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Introduction: Stigma constitutes a critical challenge to the rising rates of HIV among Chinese men who have sex with men (MSM). It reduces willingness to disclose one's sexual orientation and can lead to concurrent sexual partnerships. Disclosure decisions are also affected by cultural norms that place pressures on sons to marry. In this manuscript, we characterize how stigma and cultural factors influenced Chinese MSM's decisions around disclosure and marriage. We seek to show that MSM's actions were motivated by moral considerations, even when those choices posed HIV transmission risks., Methods: We conducted qualitative interviews with 30 MSM in Beijing, China. Interviews were audio-recorded, transcribed, and translated into English for analysis. Transcripts were coded using a procedure that allowed for themes to emerge organically., Results: Participants struggled with feelings of shame and believed that others possessed stigmatizing attitudes about homosexuality. They had experienced relatively little discrimination because they infrequently disclosed their MSM status. In response to marital pressures, participant had to reconcile same-sex attractions with filial expectations. Their choices included: not being involved with women; putting on the appearance of a heterosexual relationship by marrying a lesbian; or fulfilling family expectations by marrying a heterosexual woman. Regardless of the decision, many rooted the justifications for their choices in the considerations they had given to others' needs., Conclusion: The growing epidemic among MSM in China requires action from the public health community. As programs are scaled up to serve these men, it is critical to remember that MSM, who often fear social sanction if they were to reveal their sexual orientation, continue to face the same pressures from culturally normative social duties as heterosexual men. Interventions must find ways to help men navigate a balance between their own needs and the responsibilities they feel toward their parents and others.

Surnames have been used for studying population structure in different parts of the globe. The present study is aimed at indirectly estimating the degree of inbreeding from surnames and understanding the influences of the clan-like structure on mate selection among Manipuri Muslims. The proportion of isonymy I was found to be 0.0144. The non-random and random components were -0.0226 and 0.0239, respectively. The total inbreeding coefficient was estimated to be 0.0018. The scores of random pairs (RP) and random repeated pairs (RPr) were 0.026 and 0.010, respectively. The score of RP was higher than the RPr which gives a ratio of 0.38, indicating that Manipuri Muslims have a tendency of acquiring mates from within a given set of surnames while not in favour of isonymy. To conclude, surname/clan is a criterion for mate selection for various reasons among this population., (Copyright © 2013 Elsevier GmbH. All rights reserved.)

Diseases of women that are due to their gender specific roles and responsibilities result from cultural and social factors prevalent in the environs. World Health Organization has put special emphasis on research need regarding gender related factors for diseases disproportionately affecting women in developing countries. The objective of this write up was to determine the prevalence of depression and the associated risk factors among adult women in Pakistan. PubMed was searched using key words depression, risk factors, women and Pakistan. Out of 20 initially retrieved articles, 12 were directly related to depression and its risk factors among Pakistani women within Pakistani geographical context. Women in Pakistan are vulnerable to poor mental health due to marriage related issues, domestic violence, verbal or physical abuse by in-laws, stressful life and poor social conditions. Women in their perinatal period are more at risk of depression due to pregnancy related concerns.

Little is known about current attitudes towards cousin marriages. Using data from a rural population in the Mexican state of Oaxaca, the present research examined how life history was related to attitudes towards cousin marriages in various ethnic groups. Participants were 205 parents from three ethnic groups. i.e., Mestizos (people of mixed descent, n = 103), indigenous Mixtecs (n = 65), and Blacks (n = 35). Nearly all men in this study were farm workers or fishermen. Participants reported more negative than positive attitudes towards cousin marriage, and women reported more negative attitudes than did men. The main objection against marrying a cousin was that it is wrong for religious reasons, whereas the risk of genetic defects was considered relatively unimportant. Cousin marriage was not considered to contribute to the quality and unity of marriage and the family. The three ethnic groups did not differ in their attitude towards cousin marriages. However, a slower life history was related to a more negative attitude towards cousin marriages, especially among Blacks, less so among Mixtecs, and not at all among Mestizos. In addition, and independent of the effect of life history, with increasing levels of parental control over mate choice, the attitude towards cousin marriage was more positive, but among men the attitude was more negative the more religious they were. The results are discussed in the context of theorizing on life history theory and the benefits and costs of cousin marriages.

Purpose: The purpose of the study was to examine the roles of acculturative stress, life satisfaction, and language literacy in depression in non-Korean women residing in South Korea following marriage to Korean men., Methods: A cross-sectional study was performed, using an anonymous, self-reporting questionnaire. A total of 173 women were selected using a proportional stratified random sampling method. The relation between acculturation, depression, language literacy, life satisfaction and socio-demographic variables and the predictors of depression among participants were analyzed. The analysis included descriptive statistics and hierarchical multiple regression., Results: Of the participants, 9.2% had depression, which was almost twice the rate of depression found in the general Korean population. In hierarchical multiple regression analysis, acculturative stress (beta=-.325, P<.001) and life satisfaction (beta=-.282, P=.003) were significantly associated with the level of depression. This final model was statistically significant and life satisfaction, acculturative stress, language literacy accounted for 31.0% (adjusted R(2)) of the variance in the depression score (P<.001)., Conclusions: Elevated acculturative stress and less life satisfaction were significantly associated with a higher level of depression in migrant wives in Korea. Implications for practice and research are discussed., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objectives: This study investigates the role of gender, caregiving, and marital quality in the correlation between widowhood and depression among older people within a European context by applying the theory of Social Production Functions as a theoretical framework., Method: Fixed-effects linear regression models are estimated using the first 2 waves (2004, 2006) of "The Survey of Health, Ageing and Retirement in Europe" (SHARE). A subsample of 7,844 respondents aged 50 and older in 11 countries, who were married at baseline and are either continuously married or widowed at follow-up, is analyzed., Results: Respondents who experienced widowhood between the 2 waves report significantly more depressive symptoms than those continuously married, with respondents living in Denmark and Sweden reporting a lower increase in depressive symptoms than those living in Greece, Spain, or Italy. There is no statistically significant interaction between gender and widowhood. Widowed persons who report higher marital quality at baseline show a larger increase in the number of symptoms of depression than those with low marital quality; widowed persons who report being a caregiver for their partner at baseline report smaller increase in the symptoms of depression compared with widowed noncaregivers., Discussion: The results support the results of previous studies using longitudinal data. Furthermore, the effect of widowhood varies among the 11 countries in the subsample although only a small amount of the variation in the increase of depressive symptoms after becoming widowed can be explained by such contextual factors.

