Methodological challenges of designing a survey to capture young people’s (non-binary) affiliations in relationship to religion,sexuality and gender

ABSTRACT

Large-scale population studies surveying young people in relation to their worldviews have tended to frame their identities in a fixed and limited capacity while also treating the topics of religion/spirituality and sexuality/gender as discrete categories of scholarly analysis. We highlight the affordances and limitations of foregrounding fixed religious, sexual and gender-based identity categories in the process of collecting and analysing data related to the worldviews of young people. In this paper we argue the value of studying the complexities and intersections of these identities and worldviews together in one study. We do this through reference to the Australia’s Generation Z (AGZ) study: the first nationally representative sample focused on providing an evidence-based understanding of both the religious/spiritual/non-religious and sexuality/gender identities and worldviews of young Australians aged 13–18. We discuss how we built on existing surveys in designing the AGZ survey. We also demonstrate how this survey allowed for the incorporation of young people’s non-binary understandings of religion, sexuality and gender.     

Relative Efficacy of a Pregnancy,Sexually Transmitted Infection,or Human Immunodeficiency Virus Prevention–Focused Intervention on Changing Sexual Risk Behavior Among Young Adults

Abstract

Objectives: Despite findings suggesting that young adults are more concerned about experiencing an unplanned pregnancy or contracting a sexually transmitted infection (STI) than becoming human immunodeficiency virus (HIV) infected, no empirical work has investigated whether the specific focus of an intervention may be more or less efficacious at changing sexual behavior. Participants: Participants were 198 college students randomized to 1 of 4 conditions: pregnancy intervention, STI intervention, HIV intervention, or a control condition during 2008–2009. Methods: The authors compared the efficacy of 3 theory-based, sexual risk–reduction interventions that were exactly the same except for an exclusive focus on preventing pregnancy, STI, or HIV. Condom use and risky sexual behavior were assessed at baseline and 4-week and 8-week follow-up. Results: Participants exposed to the pregnancy or STI interventions reported greater condom use and less risky sexual behavior than those exposed to the HIV intervention. Conclusions: The focus of sexual risk–reduction interventions may lead to differential behavior change among young adults.     

The logic of protection: narratives of HIV/AIDS in the UN Security Council

ABSTRACT

When HIV/AIDS was first addressed by the UN Security Council in 2000, it was seen as the culmination of a successful securitization process and a pivotal moment for introducing human security. However, concern for the epidemic was paired with problems in including a nonmilitary issue on the Security Council’s agenda and the fear that peacekeepers were vectors of HIV. Reports of peacekeepers being involved in sexual exploitation and abuse added to these problems. This article aims to understand how gender has informed the efforts to address these issues and to rehabilitate peacekeeping forces and the Security Council from the legitimacy challenges that arose in this context. The article argues that including nonmilitary issues on the Security Council agenda requires adjustment to fit a war/peace logic. Drawing on feminist theories on security and protection, the analysis shows that the security narrative on HIV/AIDS did not form a coherent protection logic until the 2011 reformulation, when HIV/AIDS was constructed as part of the problem of wartime rape. This reformulation is interpreted as an appropriation of gender equality to reproduce a military security doctrine.     

Between rhetoric and reality: disabled Rwandan young women’s perspectives on gender inequality in school

Abstract

This article examines the limits of national discussions on gender equality in Rwanda from the perspectives of disabled young women. Based on 16 in-depth interviews and three focus group interviews with disabled Rwandan young women, this article points out that the barriers to gender equality are interpersonal and institutional. The empirical analysis reveals that gender biases at Rwanda’s largest inclusive secondary school are reinforced by wider cultural and religious norms, which endorse the subordination of disabled girls and young women in school. The study suggests that the equality rhetoric/reality gap will remain in Rwandan schools and society if the wider cultural and religious institutions are not examined and transformed.     

Gender conformity,self-objectification,and body image for sorority and nonsorority women: A closer look

Sororities have been identified as placing young women at risk for body image concerns due to a focus on traditional gender role norms and objectification of women. Objective: This study assessed the relationship between conformity to feminine gender role norms, self-objectification, and body image surveillance among undergraduate women. Participants: In a random sample of undergraduates, the authors examined data from sorority and nonsorority women. Methods: In a random sample of undergraduate women, the authors assessed the impact of traditional feminine gender role norms on self-objectification, body image, and feedback regarding physical appearance for sorority and nonsorority undergraduate women. Results: Three linear regressions were conducted, and only conformity to feminine gender role norms contributed significantly in each regression model. Conclusions: Regardless of sorority membership, conformity to feminine gender role norms was found to significantly contribute to increased body consciousness, negative body image, and feedback on physical appearance.     

