Treating ‘collective biologies’ through men’s HPV research in Mexico

Medical testing assesses individual bodies, yet its effects reach beyond their boundaries. Building on insights from medical anthropology and STS regarding the co-construction of medical technologies and bodies, I investigate how heterosexual Mexican couples used men’s HPV testing to understand and assert membership in collective ‘couple’s biologies’. I analyze interviews undertaken during men’s participation in a longitudinal, observational HPV study. Men underwent annual DNA-based HPV testing, often receiving unexpected diagnoses that led couples to deal with the possibility of HPV transmission and its possible harms. I argue that these couples drew on context-specific ideologies of gender and race in their understandings of and responses to men’s test results. I show how they understood HPV positivity as a condition of the couple’s biology, mediated by what participants viewed as potentially racially innate if problematically backward gender attributes. Couples then used the experience of medical testing to live out self-consciously modern forms of gender, marriage, and self-care, which they hoped would counteract the harms of HPV. I conclude by discussing the importance of considering context-specific collective biologies, rather than just individual bodies, in the use and social scientific study of medical technology

Perceptions and Experiences of Human Papillomavirus (HPV) Infection and Testing Among Low-Income Mexican Women

Background HPV infection causes cervical cancer, a major contributor to morbidity and mortality among low-income Mexican women. Human papillomavirus (HPV) DNA testing is now a primary screening strategy in Mexico’s early cervical cancer detection program (ECDP). Research on Mexican women’s perceptions of HPV and testing is necessary for establishing culturally appropriate protocols and educational materials. Here, we explore perceptions about HPV and HPV-related risk factors among low-income Mexican ECDP participants. Methods We conducted semi-structured interviews with 24 ECDP participants from two primary care health clinics in Michoacán state, Mexico. Interviews addressed women’s understandings of and experiences with HPV and HPV testing. Analysis was inductive and guided by the Health Belief Model with a focus on gender. Results Women’s confusion about HPV and HPV screening caused emotional distress. They understood HPV to be a serious disease that would always cause severe symptoms, often characterizing it as analogous to HIV or inevitably carcinogenic. Women also attributed it to men’s sexual behaviors, specifically infidelity and poor hygiene. Women described both sexes’ desire for sex as natural but understood men’s negative practices of masculinity, like infidelity, as the causes of women’s HPV infection. Some women believed dirty public bathrooms or heredity could also cause HPV transmission. Conclusions These results are consistent with prior findings that geographically and economically diverse populations lack clear understandings of the nature, causes, or symptoms of HPV, even among those receiving HPV testing. Our findings also reveal that local cultural discourse relating to masculinity, along with failure to provide sufficient education to low-income and indigenous-language speaking patients, exacerbate women’s negative emotions surrounding HPV testing. While negative emotions did not deter women from seeking testing, they could be ameliorated with better health education and communication

Composite masculinities: Aging, illness, erectile dysfunction and Mexican manhood.

This dissertation reveals how decreasing erectile function, aging and chronic illness shape older Mexican men's ideas and practices of masculinity. Based on ethnographic fieldwork in the Urology department of a government hospital in Cuernavaca, Mexico, it shows that despite post-Viagra global medicalization of erectile difficulty as the biomedical pathology erectile dysfunction (ED), participants generally rejected purely medical explanations of and treatments for decreasing erectile function, in favor of more complexly social accounts. The first half of the dissertation discusses participants' understandings of masculinity, and provides the theoretical tools necessary to understand the relationships between changing ideas of manliness and erectile function. It introduces the composite masculinities analytic, based on insights from gender and science and technology studies, for studying the concrete mechanisms by which embodied changes in masculine selfhood occur in relationship to social, structural, and physical contexts. Using this approach, this section address participants' understandings of the relationship between Mexicanness and their own manhood, their shared expectation of shift from a sex-centered youthful masculinity to a 'mature masculinity focused on home and family, and how relationships with women mediate men's performances of masculinity. The second half examines interactions between bodily aging and illness, medical treatment, and participants' changing ways of being men. It situates decreasing erectile function in the epidemic of chronic illness sweeping Mexico, particularly type-2 diabetes, heart disease, and prostate problems. Describing the relationships between illness experience, social and structural context, and local understandings of health and illness, this section focuses on participants' relationships to medical erectile dysfunction (ED) treatment, explaining why most participants rejected ED treatment, and the experiences of the few who sought this treatment. This research sheds new light on the understudied fields of masculinity and men's health, especially as one of the first works to focus on older, heterosexual men. It also provides a new analytic for understanding embodied changes in participants' gendered selves over time, which is applicable to studies of gender and selfhood more broadly. Finally, it counters stereotypes of Mexican masculinity as one-dimensionally macho, and demonstrates that the seeming global hegemony of medical understandings of sexuality do not always obtain.Ph.D.Cultural anthropologyForensic anthropologyGender studiesSocial SciencesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/127132/2/3392783.pd

