, for the most part leaving men out of the equation. In this study, a Photovoice methodology was used to examine social norms, media messaging and perceptions of responsibility surrounding safe sex practices, specifically condom use, among male heterosexual undergraduate students. Results showed that college-aged men are still prioritizing pregnancy prevention over disease prevention, which leads to assumptions that their female partners are on birth control and they do not need to use condoms. Participants pointed to media messages and condom placement that supports women's responsibility for safer sex and condom negotiation. Future health promotion research and practice should focus on including men in the design and implementation process to address social norms and increase their sense of responsibility.

Antecedents of Young Women's Sexual Risk Taking in Tourist Experiences

The purpose of this phenomenological exploration was to shed light on the constellation of factors anteceding young women's sexual risk taking during their tourist experiences. A total of 15 in-depth interviews (1.5 to 2.5 hours each) with 13 women were conducted and analyzed through the lens of transcendental phenomenology. An analysis of antecedent factors revealed a confluence of sociopersonal characteristics (e.g., sexual definitions, attitudes, double standards, and age) and touristic attributes (e.g., the sense of temporariness/ephemerality, anonymity, and fun-oriented mentality depending on length, destination, and type of tourist experience) that underlie women's proclivity for and perceptions of sexual risk taking in certain travel scenarios. These result in myriad effects on physical, sexual health, sociocultural, mental, and emotional aspects of women's health and well-being. While the sociopersonal antecedents highlight the cross-pollination between sex-related perceptions in everyday life and touristic environments, the touristic antecedents emphasize the uniqueness of tourist experiences as the contexts for sexual risk taking. The findings address an underresearched topic in sex and tourism scholarship and offer implications for health education and intervention programs, pointing to the value of constructing the context-specific and gender-sensitive sexual health messages underpinned by the ideas of women's empowerment and sexual agency.

When Sex and Power Collide: An Argument for Critical Sexuality Studies

Attentive to the collision of sex and power, we add momentum to the ongoing development of the subfield of critical sexuality studies. We argue that this body of work is defined by its critical orientation toward the study of sexuality, along with a clear allegiance to critical modalities of thought, particularly feminist thought. Critical sexuality studies takes its cues from several other critical moments in related fields, including critical psychology, critical race theory, critical public health, and critical youth studies. Across these varied critical stances is a shared investment in examining how power and privilege operate, understanding the role of historical and epistemological violence in research, and generating new models and paradigms to guide empirical and theoretical research. With this guiding framework, we propose three central characteristics of critical sexuality studies: (a) conceptual analysis, with particular attention to how we define key terms and conceptually organize our research (e.g., attraction, sexually active, consent, agency, embodiment, sexual subjectivity); (b) attention to the material qualities of abject bodies, particularly bodies that are ignored, overlooked, or pushed out of bounds (e.g., viscous bodies, fat bodies, bodies in pain); and (c) heteronormativity and heterosexual privilege, particularly how assumptions about heterosexuality and heteronormativity circulate in sexuality research. Through these three critical practices, we argue that critical sexuality studies showcases how sex and power collide and recognizes (and tries to subvert) the various power imbalances that are deployed and replicated in sex research.

A Question of Love and Trust? The Role of Relationship Factors in Adolescent Sexual Decision Making

OBJECTIVE

While representing only 25% of the sexually active population, 50% of all new sexually transmitted infections occur among young people mostly because of inconsistent condom use. Critically, the majority of adolescent sexual activity takes place in the context of romantic relationships; thus, it is important to understand how relationship factors may influence decision making about the use of protection.

METHODS

We used a mixed-method approach to investigate the extent to which relationship length, degree of trust or love in the relationship, and frequency of intercourse influence both perceptions of the probability of condom use and self-reported condom use in the context of relationships among a diverse sample of high-risk adolescents (age 12-19 yr).

RESULTS

Participants were least likely to use condoms if they were in relationships with high trust or love and high frequency of intercourse. Importantly, sexual experience status was a strong moderator of primary effects.

CONCLUSION

The perspective of motivated cognition provides a useful theoretical framework to better understand adolescent decision making about condom use, particularly for sexually experienced youth.

