ResearchPad - sexual-and-gender-issues https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Sexual norms and the intention to use healthcare services related to female genital cutting: A qualitative study among Somali and Sudanese women in Norway]]> https://www.researchpad.co/article/elastic_article_15732 Female Genital Cutting (FGC) is a traditionally meaningful practice in Africa, the Middle East, and Asia. It is associated with a high risk of long-term physical and psychosexual health problems. Girls and women with FGC-related health problems need specialized healthcare services such as psychosexual counseling, deinfibulation, and clitoral reconstruction. Moreover, the need for psychosexual counseling increases in countries of immigration where FGC is not accepted and possibly stigmatized. In these countries, the practice loses its cultural meaning and girls and women with FGC are more likely to report psychosexual problems. In Norway, a country of immigration, psychosexual counseling is lacking. To decide whether to provide this and/or other services, it is important to explore the intention of the target population to use FGC-related healthcare services. That is as deinfibulation, an already available service, is underutilized. In this article, we explore whether girls and women with FGC intend to use FGC-related healthcare services, regardless of their availability in Norway.MethodsWe conducted 61 in-depth interviews with 26 Somali and Sudanese participants with FGC in Norway. We then validated our findings in three focus group discussions with additional 17 participants.FindingsWe found that most of our participants were positive towards psychosexual counseling and would use it if available. We also identified four cultural scenarios with different sets of sexual norms that centered on getting and/or staying married, and which largely influenced the participants’ intention to use FGC-related services. These cultural scenarios are the virgin, the passive-, the conditioned active-, and the equal- sexual partner scenarios. Participants with negative attitudes towards the use of almost all of the FGC-related healthcare services were influenced by a set of norms pertaining to virginity and passive sexual behavior. In contrast, participants with positive attitudes towards the use of all of these same services were influenced by another set of norms pertaining to sexual and gender equality. On the other hand, participants with positive attitudes towards the use of services that can help to improve their marital sexual lives, yet negative towards the use of premarital services were influenced by a third set of norms that combined norms from the two aforementioned sets of norms.ConclusionThe intention to use FGC-related healthcare services varies between and within the different ethnic groups. Moreover, the same girl or woman can have different attitudes towards the use of the different FGC-related healthcare services or even towards the same services at the different stages of her life. These insights could prove valuable for Norwegian and other policy-makers and healthcare professionals during the planning and/or delivery of FGC-related healthcare services. ]]> <![CDATA[Human trafficking and labor exploitation: Toward identifying, implementing, and evaluating effective responses]]> https://www.researchpad.co/article/5c59ff0ed5eed0c4841359d5

In an Editorial, Ligia Kiss and Cathy Zimmerman discuss the need for research on the prevention of human trafficking and mitigation of its effects.

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<![CDATA[“To speak or not to speak”: A qualitative analysis on the attitude and willingness of women to start conversations about voluntary medical male circumcision with their partners in a peri-urban area, South Africa]]> https://www.researchpad.co/article/5c644936d5eed0c484c2f8d6

Introduction

Voluntary medical male circumcision (VMMC) reduces the risk of HIV infection in heterosexual men and has long-term indirect protection for women, yet VMMC uptake in South Africa remains low (49.8%) in men (25–49 years). We explored the attitude and willingness of women to start conversations on VMMC with their sexual partners in a South African peri-urban setting to increase VMMC uptake.

Methods

Thirty women with median age of 30 years (inter-quartile range 26–33 years) were interviewed in a language of their choice. Key questions included: types of approach to use, gender roles, benefits and barriers to introducing the topic of VMMC, and perceptions of VMMC. Interviews were digitally-recorded, transcribed, and translated. Through a standard iterative process, a codebook was developed (QSR NVIVO 10 software) and inductive thematic analysis applied.

