"They Don't See Us": Asian Students' Perceptions of Sexual Violence and Sexual Harassment on Three California Public University Campuses

Sexual violence and sexual harassment (SVSH) are prevalent among college and university students; however, the experiences of ethnic minority students, especially Asians, are understudied. This study aimed to reduce this gap by exploring Asian students' perceptions of SVSH on three public university campuses in Southern California. We examined their perceptions about the campus environment related to SVSH, attitudes, and behaviors toward help seeking, and utilization of on-campus resources. A total of 23 in-depth interviews were conducted with Asian students enrolled at the three University of California campuses. Thematic coding was conducted to generate main themes and subthemes. Five main themes emerged: (a) SVSH is considered a "taboo" topic in Asian culture and family systems, and Asian student survivors are often reluctant to disclose incidents or seek support services. (b) Students did not feel their campus environments were tailored to understand or meet the sociocultural realities and needs of Asian student survivors. (c) Campus SVSH services and reporting processes were seen as non-transparent. (d) Peers were the major source of support and SVSH information, as opposed to official campus-based resources and training. (e) Survivors often conduct an internal cost-benefit analysis evaluating their decision about whether to report. This study highlights the lack of conversation surrounding SVSH in Asian families, and how the cultural stigma of sex and sexual violence prevented Asian students from receiving knowledge and resources about these topics in their families. Instead of relying on formal campus resources (e.g., Title IX and confidential advocacy services, mental health services), many students turn to their peers for support. Thus, facilitating peer support groups, training university students to support each other through SVSH incidents, and tailoring campus services to the diverse cultural backgrounds of students are key considerations to foster a safe campus environment and prevent SVSH.

The role of community and culture in abortion perceptions, decisions, and experiences among Asian Americans

Introduction

Culture and community can play a role in views, stigma, and access related to abortion. No research to date has documented the influence of culture and community attitudes on Asian American (AA) experiences accessing abortion care in the United States (US). This paper aims to fill gaps in research and understand how cultural and community views influence medication abortion access and experiences among AAs.

Methods

We used a community-based participatory research approach, which included collaboration among experts in public health, advocates, practitioners, and community partners to understand abortion knowledge, attitudes, and experiences among AAs. Using a semi-structured interview guide, we interviewed twenty-nine eligible people of reproductive age over 18 that self-identified as Asian American or mixed race including Asian American, Native Hawaiian, and/or Pacific Islander (AANHPI), and had a medication abortion in the US between January 2016 and March 2021. Interviews were analyzed and coded in NVivo 12 using a modified grounded theory approach.

Results

Participants described various influences of religion negatively impacting acceptability of abortion among their family and community. Lack of openness around sexual and reproductive health (SRH) topics contributed to stigma and influenced most participants' decision not to disclose their abortion to family members, which resulted in participants feeling isolated throughout their abortion experience. When seeking abortion care, participants preferred to seek care with providers of color, especially if they were AANHPI due to past experiences involving stigma and judgment from White providers. Based on their experiences, respondents recommended ways to improve the abortion experience for AAs in the US including, (1) more culturally aware abortion providers from one's community who better understand their needs; (2) clinics providing abortion services located in or near AA communities with signage in local languages; and (3) tailored mental health resources with culturally aware therapists.

Conclusion

This study demonstrates ways in which culture and community opinions toward SRH can influence both the acceptability of abortion and experiences seeking abortion care among AAs. It is important to consider family and community dynamics among AAs to better tailor services and meet the needs of AAs seeking abortion care in the US.

Sexual and Reproductive Health Knowledge, Attitudes, and Self-Efficacy Among Young Adult Filipino American Women

INTRODUCTION

Little is known about Filipino American women's (FAW) sexual and reproductive health (SRH). The purpose of this study was to examine the SRH knowledge, attitudes, and self-efficacy among young adult FAW.

METHOD

This was a qualitative, descriptive interpretive design. Four focus group interviews and one individual interview were conducted. Purposive sampling was used for this study. Inclusion criteria were female, Filipino American, between the ages 18 and 24 years old, and be able to understand and speak English.

