Violated and vulnerable: women's experiences of contracting a sexually transmitted infection from a male partner

Relações de gênero e poder no contexto das vulnerabilidades de mulheres às infecções sexualmente transmissíveis

Objetivou-se investigar as relações de gênero e poder no contexto das vulnerabilidades de mulheres às infecções sexualmente transmissíveis. Trata-se de um estudo de natureza qualitativa, desenvolvido com oito mulheres em fase reprodutiva e com histórico de contaminação por infecção sexualmente transmissível. Os dados produzidos por entrevistas estruturadas foram submetidos à análise temática proposta por Bardin. As mulheres são retraídas em posição de submissão, refletindo a forte influência de gênero nas relações afetivas conjugais, situação que dificulta o diálogo e a negociação de uma relação sexual segura, além de contribuir para que a mulher não se reconheça como um sujeito de direitos sexuais e reprodutivos. Portanto, elas devem ser sensibilizadas por meio de intervenções que estimulem o empoderamento para a negociação do sexo seguro, o protagonismo e o reconhecimento de si como um sujeito de direitos sexuais e reprodutivos.

The symbiotic relationship of vulnerability and resilience in nursing

Background: Whilst the terms vulnerability and resilience are commonly used within professional nursing discourses, they are often poorly understood. Vulnerability is often framed negatively and linked to being at risk of harm, whilst resilience is often perceived as the ability to withstand challenges. Aim: The aim of this paper is to explore resilience and vulnerability; re-positioning them within the context of contemporary professional nursing practice. Design: Discussion paper. Method: Drawing upon historical and contemporary international literature, both concepts are de-constructed and then re-constructed, examining them from the position of patient care as well as from the perspective of nurses and the nursing profession. Conclusion: Resilience and vulnerability have an interdependent relationship as resilience comes into play in situations of vulnerability. Yet, contrary to the popular discourse they are multi-faceted, complex phenomena based on factors such as individual circumstances, supports, and resources.

Misperceptions and stereotypes in nursing care for sexually transmitted infections and domestic violence: a qualitative exploratory study

Background: Sexually transmitted infections (STI) and domestic violence (DV) are common healthcare issues experienced worldwide with DV increasing the risk of acquiring STI/s. Although nurses are well-placed to provide care for both issues, little is known about how and whether nurses perceive STI risk within the context of DV and whether this informs nursing care.Aim: To explore nurses' perceptions of STI acquisition within the context of DV and whether this informs nursing care.Design: Qualitative exploratory descriptive design.Methods: Eight participant narratives were collected from Australian Registered Nurses (RNs), with 1-17 years of clinical practice in varied settings. Participants were required to be registered with the Australian Health Practitioner Regulation Agency (AHPRA) and converse in English. Semi-structured interviews were undertaken via face-to-face, telephone and computer-mediated communication (CMC). Thematic analysis was guided by Braun and Clarke (2006).Results: Three themes emerged from the data: 'Perceptions: They don't talk about it, 'Stereotypes: Just that stigma and 'Provision of Care for STIs/DV: Physical and emotional. Participants held various perceptions associated with STIs and DV including the covert nature of both issues, the care of STIs within the context of DV, and how the nature of nursing care differed between STIs and DV.Conclusions: Nurses need to recognise the impact that nurse perceptions and stereotyping have on disclosures and provision of care for STIs, particularly in the context of DV. Consideration is also needed in relation to sexual and reproductive autonomy, the impact on disclosure and provision of care.

Women and HIV in the Twenty-First Century: How Can We Reach the UN 2030 Goal?

Women have always been part of the HIV/AIDS epidemic. As with other populations affected by HIV, for many years the only prevention strategy available was behavior change. Behavioral interventions for women were developed and evaluated, with some success. Because women did not control the use of male condoms, efficacious interventions needed to build skills for partner negotiation. Woman-controlled technologies such as the female condom and vaginal spermicide were unable to solve the problem of male control of the condom and enable the development of safe methods for women to protect themselves. The modern era of HIV prevention has produced biomedical solutions based on highly active retroviral chemoprophylaxis, which can be hidden from the male partner and thus eliminate his possible negative reactions. Pre-exposure prophylaxis holds promise for HIV prevention among women. This article reviews the literature on HIV prevention for women, including both successes and challenges.

Training reproductive health providers to talk about intimate partner violence and reproductive coercion: an exploratory study

To explore the effect of provider communication-skills training on frequency of intimate partner violence (IPV) and reproductive coercion (RC) assessment, four family planning clinics were randomized to IPV/RC communication-skills building workshop or standard knowledge-based IPV/RC training and compared to historical controls from the same clinics (before any training). Female patients aged 16-29 completed after-visit surveys. Primary outcomes included provider discussion about IPV/RC, receipt of safety card with IPV/RC resources and patient disclosure of IPV/RC. Chi-square tests were used to compare groups that received training and historical controls. Participants (training: n = 103; historical control: n = 576) were predominantly white with mean age of 22. More patients reported discussion about healthy relationships in both training groups (78-90%) compared to historical controls (49-52%, P < 0.001 for both). Discussion on birth control sabotage and pregnancy coercion was infrequent with patient-participants in both groups (6-17 and 4-13%, respectively). More patients in the clinics that received training reported receiving a safety card (72-84%) as compared to historical controls (9%, P < 0.001 for both). Overall, in this exploratory study, both communication-skills and standard training improved frequency of IPV communication when compared to historical controls but with few differences when compared to each other.