Search

By examining competing discourses about women who are maechii (or 'lay nuns') in Buddhist Thai society, this paper demonstrates that, although maechii vow to be celibate, social constructions of their role are grounded in sexuality. The discourses examined are those of the Buddhist canon and Sangha (Order of Monkhood), the Thai Maechii Institute, the mass media, and the government. The analysis is supplemented with field observations and interviews with monks, maechii, and lay persons. Findings suggest that maechii comprise an ambiguous category linguistically, Buddhistically, and in terms of their sexuality. Case studies of the founders of nunneries conducted in ChiangMai indicate that maechii leaders have been resisting the prevalent views that most maechii are social misfits, yet also are capable of undermining monks' celibacy and, by extension, the larger social order. The analysis contributes to the understanding of the interconnectedness of gender and sexuality in contemporary Thai society.

To explore why teenage pregnancy is regarded by researchers from the USA and UK as a major social problem, a systematic review was conducted of published research on the social influences on teenage pregnancy. Papers published in the USA and UK between 1981 and 2000 were examined with respect to samples, social influences and outcomes. UK studies often justified investigating teenage pregnancy in terms of health. Research from the USA more often viewed teenage pregnancy as problematic because of associated welfare expenditure. A few studies from the USA regarded teenage parenting as mediating the intergenerational transmission of poverty. Such studies often focused on Black and minority ethnic populations. Most research considered economic and cultural influences, with a bias in research from the USA on cultural factors, and in the UK on economic factors. Overall, there were significant differences between research in the USA and UK. These may have arisen from a combination of political, religious and research design factors.

This paper reports on an ethnographic study of gender and sexuality as factors within contemporary Thai factory women's subjectivities. Competing discourses of what it means to be a woman in contemporary Thai society make women's self-presentations fluid and incoherent. Data from participant-observation and open-ended interviews suggest that the fluidity and inconsistency of women's self-presentations reflect both their negative experiences and oppression within the Thai patriarchal system, and women's strength and resistance to the normative discourses that oppress them. By naming or reinterpreting experiences and desires in their own terms, Thai factory women can redraw elements of their own lives.

In Nepal, it is commonly assumed that young people migrating to Kathmandu Valley for work in carpet and garment factories are at risk from negative sexual health outcomes. Greater independence and mixed‐sex housing could lead young people to initiate sexual behaviour earlier, and have more sexual partners, than they would in rural communities. A recent survey among factory workers, however, suggested that sexual knowledge and experience were often gained in home villages, prior to migration. This paper presents data from a follow‐up qualitative study comprising in‐depth interviews with 11 male and 12 female young migrant workers reporting high‐risk sexual behaviour. Exploring the circumstances of such episodes in both village and factory environments, the study found that young people experience a wide range of consensual and coercive sexual relationships while still in home communities. Resulting negative emotional or sexual health outcomes can serve as a catalyst for the decision to migrate to Kathmandu...

Analysing data from interviews with traditional birth assistants and their clients in rural Nigeria, this paper examines the characteristics and conditions of persons using the services of traditional birth homes. The clients of traditional birth homes mainly comprise women with little or no formal education and in low or no‐income occupations. These persons present at traditional birth homes for child delivery, abortion, family planning, STIs, infertility and a host of other reproductive health‐related conditions. Economic and cultural factors are primary considerations in the uptake of services. Findings highlight the critical role of poverty and culture in mediating access to good quality reproductive healthcare, the burden of unmet needs for good quality neonatal healthcare and reproductive health services among local women, and the critical health role of traditional birth homes in rural Nigeria. Local peoples' access to good quality health services could be improved by integrating traditional birth ...

Early sexual debut and premarital sex are increasingly common features of female adolescence in Kenya-putting girls at the risk of unwanted pregnancy and infection by sexually transmitted infections and HIV/AIDS. Levels of knowledge concerning the protective value of condoms and other contraceptives are high, but unprotected sex is still common. Against this background, this paper examines the strategies used by young women to deal with these risks. Qualitative data were obtained from eight focus group discussions conducted with school attending girls aged between 15 and 19 years in Makueni District of Eastern Kenya. Findings suggest that, despite knowledge of the protective value of condoms and other contraceptives, the use of these methods by girls is hampered by inability to access them, the fear of the side effects of contraceptives, and the desire by girls to remain faithful to their religious calling. Most girls also resort to the use of traditional methods such whose potency and efficacy is unproven. These findings suggest the need to make condoms more easily accessible to girls in rural areas, and also for education in the proper use of 'natural' family planning methods. Young women may also benefit from training in how to be more assertive in sexual negotiations.

