Culture, Health & Sexuality最新文献

Cervical cancer is a leading cause of mortality among women in Ethiopia, particularly in rural areas where sociocultural and religious norms significantly influence health behaviour. Despite the inclusion of the HPV vaccine in the national immunisation program, uptake among adolescent girls remains low. This study explored sociocultural and religious factors that shape vaccine acceptance among adolescent girls in rural Ethiopia. Data were collected through in-depth interviews, key informant interviews, and focus group discussions with adolescent girls (vaccinated and unvaccinated), parents, public health workers, and community leaders in Gurage and Hadiya zones. Thematic analysis was conducted. Five key themes were developed: (1) limited knowledge and awareness; (2) cultural stigma surrounding reproductive health; (3) religious resistance to biomedical interventions; (4) parental and community influence; and (5) fear of vaccine-related side effects such as infertility. Parental and community influence appeared to both facilitate and discourage vaccine acceptance, while lack of knowledge and awareness, cultural stigma, and fear of vaccine-related side effects acted as discouragers. HPV vaccine acceptance in rural Ethiopia is shaped by complex social, cultura and religious factors. Interventions must go beyond awareness campaigns to include community engagement, religious leader advocacy, and parental education to improve vaccine uptake.

This paper explores the profound physical, psychological and emotional challenges experienced by women who are subjected to forced marriage in the Ganderbal district of the Kashmir division of the Union Territory of Jammu and Kashmir in India. It argues that the forced marriage of women significantly impacts their physical and mental well-being, and reduces their standard of living. It focuses mostly on the loss of autonomy, reproductive health, social stigma and other hard-to-adjust-to challenges that lead to their poor quality of life. This qualitative study involved 15 purposively selected respondents and was conducted between November and December 2024. Its findings reveal that forced marriages function as a site of ongoing emotional and bodily regulation, which places severe restrictions on women's personal freedom, reproductive choice and access to healthcare.

This study explored the experiences of pregnant women in Mawadza rural community, Mutasa District, Zimbabwe, regarding the use and non-use of a waiting mothers' shelter during pregnancy, childbirth, and the post-partum period. Guided by the Second Delay in Thaddeus and Maine's Three Delays Model, it examines how spatial, infrastructural, and socio-economic barriers influenced women's ability to reach maternal health facilities in time. The Second Delay highlights obstacles between deciding to seek care and arriving at a facility, including transport availability, distance, affordability, and social responsibilities that constrain mobility. Qualitative in-depth interviews were conducted with fifteen women who had used the waiting mothers' shelter at Bonda Mission Hospital since 2015 and thirteen key informants. Findings showed that while the shelter offered skilled birth attendance, antenatal education, and postnatal monitoring, utilisation remains low and inconsistent. Barriers included indirect costs, household labour demands, and stigma, particularly for HIV-positive women. Enabling factors include peer support, trust in biomedical care, and engagement of religious institutions. The study concludes that shelter use was influenced by structural, cultural, and economic factors, including gender power dynamics, and offers insights into policies aligned with Zimbabwe's National Development Strategy 1 (NDS1), the Maputo Protocol on Health and Reproductive Rights, and SDGs 3 and 5 to improve maternal health access.

Because rape myths, or false beliefs about sexual violence victims and perpetrators, are theorised to be a root cause of sexual violence, sexual violence prevention programming often includes a focus on reducing acceptance of rape myths. To measure the acceptance of rape myths, a small number of quantitative scales that were developed in the 1980s or 1990s, or were adapted from these scales, are still commonly used. To avoid systematic bias in our knowledge-base about rape myths, up to date descriptive research is needed to explore the framing and content of rape myths. The current study addresses this need through an individual, interpretive analysis of the content and framing of rape myths in the 25 most popular songs on Billboard's year-end song charts from 2013 to 2023, which reflect the most popular songs in the USA. Out of 151 songs that met inclusion criteria, 70% included at least one rape myth. Results provide insights into which rape myths have been widely circulated via popular song lyrics and should therefore warrant a special focus in violence prevention programming. The discussion also provides recommendations for updates to existing scales for measuring rape myth acceptance.

Immigrant adolescents in Canada face challenges accessing accurate sexual and reproductive health (SRH) information and services. Many challenges stem from taboos associated with SRH, cultural and religious restrictions, and social beliefs regarding the unnecessity of SRH education for adolescents. We explored the SRH experiences of immigrant adolescents in the context of their cultural and religious perspectives. We engaged adolescents as collaborators and active participants in the research process. With the support of an Adolescent Advisory Group (AAG) and community partners, we conducted qualitative interviews with immigrant adolescents in Edmonton, Toronto, and Vancouver (n = 58). Through thematic analysis, we identified three broad themes: (1) 'What's really happening?' Experiencing body changes from puberty to adulthood; (2) 'It's something that's shameful': Encountering myths, misperceptions, and norms about SRH; and (3) 'I'll be there for you': Navigating family and digital resources for support. Our findings highlight the specific SRH challenges faced by immigrant adolescents in Canada, such as differences between cultural values, and communication barriers within families. Dealing with SRH matters is dependent on education, family readiness, and personal values attached to these topics. Programmes must focus on engaging cultural and religious preferences and tailoring interventions to adolescents' needs.

