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Padilla MB, Rodríguez-Madera S, Ramos Pibernus AG, Varas-Díaz N, Neilands TB. The social context of hormone and silicone injection among Puerto Rican transwomen. Cult Health Sex 2018; 20:574-590. [PMID: 28862522 PMCID: PMC7170493 DOI: 10.1080/13691058.2017.1367035] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This paper draws on ethnographic, qualitative and survey data with transwomen in Puerto Rico to examine the social and political-economic context of lay injection with hormone and silicone - common practices within this community. We describe specific practices of hormone and silicone injection, the actors that govern them, the market for the sale and distribution of syringes and the networks of lay specialists who provide services to a population that is neglected by and largely excluded from biomedical settings. Our data derive from ethnographic observations, sociodemographic questionnaires, surveys and semi-structured interviews conducted with a diverse group of transwomen in metropolitan San Juan, Puerto Rico. Our analysis focuses on four overlapping social domains or processes that shape the practices of lay silicone and hormone injection among transwomen: (1) the circulation of gender transitioning technologies within local and global markets; (2) the tension between the social exclusion of transwomen and their resilient sub-cultural responses; (3) the cultural meanings that shape transwomen's attitudes about injection; and (4) the perceived consequences of injection. We conclude with a discussion of the kinds of intervention and policy changes that would respond to the factors that most endanger transwomen's health.
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Affiliation(s)
- Mark B. Padilla
- Department of Global and Sociocultural Studies, School of International and Public Affairs, Florida International University, Miami, USA
| | - Sheilla Rodríguez-Madera
- Department of Social Sciences, School of Public Health, University of Puerto Rico, San Juan, USA
| | | | - Nelson Varas-Díaz
- Department of Global and Sociocultural Studies, Florida International University, Miami, USA
| | - Torsten B. Neilands
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, USA
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Padilla MB, Rodríguez-Madera S, Varas-Díaz N, Ramos-Pibernus A. Trans-migrations: border-crossing and the politics of body modification among Puerto Rican transgender women. Int J Sex Health 2016; 28:261-277. [PMID: 29354205 PMCID: PMC5774645 DOI: 10.1080/19317611.2016.1223256] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Mark B. Padilla
- Mailing address for first author: 11200 SW 8 Street, SIPA Room #320, Miami, FL 33199.
| | | | - Nelson Varas-Díaz
- Beatriz Lassalle Graduate School of Social Work, University of Puerto Rico, Rio Piedras
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Graham LF, Padilla MB, Lopez WD, Stern AM, Peterson J, Keene DE. Spatial Stigma and Health in Postindustrial Detroit. Int Q Community Health Educ 2016; 36:105-13. [DOI: 10.1177/0272684x15627800] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An emerging body of research suggests that those who reside in socially and economically marginalized places may be marked by a stigma of place, referred to as spatial stigma, which influences their sense of self, their daily experiences, and their relations with outsiders. Researchers conducted 60 semistructured interviews at partnering community-based organizations during summer 2011 with African American and Latina/o, structurally disadvantaged youth of diverse gender and sexual identities who were between 18 and 26 years of age residing in Detroit, Michigan. The disadvantaged structural conditions and dilapidated built environment were common themes in participants’ narratives. Beyond these descriptions, participants’ framings and expressions of their experiences in and perceptions of these spaces alluded to reputational qualities of their city and particular areas of their city that appear related to spatial stigma. Young Detroit residents articulated the ways that they experience and navigate the symbolic degradation of their city.