Text messaging for sexual communication and safety among African American young adults

African American young adults are at high risk of HIV infection during their lifetimes, and the male condom remains the best method of prevention. Efforts to increase condom use should address the barrier of condom negotiation. We conducted a thematic analysis of qualitative, semistructured interviews with African American young adults to examine their use of text messaging for requesting human immunodeficiency virus (HIV) or sexually transmitted infection (STI) testing and condom use within the larger context of general sexual communication using text messages. Text messaging gave participants a level of comfort and disinhibition to discuss sexual topics and negotiate sexual safety. Benefits of text messages included ease of communication, privacy, and increased ability to express condom desires. Difficulties reflected the potential relationship implications of suggesting HIV/STI testing and condom use. Condom negotiation strategies using text messages also mirrored those found to be used in face-to-face communication.

Condom negotiation and use among female sex workers in Phnom Penh, Cambodia

We examined condom-use negotiation strategies and condom use among 81 female sex workers (FSWs) in Phnom Penh, Cambodia. Percentages of FSWs who did not negotiate condom use or could not describe a negotiation strategy with native clients, foreign clients, and non-paying partners were 15.0, 29.0 and 67.6 %, respectively. The most common negotiation strategy used was "provision of risk information" for native clients (43.8 %) and non-paying partners (26.5 %), and "direct request" for foreign clients (39.5 %). About half could not describe more than one negotiation strategy. Consistent condom use was high with native clients (98.8 %), yet comparatively lower with foreign clients (86.9 %) and non-paying partners (26.5 %). FSWs who did not negotiate or did not know how to negotiate condom use were less likely to report condom use with non-paying regular partners. Future interventions should enhance condom negotiation strategies between FSWs and all partner types.

First impressions of HIV risk: it takes only milliseconds to scan a stranger

Research indicates that many people do not use condoms consistently but instead rely on intuition to identify sexual partners high at risk for HIV infection. The present studies examined neural correlates for first impressions of HIV risk and determined the association of perceived HIV risk with other trait characteristics. Participants were presented with 120 self-portraits retrieved from a popular online photo-sharing community (www.flickr.com). Factor analysis of various explicit ratings of trait characteristics yielded two orthogonal factors: (1) a 'valence-approach' factor encompassing perceived attractiveness, healthiness, valence, and approach tendencies, and (2) a 'safeness' factor, entailing judgments of HIV risk, trustworthiness, and responsibility. These findings suggest that HIV risk ratings systematically relate to cardinal features of a high-risk HIV stereotype. Furthermore, event-related brain potential recordings revealed neural correlates of first impressions about HIV risk. Target persons perceived as risky elicited a differential brain response in a time window from 220-340 ms and an increased late positive potential in a time window from 350-700 ms compared to those perceived as safe. These data suggest that impressions about HIV risk can be formed in a split second and despite a lack of information about the actual risk profile. Findings of neural correlates of risk impressions and their relationship to key features of the HIV risk stereotype are discussed in the context of the 'risk as feelings' theory.

An expanded model of the temporal stability of condom use intentions: gender-specific predictors among high-risk adolescents

BACKGROUND

Adolescents involved with the criminal justice system are at particularly high-risk for the Human Immunodeficiency Virus and sexually transmitted infections.

PURPOSE

The purpose of this study was to longitudinally examine gender-specific models of condom use, incorporating temporal stability of intentions.

METHODS

Adolescents on probation (N=728) were recruited to complete longitudinal surveys including measures of Theory of Planned Behavior and gender-specific constructs, relationship length, and condom use.

RESULTS

Gender-specific models of condom use behavior suggested by previous research were mostly replicated. For young women, the effect of baseline intentions on subsequent condom use behavior was stronger when intentions were either stable or increasing. For young men, more stable, increasing intentions were directly associated with more condom use. There was preliminary evidence to suggest an association between temporal stability of intentions and decreasing condom use in stable relationships.

CONCLUSIONS

Intervention efforts should be tailored by gender and aim to forestall decreasing intentions and condom use over time by addressing difficulties in maintaining condom use.