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From AIDS to COVID-19: the interplay between dual pandemics in social perceptions of disease. 从艾滋病到 COVID-19:双重流行病在社会疾病观念中的相互作用。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-09-07 DOI: 10.1080/13691058.2024.2401006
Robert Wyrod, Matthew Bravo

This paper is one of the few to examine how people who have lived through both COVID-19 and AIDS understand these pandemics in relation to each other. Data were collected in Uganda, and we found that the AIDS epidemic proved to be a key reference point for people in explaining why COVID-19 was perceived as so worrisome. In addition, AIDS-related stigma was a problematically common frame when discussing responsibility for HIV versus SARS-CoV-2 infection, and there was evidence of some forgetfulness regarding the toll AIDS had taken on the country. More positively, the legacy of AIDS made many people more attentive to social inequalities tied to health risks, and this at times prompted a more nuanced understanding of the socially varied effects of COVID-19. Overall, we argue that how individuals respond to a novel epidemic is shaped not only by their understandings of current threats but also by enduring perceptions of epidemics and pandemics that may have preceded it.

本文是为数不多的研究经历过 COVID-19 和艾滋病的人如何理解这两种流行病相互关系的论文之一。我们在乌干达收集了数据,并发现艾滋病流行是人们解释 COVID-19 为何如此令人担忧的一个关键参照点。此外,在讨论艾滋病毒和 SARS-CoV-2 感染的责任时,与艾滋病相关的耻辱感是一个常见的问题框架,而且有证据表明,人们对艾滋病给国家造成的损失有所遗忘。更积极的是,艾滋病的遗留问题使许多人更加关注与健康风险相关的社会不平等现象,这有时会促使人们对 COVID-19 的各种社会影响有更细致的了解。总之,我们认为,个人如何应对一种新的流行病,不仅取决于他们对当前威胁的理解,还取决于他们对流行病和大流行病的持久看法。
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引用次数: 0
Reproductive futures within a context of uterus transplants in India. 印度子宫移植背景下的生殖未来。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-09-04 DOI: 10.1080/13691058.2024.2397464
Arpita Das

Reproduction is considered a core event in a cisgender heterosexual woman's life. Several hierarchies exist within the field of reproduction, with reproduction being privileged among people from dominant races, classes, castes, ages, and abilities. In this paper, I explore uterine transplantion as an emerging mode of reproduction, which privileges the experience of pregnancy in addition to genetic relatedness, specifically within the Indian context. The focus is on the socio-cultural and economic discourses surrounding the marketisation of reproductive technologies and how these recalibrate social and familial dynamics concerning reproduction. I argue that the mobilisation of the language of reproduction as a right could potentially transform into reproduction as a duty. Reproductive biopolitics is used as a lens to think through the value of wombs in relation to the bodies they inhabit, and the pressures the marketisation of wombs puts on both recipients and donors.

生育被认为是顺性异性恋女性生活中的核心事件。在生殖领域存在着几种等级制度,在主流种族、阶级、种姓、年龄和能力的人群中,生殖享有特权。在本文中,我将探讨子宫移植作为一种新兴的生殖模式,除了遗传亲缘关系外,它还赋予怀孕体验以特权,特别是在印度背景下。重点是围绕生殖技术市场化的社会文化和经济论述,以及这些论述如何重新调整有关生殖的社会和家庭动态。我认为,"生育是一种权利 "的语言可能会转变为 "生育是一种义务"。生殖生物政治学被用作一个透镜,用来思考子宫与其所居住的身体之间的价值关系,以及子宫市场化给接受者和捐赠者带来的压力。
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引用次数: 0
Medical gendered racism and Black women's experiences of genito-pelvic pain/penetration disorder in the USA - A conceptual exploration. 医疗性别种族主义与美国黑人妇女生殖盆腔疼痛/充血障碍的经历--概念探讨。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-09-04 DOI: 10.1080/13691058.2024.2399292
Katharina A Azim, Andrea A Lewis, Alison Happel-Parkins, Courtney Johnson-Benson, Margaux Kraemer, Hadyatou Diallo

