Sexual Scripts and Sexual Risk Behaviors Among Black Heterosexual Men: Development of the Sexual Scripts Scale

Sexual scripts are widely shared gender and culture-specific guides for sexual behavior with important implications for HIV prevention. Although several qualitative studies document how sexual scripts may influence sexual risk behaviors, quantitative investigations of sexual scripts in the context of sexual risk are rare. This mixed methods study involved the qualitative development and quantitative testing of the Sexual Scripts Scale (SSS). Study 1 included qualitative semi-structured interviews with 30 Black heterosexual men about sexual experiences with main and casual sex partners to develop the SSS. Study 2 included a quantitative test of the SSS with 526 predominantly low-income Black heterosexual men. A factor analysis of the SSS resulted in a 34-item, seven-factor solution that explained 68% of the variance. The subscales and coefficient alphas were: Romantic Intimacy Scripts (α = .86), Condom Scripts (α = .82), Alcohol Scripts (α = .83), Sexual Initiation Scripts (α = .79), Media Sexual Socialization Scripts (α = .84), Marijuana Scripts (α = .85), and Sexual Experimentation Scripts (α = .84). Among men who reported a main partner (n = 401), higher Alcohol Scripts, Media Sexual Socialization Scripts, and Marijuana Scripts scores, and lower Condom Scripts scores were related to more sexual risk behavior. Among men who reported at least one casual partner (n = 238), higher Romantic Intimacy Scripts, Sexual Initiation Scripts, and Media Sexual Socialization Scripts, and lower Condom Scripts scores were related to higher sexual risk. The SSS may have considerable utility for future research on Black heterosexual men’s HIV risk

Sexual Scripts and Sexual Risk Behaviors Among Black Heterosexual Men: Development of the Sexual Scripts Scale

Sexual scripts are widely shared gender and culture-specific guides for sexual behavior with important implications for HIV prevention. Although several qualitative studies document how sexual scripts may influence sexual risk behaviors, quantitative investigations of sexual scripts in the context of sexual risk are rare. This mixed methods study involved the qualitative development and quantitative testing of the Sexual Scripts Scale (SSS). Study 1 included qualitative semi-structured interviews with 30 Black heterosexual men about sexual experiences with main and casual sex partners to develop the SSS. Study 2 included a quantitative test of the SSS with 526 predominantly low-income Black heterosexual men. A factor analysis of the SSS resulted in a 34-item, seven-factor solution that explained 68% of the variance. The subscales and coefficient alphas were: Romantic Intimacy Scripts (α = .86), Condom Scripts (α = .82), Alcohol Scripts (α = .83), Sexual Initiation Scripts (α = .79), Media Sexual Socialization Scripts (α = .84), Marijuana Scripts (α = .85), and Sexual Experimentation Scripts (α = .84). Among men who reported a main partner (n = 401), higher Alcohol Scripts, Media Sexual Socialization Scripts, and Marijuana Scripts scores, and lower Condom Scripts scores were related to more sexual risk behavior. Among men who reported at least one casual partner (n = 238), higher Romantic Intimacy Scripts, Sexual Initiation Scripts, and Media Sexual Socialization Scripts, and lower Condom Scripts scores were related to higher sexual risk. The SSS may have considerable utility for future research on Black heterosexual men’s HIV risk

Thinking outside the Condom: Incorporating Women’s Challenges and Strengths into Safer Sex Interventions for Women Living with HIV/AIDS

