Promotion of Latina Health: Intersectionality of IPV and Risk for HIV/AIDS

Latina women in the United States are vulnerable to two intersecting public health concerns: intimate partner violence (IPV) and subsequent risk for HIV/AIDS infection. Examination of the cultural and contextual life factors of this understudied population is crucial to developing culturally relevant HIV interventions. 

Focus groups with Latinas (15 monolingual; 10 bilingual) who have experienced IPV were conducted. Monolingual and bilingual Latinas endorsed that they were concerned about HIV infection, naming partner infidelity and experiences of forced and coerced sex as primary reasons for their concern. However, monolingual participants had lower levels of HIV knowledge, spending much time discussing myths of HIV infection, whereas bilingual participants spent more time discussing specific prevention techniques, including challenges related to the violence in their relationships. 

These findings suggest that HIV/AIDS prevention programs for Latinas need to pay close attention to the different historical, contextual, and cultural experiences of this at-risk group of women.

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By:  Rountree MA1, Granillo T2, Bagwell-Gray M3.

• 1University of Texas at Austin School of Social Work, USA mrountree@mail.utexas.edu.
• 2Con Mi Madre, Austin, TX, USA.
• 3Arizona State University School of Social Work, Phoenix, USA. 
• Violence Against Women. 2016 Apr;22(5):545-64. doi: 10.1177/1077801215607358. Epub 2015 Oct 14.

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Gender-Specific Jealousy and Infidelity Norms as Sources of Sexual Health Risk and Violence among Young Coupled Nicaraguans

Gender inequity negatively affects health in Central America. In 2011, we conducted 60 semistructured interviews and 12 photovoice focus groups with young coupled men and women in León, Nicaragua, to explore the ways in which social norms around marriage and gender affect sexual health and gender-based violence. 

Participants' depictions of their experiences revealed gendered norms around infidelity that provided a narrative to justify male expressions of jealousy, which included limiting partner autonomy, sexual coercion, and physical violence against women, and resulted in increased women's risk of sexually transmitted infections, including HIV. 

By understanding and taking account of these different narratives and normalized beliefs in developing health- and gender-based violence interventions, such programs might be more effective in promoting gender-equitable attitudes and behaviors among young men and women in Nicaragua.

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By:  Boyce S1, Zeledón P1, Tellez E1, Barrington C1.

• 1At the time of the study, Sabrina Boyce was a US Fulbright fellow in León, Nicaragua. Perla Zeledón and Ever Tellez were with el Centro de Investigación e Intervenciones en Salud, León, Nicaragua. Clare Barrington was with the Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. 
• Am J Public Health. 2016 Feb 18:e1-e8.

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What Should I Say to a Straight Friend Who Thinks Gay Men Are Incapable of Monogamy?

Via:  http://goo.gl/Rk5Py5  By:  https://twitter.com/mjs_DC

Upset Over Sexual versus Emotional Infidelity among Gay, Lesbian, Bisexual, and Heterosexual Adults

One hypothesis derived from evolutionary perspectives is that men are more upset than women by sexual infidelity and women are more upset than men by emotional infidelity. The proposed explanation is that men, in contrast to women, face the risk of unwittingly investing in genetically unrelated offspring. Most studies, however, have relied on small college or community samples of heterosexual participants. 

We examined upset over sexual versus emotional jealousy among 63,894 gay, lesbian, bisexual, and heterosexual participants. Participants imagined which would upset them more: their partners having sex with someone else (but not falling in love with them) or their partners falling in love with someone else (but not having sex with them). 

Consistent with this evolutionary perspective, heterosexual men were more likely than heterosexual women to be upset by sexual infidelity (54 vs. 35 %) and less likely than heterosexual women to be upset by emotional infidelity (46 vs. 65 %). This gender difference emerged across age groups, income levels, history of being cheated on, history of being unfaithful, relationship type, and length. 

The gender difference, however, was limited to heterosexual participants. Bisexual men and women did not differ significantly from each other in upset over sexual infidelity (30 vs. 27 %), regardless of whether they were currently dating a man (35 vs. 29 %) or woman (28 vs. 20 %). Gay men and lesbian women also did not differ (32 vs. 34 %). 