Vasectomy has advantages with respect to safety and cost when compared with female sterilization. The reasons underlying the overall low use of vasectomy, particularly among Black and Latinos, have not been adequately explored. The goals of this study were to (a) explore the social context of vasectomy decisions and (b) generate hypotheses about the social factors contributing to differences in vasectomy use by race/ethnicity. Fourteen group and nine couples interviews were conducted. Participants were 37 heterosexual couples aged 25 to 55 years who had reached their desired family size and self-identified as Black, Latino, or White. Participants discussed reasons that men and women would or would not select male sterilization. Reasons to select vasectomy included a desire to care for their current family, sharing contraceptive responsibility, and infidelity. Reasons not to select vasectomy included negative associations with the term sterilization, loss of manhood, and permanence. Misconceptions about vasectomy included misunderstandings about the vasectomy procedure and adverse postvasectomy sexual function. In addition, Black and Latino participants cited perceived ease of reversibility of female sterilization and lack of support around vasectomy as reasons not to choose it. Improving communication and social support for vasectomy, particularly among Black and Latino communities, may improve vasectomy utilization. Misconceptions regarding female and male sterilization should be targeted in counseling sessions to ensure men, women, and couples are making informed contraceptive decisions.

Based on data collected from urban residents by questionnaire, the basic parameters of the genetic-demographic structure of populations of the three megalopolises, i.e., Moscow, Kharkov, and Minsk, have been calculated, including the migration coefficients and their dynamics in generations, the radius of the cities migration attraction, the parameters of marriage structure (the proportion ofinterethnic marriages, the level of intraethnic assortative mating, the marital distances), and the gene flow between the ethnic groups. It is shown that the representatives of the most numerous ethnic groups in each megalopolis have considerable amount of admixture. For Russians of Moscow, Ukrainians of Kharkov, and Belarusians of Minsk, the proportion of individuals whose ancestors were all born in the given city for at least three generations and belonged to the same nationality turned out to be very low (4.75% in Moscow, 1.83% in Kharkov, and 3.13% in Minsk). This finding questions the formation of a reference population in the megalopolis as a sampling of aboriginals of certain ethnic origins. In the paper, we justify principles of creating genetic databases for the population of the megalopolis taking into account the complexity and dynamism of its population structure.

Mexican Americans typically have better cardiovascular health than Caucasians, despite being relatively economically disadvantaged. Given research indicating the importance of relationship quality on one's health, our study examined whether certain relationship orientations (eg, communal or exchange) differed between Caucasians and Mexican Americans and if these orientations could help explain the Hispanic Paradox. We recruited 582 adults from a community being primarily Caucasian (40%) and foreign-born Mexican Americans (55%). Participants wore 24-hour ambulatory blood pressure (ABP) monitors and completed self-report measures of relationship satisfaction and relationship orientation. Results indicated that Caucasians tended to have more of a communal relationship orientation compared to foreign-born Mexican Americans. Communal orientation was predictive of higher relationship satisfaction and while higher relationship satisfaction predicted lower systolic blood pressure when ethnicity was added into the model this relationship was eliminated and foreign-born Mexican Americans had higher ABP compared to Caucasians. Even though communal and exchange relationship orientation don't seem to give us any more information to unravel the Hispanic Paradox, there are important ethnic differences in how we engage in marriage relationships and future research will need to examine the health effects of these differences.

Context: A considerable proportion of women worldwide are married during childhood. Although many studies have examined early marriage (before age 18), few have compared outcomes or correlates among girls married during different stages of adolescence or have focused on girls married very early (before age 15)., Methods: Data from a population-based survey conducted in 2009-2010 in seven Ethiopian regions were used to examine early marriage among 1,671 women aged 20-24. Cross-tabulations and logistic regression were used to compare characteristics and contextual factors among girls married before age 15, at ages 15-17 or at ages 18-19 and to identify factors associated with selected marital outcomes., Results: Seventeen percent of respondents had married before age 15 and 30% had married at ages 15-17. Most of those who married before age 18 had never been to school. Compared with young women who had married at ages 18-19, those married before age 15 were less likely to have known about the marriage beforehand (odds ratio, 0.2) and more likely to have experienced forced first marital sex (3.8). Educational attainment was positively associated with foreknowledge and wantedness of marriage and with high levels of marital discussions about fertility and reproductive health issues., Conclusions: Initiatives addressing the earliest child marriages should focus on girls who have left or never attended school. Given the vulnerability of girls married before age 15, programs should pay special attention to delaying very early marriages.