RESULTS

Twelve participants (n = 12) were recruited. Three themes emerged from this study: (a) sources of SRH information; (b) influence of cultural values, religion, and intergenerational factors; and (c) facilitators of and barriers to women's health services.

DISCUSSION

Themes emerged from the content analysis identifying SRH disparities within the Filipino American community, which may inform future interventions and research on this topic.

The Association between the Quantity and Severity of Pornography Use: A Meta-analysis

Although the quantity of pornography use (QPU, i.e., frequency/time spent on pornography use) has been positively associated with the severity of pornography use (i.e., problematic pornography use, PPU), the magnitudes of relationships have varied across studies. This meta-analysis aimed to assess the overall relationships and identify potential moderating variables to explain the variation in these associations between QPU and PPU. We performed a literature search for all published and unpublished studies from 1995 to 2020 in major online scientific databases up until December 2020. Sixty-one studies were identified with 82 independent samples involving 74,880 participants. Results indicated that there was a positive, moderate relationship between QPU and PPU (r = 0.34, p < .001). The strength of relationship significantly varied across measures of PPU based on different theoretical frameworks, indicators of QPU, and sexual cultural contexts (conservative vs. permissive sexual values). Frequency was a more robust quantitative indicator of PPU than time spent on pornography use. In conservative countries, QPU showed more robust association with self-perceived PPU. Future studies are encouraged to select the measurement of PPU according to research aims and use multi-item measures with demonstrated content validity to assess pornography use. Cross-cultural (conservative/permissive) comparisons also warrant further research.

Family Sex Communication Among Arab American Young Adults: A Mixed-Methods Study

There is a significant gap in understanding the sexual health of Arab Americans. The purpose of this study is to explore family sex communication among Arab American young adults and its association with gender and sexual attitudes. We used a parallel mixed methods design and administered an electronic survey (N = 100); a subsample of 24 participants participated in five focus groups. We observed convergence in the findings. Participants reported rare occurrences of family sex communication, with women reporting less comfort than men. Family sex communication was often "unspoken," and reinforced prevailing social norms. Gender differences were reported based on sex communication topics. The most common source of sex information was peers/friends. Focus group participants perceived their parents to be more conservative and less knowledgeable about sex than they were. Future research on strategies to bridge generational differences is needed to promote family-based sex communication, given the multiple teachable moments at home.

Sistering and sexual socialisation: a discursive study of Xhosa women's sisterly interactions concerning sex and reproduction

Considerable research has been devoted to understanding and promoting parent-child sexual socialisation. Less attention has been paid to experiences of sibling interactions concerning sex. Drawing on discursive psychology, this study explores how women report interacting about sex and reproduction in their sisterly relationships. Ten in-depth interviews were conducted, using Free Association Narrative Interview technique, with five Black isiXhosa-speaking, middle-aged and working class women in South Africa. Findings show that the participants construct their sisterly interactions concerning sex drawing on three interpretative repertoires: silence; safety and secrecy; risk and responsibilisation. The silence repertoire constructs sex talk between sisters as vague and non-viable. Within the safety and secrecy repertoire, sisters are constructed as sharing sexual secrets and providing a safe space for sexual exploration. The risk and responsibilisation repertoire is deployed when understandings of 'proper' feminine behaviour and sexual purity are breached, with sisters emphasising the importance of avoiding risk and acting responsibly. Thus, alongside encouraging the expression of women's agency in relation to sexuality, sisters potentially join a patriarchal policing and the shaming of women's sexuality. These contradictory repertoires have implications for sexual health programmes and interventions targeted at family communication about sex.

Asian American Women's Recall of Conversations With Their Mothers About Sexual Health: A Secondary Analysis of Qualitative Data

ABSTRACT

Between 2010 and 2016, Asian Americans (AA) had a 35% increase in HIV diagnosis. Although mother-daughter sexual communication was found to be protective in minority populations, the opposite is true among AAs. The purpose of this study was to explore AA women's experiences of sexual communication with their mothers. Secondary qualitative analysis using analytic expansion with a phenomenological approach was used. Thematic analysis was used to search for common patterns and themes that emerged using qualitative description methodology. Twenty East and Southeast AA cisgender women, ages 18-33 years, were interviewed. The primary finding was an intergenerational gap with two themes: (a) mothers' attitudes about sexual communication and (b) content of sexual communication. Indirect sexual communication included cautionary messages consistent with previous studies. AA mothers' strong cultural beliefs created a barrier to communication. Future research should focus on the young women who want open sexual communication and could influence the next generation.