Accounting for physicians’ gender expectations improves men's health medicine

The field of men's health seeks to improve men's health outcomes by accounting for the specific ways that gender influences male health behaviors. To meet this goal, physicians must also account for the ways that their own cultural assumptions about masculinity influence their clinical practice. Gender is not solely biological. It is a way of acting out masculinity or femininity that varies across individual and cultural contexts. Thus, doctors and patients might have different ideas about how a man should feel and act. These attitudes can influence whether men's bodily changes are viewed as pathological versus normal. Two simple interventions are proposed to enable physicians to identify their own assumptions about masculinity and differentiate these from their patients’ in order to make more appropriate treatment decisions. The first is advocating for medical guidelines for their specialty that account for gender as context-specific rather than universal. The second is incorporating attention to gender into their daily clinical practice by asking rather than assuming what patients want in order to base treatment decisions on patients’ rather than physicians’ ideas of how men should feel and behave

You'll "Get Viagraed:" Mexican men's preference for alternative erectile dysfunction treatment

The pharmaceutically focused clinical and epidemiological literature on erectile dysfunction (ED) treatment has paid little attention to men's non-medical responses to changing erectile function. This study explores the relationship of erectile function change, resulting use of medical or alternative treatments, and Mexican men's understandings of masculinity and aging, through a mixed method approach utilizing both quantitative survey and ethnographic interview data. A survey of 750 men undertaken at the Instituto Méxicano del Seguro Social hospital in Cuernavaca, Mexico in April to June 2008 showed that only about half of those who experienced erectile function changes sought treatment for these changes; treatment users were far more likely to seek alternative treatment than medical treatment, especially preferring lifestyle change and vitamins. Ethnographic data from interviews with 250 male urology patients undertaken from October 2007 to August 2008 at the same site reveal that treatment users' preferences were linked to fears about the safety and situational inappropriateness of medical ED treatment. These findings suggest that by focusing on patients' use of pharmaceuticals, biomedically oriented research has overlooked the most common responses to changing erectile function. Broadening the focus of ED treatment research to include analysis of men's rejection of pharmaceutical treatment - either in favor of alternative treatment, or because they do not see their erectile function changes as requiring medical intervention - would correct this imbalance in the literature. Further, the knowledge that even men who seek treatment may prefer alternatives to pharmaceutical interventions will help physicians to offer treatments, such as lifestyle change, that their patients might find more acceptable. Such measures would simultaneously help to mitigate the chronic illnesses, like diabetes and hypertension, which frequently co-occur with diminished erectile function.Mexico Erectile dysfunction Alternative medicine Medicalization Sexuopharmaceuticals Lifestyle change Masculinity Aging Men

Anthropologies of men, masculinities, and reproduction

In this chapter, the authors give an overview of key findings from the English language research on men, masculinities and reproduction in sociocultural anthropology and allied fields. This research spans the globe and the range of men's reproduction-related experience. Yet, it coheres around a set of three key theoretical approaches that are also fundamental to contemporary anthropological thinking more broadly. The authors review the ways that researchers have used these shared theoretical approaches to elucidate certain topics within the arena of men and reproduction: men's gendered experiences as fathers and parents (with a subsection that focuses on the burgeoning literature on gay and trans experiences); of infertility and artificial reproduction technologies (including intersections with the literature on disability); with birth control (specifically vasectomy, condoms, and abortion); and of male sexual/reproductive aging.Publisher's Versio

Understanding Factors that Influence Health Care Utilization Among Mixtec and Zapotec Women in a Farmworker Community in California.

This paper examines health care utilization among indigenous immigrants from Oaxaca, Mexico, who have settled in a farmworker community in southern California. In 2016, two trained Spanish-Mixteco and Spanish-Zapoteco bi-lingual interviewers conducted in-depth interviews with 44 indigenous women residing in Oxnard, California on issues that affect health care utilization. Interviews were conducted in Mixteco, Zapoteco and Spanish and were coded to identify structural, cultural, and provider-related barriers to health care utilization. Five bi-lingual Spanish-Mixteco indigenous interpreters employed at local clinics were also interviewed. Many women reported lack of health insurance, inability to pay, language barriers, long waiting times, rushed encounters with providers, and seeking western medical care only after home remedies did not work. However, several women were able to access routine health care services, often with support from indigenous interpreters employed at clinics. Interviews with five interpreters found that they provided assistance with interpretation during medical encounters and appointment making. They also educated patients about upcoming exams, identified low-cost services and insurance programs available to patients, assisted with paperwork and occasionally educated physicians on behalf of their patients. In addition to addressing barriers to health care access our findings suggest the importance of identifying and leveraging community assets, such as indigenous navigators, when developing programs for such underserved communities. Our findings can inform best practice in settings that provide health care to indigenous populations and may also apply to settings that provide health care to other immigrant communities that have very limited familiarity and contact with western health care