Research among same-sex attracted young people in Western cultures has described a minority group of adolescents whose sexuality is negated by the significant institutions and people in their lives. Very often, there is a silence in the family and at school about same-sex sexuality and when a young person's homosexuality is suspected or disclosed s/he suffers from denial, discrimination and abuse. Not surprisingly, living in hostile environments leaves such young people at high-risk of drug abuse, depression and suicide. This paper describes some of the ways young people resist being positioned in these negative ways. Using autobiographical stories from 200 same-sex attracted young Australians, we document the discursive field of sexuality in which these young people struggle to construct positive identities. Young people were well aware of dominant discourses which characterized homosexuality as 'evil, diseased and unnatural'. Yet they use different strategies to fault, deflect and discount these negative understandings and to highlight other discourse which positions them positively.

Belief systems are not fixed. Rather they respond to social economic and political changes in various ways sometimes accommodating sometimes resisting. Both through compliance and resistance formal belief systems shape the construction understanding and meanings of sexuality and sexual identity influence sexual practices create and maintain sexual communities and subcultures and structure social life. The papers in this issue provide us with valuable insights into the imbrication of and tensions among belief systems and ideologies popular culture and political and economic circumstances drawing our attention to these issues in order to understand sex and sexuality discourse and desire. (excerpt)

Puerto Rican drug users both in New York and Puerto Rico have disproportionately high rates of HIV/AIDS. This paper derives findings from the ARIBBA Project--a dual site study of HIV risk behaviour determinants among Puerto Rican injection drug users and crack smokers, conducted in East Harlem, NY and Bayamon, PR. Qualitative data collected in focus groups, interviews and observations revealed significant differences in sexual risk behaviours, perceptions of risks and cultural/behavioural norms between the two locations, which were supported by the results of a survey of 1200 drug users. Recommendations are made for enhancing HIV risk reduction efforts in both communities.

This paper reports on ethnographic research on the culture-specific barriers that masculinity poses to preventing HIV transmission in the sexual lives of Pitjantjatjara men. The investigation had three objectives: Investigating how the Pitjantjatjara people model the physical and social development of adult male bodies; describing the nature, range and cultural dynamics of sexual practice among Pitjantjatjara men; and delineating health and infection risks posed by sexual practice. The study used classical ethnographic approaches to investigate the deployment of men's bodies within systems of cultural production and reproduction, and post-Foucauldian analysis to examine culture-specific technologies of the self. Data were collected using participant observation, key informant interviews, and sexual life history interviews. Key findings are that the Pitjantjatjara deploy the capacities for reproduction and pleasure of men's bodies in culturally specific ways, and that men are trained in culturally approved...

Young people are among those most vulnerable to HIV/AIDS in South Africa. To date, however, there has been a shortage of fictional narratives appropriate to their needs, and addressing issues of HIV/AIDS. Accessibility to literature is of concern for a variety of reasons, ranging from low levels of literacy among many Black students to the non‐availability of books in many schools. This paper aims to extend notions of the meanings of literacy within the context of HIV/AIDS prevention amongst South African youth. It examines the significance of such literacy both to life itself and to what counts as literature.

Research on lesbian, gay and bisexual young people in the USA and UK has provided an important tool for advocacy and for developing appropriate public policy. Studies suggest that lesbian, gay and bisexual youth are more frequently victims of discrimination as a result of actual or perceived sexual orientation than adults, and anecdotal information suggests that transgender young people may be particularly vulnerable. During the past decade, high rates of victimization, particularly in school and community settings, has paralleled increased visibility. Increased media attention has focused on gay youth in schools, highlighting the need for support, appropriate policies and intervention. This paper reviews research and policy needs related to sexual minority youth in the USA and the UK and identifies strategies and approaches for reducing victimization and harassment and providing safer communities and school environments for lesbian, gay, bisexual and transgender young people.

This paper analyses patterns for pre-sexual alcohol consumption and condom use from a cross European perspective. Research was conducted in France, Greece, Italy, Switzerland, Norway and Germany. Data were collected from representative population samples aged 18-49 years-old. Surveys were conducted in 1997 and 1998. The percentage of the population who reported not having consumed any alcohol prior to intercourse was highest in Italy. In all countries, the percentage that claimed they had consumed some alcohol but were not intoxicated was fairly similar. The percentage of the population who claimed they were drunk at the occasion was highest in Norway. In all countries, alcohol use prior to intercourse was more likely to have taken place if the emotional involvement in the partner was low, and if the parties had met the same day. Controlling for selected covariates and explanatory variables, pre-sexual alcohol consumption was related to condom use (albeit in different ways) in Italy, Germany and Norway. Light drinking prior to sex was associated with condom use in Italy, whereas drinking and intoxication increased the likelihood of not using condoms in Norway and Germany.