Clinicians are frequently asked for advice on what to tell prospective marriage partners about a history of mental illness. The aim of this paper is to develop guidelines for disclosure. An electronic search was conducted of the stigma, secrecy, communication, sociology, and matchmaking literatures as they pertain to mental illness, especially to schizophrenia. The conclusion was that pre-existing psychiatric conditions must be shared with prospective marriage partners once these partners have proven trustworthy. The recommendation is that disclosure be done in stages and that discussions continue, with attempts made to address all relevant issues and address the partner's concerns. Although schizophrenia does not define who a person is, the diagnosis and its implications are important and need to be shared with prospective marriage partners.

Comments on the original article by Matthew D. Johnson (see record 2012-08242-001). It is important to challenge some of Johnson's points about the effectiveness and reach of interventions to lower income couples and couples of color and his suggested prioritization of basic over applied research. With emerging findings and practical knowledge gained in lower income communities from all across the United States over the past decade, we see evidence to support optimism for the potential utility of marriage and relationship education (MRE) programs to help disadvantaged and minority couples. Accordingly, continued support for these efforts is justified. We anticipate that the potential of these first-generation programs will only increase as the research Johnson called for advances our understanding of low-income and minority couple relationships, as more programs are rigorously evaluated, and as we learn and disseminate best practices from programs now in the field., ((c) 2013 APA, all rights reserved.)

Replies to comments made by Hawkins et al. (see record 2013-04752-002) on the author's original article (see record 2012-08242-001). I am gratified and encouraged that such an esteemed group of relationship scientists as Hawkins et al. I want to continue the discussion of government-supported marriage and relationship education (MRE) programs for lower income couples by responding to my article (Johnson, May-June 2012). In their comment, they argued that there are data that support the efficacy of MRE programs for disadvantaged couples and that the benefits of these programs outweigh the costs. My response to both of these points follows., ((c) 2013 APA, all rights reserved.)

The study of kinship systems has direct relevance for the field of human genetics and the study of microevolution in human populations. Some types of postmarital residence rules--rules requiring a married couple to live with or near relatives of the husband or wife--will have consequences for the distribution of mitochondrial DNA and Y chromosome lineages. Rules that proscribe or encourage marriage with close kin will also have consequences for allele frequency. A preference for marrying at a distance, both socially and geographically, creates alliances that can have survival value for individuals and groups in an environment of periodic or unpredictable scarcity. This article considers the nature of early contact between the indigenous foraging populations of the Philippines and Austronesian speaking settlers who began arriving ~4,500-4,000 BP. It argues that when the first Austronesians arrived they brought with them a kinship system based on symmetrical exchange between descent-based groups. It considers why such a system was gradually changed into the bilateral kinship systems that characterize the various peoples of the Philippines today, "negrito" and non-negrito alike., (Copyright © 2013 Wayne State University Press, Detroit, Michigan 48201-1309.)

The paper describes findings from an ethnographic study exploring understandings of love and intimacy amongst young heterosexual middle-class Indians of Gujarati origin in the UK and India. A two-site comparative study was used to enable an understanding of how social and economic contexts shape cultural constructions of intimate relationships and sexuality. Focusing on attitudes to 'love at first sight', this paper shows that, for Indian participants, love based on physical attraction denotes a lesser kind of love. A relationship based on 'physical love' is not expected to last, since it has been formed without regard to family and status concerns. Even couples who meet outside of the arranged marriage system demonstrate the quality of their love by not having sex with one another before marriage. In the UK, however, participants view love as properly spontaneous. Love at first sight is considered desirable and demonstrates how the relationship must be based on love only, without any concern for (for example) material gain. This spontaneous love entails both physical attraction and emotional connection - an early transition to sex, usually before marriage, was seen as both desirable and inevitable.

We studied mainstream couples in The Netherlands and Turkey as well as Turkish-Dutch immigrant couples to address cultural factors associated with marital satisfaction. A total of 13 Turkish (mainstream couples living in Turkey), 19 Turkish-Dutch (Turkish immigrant couples living in The Netherlands), and 17 Dutch (mainstream couples living in The Netherlands) married dyads (total of 98 individuals) were independently interviewed about positive and negative characteristics of marriages, determinants of general marital satisfaction and dissatisfaction, spousal communication, marital conflict, and marital roles. Multivariate tests revealed ethnic group differences on all marriage-related domains except the conflict resolution strategies. However, univariate analyses showed differences in few themes within domains; main differences were assessed between the Turkish/Turkish-Dutch (who put more emphasis on children and economical aspects) and Dutch couples (who put more emphasis on behavior, and personality of the spouse, reciprocity, emotional sharing, and psychological roles). Turkish-Dutch couples were more similar to Turkish than to Dutch couples. Results were discussed in light of the socioeconomic development and cultural value theories, which are believed to provide a useful framework for understanding the role of culture in marital satisfaction.

In Pakistan, the issue of spousal violence is under-researched and still not considered a public health problem. To assess the association of spousal violence with women's mental health, a hospital-based cross-sectional survey was conducted through a structured interview schedule with 373 randomly selected ever-married women of reproductive age in eight randomly selected hospitals in the cities of Lahore and Sialkot, Pakistan. After controlling for sociodemographic variables, women's experiences of past and current psychological, physical, and sexual violence remained significantly associated with women's poor mental health. The situation warrants urgent action to mitigate the violence-induced damages done to women's mental health.