Results

Most women were willing talk to their sexual partners about circumcision, but indicated that the decision to circumcise remained that of their sexual partner. Women felt that they should encourage their partners, show more interest in circumcision, be patient, speak in a caring and respectful tone, choose a correct time when their partner was relaxed and talk in a private space about VMMC. Using magazine/newspaper articles, pamphlets or advertisements were identified as tools that could aid their discussion. Substantial barriers to initiating conversations on VMMC included accusations by partner on infidelity, fear of gender-based violence, cultural restrictions and hesitation to speak to a mature partner about circumcision.

Conclusions

Women need to ensure that before talking to their partner about circumcision, the environment and approach that they use are conducive. Female social network forums could be used to educate women on conversation techniques, skills to use when talking to their partners and how to address communication challenges about circumcision. Involvement of women in VMMC awareness campaigns could encourage circumcision uptake among men.

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<![CDATA[Gender differences in self-view and desired salaries: A study on online recruitment website users in China]]> https://www.researchpad.co/article/5c40f7e3d5eed0c484386b87

One explanation for the gender pay differences in labor markets is that women propose lower desired salaries. By using an actual job seeking resume database and applying text mining techniques, we are able to observe both the extent of gender differences in desired salaries and job-related self-view. We find gender differences in global self-view favoring females, and in some domain-specific self-view favoring males. Previous findings of disadvantaged groups having levels of self-view at least as high as those of advantaged groups lend credibility to our findings. Moreover, we argue that the differences in global self-view favoring females may be related to the theories of “belief flipping”, since women in our sample of online-recruitment markets are distinct from the general population, with on average 15.2 years of education and 8.99 years of work experience, due to self-selection. In addition, we find that women do propose lower desired salary than men, after controlling for various factors such as human capital, marital status, industries. We further investigate the role of self-view and find it contributes to explain desired salaries, with modest mediator effect but little moderator effect on gender differences in desired salaries.

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<![CDATA[On the prevalence of racial discrimination in the United States]]> https://www.researchpad.co/article/5c40f81ed5eed0c484387102

Boutwell, Nedelec, Winegard, Shackelford, Beaver, Vaughn, Barnes, & Wright (2017) published an article in this journal that interprets data from the Add Health dataset as showing that only one-quarter of individuals in the United States experience discrimination. In Study 1, we attempted to replicate Boutwell et al.’s findings using a more direct measure of discrimination. Using data from the Pew Research Center, we examined a large sample of American respondents (N = 3,716) and explored the prevalence of discrimination experiences among various racial groups. Our findings stand in contrast to Boutwell et al.’s estimates, revealing that between 50% and 75% of Black, Hispanic, and Asian respondents (depending on the group and analytic approach) reported discriminatory treatment. In Study 2, we explored whether question framing affected how participants responded to Boutwell’s question about experiencing less respect and courtesy. Regardless of question framing, non-White participants reported more experiences than White participants. Further, there was an interaction of participant race and question framing such that when participants were asked about experiences of less respect or courtesy broadly, there were no differences between non-White participants and White participants, but when they were asked about experiences that were specifically race-based, non-White participants reported more experiences than White participants. The current research provides a counterweight to the claim that discrimination is not a prevalent feature of the lives of minority groups and the serious implications this claim poses for research and public policy.

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<![CDATA[A simplified approach to measuring national gender inequality]]> https://www.researchpad.co/article/5c37b790d5eed0c48449047e

The Global Gender Gap Index is one of the best-known measures of national gender inequality, used by both academics and policy makers. We argue that that this measure has a number of problems and introduce a simpler measure of national levels of gender inequality. Our proposed measure is based on sex differences in the opportunity to lead a long healthy and satisfied life that is grounded on educational opportunities. The measure better captures variation in gender inequality than other measures, with inclusion of outcomes that can be favorable or unfavorable to either sex, not simply unfavorable to women. We focus on some of the most basic measures available for 134 countries from 2012–2016 (i.e., disadvantages in children’s basic education, life satisfaction, and healthy life span) and we relate these to various measures, including the United Nations' Human Development Index. We found that low levels of human development are typically associated with disadvantages for girls and women, while medium and high levels of development are typically associated with disadvantages for boys and men. Countries with the highest levels of human development are closest to gender parity, albeit typically with a slight advantage for women. We argue that the disparities, when they are found, are related to the sexual division of labor (i.e., traditional gender roles) in poorly developed countries as well as the underinvestment in preventative health care in more developed nations.