The findings present strong evidence that a gender difference exists in a broad sample of U.S. adults, but only among heterosexuals.

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By:  Frederick DA1, Fales MR2.

• 1Department of Psychology, Crean School of Health & Life Sciences, Chapman University, One University Drive, Orange, CA, 92866, USA. enderflies1@aol.com.
• 2Psychology Department, University of California, Los Angeles, CA, USA.
• Arch Sex Behav. 2016 Jan;45(1):175-91. doi: 10.1007/s10508-014-0409-9. Epub 2014 Dec 18. 

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Evidence of Increased STI/HIV-Related Risk Behavior among Male Perpetrators of Intimate Partner Violence in Guatemala

Intimate partner violence (IPV) is a significant public health problem with a demonstrated link to increased sexually transmitted infection (STI)/HIV-related risk and vulnerability. While IPV is an important issue in Central America, the link to STI/HIV risk has not been explored in this region. 

In this study, the relationship between emotional and physical/sexual IPV and the STI/HIV-related risk behaviors of sex worker patronage and infidelity is assessed among male IPV perpetrators using data from a national survey conducted in 2009 in Guatemala (n = 4773 married/partnered men). Bivariate associations between background characteristics and emotional and physical IPV perpetration were explored. Logistic regression models were run to test associations between IPV for each sexual risk behavior. Perpetration of emotional and physical/sexual IPV was more common among married/partnered men who were older than 24, had more education, lived in urban areas, or were in common law versus married unions. Reports of past-year emotional IPV perpetration increased as wealth quintile increased. After adjusting for demographics and other characteristics, physical/sexual IPV perpetration was associated with past-year infidelity (AOR 1.9, 95% CI: 1.1-3.6). Lifetime emotional IPV (AOR 1.4, 95% CI: 1.1-1.7) and physical/sexual IPV 1.6 (95% CI 1.2-2.0) were positively associated with a history of sex worker patronage. Endorsement of traditional gender role norms showed a marginally positive association with past-year infidelity in the adjusted model (AOR 1.3, 95% CI 1.0-1.8). 

The study findings from Guatemala reinforce the growing evidence globally that male IPV perpetrators are more likely to engage in risky sexual behavior, including sex worker patronage and main partner infidelity. The concurrency of violence and increased STI/HIV risk may compound the health risks for female victims of IPV who also face injury and psychological trauma. Integration of prevention and screening of IPV and STI/HIV prevention services should be adopted in Guatemala and other similar contexts.

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By:   Hembling J¹, Andrinopoulos K.

¹a Department of Global Health Systems and Development , Tulane School of Public Health and Tropical Medicine , New Orleans , LA , USA.

AIDS Care. 2014;26(11):1411-8. doi: 10.1080/09540121.2014.913766. Epub 2014 May 6.

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Contested Domains, Verbal 'Amplifiers,' and Intimate Partner Violence in Young Adulthood

We draw on structured and qualitative data to examine relationship dynamics associated with intimate partner violence (IPV) that occurs during the young adult period. Relying on a symbolic interactionist perspective, we identify specific contested domains associated with what has been called 'situational couple violence,' and explore the degree to which certain forms of communication about contested areas ('verbal amplifiers') exacerbate the risk of violence. 

Consistent with this relational focus, measures index respondent as well as partner concerns and use of these negative forms of communication. Results of analyses of interview data from a large, diverse sample of young adults show that net of family background, history of antisocial behavior, and other controls, concerns about the partner's or individual's own economic viability, disagreements about time spent with friends, and issues of infidelity are significantly related to IPV perpetration. 

Yet the analyses indicate that infidelity is particularly central as a source of conflict associated with violence, and the use of verbal amplifiers explained additional variance. Further, while research has highlighted important differences in the meaning and consequences of male and female IPV, findings point to some areas of overlap in the relationship concerns and communication processes associated with variations in self-reports of the use of violence. 