This paper presents preliminary insights into the complex nature of the same‐sex orientation of seven women who are sangomas (traditional healers) in Soweto. Data was derived from an ethnographic study, used as the appropriate methodology because of the veiled and secret nature of same‐sexuality amongst traditional healers. In‐depth semi‐structured interviews were taped in audio or video format, transcribed and translated into English. A close reading of the transcripts in relation to notions of gender, agency, kinship, community and power revealed that the belief system of the sangomas provides a window into different categories of sexuality in an African framework through which the interaction and intersection of their personal same‐sex desire, and that of their male ancestors, can be viewed. Sangomas construction of identity and desire shifted between that of personal agency and that of a dominant male ancestor. This required constant negotiation and encompassed elements of both the ‘modern’ and ‘tradi...

There has been little research into how the diverse cultures within Papua New Guinea interpret, represent and understand the HIV/AIDS epidemic. Using qualitative ethnographic research, this study examines how incoming ideas about AIDS relate to the existing cultural frameworks of a rural Christian community. Although Lelet respondents in New Ireland have recourse to indigenous conceptions, apocalyptic Christianity is the most influential framework in their understanding of AIDS. Two interconnected issues are examined: How the epidemic is understood in apocalyptic terms, and how this affects practical approach to the disease. The paper indicates a need for more research into the stances taken by different Christian groups towards HIV/AIDS. This is especially important in the Pacific, where Christianity is the dominant worldview and where there has been a rapid spread of apocalyptic forms of Christianity, which may have particularly significant consequences for the epidemic. Jusqu'ici, peu de recherches ont...

This paper reports on findings from five studies on the ways in which culturally specific identities and relationships shape women's and men's attitudes towards, and experiences of, sexual and reproductive health and health care in Bolivia. Quantitative and qualitative methods were used to examine knowledge, power and decision‐making in sexual relationships, and between health care providers and clients. Findings indicate that men and women hold different attitudes towards, and knowledge of, certain aspects of sexual and reproductive health. Moreover, health providers and users have dissimilar perceptions of health care encounters. In both arenas, poor communication was identified as a major constraint to improving sexual and reproductive health. Taken as a whole, these studies suggest that a deeper understanding of the relational dynamics and cultural contexts of sexual and reproductive health can contribute to the development of more successful health care programmes. They also suggest that much work ne...

In this paper, we examine 2400 personal advertisements in the USA collected from the Internet, focusing on health concerns and looking for differences by race and sexuality. Our results show that overall, the gay men represented in this sample were more concerned with health than the heterosexual men. One notable racial difference was that gay Latinos were less concerned about health, particularly among those who were explicitly looking for sexual encounters. In the light of this finding, we suggest further investigation into the extent to which Latino machismo affects health concerns. We also find that advertisers who sought to engage in sexual activities and who were explicit about sex were more likely to mention health in their personals. We suggest further research to explore the links between health concerns in personal advertisements and sexual behaviour.

This paper explores the ways in which newly married working-class adolescent women of Mumbai, India deal with their marital sexual experiences to transform their bodies from a body-for-others to become also a body-for-self. Using qualitative data gathered through repeated focus group discussions and in-depth interviews with 100 women, I examine the ways women used their bodies in culturally expected ways through participation in sexual activity and reproduction to acquire personal honour. Through the daily disciplining of sexual relations, women characterized their sexual bodily experiences to move from reluctance, shyness, and fear to one of pragmatism. Older married women invoked discourses of ideal femininity to normalize what newly married adolescents perceived as unpleasant events. In retrospect these women, who had experienced gains of status as mothers and honour as married women, transformed the disciplining of their bodies into a force for personal transformation, raising the possibility that the...

This paper presents findings from qualitative research carried out by the CARAM Southeast Asia Research Network in the period 1997-1999. In several countries in Asia, interviews and focus group discussions were held with migrant workers about their working conditions, access to health care, and factors affecting vulnerability to HIV/AIDS. Factors that have an impact on migrants' sexual behaviour include the country of destination and the availability of a commercial sex sector. Cultural differences with respect to sexual behaviour are also important. As social control in migrant communities is often limited, sexual relationships that are prohibited at home are often possible abroad. Besides continuing to belong to their home communities, migrants gradually adapt to their new communities abroad. In so doing, they adopt a so-called 'migrant identity' which can lead to a denial of certain (sexual) behaviours. This can make them difficult to reach by means of conventional HIV/AIDS prevention approaches.