Stigma remains a significant burden for people living with HIV and while studies have examined the impacts of gender, ethnicity, and sexual orientation on stigma separately, little is known about how these factors may intersect and potentially exacerbate levels of stigma. This study examines how these intersecting social positions may relate to levels of internalised, enacted and anticipated HIV stigma. Participants were recruited in Ontario, Alberta, and Québec (n = 1040) as part of the People Living with HIV Stigma Index study in Canada. Three-way interaction models were constructed by creating interaction terms from the product of gender, ethnicity, and sexual orientation variables that predicted each type of stigma. Levels of internalised, enacted and anticipated stigma were consistent across most intersecting groups; however, people occupying certain intersections experienced significantly higher levels of stigma. Three-way interaction analyses showed that for internalised stigma, people at the intersection of African/Caribbean/Black, lesbian, cis-women identities had significantly higher scores (b = 0.90, p = 0.06), while people at the intersection of Indigenous, lesbian, and cis-women identities had higher scores for enacted stigma (b = 1.21, p = 0.01) compared to the White, heterosexual, cis-men reference group. Interventions designed for populations that take intersectionality into account may be effective in reducing HIV stigma, although more quantitative intersectionality work must be done to understand these implications fully.

Hymenoplasty is a procedure to surgically restore the hymen, a thin membrane that partially closes the entrance to the vagina and which may be ruptured due to sexual activity. It is requested by women whose culture demands they prove their virginity by bleeding on their wedding night. As a result, this surgery is filled with ethical and legal controversy surrounding virginity, sexual equality, and women's rights to bodily autonomy and self-determination. This paper is a qualitative analysis of conversations with four Canadian doctors faced with the request for hymenoplasty and their experiences and decision-making process. Results indicate doctors relied on values of self-determination, bodily autonomy, honesty and integrity, and ethical principles of informed consent, competence, privacy, confidentiality, and culture and gender awareness, to inform their decision making. In their dialogues they placed different weight on the biological aspects of the surgery, culture, and personal autonomy resulting in different decisions and actions in response to the request. In addition, compartmentalisation, simplification, distance, differentiation and responsiveness appeared to assist the doctors in engaging with the discomfort and ethical dilemmas inherent in responding to the request for hymenoplasty. Future research is needed to verify these results and to explore the impact of the differing approaches to the women requesting the surgery.

Initial efforts to control COVID-19 included restricting human movement, which caused heightened economic insecurity and challenges to the management of chronic health conditions such as HIV. The aims of this study were to: (1) explore how female sex workers living with HIV in the Dominican Republic and Tanzania, two different cultural and epidemic contexts, reacted to the onset of the COVID-19 pandemic, and (2) assess how lockdown measures impacted HIV care and treatment experiences. We analysed data from interviews (20 in each country) conducted during the onset of the COVID-19 pandemic as part of a longitudinal study of the social determinants of HIV outcomes. Using narrative and thematic analytic techniques, we identified fear and financial insecurity as the two main impacts of the initial COVID-19 lockdown on female sex workers in both settings. While participants experienced challenges accessing HIV-related care and treatment and received limited to no state-level social protection, they adapted to these changes by drawing on individual resilience and family and community support to sustain adherence to medication and overall wellbeing. Findings highlight the need for systems-level social protection to reduce economic insecurity prior to shocks and bolster individual resilience, family, and community-level supports during crises such as COVID-19.

Half a century after the birth of Louise Brown, assisted reproductive technologies (ART) have evolved from specialised infertility treatments to become a reproductive norm in specific societal contexts. In Japan-where sexlessness and declining birthrates are widespread-ART has emerged not only as a medical solution but also a societal workaround. This paper explores the ethical implications of ART's normalisation in Japan, focusing on three key concerns: (1) the commercialisation of ART and its framing as 'natural'; (2) pronatalist incentives that blur the line between support and coercion; and (3) the decoupling of sex and reproduction through medicalisation. Using Japan as a case study, the paper examines whether ART should require clear medical indications, whether societal factors like sexlessness justify its use, and how government and industry pressures subtly shape patient choices. Ultimately, it argues for the stricter regulation of ART practices and more effective pronatalist policies that directly address sexlessness, calling for a stronger emphasis on relational ethics to balance individual autonomy with societal needs in reproductive health.

Transgender and nonbinary people's experiences are distinct from cisgender people's experiences, and relatively little is known with respect to their desire for parenthood or to remain childfree. This study aimed to explore aspirations about parenthood among fifteen trans men and women (n = 7) and nonbinary adults (n = 8) without children from Italy, adopting a life course theory approach. Employing thematic analysis, we identified three overarching themes: (1) navigating obstacles that excluded the choice of parenthood; (2) encountering violence and stigma; and (3) future possibilities for transgender and nonbinary parenthood. Results showed that transgender and nonbinary people's parenthood aspirations were hampered by violence, stigma, and difficulties with affirming and care pathways. Participants saw themselves as being potentially competent to be parents. However, they experienced challenges to their aspirations living in a society that rejected their personal ideas about what a family is supposed to be. Although twelve participants desired or considered parenthood, they did not imagine this to be a realistic option. Many of them thought about becoming parents in a different country, through adoption, and of negotiating parenthood outside of limits imposed by binarism, within safe and creative spaces.