In-depth "relationship history narratives" elicited from a subset of respondents and a sample of their partners support the quantitative results, but also highlight variations within the sample, the sequencing of these interrelated processes, and ways in which gender may have influenced respondents' perspectives and behavior.

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By:  Giordano PC1, Copp JE1, Longmore MA1, Manning WD1.

• 1Department of Sociology, and Center for Family and Demographic Research, Bowling Green State University, Bowling Green, OH 43403. 

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Drawing the Line: The Development of a Comprehensive Assessment of Infidelity Judgments

Infidelity is a leading cause of relationship discord and dissolution, and couples generally report expectations to maintain monogamy. However, a majority of men and women report engaging in some form of infidelity at least once in their lives. 

Research assessing judgments of the behaviors that constitute infidelity is lacking. The three studies reported here advanced the literature by developing and validating the Definitions of Infidelity Questionnaire (DIQ), a comprehensive measure examining infidelity judgments. Exploratory and confirmatory factor analyses indicated four factors to the scale: sexual/explicit behaviors, technology/online behaviors, emotional/affectionate behaviors, and solitary behaviors. Investigation of the psychometric properties demonstrated the DIQ to be reliable and valid. 

Participants agreed that sexual/explicit behaviors comprised infidelity to the largest extent, whereas other types of behaviors (technology/online behaviors, emotional/affectionate behaviors, and solitary behaviors) were judged as comprising infidelity to a lesser extent. Men reported more permissive judgments than did women. 

This study provides insights regarding operationalizing infidelity and identifying areas of ambiguity and consensus. Implications of the findings for educators and practitioners working with individuals in intimate relationships are discussed.

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By:  Ashley E. Thompson^a* & Lucia F. O’Sullivan^a

• ^a Department of Psychology, University of New Brunswick

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Violence Against Wives: A Silent Suffering in Northern Saudi Community

Violence against women is a worldwide epidemic. It may take different forms depending on history, culture, background, and experiences, but it causes great suffering for women, their families, and the communities in which they live. Despite its high prevalence, no previous studies that have been conducted in Arar, northern area of Kingdom of Saudi Arabia (KSA), addressing this issue could be traced.

The aim of this study was to measure the prevalence and determinants of violence experienced by ever-married women attending primary health centers in Arar city, Northern Border, KSA.

This study is a cross-sectional study conducted during the period from January to June 2014 in Arar city in the Northern Province of the KSA. Data were collected through an interviewer-administered questionnaire. A total of 208 wives (184 currently married, 16 divorced, and eight widowed) attending five randomly selected primary healthcare centers in Arar, KSA, were interviewed. Collected data provided information on both physical and emotional violence.

The study revealed that the overall prevalence of domestic violence in the studied group was 80.7 and 100.0% for physical and psychological violence, respectively. On studying the reasons for physical violence, half (50%) of the participants reported no clear cause, 19.2% reported failure to adequately care for children (such as cleaning, feeding, and dressing), and 7.8% reported causes related to poor scholastic achievement and couple conflict about appropriate approaches of upbringing of children. Suspicion on wife's fidelity was the most common form of psychological violence (21%). The perpetrator was the husband in 76.9% of cases and the husband's family was the perpetrator in 3.8% of cases. Physical violence was significantly higher during the first 10 years of marriage compared with other durations. University-educated husbands showed significantly lower percentage of physical violence against women compared with those of other educational levels.

Violence against women was highly prevalent in Arar city. Inadequate care of children and poor scholastic achievement were the most common reasons of physical violence, whereas financial conflicts and suspicion of wife's fidelity were the most common reasons for psychological violence. We recommend awareness programs aiming at educating current and future couples, and proper training of healthcare providers for assisting cases experiencing violence against women.

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By:  Abo-Elfetoh NM1, Abd El-Mawgod MM.

• 1Public Health and Community Medicine Department, Faculty of Medicine, Sohag University, Sohag b Public Health and Community Medicine Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt c Public Health and Community Medicine Department, Faculty of Medicine and Applied Medical Sciences, Northern Border University, Arar, Kingdom of Saudi Arabia.