This study aimed to extend notions of male involvement to maternal health and to understand how Guatemalan men and women think about husband involvement in pregnancy, birth, and the postpartum period. Based on individual interviews and focus groups with men, women, and community health workers in two areas of rural Guatemala, this paper describes the pregnancy-related advice and assistance husbands give, and the reasons men are and are not involved in maternal health. Both men and women reported that male involvement in maternal health is relatively high, desirable, unique and affected by many factors. These include love, men's work demands, economic concerns and men's knowledge. The results help to fill broad gaps in understanding of male involvement in this aspect of family health and to amend stereotypes about husbands' relationship to maternal health and health care.

This paper describes findings from a study on spousal communication and sexual decision making among women and men from a low-income community in Mumbai. The study explored the link between contextual, individual and socio-economic factors, sexual behaviours and communication to highlight sexual health consequences for women and men. It utilized a combination of qualitative and quantitative methods including a community profile survey, focus group discussions, repeated in-depth interviews, pile sorting and the sequencing of sexual behaviours. Family structure and duration of marriage were found to influence the quality of marital sexual relationship. Early experiences of violence and coercive sex limited women's participation in, and enjoyment of, sex. Respondents revealed a normative sequence of pre-coital sexual behaviours; those reporting sexual violence invariably violated this sequence. Women's experiences of sexual violence revealed lower perceived equity compared with men. Respondents reporting an ...

This paper analyses folk constructions of syphilis in a predominately African-American community in Houston, Texas. In-depth interviews with 17 African-Americans were conducted to describe the folk models of syphilis present. Interviews centred on prevalence transmission, risk, personal protection and detection, relationships and expectations for the future. Physical appearance, the earwax test, the match test and the smell test were used to 'detect' syphilis infection. Respondents conflated the symptoms of several STDs including syphilis, gonorrhoea, herpes and chlamydia into a single class. The study findings indicate miscommunication regarding STD information and use of different models (folk vs. medical) to explain risk of infection and prevention. The use of folk constructions in syphilis interventions would provide a better understanding of the community's knowledge and perceptions of STDs and a better focus for future education and prevention programmes.

This paper analyses the use of contraception and protection against sexually transmitted diseases (STDs) in an urban Norwegian population. In 1997, a random sample of 5000 persons (18-49 years), drawn from the population register in Oslo, participated in a sexual behaviour survey. Data collection was carried out by means of postal questionnaires. Thirty-seven per cent of respondents reported not using any contraception, 18% used condoms for contraception, 28% used oral contraception (OC) and 19% an intrauterine device (IUD) at most recent intercourse. The use of contraception decreased by a factor of 0.95 for every year increase in age, and also increased with level of education. Twelve per cent reported using some form of STD protection. Older age, being in love with the partner, and having sex in a committed relationship were associated with low use of STD protection. Higher education, having had a same-sex partner, having penetrative sex, longer time since last intercourse, and strong 'love-monogamous'...

This paper explores the role of ambiguity in sexual encounters between young people. It is based on a qualitative study of young peoples' communication about sexual matters whilst on a date. Focus groups (4) and semi-structured interviews ( n = 29) were conducted with young people (aged 16-29) in three areas of England. The results suggest that ambiguity may serve a useful function in the management of ambivalence during sexual encounters; may protect the self and others from the pain of rejection; and may guard against the possibility of making a false assumption. In such contexts, ambiguity may constitute a reasoned or rational response to a given set of circumstances. This rationality needs to be acknowledged by health professionals. Ambiguity is also sometimes construed as an appropriate mode of communication for a passive female role. Given the complex motivations behind the adoption of ambiguous cues, discussion-based teaching and peer group formats may be more appropriate than didactic teaching met...

This paper explores the obstacles and opportunities experienced by a diverse group of persons living with HIV and AIDS in accessing medical and social services. A social networks approach is used to analyse data from 56 in-depth interviews conducted with persons living with HIV and AIDS in Orange County, California. From this analysis, the service pathways by White/Caucasian gay men, Latina/Hispanic women who speak only Spanish, and injecting drug users of diverse ethnicities are used to illustrate the influence of race/ethnicity, gender, and sexual orientation on service access. Implications for service provision and future research are discussed.

This paper, based on in-depth interviews of 54 women selected from both rural and urban areas, analyses the sexual behaviour of married women in Bangladesh. The study reveals that at the time of marriage girls have very limited knowledge about sex and married life. In a few cases, this has a significant bearing on later sexual behaviour and the expression of sexuality. The study also indicates that, despite normative restrictions, many women find ways of communicating about sex and sexuality with their husbands, and most enjoy their sexual life. Communication on contraception is almost desexualized and generally occurs early in their married life. In most cases, discussion of sex or contraception is initiated by husbands. These findings encourage new efforts to prevent the transmission of STIs/HIV and make married life sexually more enjoyable. The study reveals considerable variation in the sexual behaviour of women with respect to sexual negotiation, sex during menstruation and forced sex. Findings sugge...

