Culture, Health & Sexuality最新文献

This article examines how intrauterine device (IUD) self-removal is framed in online sources containing the views of contraceptive providers. While research has explored power and knowledge hierarchies in clinical interactions between contraceptive users and providers, and has highlighted the safety of IUD self-removal, little is known about how self-removal is represented by providers in accessible online sources that may be relied upon by contraceptive users for information. A discourse analysis of 42 provider-generated online sources found that provider authority over contraception is reinforced through biomedical constructions of risk and safety in framings of self-removal. The data reveal how the sharing of self-removal experiences between IUD users via online platforms was perceived to threaten contraceptive provider expertise, resulting in the dismissal of users' experiential knowledge. While some sources were supportive, the framings of self-removal discussed in this paper typically mirror the unequal power relations of in-person contraceptive user/provider interactions. The sources analysed therefore demonstrate how power and knowledge hierarchies are reproduced and extend beyond clinical interactions to the digital context, reflecting broader socio-structural controls over bodies, knowledge, and reproductive decision-making.

Black women in the USA experience some of the poorest health outcomes and this is especially true for those involved in the carceral system who are at elevated risks for HIV/STIs, reproductive health, and chronic diseases. This study aimed to investigate Black women's experience accessing healthcare services. We conducted semi-structured interviews with 43 women from Project EWORTH under community supervision in New York City. We analysed responses focusing on barriers to healthcare engagement. All interviews were recorded, and data analysis was conducted using NVivo. Themes influencing Black women's ability to engage with healthcare providers and systems included: 1) disclosed provider mistrust/judgement; 2) feeling disrespected by providers and the medical system; 3) mistrust of medical providers/system/hospital/government; 4) lack of health communication; 5) low health literacy; 6) provider gender preference. Findings highlight the need to improve trust and collaboration between healthcare providers and Black women. This study addresses the critical gap in understanding perceptions of discrimination, stigma, and barriers to attaining health care. Funders and accreditation agencies must hold providers and organisations accountable for acquiring and making available diversity, equity and inclusion training for providers, demonstrating increasingly equitable medical relationships through responsiveness to patient feedback, and increasing the number of Black providers.

Ministerial Approvals in 2021 clearly articulated for the first time the wide range of circumstances under which abortion in Lao People's Democratic Republic (PDR) is legal. These approvals likely reflect norms around abortion existent since the establishment of the Lao PDR in 1975: unregulated abortion is and remains illegal, but abortion that meets certain criteria is and has always been legal in Lao PDR. The legal status of abortion was fuzzy in practice until 2021, likely due to cultural factors. Buddhist conceptions of life and morality contribute to a widespread sense that abortion is fundamentally wrong and ought to be illegal. Laos' political culture strongly values solidarity, meaning prolonged public discussion of potentially divisive topics is rare. As a result, abortion is often misunderstood in international research. For instance, Laos regularly appears on lists of the few countries where abortion is completely banned. Abortion is also not a politically charged topic in Lao PDR. Women's experiences of accessing abortion are not rooted in a rights-based discourse. Instead, abortion is a possible (and legal) path in Laos, but one that entails considerable anguish and concern about its moral and ethical consequences.

Unsafe abortion is a preventable contributor to maternal morbidity and mortality, particularly for young unmarried women in low resource settings. In Papua New Guinea, abortion is legally restricted and highly stigmatised, limiting access to safe abortion and post-abortion care, resulting in unsafe abortion. This paper explores young people's lived experiences and agency in relation to unsafe abortion. We undertook qualitative research between 2019 and 2021 in rural, peri-urban and urban settings in Papua New Guinea and found that agency was enacted or constrained at different points along their abortion trajectories. Findings demonstrate the ways in which abortion was negotiated within (and outside of) young people's intimate relationships, while highlighting the social, temporal and emotional dimensions of this agency. By considering what agency means, and the different forms it takes, it is possible to identify critical support mechanisms and socio-structural changes that could support young people at different stages of their abortion trajectories, from accessing modern contraceptives to prevent unintended pregnancy, to seeking support for safe abortion. Moving forward, we call for greater attentiveness to young people's everyday lived experiences of sexual and reproductive health as a basis for understanding how to support them to safely prevent and manage unintended pregnancy.

This paper examines the motivations and experiences of older French-speaking men who relocate to Thailand driven by the desire for a more fulfilling and liberated lifestyle that contrasts with their experiences in their home countries. Through an analysis of video interviews with 31 expatriates available online, the study reveals a prevalent trend among these men to initially engage in short-term sexual relationships, enjoying the freedoms of Thailand's vibrant social scene. However, as they acclimate to their new environment, a significant shift towards long-term partnerships is observed, marking a transition from transient interactions to more meaningful connections. Members of this group often form relationships with Thai women typically between the ages of 25 and 45. Contrary to common stereotypes, the research reveals that men often seek long-term partnerships over casual relationships. Although they may initially engage with multiple short-term partners, over time a clear preference for stable, committed relationships emerges. It is important to distinguish these sustained partnerships from buying sex, as the women involved are better described as freelancers who provide a range of services - from caregiving to companionship - similar to a contractual marriage or being a so-called rented wife, typically for an average of 500-700 euros per month.