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<![CDATA[Women’s reproductive health decision-making: A multi-country analysis of demographic and health surveys in sub-Saharan Africa]]> https://www.researchpad.co/article/5c3fa58fd5eed0c484ca5c5a

Introduction

Women’s ability to make decisions regarding their reproductive health has important implications for their health and well-being. We studied the socio-demographic factors affecting reproductive health decision-making among women in 27 sub-Sahara African countries.

Materials and methods

The study made use of pooled data from current Demographic and Health Survey (DHS) conducted from January 1, 2010 and December 31, 2016 in 27 countries in sub-Sahara African. Binary and multivariate logistic regression models were used to investigate the associations of women’s socio-demographic factors with decision-making regarding sexual reproductive health.

Results

The proportion of women who can ask their partners to use a condom during sexual intercourse ranged from lowest in Mali (16.6%) to highest in Namibia (93.4%). Furthermore, the proportion of women who can refuse sex ranged from 18.3% in Mali to 92.4% in Namibia. Overall, approximately every five out of ten women can ask their partners to use a condom, six out ten women could refuse their partners sex and seven out of ten women could make at least 1 decision. Women from rural areas (OR = 0.51, CI = 0.48–0.54), those with no education (OR = 0.11, CI = 0.10–0.12), Muslim women (OR = 0.29, CI = 0.27–0.31), women not working (OR = 0.53, CI = 0.51–0.56) and women whose partners had no education (OR = 0.17, CI = 0.16–0.19) were less likely to make a decision on their reproductive health.

Conclusion

Residence, age, level of education, religion, occupation and partner’s education were found to be associated with women’s decision-making about sexual intercourse, condom use and reproductive health decision-making index. This study contributes to the discourse on reproductive health decision-making in Africa. Policies and intervention targeted at improving women’s autonomy and empowering them to take charge of their sexual and reproductive health issues should be focused on these factors.

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<![CDATA[Associations between sex work laws and sex workers’ health: A systematic review and meta-analysis of quantitative and qualitative studies]]> https://www.researchpad.co/article/5c196690d5eed0c484b523f7

Background

Sex workers are at disproportionate risk of violence and sexual and emotional ill health, harms that have been linked to the criminalisation of sex work. We synthesised evidence on the extent to which sex work laws and policing practices affect sex workers’ safety, health, and access to services, and the pathways through which these effects occur.

Methods and findings

We searched bibliographic databases between 1 January 1990 and 9 May 2018 for qualitative and quantitative research involving sex workers of all genders and terms relating to legislation, police, and health. We operationalised categories of lawful and unlawful police repression of sex workers or their clients, including criminal and administrative penalties. We included quantitative studies that measured associations between policing and outcomes of violence, health, and access to services, and qualitative studies that explored related pathways. We conducted a meta-analysis to estimate the average effect of experiencing sexual/physical violence, HIV or sexually transmitted infections (STIs), and condomless sex, among individuals exposed to repressive policing compared to those unexposed. Qualitative studies were synthesised iteratively, inductively, and thematically. We reviewed 40 quantitative and 94 qualitative studies. Repressive policing of sex workers was associated with increased risk of sexual/physical violence from clients or other parties (odds ratio [OR] 2.99, 95% CI 1.96–4.57), HIV/STI (OR 1.87, 95% CI 1.60–2.19), and condomless sex (OR 1.42, 95% CI 1.03–1.94). The qualitative synthesis identified diverse forms of police violence and abuses of power, including arbitrary arrest, bribery and extortion, physical and sexual violence, failure to provide access to justice, and forced HIV testing. It showed that in contexts of criminalisation, the threat and enactment of police harassment and arrest of sex workers or their clients displaced sex workers into isolated work locations, disrupting peer support networks and service access, and limiting risk reduction opportunities. It discouraged sex workers from carrying condoms and exacerbated existing inequalities experienced by transgender, migrant, and drug-using sex workers. Evidence from decriminalised settings suggests that sex workers in these settings have greater negotiating power with clients and better access to justice. Quantitative findings were limited by high heterogeneity in the meta-analysis for some outcomes and insufficient data to conduct meta-analyses for others, as well as variable sample size and study quality. Few studies reported whether arrest was related to sex work or another offence, limiting our ability to assess the associations between sex work criminalisation and outcomes relative to other penalties or abuses of police power, and all studies were observational, prohibiting any causal inference. Few studies included trans- and cisgender male sex workers, and little evidence related to emotional health and access to healthcare beyond HIV/STI testing.