Polygyny has been identified both as a 'benign' form of concurrency and as the cultural basis of concurrent partnerships that are considered important drivers of the HIV epidemic in sub-Saharan Africa. This paper investigates the changing cultural and economic dynamics of polygyny in concurrency in Iringa, Tanzania, a region with traditions of polygyny and high prevalence of HIV. Our analysis of focus group discussions, in-depth interviews and key informant interviews indicate that contemporary concurrent partnerships differ from regional traditions of polygyny. Whereas in the past, polygyny reflected men's and their kin group's wealth and garnered additional prestige, polygyny today is increasingly seen as a threat to health, and as leading to poverty. Nevertheless, participants evoked the social prestige of polygyny to explain men's present-day concurrency, even outside the bounds of marriage, and despite continued social prohibitions against extramarital affairs. Difficult economic conditions, combined with this prestige, made it easier for men to engage in concurrency without the considerable obligations to wives and children in polygyny. Local economic conditions also compelled women to seek concurrent partners to meet basic needs and to access consumer goods, but risked greater moral judgement than men, especially if deemed to have excessive 'desire' for money.

Men who have sex with men are a hidden population in India. This study explores the psychological violence such men are exposed to in Puducherry, India. Eleven in-depth interviews probe experiences of blackmail, discrimination, and rejection. Some informants modified their behaviors or appearances to avoid harassment and safeguard their families' reputations. Others told how Indian men accepted their behaviors, but rejected their identities. Social pressure to marry was also a recurring theme. Understanding the factors behind these violent experiences may facilitate their amelioration.

Transnational marriages in Taiwan are largely mediated by marriage brokers. The present study was conducted to evaluate the satisfaction of immigrant women with their family function and health-related quality of life in a rural township in southern Taiwan. Data were collected from January 1, 2006 to November 31, 2006, and 157 immigrants agreed to participate in the study, with a 79.3% response rate. A structured questionnaire was used for data collection. The interviewers also collected information on the immigrants' and husbands' demographics, self-reported mental conditions, family function using a Family APGAR questionnaire (Adaptability, Partnership, Growth, Affection, and Resolve), and health-related quality of life. Marriage arranged through a marriage broker and having emotional distress were factors that were strongly associated with lower Family APGAR scores. Based on multiple regression models, higher Family APGAR scores were more positively related to vitality and mental health scales. Self-reported mental conditions, including feeling economic distress, emotional distress, loneliness, and having sleep problems, were negatively associated with most scales of the health-related quality of life. Female migrants' mental health was significantly related to their health-related quality of life. These findings suggest that migrant women must be educated regarding the importance of mental health by physicians and hygiene authorities in Taiwan.

In this study, we aimed to determine the different sociodemographic variables of polygamous and monogamous wives, and the relationship between depression and polygamous marriage. Seventy-nine polygamous wives and 73 monogamous wives from Kahramanmaras, located in southern Turkey, were interviewed. After reviewing the data, we suggest that there is a statistically significant difference between polygamous wives and monogamous wives in terms of Beck Depression Inventory (BDI) scores. The results highlighted many implications for clinical practice and for future research. Additional research needs to be conducted in order to investigate the effects of polygamy on women's mental health.

We examine the influence of family processes and acculturation for gender differences in alcohol and drug use among a sample representative of the Hispanic population in Miami-Dade County, Florida (N = 734). We found that (a) increases in age at marriage and acculturation were associated with greater substance use, (b) the associations between age at marriage, acculturation, and substance use were found to be greater for Hispanic women than men, and (c) with each additional child born, Hispanic women are increasingly less likely to use substances than Hispanic men. Data reveal that family processes and acculturation jointly impact substance use.

We interviewed 12 Jordanian women who had experienced domestic violence (DV) and were receiving assistance at the Jordanian Women's Union (JWU). Our aim was to explore the history and factors supporting attainment of freedom from DV. Narratives revealed themes of DV toward girls; forced marriage; physical, psychological, or sexual abuse before and during marriage; and escalation and enduring DV. Escaping from DV required family and JWU support. In the context of a strongly patriarchal, religious society, we observed a process of resolution by shifting cultural values and themes of empowerment, with an undercurrent of suffering blamed on inequalities in the legal process.

In many parts of Asia, the Middle East and North Africa, women and children are so undervalued, neglected, abused, and so often killed, that sex ratios are now strongly male biased. In recent decades, sex-biased abortion has exacerbated the problem. In this article I highlight several important insights from evolutionary biology into both the origin and the severe societal consequences of "Asia's missing women", paying particular attention to interactions between evolution, economics and culture. Son preferences and associated cultural practices like patrilineal inheritance, patrilocality and the Indian Hindu dowry system arise among the wealthy and powerful elites for reasons consistent with models of sex-biased parental investment. Those practices then spread via imitation as technology gets cheaper and economic development allows the middle class to grow rapidly. I will consider evidence from India, China and elsewhere that grossly male-biased sex ratios lead to increased crime, violence, local warfare, political instability, drug abuse, prostitution and trafficking of women. The problem of Asia's missing women presents a challenge for applied evolutionary psychology to help us understand and ameliorate sex ratio biases and their most severe consequences.

To investigate the involvement of psychological/social factors in the condition of climacteric disturbance in Japan and the Philippines, we examined the menopausal symptoms and psychological/social factors in menopausal women living in local communities and compared among both countries whether differences in culture, lifestyle, etc. affected the condition of climacteric disturbance. High percentages of Japanese women reported mental symptoms, while relatively high percentages of Filipino women also experienced motor neurological symptoms in addition to psychoneurological symptoms. Japanese and Filipino women were found to have different stressors: a high percentage of the Japanese women had problems involving human relationships, such as providing nursing care, while a high percentage of the Filipino women had household problems, including husband's health and financial problems. Stress severity was associated with SMI scores in both countries. A poorer marital relationship in Japan than in the Philippines and an association between marital relationship and SMI scores were found. The present study suggests the association of differences in psychological/social factors between Japanese and Filipino women with differences in menopausal symptoms.

