Qualitative research on homosexual and bisexual behavior relevant to HIV/AIDS

The spread of the international AIDS pandemic has drawn attention to the urgent need for data on human sexual behavior; yet the lack of an established tradition of theory and method in sex research has limited the development of research initiatives in this area. This has been particularly true in the study of homosexual and bisexual behavior, which has relied heavily on the use of quantitative survey methods that largely fail to address cross‐cultural differences in the structure and meaning of same‐sex sexual experience. More qualitative approaches offer the possibility of investigating homosexual and bisexual behavior within a broader social and cultural context and can therefore play an important role in developing a framework for the comparative analysis of behavioral data. This article seeks to contribute to the development of theory and method in sex research by outlining key research issues and possible methodologies for the qualitative investigation of homosexual and bisexual behavior in relation to HIV/AIDS.     

Vietnamese American sexual behaviors & HIV infection

This brief report presents some preliminary findings of an on‐going ethnosexual field study of Vietnamese American sexual behaviors in Orange County, California, and indicates how they may be related to HIV infection. The primary objective of the study is to gather data on those sexual behaviors having the highest likelihood of transmitting the AIDS virus. The field research data indicate that in the ‘Vietnamese American population, highly acculturated Vietnamese homosexual men, whose partner preference is primarily for Anglo men with whom they play both sexual roles in anal intercourse, appear at present to be at highest risk for HIV infection. Transmission of the AIDS virus within the Vietnamese American population may be facilitated by Vietnamese American men who practice unsafe sex with both Anglo and Vietnamese men. The field research data also indicate that a potential exists for the spread of HIV into the heterosexual population through the sexual activity of Vietnamese men with non‐Vietnamese female prostitutes in California and Mexico, and through the sexual activity of ‘Vietnamese men with Thai and Vietnamese prostitutes in Thailand and Vietnam while on return visits to Southeast Asia.     

Mexican and Mexican American male sexual behavior & spread of AIDS in California∗

Data generated by the authors' field research on the bisexual and homosexual behaviors of men of Mexican origin living in southern California are presented and compared with the same behaviors of Anglo men in California and Mexican men in Mexico. Preferences for playing either the anal receptive or insertive sexual role and a focus on anal intercourse by unacculturated and less acculturated men of Mexican origin who have sex with men are the sexual behaviors judged to be most significantly different from Anglo men who have sex with men in California. Sexual socialization and acculturation were found to be the most important determinants of whether an individual's adult patterns of homosexual behavior will be more or less influenced by Mexican or Anglo homosexuality in spite of the length of time they may have lived in California. Evidence is presented about the effects that acculturation, preference for a sexual role in anal intercourse, and endogamy have on the spread of the AIDS virus in the Mexican origin population in California.     

An Investigation of the Incidence of Client-Perpetrated Sexual Violence Against Male Sex Workers

ABSTRACT

This article discusses exploratory research investigating the incidence and context of client-perpetrated sexual violence against male sex workers. Four different methods (Web-based surveys, tick-box questionnaires, telephone, and face-to-face interviews) were employed in this study of 50 male escorts. The qualitative data were analyzed using an adapted form of grounded theory. It was found that client-perpetrated sexual violence within male sex work appears to be uncommon. However, when sexual violence did occur the cause was a disagreement over barebacking. Escorts’ explanations for the low level of sexual violence within this sector included (1) that gay men were non-confrontational, (2) their clients led clandestine lifestyles avoiding undue attention, and (3) comparatively, female sex workers were perceived to be more vulnerable resulting in the higher level of sexual violence within the female sex work industry.     

