Culture, Health & Sexuality最新文献

Despite improved access to sexual and reproductive health services, uptake among adolescents and young people remains low. Supporting their decision-making and addressing barriers to service use is critical to improving HIV prevention, reducing sexually transmitted infections, improving treatment outcomes, and preventing early pregnancies. This analysis explored factors influencing participants sexual and reproductive health service use decisions in a study conducted between June and August 2023 in KwaZulu-Natal, South Africa. Thematic analysis revealed four key themes: (1) cues to seeking sexual and reproductive health services; (2) social influences; (3) clinic experiences; and (4) perceived effort of accessing services. Most participants sought services reactively-after sex-due to concerns about potential negative outcomes, rather than proactively. Social influences and clinic experiences shaped how the effort versus the benefit of using services was evaluated. When the perceived effort outweighed the anticipated benefits, participants often avoided services. Understanding the decision process is essential for designing more responsive, user-centred programmes interventions to improve SRH service uptake among peoples.

Transgender and gender diverse adults experience significant health disparities, including accessing and utilising healthcare services. Geographic location appears to impact health disparities with rural-residing transgender and gender diverse adults experiencing less healthcare access, utilisation of services, and ultimately worse health outcomes compared to their urban-residing peers. However, less is known about the unique experiences of transgender and gender diverse adults living in rural areas within states in the USA that have enacted policies protecting access to and/or extending benefits for gender-affirming healthcare. In this study, fifteen adults participated in interviews describing their healthcare experiences in one rural community within US states that had enacted policies protecting access to and/or extending benefits for gender-affirming healthcare. Findings suggest residing in a state with these protections and benefits may not sufficiently address issues with access and patient experience. Negative findings included a lack of healthcare services, the need to travel long distances for healthcare, a lack of consistent healthcare, and experiences of discrimination. Positive findings included local support services and affirming healthcare providers. These findings can inform medical providers and policymakers about persistent issues related to the access and use of healthcare services by transgender and gender diverse adults.

Public health campaigns offer one strategy for promoting awareness and acceptability of HIV prevention options among at-risk populations. Four focus groups were conducted with Black gay and bisexual men to elicit their recommendations on developing a public health campaign to promote awareness of long-acting injectable PrEP in the USA. Participants offered suggestions about the content they wanted to see included in a campaign, and how it should be delivered. Data were analysed using thematic analysis. It was felt that a well-focused campaign should: 1) provide basic information about long-acting injectable PrEP and where it can be accessed; 2) highlight the individual- and community-level benefits of long-acting injectable PrEP; 3) exclude images of syringes to avoid their negative connotations; 4) be direct and use appropriate language; 5) be inclusive and highlight the diversity of Black gay and bisexual men; 6) use Black gay and bisexual men as messengers to promote long-acting injectable PrEP within the community; and 7) encourage Black gay and bisexual men to seek out and share information about long-acting injectable PrEP. Incorporating community recommendations from Black gay and bisexual men will help ensure a campaign is culturally acceptable, relatable, and is not stigmatising.

Female genital cutting (FGC) may lead to clinical infertility (failure to achieve a pregnancy after 12 months of regular unprotected sexual intercourse) through gynaecologic morbidity and reduced sexual frequency, but previous studies were inconclusive. Therefore, we examined if FGC and FGC severity were associated with longer time-to-pregnancy (TTP) in Nigeria. We restricted 2013 Nigeria Demographic Health Survey (NDHS) data to women at risk of pregnancy at the time of the interview (18-44 years, married/cohabiting, sexually active, not using contraception, and not sterilised) with self-reported FGC status (n = 4,431). Using the current duration approach, we conducted weighted accelerated-failure-time regression survival modelling to estimate time ratios for TTP by FGC status/severity, stratified by parity as a proxy for primary (nulliparous) and secondary (parous) infertility. Thirty-three percent of women reported having undergone FGC (severity: Type I: 2.9%, Type II: 17.7%, Type III: 1.6%, Unknown/missing severity: 10.9%). Overall, there were no differences in TTP between those with and without FGC. However, nulliparous women with Type III FGC had longer TTP (adjTR = 11.80, 95% CI: 4.09-34.01). FGC was not significantly associated with longer TTP for other severity groups or among parous women.

This study examined the experiences of social workers providing sexual and reproductive health and rights (SRHR) services to migrant populations in Türkiye. Using a qualitative phenomenological approach, in-depth interviews were conducted with 25 social workers, and data were analysed through thematic analysis. Findings were organised under three headings: intersectional vulnerabilities in migrant communities; institutional and individual challenges for social workers; and recommendations for strengthening SRHR-focused social work. Legal precarity, cultural differences, and information gaps created complex SRHR needs among migrants. Participants reported role ambiguity, institutional neglect, and emotional burden, which reduced their capacity to deliver sustainable and rights-based care. Access to SRHR services for migrants-particularly those of uncertain legal status-remained structurally constrained, highlighting a key barrier undermining long-term service sustainability. Informal coping strategies and peer support helped manage emotional strain, yet were insufficient without structural backing. Study findings underscore the need for culturally responsive, coordinated, and ethically grounded SRHR provision. They also call for rights-based and status-independent service models to ensure equitable access for all individuals. Strengthening social work practice in migrant SRHR settings in Türkiye requires investment in training, supervision, and interdisciplinary collaboration to improve both service quality and practitioner well-being.