Traditional societies place especial value on marriage and having children, and marriages are often arranged. A series of situations and dilemmas associated with arranged matches and their consequences are described in the course of mental health work with ultra-orthodox Jewish people with severe mental illness. Issues of confidentiality may arise with parents and matchmakers; on the other hand, respectful cooperation with religious authorities, counselors in the community, and family members is important. Information on genetic counseling, contraception, medication during pregnancy, and breastfeeding are considered and interact with communal structures and practices. There is a need for close support and evaluation during the process of marriage, childbearing, and parenthood.

Introduction: Access to health care services is vital for every migrant's health and wellbeing. However, migrants' cultural health beliefs and views can hinder their ability to access available services. This study examined factors affecting access to healthcare services for intermarried Filipino women in rural Tasmania, Australia., Methods: A qualitative approach using semi-structured interviews was employed to investigate the factors affecting access to healthcare services for 30 intermarried Filipino women in rural Tasmania. The study used grounded theory and thematic analysis for its data analysis. Nvivo v8 (www.qsrinternational.com) was also used to assist the data coding process and analysis., Results: Five influencing factors were identified: (1) language or communication barriers; (2) area of origin in the Philippines; (3) cultural barriers; (4) length of stay in Tasmania; and (5) expectations of healthcare services before and after migration., Conclusion: Factors affecting intermarried Filipino women in accessing healthcare services are shaped by their socio-demographic and cultural background. The insights gained from this study are useful to health policy-makers, healthcare professionals and to intermarried female migrants. The factors identified can serve as a guide to improve healthcare access for Filipino women and other migrants.

Purpose: This study examines the association between marriage and colorectal endoscopy exam, and whether this association varies by gender and financial benefits of marriage including improved access to health insurance and pooled family income., Methods: Representative survey data of the non-institutionalized United States population were used from the 2000, 2005, and 2008 National Health Interview Survey. Analyses targeted persons 50-85 years of age without a personal history of cancer and with complete information on all study variables (n=21,760). Multivariate logistic regression was used to model marital status differences in the probability of undergoing a colorectal endoscopy exam with interaction effects used to model variation over time by gender, health insurance, and poverty level., Results: Married persons were more likely than unmarried persons to report ever having undergone a colorectal endoscopy exam (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.12-1.29), and the difference between married and unmarried persons in the probability of undergoing a colorectal endoscopy exam remained stable over time. Married persons were more likely than unmarried persons to report having undergone a colorectal endoscopy exam within the past 10 years (OR, 1.49; 95% CI, 1.15-1.95). For each survey year, married men were significantly more likely than women and unmarried men to report having undergone a colorectal endoscopy exam. For example, in 2008, 56% of married men reported having undergone a colorectal endoscopy exam, compared to 49% of unmarried men, 52% of married women, and 50% of unmarried women. Among persons with health insurance, married persons were significantly more likely than unmarried persons to have undergone a colorectal endoscopy exam. Among persons who were poor, there was no difference by marital status in the likelihood of having undergone a colorectal endoscopy exam. However, among persons who were not poor, married persons were more likely than unmarried persons to have undergone a colorectal endoscopy exam., Conclusion: Given that colorectal endoscopy exams are a potentially life-saving procedure, persistently higher uptake of colorectal endoscopy for married persons over time may be an important health promoting benefit of marriage. Therefore, clinicians and policy makers should focus on improving the use of cancer prevention services among unmarried persons., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

The aim of the study was to evaluate the psychometric properties of the Chinese version of Medical Outcomes Study Family and Marital Functioning Measures (C-MOS-FMFM) in Hong Kong Chinese childbearing families. A cross-sectional survey was conducted using a convenience sample of 128 childbearing couples recruited from antenatal clinics. The C-MOS-FMFM demonstrated good internal consistency (Cronbach's alpha = 0.79) and test-retest reliability (intraclass correlation coefficient = 0.74). Significant correlations with Medical Outcomes Study-Social Support Survey (r = 0.38, P < 0.01) and Trait Anxiety Inventory (r = -0.48, P < 0.01) supported construct validity. Factor analysis identified one factor corresponding to family functioning and two factors corresponding to marital functioning. The C-MOS-FMFM has satisfactory psychometric properties. It has the potential to be used as a clinical and research instrument for measuring family and marital functioning in the Chinese population.

This paper explores the decline in child marriage and changes in its effect on reproductive outcomes of Bangladeshi women, using the 2007 Bangladesh Demographic and Health Survey data. Chi-square tests, negative binomial Poisson regression and binary logistic regression were performed in analyzing the data. Overall, 82% of women aged 20-49 years were married-off before 18 years of age, and 63% of the marriages took place before 16 years of age. The incidence of child marriage was significantly less among the young women aged 20-24 years compared to their older counterparts. Among others, women's education appeared as the most significant single determinant of child marriage as well as decline in child marriage. Findings revealed that, after being adjusted for sociodemographic factors, child marriage compared to adult marriage appeared to be significantly associated with lower age at first birth (OR=0.81, 95% CI=76-0.86), higher fertility (IRR=1.45, 95% WCI=1.35-1.55), increased risk of child mortality (IRR=1.64, 95% WCI=1.44-1.87), decreased risk of contraceptive-use before any childbirths (OR=0.56, 95% CI=0.50-0.63), higher risk of giving three or more childbirth (OR=3.94, 95% CI=3.38-4.58), elevated risk of unplanned pregnancies (OR=1.21, 95% CI=1.02-1.45), increased risk of pregnancy termination (OR=1.16, 95% CI=1.00-1.34), and higher risk of the use of any current contraceptive method (OR=1.20, 95% CI=1.06-1.35). Increased enforcement of existing policies is crucial for the prevention of child marriage. Special programmes should be undertaken to keep girls in school for longer period to raise the age of females at first marriage in Bangladesh and thereby reduce the adverse reproductive outcomes.

