1
|
Seth K, Nanda S, Sahay A, Verma R, Achyut P. Men, The Missing Link In Gender-equitable Family Planning: A Scoping Review. Gates Open Res 2022. [DOI: 10.12688/gatesopenres.13536.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Across societies, gender norms often allow men to hold key decision-making power within relationships, households and communities. This extends to almost all domains, consisting of family planning (FP) as well. FP programs have largely engaged men as clients and rarely as equal partners or influencers although across lower- and middle-income countries (LMICs), and especially in South Asia, men hold key decision-making power on the domain of family planning. The objective of this article is to explore couple dynamics through the lens of spousal communication and decision-making and unpack male engagement and spousal dynamics in family planning. Methods: This review presents a synthesis of evidence from two peer-reviewed databases, PubMed and Jstor, and and insights from programmatic documents to shed light on gender equitable engagement of young married men in family planning. Inclusion and exclusion criteria for both these databases was set and search strategies were finalized. This was followed by title and abstract screening, data extraction, synthesis and analysis. Results: Study participants included unmarried men (16%, n=8), married men (19%, n=9), married women (19%, n=9), married couples (25%, n=12) or more than two respondent categories (21%, n=10). Almost three quarters (71%, n=34) of the studies selected had FP as the primary area of inquiry. Other prominent thematics on which the studies reported were around norms (n=9, 16%), couple dynamics and intimacy (n=12, 22%). Conclusions: The evidence presented provides sufficient impetus to expand on gender-equitable male engagement, viewing men as equal and supportive partners for informed, equitable and collaborative contraceptive uptake and FP choices by couples.
Collapse
|
2
|
Kirwan M, Davis KC, Stappenbeck CA, George WH. The Roles of Emotion Regulation, Alcohol Consumption, and Women's Condom Request Style in Men's Coercive Condom Use Resistance Intentions. JOURNAL OF AGGRESSION, MALTREATMENT & TRAUMA 2022; 31:1187-1205. [PMID: 36686317 PMCID: PMC9857612 DOI: 10.1080/10926771.2022.2089862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 04/14/2022] [Accepted: 05/22/2022] [Indexed: 06/17/2023]
Abstract
Condom use resistance (CUR) remains a significant problem, and many men employ coercive CUR strategies to avoid using condoms with partners who do not consent to unprotected sex. To assess the decision-making process underlying men's coercive CUR, the present study administered alcohol to assess the effects of alcohol intoxication, condom request style, and emotion regulation (ER) strategies (i.e., cognitive reappraisal, expressive suppression) on intentions to use coercive CUR to have unprotected sex during a hypothetical sexual scenario. Sexually active, male social drinkers (N = 297) were randomly assigned to either consume alcohol or remain sober, and to project themselves into a hypothetical sexual scenario during which they received either indirect, direct, or insistent condom requests. Results showed that, although cognitive reappraisal had no relationship with coercive CUR or unprotected sex intentions, expressive suppression's relationship with intentions to have unprotected sex was mediated by coercive CUR and moderated by alcohol intoxication and condom request. Specifically, suppression was positively associated with coercive CUR among sober individuals who received an indirect condom request only. Such results suggest that sober men with suppressive tendencies may use coercive CUR to regulate negative emotions, such as frustration at not being able to have unprotected sex.