This article examines why same-sex intimate partner violence remains largely unaddressed in Namibia, despite evidence that it is a significant issue affecting local LGBTI+ (lesbian, gay, bisexual, trans, inter and more) communities. Drawing on 12 in-depth interviews with same-sex intimate partner violence survivors conducted between August and October 2023, the article illustrates how cultural and heteronormative understandings of intimate partner violence, necropolitical silencing by state and public institutions, and the social dynamics within LGBTI+ communities contribute to the marginalisation of same-sex intimate partner violence. This oppressive silence severely limits the agency of survivors to respond to their abusive experiences. By focusing primarily on trans people and queer women, the research broadens the scope of studies on same-sex intimate partner violence in the Global South and moves beyond the dominant emphasis on cisgender gay and other men who have sex with men.

Despite the documented benefits of masturbation, cisgender Latina women remain underrepresented in research on self-pleasure. Values rooted in colonialism and Catholicism, particularly the gendered construct of marianismo, may strongly shape sexual attitudes and behaviours. This exploratory study examined the relationship between marianismo, as measured by the Marianismo Beliefs Scale (MBS), masturbation guilt and frequency among cisgender Latinas in the USA. One hundred and fifty self-identified Latina/Chicana/Hispanic cisgender women living in the USA completed an online survey including the MBS and the Negative Attitudes Towards Masturbation Inventory. Responses on four of the five marianismo subscales (Family Pillar, Virtuous and Chaste, Spiritual Pillar and Silencing Self to Maintain Harmony) were positively associated with masturbation guilt. Although responses on these subscales did not directly predict masturbation frequency, greater guilt was significantly linked to reduced masturbation frequency. These findings suggest that scripts promoting self-sacrifice, chastity, and spiritual purity may indirectly limit sexual agency and self-exploration among cisgender Latinas. The study adds to the literature advocating for the exploration of gendered beliefs in understandings of sexuality and highlights how internalised values influence intimate behaviours.

Medical mistrust as a construct often places the onus of blame for adverse health outcomes on individuals rather than on social structures. In this study, we aimed to determine if medical mistreatment and access to transgender care were potential determinants of medical mistrust. We used longitudinal survey data from 193 transgender women of colour living in New York City. We measured medical mistrust using the Group-Based Medical Mistrust (GBMM) scale. Additionally, we analysed and coded open-ended survey data from participants regarding their trust towards medical institutions to identify potential determinants of medical mistrust. From the quantitative analysis, we found that individuals who experienced mistreatment in healthcare and those who reported poor access to transgender care had higher GBMM scores. Qualitative findings suggested that negative experiences within the healthcare system and historical trauma were key factors contributing to mistrust in medical institutions. Addressing medical mistrust should not occur at the individual level, but rather at the structural level. Potential interventions include improving access to gender affirming care and training health professionals.

International estimates of intimate partner violence (IPV) among adolescents and young women are high, indicating the need to address IPV prevention early in life. Structural economic interventions, such as household cash transfer programmes, have the potential to improve the wellbeing of youth who are not the direct recipients of the transfers themselves. However, few studies have addressed this topic in terms of youth romantic and/or sexual relationships. We conducted 39 in-depth interviews with young women aged 19-29 years in households participating in the Government of Malawi's Social Cash Transfer Programme (SCTP) to examine relationship formation, IPV triggers and experiences, and help-seeking behaviours. We found that young women did not directly attribute SCTP effects to their intimate relationships or IPV experiences. Threats to masculinity and transgressions of women's gender norms were key triggers of IPV, but specific triggers were linked to specific types of IPV. Furthermore, women sought help for non-IPV concerns more than IPV-related issues. Our results reveal there is a need to strengthen cash transfer programmes and layer them with tailored interventions for adolescents and young women in participant households to improve relationships and prevent IPV early in life.

This study explores the career motivations, work experiences, and stigma management strategies of women engaged in adult webcam modelling in Türkiye. Based on qualitative interviews with twelve participants, the research situates webcam modelling within broader socio-cultural, economic, and moral frameworks that shape both opportunities and constraints. The study adopted a multi-theoretical approach, drawing on deviant leisure, social learning, stigma, and sexuality labour intersectional frameworks. Key findings reveal that webcam modelling is often driven by a mix of financial necessity and emotional need, and that participants develop adaptive strategies to navigate platform demands, gendered expectations, and societal stigma. The study contributes to the literature on digital labour and sex work by highlighting the complex, context-specific negotiations involved in performing sexual labour online, particularly within a morally conservative, legally ambiguous setting such as Türkiye. It calls for nuanced theoretical engagement and culturally informed policy responses that acknowledge the agency, vulnerabilities, and rights of webcam workers.