This paper reviews the literature regarding levels of HIV antibody testing amongst gay men and rationales both for and against testing. Whilst marked differences in levels of reported testing were identified (regionally, nationally and across time), some consensus was found regarding reasons both for and against HIV antibody testing. Reasons for testing included accessing medical treatments, planning for the future and hoping for peace of mind. Reasons against testing included the negative psychological and social consequences of positive test results. The findings of the review are discussed in terms of recent medical discourses, which provide a powerful rationale for the uptake of HIV antibody testing amongst all gay men where treatments are available. Critically, we illustrate the lack of current research that seeks to reappraise HIV testing in the light of new HIV treatments, and discuss the implications for both research and practice.

Mobile populations present particular challenges for the delivery of health services. This paper focuses on a highly mobile population-truck drivers who cross the Mexico-Guatemala border through Ciudad Hidalgo in Chiapas-and examines the impact of an intervention that provided information regarding STD/HIV/AIDS, and promoted condom use. Following an ethnographic study to identify key actors, interaction sites and sexual practices, a baseline questionnaire survey was administered to 307 truck drivers. Information gathered in both the ethnographic study and the survey was used to design a series of interventions to promote condom use and provide information about STD/HIV transmission. Perceptions of risk for HIV/AIDS were lower for truck drivers in the intervention group compared with the baseline survey, an effect associated with greater reported condom use by truck drivers in this group. Border crossings are strategic setting for prevention interventions regarding STD/HIV/AIDS. Strategies must be develope...

While the content of school-based sex education has been recognized as vitally important, less attention has been paid to the classroom context in which it is delivered. This paper explores pupil accounts of the classroom context in which their sex education lessons take place, investigating, in particular, reasons for discomfort and factors that mediate this discomfort and facilitate pupil engagement. Sixty-six in-depth interviews and 16 group discussions were conducted with pupils from six co-educational schools in the east of Scotland. The majority of pupils talked about being uncomfortable in sex education lessons and nearly all mentioned that gender dynamics were problematic. Discomfort manifested itself in reluctance to ask questions and/or to participate actively in lessons, as well as in disruptive behaviour. From the analysis, four inter-related themes have been identified which work to reduce pupils' discomfort: 'The teacher as protector', 'the teacher as friend', 'trust between pupils' and 'sex...

This paper describes the contribution of gender beliefs and gender-skewed cultural practices to the high prevalence of uterine prolapse among rural women in Nepal. In conditions of difficult geography, inadequate health services and underdevelopment, the pre-natal period is marked by a heavy workload, a low rate of pre-natal care, and restrictions on a woman's own health decision-making. Delivery is often facilitated by untrained assistants using push and pull methods that may cause pelvic damage. The recovery period after delivery is defined by ethnic prescriptions and household needs that disregard the woman's physical readiness to resume work. The Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW), the most central and comprehensive of the United Nations documents for the advancement of women, mandates that cultural beliefs and practices that are injurious to women must be modified. Reproductive health interventions can legitimately challenge the social causation of uter...

This paper presents the findings of a qualitative study of women's perceptions of reproductive tract infection in two communes in northern Viet Nam. The objective of the study was to gain information concerning women's perceptions of reproductive tract infection and their associated symptoms and help seeking behaviours. Focus group discussions, in-depth interviews, free listings and pile sortings were conducted with approximately 230 women. Although infections are perceived to be common and to cause much discomfort, there is little consistency in the reporting of symptoms, causes and consequences of infection. Perceived causes are predominantly associated with dampness and exposure to dirty water, although there is also a perceived association with medical procedures such as IUD insertion and abortion. Little attention is paid to the risk of sexual transmission. Treatment is generally with guava liquid and 'hygienic washes' at home, with women only consulting a health care provider if symptoms persist or ...

Analysing excerpts from a large interview database, the paper examines the content, rhetorical structure, and apparent function of adolescents' moral argumentation in commentaries about sex. We compare the approaches of cognitive science and discourse analysis to the topic of adolescent sexual cognition, concluding that the discourse approach is more successful in identifying underlying gender-related ideological conflict. We conclude that if an ideology mobilizes a great deal of rhetorical and self-justificational energy, then sexual behaviour may also be affected by that ideology since personal behaviour is itself a major asset/liability in moral self-presentation. We suggest that altering the content of risk reduction interventions so as to encompass issues related to gender ideology may facilitate exposing the rationale of relevant sexual behaviours to examination and possible change. En s'appuyant sur une analyse d'extraits d'entretiens provenant d'une large banque de donnees, cet article examine le ...