Extensive research on the process of 'coming out' underscores the significance of disclosing one's sexual orientation and gender identity for personal development and self-expression. However, sharing this information with family members can be difficult, particularly in Zimbabwe where broader social and cultural forces pose significant challenges to 'coming out', and gender and/or sexuality diversity is strongly reacted against. This paper explores the experiences of gender and sexuality diverse persons in Harare as they came out to their families, or were 'outed' by others. The study involved semi-structured interviews, informal conversations, and focus group discussions with 31 gender and sexuality diverse individuals aged between 18-31 years. The participants revealed the different ways in which their families became aware of their sexual orientation. These pathways included planned disclosure, outing through extortion, blackmail, and other incidents. The narratives shared by participants varied significantly, encompassing a spectrum from overtly negative or positive responses to more complex reactions from families regarding their child or siblings' gender and sexuality diversity.

Religion contributes to the identity, well-being, and life satisfaction of many people globally, however, its traditional stance on infertility and assisted reproductive technologies (ART) can conflict with individuals' personal reproductive aspirations and desire for a family. As the fertility rates of certain ethnic and religious groups decline, it is essential to discuss the interface between religion, infertility and ART, to understand how to best navigate the infertility journeys of proclaimed Christians. This article contextualises this discussion in the experiences of eight Pacific Christian adults living with infertility and/or accessing ART in Aotearoa New Zealand. Participants expressed the importance of having family members or a partner with them on their infertility journey. Although their religious beliefs elicited a sense of shame and hindered their confident participation in ART services, religion also provided access to a supportive community and a strong sense of hope. Culture was another significant influence on their infertility journeys but could be burdensome and a source of internal conflict. Improving ART strategies for service engagement with Pacific communities is an important first step towards ensuring these services are accessible and responsive to individuals' cultural and religious needs.

Migrants with refugee backgrounds in the Netherlands face significant reproductive health challenges, including higher rates of unintended pregnancies and limited access to contraception. This study explores how post-migration realities affect the reproductive agency of refugees from Afghanistan, Somalia, Eritrea and Syria. Utilising a participatory approach, eight peer researchers from these communities conducted eight focus-group discussions and 118 in-depth interviews, involving four migrant grassroots organisations and two Dutch non-governmental organisations. The findings reveal that refugees must navigate multiple tensions: (1) adapting to a new country, including securing housing, employment and adjusting to social norms and gender dynamics; (2) navigating cultural norms and family expectations; and (3) obtaining resources such as knowledge and contraception, within a healthcare system that may lack cultural sensitivity and reflect broader societal stigma. These challenges may require strategies that differ from Dutch notions of individualistic reproductive choices. Reproductive services must be sensitive to this complex navigation and adopt a culturally sensitive approach, focusing on refugees' strengths and agency rather than solely on issues like cultural taboos, lack of knowledge, low literacy or language barriers.

Temporal constructs are central to reproduction and kinship, as epitomised by the pervasive concept of the biological clock within public imaginaries. While queer scholarship has problematised linear models of kinship and reproductive temporality, the specific temporalities associated with donor-conceived families have received less scholarly attention, despite the increasing prevalence of these family structures. In this article, we explore the question: how does donor conception reconfigure temporal logics. More specifically, we ask how does donor conception challenge (hetero)normative temporalities and kinship organisations. We examine donor conception through narratives of the embodied and intimate experiences of key stakeholders in the form of clinical staff, parents and donor-conceived adults, across case studies conducted in Denmark, Sweden and Australia. Our analysis illuminates distinct temporal perspectives: for clinic staff, donors exist in a static present; for recipient parents, the donor's past is integrated into the present; and for donor-conceived adults, the donor is embedded within fragile futurities. We propose the concept of sideways temporalities to capture the queering of temporal logics in donor conception, characterised by non-normative scale (e.g. extensive sibling networks) and velocity (e.g. immediate matching via DNA testing).

In 2022, a global outbreak of mpox (formerly 'monkeypox') emerged in non-endemic countries, including Australia, predominantly affecting gay, bisexual and other men who have sex with men. Public health advice on transmission and isolation emerged rapidly from different sources, sometimes conflicting and producing uncertainty. Using the concept of 'counterpublic health', which acknowledges the incorporation of official science and experiences of affected communities into embodied practice, this paper investigates how people affected by mpox in Australia managed risk of transmission and navigated self-isolation. In-depth interviews were conducted with 16 people: 13 people diagnosed with mpox and three close contacts. All participants were cisgender gay and bisexual men living in Australia. Participants thought critically about public health advice, often finding it restrictive and unresponsive to the needs of people with mpox. Participants' decisions about reducing mpox risk and isolating often drew on experiences with other infections (i.e. HIV; COVID-19) and were made collaboratively with the people closest to them (e.g. partners, friends, family) to sustain relationships. Future public health responses to infectious disease outbreaks would benefit from identifying more opportunities to formalise and embed mechanisms to obtain feedback from affected communities so as to inform responses.