RESUMO
INTRODUCTION: Sexually Transmitted Infections (STI) rates are the highest of the last 20â¯years, with people of color and women particularly affected. Ongoing research has identified risk factors (e.g., alcohol intoxication) and protective factors (e.g., risk perception) for sexual risk behaviors, such as inconsistent condom use. Depending on behavioral norms within a group, ethnic identity (EI) - the exploration and sense of belonging to one's ethnicity - may be a risk or protective factor. This study examined the relations between EI, alcohol intoxication, and STI risk perception on sexual risk intentions among women of color (WOC) and white women (WW). METHODS: Cisgender women (Nâ¯=â¯390; 35% WOC; 65% WW) completed measures and were randomly assigned to an alcohol condition (0.10% BrAC vs control). They projected themselves into an eroticized scenario and self-reported two aspects of STI risk perception (personal, partner) and two sexual risk behaviors (condomless sex intentions, condom decision abdication intentions). RESULTS: Path analysis indicated that intoxicated women endorsed higher sexual risk intentions compared to women in the control group. Personal STI risk perception was negatively associated with sexual risk intentions. Indirect effects indicated that race was indirectly associated with both indicators of sexual risk, such that WOC reported higher perceived personal STI risk and subsequently endorsed lower sexual risk intentions compared to WW. Surprisingly, EI was associated with higher perceived partner risk for WW only. CONCLUSIONS: Prevention initiatives that address STI risk perception, condom assertion behaviors, and alcohol may be effective for mitigating women's sexual risk behaviors.
Assuntos
Intoxicação Alcoólica , Infecções Sexualmente Transmissíveis , Consumo de Bebidas Alcoólicas , Preservativos , Feminino , Humanos , Intenção , Masculino , Comportamento Sexual , Parceiros Sexuais , Infecções Sexualmente Transmissíveis/prevenção & controleRESUMO
Between 20% and 50% of Asian American women report experiencing partner violence (PV). Furthermore, nearly half of PV victims experience their first assault between the age of 18 and 24 years, suggesting that Asian American college women may be particularly at risk of PV. Experiencing childhood abuse (CA) may impair women's capacity to perceive risk during a potential PV situation, increasing their risk for revictimization. The purpose of the current study was to examine differences among Asian American college women's (N = 324) in-the-moment behavioral intention, risk perception, and likelihood to stay in an abusive relationship during a progressively threatening PV scenario, based on victimization history and posttraumatic stress disorder (PTSD) symptoms. We tested three path models, each assessing the relations among CA, PV, PTSD, current and future risk perception, likelihood of staying in the relationship, and one of three behavioral intentions (soothe the perpetrator, escape, and escalation/resistance). As hypothesized, CA history positively predicted PV history and PTSD symptoms. Furthermore, CA and PV predicted more in-the-moment soothe behavioral intentions and fewer escape behavioral intentions which, in turn, predicted diminished current and future risk perception. CA and PV also predicted stronger escalation/resistance behavioral intentions, such that escalation/resistance intentions were associated with higher risk perception during a more violent part of the scenario but lower risk perception during a less violent part of the scenario. Finally, higher risk perception predicted lower likelihood of staying in the relationship. Findings indicate that victimization history is associated with increased risky behavioral intentions among Asian American college women and suggest that targeted interventions to improve assault-exposed Asian American women's awareness of risk cues may be warranted.
Assuntos
Vítimas de Crime , Transtornos de Estresse Pós-Traumáticos , Adolescente , Adulto , Agressão , Asiático , Criança , Feminino , Humanos , Violência , Adulto JovemRESUMO
The COVID-19 pandemic presents major challenges for mental health care providers. In particular, providers who treat posttraumatic stress disorder (PTSD) are now tasked with determining whether to initiate trauma-focused therapy during the pandemic and, if so, whether and how to adapt treatment. The purpose of this communication is to identify and organize key considerations for whether and how to deliver commonly used evidence-supported therapy protocols for trauma treatment-specifically, cognitive processing therapy (CPT) and prolonged exposure (PE) therapy-during the ongoing COVID-19 pandemic for adults who currently meet the criteria for PTSD. Based on relevant public health and clinical literature, we present a structured guide that can be used by treatment teams and individual providers to evaluate whether initiating CPT or PE is indicated given a particular patient-provider pair and system context amidst pandemic conditions. In addition, we suggest appropriate action steps, including problem-solving strategies, evidence-informed modifications to CPT and PE, and alternative intervention approaches.