This paper examines how patients with HIV and their doctors jointly interpret 'viral load'. We show that the term 'viral load' is multiply coded: It calls up the idea of a biological property of the HIV positive body, but the term is also used as an indicator of drug treatment effectiveness, of patient compliance, and of overall wellness. Such multiple codings can be problematic because they index multiple and potentially conflicting discourses. Three distinct discourses which inform HIV medicine are identified: health measurement, health care, and health experience. These are described in terms of their semantic, lexicogrammatical and interactional patterns to illustrate how doctors and patients navigate their paths through them. In practice, what a viral load result is taken to mean depends on the alignment of patient and doctor in terms of their respective interdiscursive positions. The ability to recognize and flag discursive shifts should be considered a central component of doctors' professional exp...

This paper analyses community members' descriptions of subgroups of gay and bisexual men in San Francisco. Five group categories are identified and subjected to detailed analysis. These are labelled leather, men of colour, activists, men who go to clubs and younger. While some of these groups meet established criteria of 'community', they do so in different ways suggesting the existence of relatively discrete sub-communities within the San Francisco gay community. While the gay community is often conceived of as monolithic it may in fact be culturally heterogenous. An alternate multi-constitutive model of community is proposed to account for this cultural heterogeneity. We also discuss how some sub-communities develop around culturally charged areas of difference, and consider the possible implications of these differences for future community interventions.

This study examines the acceptability of the RealityTM female condom among a population of women in the US exhibiting a high prevalence of risk factors for infection with the human immunodeficiency virus (HIV). The female condom was introduced to incarcerated women via a 20 hour didactic health and HIV education course. The 246 course graduates were interviewed before they started the course (baseline), and at 2, 6, 12 and 16 months post-release. This paper reports on the baseline and two month follow-up data to focus on the women's initial experiences with the female condom. None of the respondents reported ever using a female condom at baseline, but 62% had used one within two months of release from incarceration. Virtually all used it during vaginal sex, with 68% trying it with their husband/boyfriend and 36% trying it with a friend. Overall, 23% report using a female condom and 27% report using a male condom every time they had vaginal sex, so fully half of the respondents reported always using a cond...

This paper discusses distinctions made by married Mexican women in the USA and Mexico between withdrawal and rhythm, as well as differences between women who use these traditional methods and those who use more 'modern' ones. Findings derive from an ethnographic study of gender and reproductive health in a Mexican transnational community. The primary method used was life histories, complemented by 15 months of participant observation. The sample consisted of 13 systematically selected pairs of women; one woman in each pair lived in Atlanta and the other lived in the sending community in western Mexico. While research on fertility regulation frequently classifies rhythm and coitus interruptus as traditional methods, this study showed that those who use these methods may base their classificatory system on other conceptions, including a contraceptive method's ideal properties. Generational changes in ideologies of marriage and intimacy and migration-related changes shape women's ideas about the meaning of s...

The family, household and community have often been identified as having a crucial role to play in HIV and AIDS-related care in developing countries. Yet few studies have sought to examine the limits to the support that such institutions can provide. This paper describes findings from a study of the care and support offered to people living with HIV and AIDS in Chiang Mai province, an area of Thailand severely affected by the epidemic. Following an initial Rapid Assessment Process (RAP), data was collected from in-depth household and individual interviews, focus group discussions and participant observation in two village communities. A number of recurrent themes emerge from the data: Local beliefs and practices as factors mediating family and community responses; the impact of recent economic and social change on the social organisation of family and village life (including the role of formal village leaders and the growth of sex work); the complex interface between traditional and modern systems of care...

This paper uses two specific 'moments' in the history of the UK HIV/AIDS health promotion response to illustrate the way in which social narratives and moralities underpin different safer sex messages. Drawing on narrative psychological theory (see Crossley 2000a, Maclntyre 1981, Taylor 1989), it works from the premise that the language and cultural images used in health promotion campaigns are inscribed within predominant narratives and stories. The stories and the meanings thereby set in motion are intrinsic to our making sense of ourselves and others around us. This is because stories constitute manifestations of specific versions of what is 'valuable', 'worthwhile', 'justifiable' and 'moral' for people in any given culture, thereby having the capacity to confer meaning and substance on our lives (Taylor 1989). The case studies examined here are used to illustrate the way in which different health promotional materials offer very different accounts of sexuality that are inextricably related to culturally inscribed visions of 'self' and ways of relating to others. An important part of deconstructing the images and messages offered by HIV/AIDS health promotion campaigns, involves questioning and assessing the suitability of such narratives for contemporary challenges facing the audience for which they are intended. The safer sex promotional materials produced by two very different UK based health related agencies, the Health Education Authority (HEA) and the Terrence Higgins Trust (THT) will be focused on. Chronicles of the HIV/ AIDS epidemic have dubbed these agencies as advocating 'heterosexual' and 'gay' approaches, respectively, to health promotion (e.g. Garfield 1994).