The Effect of Gender on Sex-Role Attitudes

Abstract

An examination of the contradiction between college student studies and national public opinion polls.

The evidence concerning the existence and magnitude of gender differences in sex-role attitudes is contradictory. A large number of studies, based primarily on college samples, have reported significant gender differences in the sex-role attitudes of young adults; males have been found to be more traditional than females. However, studies based on national samples including all age and educational groups have not found consistent gender differences. In order to investigate this contradiction, NORC General Social Survey was aggregated from the years 1974 through 1978 to create a data set that included a large number of young adults who were currently attending or who had recently attended college. Both age and education were found to be significant predictors of sex-role attitudes, but for most of the items examined gender differences were not found to be larger for young adults than for older adults. For both age groups larger gender differences were found in items pertaining to caring for children than for items pertaining to women's roles in the public sphere.     

HIV Voluntary Testing among Portuguese Women Attending Family Planning Clinics: Implications for HIV Prevention Education and Testing

ABSTRACT

Objectives: The aim of this article is to analyze the factors associated with HIV testing among 767 sexually active women. Methods: Participants were administered several self-report questionnaires that assessed behavioral and psychosocial measures. Results: Overall, 59.8% of the participants reported ever having tested for HIV. Results show that higher levels of education, being pregnant or having been pregnant, concern about AIDS, AIDS knowledge, self-efficacy in condom negotiation and perception of no risk in partner significantly predicted the likelihood of testing among women. Attending the mass was negatively associated with HIV testing. Conclusions: These findings provide information that can be used in the development of a focused gender sensitive HIV prevention program to increase HIV testing.     

Meeting the needs of adolescents living with HIV through home based care: Lessons learned from Tanzania

PurposeHome based care is central to HIV care and support throughout Africa. Most programs have not addressed the unique needs of adolescents living with HIV, who display lower retention in HIV care and treatment adherence. This study examined the experiences of adolescents living with HIV in Tanzania in order to identify ways to improve home based care to better meet their needs.MethodsWe conducted a qualitative study in Dar es Salaam and Tanga Region consisting of in-depth interviews with 14 adolescents living with HIV, 10 primary caregivers, and 12 providers assigned to their households. Interviews examined adolescents' experiences of growing up with HIV, perceptions of current home based care, and challenges in increasing acceptability of services.ResultsWe found the program did not align well with adolescents' expectations. Adolescents felt home based care to be more relevant to their caregivers and did not form independent relationships with providers. They expressed anxiety that participation might lead to inadvertent disclosure of their status and consequent discrimination. Both adolescents and their caregivers felt disappointment that no material or financial support was available despite widespread poverty, although they appreciated receiving psychosocial support and practical referrals. Providers demonstrated motivation to work with adolescents but acknowledged lacking requisite skills such as ways to communicate with young people and key messages to deliver.ConclusionsDespite challenges, we identified feasible adaptations to make home based care more adolescent-centered. These include actively engaging adolescents in program design, improving provider training in communication with adolescents, and proactively addressing unrealistic expectations. Finally, increasing referral links to a wider range of services could improve program effectiveness by integrating it into a broader development approach.     

‘He enjoyed it more than I did’!: young British Sikh women negotiating safe sex in heterosexual encounters

ABSTRACT

Sex education and relationship strategy of the U.K. allows parents to withdraw their children from sex education, which has left many young people especially those from Black Minority and Ethnic communities with low or no sex education. Similarly, the government's policy environment enables faith schools to teach these subjects under the tenets of their faith. This empirical research was carried out in South-West London using 12 qualitative interviews with women and men (ages 18–20 years) discusses young women's experiences of their first sexual encounter who navigate their reputations, relationships as well as negotiate safe sex in the absence of appropriate relationships and sex education. Sex education not only brings into focus sensitivities around gender but also tensions around religion in the U.K. Evidence from the study suggests that despite the importance placed by the Indian community on maintaining virginity, young women asserted that religion and culture did not prohibit them from exploring their sexuality. In this study, the priority is to present young women's voices and experience of sexual encounters.     

Alternative Practicum in Health Education

Abstract

Young African American men in the inner city have higher rates of mortality and morbidity from potentially preventable causes than other American men of the same age. They suffer disproportionately high rates of preventable illness from violence, sexually transmitted diseases, and HIV infection. These young men present with problems related to sexual concerns, mental health issues, substance abuse, and violence. They also report substantial risk-taking behaviors, including unprotected sex, substance use, and weapon carrying, as well as exposure to violence. Access to and use of preventive primary care services has been limited for these patients in the past because of financial barriers and competing social issues. Racism and historical oppression have created barriers of mistrust for young men of color. Factors that contribute to their adverse health status, as well as ways to address these problems, are discussed.     

