Young Women's Use of a Vaginal Microbicide Surrogate: The Role of Individual and Contextual Factors in Acceptability and Sexual Pleasure

Currently in clinical trials, microbicides have historically been promoted as a woman-controlled (although more recently woman initiated) method of sexually transmitted infection (STI) prevention. The contradicition that exists in this rationale is that women's bodies, specifically the genitals, have been constructed as a negotiated space within sexual interactions. This study qualitatively explored the factors influencing 40 young women's use of a vaginal moisturizer (VM), utilized as a microbicide surrogate. The results indicated that use of the VM was dependent upon product characteristics (i.e., the lubricating qualities affect on sexual pleasure, timing of insertion), individual factors (i.e., reproductive health goals, experiences with side effects of existing contraceptive methods), and contextual factors (i.e., social norms). An understanding of these bodily and social issues may be beneficial in designing targeted educational campaigns and effective instructional materials as well as in facilitating positive dialogue around women's bodies and their sexuality.     

Shattering the Myth of Invulnerability: Exploring the Prevention Needs of Sexual Minority Women Living with HIV/AIDS

Developing effective safer-sex programs for women living with HIV/AIDS (WLH/A) is a national HIV prevention priority. Existing programs focus predominantly on heterosexual women's experiences and ignore the needs of sexual minority women (SMW). Thus, we conducted semi-structured interviews with 16 sexual minority WLH/A to better understand their sexual risk behaviors and corresponding HIV prevention needs. Most of the interviewees were African American (75%) and poor (75%). We used strategies of Grounded Theory to code the interviews for key themes, which included the following: differences between relationships, risk, and protective behaviors in male and female relationships; links between substance abuse and unsafe sex; need for safer-sex or prevention programs to address SMW-specific skills and topics; and the importance of addressing women's resiliency and the social context of women's risk in prevention programs. Conclusions include concrete suggestions to make safer-sex programs more responsive to the needs of SMW.     

Gender attitudes,sexual violence,and HIV/AIDS risks among men and women in Cape Town,South Africa

This study examined gender attitudes and sexual violence‐supportive beliefs (rape myths) in a sample of South African men and women at risk for HIV transmission. Over 40% of women and 16% of men had been sexually assaulted, and more than one in five men openly admitted to having perpetrated sexual assault. Traditional attitudes toward women's social and gender roles, as well as rape myths, were endorsed by a significant minority of both men and women. Multivariate analyses showed that for men, sexual assault history and rape myth acceptance, along with alcohol and other drug use history, were significantly related to cumulative risks for HIV infection. In contrast, although we found that women were at substantial risk for sexually transmitted infection (STI), including HIV, women's risks were only related to lower levels of education and alcohol use history. We speculate that women's risks for STI/HIV are the product of partner characteristics and male‐dominated relationships, suggesting the critical importance of intervening with men to reduce women's risks for sexual assault and STI/HIV.     

An Examination of Employed Mothers' Work-Family Narratives and Perceptions of Husbands' Support

Abstract

In this study I examine the role of husbands' supportive communication practices in serving to mediate some of the common problems that are often experienced by employed mothers. The problems that are examined in this study are work-family conflict, stress, inequity in the division of labor, and double bind beliefs. Employed mothers completed open-ended narratives of recent work-family conflicts. Wives' perceptions of their husbands' supportive communication practices were examined in the narratives. Either the presence or absence of husbands' concern was related to women's perception of inequity and work-family conflict, while husbands' participation was related to double bind beliefs. Collectively, the husbands' support practices of minimizing child care concerns, avoidance of housework, expressions of concern about housework, and participation in child care accounted for 15% of the variance in women's marital satisfaction.     