This paper reports on research conducted among young people in two rural communities in the state of Morelos, Central Mexico. Methods used included participant observation, indepth interviews and focus groups. Findings suggest that a person's constitution or 'nature', their gender and perceived risks during agricultural work were strongly associated with riskrelated sexual behaviour. Those who perceive themselves as having a strong constitution see themselves at low risk of acquiring STIs/AIDS. Young people reported receiving little information about reproductive matters at school, including condom use. When information was provided, it was often in a form disassociated from its cultural context. Efforts to control female sexuality between puberty and marriage were particularly marked in the communities studied and may interfere with risk reduction among both young women and young men. Policy recommendations for the future development of sexual education in rural areas in Mexico are outlined.

To explain the persistence of high fertility and low contraceptive prevalence in rural sub-Saharan Africa, demography has relied heavily on a framework that emphasizes institutional barriers to individual behavioural change. Such an approach assumes that in traditional societies, institutions such as polygyny exert a uniform effect on fertility for all women and hence, actors have little agency in fertility decision-making. One consequence of this approach is its inability to perceive how women might use such social institutions for their own ends: Most notably, their efforts to plan their childbearing and to safeguard their own health. This paper uses data from a micro-level study in the North Bank region of The Gambia to investigate the management of fertility within the context of polygynous households. The results suggest that a woman's success in pacing her childbearing, using contraception, and finally 'retiring' from childbearing depends not only on her own fertility status but that of other co-res...

Feminist analyses of gender power inequalities in the negotiation of heterosexual sexuality (heterosex) have exposed heterosexuality as a key site for the reproduction of patriarchy. Empirical studies have highlighted women's lack of negotiation and men's dominance in heterosex. This paper reports on a qualitative study exploring the negotiation of heterosex among young men and women students at the University of the Western Cape, South Africa. A discourse analysis was carried out on the transcripts of focus group discussions held with over 100 male and female students speaking about their sexual experiences with the opposite sex. The study highlights the lack of a positive discourse on women's sexual desires, and continued double standards in the construction of masculine and feminine sexualities, with men viewed as positively sexual while women are representative of love and relationships. Nonetheless, there are some marginal voices contradicting these discourses and challenging the hegemonic constructi...

This paper presents findings on how sexual safety is sustained in relationships. A qualitative study was undertaken to gather data on the social relations of sexual negotiation and safety among HIV positive people and their sexual partners. HIV positive people were found to avoid close relationships because of the difficulties of sustaining safer sex with regular partners. In response, many sought HIV positive concordant partners, and unprotected sex in these relationships was considered 'acceptable'. Action that suspended protected sex helped define relationships as intimate and important. As the emotional content of relationships developed, the acceptability of risk increased. Relationship risk management in the time of AIDS is as much an effort to protect relationships as intimate, loving and secure, as it is an effort to ensure viral safety. This was particularly the case in antibody discordant relationships. Here, 'love relationships' were presented as important as life itself. It was HIV negative pa...

This paper discusses sexual health strategies among Chilean women living in Melbourne, Australia. Twenty in-depth qualitative interviews and a survey questionnaire were administered to 100 Chilean-born women. Findings illustrate the importance of 'authority' when it comes to 'socially risky' illnesses like sexually transmitted diseases (STDs). Women stressed that western trained doctors are the only answer for STDs and the only way women can protect themselves from getting STDs is by visiting the doctor. The western trained doctor is seen to have the authority and legitimacy to treat the disease and heal the social relationships threatened by STDs. Chilean women continue to value the importance of alternative medicine within the array of health and medical seeking behaviours, although their use has shifted from the traditional Latin American folk healer to the Chinese doctor, herbalist and other alternative medical practitioners, including naturopaths. We conclude by arguing that while traditional medicin...

This paper argues the case for critical regional enquiries in East and South East Asia into the study of gender and sexual diversity. The concept of 'regions' is here seen as a partial and provisional way of describing both the various ways in which an area of the world is imagined as being separate and distinct, and of describing the flows of people, goods and ideas through which a particular region or world area is made. Further, it is suggested that the idea of regions is a theoretically and politically necessary fiction. On the one hand, a critical regional perspective provides a vantage point from which to problematize naive and uncritical writing on globalization, including the 'globalization' of gender and sexual identities. On the other hand, it enables us to think about the wider networks of material and symbolic relations within, and through which, gender and sexuality are made and experienced in particular locales.