Assuntos
Terapia Cognitivo-Comportamental/métodos , Infecções por Coronavirus/psicologia , Atenção à Saúde/organização & administração , Terapia Implosiva/métodos , Pneumonia Viral/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Atitude do Pessoal de Saúde , Betacoronavirus , COVID-19 , Continuidade da Assistência ao Paciente , Humanos , Pandemias , Cooperação do Paciente , SARS-CoV-2 , Transtornos de Estresse Pós-Traumáticos/psicologiaRESUMO
With high college enrollment and increasing alcohol use, Asian American (AA) college women may be at particular risk for experiencing alcohol-involved acquaintance rape. Although AA women have expressed the weakest intentions to report rape when compared to other ethnic groups, cultural factors influencing these intentions remain unexamined. Guided by grounded theory, 17 self-identified AA college women were interviewed about how the average AA college woman would respond to an alcohol-involved acquaintance rape. Despite awareness of benefits of disclosing rape, participants emphasized that nondisclosure would be the normative response. Three themes emerged from participants: institutional, sociocultural, and psychological contexts of nondisclosure. At an institutional level, nondisclosure referenced mental health and police services, which included Asian stereotypes and mistrust of police. Within a sociocultural context, rape nondisclosure focused on negative consequences on relationships with parents and, to a lesser extent, on friendships. Emotional avoidance and not labeling an acquaintance rape as rape were psychological strategies for rape nondisclosure. Participant's conceptualizations of mental and physical health concerns, specifically post-rape concerns, were framed within sociocultural/macrostructural contexts and may not match that of the more individualistic U.S. mainstream conceptualizations of health. Culturally sensitive rape education may be more effective in increasing rape prevention and support.
Assuntos
Consumo de Álcool na Faculdade/etnologia , Asiático/etnologia , Amigos/etnologia , Estupro/psicologia , Estudantes/psicologia , Revelação da Verdade , Adolescente , Adulto , Feminino , Humanos , Pesquisa Qualitativa , Universidades , Adulto JovemRESUMO
The need for trauma research with monoracial groups such as Asian Americans (AA) has recently been emphasized to better understand trauma experiences and inform interventions across populations. Given AA cultural contexts, posttraumatic cognitions and somatization may be key in understanding trauma experiences for this group. AA and White American (WA) trauma-exposed college women completed a survey on sexual trauma history, posttraumatic cognitions, somatic symptoms, and PTSD severity. For the overall sample, higher negative cognitions were associated with higher somatization. Asian race was associated with higher negative cognitions, which then predicted higher PTSD. Unexpectedly, WAs more strongly endorsed somatization than AAs. These findings indicate that posttraumatic cognitions may be helpful in understanding relationships between somatization and PTSD severity among those of Asian backgrounds and that the relationship between somatization and PTSD symptoms is culturally complex.
RESUMO
Sexually victimized women may make sexual decisions differently than nonvictimized women. This study used an eroticized scenario and laboratory alcohol administration to investigate the roles of victimization history, intoxication, and relationship context in women's perceptions of a male partner and their subsequent intentions for unprotected sex. A community sample of 436 women completed childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) measures. After random assignment to an alcohol or control condition, participants read and projected themselves into a sexual scenario that depicted the male partner as having high or low potential for a lasting relationship. Participants rated their perceptions of his intoxication, sexually transmitted infection (STI) risk level, and anticipated reactions to insistence on condom use. They then indicated their likelihood of allowing the partner to decide how far to go sexually (abdication) and of engaging in unprotected sex. Structural equation modeling (SEM) analyses revealed that intoxication predicted greater unprotected sex likelihood indirectly via abdication. CSA and ASA predicted partner perceptions, which in turn predicted unprotected sex likelihood. These findings indicate that, compared to their nonvictimized counterparts, sexually victimized women may respond differently in sexual encounters partly as a function of their perceptions of partners' STI risk and anticipated reactions to condom insistence.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Intoxicação Alcoólica/psicologia , Delitos Sexuais/psicologia , Percepção Social , Sexo sem Proteção/psicologia , Adulto , Criança , Feminino , Humanos , Intenção , Adulto JovemRESUMO
Childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) are strongly associated with women's alcohol use and the rates of both alcohol use and sexual assault history are higher among lesbian and bisexual women than heterosexual women. Although descriptive drinking norms are one of the highest predictors of alcohol use in emerging adults, this is the first study to examine the relationship between sexual assault history, drinking norms, and alcohol use in lesbian and bisexual women. We found that CSA severity was associated with a higher likelihood of experiencing more severe alcohol-involved ASA, more severe physically forced ASA, and was indirectly associated with more drinking behavior and higher drinking norms. Additionally, more severe alcohol-involved ASA was associated with higher drinking norms and more drinking behavior, but physically forced ASA was not. These findings help explain previous contradictory findings and provide information for interventions.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Consumo de Bebidas Alcoólicas/epidemiologia , Bissexualidade/estatística & dados numéricos , Abuso Sexual na Infância/estatística & dados numéricos , Vítimas de Crime/estatística & dados numéricos , Homossexualidade Feminina/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Adolescente , Adulto , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Consumo de Bebidas Alcoólicas/psicologia , Abuso Sexual na Infância/psicologia , Vítimas de Crime/psicologia , Feminino , Humanos , Delitos Sexuais/psicologia , Adulto JovemRESUMO