Collapse
Affiliation(s)
- Mitchell Kirwan
- Edson College of Nursing and Health Innovation, Arizona State University
| | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University
| | | | | |
Collapse
|
3
|
Lungu DA, Røislien J, Wiig S, Shortt MT, Ferrè F, Berg SH, Thune H, Brønnick KK. The Role of Recipient Characteristics in Health Video Communication Outcomes: Scoping Review. J Med Internet Res 2021; 23:e30962. [PMID: 34967758 PMCID: PMC8759013 DOI: 10.2196/30962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/21/2021] [Accepted: 10/29/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The importance of effective communication during public health emergencies has been highlighted by the World Health Organization, and it has published guidelines for effective communication in such situations. With video being a popular medium, video communication has been a growing area of study over the past decades and is increasingly used across different sectors and disciplines, including health. Health-related video communication gained momentum during the SARS-CoV-2 pandemic, and video was among the most frequently used modes of communication worldwide. However, although much research has been done regarding different characteristics of video content (the message) and its delivery (the messenger), there is a lack of knowledge about the role played by the characteristics of the recipients for the creation of effective communication. OBJECTIVE The aim of this review is to identify how health video communication outcomes are shaped by recipient characteristics, as such characteristics might affect the effectiveness of communication. The main research question of the study is as follows: do the characteristics of the recipients of health videos affect the outcomes of the communication? METHODS A scoping review describing the existing knowledge within the field was conducted. We searched for literature in 3 databases (PubMed, Scopus, and Embase) and defined eligibility criteria based on the relevance to the research question. Recipient characteristics and health video communication outcomes were identified and classified. RESULTS Of the 1040 documents initially identified, 128 (12.31%) met the criteria for full-text assessment, and 39 (3.75%) met the inclusion criteria. The included studies reported 56 recipient characteristics and 42 communication outcomes. The reported associations between characteristics and outcomes were identified, and the potential research opportunities were discussed. Contributions were made to theory development by amending the existing framework of the Integrated-Change model, which is an integrated model of motivational and behavioral change. CONCLUSIONS Although several recipient characteristics and health video communication outcomes were identified, there is a lack of robust empirical evidence on the association between them. Further research is needed to understand how the preceding characteristics of the recipients might affect the various outcomes of health video communication.
Collapse
Affiliation(s)
- Daniel Adrian Lungu
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Jo Røislien
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Siri Wiig
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Marie Therese Shortt
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Francesca Ferrè
- Management and Health Laboratory, Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Siv Hilde Berg
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Henriette Thune
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Kolbjørn Kallesten Brønnick
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| |
Collapse
|
4
|
Vanterpool KB, Yarber WL, Rosenberg M, Mowatt RA, Garcia JR. The Impact of Sex Ratio Perceptions on Condom Use Attitudes and Behaviors among Black Women in the United States. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2021; 34:221-232. [PMID: 38596529 PMCID: PMC10903657 DOI: 10.1080/19317611.2021.2000088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 10/09/2021] [Accepted: 10/23/2021] [Indexed: 04/11/2024]
Abstract
Objective:Explore how perceptions of the sex ratio in Black communities' impact heterosexual Black women's confidence in negotiating condom use with sex partners and condom use at last sex. Methods: Using log-binomial regression models, we estimated the association between perception of the sex ratio and condom negotiation self-efficacy and condom use at last sex. Results: Perception of the sex ratio among Black women surveyed was not significantly associated with condom negotiation self-efficacy and condom use at last sex. Conclusion: Overall, the results do not demonstrate an association between perception of the sex ratio and condom negotiation self-efficacy and condom use at last sex.
Collapse
Affiliation(s)
- Karen B. Vanterpool
- Department of Applied Health Science, Indiana University, Bloomington, IN, USA
- The Kinsey Institute, Indiana University, Bloomington, IN, USA
- Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA
| | - William L. Yarber
- Department of Applied Health Science, Indiana University, Bloomington, IN, USA
- The Kinsey Institute, Indiana University, Bloomington, IN, USA
- Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA
| | - Molly Rosenberg
- Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA
- Department of Epidemiology and Biostatistics, Indiana University, Bloomington, IN, USA
| | - Rasul A. Mowatt
- Department of American Studies, Indiana University, Bloomington, IN, USA
| | - Justin R. Garcia
- The Kinsey Institute, Indiana University, Bloomington, IN, USA
- Department of Gender Studies, Indiana University, Bloomington, IN, USA
| |
Collapse
|
5
|
Carmack C, Roncancio AM, Gerecht L, Ansari M. Perceived partner beliefs about condoms and self-efficacy communication within the context of the theory of gender and power. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:1424-1437. [PMID: 32168397 DOI: 10.1002/jcop.22337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/14/2020] [Accepted: 02/17/2020] [Indexed: 05/25/2023]
Abstract
The theory of gender and power provides a unique framework for understanding condom use by accounting for distinct challenges faced by minority women in particular. This study examined whether self-efficacy about condom use communication (SECC) and perceived partner's beliefs about condom (PPBC) use had an influence on condom use frequency; and whether these associations varied by gender. A sample of 252 African-American college students (101 males and 151 females) completed a confidential online survey assessing SECC, PPBC, and condom use behavior. SECC and PPBC showed significant associations with condom use behavior. Furthermore, there was a gender interaction effect with PPBC on condom use behavior. As PPBC increases toward positive associations about condom use, condom use behavior increased significantly more for females (B = 0.42; p = .02) as compared to males (B = 0.26; p = .19). This study supports the need to teach young women effective communication skills in order for them to accurately assess what their partner thinks about condom-related behaviors; and ultimately not allow partner discouragement to influence their decisions to use condoms. Interventions aimed at reducing risky sexual behavior on predominantly Black college campuses, in particular, may benefit from directly addressing relationship power and focusing on building self-efficacy in communicating condom use.