Conclusions

Together, the qualitative and quantitative evidence demonstrate the extensive harms associated with criminalisation of sex work, including laws and enforcement targeting the sale and purchase of sex, and activities relating to sex work organisation. There is an urgent need to reform sex-work-related laws and institutional practices so as to reduce harms and barriers to the realisation of health.

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<![CDATA[Students from single-sex schools are more gender-salient and more anxious in mixed-gender situations: Results from high school and college samples]]> https://www.researchpad.co/article/5c141ef2d5eed0c484d28f24

Gender segregation exists in all walks of life. One of the most common forms of institutionalized gender segregation is perhaps single-sex schooling. Because schooling experience has important influence on students’ psychosocial development, interest in gender-segregated education has been reviving over the globe. Skeptics of single-sex schooling have suggested that such schooling may increase students’ gender salience (awareness of gender in categorizations), reduce opportunities for mixed-gender interactions, and increase mixed-gender anxiety, but little evidence has been found. It is critical to explore how single-sex schooling is associated with these psychosocial outcomes in adolescents and young adults because they are in the developmental stage when the desire and need to establish mixed-gender relationships increase. We report two systematic studies on gender salience, mixed-gender friendships, and mixed-gender anxiety on 2059 high school students and 456 college students from single-sex or coeducational schools. Even with demographic background controlled, results suggested higher gender salience in single-sex school students in the high school sample, and greater mixed-gender anxiety and fewer mixed-gender friendships in these students in both samples. These differences were not moderated by student gender and were similar in first-year versus senior college students. Moreover, mixed-gender friendships, though not gender salience, appeared to engage in a possibly bi-directional mediation relationship with mixed-gender anxiety that is consistent with a vicious cycle of escalating anxiety and lack of mixed-gender interaction among single-sex school students. These findings help fill the knowledge gap about the correlates of gender-segregated schooling and shed light on the precursors of later social and achievement differences between single-sex and coeducational school students.

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<![CDATA[Satisfaction with medical support in women with endometriosis]]> https://www.researchpad.co/article/5c0993d1d5eed0c4842ad9fc

Endometriosis affects various aspects of women’s lives. We searched for predictors for patient satisfaction with medical support (PSwMS) in women with endometriosis. The study was designed as a multi-centre retrospective cohort study. We approached women with histologically confirmed endometriosis from 2010 until 2016, comparing women satisfied to women dissatisfied with medical support. We analysed data on characteristics of endometriosis, PSwMS and the influence of disease characteristics on PSwMS. Information on satisfaction with medical support was collected through a standardized questionnaire. After exclusion of 73 women because of inchoately filled in questionnaires, data from 498 women was evaluated. Altogether, it was observed that 54.6% (n = 272) of the study participants were satisfied with medical support and 45.4% (n = 226) were not. Feeling adequately informed by the time of diagnosis (p < 0.001), taking women’s mental troubles seriously (p < 0.001) and supporting women in handling their pain (p < 0.001) were significantly associated with satisfaction.