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Gendered Power Dynamics & Women's Negotiation of Family Planning in a High HIV Prevalence Setting: A Qualitative Study of Couples in Western Kenya

In sub-Saharan Africa, high burdens of HIV and unmet need for contraception often coexist. Research emphasises the need to engage men and couples in reproductive health, yet couples' negotiations around fertility and family planning in the context of HIV have been sparsely studied. 

This study examined the gendered power dynamics that frame women's and couples' negotiations of contraceptive use in western Kenya. We conducted 76 in-depth interviews with 38 couples, of whom 22 couples were concordant HIV-positive. Qualitative data were analysed using a grounded theory approach. Direct communication around contraception with men was often challenging due to perceived or expressed male resistance. 

A substantial minority of women avoided male reproductive decision-making authority through covert contraceptive use, with concern for severe consequences when contraceptive use was discovered. Many men assumed that family planning use signified female promiscuity and that infidelity motivated covert use. 

Men were more willing to use condoms to avoid HIV re-infection or on the recommendation of HIV care providers, which allowed some women leverage to insist on condom use. 

Our findings highlight the tension between male dominated reproductive decision making and women's agency and point to the need for gender transformative approaches seeking to challenge masculinities that negatively impact health.

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By:  Harrington EK1, Dworkin S2, Withers M3, Onono M4, Kwena Z4, Newmann SJ5.

• 1 Department of Obstetrics and Gynecology , Oregon Health and Science University , Portland , USA.
• 2 Department of Social and Behavioral Sciences , University of California , San Francisco , USA.
• 3 Institute for Global Health , University of Southern California Keck School of Medicine , Los Angeles , USA.
• 4 Research, Care, and Training Program, Center for Microbiology Research , Kenya Medical Research Institute , Kisumu , Kenya.
• 5 Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco General Hospital , University of California , San Francisco , USA.

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Differences According to Sex in Sociosexuality and Infidelity after Traumatic Brain Injury

To explore differences according to sex in sociosexuality and infidelity in individuals with TBI and in healthy controls. 

Forty-two individuals with mild, moderate, and severe TBI having completed a postacute TBI rehabilitation program, at least six months after injury, and 47 healthy controls.Main Measures. Sociosexual Orientation Inventory-Revised (SOI-R) and Attitudes toward Infidelity Scale.

Overall, men score significantly higher than women in sociosexuality. However, there was a nonsignificant trend towards a reduction of sociosexuality levels in men with TBI. Infidelity levels were comparable in healthy controls and individuals with TBI. In individuals with TBI, less acceptance of infidelity was significantly associated with an unrestricted sociosexual orientation, but not in healthy controls.

As documented in previous cross-cultural studies, men have higher levels of sociosexuality than women. However, men with TBI showed a tendency towards the reduction of sociosexuality. The possibility of a latent explanatory variable is suggested (e.g., post-TBI neuroendocrinological changes). TBI does not seem to have an impact on infidelity, but individuals with TBI who express less acceptance of infidelity also report a more promiscuous mating strategy regarding their behavior, attitudes, and desire. Theoretical implications are discussed in terms of evolutionary theories of human sexuality and neuropsychology.

Below:  Estimated marginal means for sociosexuality as a function of group and gender. Abbreviation: SOI, total score of the Sociosexual Orientation Inventory.

Full article at: http://goo.gl/79qD9D

By: Jhon Alexander Moreno 1 , 2 , * and Michelle McKerral 1 , 2 , *

¹Center for Interdisciplinary Research in Rehabilitation (CRIR), Centre de Réadaptation Lucie-Bruneau (CRLB), 2275 Laurier Avenue East, Montréal, QC, Canada H2H 2N8

²Centre de Recherche en Neuropsychologie et Cognition (CERNEC), Département de Psychologie, Université de Montréal, Montréal, QC, Canada

*Jhon Alexander Moreno: Email: ac.laertnomu@onerom.rednaxela.nohj and

*Michelle McKerral: Email: ac.laertnomu@larrekcm.ellehcim

Academic Editor: Hrayr Attarian

  

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Prevalence Of & Risk Factors for Bacterial Vaginosis among Women of Reproductive Age Attending Cervical Screening in Southeastern Brazil

To determine the prevalence of and risk factors for bacterial vaginosis.