Medical gendered racism in the USA has been and continues to be a significant issue for Black women across various healthcare domains, including sexual and pelvic healthcare. The experiences of Black women with Genito-Pelvic Pain/Penetration Disorder, characterised by pain with sexual intercourse, are particularly understudied in relation to medical gendered racism. This paper advances existing research on Genito-Pelvic Pain/Penetration Disorder by employing Black feminist thought and intersectionality as theoretical frameworks. We seek to conceptualise how medical gendered racism impacts Black women's experiences with genito-pelvic pain and the quality of their healthcare. We offer a nuanced, culturally sensitive approach to doing so and to clinical practice, and provide actionable recommendations for healthcare professionals. This work aims to equip researchers and healthcare practitioners with the knowledge and tools to acknowledge, understand, and support effective treatment of genito-pelvic pain experienced by Black women in the USA.

在美国,医疗性别种族主义一直是并将继续是黑人妇女在各种医疗保健领域(包括性保健和盆腔保健)面临的一个重要问题。黑人妇女患有以性交疼痛为特征的生殖器-盆腔疼痛/插入障碍,她们的经历与医疗性别种族主义的关系尤其缺乏研究。本文以黑人女权主义思想和交叉性为理论框架,推进了对生殖盆腔疼痛/插入障碍的现有研究。我们试图从概念上说明医疗性别种族主义是如何影响黑人妇女的盆腔生殖器疼痛经历及其医疗质量的。我们为此和临床实践提供了一种细致入微、具有文化敏感性的方法,并为医疗保健专业人员提供了可行的建议。这项工作旨在为研究人员和医疗保健从业人员提供知识和工具,以承认、理解和支持对美国黑人妇女经历的生殖器盆腔疼痛的有效治疗。
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引用次数: 0
Parental attitudes towards sexual orientation and gender diversity: challenging LGBT discrimination in Australian schools. 家长对性取向和性别多样性的态度:挑战澳大利亚学校中对男女同性恋、双性恋和变性者的歧视。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-09-04 DOI: 10.1080/13691058.2024.2394223
Jacqueline Hendriks, Neil Francis, Hanna Saltis, Katrina Marson, Jenny Walsh, Tasha Lawton, Sharyn Burns

As Australia considers legislative reform regarding the rights of religious schools to discriminate against LGBT students and staff, claims are often made that religious parents or those enrolling children in religious schools do not affirm diversity of sexuality or gender. Using a national dataset of parents (n = 2418), attitudes towards sexual orientation, gender diversity, homophobia and transphobia were examined. Across all religiosities, school sectors and attitudinal statements, significant majorities of parents reported positive attitudes (62.7%-93.5%). Only small minorities expressly reported negative attitudes (1.6%-20.2%). Pairwise religiosity comparisons between parents with children only at a secular school, versus any religious school, revealed few differences. Amongst Catholic parents, those with children at Catholic schools and those with children only at secular schools, held similar attitudes towards LGBT issues and a majority held favourable attitudes, suggesting most Catholic parents who enrol their children in Catholic schools do so despite or in ignorance of Catholic doctrine. Findings suggest a significant majority of parents sending children to religious schools hold supportive attitudes towards diverse sexual orientations, gender diversity, and actions to address homophobia and transphobia. This empirical evidence contradicts religious schools' calls for the rights to discriminate against LGBT persons based on parental values and attitudes.