We found adequate information to be the most distinctive indicator for PSwMS. Further, acknowledging psychological distress and supporting women in handling their symptoms rather than to alleviate them, positively affect PSwMS. To achieve PSwMS, healthcare providers have to give adequate information on endometriosis and its management.

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<![CDATA[‘That’s how we help each other’: Community savings groups, economic empowerment and HIV risk among female sex workers in Iringa, Tanzania]]> https://www.researchpad.co/article/5b4a192d463d7e428027f891

Female sex workers (FSW) are a socially and economically marginalized population heavily affected by HIV. Community empowerment approaches focus on FSW taking collective action to address structural barriers to their health and have demonstrated effectiveness in reducing HIV risk. This study examines the potential for community savings groups (locally called michezo) among FSW in Iringa, Tanzania to reduce HIV risk and promote economic and community empowerment. We conducted 27 in-depth interviews (IDIs) with 15 FSW over time and 4 focus group discussions (FGDs) with 35 FSW participating in michezo, and 10 key informant interviews (KIIs) with group collectors. Content analysis was used to identify salient themes around participants’ sex work and financial realities; the role of savings groups in their lives and work; and experiences with social cohesion associated with group participation. Michezo were described as providing a safety net for times of financial need, allowing FSW to create greater financial security for themselves and their families. Participation in the groups was also reported to facilitate both individual agency, resulting in members' ability to negotiate condom use and be selective about clients, and a sense of collective identity and solidarity. Participants described group challenges including high mobility and low income of FSW making it difficult for women to fulfill their financial obligations to the group. As a result, participants reported preferences for joining michezo whose members were perceived as more stable (e.g. older, married, from more established venues). Group collectors and members were eager to have michezo formally registered and become recognized by the broader community. Findings indicate that savings groups promote individual agency to reduce sexual risk behaviors and foster community empowerment among FSW. The groups hold potential as an empowerment strategy to enable sex workers to address structural sources of HIV vulnerability and help them achieve socioeconomic inclusion.

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<![CDATA[Prospective Study of Rape Perpetration by Young South African Men: Incidence & Risk Factors]]> https://www.researchpad.co/article/5989d9f0ab0ee8fa60b6e4bb

Background

There has been very little prospective research on rape perpetration among men. This paper describes the incidence and risk factors for new rape and attempted rape events among young South African men in an HIV prevention trial.

Methods

We followed 1,147 men aged 15–26 years who enrolled into a cluster randomised controlled trial to evaluate the HIV prevention behavioural intervention Stepping Stones. Incidence rate ratios for factors associated with incident rape were derived from Poisson models.

Results

The young men reported 217 incident rapes (completed or attempted) of a girl or woman over 1,914 person years of follow up, yielding a rape incidence of 11.2 per 100 person years. Overall 24.9% of men had previously raped at baseline, and 18.9% did so during the follow up. Among the latter, 61.3% raped for the first time, and 38.7% re-offended. Multivariable Poisson modelling showed a higher incidence of rape perpetration among men who had ever used drugs (IRR 1.86 95%CI 1.39, 2.49), had eight or more lifetime partners (IRR 1.48 95% CI 1.09, 2.01), had been physically violent toward a female partner (IRR 1.50 95%CI 1.11, 2.03) and had disclosed rape perpetration at baseline (IRR 1.45 95%CI 1.07, 1.97). A lower incidence was found among those with greater resistance to peer pressure (IRR 0.85 95%CI 0.74, 0.97).

Conclusions

The findings highlight the importance of male gender socialisation and addressing delinquent youth sub-cultures in rape prevention. Prevention requires change in hegemonic masculinity, with its emphasis on gender hierarchy, exaggerated performance of heterosexuality and control of women. Interventions are needed to address male socialisation with delinquent peers, by reducing exposure to childhood trauma and strengthening opportunities for gainful employment (in work or recreation).