A cross-sectional study of women aged 14-54 years attending 18 primary healthcare units in Botucatu, Brazil, for cervical screening was undertaken between September 1, 2012, and January 31, 2013. Data on sociodemographics, sexual behavior, and medical history were obtained by interview. Vaginal swabs were taken to classify the vaginal flora according to the Nugent scoring system. Candida sp. hyphae and infection by Trichomonas vaginalis were also evaluated by microscopy and culture, respectively. Stepwise logistic regression analysis was performed to identify risk factors independently associated with bacterial vaginosis.

Among 1519 women included in analyses, 30.1% had bacterial vaginosis. Variables independently associated with bacterial vaginosis were a single marital status, partner infidelity, abnormal discharge in the previous year, and concurrent trichomoniasis. Current use of hormonal contraception, luteal phase of menstrual cycle, higher income, and vaginal candidiasis all had protective effects.

The prevalence of bacterial vaginosis in the study population is high. The epidemiological data provide evidence of the sexual transmissibility of bacterial vaginosis.

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By: Marconi C1, Duarte MT2, Silva DC3, Silva MG4.

• 1Department of Pathology, Botucatu Medical School, Univ Estadual Paulista, Botucatu, São Paulo, Brazil.
• 2Department of Nursing, Botucatu Medical School, Univ Estadual Paulista, Botucatu, São Paulo, Brazil.
• 3Department of Health of Botucatu Prefecture, Botucatu, São Paulo, Brazil.
• 4Department of Pathology, Botucatu Medical School, Univ Estadual Paulista, Botucatu, São Paulo, Brazil. Electronic address: mgsilva@fmb.unesp.br.  

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Discovery of a Partner Affair & Major Depressive Episode in a Probability Sample of Married or Cohabiting Adults

Prior research has found that humiliating marital events are associated with depression. Building on this research, the current study investigated the association between one specific humiliating marital event-discovering that one's partner had an affair-and past-year major depressive episode (MDE) in a probability sample of married or cohabiting men and women who were at high risk for depression based on the criterion that they scored below the midpoint on a measure of marital satisfaction (N = 227). 

Results indicate that (i) women were more likely than men to report discovering their partner had an affair in the prior 12 months; (ii) discovering a partner affair was associated with a higher prevalence of past-year MDE and a lower level of marital adjustment; and (iii) the association between discovering a partner affair and MDE remained statistically significant when holding constant demographic variables and marital adjustment. 

These results support continued investigation into the impact that finding out about an affair has on the mental health of the person discovering a partner affair.

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By: Whisman MA1.

• 1Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO.  

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Concurrent Sexual Partnerships among Married Zimbabweans – Implications for HIV Prevention

Concurrent sexual partnerships play a key role in sustaining the HIV epidemic in Zimbabwe. Married couples are at an increased risk of contracting HIV from sexual networks produced by concurrent sexual partnerships. Addressing these partnerships is an international HIV prevention priority.

Our qualitative study presents the socioeconomic factors that contribute to the occurrence of concurrent sexual partnerships among married people in Zimbabwe. We conducted 36 in-depth interviews and four focus group discussions with married men and women in Zimbabwe in 2008 to understand the organizations of concurrent sexual partnerships. Data were analyzed using framework analysis.

Our study indicates that relationship dissatisfaction played a key role in the engagement of concurrent sexual partnerships. Depending on the source of the dissatisfaction, there were four possible types of concurrent sexual relationships that were formed: sex worker, casual partner, regular girlfriend or informal polygyny which was referred to as “small house”. These relationships had different levels of intimacy, which had a bearing on practicing safer sex. Participants described three characteristics of hegemonic masculinity that contributed to the sources of dissatisfaction leading to concurrent sexual activity. Similarly, various aspects of emphasized femininity were described as creating opportunities for the occurrence of concurrent sexual relationships. Economic status was also listed as a factor that contributed to the occurrence of concurrent sexual partnerships.