Gendered Dimensions of the HIV Pandemic: A Cross‐National Investigation of Women's International Nongovernmental Organizations,Contraceptive Use,and HIV Prevalence in Less‐Developed Nations

The human immunodeficiency virus (HIV) pandemic has a profound impact on women as a result of social and biological vulnerabilities to the infection. In this article, we explore the influence of democracy, women's international nongovernmental organizations (INGOs), and contraceptive use on female HIV rates, using indirect‐effect modeling techniques to properly test the interrelationships among key variables. Structural equation models reveal that democracy and women's INGOs work to reduce female HIV rates indirectly, by promoting the use of contraceptives among women in less‐developed nations. Despite these promising findings, the analyses also reveal that INGOs are negatively associated with sociohealth dimensions of female empowerment, which thus serves to promote HIV rates. The results suggest that interventions undertaken by INGOs may not be as successful as government programs in addressing inequalities in health and social resources for women in poor nations.     

Rapid Ethnographic Assessment of HIV/AIDS among Garífuna Communities in Honduras: Informing HIV Surveillance among Garífuna Women

ABSTRACT

Garífuna, an Afro-Caribbean ethnic group in Honduras, have among the highest HIV prevalence rates in Central America; 15- to 49-year-old Garífuna have HIV rates comparable to heterosexual transmission rates in regions of sub-Saharan Africa. The heightened rates in this age range pose a significant risk of vertical transmission from woman to child at birth. In 2006, a Behavioral Surveillance Survey plus Biomarkers (BSS+) reexamined seroprevalence of HIV, sexually transmitted infections, and HIV-related risk behaviors among Garífuna to inform HIV prevention activities and monitor trends in HIV transmission over time. To inform the BSS+ survey protocol, we conducted a rapid ethnographic assessment (REA) in Garífuna communities to specifically examine acceptability among Garífuna to be surveyed, suggest ways to minimize HIV-testing related stigma, and determine female gender-specific concerns among BSS+ respondents. Data were collected in 2 weeks in November, 2004, using a semi-structured interview guide for key informant interviews and focus groups. Seventeen key informant interviews and three focus groups were conducted; participant observation and 11 site visits were also conducted. Major findings included high Garífuna acceptability to participate in the BSS+ with key member involvement and incentives. Maintaining confidentiality at HIV testing sites is required to minimize Garífuna women's risk of intimate partner violence. Recommendations to BSS+ partners from this REA informed the BSS+ study protocol and was expected to increase participation and validity and decrease potential risks associated with women's survey participation.     

‘Behind Closed Doors’: Debt-Bonded Sex Workers in Sihanoukville,Cambodia

In the trafficking discourse and international law, debt-bonded sex workers have been defined as ‘victims of trafficking’. The hyperexploitative contractual arrangements faced by debt-bonded sex workers may be the most common form of contemporary forced labour practices in the modern industry. However, in this paper, I present women's individual experiences working under indenture in Sihanoukville, Cambodia. I do so because women's narratives raise many questions about ‘consent’ and ‘coercion’ that, to date, remain unanswered. By examining women's own perceptions of the situation, the present paper attempts to address issues related to ‘consent’ and ‘coercion’ in order to highlight some of the possible implications this has for both how we theorise about and respond to the issue of indenture.     

Conundrum of Sexual Decision Making in Marital Relationships: Safer-Sex Knowledge,Behavior, and Attitudes of Married Women in Zambia

Recent research suggests that Zambian women face an increasing risk of contracting human immunodeficiency virus (HIV) within marital relationships. Married women's perceived ability to negotiate safer sex or adopt self-efficacy practices is recognized as critical in preventing new infections within marriage. Yet women's self-efficacy practices, such as requesting condom use or refusing sex within marriage, are influenced by individual and context-specific factors. Using the 2007 Zambia Demographic and Health Survey data from 4,306 married women, this article examines the association between married women's perceived ability to negotiate safer sex and a range of attitudinal, knowledge, and sociodemographic variables. Results from complementary log-log regression models reveal that married women who have factual knowledge about HIV transmission and prevention, as well as those who have been tested for their HIV serostatus, were more likely to report they can request that their husbands use a condom. Rural married women were more likely to report they can refuse their husbands sex compared to woman in urban areas. Likewise, married women who agree that a wife is justified in refusing her husband sex if he sleeps with other women were more likely to report they can negotiate safer sex compared to women who disagree. These findings suggest that married women are able to negotiate safer sex if they have correct factual knowledge about HIV transmission and are aware of their rights within marital relations.     

