Women's Construction of Embodiment and the Abject Sexual Body After Cancer.

Cancer and cancer treatments can cause significant changes to women's sexual well-being. We explored how women construct a sense of their bodies and sexual "selves" in the context of cancer. Sixteen women, across a range of ages (20-71 years), cancer types, and cancer stages, took part in in-depth semistructured interviews. We conducted a thematic discourse analysis, drawing on feminist poststructuralist theory, identifying "the abject body" as a dominant theme. Participants constructed abject bodies as being "beyond abnormality," "outside idealized discourses of embodied femininity," and "out of control." The women's accounts varied in management and resistance of the abject body discourse, through bodily practices of concealment, resisting discourses of feminine beauty, and repositioning the body as a site of personal transformation. The corporeality of the cancerous body can be seen to disrupt hegemonic discourses of femininity and sexuality, with implications for how women practice and make meaning of embodied sexual subjectivity.

Facilitating communication about sexual health between aging women and their health care providers.

Many women experience changes in sexual health as they age, and discussing these changes with health care providers is an essential component of optimal health management. The purpose of this study was to understand aging women's perspectives about communicating with providers about sexual health. We used the integrative model of behavioral prediction as a theoretical lens to explore women's attitudes, perceived norms, and perceived self-efficacy that promote or inhibit the likelihood of communicating about sexual health. In this theory-based qualitative study, we interviewed 28 community-dwelling older women in the Midwestern United States. Through thematic analysis, we identified both positive and negative attitudes about communicating with providers. Women seemed most inclined to discuss sexual health if they perceived that important patient-provider conditions, such as trust and rapport, were in place. Despite situational obstacles and perceived norms, these women held strong beliefs about their abilities to discuss sexual health topics with providers.

Bundles of Norms About Teen Sex and Pregnancy.

Teen pregnancy is a cultural battleground in struggles over morality, education, and family. At its heart are norms about teen sex, contraception, pregnancy, and abortion. Analyzing 57 interviews with college students, we found that "bundles" of related norms shaped the messages teens hear. Teens did not think their communities encouraged teen sex or pregnancy, but normative messages differed greatly, with either moral or practical rationalizations. Teens readily identified multiple norms intended to regulate teen sex, contraception, abortion, childbearing, and the sanctioning of teen parents. Beyond influencing teens' behavior, norms shaped teenagers' public portrayals and post hoc justifications of their behavior. Although norm bundles are complex to measure, participants could summarize them succinctly. These bundles and their conflicting behavioral prescriptions create space for human agency in negotiating normative pressures. The norm bundles concept has implications for teen pregnancy prevention policies and can help revitalize social norms for understanding health behaviors.

Youth Perspectives on Sexual Health Workshops: Informing Future Practice.

Newcomer and street-involved youth provided their perspective on the design and content of a sexual education workshop. Following the workshop, focus group discussions were held with 80 youth from four youth-serving agencies. Youth expressed increased levels of confidence and empowerment, consistent with recent criticism that a focus on specific behaviors as intervention outcome measures may miss important psychosocial changes in participants. Some youth views on cultural adaptation of workshops were not consistent with current views expressed by some adult educators, highlighting the need to ensure a youth perspective is captured during intervention development. Finally, the dichotomous views that youth expressed regarding workshop activities emphasizes a research gap related to how best to adapt interventions to different cognitive capacities, literacy levels, and learning styles. Information of this kind is relevant in terms of knowledge translation from youth to program planners and educators.

The sexuality experience of older widows in Korea.

Sexuality plays an important role in elders' lives. However, few studies exist concerning the essential meaning crucial for the overall understanding of sexuality in later life. In this study we explored the experience of what sexuality implied and meant to older widows using the descriptive phenomenological approach. Purposive sampling yielded 10 elderly women who were in sexual relationships. We collected data through in-depth interviews with participants and conducted a thematic analysis. The findings were classified into eight themes: trying to find another side of herself, starting a romantic relationship, invigorating life, displaying femininity, being concerned about the perceptions of others, enjoying sexual freedom, feeling the limit of sexual intimacy, and facing up to reality. The sexual lives of older widows entailed a process of recovering their femininity, self-achievement, and self-esteem, which helped them to live independent lives by developing more active and flexible attitudes.

A culture of future planning: perceptions of sexual risk among educated young adults.

In this study we examined how social processes, specifically the acquisition of postsecondary education and capital, shaped perceptions of sexual risk and impacted sexual practices and sexual health among young adults. Using qualitative research methods we collected and analyzed data among students attending a 4-year university in the northeastern region of the United States over a 1-year period. By analyzing participants' narratives, we found that the reproduction of shared norms and values encouraged educated young adults to focus on educational and professional success, pressing many of them to be concerned about preventing pregnancy rather than preventing disease transmission, and increasing their risk for sexually transmitted infections, including HIV/AIDS. Sexual-health educators need to address how social processes shape sexual practices, encourage educated young adults to challenge unequal gender expectations, and consider how sexually transmitted infections might also interfere with life plans.