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<![CDATA[Psychological Balance in High Level Athletes: Gender-Based Differences and Sport-Specific Patterns]]> https://www.researchpad.co/article/5989daa2ab0ee8fa60ba64ce

Objectives

Few epidemiological studies have focused on the psychological health of high level athletes. This study aimed to identify the principal psychological problems encountered within French high level athletes, and the variations in their prevalence based on sex and the sport practiced.

Methods

Multivariate analyses were conducted on nationwide data obtained from the athletes' yearly psychological evaluations.

Results

A representative sample of 13% of the French athlete population was obtained. 17% of athletes have at least one ongoing or recent disorder, generalized anxiety disorder (GAD) being the most prevalent (6%), followed by non-specific eating disorders (4.2%). Overall, 20.2% of women had at least one psychopathology, against 15.1% in men. This female predominance applied to anxiety and eating disorders, depression, sleep problems and self-harming behaviors. The highest rates of GAD appeared in aesthetic sports (16.7% vs. 6.8% in other sports for men and 38.9% vs. 10.3% for women); the lowest prevalence was found in high risk sports athletes (3.0% vs. 3.5%). Eating disorders are most common among women in racing sports (14% vs. 9%), but for men were found mostly in combat sports (7% vs. 4.8%).

Discussion

This study highlights important differences in psychopathology between male and female athletes, demonstrating that the many sex-based differences reported in the general population apply to elite athletes. While the prevalence of psychological problems is no higher than in the general population, the variations in psychopathology in different sports suggest that specific constraints could influence the development of some disorders.

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<![CDATA[Text Messaging to Improve Attendance at Post-Operative Clinic Visits after Adult Male Circumcision for HIV Prevention: A Randomized Controlled Trial]]> https://www.researchpad.co/article/5989d9f3ab0ee8fa60b6f5b9

Background

Following male circumcision for HIV prevention, a high proportion of men fail to return for their scheduled seven-day post-operative visit. We evaluated the effect of short message service (SMS) text messages on attendance at this important visit.

Methodology

We enrolled 1200 participants >18 years old in a two-arm, parallel, randomized controlled trial at 12 sites in Nyanza province, Kenya. Participants received daily SMS text messages for seven days (n = 600) or usual care (n = 600). The primary outcome was attendance at the scheduled seven-day post-operative visit. The primary analysis was by intention-to-treat.

Principal Findings

Of participants receiving SMS, 387/592 (65.4%) returned, compared to 356/596 (59.7%) in the control group (relative risk [RR] = 1.09, 95% confidence interval [CI] 1.00–1.20; p = 0.04). Men who paid more than US$1.25 to travel to clinic were at higher risk for failure to return compared to those who spent ≤US$1.25 (adjusted relative risk [aRR] 1.35, 95% CI 1.15–1.58; p<0.001). Men with secondary or higher education had a lower risk of failure to return compared to those with primary or less education (aRR 0.87, 95% CI 0.74–1.01; p = 0.07).

Conclusions

Text messaging resulted in a modest improvement in attendance at the 7-day post-operative clinic visit following adult male circumcision. Factors associated with failure to return were mainly structural, and included transportation costs and low educational level.

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<![CDATA[Gender, Culture, and Sex-Typed Cognitive Abilities]]> https://www.researchpad.co/article/5989d9e3ab0ee8fa60b6a36b