Invisible Minority: HIV Prevention Health Policy for the Asian American Population

There has been a 72% increase in the Asian American population from approximately 12 million in 2000 to 21 million in 2015. By 2050, there will be 33.4 million Asian Americans living in the United States, making this population the most rapidly growing ethnic group in the country. There is a myth that Asian Americans are a model conservative minority group in terms of sexual behavior and safe sexual practices and are not at risk of sexually transmitted infections including HIV. However, they are the only ethnic group in the United States that had a continuous increase in HIV infection rates from 4.9 per 100,000 in 2011 to 5.5 per 100,000 in 2016. Due to state and national methods of data collection for race and ethnicity with regard to sexually transmitted infection and HIV, the Asian American population's data are often limited. The purpose of this article is to identify the potential historical and political reasons why the Asian American population's HIV or sexual risk has not been fully documented and to propose potential health policy solutions.

Turning a Blind Eye: Public Support of Emergency Housing Policies for Sex Offenders

In this study, we examine the influences of citizen decision making in the context of four policy scenarios that would affect the living conditions of sex offenders (SOs) residing at an "emergency shelter" budget motel. We surveyed 773 citizens in an online survey about their support for four policy scenarios that would improve the living conditions of SOs: (a) at no cost to the respondent, (b) in exchange for a US$100 tax increase, and (c) by relocating SOs within the respondent's neighborhood (i.e., "in my backyard"/IMBY scenario). The fourth scenario involved moving nearby SOs into substandard housing located far away from the respondent (i.e., "not in my backyard"/NIMBY). While prior research finds that the public overwhelmingly supports punitive SO policies, we find that indifference is a mainstay of public opinion about improving SO housing conditions. That is, we find only modest levels of average support for any of the policy scenarios, and policy support decreased when increased taxes would be involved, compared with a "no cost" scenario. While no respondent characteristics significantly predicted policy support consistently across all four scenarios, some scenarios showed stark differences in support when considering specific respondent characteristics. Overall, these results suggest that what does affect support depends on the details of the policy being proposed, as well as who is considering the policy. We end by discussing the policy implications of our study for both policymakers and the public.

21st Century Parent-Child Sex Communication in the United States: A Process Review

Parent-child sex communication results in the transmission of family expectations, societal values, and role modeling of sexual health risk-reduction strategies. Parent-child sex communication's potential to curb negative sexual health outcomes has sustained a multidisciplinary effort to better understand the process and its impact on the development of healthy sexual attitudes and behaviors among adolescents. This review advances what is known about the process of sex communication in the United States by reviewing studies published from 2003 to 2015. We used the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, SocINDEX, and PubMed, and the key terms "parent child" AND "sex education" for the initial query; we included 116 original articles for analysis. Our review underscores long-established factors that prevent parents from effectively broaching and sustaining talks about sex with their children and has also identified emerging concerns unique to today's parenting landscape. Parental factors salient to sex communication are established long before individuals become parents and are acted upon by influences beyond the home. Child-focused communication factors likewise describe a maturing audience that is far from captive. The identification of both enduring and emerging factors that affect how sex communication occurs will inform subsequent work that will result in more positive sexual health outcomes for adolescents.

Accessing sexual and reproductive health care and information: Perspectives and recommendations from young Asian American women

OBJECTIVES

Understanding the influence of culture on how sexual and reproductive health is perceived and addressed in Asian American communities is important for the effective provision of care and health information. This study aimed to explore how and when sexual and reproductive health information is shared within Asian American families and communities, barriers and facilitators to accessing sexual and reproductive health care and information for young Asian American women, and their recommendations to improve access.

METHODS

Qualitative data were collected through six focus groups conducted with a total of 33 young Asian American women.

RESULTS

The majority of participants reported that stigma created a barrier to discussing these topics within their families and communities, and discussed ways in which they confidentially seek out care and information. Responses varied with respect to participants' preferred means of increasing access to care and information; some recommended strategies that would increase communication about these issues in their families and communities, while others expressed a desire to maintain confidentiality.