Marital dissatisfaction was indicated as a contributing factor to the occurrence of concurrent sexual relationships. There were several reports of satisfying marital relationships in which affairs did not occur. Lessons from these marriages can be made part of future HIV prevention interventions targeted at preventing concurrent sexual partnerships by married couples.

Below:  Cycle of extramarital relationships

Below:  Participants’ explanations for men’s lust

Below:  Characteristics of emphasized femininity that shaped extramarital sexual activity

Full article at: http://goo.gl/EqPWNi

By: Esther Mugweni,1 Stephen Pearson,2 and Mayeh Omar2

1UCL Department of Infection and Population Health, University College London, London, UK

2The Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK

  

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The Impact of Infidelity on Combat-Exposed Service Members

This study examined relationships between combat-exposed Operation Enduring Freedom/Operation Iraqi Freedom veterans' experiences related to infidelity during deployment (i.e., indicating that a partner was unfaithful or reporting concern about potential infidelity) and postdeployment mental health, as well as the role of subsequent stress exposure and social support in these associations. 

The sample consisted of 571 individuals (338 men). There were 128 participants (22.2%) who indicated that their partners were unfaithful during their most recent deployment. Of the remaining 443 participants, 168 (37.8%) indicated that they were concerned that their partners might have been unfaithful. Individuals who indicated that their partners were unfaithful exhibited higher levels of posttraumatic stress symptomatology and depression symptom severity, compared to individuals who did not indicate that their partners were unfaithful. 

For both men and women, reported infidelity was associated with mental health indirectly via postdeployment life stressors, whereas infidelity concerns were indirectly associated with mental health via postdeployment life stressors for men only. 

Findings suggested that infidelity can have a significant impact on combat-exposed veterans' mental health and highlight the need for additional research on this understudied topic within the military population.

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By: Kachadourian LK1,2, Smith BN3,4, Taft CT3,4, Vogt D3,4.

• 1National Center for PTSD, VA Connecticut Healthcare System, West Haven, Connecticut, USA.
• 2Yale University School of Medicine, Department of Psychiatry, New Haven, Connecticut, USA.
• 3National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.
• 4Boston University School of Medicine, Department of Psychiatry, Boston, Massachusetts, USA.

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How Reliable Are Self-Reports of HIV Status Disclosure? Evidence from Couples in Malawi

The majority of research on human immunodeficiency virus (HIV) disclosure utilizes the perspective from a single individual, which cannot be substantiated in the absence of supporting data such as from a primary partner.

The objectives of this study were to evaluate: 

• the extent to which self-reported HIV disclosure was confirmed by a primary partner; 
• individual and relationship-level predictors of self-reported versus confirmed disclosure; and 
• whether confirmed disclosure was a stronger predictor of correctly assessing a partner's HIV status compared to self-reported disclosure.

As part of an 8-wave longitudinal study from 2009 to 2011 in southern Malawi, 366 individuals (183 couples) were interviewed about their primary relationship (wave 3), individually tested for HIV (wave 4), and then asked whether they disclosed to their primary partner (wave 5).

• While 93% of respondents reported that they disclosed, only 64% of respondents had confirmed reports from their partner. 
• Having communicated with partner about HIV was positively associated with self-reported disclosure; this association remained significant but became more precise in the models for confirmed disclosure. 
• Confirmed disclosure, but not self-report, was a significant predictor of correctly assessing a partner's HIV status. 
• Being male, 
• having lower perceived partner infidelity, 
• having higher relationship unity, 
• and testing HIV-negative 
• Were positively and significantly associated with correct assessment. .

Dyadic data from two partners provide an improved measure of disclosure as compared to a single individual's self-report and could be used to identify behavioral and biomedical opportunities to prevent HIV transmission within couples 

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By:  Conroy AA1, Wong LH2.

• 1Center for AIDS Prevention Studies, University of California San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA 94158, USA
• 2Center for AIDS Prevention Studies, University of California San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA 94158, USA.

What Counts As Cheating: Respondents Who Say Extramarital Sex Is "Always Wrong"

Via: http://ht.ly/Q7sHr MT @MonaChalabi