Perspectives on disclosure among children living with HIV in India

BackgroundFollowing the widespread uptake of anti-retroviral therapy (ART), young children living with HIV are entering adolescence and beyond, necessitating disclosure of HIV status. However, few studies have described children's experiences following disclosure.MethodsWe assessed disclosure status among children attending HIV clinics at two tertiary-care centers in southern India. Children who had disclosure were administered a pre-tested questionnaire assessing their knowledge about HIV, ART, experiences following disclosure, perceived stigma and ideas about their future. The association of the children's responses with social desirability bias was examined using a modified social desirability scale.ResultsTwenty-four caregiver-child dyads participated in this study. They constituted a subset of children who had been told of their HIV diagnosis from a larger study of 247 dyads. Mean age at disclosure was 10.9 ± 2.5 years. Medical personnel were responsible for disclosure to 14 children, parents/caregivers to 3 children, both medical and care personnel together to 4 children and other relatives to remaining 3 children. Disclosure was met with acceptance by one-third of the children. Despite disclosure, five children did not know how HIV spreads, and three were unaware about how infection could be prevented. Notwithstanding their positive status, 20 children felt that they were treated well at school and by their immediate relatives, although 11 children mentioned that they needed to hide while taking ART. Social desirability bias did not play a role in the responses given by these children.ConclusionsThe rate of disclosure of HIV status among children living with HIV in India was low, even among older children. Most children accepted their status, but knowledge about HIV and ART was inadequate. Disclosure was predominantly performed by medical personnel, rather than the primary caregiver. Incorporating disclosure into the care process for older children is likely to be beneficial, and should be recognized as an iterative process with a need for incorporating cultural sensitivities and a comprehensive approach to health education.     

Context is Everything

SUMMARY

As we approach the third decade of AIDS, HIV prevention in the United States confronts expanding public concern about continuing infections among gay men. This paper provides a brief history of HIV prevention efforts among gay men in the United States, as well as a succinct analysis of its successes and failures. By focusing on lessons learned from work in the 1980s-as well as lessons which have not yet' been learned-the author suggests future directions in HIVprevention for gay men which emphasize critical analysis of epidemiological trends, and countering the merging of gay identity with HIV infection. Supporting men to gain greater authority and responsibility¹ for their sexual community-building and redevelopment is necessary for lowering the infection rate among successive generations of gay men.     

Beyond the Gender Differential: Very Young Children Coping with HIV/AIDS

This article reports on a recent study of HIV/AIDS which investigated the role of gender in the experiences of young children in one region of Namibia. The findings reveal that while gender is reported to shape school‐age girls and boys’ experiences of being infected or affected by HIV/AIDS in many African nations, gender was not an influential variable in the experiences of very young children coping with HIV/AIDS. Conditions of poor health, deprivation and stigma were equally distributed amongst young girl and boy participants. Connectivity with families and communities was shown to be influenced by living conditions but not differentiated by gender. No gender differences were identified regarding young childrens’ sense of hope and vision for the future. The article implies that there may be a particular juncture when gender begins to make a difference in the life of girls and boys—and that this could be an important focus for research. Copyright © 2006 The Author(s).     

Evaluation from a Gender+ Perspective as a Key Element for (Re)gendering the Policymaking Process

ABSTRACT

Feminist scholars have challenged the neutrality of policymaking processes and the outputs resulting from these processes. However, some elements of policymaking have not been studied as well as others. In this article I explore the concept of evaluation from a gender+ perspective as an essential step for a complete gender mainstreaming strategy, which can help to identify gender issues that should be integrated into the content of evaluated policies and to ensure gender does not get lost in the policymaking process. This exploration is carried out by relying on feminist policy and evaluation studies.     

The relation between cultural values and condom use among Latino gay men

ABSTRACT

Latino men who have sex with men (MSM) are the second largest group to be affected by human immunodeficiency virus (HIV). Latino cultural values may influence sexual behaviors that can result in HIV acquisition. This study explored the relations among traditional machismo, caballerismo, familismo, unprotected anal intercourse (UAI), and the appeal of sex without condoms (ASWC) among Latino gay men. Results indicated that higher levels of familial honor and traditional machismo predicted higher levels of ASWC. These findings suggest that exploration of gender roles and family are important factors to be included in HIV prevention and intervention programs.     