Collapse
Affiliation(s)
- Chakema Carmack
- Department of Psychological, Health, and Learning Sciences, College of Education, University of Houston, Houston, Texas
| | - Angelica M Roncancio
- Health and Behavioral Science, College of Humanities and Social Sciences, Houston, Texas
| | - Lena Gerecht
- Department of Psychological, Health, and Learning Sciences, College of Education, University of Houston, Houston, Texas
| | - Mohammed Ansari
- Department of Psychological, Health, and Learning Sciences, College of Education, University of Houston, Houston, Texas
| |
Collapse
|
6
|
Stappenbeck CA, Gulati NK, Davis KC. A Prospective Examination of Men's Condom Use Resistance: Event-Level Associations with Sexual Aggression, Alcohol Consumption, and Trait Anger. JOURNAL OF SEX RESEARCH 2019; 56:947-956. [PMID: 31140874 PMCID: PMC6756970 DOI: 10.1080/00224499.2019.1620162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 05/09/2019] [Accepted: 05/14/2019] [Indexed: 06/09/2023]
Abstract
Burgeoning research suggests that men engage in a variety of coercive and non-coercive tactics to avoid condom use (condom use resistance; CUR), suggesting a risk nexus regarding sexual risk and sexual aggression (SA). Laboratory-based research has found that acute alcohol intoxication is associated with CUR; however, no study has examined event-level associations among alcohol consumption, SA history, and CUR or the moderating effects of trait anger. Non-problem drinking young adult men who have sex with women (N = 430) completed a background survey and follow-up assessments regarding their sex events and alcohol consumption over three months. CUR was reported in 113 sex events; 6.2% of these involved SA and 40.7% involved alcohol consumption. Generalized estimating equations demonstrated that men with more severe SA histories were more likely to perpetrate CUR. Men lower in trait anger were more likely to perpetrate CUR the more they increased above their typical level of alcohol consumption, whereas men higher in trait anger were similarly likely to perpetrate CUR regardless of their alcohol consumption. Results suggest that men with greater SA histories and high trait anger are at increased risk of perpetrating CUR, and that risk of CUR increases among other men the more they increase their alcohol consumption beyond their average.
Collapse
Affiliation(s)
| | | | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University
| |
Collapse
|
7
|
Weiss NH, Peasant C, Sullivan TP. Avoidant Coping as a Moderator of the Association Between Childhood Abuse Types and HIV/Sexual Risk Behaviors. CHILD MALTREATMENT 2019; 24:26-35. [PMID: 30124064 DOI: 10.1177/1077559518793228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Women who experience intimate partner violence (IPV) report high rates of HIV/sexual risk behaviors. Childhood abuse has been linked to HIV/sexual risk behaviors among IPV-victimized women; however, limited research has examined factors that may influence this association. The current study tested the moderating role of avoidant coping in the relation between childhood abuse types (physical, emotional, and sexual) and HIV/sexual risk behaviors. Participants were 212 community women currently experiencing IPV (mean age = 36.63 years, 67.0% African American). Higher levels of avoidant coping were related to more severe childhood abuse types. Severity of childhood abuse types was associated with greater HIV/sexual risk behaviors. Avoidant coping moderated the relation between childhood sexual abuse severity and HIV/sexual risk behaviors, such that this association was significant for IPV-victimized women with high (but not low) levels of avoidant coping. Findings suggest the utility of targeting avoidant coping in interventions aimed at preventing or reducing HIV/sexual risk behaviors among IPV-victimized women with a history of childhood sexual abuse.