Although gender differences in cognitive abilities are frequently reported, the magnitude of these differences and whether they hold practical significance in the educational outcomes of boys and girls is highly debated. Furthermore, when gender gaps in reading, mathematics and science literacy are reported they are often attributed to innate, biological differences rather than social and cultural factors. Cross-cultural evidence may contribute to this debate, and this study reports national gender differences in reading, mathematics and science literacy from 65 nations participating in the 2009 round of the Programme for International Student Assessment (PISA). Consistently across all nations, girls outperform boys in reading literacy, d = −.44. Boys outperform girls in mathematics in the USA, d = .22 and across OECD nations, d = .13. For science literacy, while the USA showed the largest gender difference across all OECD nations, d = .14, gender differences across OECD nations were non-significant, and a small female advantage was found for non-OECD nations, d = −.09. Across all three domains, these differences were more pronounced at both tails of the distribution for low- and high-achievers. Considerable cross-cultural variability was also observed, and national gender differences were correlated with gender equity measures, economic prosperity, and Hofstede’s cultural dimension of power distance. Educational and societal implications of such gender gaps are addressed, as well as the mechanisms by which gender differences in cognitive abilities are culturally mediated.

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<![CDATA[Improved HIV Awareness and Perceived Empowerment to Negotiate Safe Sex among Married Women in Ethiopia between 2005 and 2011]]> https://www.researchpad.co/article/5989da6dab0ee8fa60b9362e

Introduction

The HIV prevalence rate in Ethiopia for married (or cohabiting) women is 3 times that found amongst women who have never been married. While marriage used to be seen as a protective factor against HIV, evidence suggests that this is no longer necessarily the case. This study analyses the trend and socio-demographic determinants of HIV awareness and safe sex negotiation among married women in Ethiopia between 2005 and 2011.

Methods

Data from Ethiopian Demographic and Health Surveys conducted in 2005 and in 2011 were analysed. Socio-demographic variables as well as ‘survey year’ were selected to assess their interaction with selected HIV awareness and safe sex negotiation indicators. Multivariable regression analyses were performed. Odds ratios and confidence intervals were computed.

Results

A significant increase in knowledge of HIV and ability to negotiate safer sex occurred between 2005 and 2011 reflecting a positive trend in gender empowerment amongst married Ethiopian women. Some of these advancements were striking, for instance respondents were 3.6 times more likely to have “Heard of AIDS” in 2011 than in 2005. HIV awareness and safer sex negotiation were significantly associated with higher education, higher socioeconomic status, those who had heard of HIV, those of the Orthodox Christian faith, and (to some extent) those living in rural areas.

Conclusion

HIV awareness has increased significantly in Ethiopia over the last decade but married women are still disproportionately susceptible to HIV. Community programmes, already effective in Ethiopia, also need to target this vulnerable sub-group of women.

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<![CDATA[Safety and Adherence to Intermittent Pre-Exposure Prophylaxis (PrEP) for HIV-1 in African Men Who Have Sex with Men and Female Sex Workers]]> https://www.researchpad.co/article/5989da5dab0ee8fa60b9042b

Background

Little is known about safety of and adherence to intermittent HIV PrEP regimens, which may be more feasible than daily dosing in some settings. We present safety and adherence data from the first trial of an intermittent PrEP regimen among Kenyan men who have sex with men (MSM) and female sex workers (FSW).

Methods/Principal Findings

MSM and FSW were randomized to daily oral FTC/TDF or placebo, or intermittent (Monday, Friday and within 2 hours after sex, not to exceed one dose per day) oral FTC/TDF or placebo in a 2∶1∶2∶1 ratio; volunteers were followed monthly for 4 months. Adherence was assessed with the medication event monitoring system (MEMS). Sexual activity data were collected via daily text message (SMS) queries and timeline followback interviews with a one-month recall period. Sixty-seven men and 5 women were randomized into the study. Safety was similar among all groups. Median MEMS adherence rates were 83% [IQR: 63–92] for daily dosing and 55% [IQR:28–78] for fixed intermittent dosing (p = 0.003), while adherence to any post-coital doses was 26% [IQR:14–50]. SMS response rates were low, which may have impaired measurement of post-coital dosing adherence. Acceptability of PrEP was high, regardless of dosing regimen.