Views on sex and sex education among gang-involved Latino youth in the United States.

Although gang-involved Latino youth in the United States are uniquely at risk of adverse consequences from sexual behavior, little research is available that can guide those who wish to develop interventions to reduce sexual risk among these youth. To facilitate the development of effective interventions, we identified cultural and contextual factors that influence sexual behavior and sex education among gang-involved Latino youth in one U.S. community. By analyzing transcripts from interviews and focus groups with three different groups of key stakeholders--gang-experienced Latino youth, the parents of gang-experienced Latino youth, and the personnel of a program providing comprehensive human services for gang-involved Latino youth--we identified three domains to be considered in developing sexual risk-reduction interventions for gang-involved U.S. Latino youth. The focus of our discussion is on the implications of these findings for future development or adaptation of interventions.

No drama: key elements to the success of an HIV/STI-prevention mass-media campaign.

We qualitatively examined gay men's reactions to the national "Drama Downunder" HIV/STI social marketing campaign targeting gay men in Australia to identify key campaign elements that underpinned the demonstrated effectiveness of the campaign. We present findings from six qualitative focus groups held with 49 participants as part of the evaluation of the sexual-health-promotion campaign over 2008-2009. Participants identified attention-grabbing images, a humorous approach, positive and simple tailored messaging, and the use of mainstream media as campaign features crucial in normalizing sexual health testing, driving campaign engagement, and ensuring high message exposure. Our results suggest that designers of future campaigns should strive to balance positive and negative campaign images and messages, and find new ways to engage men with sexual health topics, particularly younger gay men. We discuss the implications of our findings about campaign effectiveness for future health-promotion campaigns and message design.

Structural factors that increase HIV/STI vulnerability among indigenous people in the Peruvian amazon.

We examined structural factors-social, political, economic, and environmental-that increase vulnerability to HIV among indigenous people in the Peruvian Amazon. Indigenous adults belonging to 12 different ethnic groups were purposively recruited in four Amazonian river ports and 16 indigenous villages. Qualitative data revealed a complex set of structural factors that give rise to environments of risk where health is constantly challenged. Ferryboats that cross Amazonian rivers are settings where unprotected sex-including transactional sex between passengers and boat crew and commercial sex work-often take place. Population mobility and mixing also occurs in settings like the river docks, mining sites, and other resource extraction camps, where heavy drinking and unprotected sex work are common. Multilevel, combination prevention strategies that integrate empirically based interventions with indigenous knowledge are urgently needed, not only to reduce vulnerability to HIV transmission, but also to eliminate the structural determinants of indigenous people's health.

Text messaging for sexual communication and safety among African American young adults.

African American young adults are at high risk of HIV infection during their lifetimes, and the male condom remains the best method of prevention. Efforts to increase condom use should address the barrier of condom negotiation. We conducted a thematic analysis of qualitative, semistructured interviews with African American young adults to examine their use of text messaging for requesting human immunodeficiency virus (HIV) or sexually transmitted infection (STI) testing and condom use within the larger context of general sexual communication using text messages. Text messaging gave participants a level of comfort and disinhibition to discuss sexual topics and negotiate sexual safety. Benefits of text messages included ease of communication, privacy, and increased ability to express condom desires. Difficulties reflected the potential relationship implications of suggesting HIV/STI testing and condom use. Condom negotiation strategies using text messages also mirrored those found to be used in face-to-face communication.

Experiences of intimacy among people with bladder exstrophy.

Previous research investigating the psychosocial and psychosexual impact of living with the complex genitourinary condition bladder exstrophy has been limited in scope and methodological quality. However, the limited evidence suggests that people with bladder exstrophy commonly encounter difficulties that might negatively impact their experiences of intimacy. We conducted an interpretative phenomenological analysis to explore intimacy in 6 participants aged 16 to 56 years. Participants discussed how their parents and later they themselves concealed their health condition. This concealment was associated with feeling safe and protected, yet shameful. Participants also discussed developing intimate knowledge of their own emerging identity while developing intimacy with others, as well as the importance of sharing the experience of bladder exstrophy with others in the development of intimate relationships. We discuss the findings in relation to theoretical issues of concealment, shame, attachment, psychosocial development, intimacy, and chronic illness.

Gay men's explanations of health and how to improve it.

Little is known about the health views of gay men. In this article we report on how gay men explained health and the ways they discussed how health for gay men can be improved. We conducted a thematic analysis of data collected from 45 gay men in 11 focus groups and identified that health was mainly explained in individual terms, as were the ways to improve health (personal health care services and health promotion). The second way health was explained drew on social and community factors, with the societal acceptance of gay men being reported as essential for health improvements. These individual and social/community approaches were in tension; overall, the individualized approaches dominated. In line with other theorizing in health, we argue that appropriate policy and service provision to meet the health needs of gay men require greater acknowledgment of the social and community explanations of health and ways of improving health.