澳大利亚正在考虑对宗教学校歧视女同性恋、男同性恋、双性恋和变性者(LGBT)学生和教职员工的权利进行立法改革。我们利用全国家长数据集(n = 2418),研究了家长对性取向、性别多样性、仇视同性恋和变性者的态度。在所有宗教、学校部门和态度声明中,绝大多数家长都表示了积极的态度(62.7%-93.5%)。只有少数家长明确表示持消极态度(1.6%-20.2%)。仅有子女在非宗教学校就读的家长与有子女在任何宗教学校就读的家长在宗教信仰方面的对比显示,两者之间的差异很小。在天主教家长中,子女在天主教学校就读的家长与子女只在非宗教学校就读的家长对 LGBT 问题的态度相似,大多数家长持赞成态度,这表明大多数让子女就读天主教学校的天主教家长是在无视或不了解天主教教义的情况下这样做的。研究结果表明,绝大多数送孩子上宗教学校的家长对不同性取向、性别多样性以及解决仇视同性恋和变性者问题的行动持支持态度。这一实证证据与宗教学校基于家长的价值观和态度而要求有权歧视男女同性恋、双性恋和变性者的呼吁相矛盾。
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引用次数: 0
'It's not a me thing': the role of transcendence and critical politics in Black LGBTQ wellness in Montreal. 这不是我的事":超越和批判政治在蒙特利尔黑人 LGBTQ 健康中的作用。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-09-03 DOI: 10.1080/13691058.2024.2390893
Darius Scott

This study explores well-being strategies and challenges for Black LGBTQ individuals in Montreal, Canada. Semi-structured interviews were conducted between March and May 2023 with key informants, or advocates and service providers for LGBTQ communities in the Montreal metropolitan area. Thematic analysis was used and involved transcription, memo-writing and a multi-step, inductive coding process using MAXQDA. The findings highlight three areas of well-noted challenges for Black LGBTQ individuals: systemic barriers; lack of targeted support; and challenges to accessing services. Two strategic domains emerged as innovative approaches to support well-being: transcendental practices and intersectional sociopolitical awareness raising. Transcendental practices, ranging from fine arts and dance to reiki energy healing, offered avenues for healing and community-building. Intersectional sociopolitical awareness was described as crucial in informing and contributing to existing efforts to improve well-being such as therapeutic engagement with clients and facilitating mutual aid. The identified transcendental practices and political awareness offer promising avenues for holistic well-being and comprehensive approaches to challenges such as inequitable HIV burden. Recognising the convergence of identities and social power axes can inform future interventions to foster more inclusive and empowering health strategies for Black LGBTQ communities.

本研究探讨了加拿大蒙特利尔黑人 LGBTQ 的幸福战略和挑战。研究人员在 2023 年 3 月至 5 月期间对蒙特利尔大都会地区的主要信息提供者或 LGBTQ 社区的倡导者和服务提供者进行了半结构式访谈。访谈采用了主题分析法,包括转录、撰写备忘录以及使用 MAXQDA 进行多步骤归纳编码。研究结果强调了黑人 LGBTQ 所面临的三个方面的挑战:系统性障碍;缺乏有针对性的支持;以及获得服务方面的挑战。作为支持福祉的创新方法,出现了两个战略领域:超越性实践和提高跨部门社会政治意识。从美术、舞蹈到灵气能量治疗等超验实践为治疗和社区建设提供了途径。跨部门社会政治意识被认为是至关重要的,它为改善福祉的现有努力提供了信息并做出了贡献,如与客户进行治疗接触和促进互助。所确定的超越性实践和政治意识为整体福祉和应对艾滋病毒负担不平等等挑战的综合方法提供了大有希望的途径。认识到身份和社会权力轴线的交汇,可以为未来的干预措施提供信息,从而为黑人 LGBTQ 群体制定更具包容性和赋权的健康战略。
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引用次数: 0
Communicating sexual health to the incarcerated population: information dissemination in a US sample of inmate handbooks. 向被监禁者宣传性健康:美国囚犯手册样本中的信息传播。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-09-03 DOI: 10.1080/13691058.2024.2395465
Jessie L Krienert, Jeffrey A Walsh, Kimberly A Ingold