Developing effective prevention programs for women living with HIV/AIDS hinges on understanding and responding to the myriad contexts in which women make sexual decisions. These include the challenges imposed on women by intersecting social inequities that can limit their relationship power, such as gender, racial/ethnic, and economic inequality. Existing behavioral research on the reasons why HIV positive women make sexual decisions is limited in scope, however, and current prevention programs posit male condoms as a panacea for HIV positive women’s complex safer sex needs. This study explored HIV positive women’s experiences of structural violence (oppression) and stress-related growth (growth from adversity) in order to understand better the context of their sexual practices.Methods: The participants included 24 women living with HIV/AIDS who attended skill and peer support groups that were part of the Protect and Respect program. The women were predominantly Black (83%), reported earning less than $10,000/year (80%) and reported acquiring HIV through sex with a male partner (58%). I transcribed 30 group sessions verbatim, editing for clarity only; entered the transcripts into Atlas.ti.5.2, a qualitative software analysis package; and employed analytic strategies of grounded theory and narrative analysis to explore women’s structural violence and stress-related growth experiences.Results: Structural violence manifested in the women’s lives in three primary ways: (1) daily and overwhelming stress; (2) AIDS related stigma; and (3) unhealthy and violent relationships. The women associated these experiences with emotional pain, suffering and substance use. In addition, the participants responded to these challenges through their examples of: (1) stress-related growth; (2) resilience; and (3) resistance.Conclusions: Women’s experiences with structural violence and stress-related growth revealed their barriers and facilitators to having safer sex and suggested that traditional HIV prevention interventions for women living with HIV/AIDS fail to account for women’s challenges and their strengths. The analysis of women’s experiences with structural violence revealed that women have fundamental health and safety challenges that must be addressed in order for them to be able to have safer sex. The analysis of women’s stress related growth experiences revealed that women possess various strengths that are ignored in current HIV prevention programming, but that women associate with their health and ability to have safer sex. These findings suggested that interventions that are not grounded in women’s experiences may do more harm than good by instructing women to engage in behaviors that are unrealistic or harmful in the context of their challenges (e.g., condom use in violent relationships), reinforcing women’s sense of powerlessness, and obscuring the root causes of and solutions for women’s sexual risk practices. I discuss the theoretical, practical, research and methodological implications of these findings, all of which focus on the significance of holistic and multi-leveled prevention strategies for women and addressing the precursors that facilitate or hinder safe sex in prevention programs for women, and not just condom use.Dr.P.H., Public Health -- Drexel University, 200

Community leaders’ perspectives on facilitators and inhibitors of health promotion among the youth in rural South Africa

INTRODUCTION: There are a number of factors that influence health promotion activities among the youth. This study sought to gain a comprehensive understanding of the facilitators and inhibitors of health promotion among the youth from the perspectives of community leaders in a rural setting in South Africa. METHODS: The study adopted an exploratory, descriptive and contextual qualitative approach involving community leaders in rural South Africa. Data saturation occurred after individual interviews with 21 participants. Data analysis employed the principles of content analysis. RESULTS: We found that facilitators of health promotion were access to education on the benefits of health promotion activities, efforts of organizations and community leaders/teachers, access to health care services and engaging in physical activities, and youth motivation and positive role modelling. The themes that described the inhibitors of health promotion were inadequate recreational and health facilities and health personnel, the impact of stringent religious doctrines, unemployment, social vices and poor parenting. CONCLUSION: We concluded that there is the need to implement more engaging activities and opportunities for the youth and parents in rural communities to enhance health promotion

Facebook for Health Promotion: Female College Students’ Perspectives on Sharing HPV Vaccine Information Through Facebook

Facebook, a social network site, has been widely used among young adults. However, its potential to be used as a health promotion medium has not been fully examined. This study explored Facebook\u27s potential for sharing human papillomavirus (HPV) vaccine information among female college students in Hawai‘i. Culturally tailored flyers and handouts were developed and distributed at one large university in Hawai‘i to recruit female college students between the age of 18 and 26 having an active Facebook account. Three focus group meetings were conducted to gather student perspectives about how information about HPV vaccine may be best shared via Facebook. We found that students believed Facebook is a good awareness tool but they needed more knowledge about the HPV vaccine to feel comfortable sharing the information. Participants preferred forwarding information to chatting about HPV. Some participants expressed concern that their Facebook friends would think the HPV vaccine information they forwarded on Facebook is spam. Participants suggested prefacing the posted HPV vaccine information with a personal note in their own words to make the message more interesting and relevant to their Facebook friends. Future interventions using Facebook to promote HPV vaccine could provide students with HPV vaccine information from credible sources and ask students to attach personal testimonials or endorsements while forwarding the information on Facebook

Examining the Factors That Influence African Americans in the Midwest to Reduce Salt Intake

Purpose: Salt intake is associated with cardiovascular diseases that are the leading cause of death especially among African American communities in the Midwest. Interventions need to be developed to address the culture of this population to decrease the health disparities of cardiovascular disease. This study applying the Health Belief Model aims to explore the factors that are associated with the behavior of reducing salt intake among this population. Methods: Three hundred ninety-nine African American adults participated in the telephone surveys. Logistic regression analysis was performed. Results: We found that affective risk perception in the form of concern of salt intake as well as self-efficacy were associated with the behavior of reducing salt intake among this population. However, seeing advertisement on mass media about the effect of eating too much salt and talking to anyone about heart problems or high blood pressure issues could not influence their behavior of reducing salt intake. Conclusion: This study shed light on how public health practitioners can potentially persuade African American population in Midwest to reduce salt intake through designing culturally appropriate interventions educating them about the risk of eating too much salt and increase their confidence in reducing salt in community settings