HIV and the Cycle of Trauma in Gay Men

Summary

Forged within the sociocultural context of the collective trauma of AIDS, HIV prevention efforts became rigid, focusing almost exclusively on patient education as risk reduction. However, while some people have not been able to incorporate risk reduction into their behavioral patterns, others have indeed returned to high-risk behavior after a period of reduced risk as evidenced by the “Bareback” movement. HIV prevention education has overlooked the effect of oppression and sexual trauma on the lives of gay men, and the impact of these phenomena on the gay male's interest in, and ability to, negotiate safer sex. Sexual trauma has been shown to have a direct effect on HIV risk and seropositivity. Additionally, as sexual trauma (often in the form of homophobia) and HIV infection have numerous parallels, the gay man may have analogous ways of relating to, processing and dealing with the two phenomena. Case histories are offered to illustrate how the relationship between HIV and sexual trauma may be examined in an effort to enhance the self-esteem and self-concept of the gay man, and thereby offer greater possibilities for him to protect himself.     

Upsetting ‘Others’ in the Netherlands: Narratives of Muslim Turkish Migrant Businesswomen at the Crossroads of Ethnicity,Gender and Religion

In this paper we use insights from postcolonial feminism to explore the identity narratives of three Muslim businesswomen of Turkish descent in the Netherlands. We identify some of the ways in which contemporary political discourse in the Netherlands constructs Muslim ‘Others’ and discuss how this discursive positioning impacts on the multiple identities these women create for themselves in response. Postcolonial feminism challenges the discursive and material relations of both patriarchy and Eurocentric feminisms, which work together to obscure the rich diversity of women's lived experiences, their agency and identities. By exploring how Othering impacts on these women's multiple identities, we aim to enrich understandings of women's migrant entrepreneurship. These identity narratives, shared by women who each describe quite different ways of experiencing, interpreting and responding to marginalization, shed light on the West's relationship to the Other and reveal some of the underlying relations of power that shape identity.     

Vaginal reconstruction in gynecologic cancer: A feminist perspective

Vaginal reconstruction is a frequent accompaniment of or sequel to radical surgery for recurrent gynecologic cancers. After reviewing research on vaginal reconstruction, undertaken from a perspective which gives prominence to women's power over decisions concerning the use of their bodies and over the definition of their sexuality, we note that the psychosocial and sexual impact of such surgery for the patient and her partner has often been underestimated, ignored, or misunderstood. We discuss the need for vaginal reconstruction and the definition of its success in terms of researchers' Stereotypic attitudes and assumptions about female sexuality as these are exemplified in their research methodologies. This analysis raises serious concerns about what constitutes informed consent for reconstructive surgery, the medical professionals' biases about female sexuality concerning power over their own bodies, and how best to meet the sexual rehabilitation needs of women with gynecologic cancer.     

Determinants of Vaginal Cleansing,Application, and Insertion in Tete Province,Mozambique, and Products Used

Objective: In this article, we review insertion, application, and cleansing as they include the use of products other than water and have a number of harmful effects. Method: In 2007, a household survey of 919 women carried out in Tete Province, Mozambique, examined 8 vaginal practices. Results: Overall, 10% of the sexually active women reported regularly using these 3 vaginal practices concurrently. Of the women who practiced insertion, 65% used natural substances. A wider variety of products was used for applying substances on the external genitalia and for cleansing purposes. Conclusions: These findings have important implications for future HIV prevention, including in the use of microbicides.     