Conclusions/Significance

Adherence to intermittent dosing regimens, fixed doses, and in particular coitally-dependent doses, may be more difficult than adherence to daily dosing. However, intermittent dosing may still be appropriate for PrEP if intracellular drug levels, which correlate with prevention of HIV acquisition, can be attained with less than daily dosing and if barriers to adherence can be addressed. Additional drug level data, qualitative data on adherence barriers, and better methods to measure sexual activity are necessary to determine whether adherence to post-coital PrEP could be comparable to more standard regimens.

Trial Registration

ClinicalTrials.gov NCT00971230

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<![CDATA[Genetic and Environmental Influences on Female Sexual Orientation, Childhood Gender Typicality and Adult Gender Identity]]> https://www.researchpad.co/article/5989da20ab0ee8fa60b7e8b3

Background

Human sexual orientation is influenced by genetic and non-shared environmental factors as are two important psychological correlates – childhood gender typicality (CGT) and adult gender identity (AGI). However, researchers have been unable to resolve the genetic and non-genetic components that contribute to the covariation between these traits, particularly in women.

Methodology/Principal Findings

Here we performed a multivariate genetic analysis in a large sample of British female twins (N = 4,426) who completed a questionnaire assessing sexual attraction, CGT and AGI. Univariate genetic models indicated modest genetic influences on sexual attraction (25%), AGI (11%) and CGT (31%). For the multivariate analyses, a common pathway model best fitted the data.

Conclusions/Significance

This indicated that a single latent variable influenced by a genetic component and common non-shared environmental component explained the association between the three traits but there was substantial measurement error. These findings highlight common developmental factors affecting differences in sexual orientation.

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<![CDATA[The Roles of Featural and Configural Face Processing in Snap Judgments of Sexual Orientation]]> https://www.researchpad.co/article/5989db48ab0ee8fa60bd916a

Research has shown that people are able to judge sexual orientation from faces with above-chance accuracy, but little is known about how these judgments are formed. Here, we investigated the importance of well-established face processing mechanisms in such judgments: featural processing (e.g., an eye) and configural processing (e.g., spatial distance between eyes). Participants judged sexual orientation from faces presented for 50 milliseconds either upright, which recruits both configural and featural processing, or upside-down, when configural processing is strongly impaired and featural processing remains relatively intact. Although participants judged women’s and men’s sexual orientation with above-chance accuracy for upright faces and for upside-down faces, accuracy for upside-down faces was significantly reduced. The reduced judgment accuracy for upside-down faces indicates that configural face processing significantly contributes to accurate snap judgments of sexual orientation.

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<![CDATA[Implementation of Web-Based Respondent-Driven Sampling among Men Who Have Sex with Men in Vietnam]]> https://www.researchpad.co/article/5989da68ab0ee8fa60b92617

Objective

Lack of representative data about hidden groups, like men who have sex with men (MSM), hinders an evidence-based response to the HIV epidemics. Respondent-driven sampling (RDS) was developed to overcome sampling challenges in studies of populations like MSM for which sampling frames are absent. Internet-based RDS (webRDS) can potentially circumvent limitations of the original RDS method. We aimed to implement and evaluate webRDS among a hidden population.

Methods and Design

This cross-sectional study took place 18 February to 12 April, 2011 among MSM in Vietnam. Inclusion criteria were men, aged 18 and above, who had ever had sex with another man and were living in Vietnam. Participants were invited by an MSM friend, logged in, and answered a survey. Participants could recruit up to four MSM friends. We evaluated the system by its success in generating sustained recruitment and the degree to which the sample compositions stabilized with increasing sample size.

Results

Twenty starting participants generated 676 participants over 24 recruitment waves. Analyses did not show evidence of bias due to ineligible participation. Estimated mean age was 22 years and 82% came from the two large metropolitan areas. 32 out of 63 provinces were represented. The median number of sexual partners during the last six months was two. The sample composition stabilized well for 16 out of 17 variables.

Conclusion

Results indicate that webRDS could be implemented at a low cost among Internet-using MSM in Vietnam. WebRDS may be a promising method for sampling of Internet-using MSM and other hidden groups.

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