The Process of Becoming a Sexual Black Woman: A Grounded Theory Study

Black females in the United States disproportionately suffer from STDs, including HIV. Understanding the sociocultural conditions that affect their risk is essential to developing effective and culturally relevant prevention programs. METHODS: In 2016-2017 in Madison, Wisconsin, 20 black females aged 19-62 completed interviews that explored the sociocultural conditions associated with sexual development and STD/HIV risk. Interviews were guided by grounded theory; open, axial and selective coding and constant comparative analysis were used to identify developmental phases and relevant sociocultural conditions. RESULTS: Three phases of becoming a sexual black woman were identified: Girl, when participants reported beginning to understand their sexuality; Grown, marking a transition to adulthood, when participants began to feel more self-sufficient yet still grappled with their emerging sexuality; and Woman, when participants developed a strong sense of self and took ownership of their bodies. Two sociocultural conditions affected progression through these phases: stereotype messaging and protection (both self-protection and protecting others). Negative life events (e.g., sexual trauma) and early sexualization reportedly affected sexual development, and STD experience influenced self-perceptions of sexuality and sexual behavior, often leading to self-protective behaviors. Older participants reported strategies to protect young black females from negative sexual experiences. CONCLUSION: Interventions at multiple levels of the social ecology throughout the life course may help reduce STD/HIV risk among black women in the United States. Future research should include examination of the experiences of black females younger than 18 and evaluation of the protective strategies employed by older black females

The impact of obesity on pulmonary deterioration in patients undergoing robotic-assisted laparoscopic prostatectomy

Obesity affects respiratory and hemodynamic function in anesthetized patients. The aim of this study was to evaluate the influence of the body mass index (BMI) on pulmonary changes in a permanent 45 degrees steep Trendelenburg position (STP) during robotic-assisted laparoscopic prostatectomy (RALP). 51 patients undergoing RALP under standardized anesthesia were included. Perioperative pulmonary function and oxygenation were measured in awake patients (T-0), 20 min after the induction of anesthesia (T-1), after insufflation of the abdomen in supine position (T-2), after 30 min in STP (T-3), when controlling Santorini's plexus in STP (T-4), before awakening while supine (T-5), and after 45 min in the recovery room (T-6). Patient-specific and time-dependent factor on ventilation and predicted peak inspiratory pressure (PIP), driving pressure (P-driv) and lung compliance (LC) in a linear regression model were calculated. PIP and P-driv increased significantly after induction of capnoperitoneum (T2-4) (p 31 kg/m(2) reached critical PIP values >= 35 cmH(2)O. Postoperative oxygenation represented by the PaO2/FiO(2) ratio was significantly decreased compared to T-0 (p < 0.0001). Obesity in combination with STP and capnoperitoneum during RALP has a profound effect on pulmonary function. Increased PIP and P-driv and decreased LC are directly correlated with a high BMI. Changes in PIP, P-driv and LC during RALP may be predicted in relation to patient's BMI for consideration in the preoperative setting