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Affiliation(s)
- Louis F. Graham
- Health Promotion and Policy, University of Massachusetts Amherst School of Public Health and Health Sciences, Amherst, MA, USA
| | - Mark B. Padilla
- Global and Sociocultural Studies, Florida International University, Miami, FL, USA
| | - William D. Lopez
- Health Behavior Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Alexandra M. Stern
- Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Danya E. Keene
- Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
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Holloway IW, Padilla MB, Willner L, Guilamo-Ramos V. Effects of minority stress processes on the mental health of Latino men who have sex with men and women: a qualitative study. Arch Sex Behav 2015; 44:2087-2097. [PMID: 25367595 PMCID: PMC4418960 DOI: 10.1007/s10508-014-0424-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 09/24/2014] [Accepted: 10/05/2014] [Indexed: 06/04/2023]
Abstract
Emerging literature on minority stress among sexual minority populations has described the negative consequences that multiple minority statuses may exert on mental health and well-being. This literature has tended to focus on individuals whose self-identifications reflect sexual minority sexual categories, such as gay or bisexual, and has explored the intersection of these definitions with ethnic, racial, and class statuses. Few such studies have explored mental health among men who actively deny a sexual minority sexual identity label while engaging in same-sex sexual behaviors. The present study used ethnographic interview data from 20 non-gay-identified bisexually behaving Dominican and Puerto Rican men in New York City. Participants described discovery of same sex sexual behavior as a threat to their intimate relationships, community affiliation, and counter to expectations of Latino masculinity. Recounting a wide range of information management strategies used to avoid open disclosure about their sexual lives, participants experienced the potential consequences of disclosure as extreme and even life threatening. Men anticipated social isolation, depression, self-injury, and suicidality as possible outcomes from disclosing sexual behavior with other men to their female romantic partners. This analysis provides direction for future research on minority stress processes and mental health service delivery among Latino men who have sex with men and women.
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Affiliation(s)
- Ian W Holloway
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, 3250 Public Affairs Building, Box 951656, Los Angeles, CA, 90095-1656, USA,
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Graham LF, Crissman HP, Tocco J, Hughes LA, Snow RC, Padilla MB. Interpersonal Relationships and Social Support in Transitioning Narratives of Black Transgender Women in Detroit. Int J Transgend 2014. [DOI: 10.1080/15532739.2014.937042] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Graham LF, Reyes AM, Lopez W, Gracey A, Snow RC, Padilla MB. Addressing Economic Devastation and Built Environment Degradation to Prevent Violence: A Photovoice Project of Detroit Youth Passages. ACTA ACUST UNITED AC 2013. [DOI: 10.1353/clj.2013.0019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Connolly MD, Padilla MB, Reyes AM, Natsui S. Beyond ‘state pimpage’: insights from local leaders on HIV/AIDS prevention in the Dominican tourism industry. Critical Public Health 2012. [DOI: 10.1080/09581596.2012.688798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Padilla MB, Guilamo-Ramos V, Godbole R. A syndemic analysis of alcohol use and sexual risk behavior among tourism employees in Sosúa, Dominican Republic. Qual Health Res 2012; 22:89-102. [PMID: 21859907 PMCID: PMC3322414 DOI: 10.1177/1049732311419865] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The Dominican Republic has high rates of HIV infection and alcohol consumption. Unfortunately, little research has been focused on the broader sources of the synergy between these two health outcomes. We draw on syndemic theory to argue that alcohol consumption and sexual risk behavior are best analyzed within the context of culture and economy in Caribbean tourism spaces, which produce a synergy between apparently independent outcomes. We sampled 32 men and women working in the tourism industry at alcohol-serving establishments in Sosúa, Dominican Republic. Interviewees described alcohol consumption as an implicit requirement of tourism work, tourism industry business practices that foster alcohol consumption, and an intertwining relationship between alcohol and sexual commerce. The need to establish relationships with tourists, combined with the overconsumption of alcohol, contributed to a perceived loss of sexual control, which participants felt could impede condom use. Interventions should incorporate knowledge of the social context of tourism areas to mitigate the contextual factors that contribute to HIV infection and alcohol consumption among locals.
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Affiliation(s)
- Mark B Padilla
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan 48109, USA.
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Haile R, Padilla MB, Parker EA. 'Stuck in the quagmire of an HIV ghetto': the meaning of stigma in the lives of older black gay and bisexual men living with HIV in New York City. Cult Health Sex 2011; 13:429-42. [PMID: 21229421 PMCID: PMC3053418 DOI: 10.1080/13691058.2010.537769] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
In this paper, we analyse the life history narratives of 10 poor gay and bisexual Black men over the age of 50 living with HIV/AIDS in New York City, focusing on experiences of stigma. Three overarching themes are identified. First, participants described the ways in which stigma marks them as 'just one more body' within social and medical institutions, emphasising the dehumanisation they experience in these settings. Second, respondents described the process of 'knowing your place' within social hierarchies as a means through which they are rendered tolerable. Finally, interviewees described the dynamics of stigma as all-consuming, relegating them to the 'quagmire of an HIV ghetto'. These findings emphasise that despite advances in treatment and an aging population of persons living with HIV, entrenched social stigmas continue to endanger the well-being of Black men who have sex with men.
