Health Care and Female Survivors of Childhood Sexual Abuse: Health Professionals' Perspectives

The present study explored health professionals' experiences with adult survivors of child sexual abuse in New Zealand. Face-to-face, semistructured interviews of up to an hour took place with 13 health professionals. The participants were asked about training, screening practices, their response to disclosures, and advice to other health professionals. A model—transition to ethical practice—emerged from the data, where delivering more sensitive health care to child sexual abuse survivors sits on a continuum from lack of awareness of child sexual abuse to delivery of care where all patients are comfortable. We recommend making sensitive care for all as the standard care of practice and providing training for health professionals on how to deal with disclosures.     

Changes in Sexual Distress,Depression and Sexual Function after Clitoral Reconstruction in Women with Female Genital Mutilation/Cutting

Abstract

Background: Female genital mutilation/cutting (FGM/C) links health complications and psychological distress. However, there is scarce literature on how women with FGM/C respond to treatment interventions. Objective: In this study, we aimed to assess changes in depression symptomatology, sexual function, and distress following clitoral reconstructive surgery combined with a psychoeducational intervention. Methods: The reconstructive surgery consisted of recovering the remaining clitoris and placing it externally and as close to the vagina as possible. FGM/C patients (n?=?27) received psychological support and sexual counseling upon undergoing the surgical intervention and were further assessed at 6-month follow-up. Moreover, they completed the Beck Depression Inventory and the Female Sexual Distress Scale Revised at these two time points. Patients’ sexual dysfunction was assessed according to DSM-5 criteria. Results: Statistically significant clinical changes after FGM/C were reported. Overall, patients presented reduced depression and sexual distress levels, and decreased female sexual interest/arousal disorder prevalence. Results also revealed that sexual distress improvements were more significant in Type I FGM/C patients. Conclusions: Significant improvements in sexual distress, psychopathology, and sexual function were observed in our sample following reconstructive surgery, suggesting that combined interventions are effective for treatment.     

Promotion of Sexual Health in the United States

Abstract

The United States has been experiencing a severe sexual health crisis in the last decade. This paper reviews these sexual health challenges and discusses a major initiative and a “Call to Action” that was launched by the U.S. Surgeon General in 2001 to promote sexual health. This led to several initiatives to overcome obstacles that were preventing the development of a sound, scientifically based public health policy to promote sexual health. This paper specifically outlines the components of the Sexual Health Program housed at the Morehouse School of Medicine's National Center for Primary Care, including the National Advisory Council and the National Consensus Process.     

Sexual Health Interventions for Black Women in the United States: A Systematic Review of Literature

Objective: The purpose of this systematic review was to identify and evaluate approaches used in sexual health interventions targeting Black women in the United States. Methods: We conducted a review of 15 sexual health intervention studies for Black women published between January 2000 and May 2017 in the United States. Results: Each intervention focused on HIV/sexually transmitted infection prevention, incorporated an asset and deficit-based approach, primarily used individual-level assets, and was effective in achieving the stated sexual health-related outcomes. Conclusions: Comprehensive sexual health interventions require further development and refinement to include more community and institutional-level assets to improve long-term sustainable change and empower Black women.     

Experience of Forced Sex and Subsequent Sexual,Drug, and Mental Health Outcomes: African American and Hispanic Women in the Southeastern United States

ABSTRACT. Objectives: This cross-sectional study examined African American and Hispanic women's (N = 1,509) self-reports of unwanted forced sex and its association with behavioral and mental health outcomes after the event. Methods: Twenty percent of the women had experienced forced sex (1st occurrence at age 15 years or younger for 10%, 1st occurrence at older than 15 years of age for 10%). Results: Regardless of when forced sex 1st occurred, women were more likely to have engaged in unprotected vaginal and anal sex, to have had multiple unprotected sex partners, to have sexually transmitted infections, to have reported binge drinking and illicit drug use, and to exhibit distress and have received mental health counseling. Conclusions: Forced sex may have wide-ranging behavioral and mental health consequences years later.     