“Empowered Criminals and Global Subjects”: Transnational Norms and Sexual Minorities in India

In this paper, I comparatively examine the influence of transnational advocacy on legal struggles around sex work and homosexuality in contemporary India. While transnational scholars of sexuality understand globalization as a contradictory and uneven process, there has been little attention to how this unevenness is manifest in the realm of sexual rights and law. Based on qualitative research, I show how transnational discourses on health—in particular, HIV/AIDS interventions—and on human rights interact unevenly with national discourses on sexuality. Whereas discourses regarding HIV/AIDS enable sex workers to mobilize at the national level, global anti-trafficking discourses effectively reduce sex workers to “victims.” For Indian LGBTQ groups, discourses regarding the HIV/AIDS epidemic and global human rights enable these groups to problematize the anti-sodomy law in national politics. However, national legal discourses effectively reduce LGBQ individuals to “criminals,” and legal advancements in this arena are uneven. Focusing on this unevenness produced by transnational advocacy this paper highlights how sexual rights are articulated in context of asymmetric and uneven globalizations.     

A mixed-methods examination of sexual coercion and degradation among women in violent relationships who do and do not report forced sex

Although partner sexual abuse is clearly an important dimension of partner violence, it has received less research attention than partner physical and psychological abuse. This article contributes to the literature by examining similarities and differences in coercive and degrading sexual tactics experienced by women who do (n = 31) and women who do not (n = 31) report forced sex using quantitative and qualitative data. The women in the sample had all been recently (within the past 6 months) stalked by a violent intimate partner. Results suggest that both women who do and women who do not report forced sex experience various coercive and degrading tactics within the context of sexual activity. Results also suggest that multiple sexual abuse dimensions should be considered within the context of partner psychological abuse, physical abuse, and stalking and that more research on understanding the outcomes associated with dimensions of sexual abuse within the context of physical and psychological abuse is needed.     

The impact of family structure and social change on adolescent sexual behavior

This article presents a biophysical perspective on adolescent sexual feelings and behavior. The study particularly analyzes sexual attraction, desire, and mate selection as evolutionary adaptations just as important to species survival. Sex differences in mating strategies are described as part of this evolutionary adaptation. Recent research findings demonstrate how these strategies explain contemporary sexual and reproductive behavior in Western societies today, as they do sexual behavior in the past or across diverse cultures. The implications of this analysis are significant to intervention efforts to postpone sexual initiation and avert nonmarital births. Discussion on demographic and normative changes that affect adolescent sexual behavior included trends in sexual maturation and changing marriage norms. The author urges greater emphasis on the early pubertal years; increased attention to teaching adolescents more about their own sexual development; a less absolutist focus on sexual abstinence, which may be appropriate and more feasible for 12 year olds but not for 16 year olds; better and more widespread sex education at earlier ages and throughout the school curriculum; frank discussion of all the options available for those who experience an unwanted pregnancy; and same level of attention towards adolescent boys and girls.     

Sexual behavior and AIDS knowledge of young male prostitutes in Manhattan

Despite their presumed high risk for AIDS, there are almost no sexual behavior data available which are sufficient for the development and assessment of intervention programs for male prostitutes. This study was designed to obtain such data. Fifty 14–27‐year‐old male prostitutes in Manhattan were interviewed using structured instruments to assess sexual orientation, sexual behavior, knowledge of AIDS, and substance abuse. The sample was 50% homosexual, 26% bisexual, and 24% heterosexual. High rates of condom use were found for anal intercourse (average 85%). Subjects were safest in sex with male customers, less safe with male partners for pleasure, and least safe with female partners. Differential use of condoms plus other unsafe sexual activities continue to place the male prostitute at risk for HIV infection. AIDS knowledge was high and positively correlated with safety of sex. Drug and alcohol abuse and dependence were frequent, although there was little intravenous drug use. These and other variables were not significantly associated with degree of safety in sex. The methods employed in this study can be used to assess other populations of male prostitutes as well as intervention programs.     

Contributions of Qualitative Research in Informing HIV/AIDS Interventions Targeting Black MSM in the United States