Photovoice: A user-centered design method to understand apparel needs of Female to Male (FTM) in gender identity and expression

Apparel plays a significant role in gender identity and expression. For females who are transitioning to male (FTM), clothing can be used to decrease stigma, discrimination, and body dysphoria during periods of transition. This project involved transgender men as active participants in a user-centered design process, known as photovoice. Photovoice is a participant-driven qualitative research strategy in which participants use images and discussions to express themselves, share ideas, and shape future apparel design by visually describing their design needs. To date, no apparel researchers have used photovoice methods for apparel design. Therefore, the purpose of this project was to use the photovoice method to understand trans apparel needs to make apparel a health-supportive part of the FTM transition experience. Sixteen FTM participants took part in the study in four focus groups of that lasted approximately 90 minutes each. Through the data analysis, it was revealed that the two primary roles of apparel in FTM identity are to reduce body dysphoria and help people pass as their desired gender. These findings were further broken down into symbolic and functional values where it is acknowledged that the symbolic and functional values are not mutually exclusive. The symbolic values were: Clothing can reveal group membership and grow self-confidence through self-expression while attempting to achieve body satisfaction. The functional values were: For FTM Individuals, clothing can be the source of physical and physiological discomfort and body shape and fit issues. Most of the clothing items used by participants to pass as male do not have any negative health implications. However, improperly wearing a chest binder can result in physical and physiological discomfort. Because of the intense pressure of the garment on the body, participants in our study experienced restricted breathing, reduction in arm range of motion, and thermal discomfort as it cannot be ventilated easily. In this exploratory research, both symbolic and functional values of apparel for FTM were addressed. Through the photovoice process, the participants were able to visually express the relationship of gender and clothing, possibly better than through dialogue alone. The next stage of this research will use the results of this data to specify design features that can be used to address symbolic and functional properties to inform novel design concepts for FTM

The Implications of 3D Body Scanning on State Self-Objectification

In this research, the researchers aimed to isolate the 3D body scanning process as a separate variable from viewing the avatar so that the implications of the 3D body scanning on body image and self-objectification may be better understood. The sample of 105 women completed a pretest, body scan, and post-test. The research team found that the process of being body scanned did not significantly change the participants\u27 state self-objectification scores. Demographic differences such as age, race, education, and socioeconomic status did not influence this finding. This finding is important, given that recent studies report that 3D body scanning can have detrimental effects on participants\u27 body satisfaction. This information may be useful for researchers who are concerned that the process of being 3D body scanned may have negative impacts on a participant\u27s state self-objectification

How Midwestern College students protected their families in the first year of COVID-19

IntroductionCollege students routinely visit their families due to geographic proximity and their financial dependence. Consequently, the potential of transmitting COVID-19 from campus to their families’ homes is consequential. Family members are key sources of support for one another in nearly all matters but there is little research uncovering the mechanisms by which families have protected each other in the pandemic.MethodsThrough an exploratory qualitative study, we examined the perspectives of a diverse, randomly sampled, group of students from a Midwestern University (pseudonym), in a college town, to identify COVID-19 prevention practices with their family members. We interviewed 33 students between the end of December 2020 and mid-April 2021 and conducted a thematic analysis through an iterative process.ResultsStudents navigated major differences in opinions and undertook significant actions in attempts to protect their family members from COVID-19 exposure. Students’ actions were rooted in the greater good of public health; prosocial behavior was on display.DiscussionLarger public health initiatives could target the broader population by involving students as messengers

Perceptions of Audio Computer-Assisted Self-Interviewing (ACASI) among Women in an HIV-Positive Prevention Program

Background: Audio Computer-Assisted Self Interviewing (ACASI) has improved the reliability and accuracy of self-reported HIV health and risk behavior data, yet few studies account for how participants experience the data collection process. Methodology/Principal Findings: This exploratory qualitative analysis aimed to better understand the experience and implications of using ACASI among HIV-positive women participating in sexual risk reduction interventions in Chicago (n = 12) and Philadelphia (n = 18). Strategies of Grounded Theory were used to explore participants ’ ACASI experiences. Conclusion/Significance: Key themes we identified included themes that could be attributed to the ACASI and other methods of data collection (e.g., paper-based self-administered questionnaire or face-to-face interviews). The key themes were usability; privacy and honesty; socially desirable responses and avoiding judgment; and unintentional discomfort resulting from recalling risky behavior using the ACASI. Despite both positive and negative findings about the ACASI experience, we conclude that ACASI is in general an appropriate method for collecting sensitive data about HIV/AIDS risk behaviors among HIV-positive women because it seemed to ensure privacy in the study population allowing for mor