Collapse
Affiliation(s)
- Nicole H Weiss
- 1 Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | | | - Tami P Sullivan
- 3 Division of Prevention and Community Research, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
8
|
|
9
|
Krüsi A, Ranville F, Gurney L, Lyons T, Shoveller J, Shannon K. Positive sexuality: HIV disclosure, gender, violence and the law-A qualitative study. PLoS One 2018; 13:e0202776. [PMID: 30142220 PMCID: PMC6108491 DOI: 10.1371/journal.pone.0202776] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 08/08/2018] [Indexed: 11/20/2022] Open
Abstract
While a growing body of research points to the shortcomings of the criminal law in governing HIV transmission, there is limited understanding of how cis and trans women living with HIV (WLWH) negotiate their sexuality and HIV disclosure in a criminalized environment. Given the ongoing criminalization of HIV non-disclosure and prevalence of gender-based violence, there is a critical need to better understand the dynamics of negotiating sexual relationships and HIV disclosure among WLWH. We conducted 64 qualitative interviews with cis and trans WLWH in Vancouver, Canada between 2015 and 2017. The interviews were conducted by three experienced researchers, including a cis and a trans WLWH using a semi-structured interview guide. Drawing on a feminist analytical framework and concepts of structural violence, the analysis sought to characterize the negotiation of sexual relationships and HIV disclosure among WLWH in a criminalized setting. For many participants their HIV diagnosis initially symbolized the end of their sexuality due to fear of rejection and potential legal consequences. WLWH recounted that disclosing their HIV status shifted the power dynamics in sexual relationships and many feared rejection, violence, and being outed as living with HIV. Participants' narratives also highlighted that male condom refusal was common and WLWH were not only subjected to the gendered interpersonal violence of male condom refusal but also to the structural violence of legislation that requires condom use but fails to account for the gendered power imbalance that shapes condom negotiation. Despite frequently being represented as a law that 'protects' women, our findings indicate that the criminalization of HIV non-disclosure constitutes a form of gendered structural violence that exacerbates risk for interpersonal violence among WLWH. In line with recommendations by, the WHO and UNAIDS these findings demonstrate the negative impacts of regulating HIV prevention through the use of criminal law for WLWH.
Collapse
Affiliation(s)
- Andrea Krüsi
- Gender and Sexual Health Initiative, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Flo Ranville
- Gender and Sexual Health Initiative, Vancouver, British Columbia, Canada
| | - Lulu Gurney
- Gender and Sexual Health Initiative, Vancouver, British Columbia, Canada
| | - Tara Lyons
- Gender and Sexual Health Initiative, Vancouver, British Columbia, Canada
- Kwantlen Polytechnic University, Surrey, British Columbia, Canada
| | - Jean Shoveller
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kate Shannon
- Gender and Sexual Health Initiative, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
10
|
Li Y, Samp JA, Cone VBC, Kollar LMM, DiClemente RJ, Monahan JL. African American Women's Language Use in Response to Male Partners' Condom Negotiation Tactics. COMMUNICATION STUDIES 2017; 69:67-84. [PMID: 30899149 PMCID: PMC6424507 DOI: 10.1080/10510974.2017.1412335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
African American women are vulnerable for sexual health risk; thus, condom use is essential. Guided by research linking goals to communicative content, this study explored women's use of I-, you-, we-, and hedging language during condom negotiation. Female participants (N = 193) engaged in a condom negotiation role play with male confederates, where language use measures were coded. I-language was used the most frequently. Language use differed as a function of men's tactics, such that women primarily used I-language in response to verbal attacks, you-language in response to seduction, and I- and we-language in response to information seeking. Women who engaged in more recent condom use were more likely to use you-language, and when confederates attacked, they responded with more you-language and less hedging.
Collapse
Affiliation(s)
- Yachao Li
- Department of Communication Studies at the University of Georgia where
| | | | | | | | | | | |
Collapse
|
11
|
Neilson EC, Eakins DR, Davis KC, Norris J, George WH. Depressive Symptoms, Acute Alcohol Intoxication, and Risk Rationale Effects on Men's Condom Use Resistance. JOURNAL OF SEX RESEARCH 2017; 54:764-775. [PMID: 27547862 PMCID: PMC5526205 DOI: 10.1080/00224499.2016.1217500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study examined the role of depressive symptoms, acute intoxication, and risk rationale in men's use of condom use resistance (CUR) tactics in an experimental study. Participants included 313 heterosexual male, nonproblem drinkers, ages 21 to 30. Participants were randomized to one of four beverage conditions: no alcohol, placebo, low (.04%) alcohol dose, or high (.08%) alcohol dose. They read an eroticized scenario depicting a consensual sexual encounter with a female partner who requested a condom to prevent either pregnancy or sexually transmitted infections (STIs) (risk rationale) and then indicated their intentions to use 10 different CUR tactics. Hypotheses related to the pharmacological, dosage, and expectancy effects of alcohol were tested in a generalized linear model. In intoxicated (.04% and .08%) men who were given a pregnancy risk rationale, depressive symptoms were associated with stronger intentions to use CUR tactics than in sober (control and placebo) men. Men who received a high alcohol dose (.08%) and who were given a pregnancy risk rationale reported higher intentions to use CUR tactics than those who received a lower alcohol dose (.04%). Findings suggest that the pharmacological effects of alcohol on men's likelihood to resist condoms vary by the saliency of the risk rationale and mood-related variables.