Rebooting and Rerouting: Women's Articulations of Frayed Careers in Science,Engineering and Technology Professions

This paper expands on previous work about women's non‐linear and frayed careers by examining the experiences of women who have attempted to return to science, engineering and technology (SET) professions in the UK and Republic of Ireland after taking a career break. These women potentially offer an important perspective on gender and career, because of the deep‐rooted, gendered associations of science and technology with masculinity. Drawing on qualitative interviews with women SET professionals, the paper identifies three narratives — Rebooting, Rerouting and Retreating — which women use to talk about their careers. Some of these women present themselves as career changers, having often made compromises and trade‐offs, while others, who have returned to their substantive professions, focus on continuity in their career narratives. The precarious nature of their careers is also apparent and in some cases leads to opting out or retreating. The paper concludes by exploring how women's scientist and technical identities persist, even among those who had not returned to work, and are drawn on in narratives of return and career change.     

Gendered Economic,Social, and Cultural Challenges to HIV/AIDS Prevention and Intervention for Chinese Women

ABSTRACT

China is experiencing the most rapidly expanding HIV prevalence in the world, with the percentage of Chinese women living with HIV/AIDS also increasing significantly. Chinese women's risk of HIV infection is heavily influenced by patriarchal cultural beliefs, Confucian doctrines, and rapid social and economic changes in China. Chinese women generally have a low level of awareness of HIV/AIDS. With inherent inferior social status and economic disadvantage, their vulnerability to HIV infection is heightened by adverse impacts of massive rural-to-urban migration, explosion of the commercial sex industry, and prevalence of gender-based violence. In order to target HIV/AIDS prevention and treatment programs for Chinese women, their specific needs and gendered obstacles must be addressed and tackled. These include strategies that aim to fight against poverty, improve education, enhance HIV/AIDS awareness, facilitate new life-skills acquisition and behavior change, make available woman-centered services for testing and treatment of HIV, and eradicate gender-based discrimination and violence. There is also an urgent need to further develop various public health infrastructure in China, especially in remote and rural areas. The pool of gender experts in China should also be expanded to conduct a thorough gender analysis and design a national response to address the evolving HIV/AIDS epidemic in Chinese women.     

How Does a “Risk Group” Perceive Risk?

Abstract

Throughout the HIV/AIDS epidemic, female sex workers have been identified as a “risk group” and interventions developed to reduce their behavioral risk-taking. Both individual and structural level programs continue to target “risks” such as multiple partners and lack of condom use. Sex workers themselves, however, are likely to view their experiences more holistically, perceiving a range of risks within their work. This paper presents qualitative data from a participatory study conducted with brothel-based migrant Vietnamese sex workers in Cambodia, illuminating one community's perceptions of the sex industry. It argues that design and implementation of effective HIV prevention activities must be based on sex workers' own interpretations and responses to risk, using them as a realistic entry point for effecting change. Actively engaging with sex workers through participatory research and projects offers the first step in shifting the current epidemiological focus toward identifying feasible, context-specific risk-reduction strategies.     

Entertainment Venue Visiting and Commercial Sex in China

ABSTRACT

Entertainment venues in China play an important role in the sexually transmitted disease (STD)/HIV epidemic. Most previous studies have focused on sex workers working in entertainment venues, but little is known about their clients. This study investigated the perceptions and behavior of the patrons visiting entertainment venues. Qualitative in-depth interviews were conducted with 30 male market vendors who visited entertainment venues at least once in the past 3 months in an eastern city in China. Information about their risky behavior, attitude toward commercial sex, and STD/HIV prevention approaches was collected. Saunas, karaoke bars, and massage centers are the most frequently visited entertainment venues. Seventy-three percent of study participants reported purchasing commercial sex at these entertainment venues. Participants expressed a very liberal attitude toward commercial sex. Seeking commercial sex was perceived as a characteristic of a male's nature. The perceived risks of STD/HIV infection do not deter participants from engaging in commercial sex. Commercial sex clients reported irregular condom use and a number of other misperceptions and improper practices toward preventing STD/HIV infection. Venue-based intervention is urgently needed to target the population. The sex workers themselves could potentially serve as “health educators” to communicate prevention information to their clients and encourage safer sex behavior.     