CONCLUSIONS

These findings suggest that diversified strategies are needed to connect Asian American women with sexual and reproductive health care and information in order to meet their varied preferences, including strategies that are community-driven and culturally appropriate.

Factors related to sexual behaviors and sexual education programs for Asian-American adolescents

AIM

To understand the influential factors related to sexual behaviors among Asian-American adolescents and to evaluate common factors across successful sexual education programs for this population.

BACKGROUND

Despite a rapid increase in cases of STIs/HIV among Asian-American populations, there remains a need for a comprehensive understanding of the influential factors related to risky sexual behaviors for this population.

METHODS

An integrative literature review was conducted. Peer-reviewed articles and government resources were analyzed.

RESULTS

Five influential factors were identified: family-centered cultural values, parental relationship, acculturation, gender roles, and lack of knowledge and information about sex and STIs. Only two sexual educational programs met the inclusion criteria and provided evidence towards effectiveness: Safer Choices and Seattle Social Development Project.

CONCLUSIONS

The findings of this study indicate an urgent need for culturally sensitive sexual education programs that incorporate the identified influential factors, especially cultural values in order to reduce risky sexual behaviors among Asian-American adolescents.

Drug use and suicidality among Asian American women who are children of immigrants

This study investigates the association between drug use and lifetime suicidal behaviors among Asian American women (n = 720) residing throughout Massachusetts, using data collected from 2010 to 2011. Logistic regression models identified that a history of hard drug use alone or in combination with soft drug use has a significant association with both suicidal ideation and suicide attempts among Asian American women, adjusting for demographic covariates, history of psychiatric diagnosis, and family communication. These findings highlight the importance of addressing hard drug use when designing suicide prevention programs for Asian American women.

Health Risk Behavior and Sexual Assault Among Ethnically Diverse Women

Sexual assault is associated with a number of health risk behaviors in women. It has been hypothesized that these risk behaviors, such as hazardous drinking, may represent women's attempts to cope with psychological distress, such as symptoms of depression and anxiety. However, extant research has failed to evaluate these relationships among ethnic minority samples or identify the mechanisms responsible for this association. The current study examined sexual assault history and two health risk behaviors (hazardous drinking and engaging in sexual behavior to regulate negative affect) in a diverse sample of 1,620 college women. Depression and anxiety were examined as mediators of the relationship between sexual assault and health risk behaviors. There was evidence of moderated mediation, such that for European American women, but not for ethnic minority women, both forms of psychological distress were significant mediators of the sexual assault/hazardous drinking relationship. In contrast, among all ethnic groups, the relationship between sexual assault and both forms of psychological distress was mediated by the use of sexual behavior as an affect regulation strategy. Results support a need to evaluate the assault experiences of ethnically diverse women, as well as the impact of the assault on their postassault experiences including health risk behaviors and psychological adjustment. Additionally, results suggest that practitioners should carefully assess health risk behaviors among victims of sexual assault and be aware that there may be differences in the risk factors and motives for these behaviors among women of various ethnic backgrounds.

Awkward or Amazing

Although research continues to highlight significant gender differences in first coital experiences, developmental approaches suggest that some of these patterns may be age-related. Therefore, this study investigated both gender and age differences in first intercourse experiences. Open-ended responses regarding reasons for, and descriptions of, first vaginal intercourse were provided by 323 sexually active undergraduate students (65.3% female; 75.7% White; Mage = 19.87) and coded into a range of categories. Several gender and age differences emerged, such that women’s descriptions were generally less positive than men’s, and women’s reasons were more likely than men’s to emphasize relationships and emotions. However, there were also a number of similarities in women’s and men’s experiences. Those who first experienced coitus during early adolescence were more likely to describe it as awkward, were less likely to describe it as positive, and differed in their reasons from those whose first coitus occurred later. Importantly, gender differences were less pronounced among older versus younger initiates, suggesting that commonly-identified gender differences may be developmentally specific. Future research focusing on subjective aspects of first intercourse experiences should carefully attend both to age or developmental stage and to gender similarities.