A Review of Human Papillomavirus (HPV) Infection and HPV Vaccine-Related Attitudes and Sexual Behaviors Among College-Aged Women in the United States

Abstract Objective: To identify human papillomavirus (HPV) infection and HPV vaccine-related attitudes among college-aged women and the relationship between HPV vaccine uptake and subsequent sexual behaviors. Methods: PubMed, MEDLINE, CINAHL, and Google Scholar searches were performed from 2006, the date after the first HPV vaccine became available, to present. Results: Of the 13 studies identified, most were cross-sectional. College-aged women saw HPV infection as serious and had positive attitudes toward the HPV vaccine. Barriers (ie, cost, lack of insurance coverage) existed that prevented women from obtaining the vaccine and many women did not see themselves at risk for HPV. The vaccine uptake rate, although increasing, has been slow. Conclusion: College-aged women in the United States may need unbiased information about HPV and HPV vaccine. Studies that focus on risk perception and the relationship between knowledge, attitudes, vaccine uptake, and sexual behaviors are needed to inform interventions and public health programs.     

Technology-Based Innovation for Independent Living: Policy and Innovation in the United Kingdom,Scandinavia, and the United States

Interest in utilizing technology to help older adults remain living at home is growing; however, uptake remains low. We present a conceptual framework for understanding independent living technology innovation within health and social services. Public policy and innovation in the United States, the United Kingdom, and Scandinavia are profiled as case studies. In all profiled countries, independent living technology is more rapidly advancing than associated state policy, regulation, and payment systems. The findings from this comparative analysis reveal areas for further exploration, including policy subsystem environments in which technologies and services are regulated, as well as trends and desires of older adults and their caregivers within particular cultural contexts.     

Femininity Ideology and Sexual Health in Young Women: A focus on Sexual Knowledge,Embodiment, and Agency

ABSTRACT

Traditional femininity ideology is associated with diminished sexual agency in women; yet we know little about its connection to sexual knowledge or experiences of one's body during sex. This study examined how femininity ideology related to sexual health knowledge, body comfort during sex, condom self-efficacy, and sexual assertiveness in college-age women. Femininity ideologies were related to decreased sexual-risk knowledge and lowered body esteem during sex. Femininity ideologies were also related to decreased sexual assertiveness and condom use self-efficacy. Results highlight the importance of understanding the association between femininity ideologies and sexual knowledge acquisition as an aspect of sexual agency, as well as sexual embodiment, in addition to the more commonly studied sexual self-efficacy and assertiveness.     

Marriage,Work, and Racial Inequalities in Poverty: Evidence From the United States

This article explores recent racial and ethnic inequalities in poverty, estimating the share of racial poverty differentials that can be explained by variation in family structure and workforce participation. The authors use logistic regression to estimate the association between poverty and race, family structure, and workforce participation. They then decompose between‐race differences in poverty risk to quantify how racial disparities in marriage and work explain observed inequalities in the log odds of poverty. They estimate that 47.7% to 48.9% of Black–White differences in poverty risk can be explained by between‐group variance in these two factors, while only 4.3% to 4.5% of the Hispanic–White differential in poverty risk can be explained by these variables. The findings underscore the continued but varied association between racial disparities in poverty and labor and marriage markets. Clear racial differences in the origin of poverty suggest that policy interventions will not have uniformly effective impacts on poverty reduction.     

Childlessness Among Older Women in the United States: Trends and Profiles

In the last 2 decades, the United States has seen an increase in childlessness and first births at older ages. Using the National Survey of Family Growth, we focus on women aged 35 – 44 who are voluntarily childless (expect no children and are fecund or contraceptively sterile). We compare these women to those who are involuntarily childless (fecundity impaired) and to those who are temporarily childless (expect children). Voluntary childlessness grew from 1982 (5%) to 1988 (8%), was stable up to 1995 (9%), and fell slightly in 2002 (7%). Voluntarily childless women have the highest income, prior work experience, and lowest religiosity compared to other women. This has been true since 1982, the earliest time point examined.     