‘Pain on Top of Pain,Hurtness on Top of Hurtness’: Social Discrimination,Psychological Well-Being,and Sexual Risk Among Women Living With HIV/AIDS

ABSTRACT

This qualitative study explored how a subsample (n = 26) of participants in Protect and Respect (N = 184), a safer-sex intervention for women living with HIV/AIDS (WLH/A), discussed their experiences of social discrimination and the impact of discrimination on their lives, psychological well-being, and risk behaviors during group intervention sessions. The majority of participants was Black (83%), earned less than $10,000 per year (80%), and acquired HIV through heterosexual sex (58%). Analyses demonstrated that social discrimination manifested in the women's lives as poverty, HIV/AIDS-related stigma, and gender inequality. These experiences caused intense psychological distress and limited WLH/A's ability to implement the safer-sex skills that they learned during the intervention. We discuss the applied and theoretical implications of our findings, advocating for HIV and sexual risk-reduction interventions that are based on an ecological framework that addresses holistically the individual, relational, and sociostructural factors that affect women's sexual risk behaviors.     

Measuring Gender Disparity in the HIV Pandemic: A Cross‐National Investigation of Female Empowerment,Inequality, and Disease in Less‐Developed Nations

Current research recognizes that the HIV pandemic uniquely impacts women, as they are socially and biologically more vulnerable to the infection. However, present measurement strategies focus on assessing the level of HIV infection among women, rather than inequality in the distribution of HIV cases by gender in less‐developed nations. In this study, we compare the cross‐national determinants of the level of female HIV prevalence to the determinants of the percentage of HIV cases among women. Ordinary least squares (OLS) regressions suggest that the predictors of female HIV differ across the two measures, where aspects of female empowerment and female access to health resources are more influential in explaining the distribution of HIV cases across gender than the level of female HIV prevalence. These results suggest that analyzing the distribution of HIV cases by gender is a more appropriate way to measure gender disparities in the HIV pandemic. Therefore, future research should be cautious to consider the implications of investigating levels of HIV versus the distribution of HIV cases across populations.     

‘Yes,I Am More than Just That’: Gay/Bisexual Young Men Residing in the United States Discuss the Influence of Minority Stress on their Sexual Risk Behavior Prior to Hiv Infection

ABSTRACT. Rates of HIV infection in the United States are markedly over-represented among gay/bisexual young men (GBYM), especially those who are African American and Latino. The degree to which minority stress may explain racial disparities in HIV incidence is understudied in GBYM. This qualitative study examined racial/ethnic-minority and sexual-minority stress and their perceived influence on HIV infection in a sample of GBYM living with HIV. Findings indicated that racial/ethnic-minority stress more often emerged during sexual interactions, while sexual-minority stress was often family-based. Our discussion offers recommendations for primary HIV prevention efforts for GBYM.     

Determinants Influencing Male Condom use Among University Students in Portugal

ABSTRACT. A self-administered questionnaire was carried out among university students in Portugal, with the aim to examine determinants influencing male condom use, according to the information–motivation–behavioral skills model (J. Fisher & Fisher, 1992). Students’ levels of information, motivation, and behavioral skills regarding preventive sexual behavior (male condom use) were ascertained and were used to determine their association with condom use among 880 male and 1,807 female students aged 18 to 35 years old. Although 86.9% of respondents indicated that they used a condom during their first sexual intercourse, only 32.8% used a condom always during sexual intercourse in the last 12 months. Most young people, especially women, had a good level of information regarding HIV/AIDS transmission/prevention. They also showed reasonable positive attitudes and had positive subjective norms and intentions toward HIV/AIDS preventive behaviors. Men presented a higher perceived difficulty and a lower perceived effectiveness of HIV/AIDS preventive behavior, therefore reporting higher risk acceptance. A path analysis revealed that preventive sexual behavior did not depend directly on information level but on motivation and behavioral skills (especially among men). Information about HIV prevention/transmission was not significantly associated with condom use. The finding that motivation and behavioral skills were the strongest determinants of condom use suggested that these may be important factors in effective sexually transmitted infection-prevention programs.     

Issues Related to HIV Stigma in Nepal

ABSTRACT

We conducted a qualitative study to understand and describe experiences of people living with HIV and AIDS with regard to HIV-associated stigma in Nepal. The study has revealed four key themes associated with HIV stigma: a hierarchy of stigma (sexual transmission and women stigmatized more than injecting-drug transmission and men); exclusion and rejection (denial of care services, rejection from family); death as a form of punishment (untimely death is seen as a punishment for something done wrong in the past); and Mumbaiya disease (caught from working in “other places”). Cultural contexts are the best ways to understand HIV stigma in Nepal along with socially and culturally established gender roles. This study has confirmed that stigma manifests at different levels: individual, social, and structural, with denial and rejection being a key mechanism of stigma.