The present research examined how a preference for influencing the mate choice of one's offspring is associated with opposition to out-group mating among parents from three ethnic groups in the Mexican state of Oaxaca: mestizos (people of mixed descent, n = 103), indigenous Mixtecs (n = 65), and blacks (n = 35). Nearly all of the men in this study were farmworkers or fishermen. Overall, the level of preferred parental influence on mate choice was higher than in Western populations, but lower than in Asian populations. Only among the Mixtecs were fathers more in favor of parental influence on the mate choice of children than mothers were. As predicted, opposition to out-group mating was an important predictor of preferred parental influence on mate choice, more so among fathers than among mothers, especially in the mestizo group-the group with the highest status. In addition, women, and especially mestizo women, expressed more opposition to out-group mating than men did.

Recent studies have examined the influence on patterns of human genetic variation of a variety of cultural practices. In India, centuries-old marriage customs have introduced extensive social structuring into the contemporary population, potentially with significant consequences for genetic variation. Social stratification in India is evident as social classes that are defined by endogamous groups known as castes. Within a caste, there exist endogamous groups known as gols (marriage circles), each of which comprises a small number of exogamous gotra (lineages). Thus, while consanguinity is strictly avoided and some randomness in mate selection occurs within the gol, gene flow is limited with groups outside the gol. Gujarati Patels practice this form of "exogamic endogamy." We have analyzed genetic variation in one such group of Gujarati Patels, the Chha Gaam Patels (CGP), who comprise individuals from six villages. Population structure analysis of 1,200 autosomal loci offers support for the existence of distinctive multilocus genotypes in the CGP with respect to both non-Gujaratis and other Gujaratis, and indicates that CGP individuals are genetically very similar. Analysis of Y-chromosomal and mitochondrial haplotypes provides support for both patrilocal and patrilineal practices within the gol, and a low-level of female gene flow into the gol. Our study illustrates how the practice of gol endogamy has introduced fine-scale genetic structure into the population of India, and contributes more generally to an understanding of the way in which marriage practices affect patterns of genetic variation., (Copyright © 2012 Wiley Periodicals, Inc.)

Objective: To describe and interpret the experiences of and adversities faced by infertile Jordanian women as described from their own perspectives., Design: A qualitative descriptive design., Setting: The women were interviewed at a nonprofit women's organization in the north of Jordan. The organization focuses on empowerment and health issues., Patient(s): This study included a purposive sample of 25 infertile Jordanian women who were unsuccessfully trying to conceive for a minimum of 1 year, and who were receiving treatment for infertility., Intervention(s): Face-to-face, in-depth, semistructured interviews were conducted, audiotaped, and transcribed using thematic analysis., Main Outcome Measure(s): Outcomes were measured using thematic analysis of the interview transcripts., Result(s): Four key adversity themes emerged from the data: the adversity of incomplete being, the social adversity of being infertile, the adversity of another wife, and the adversity of changes in the marital relationship., Conclusion(s): Jordanian women are seriously affected by infertility and experience personal, social, and marital adversities, which affect their well-being. These adversities need to be conceptualized within a framework that can be used to empower and counsel infertile women in all aspects of life., (Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

We study the relationship between polygyny and HIV infection using nationally representative survey data with linked serostatus information from 20 African countries. Our results indicate that junior wives in polygynous unions are more likely to be HIV positive than spouses of monogamous men, but also that HIV prevalence is lower in populations with more polygyny. With these results in mind, we investigate four explanations for the contrasting individual- and ecological-level associations. These relate to (1) the adverse selection of HIV-positive women into polygynous unions, (2) the sexual network structure characteristic of polygyny, (3) the relatively low coital frequency in conjugal dyads of polygynous marriages (coital dilution), and (4) the restricted access to sexual partners for younger men in populations where polygynous men presumably monopolize the women in their community (monopolizing polygynists). We find evidence for some of these mechanisms, and together they support the proposition that polygynous marriage systems impede the spread of HIV. We relate these results to the debate about partnership concurrency as a primary behavioral driver for the fast propagation of HIV in some parts of sub-Saharan Africa.

To better meet the needs of eligible African American men who were reluctant to enroll in a 5-year study called the Program for Strong African American Marriages (ProSAAM), we employed two focus groups to listen to the voices of a sample of the population being recruited and to explore their feedback about taking part in such a marriage enrichment program and how best to recruit other African American men. We explain our application of the focus group results to our recruitment of African American married couples for ProSAAM. The positive outcomes from the implementation of these results can provide potential ideas for those seeking innovative means to improve recruitment of African American men to programs that strengthen marital relationships.