This article presents a systematic review of qualitative studies focusing on human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) among Black men who have sex with men (BMSM) in the United States. We reviewed studies that were published between 1980 and 2014. Qualitative methods employed in the studies reviewed include in-depth interviews, focus groups, participant observation, and ethnography. We searched several databases (PubMed, PsychINFO, JSTOR, ERIC, Sociological Abstracts, and Google Scholar) for relevant articles using the following broad terms: “Black men” “Black gay/bisexual” or “Black men who have sex with men,” and “qualitative” and/or “ethnography.” We include 70 studies in this review. The key themes observed across studies were (1) heterogeneity, (2) layered stigma and intersectionality, (3) risk behaviors, (4) mental health, (5) resilience, and (6) community engagement. The review suggests that sexual behavior and HIV-status disclosure, sexual risk taking, substance use, and psychological well-being were contextually situated. Interventions occurring at multiple levels and within multiple contexts are needed to reduce stigma within the Black community. Similarly, structural interventions targeting religious groups, schools, and health care systems are needed to improve the health outcomes among BMSM. Community engagement and using community-based participatory research methods may facilitate the development and implementation of culturally appropriate HIV/AIDS interventions targeting BMSM.     

A Test of an Adapted Multiple Domain Model in Predicting Sexual Behaviors Among Unmarried Young Adults in India

Theory-based, scientific research examining sexual behaviors of young adults is sparse in India, even though pre-marital sex among unmarried young people has been rising in recent years. At the same time, young people aged 15 to 24 are disproportionately affected by HIV/AIDS. This has been attributed in part to rising pre-marital sexual behaviors, coupled with a lack of sex education. The objective of this study was to advance an understanding of the determinants of sexual behavior among unmarried young adults in northern India. An adaptation of a comprehensive model of health behavior, the Multiple Domain Model, was employed to study the effects of environmental/cultural influences (parental and media), structural determinants (sex, socioeconomic status, age, caste, and place of residence), personality factors (sensation-seeking and impulsive decision making), gender role identity, psychosocial variables (attitudes, norms, and self-efficacy), contextual influences (relationship status and alcohol/drug use) and preparatory behaviors (frequency of being in sexual situations) on adolescents' sexual behaviors. Results of path analysis indicated that key predictors of ever having had vaginal sex included preparatory behaviors, masculine gender role identity, attitudes toward having sex and peer norms regarding sex. Implications of these findings for future research and intervention are discussed.     

Adaptive training for existing male transsexual gender role: A case history

The development of AIDS interventions for adolescents is hindered by the lack of data on the conditions that influence high‐risk sexual behavior. We examined psychosocial correlates of condom use and multiple partner sex for a sample of sexually‐active heterosexual adolescent women. Respondents reported higher levels of vaginal intercourse than the “average” adolescent. A minority were engaging in anal intercourse. Condom use was associated with perceived enjoyment of condoms and communication skills. Number of sexual partners was associated with susceptibility beliefs, social norms, and sexual communication skills. The findings support the general observation that AIDS interventions with adolescents should build sexual communication skills, address motivational issues, and teach people how to enjoy safe‐sex activities.     

A theory-based approach to understanding sexual behavior at Mardi Gras

Using the Triandis Model of Interpersonal Behavior (TIB), we considered the unique context of Mardi Gras, the annual festival in New Orleans, Louisiana, and how it might influence sexual behavior. This study utilized a two-stage, qualitative and quantitative methodological framework. Focus groups of past Mardi Gras participants were held to gather data to inform the development of the study instruments, and data were subsequently collected from 300 Mardi Gras participants in February 2004 using a pencil-and-paper questionnaire. For women, the TIB model did not significantly predict intentions to engage in sexual behavior at Mardi Gras. Cognitive beliefs and subjective social norms predicted intentions to engage in oral and vaginal sex among male participants. For men and women, peer sexual activity, intentions, and previous sexual experience predicted engaging in sexual behaviors at Mardi Gras. Situational conditions related to Mardi Gras culture predicted anal sex behavior. The TIB, as a guiding framework for the study, makes apparent the importance of cultural context when developing interventions related to sexuality that are to be implemented in a specific setting like Mardi Gras.     