Collapse
Affiliation(s)
- Elizabeth C. Neilson
- University of Washington, Department of Psychology, Box 351525, Seattle, WA 98195
| | | | | | | | | |
Collapse
|
12
|
Klein H, Sterk CE, Elifson KW. Knowledge about HIV in a Community Sample of Urban African Americans in the South. ACTA ACUST UNITED AC 2016; 7. [PMID: 27891291 PMCID: PMC5123594 DOI: 10.4172/2155-6113.1000622] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE Race and HIV are intertwined in complex ways. African Americans, particularly those residing in the southern United States, are at great risk for contracting and subsequently transmitting HIV. Research on the extent to which members of this population understand the risks associated with engaging in specific behaviors is limited. This paper examines HIV knowledge among at-risk adult African American men and women and the factors associated with levels of HIV knowledge. METHODS Based on a conceptual model derived from Social Disorganization Theory and Syndemics Theory, interviews were conducted between 2009 and 2011. Questionnaire-based interviews were conducted with 1,864 respondents from 80 strategically-chosen census block groups in Atlanta, Georgia. An innovative approach to assessing amount of HIV knowledge was implemented, to derive better estimates of the extent of knowledge. RESULTS Overall, HIV knowledge was low (average=43.5% correct answers). Seven factors were identified as contributing uniquely to having higher levels of knowledge about HIV transmission: (1) younger age, (2) being educated beyond the high school level, (3) being gay, lesbian or bisexual, (4) experiencing sexual abuse during childhood and/or adolescence, (5) drinking alcohol less frequently, (6) knowing a larger number of HIV-infected persons and (7) knowing anyone currently living with "full blown" AIDS. CONCLUSION HIV educational and intervention programs targeting at-risk African American adults need to develop effective ways of bolstering a solid understanding of how HIV is/not transmitted. In particular, efforts need to be targeted toward older adults, those with lower levels of educational attainment and persons who are not acquainted with anyone who is HIV-infected.
Collapse
Affiliation(s)
- H Klein
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University Atlanta, Georgia
| | - C E Sterk
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University Atlanta, Georgia
| | - K W Elifson
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University Atlanta, Georgia
| |
Collapse
|
13
|
Peasant C, Sullivan TP, Weiss NH, Martinez I, Meyer JP. Beyond the syndemic: condom negotiation and use among women experiencing partner violence. AIDS Care 2016; 29:516-523. [PMID: 27590004 DOI: 10.1080/09540121.2016.1224296] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND HIV and sexually transmitted infections (STIs) disproportionately affect women who experience intimate partner violence (IPV). OBJECTIVE The current study (1) applied a syndemic framework to study the collective effects of problematic drug use, hazardous drinking, depression, and posttraumatic stress disorder (PTSD) on fear of condom negotiation, condom negotiation, and condom use and (2) evaluated condom negotiation (controlling for fear of condom negotiation) as a mediator of the association between syndemic severity and condom use among low-income IPV-exposed women. METHODS Participants were 158 women living in the community and experiencing ongoing IPV who completed face-to-face, computer-assisted interviews. RESULTS Almost three-fourths of the participants reported problematic drug use, hazardous drinking, depression, and/or PTSD; many of these factors were correlated, indicating a syndemic. Multivariate logistic and linear regression analyses revealed associations between syndemic severity and fear of condom negotiation (OR = 1.57, p = .02), condom negotiation (β = -8.51, p = .001), and condom use (β = -8.26, p = .01). Meditation analyses identified condom negotiation as a mediator of the association between syndemic severity and condom use (effect = -6.57, SE = 2.01, [95% CI: -10.66, -2.77]). CONCLUSIONS Results fill a critical gap in previous research by identifying condom negotiation as a mechanism through which this syndemic affects condom use. Prevention and intervention programs should consider addressing condom negotiation to reduce sexual risk among this high-risk population. Further, because IPV-exposed women may experience fear related to condom negotiation, it is critical that prevention and intervention efforts for this population offer skills to safely negotiate condom use, increase condom use, and reduce STI and HIV risk.