Background: Taiwan has experienced a large influx of cross-border marriage migrants in recent years. The majority have been women in their childbearing ages and have come from countries with lower average standards of living than Taiwan. This trend has changed the ethnic composition of children who live in Taiwan, and it has generated considerable social concern over the future health status of Taiwan's citizens. This study aimed to examine: (1) whether there are disparities in development between children reared in families characterized by cross-border marriages and children reared in families with two Taiwanese-born parents; and (2) whether the quality of home environment explains the group differences in early childhood development., Methods: Data came from the Taiwan Birth Cohort Study. A total of 19,499 participants who completed 6-month, 18-month and 3-year surveys were included for analysis. Cross-border marriage status was defined by mother's original nationality and categorized into three broad groups: Taiwanese-born, Chinese cross-border and South-East Asian (SEA) cross-border. Early childhood development was measured at age 3 years, and covered the domains of gross motor, fine motor, language and socio-emotional competence. Hierarchical linear regressions were used to examine the mediation effects of the home environment., Results: Children of Chinese and SEA cross-border groups scored lower in fine motor, language and socio-emotional competence than those of their Taiwanese-born counterpart at age 3 years. Chinese-Taiwanese group differences in all three developmental domains became insignificant after the addition of home environment, while SEA-Taiwanese group differences in fine motor and language development remained, yet were noticeably reduced. The mediation of home environment was further confirmed using the Sobel test., Conclusions: Home environment plays a central role in reducing the disparities in developmental outcomes among children of different marriage groups. Interventions should be directed towards enhancing the quality of early home environment for children reared in families of cross-border marriages., (© 2011 Blackwell Publishing Ltd.)

The meaning and purpose of marriage, and the manner in which spouses are selected, varies across cultures. Although many cultures have a tradition of arranged marriage, researchers interested in marital dynamics generally have focused on love-based marriages. Consequently, there is little information on relational outcomes within arranged marriages. This study compared relationship outcomes in love-based and arranged marriages contracted in the U.S. A community sample of 58 Indian participants living in the U.S. (28 arranged marriages, 30 love-based marriages) completed measures of marital satisfaction, commitment, companionate love, and passionate love. Men reported greater amounts of commitment, passionate love, and companionate love than women. Unexpectedly, no differences were found between participants in arranged and love-based marriages; high ratings of love, satisfaction, and commitment were observed in both marriage types. The overall affective experiences of partners in arranged and love marriages appear to be similar, at least among Indian adults living in contemporary U.S. society.

Despite the growing number of interethnic marriages in the United States, few studies have examined intimate partner violence (IPV) in interethnic couples. This article examined past-year occurrences of IPV across interethnic and intraethnic couples and tested correlates of IPV specifically in interethnic couples. Data were from a national survey of couples 18 years of age and older from the 48 contiguous states. Interethnic couples (n = 116) included partners from different ethnic backgrounds, including Black-White, Hispanic-White, and Black-Hispanic couples. White (n = 555), Black (n = 358), and Hispanic (n = 527) intraethnic couples included partners with the same ethnicity. Data analyses were prevalence rates and logistic regressions. The analysis showed that interethnic couples were comparatively younger and had shorter relationships than intraethnic White, Black, and Hispanic couples. Male partners in interethnic couples had higher rates of binge drinking and alcohol problems compared with male partners in intraethnic couples. Past-year prevalence rates for any occurrence of IPV and acts of severe IPV were higher for interethnic couples relative to intraethnic couples. Most occurrences of IPV for interethnic couples were mutual. Factors predicting IPV among interethnic couples included marital status, couples' age, male alcohol problems, and female impulsivity. Mounting evidence points to interethnic couples as a high-risk group for IPV. Interethnic couples may be at greater risk for IPV because of their younger age, binge drinking, and alcohol problems. Future research could build on this study by examining cohort effects and regional differences in IPV for interethnic couples and the risk for IPV across interethnic couples of different ethnic compositions.

We have identified a sample of 53 societies outside of the classical Himalayan and Marquesean area that permit polyandrous unions. Our goal is to broadly describe the demographic, social, marital, and economic characteristics of these societies and to evaluate some hypotheses of the causes of polyandry. We demonstrate that although polyandry is rare it is not as rare as commonly believed, is found worldwide, and is most common in egalitarian societies. We also argue that polyandry likely existed during early human history and should be examined from an evolutionary perspective. Our analysis reveals that it may be a predictable response to a high operational sex ratio favoring males and may also be a response to high rates of male mortality and, possibly, male absenteeism. Other factors may contribute, but our within-polyandry sample limits analysis.

The continuing decline in fertility despite a contraction in contraceptive use in Peninsular Malaysia since the mid-1980s has triggered considerable interest in the reasons behind this phenomenon, such as increase in abortion, sterility, and out-of-wedlock pregnancy. Fertility decline has been attributed to rapid socioeconomic development, which can only influence fertility through the intermediate variables. Application of vital statistics, population census, and survey data of Peninsular Malaysia on Bongaarts's model vindicates that marriage postponement and contraceptive use are the 2 most important proximate determinants of fertility, but the effects are not uniform across the ethnic groups. For instance, the predicted total fertility rate for Chinese and Malays are 2.9 and 1.6, respectively, compared with the observed level of 3.0 and 1.9. Postpartum infecundability and abortion also play a part in explaining ethnic fertility differentials. The fertility inhibiting effects of these proximate determinants have significant implications on reproductive health and future population growth.

The study examined how marriage and religiosity can protect members of certain racial/ethnic groups against co-occurring substance use and serious psychological distress. Using the national dataset 2007 National Survey on Drug Use and Health, we analyzed data via multinomial logistic regression, observing several important results. Our findings generally support the deprivation-compensation thesis, in that religiosity elevates the mental health of racial/ethnic minority individuals more than that of Whites. We also found, however, that race/ethnicity moderates effects of education and poverty on the co-occurring behaviors, with Whites' mental health benefiting more from wealth and education than Blacks' or Hispanics' mental health did.