Men in online eating disorder recovery spaces: Gendered barriers,content moderation,and narrative experimentation

Eating disorders (EDs), once considered solely a women's health problem, have increasingly affected men. Previous research on recovery from addiction has emphasized the importance of narratives, which help provide structure and make sense of events. While narratives are often important for an individual's recovery from hardship, hegemonic narratives can be invalidating and obstacles to wellbeing. The highly gendered nature of ED recovery narratives has posed a barrier to men adopting alternative, more successful narratives, particularly in female-dominated spaces. This study examines how content moderation policies and enforcement on Tumblr, Reddit, and an ED recovery website shape men's participation in ED recovery support groups dominated by women. We find that high degrees of moderation and censorship limit men's platform participation and narrative experimentation. However, platform rules without active censorship face the same challenges. Instead, narrative experimentation and greater participation from men occur during moderate regulation because they can share their experiences while also being encouraged to find salient aspects of other, healthier narratives. We observed that men were able to break from unhelpful recovery narratives when they could masculinize the suggestions from women with more productive approaches. While past research has shown that men are particularly reliant on hegemonic masculinity when their gender is challenged, we find that phenomenon is part of a more fundamental process of reconciling ideas into one's self-concept.     

A Model Program for Increasing Treatment Access for African American Women Who Use Crack Cocaine and Are at Risk of Contracting HIV

ABSTRACT

In the United States, the threat of HIV/AIDS to African-American women's health has become the focus of much concern. This article describes a federally funded community-based program that provides services to African-American women at risk for HIV/AIDS in Nashville, TN. This program provides a culturally relevant set of interventions specific to crack cocaine users aimed at reducing substance use and HIV/AIDS risk behaviors. The model is important to the continued development of culturally relevant interventions that are vital to stemming the disproportionate rates of HIV/AIDS within the African-American community by ensuring treatment access to all populations.     

‘Dirty Work?’ Gender,Race and the Union in Industrial Cleaning

The study uses an eclectic framework and through an intersectional analysis and use of narratives explores the meaning of janitorial work, the gender division of labour (GDL), the unions and organizing for janitors engaged in industrial cleaning for a big cleaning company, Pluto, in Toronto. Pluto was organized by the Service Employees International Union (SEIU) in 2006. The study is based on the organizing drive for Pluto and uses participant observation and interview methods. Intersectional analysis is useful in understanding the worker's perceptions of the racialized, gendered and classed constitution of cleaning work as ‘dirty’ and their resistance to these constructs. We explore GDL in industrial cleaning and the construction of women's work as ‘light duty’ and men's work as ‘heavy duty’. We conclude that union membership is important not only for material benefits of the janitors but also for their alternative identity construction. However, there is a persistence of GDL and gender pay equity is not addressed seriously in the organizing drive or upon organizing.     

Repositioning culture for development: women and development in a Nigerian rural community

Most studies on women have ignored women's view of themselves in relation to their roles in community development. This study uses interview and ethnographic data from Nigeria to investigate women's narratives of themselves concerning their position in a rural cultural space in relation to community development. It explores ways of repositioning patriarchal or gender unresponsive cultures for eliciting women's potentials in community development. It emphasises how women's cultural constrains in a patriarchal community have led to a rare survival strategy – that is, the evolution of an invisible matriarchy. As a recommendation, it presents a framework for culture repositioning and a map of actors' responsibilities for its achievement. It contributes to ongoing debates on women in rural community development. It raises conceptual questions about customary practices that affect women's values in communities in Nigeria's rural areas. Finally, it presents three main lessons that can be drawn by women (and men) in traditional communities in non-Western societies.