Collapse
Affiliation(s)
- Courtney Peasant
- a Center for Interdisciplinary Research on AIDS , Yale School of Public Health , New Haven , CT , USA
| | - Tami P Sullivan
- b Division of Prevention and Community Research, Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA
| | - Nicole H Weiss
- b Division of Prevention and Community Research, Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA
| | - Isabel Martinez
- a Center for Interdisciplinary Research on AIDS , Yale School of Public Health , New Haven , CT , USA
| | | |
Collapse
|
14
|
Klein H, Elifson KW, Sterk CE. How the Interaction of Childhood Sexual Abuse and Gender Relates to HIV Risk Practices among Urban-Dwelling African Americans. ACTA ACUST UNITED AC 2016; 2. [PMID: 30197963 DOI: 10.15744/2454-499x.2.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Purpose Previous research has demonstrated that HIV risk practices often differ based on gender and on whether or not people experienced sexual abuse during their formative (i.e., childhood and adolescence) years. The interaction of these two factors, which is the focus of this paper, has received limited attention. Methods Based on a model derived from Social Disorganization Theory and Syndemics Theory, interviews were conducted between 2009 and 2012 with 1,864 African American adults residing in Atlanta, Georgia in 80 strategically-chosen consensus block groups. Results Based on multiple regression and structural equation analyses, the interaction of sexual abuse and gender was found to be a significant predictor of involvement in (un)protected sex. The interaction of sexual abuse and gender also was related to condom use self-efficacy, which was one of the strongest factors underlying (un)protected sex. Conclusion The relationship of sexual abuse history and gender is relevant in the understanding of HIV risk practices. The interaction of these factors with one another and with other relevant influences that shape people's HIV risk profiles is complex. The Syndemics Theory approach used to conceptualize the relationships among relevant variables in this study is an effective way of trying to understand and address HIV risk practices.
Collapse
Affiliation(s)
- H Klein
- Kensington Research Institute, Kensington MD and Rollins School of Public Health, Emory University, Atlanta GA, United States
| | - K W Elifson
- Rollins School of Public Health, Emory University, Atlanta GA, United States
| | - C E Sterk
- Rollins School of Public Health, Emory University, Atlanta GA, United States
| |
Collapse
|
15
|
Minority College Women's Views on Condom Negotiation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 13:ijerph13010040. [PMID: 26703642 PMCID: PMC4730431 DOI: 10.3390/ijerph13010040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 10/15/2015] [Accepted: 10/19/2015] [Indexed: 01/25/2023]
Abstract
This study utilized quantitative and qualitative methods to (1) investigate the relationship between frequency of condom use and negotiation strategies and (2) evaluate experiences with condom negotiations among sexually active, heterosexual, African American college women. One hundred female students from a Historically Black Colleges and Universities (HBCU) completed a questionnaire that included the Condom Influence Strategies Scale (CIS) and participated in a focus group. An ANOVA was conducted to compare differences between never, inconsistent, and consistent condom users. Consistent condom users scored higher than never users on the “withholding sex” subscale of the CIS (4.88 vs. 3.55; p < 0.001) as well as endorsed items more strongly on the “direct request” subscale of the CIS (4.63 vs. 3.82, p < 0.05) than never users. A thematic analysis of open discussions identified overarching themes. Similarly, refusing sex and/or having direct communications with partner emerged as primary strategies. Threats to negotiation included deciding the “right timing” of discussion and having a previous history of sexual intercourse without a condom with their partner. Other key concepts that contribute to condom negotiation are the views that condoms are a male’s responsibility and stigma of women who carry condoms.