This study used an experimental paradigm to investigate the roles of sexual victimization history and alcohol intoxication in young women's sexual-emotional responding and sexual risk taking. A nonclinical community sample of 436 young women, with both an instance of heavy episodic drinking and some HIV/STI risk exposure in the past year, completed childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) measures. A majority of them reported CSA and/or ASA, including rape and attempted rape. After random assignment to a high alcohol dose (.10 %) or control condition, participants read and projected themselves into an eroticized scenario of a sexual encounter involving a new partner. As the story protagonist, each participant rated her positive mood and her sexual arousal, sensation, and desire, and then indicated her likelihood of engaging in unprotected sex. Structural equation modeling analyses revealed that ASA and alcohol were directly associated with heightened risk taking, and alcohol's effects were partially mediated by positive mood and sexual desire. ASA was associated with attenuated sexual-emotional responding and resulted in diminished risk taking via this suppression. These are the first findings indicating that, compared to non-victimized counterparts, sexually victimized women respond differently in alcohol-involved sexual encounters in terms of sexual-emotional responding and risk-taking intentions. Implications include assessing victimization history and drinking among women seeking treatment for either concern, particularly women at risk for HIV, and alerting them to ways their histories and behavior may combine to exacerbate their sexual risks.
Assuntos
Intoxicação Alcoólica/psicologia , Libido , Comportamento Sexual/psicologia , Adulto , Criança , Abuso Sexual na Infância/psicologia , Vítimas de Crime/psicologia , Etanol/farmacologia , Feminino , Infecções por HIV , Humanos , Libido/efeitos dos fármacos , Estupro/psicologia , Risco , Assunção de Riscos , Comportamento Sexual/efeitos dos fármacos , Sexo sem Proteção/psicologia , Adulto JovemRESUMO
Although links between low mate availability and increased HIV and STI risk for African American women have been documented in the literature, we know little about the impact of limited mate choices on the quality of relationships between Black men and women and how these relationship dynamics impact risk for young Black women. We conducted a qualitative study with African American female young adults (N=12) to explore the perceived impact of structural forces on African American female young adults' dating and sexual behavior. Participants reported (1) perceptions of Black men as untrustworthy and manipulative, (2) the limited and often negative roles for Black men in the larger Black community, and (3) heterosexual relationships in the Black community as increasingly influenced by economics and commerce. Recommendations for HIV prevention interventions that include micro and macro level approaches are discussed.
RESUMO
Scenarios simulating real-world risk situations have proven effective for substance use intervention methods and could potentially prove useful as an HIV-prevention method. This study explored qualitatively the development and use of such "in-the-moment" methods. We interviewed 97 moderate-drinking women (50 % Caucasian) after participation in an experiment requiring that they project themselves into a risky-sex scenario. Most participants (58 %) reported experiencing the scenario as a reflective tool characterized by two primary themes: (1) increased awareness of risk and (2) contemplation of behavior change. Findings suggest that "in-the-moment" methods depicting real-world risk situations and providing opportunities to reflect about behavioral choices and subsequent outcomes could prove a useful adjunct to HIV/AIDS-prevention interventions. Such methods could potentially augment existing prevention protocols.
Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Intoxicação Alcoólica/psicologia , Infecções por HIV/prevenção & controle , Assunção de Riscos , Comportamento Sexual , Adulto , Feminino , Humanos , Entrevistas como Assunto , Pesquisa Qualitativa , Fatores Socioeconômicos , Sexo sem Proteção/psicologia , Adulto JovemRESUMO
Although studies suggest that alcohol increases women's sexual desire, no studies to our knowledge have examined the effects of acute alcohol intoxication on women's sexual desire. The majority of research examining alcohol's effects on sexual arousal in women suggests that alcohol increases self-reported arousal. In an alcohol administration study in which women projected themselves into an eroticized scenario depicting a consensual sexual encounter with a new male partner, we examined the effects of alcohol and condom condition on women's sexual desire and arousal. The moderating effects of sex-related alcohol expectancies were also examined. Results revealed that alcohol intoxication was related to less desire to engage in sex with a new partner and condom presence was related to more desire. Alcohol interacted with sexual disinhibition alcohol expectancies, indicating that more expectancy endorsement was associated with greater sexual desire and self-reported arousal in the alcohol condition, but not the control condition. Condom condition had no effect on self-reported sexual arousal. The present research suggests that sexual desire merits research attention in non-clinical samples, and experimental methodology can provide valuable information about alcohol's influence on women's sexual desire, thus advancing our understanding of this relationship beyond cross-sectional correlations. The current findings also provide evidence that sex-related alcohol expectancies may play an important role in alcohol-involved sexual experiences including desire and arousal.