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Affiliation(s)
- Rahwa Haile
- HIV Center for Clinical and Behavioural Studies, Columbia University and NY State of Psychiatric Institute, New York, USA.
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Estrada-Martínez LM, Padilla MB, Caldwell CH, Schulz AJ. Examining the influence of family environments on youth violence: a comparison of Mexican, Puerto Rican, Cuban, non-Latino Black, and non-Latino White adolescents. J Youth Adolesc 2010; 40:1039-51. [PMID: 21188487 DOI: 10.1007/s10964-010-9624-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Accepted: 12/12/2010] [Indexed: 10/18/2022]
Abstract
Existing research rarely considers important ethnic subgroup variations in violent behaviors among Latino youth. Thus, their risk for severe violent behaviors is not well understood in light of the immense ethnic and generational diversity of the Latino population in the United States. Grounded in social control theory and cultural analyses of familism, we examine differences in the risk for severe youth violence, as well its associations with family cohesion, parental engagement, adolescent autonomy, household composition, and immigrant generation among Mexican (n = 1,594), Puerto Rican (n = 586), Cuban (n = 488), and non-Latino Black (n = 4,053), and White (n = 9,921) adolescents with data from the National Longitudinal Study of Adolescent Health. Results indicate a gradient of risk; White youth had the lowest risk for severe violence and Puerto Rican youth had the highest risk compared to all other racial/ethnic subgroups. Within-group analysis indicates that family factors are not universally protective or risk-inducing. While family cohesion decreased the risk of severe violence among all groups, parental engagement was associated with increased risk among Blacks and Whites, and adolescent autonomy was associated with increased risk among Puerto Ricans and Cubans. In addition, Cuban and White adolescents who lived in single parent households or who did not live with their parents, had higher risk for severe violent behaviors than their counterparts who lived in two parent households. Among Latinos, the association of immigrant generation was in opposite directions among Mexicans and Cubans. We conclude that family and immigration factors differentially influence risk for violence among Latino subgroups and highlight the significance of examining subgroup differences and developing intervention strategies that are tailored to the needs of each ethnic subgroup.
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Affiliation(s)
- Lorena M Estrada-Martínez
- Center for Research on Ethnicity, Culture, and Health, University of Michigan, SPH I 1415 Washington Heights, Ann Arbor, MI 48109, USA.
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Keene DE, Padilla MB, Geronimus AT. Leaving Chicago for Iowa's "Fields of Opportunity": Community Dispossession, Rootlessness, and the Quest for Somewhere to "Be OK". Hum Organ 2010; 69:275-284. [PMID: 21037928 PMCID: PMC2964883 DOI: 10.17730/humo.69.3.gr851617m015064m] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In recent years, urban development and public housing demolition have posed challenges to the social and geographic rootedness of low-income African Americans in urban areas. In particular, in Chicago, widespread public housing demolition, occurring in the context of rapid gentrification, has contributed to increasing shortages of affordable low-income housing. This study uses in-depth interviews and participant observation to examine the migration experiences of men and women who have left urban neighborhoods and public housing developments in Chicago searching for affordable housing and economic opportunity in eastern Iowa. This particular analysis focuses on experiences of social and geographic "rootlessness" that emerged as a major theme in these interviews. Participants describe community dispossession in Chicago that has threatened not only the ties between individuals and their social support networks, but also connections and claims to the places in which these ties are rooted. Narratives that describe leaving Chicago in this context and then trying to get by as a stigmatized outsider in "someone else's city" speak to a process of dislocation that may disrupt critical social-support resources that are known to mitigate the consequences of structural disadvantage.
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Affiliation(s)
- Danya E Keene
- postdoctoral fellow at the University of Michigan Population Studies Center
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Keene DE, Padilla MB. Race, class and the stigma of place: moving to "opportunity" in Eastern Iowa. Health Place 2010; 16:1216-23. [PMID: 20800532 DOI: 10.1016/j.healthplace.2010.08.006] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Revised: 08/02/2010] [Accepted: 08/03/2010] [Indexed: 10/19/2022]
Abstract
In this paper, we explore how the stigmatization of place is transported to new destinations and negotiated by those who carry it. Additionally, we discuss the implications of 'spatial stigmatization' for the health and well-being of those who relocate from discursively condemned places such as high-poverty urban neighborhoods. Specifically, we analyze in-depth interviews conducted with 25 low-income African American men and women who have moved from urban neighborhoods in Chicago to predominantly white small town communities in eastern Iowa. These men and women, who moved to Iowa in the context of gentrification and public housing demolition, describe encountering pervasive stigmatization that is associated not only with race and class, but also with defamed notions of Chicago neighborhoods.