This paper investigates the widespread representation of (mainly male) homosexuality in a variety of Japanese popular cultural media. Generally, representation of homosexuality in Japan is situated in the 'entertainment world' and male homosexuality, in particular, is often conflated with transsexuality and transgenderism. Discussion of homosexuality as a 'lifestyle choice' or in terms of 'sexual rights' is extremely rare, even in the Japanese gay media. It is suggested that media discourses about homosexuality, which conflate it with transsexuality, work against same-sex desiring men in Japan developing a politicized sense of 'gay identity'. Interview data from Japanese men as well as material gathered from the gay media are used to reflect on Altman's notion of 'global queering' and to question the argument put forward by some Western gay and lesbian theorists that 'gay identity' is something Japanese homosexuals 'lack', and should therefore develop.

This paper explores the role of locale and location in understanding gay men's sexual behaviour. Twenty gay men from Glasgow, Scotland took part in semi-structured, in-depth interviews. Interpretative Phenomenological Analysis (IPA) was employed to analyse transcripts for recurrent themes. Shared understanding relating to the relationship between locale and sexual activity emerged as important. Findings suggest the existence of distinct sexual cultures associated with locales such as the commercial gay scene (the bars), public toilets (the bogs) and public parks (the bushes). Furthermore, sexual activity was directly affected by its specific location. Sexual behaviour is understood and patterned by the locale (i.e. sexual space) in which it occurs; it is also constrained by location (i.e. specific site). In the light of these findings the appropriateness of traditional psychological approaches to understanding sexual activity and the relevance of other perspectives which map the links between social context and sexual behaviour are discussed.

Death from HIV/AIDS is increasingly common in Kenya. However, the ways in which people diagnosed with HIV/AIDS and society more generally make sense of this kind of death has been little investigated. By analysing accounts from a sample of fourteen heterosexual people diagnosed HIV positive and presented for treatment in four specialized clinics in Nairobi, and other accounts elicited from members of the clergy and lay persons, this paper examines how people make sense of death from HIV/AIDS. To be infected by HIV equates to death, and because AIDS acts as a metaphor for moral and physical contamination, HIV infection confers on the individual a spoilt image and identity. This image and identity is projected into life beyond physical death, and is reinforced, popularized and legitimized by Christian and African religious schema in such a way that death from HIV/AIDS is now constructed and experienced as 'permanent'. This kind of death has implications for the way in which people living with HIV/AIDS seek ...

The Indonesian Communist Organization Gerwani was banned in 1966. It had been associated with sexual perversions during the 1 October 1965 putsch in which senior figures within the Indonesian army were killed. These accusations helped fuel the massacre of over a million people and brought General Suharto to power. Yet in many ways Gerwani's ideology was puritanical and geared towards strengthening the monogamous family unit. It breached traditional gender ideology only in its insistence that women should be political actors and militant mothers. More recently, the organization has been accused of 'promoting lesbianism', when it in fact has never discussed the issue. This paper analyses Gerwani's ideology to explore the link between political activism and sexuality. The women's organization can be regarded as one of the forces of 'modernity' which stimulated homophobia. It is suggested that Gerwani's political activism was considered such a breach of traditional gender ideologies that it triggered a fear o...

This paper presents findings from an elicitation study that focused on the sexual risks and condom use behaviour of African American crack smokers. Of interest were the attitudes, beliefs, and barriers that affect the adoption and maintenance of condoms as an HIV prophylactic. Thick descriptive data were collected from 64 heterosexual African Americans who smoke crack cocaine. Data were content analysed for descriptions of condom use attitudes, normative beliefs, and barriers or facilitators of condom use. Participants described few positive condom use outcome expectations, while detailing several negative expectations. Normative beliefs were found to be weakly related to condom use with casual partners. However, descriptions of sexual relationships with intimate partners indicated that the normative expectations of the partner strongly influenced condom use. Participants described few contextual barriers to condom use, although situational barriers, including crack addiction, were identified.

This paper explores the intersection of sexuality and ethnicity in the lives of a group of South-East Asian gay men. Data derive from an exploratory study conducted in Manila involving semi-structured face-to-face in-depth interviews with self-identified homosexual Chinese Filipino men. Findings suggest that the men shared a strong sense of being Chinese while also being conscious of their double marginalization as homosexual and as part of an ethnic minority. Ethnicity was found to play a key role with respect to sexual partnership, influencing choice of partners and age and class status of their ideal mates. Chinese gay men's use of Fukkien was identified as a key marker of their identity both as gays and as Chinese Filipinos. Further research is needed to explore further the relationship between sexuality and ethnicity, as well as how class and age influence present and prospective sexual relationships.