Narratives of development, experiences of risk: Adult women's perspectives on relationships and safer sex

Gender differences in the relationship of sexual partnership characteristics and inconsistent condom use among people living with HIV in China

Few studies have examined the relationship between inconsistent condom use and sexual partnership characteristics among people living with HIV (PLWH). The current study focused on such association and its gender differences. The study was conducted in a large hospital in South China in 2013. A total of 320 dyads (PLWH indexes and their sexual partners) were recruited from an outpatient clinic using convenience sampling. The proportion of inconsistent condom use in the last six months among female indexes was higher than that among male indexes (52.4% vs. 43.6%). Of sexual partnership characteristics, HIV seropositive status was a risk factor for inconsistent condom use for both male and female indexes (aOR = 2.32, 95%CI = 1.15∼4.66, aOR = 3.09, 95%CI = 1.10∼8.67, respectively). For male indexes, lower educational level was also a risk factor (aOR = 2.39, 95%CI = 1.23∼4.67); while having had emotionally intimate relationships was a protective factor (aOR = 0.40, 95%CI = 0.21∼0.77). For female indexes, receiving material support was a risk factor (aOR = 10.17, 95%CI = 2.13∼48.61) and receiving health-related advice was a protective factor (aOR = 0.11, 95%CI = 0.02∼0.55). Future HIV interventions for PLWH need to be gender-sensitive and include their sexual partners.

Psychosocial factors influencing risk-taking in middle age for STIs

OBJECTIVES

To increase the knowledge of the psychosocial factors influencing sexual risk-taking for STIs among adults in late middle age.

METHODS

Individual interviews were conducted either face to face or by telephone with 31 heterosexual men and women aged between 45 and 65. They were recruited from NHS sexual health services (n=16) and council run culture and leisure facilities (n=15) in a large Scottish city. A total of 18 women and 13 men were interviewed. All interviews were transcribed in full and thematically analysed.

RESULTS

Analysis detailed important psychosocial and sociocultural factors; the prioritisation of intimacy above and beyond concerns about risks for STI in sexual partnerships; the importance of unwanted pregnancy in shaping risk perceptions throughout the life course; vulnerability associated with periods of relationship transition (eg, bereavement, divorce or separation); social norms and cultural expectations relating to age-appropriate sexual and health-seeking behaviours.

CONCLUSIONS

This is the first qualitative study to examine the factors associated with sexual risk-taking among heterosexual adults in late middle age in the UK. Many factors associated with sexual risk-taking are similar to those reported within other populations. However, we also detail population-specific factors, which should be considered in terms of the development of interventions for 'at risk' older adults, or the tailoring of wider behaviour change interventions to this specific age group.

The Impact of Condom Use Negotiation Self-Efficacy and Partnership Patterns on Consistent Condom Use Among College-Educated Women

This study sought to explore the impact of condom negotiation self-efficacy, interpersonal factors, and sensational factors on condom use behavior among a population of college-educated women with different patterns and types of sexual partner. We administered an online questionnaire capturing sexual behavior, partnership patterns, perceived benefits of and barriers to condom use, and condom use negotiation self-efficacy. A total of 433 women completed the online survey. Perceived sensual, erotic, and interpersonal benefits and barriers to condom use, along with negotiation self-efficacy, were found to be significantly associated with consistent condom use. When compared to respondents reporting only main partners, respondents reporting only casual partners were more likely to use condoms while respondents reporting both main and casual partners were least likely to use condoms. Previous negative experiences with condoms were significantly associated with decreased condom use, while history of sexually transmitted infection diagnosis was not consistently associated with condom use. This study supports the importance of negotiation self-efficacy in promoting condom use; however, building women's self-efficacy is not enough for effective condom use promotion among women. The impact of interpersonal, sensual and erotic factors, as well as the context of different partnership patterns, must be considered in future interventions.

Sex and relationships on the street: how homeless men judge partner risk on Skid Row

Homeless men in the U.S. represent a large and growing population, and have elevated rates of HIV/AIDS and sexual risk behaviors, including unprotected sex with women. We conducted qualitative interviews (n = 30) with homeless men using shelters and meal lines in downtown Los Angeles (Skid Row) to better understand how such men view the risks of sexual encounters with female partners. Men living on Skid Row perceived multiple risks, including HIV and unwanted pregnancy as well as emotional trauma, loss of resources, exacerbation of drug addiction, and physical attack. Respondents described using visual and behavioral cues, social reputation, geographical location, feelings of trust, perceived relationship seriousness, and medically inaccurate "folk" beliefs to judge whether partners were risky and/or condom use was warranted. Medically inaccurate beliefs suggest the potential utility of evidence-based interventions to change such beliefs. We also consider implications for relationships on the street and housing interventions.

"And let me see them damn papers!" The role of STI/AIDS screening among urban African American and Puerto Rican youth in the transition to sex without a condom

Common strategies employed in preventing STI/AIDS transmission among young adults in America include abstinence, monogamy and safer sex. These strategies require a high level of vigilance and responsibility and, according to inner city participants in Project PHRESH.comm, neither option is always desirable, available, or rational in the context of their lived experiences. This article reports findings from Project PHRESH.comm, a mixed-method, ethnographic study incorporating data from focus group discussions, semi-structured interviews, coital diaries, systematic cultural assessments and a structured survey designed to explore concepts of risk and decision making about condom use among at risk African American and Puerto Rican young adults aged 18-25 years in Hartford, CT. We found that many young adults from our study population rely on a strategy of using clinic-sponsored STI/AIDS screening when wanting to discontinue condom use with a partner. While our data suggest that screening is a common strategy used by many couples to transition to having sex without a condom, the data also show that most youth do not maintain monogamy even in long-term, serious relationships. Thus, sharing test results may provide a false sense of security in the sexual culture of inner city, minority youth.

Women narrate later life remarriage: Negotiating the cultural to create the personal

Narrative provides a window to experience in a way that is different from traditional research methods. In this study, narrative affords both a holistic vantage point on later life relationships, and at the same time, a "view from the inside"-older women's own accounts of single life, relationship development, and remarriage. The narratives were obtained in interviews with eight recently remarried women between the ages of sixty-five and eighty. A two-stage analysis addresses, first, the narrative content-the phenomenology of remarriage for these older women. The second stage focuses on process, analyzing how cultural-level narratives are drawn upon in the creation of the women's personal stories. Based upon these analyses, we discuss the ways that a narrative approach can inform our understanding of later life relationships, and we comment on the potential of narratives such as these to rewrite a script for older women's relationships.