Incarcerated individuals frequently enter prison with a history of high-risk lifestyle behaviours likely to contribute to the transmission of infectious disease. Prisons offer a unique setting in which to advance health equity to an underserved population by disseminating information and education. Sexual health education has the potential to mitigate negative health consequences in the incarcerated population and improve sexual health practices upon community re-entry, benefiting both incarcerated individuals and communities. Limited empirical research examines sexual health information and education in US correctional facilities. Handbooks, given to all people upon incarceration, have the potential to provide vital information and education to promote safe sexual practice and prevent disease transmission. This work, guided by 22 critical sexual health education recommendations from the US Centers for Disease Control and Prevention, examines the presence (or absence) of recommended sexual health information and guidance in prison handbooks. Handbooks (n = 74) from 49 of 50 US states were qualitatively analysed with results revealing limited information, education or guidance about sexual health/safe sexual practice during incarceration or afterwards. Utilising handbooks for comprehensive sexual education could be a critical step towards reaching members of an already at-risk underserved population.

被监禁者进入监狱时往往有高风险生活方式行为史,这些行为可能会导致传染病的传播。监狱提供了一个独特的环境,可以通过传播信息和教育来促进未得到充分服务的人群的健康平等。性健康教育有可能减轻对被监禁人群健康的负面影响,并改善他们重返社区后的性健康行为,使被监禁者和社区都能从中受益。对美国惩教机构中的性健康信息和教育进行的实证研究十分有限。向所有入狱人员发放的手册有可能提供重要的信息和教育,以促进安全的性行为和预防疾病传播。这项工作以美国疾病控制和预防中心提出的 22 条重要的性健康教育建议为指导,研究了监狱手册中是否存在(或缺少)建议的性健康信息和指导。对美国 50 个州中 49 个州的手册(n = 74)进行了定性分析,结果显示,在监禁期间或监禁后,有关性健康/安全性行为的信息、教育或指导非常有限。利用手册开展全面的性教育可能是向已经处于风险之中、得不到充分服务的人群迈出的关键一步。
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引用次数: 0
Reproductive health service access and utilisation among migrant women in Dhaka's urban slums: a qualitative study. 达卡城市贫民区移民妇女获得和利用生殖健康服务的情况:一项定性研究。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-09-01 Epub Date: 2024-01-27 DOI: 10.1080/13691058.2024.2302052
Ishrat Jahan, Myriam Vuckovic, Selima Sara Kabir, Sabina Faiz Rashid, Jennifer Bouey

This study explores the impact of migration on the access and utilisation of sexual and reproductive health services by women living in an informal settlement in Dhaka, Bangladesh. A total of 16 in-depth interviews were conducted in March and April of 2019 with women (18-49 years old) who had migrated from rural areas to Dhaka. They reported continued economic insecurity while receiving minimal support from the state. All women reported financial and infrastructural barriers to accessing formal sexual and reproductive health services and tended to seek resources and support through social networks within the slum and from informal health services. Compared with more recent migrants, women who had migrated and resided in the slums for longer found it easier to utilise social networks and resources for sexual and reproductive health. Women had more agency in experimenting with contraceptives but had less power in making decisions during pregnancy and when seeking health care. Menstrual health was a neglected aspect of public health. The study indicates that public health policy targeting the urban poor needs to address the unique challenges faced by migrant women in informal settlements to rectify inequities in health services that leave significant portions of the urban poor population behind.

本研究探讨了移民对生活在孟加拉国达卡非正规定居点的妇女获得和利用性健康和生殖健康服务的影响。我们于 2019 年 3 月和 4 月对从农村地区迁移到达卡的妇女(18-49 岁)进行了 16 次深入访谈。她们报告称,在从国家获得极少支持的同时,经济仍无保障。所有妇女都表示在获得正规性健康和生殖健康服务方面存在经济和基础设施障碍,她们倾向于通过贫民窟内的社会网络和非正规医疗服务机构寻求资源和支持。与新移民相比,在贫民窟居住时间较长的妇女更容易利用社会网络和资源获得性健康和生殖健康服务。妇女在尝试使用避孕药具方面有更大的自主权,但在怀孕期间和寻求保健服务时,她们在做决定方面的权力较小。月经健康是公共卫生中被忽视的一个方面。研究表明,针对城市贫民的公共卫生政策需要解决非正规居住区的移民妇女所面临的独特挑战,以纠正医疗服务中的不公平现象,因为这些不公平现象使相当一部分城市贫民落在后面。
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引用次数: 0
An examination of the independent and intersectional effects of racial and heterosexist medical mistrust on timing of sexual/reproductive health care visits among Black sexual minority women in the USA. 研究种族和异性恋医疗不信任对美国黑人性少数群体妇女性/生殖保健就诊时间的独立和交叉影响。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-09-01 Epub Date: 2024-01-19 DOI: 10.1080/13691058.2024.2304150
Aaliyah Gray, Celia B Fisher