LG(BT) Families and Counting

Counting and understanding lesbian and gay families have gained attention over the last decade in popular culture, policy, and academic research. Contentious debates on family values and same‐sex marriage, increasing rates of social tolerance for homosexuality, and a greater general academic attention on issues of sexual orientation have partially spurred this attention in demographic analysis of lesbian and gay families. It is becoming increasingly clear that sexual orientation and gender identity have an effect on demographic processes and life outcomes. Although not perfect, practically speaking, drawing on nationally representative survey data has allowed us to illuminate the presence of same‐sex families and their children. These findings have an iterative relationship with social change, public policy, and increasing tolerance for diversity. This article reviews the recent demographic contributions related to lesbian, gay, bisexual, and transgender (LGBT) families. Due to research concentrations, the content of this article not only mostly addresses what is known about gay and lesbian families but also offers future directions to fill research voids including a call for greater attention to and visibility for families with bisexual and transgender members.     

Returning to sexual stigma: post‐trafficking lives

This article is concerned with returning to sexual stigma in two key respects. First, it prompts a return to the conceptual understanding of sexual stigma and makes an important contribution to critiques of the individualized frameworks that have dominated much of the literature on stigma to date, through a critical analysis of sexual stigma as a collective process at different scales and locations. Second, using empirical data from a qualitative study of post‐trafficking experiences of women in Nepal as a case study to develop theoretical understandings of the production of stigma, it explores modalities of sexualized stigma encountered on return from trafficking situations. Within the trafficking literature there has been very little attention to what happens after trafficking. This article addresses this gap in focusing on lives post‐trafficking and, in addition, contributes to the limited research on trafficking in Nepal.     

Review of Chinese sex attitudes & applicability of sex therapy for Chinese couples with sexual dysfunction

Although sex therapy techniques have widely been used to help Western couples with sexual dysfunction, there has been little research on the applicability of these techniques among Chinese couples. This article discusses the Chinese views and concepts of sex and sexual dysfunction in the past and present, culturally bound sexual problems, and gender role stereotypes. We suggest that with careful integration of the therapeutic techniques with Chinese sex concepts, sex therapy can be applied to Chinese couples experiencing problems in sexual functioning.     

TOO MANY MEN? SEX RATIOS AND WOMEN'S PARTNERING BEHAVIOR IN CHINA

The relative numbers of women and men are changing dramatically in China, but the consequences of these imbalanced sex ratios have received little attention. We merge data from the Chinese Health and Family Life Survey with community-level data from Chinese censuses to examine the relationship between cohort- and community-specific sex ratios and women's partnering behavior. Consistent with demographic-opportunity theory and sociocultural theory, we find that high sex ratios (indicating more men relative to women) are associated with an increased likelihood that women marry before age 25. However, high sex ratios are also associated with an increased likelihood that women engage in premarital and extramarital sexual relationships and have had more than one sexual partner, findings consistent with demographic-opportunity theory but inconsistent with sociocultural theory.     

Forced Sexual Experiences and Sexual Situation Self‐Efficacy Among South African Youth

Nearly 20% of South African youth experience forced or coerced sexual intercourse. Understanding the factors associated with forced sex is important for informing prevention programs aimed at reducing sexual violence and HIV and AIDS. Multilevel regression models test the association between sexual situation self‐efficacy and forced sex among 2,893 South African adolescents. Findings suggest that youth are more likely to experience forced sex after periods of time when their levels of self‐efficacy are lower than their average levels of self‐efficacy. Furthermore, youth who are lower on their self‐efficacy compared to their peers are more likely to experience forced sex. Implications for prevention research are discussed.     

Imbalanced sex ratios, men's sexual behavior, and risk of sexually transmitted infection in China

China has been experiencing pronounced changes in its sex ratio, but little research has explored the consequences of these changes for sexual behavior and health. We merge data from the 1999-2000 Chinese Health and Family Life Survey with community-level data from the 1982, 1990, and 2000 Chinese censuses to examine the relationship between the local sex ratio and several dimensions of men's sexual behavior and sexual health. Multilevel logistic regression models show that, when faced with a relative abundance of age-matched women in their community, Chinese men are slightly less likely to have intercourse with commercial sex workers, but are more likely to engage in premarital noncommercial intercourse and to test positive for a sexually transmitted infection. These findings are consistent with hypotheses derived from demographic-opportunity theory, which suggests that an abundance of opposite-sex partners will increase the risk of early, frequent, and multi-partner sex and, through this, sexually transmitted infection risk.