Assuntos
Intoxicação Alcoólica/psicologia , Consumo Excessivo de Bebidas Alcoólicas/psicologia , Preservativos , Libido/efeitos dos fármacos , Meio Social , Adulto , Nível de Alerta/efeitos dos fármacos , Tomada de Decisões/efeitos dos fármacos , Etanol/farmacologia , Feminino , Humanos , Comportamento Sexual/efeitos dos fármacos , Sexo sem Proteção/efeitos dos fármacosRESUMO
Rates of sexually transmitted infections, including HIV, vary across ethnic minority groups, yet few studies have evaluated sexual risk behaviors and their psychological correlates to determine if risk and protective factors vary by ethnicity. The purpose of the current study was to assess sexual sensation seeking (SSS), sexual inhibition (SIS1 and SIS2), and sexual excitation (SES) as correlates of risky sexual behaviors in 106 (55 male and 51 female) Asian Americans, African Americans, and Caucasian Americans. Results revealed that higher SSS was associated with more vaginal and anal sex partners. Further, the association between SSS and the number of anal sex partners was positive among Asian Americans and Caucasians, but non-significant among African Americans. SIS1 was positively associated with unprotected sex on the first date among Asian Americans and African Americans. However, the association was not significant for Caucasians. SIS2 was negatively associated with general unprotected sex, and SES was positively associated with the number of vaginal sex partners. Findings suggest that ethnicity plays an important moderating role in the relationship between sexual traits and risky sexual behaviors.
Assuntos
Etnicidade/psicologia , Comportamento Sexual/psicologia , Sexualidade/psicologia , Sexo sem Proteção , Adulto , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Asiático/psicologia , Asiático/estatística & dados numéricos , Preservativos/estatística & dados numéricos , Etnicidade/estatística & dados numéricos , Feminino , Infecções por HIV/etnologia , Infecções por HIV/psicologia , Humanos , Masculino , Fatores de Risco , Comportamento Sexual/estatística & dados numéricos , Sexualidade/estatística & dados numéricos , Infecções Sexualmente Transmissíveis/etnologia , Infecções Sexualmente Transmissíveis/psicologia , Estados Unidos/epidemiologia , Sexo sem Proteção/etnologia , Sexo sem Proteção/psicologia , Sexo sem Proteção/estatística & dados numéricos , População Branca/psicologia , População Branca/estatística & dados numéricosRESUMO
AIMS: Prior research has suggested that problematic alcohol and drug use are related to risky sexual behaviors, either due to trait-level associations driven by shared risk factors such as sensation seeking or by state-specific effects, such as the direct effects of substance use on sexual behaviors. Although the prevalence of both high-risk sexual activity and alcohol problems decline with age, little is known about how the associations between substance use disorder symptoms and high-risk sexual behaviors change across young adulthood. DESIGN, SETTING AND PARTICIPANTS: Using a community sample (n = 790) interviewed every 3 years from age 21 to age 30 years, we tested trait- and state-level associations among symptoms of alcohol and drug abuse and dependence and high-risk sexual behaviors across young adulthood using latent growth curve models. MEASUREMENTS: We utilized diagnostic interviews to obtain self-report of past-year drug and alcohol abuse and dependence symptoms. High-risk sexual behaviors were assessed with a composite of four self-reported behaviors. FINDINGS: Results showed time-specific associations between alcohol disorder symptoms and risky sexual behaviors (r = 0.195, P < 0.001), but not associations between their trajectories of change. Conversely, risky sexual behaviors and drug disorder symptoms were associated only at the trait level, not the state level, such that the levels and rate of change over time of both were correlated (r = 0.35, P < 0.001). CONCLUSIONS: High-risk sexual behaviors during young adulthood seem to be driven both by trait and state factors, and intervention efforts may be successful if they are either aimed at high-risk individuals or if they work to disaggregate alcohol use from risky sexual activities.
Assuntos
Transtornos Relacionados ao Uso de Substâncias/psicologia , Sexo sem Proteção/psicologia , Adulto , Transtornos Relacionados ao Uso de Álcool/psicologia , Feminino , Humanos , Masculino , Assunção de Riscos , Fatores de Tempo , Sexo sem Proteção/estatística & dados numéricos , Adulto JovemRESUMO
This study examined the role of Asian ethnicity as a moderator of drinking outcomes associated with alcohol-related sexual assault (incapacitated rape). Participants were 5,467 Asian American and White college women. Results found the overall MANOVA for ethnicity and incapacitated rape (IR) interactions to be significant. Asian American participants with no history of IR had fewer drinking problems than White American participants with no history of IR. Asian American participants with IR histories had more drinking problems than White Americans with IR histories. Findings indicate Asian Americans who experience IR may be at increased risk for negative alcohol outcomes.