Experiences of racism and heterosexism in medical settings are social and systemic barriers to 'on-time' receipt of sexual and reproductive health services among women with both racial and sexual minority identities. Medical mistrust based on experiences related to these dual identities is associated with avoidance and delays in care. However, investigators are just beginning to apply an intersectional lens to quantitatively understanding such barriers. The purpose of this study was to examine the independent and interaction effects of racial and heterosexist medical mistrust on timing of sexual/reproductive health care among Black sexual minority women who have sex with women and men. A total of 320 women participated in an online study of factors affecting sexual health in this population. Ordinal logistic regression was used to assess the independent and interaction effects of racial and heterosexist medical mistrust on self-reported time since last sexual/reproductive health visit. Results indicated an interaction between the two types of medical mistrust. Research on Black women who have sex with women and men's experiences of racism and heterosexism in the US healthcare system can lead to the development of the comprehensive training programmes needed to alleviate medical mistrust among women with racial and sexual minority identities.

医疗环境中的种族主义和异性恋是具有少数种族和少数性别特征的妇女 "按时 "接受性健康和生殖健康服务的社会和系统性障碍。基于与这些双重身份相关的经历而产生的对医疗的不信任与回避和延误治疗有关。然而,研究人员才刚刚开始运用交叉视角来定量了解这些障碍。本研究旨在探讨种族和异性恋医疗不信任对黑人性少数群体女性性健康/生殖健康护理时机的独立影响和交互影响。共有 320 名女性参与了关于影响该人群性健康因素的在线研究。研究采用正序逻辑回归法评估了种族和异性恋医疗不信任对自我报告的上次性/生殖健康就诊时间的独立影响和交互影响。结果表明,两种医疗不信任之间存在交互作用。对黑人女性同性恋者和男性同性恋者在美国医疗保健系统中的种族主义和异性恋经历进行研究,有助于制定所需的综合培训计划,以减轻具有种族和性少数群体身份的妇女对医疗的不信任。
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引用次数: 0
The experience of abortion for Cook Islands women: exploring the socio-cultural dimensions of abortion safety. 库克群岛妇女的堕胎经历:探索堕胎安全的社会文化层面。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-09-01 Epub Date: 2024-02-05 DOI: 10.1080/13691058.2024.2305814
Kate Burry, Kristen Beek, Lisa Vallely, Heather Worth, Bridget Haire

Abortion is significantly restricted by law in most Pacific Island countries, impacting the rights, health and autonomy of people who experience pregnancy. We undertook qualitative research between February and August 2022 on Rarotonga, Cook Islands, where abortion is illegal under most circumstances. We conducted interviews with women who had accessed or tried to access abortion services; people who had supported women to access abortion services; health workers; and advocates to understand their experiences regarding abortion. We conducted focus groups to explore broader social perceptions and experiences of sexual and reproductive health and rights, including abortion. Participants described their abortion decisions and methods, and their negotiation of the personal context of their sexual behaviours, pregnancies, and abortions relative to their socio-cultural context and values. As defined by the World Health Organization, safe abortion relates to the methods and equipment used and the skills of the abortion provider. We argue for an expansion of this definition to consider inclusion of reference to individuals' 'abortion safety nets' as the sum of their access to financial, political, health care and socio-cultural resources. These safety nets are shaped by discourses related to abortion and socio-cultural support and values, impacting physical, emotional, psychological, social and spiritual health.