The Great Recession,Fertility, and Uncertainty: Evidence From the United States

The Great Recession produced the highest rates of unemployment and foreclosure in the United States since the Great Depression. In this article the author examines the consequences of these poor economic conditions for fertility in the United States by estimating the effect of area‐level economic conditions on state fertility in the years leading up to and including the Great Recession. The economic impacts of the Great Recession, captured by state‐level economic conditions, had a strong negative effect on fertility in models with state and year fixed effects. These reductions in fertility were likely caused both by increased economic hardship and increased economic uncertainty.     

Health Social Movements in the United States: An Overview

This article reviews the literature on health social movements (HSMs) and provides an overview of their main conceptual, theoretical and empirical underpinnings. Health social movements is not a single paradigm but spans several decades’ worth of theoretical and research activity in the areas of social movements, medical sociology and social studies in science. Case studies of HSMs have been accumulating for years, and several new collections of papers attempt to systematize the various strands of health social movements research to answer questions about their origins, different strategic and political approaches to social change, their trajectories and consequences. We provide a selective overview of the literature on health social movements that explore these questions, while distinguishing between health social movements seeking greater access to healthcare, those focusing on health disparities and inequality, and those challenging the underlying science of health and healthcare. We conclude with some suggestions for the direction of future studies.     

Veiled Submission: Gender,Power, and Identity Among Evangelical and Muslim Women in the United States

The past decade has witnessed a proliferation of studies that illuminate devout women's affiliation with conservative religious communities. Despite the increasingly multicultural character of contemporary social and religious life, few studies to date have compared the experiences of conservative religious women across faith traditions. Guided by insights from cultural theory, this study begins by comparing elite gender discourses within evangelical Protestantism and Islam. Elite evangelical gender debates hinge on biblical references to women's submission. Similarly, Muslims dispute the meaning of the veil to Islamic womanhood. After outlining the contours of these debates, we draw on in-depth interview data with evangelical and Muslim women to demonstrate how these two groups of respondents negotiate gender in light of their distinctive religious commitments. In the end, we reveal that the unique cultural repertoires within these two religious communities enable women to affirm traditional religious values while refashioning such convictions to fit their post-traditional lifestyles.     

(Im)perishable Pleasure, (In)destructible Desire: Sexual Themes in U.S. and English News Coverage of Male Circumcision and Female Genital Cutting

Under what conditions do sexual pleasure and desire get addressed in news coverage of sexual health issues like female genital cutting (FGC) and male circumcision (MC)? In this study we employed an embodied ethnosexuality approach to analyze sexual themes in 1,902 items published from 1985 to 2009 in 13 U.S. and 8 English newspapers and news magazines. Journalists' discussions of sexual pleasure, desire, control, problems, and practices differed in quantity and quality depending on the practice and nation to which they pertained. News coverage in both nations presented FGC as impeding female sexual pleasure, desire, and activity in ways that reinforce (hetero)sexist understandings of sexuality. The English press depicted MC as diminishing male sexuality, whereas U.S. papers showed it as enhancing male sexuality. These patterns are influenced by, and serve to reinforce, cultural norms of embodiment and ethnosexual boundaries based on gender, race, and nationality. They may, in turn, shape public understandings of FGC and MC as social problems.     

Sexual orientation and household financial decisions: evidence from couples in the United States

We analyze how sexual orientation is related to household financial decisions using 2000 US Census data, and find that lesbian couples pay higher annual mortgages relative to house value than do heterosexual or gay couples. We also estimate that cohabiting heterosexuals pay more than their married counterparts. We link this homosexual-specific differential to homeowners’ propensity to save. This differential reflects the gender composition of same-sex households, and their very low fertility, in addition to the precautionary motives increasing cohabiting couples’ propensity to save relative to married ones. Evidence from retirement and social security income of older couples exhibits the same pattern of differentials by sexual orientation and cohabiting status.