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Affiliation(s)
- Danya E Keene
- University of Michigan Population Studies Center, Ann Arbor, MI 48106, USA.
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Padilla MB, Pingel E, Renda E, Reyes AM, Fiereck K. Gender, sexuality, health and human rights in Latin America and the Caribbean. Glob Public Health 2010; 5:213-20. [PMID: 20397083 DOI: 10.1080/17441691003688816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Mark B Padilla
- a Department of Health Behaviour and Health Education School of Public Health , University of Michigan , Ann Arbor , MI , USA
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Abstract
The Caribbean has the highest HIV rates outside of sub-Saharan Africa. In recent decades, tourism has become the most important Caribbean industry. Studies suggest that tourism areas are epicenters of demographic and social changes linked to HIV risk, such as transactional sex, elevated alcohol and substance use, and internal migration. Despite this, no formative HIV-prevention studies have examined tourism areas as ecologies that heighten HIV vulnerability. HIV/AIDS research needs to place emphasis on the ecological context of sexual vulnerability in tourism areas and develop multilevel interventions that are sensitive to this context. From our review and integration of a broad literature across the social and health sciences, we argue for an ecological approach to sexual health in Caribbean tourism areas, point to gaps in knowledge, and provide direction for future research.
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Affiliation(s)
- Mark B Padilla
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 109 Observatory St, Room 3830, Ann Arbor, MI 48108, USA.
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Abstract
While theories of "structure" and social inequality have increasingly informed global health efforts for HIV prevention--with growing recognition of the linkages between large-scale political and economic factors in the distribution and impact of the HIV/AIDS epidemic--there is still little theorization of precisely how structural factors shape the very bodies and sexualities of specific populations and groups. In order to extend the theoretical understanding of these macro-micro linkages, this article examines how the growth of the tourism industry in the Dominican Republic has produced sexual practices and identities that reflect both the influence of large-scale structural processes and the resistant responses of local individuals. Drawing on social science theories of political economy, embodiment, and authenticity, I argue that an understanding of patterns of sexuality and HIV risk in the region requires analysis of how political-economic transformations related to tourism intersect with the individual experiences and practices of sexuality on the ground. The analysis draws on long-term ethnographic research with bisexually behaving male sex workers in two cities in the Dominican Republic, including participant observation, in-depth interviews, focus groups, and surveys. By examining the global and local values placed on these men's bodies and the ways sex workers use their bodies to broker tourists' pleasure, we may better understand how the large-scale structures of the tourism industry are linked to the specific meanings and practices of sexuality.
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Affiliation(s)
- Mark B Padilla
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 109 Observatory, Room #M3820, Ann Arbor, MI 48109, USA.
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Padilla MB. 'Western Union daddies' and their quest for authenticity: an ethnographic study of the Dominican gay sex tourism industry. J Homosex 2007; 53:241-275. [PMID: 18019077 DOI: 10.1300/j082v53n01_11] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This article draws on ethnographic research among two categories of male sex workers in the Dominican Republic in order to describe the relationships between gay male tourists and the Dominican men they hire on their trips to the Caribbean. Drawing on both qualitative interview data and quantitative surveys, the discussion examines the usefulness of theories of 'authenticity,' as they have been applied in the analysis of tourist practices more generally, in accounting for the behaviors and practices of male sex workers and their foreign gay clients. While the flow of international remittances from 'Western Union daddies' to their Dominican 'boys' creates a continuous reminder of the utilitarian nature of the exchange, both sex workers and clients are motivated to camouflage this instrumentality in their construction of a more 'authentic,' fulfilling relationship. The article examines the consequences of this ambivalent negotiation for the emotional and economic organization of gay male sex tourism in the Caribbean.
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Affiliation(s)
- Mark B Padilla
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor 45109-2029, USA.
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