在大多数太平洋岛国,堕胎都受到法律的严格限制,对怀孕者的权利、健康和自主权造成了影响。2022 年 2 月至 8 月期间,我们在库克群岛的拉罗汤加岛开展了定性研究,在那里,堕胎在大多数情况下都是非法的。我们采访了曾经获得或试图获得堕胎服务的妇女、支持妇女获得堕胎服务的人、卫生工作者和倡导者,以了解她们在堕胎方面的经历。我们还开展了焦点小组活动,探讨社会对性健康和生殖健康及权利(包括堕胎)的广泛看法和经验。参与者描述了她们的堕胎决定和方法,以及她们在社会文化背景和价值观下对性行为、怀孕和堕胎的个人背景进行的协商。根据世界卫生组织的定义,安全堕胎与所使用的方法和设备以及堕胎提供者的技能有关。我们主张对这一定义进行扩展,考虑将个人的 "堕胎安全网 "作为其获得经济、政治、医疗保健和社会文化资源的总和。这些安全网是由与堕胎有关的言论以及社会文化支持和价值观形成的,影响着身体、情感、心理、社会和精神健康。
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引用次数: 0
Unintended pregnancies in the lives of young people in Luwero, Uganda: a narrative analysis. 乌干达卢韦罗年轻人生活中的意外怀孕:叙事分析。
IF 1.8 3区 医学 Q2 FAMILY STUDIES Pub Date : 2024-09-01 Epub Date: 2024-02-05 DOI: 10.1080/13691058.2024.2305820
Jenny Parkes, Simone Datzberger, Rehema Nagawa, Junior Brian Musenze, Joan Ritar Kasidi, Amiya Bhatia, Dipak Naker, Karen Devries

Using a feminist narrative approach, this article explores how unintended pregnancy can rupture young lives, and how young people respond to and navigate these ruptures. We analyse qualitative data from a longitudinal cohort study in Luwero, Uganda, focusing on narratives of a girl and a boy about their recent experiences of unintended and unwanted pregnancy during COVID-19 school closures. We argue that laws, policies and norms relating to education, sexual and reproductive health, and the family in Uganda position young people in complex and contradictory ways, that create the conditions for unintended pregnancies, and restrict the choices open to them. The analysis traces how pregnancy ruptures their everyday lives, their identities, and relationships. Their narratives reveal gendered ways in which they enact identities to manage the ruptures. Families are sites of contestation, where gender and sexuality are regulated, but are also mobilised by young people to support their efforts to repair the ruptures. Our analysis underscores the importance of working with young people to understand their positionalities, resource environments and social networks as they make and navigate decisions about pregnancy, and of addressing the structural forces that underpin the rupturing effects of pregnancy on teenage lives.

本文采用女权主义叙事方法,探讨意外怀孕如何破坏年轻人的生活,以及年轻人如何应对和驾驭这些破坏。我们分析了乌干达卢韦罗一项纵向队列研究的定性数据,重点讲述了一名女孩和一名男孩在 COVID-19 学校关闭期间意外怀孕和意外怀孕的近期经历。我们认为,乌干达与教育、性健康和生殖健康以及家庭有关的法律、政策和规范以复杂而矛盾的方式为年轻人创造了意外怀孕的条件,并限制了他们的选择。分析追溯了怀孕是如何破坏他们的日常生活、身份和关系的。她们的叙述揭示了她们为处理这些破裂而制定身份的性别方式。家庭是竞争的场所,在这里,性别和性行为受到规范,但也被年轻人动员起来,支持他们修复破裂的努力。我们的分析强调了与年轻人合作的重要性,以了解他们在做出怀孕决定时所处的地位、资源环境和社会网络,以及解决支撑怀孕对青少年生活产生破裂影响的结构性力量的重要性。
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引用次数: 0
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