Collapse
|
16
|
Downs JS, Bruine de Bruin W, Fischhoff B, Murray PJ. Behavioral Decision Research Intervention Reduces Risky Sexual Behavior. Curr HIV Res 2015; 13:439-46. [PMID: 26149165 PMCID: PMC5523954 DOI: 10.2174/1570162x13666150511145328] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 05/08/2014] [Accepted: 01/06/2014] [Indexed: 11/22/2022]
Abstract
Although adolescents are at disproportionate risk for sexually transmitted infections, most sex education programs have shown little effect on sexual behavior. An interactive video intervention developed by our team has been identified as one of a few programs that have been documented to reduce sexually transmitted infections in this population. Building on behavioral decision research, we used a mental models approach to interview young women about their sexual decisions, finding, among other things, the strong role of perceived social norms. We based our intervention on these results, aiming to help young women identify and implement personally and socially acceptable decision strategies. A randomized controlled trial found that the video reduced risky sexual behavior and the acquisition of chlamydia infection. We recently revised the video to suit more diverse audiences, and upgraded it to modern standards of cinematography and interactivity. It is now in field trial.
Collapse
Affiliation(s)
- Julie S Downs
- Department of Social and Decision Sciences, Carnegie Mellon University, Pittsburgh, PA 15213- 3890, USA.
| | | | | | | |
Collapse
|
17
|
Peasant C, Parra GR, Okwumabua TM. Condom negotiation: findings and future directions. JOURNAL OF SEX RESEARCH 2014; 52:470-483. [PMID: 24670110 DOI: 10.1080/00224499.2013.868861] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The aim of this review was to summarize factors associated with condom negotiation among heterosexual men. Literature searches were conducted using multiple databases spanning several disciplines. Studies examining psychological, demographic, relational, communication, and environmental factors related to condom negotiation are described, and a three-dimensional framework of condom negotiation is proposed. This framework of condom negotiation may aid researchers in operationalizing this construct, organizing this literature, and facilitating measurement development. We used this three-dimensional framework to articulate the influence of gender, ethnicity, relationship type, partner characteristics, trauma history, post-traumatic stress, and alcohol use on condom negotiation. Areas for future research are outlined. More research is needed to understand how these factors interact to influence condom negotiation, as well as the interaction between gender and the identified factors.
Collapse
|
18
|
Deardorff J, Tschann JM, Flores E, de Groat CL, Steinberg JR, Ozer EJ. Latino youths' sexual values and condom negotiation strategies. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2013; 45:182-90. [PMID: 24165307 PMCID: PMC4124077 DOI: 10.1363/4518213] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
CONTEXT Young Latinos in the United States are at high risk for STDs and are less likely than other youth to use condoms. To our knowledge, no studies have examined the relationship between sexual values and condom negotiation strategies among young Latinos. METHODS Cross-sectional data collected in 2003-2006 from 571 Latino women and men aged 16-22 in the San Francisco Bay Area were used to examine associations between sexual values (e.g., considering sexual talk disrespectful or female virginity important) and use of strategies to engender or avoid condom use. Linear regression analyses were used to identify such associations while adjusting for potential covariates and gender interactions. RESULTS Among women, sexual comfort and comfort with sexual communication were positively associated with frequency of direct communication to foster condom use; the importance of female premarital virginity and levels of sexual self-acceptance were positively associated with expressing dislike of condoms to avoid using them; and levels of sexual self-acceptance were negatively associated with expressing dislike of condoms to avoid using them. Moreover, the degrees to which women considered sexual talk disrespectful and female virginity important were positively associated with the frequency with which they shared risk information as a condom use strategy. Among both sexes, the importance that respondents placed on premarital female virginity was negatively associated with use of direct communication strategies. CONCLUSION Researchers designing interventions to influence Latino youths' sexual decision making and behaviors should consider including program components that address sexual values.
Collapse
Affiliation(s)
- Julianna Deardorff
- Division of Community Health and Human Behavior, School of Public Health, University of California, Berkeley
| | - Jeanne M. Tschann
- Department of Psychiatry, School of Medicine; University of California, San Francisco
| | - Elena Flores
- Department of Counseling Psychology, School of Education, University of San Francisco
| | | | - Julia R. Steinberg
- Department of Psychiatry, School of Medicine; University of California, San Francisco
| | - Emily J. Ozer
- Division of Community Health and Human Behavior, School of Public Health, University of California, Berkeley
| |
Collapse
|
19
|
Deardorff J, Tschann JM, Flores E, de Groat CL, Steinberg JR, Ozer EJ. Latino youths' sexual values and condom negotiation strategies. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2013; 45:182-190. [PMID: 24165307 DOI: 10.1363/psrh.2013.45.issue-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
CONTEXT Young Latinos in the United States are at high risk for STDs and are less likely than other youth to use condoms. To our knowledge, no studies have examined the relationship between sexual values and condom negotiation strategies among young Latinos. METHODS Cross-sectional data collected in 2003-2006 from 571 Latino women and men aged 16-22 in the San Francisco Bay Area were used to examine associations between sexual values (e.g., considering sexual talk disrespectful or female virginity important) and use of strategies to engender or avoid condom use. Linear regression analyses were used to identify such associations while adjusting for potential covariates and gender interactions. RESULTS Among women, sexual comfort and comfort with sexual communication were positively associated with frequency of direct communication to foster condom use; the importance of female premarital virginity and levels of sexual self-acceptance were positively associated with expressing dislike of condoms to avoid using them; and levels of sexual self-acceptance were negatively associated with expressing dislike of condoms to avoid using them. Moreover, the degrees to which women considered sexual talk disrespectful and female virginity important were positively associated with the frequency with which they shared risk information as a condom use strategy. Among both sexes, the importance that respondents placed on premarital female virginity was negatively associated with use of direct communication strategies. CONCLUSION Researchers designing interventions to influence Latino youths' sexual decision making and behaviors should consider including program components that address sexual values.
Collapse
Affiliation(s)
- Julianna Deardorff
- Julianna Deardorff is assistant professor, and Emily J. Ozer is associate professor, Division of Community Health and Human Behavior, School of Public Health, University of California, Berkeley
| | | | | | | | | | | |
Collapse
|
20
|
Crosby RA, DiClemente RJ, Salazar LF, Wingood GM, McDermott-Sales J, Young AM, Rose E. Predictors of consistent condom use among young African American women. AIDS Behav 2013; 17:865-71. [PMID: 21796442 DOI: 10.1007/s10461-011-9998-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to determine the predictive value of selected factors to the consistent use of condoms among high-risk young African American women. A clinic-based, prospective, study of 242 young, African-American women (ages 15-21) was conducted. In multivariate analysis, consistent condom use was predicted by having greater perceptions of condom negotiation self-efficacy, lower fear of negotiating condom use, and having communicated with sex partners (during the recall period) about condom use. Relational variables were predictive of consistent condom use among young African American women. STD/HIV preventive interventions should target these factors, perhaps in dyad-level interventions.
Collapse
Affiliation(s)
- Richard A Crosby
- College of Public Health at the University of Kentucky, 121 Washington Ave, Lexington, KY 40506-0003, USA.
| | | | | | | | | | | | | |
Collapse
|
21
|
|
22
|
Davis KC. The influence of alcohol expectancies and intoxication on men's aggressive unprotected sexual intentions. Exp Clin Psychopharmacol 2010; 18:418-28. [PMID: 20939645 PMCID: PMC3000798 DOI: 10.1037/a0020510] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
An experiment tested the pathways through which alcohol expectancies and intoxication influenced men's self-reported sexual aggression intentions during an unprotected sexual encounter. After a questionnaire session, male social drinkers (N = 124) were randomly assigned to either an alcohol condition (target peak BAC = .08%) or a control condition. Upon completion of beverage consumption, participants read a description of a sexual encounter in which the female partner refused to have unprotected sexual intercourse. Participants then rated their emotional state, their intentions to have unprotected sex with the unwilling partner, and their postincident perceptions of the encounter. Structural equation modeling indicated that intoxicated men reported feeling stronger sexual aggression congruent emotions/motivations such as arousal and anger; however, this effect was moderated by alcohol expectancies. Intoxicated participants with stronger alcohol-aggression expectancies reported greater sexual aggression congruent emotions/motivations than did intoxicated participants with weaker alcohol-aggression expectancies. For sober participants, alcohol-aggression expectancies did not influence emotions/motivations. In turn, stronger sexual assault congruent emotions/motivations predicted greater sexual aggression intentions. Men with greater sexual aggression intentions were less likely to label the situation as a sexual assault and reported less concern about their intended actions. These findings underscore the relevance of both alcohol expectancies and alcohol intoxication to sexual aggression perpetration and highlight the importance of including information about alcohol's influence on both emotional and cognitive responses in sexual aggression prevention work.
Collapse
Affiliation(s)
- Kelly Cue Davis
- School of Social Work, University of Washington, Seattle, WA 98105-6299, USA.
| |
Collapse
|