The association between marriage and well-being has led to policies that promote marital interventions and discourage divorce. These include federal initiatives specifically targeting poor couples and couples of color. While there are many prospective studies on marriage that have informed some couple interventions, the studies that are included in this literature sampled predominantly White and middle-class couples. By comparison, far less is known about the longitudinal predictors of relationship satisfaction and status for poor couples and couples of color. Therefore, it is unsurprising that preliminary data on applying current interventions to the couples targeted by these federal initiatives have been disappointing. In this article, I detail three concerns with these initiatives, propose a course of psychological research to address deficits in what is known about poor couples and couples of color, and make specific recommendations to enhance the effectiveness of these initiatives.

The experience of racial or ethnic discrimination is a salient and severe stressor that has been linked to numerous disparities in important outcomes. Yet, the link between perceived discrimination and marital outcomes has been overlooked by research on relationship stressors. The current study examined this link and tested whether ethnic identity buffered the relation between discrimination and ratings of marital quality and verbal aggression. A sample of 330 Latino newlyweds completed measures of perceived discrimination, ethnic identity, spouse's verbal aggression, and marital quality. Each spouse's interviewer also independently rated marital quality. Dyadic analyses revealed that husbands' experience of discrimination negatively predicted wives' marital quality, but only for husbands with weak ethnic identity. Wives whose husbands had strong ethnic identity were buffered from this effect. Identity also buffered the relation between husbands' discrimination and verbal aggression toward their wives, and this effect mediated the association between discrimination, identity, and marital quality.

The study investigated how unequal gender relations inhibit the attainment of women's reproductive rights. It examined whether women can choose if and when to marry, who to marry/have sex with, ability to negotiate sex with spouse, and their access to family planning. Based on theoretical orientation from gender-sexuality framework, this paper employed the qualitative research design. The main respondents were female and male of various sociodemographic groups who were engaged through in-depth interviews and focus group discussion sessions. Findings show wide scale abuses of Tarok women's reproductive rights. Most of these abuses may be traced to traditional male-centred socio-cultural structures and patriarchy that help guarantee the immunity of male violators. It is concluded that in the context of unequal gender relations and dominance of patriarchy, the attainment of women's reproductive rights is a major challenge which has profound implications for life and death.

Objectives: We sought to determine whether health care use and expenditures among gay and bisexual men were reduced following the enactment of same-sex marriage laws in Massachusetts in 2003., Methods: We used quasi-experimental, prospective data from 1211 sexual minority male patients in a community-based health center in Massachusetts., Results: In the 12 months after the legalization of same-sex marriage, sexual minority men had a statistically significant decrease in medical care visits (mean = 5.00 vs mean = 4.67; P = .05; Cohen's d = 0.17), mental health care visits (mean = 24.72 vs mean = 22.20; P = .03; Cohen's d = 0.35), and mental health care costs (mean = $2442.28 vs mean = $2137.38; P = .01; Cohen's d = 0.41), compared with the 12 months before the law change. These effects were not modified by partnership status, indicating that the health effect of same-sex marriage laws was similar for partnered and nonpartnered men., Conclusions: Policies that confer protections to same-sex couples may be effective in reducing health care use and costs among sexual minority men.

In Ghana reliable official data on suicidal behavior are not available. There is also limited empirical research on suicidal behavior in the country. At the same time, police-recorded suicide data, media reports, and communication from professionals in the field indicate that suicidal behavior is a growing problem. To identify current patterns and meanings of male suicidal behavior in Ghana, the study examined official police data spanning 2006-2008. This investigation revealed that reported cases of fatal and nonfatal suicidal behavior overwhelmingly involved males. Furthermore, the majority of males who engaged in suicidal acts did so to deal with feelings of shame and dishonor of variable sources. Findings suggest changing the rigid dichotomization associated with male-female gender roles and socialization that emphasize masculinity ideals in Ghana and the need for increased research and the promotion of counseling for males facing emotional stress., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

This article explores whether mothers’ perceived control over their own workplace flexibility options has any relationship to their satisfaction with their husbands’ contributions to household labor in the United States. We hypothesize that flexibility enhances their ability to more adeptly engage in role management in multiple life areas, thus enabling them to be more satisfied with their partners’ domestic input as well. We use a unique data set of 1,078 randomly sampled women involved in mothers’ organizations that generally attract members based on their current level of participation in the paid labor market. We then link nine distinct workplace flexibility policies with mothers’ satisfaction related to their husbands’ participation in all household tasks, as well as a subset of female-typed tasks. We find that across both arrays of tasks, mothers with more perceived control over work-related schedule predictability and those that had the ability to secure employment again after an extended break had higher levels of satisfaction with their husbands’ participation in household labor. In addition, short-term time off to address unexpected needs was important for all tasks considered together only.

Using a representative sample of children all born to unwed parents drawn from the Fragile Families and Child Wellbeing Study and a potential outcome approach to account for self-selection into marriage, we investigate whether marriage after childbearing has a causal effect on early child development. Comparing children with similar background characteristics and parental mate-selection patterns who differ only in terms of whether their parents marry after childbirth, we find that marriage after childbirth significantly increases a child's early cognitive performance but there is no evidence that it affects child asthma risk or behavioral outcomes.

Background: Polygamy is defined as a marriage in which a spouse of either gender has more than one mate at the same time. Polygamy is considered a valid form of marriage in many countries and communities around the globe., Aim: The purpose of this study is to examine the psychological symptoms, family function, marital satisfaction, life satisfaction and the degree of agreement with the practice of polygamy among 'senior wives' - the first wife in the polygamous marriage - and women in monogamous marriages in the West Bank, Palestine., Method: A convenience sample of 309 women, 187 from polygamous and 122 from monogamous families, participated in this study. All women from polygamous families were senior wives. The following instruments were deployed: the McMaster Family Assessment Device (FAD), the ENRICH marital satisfaction questionnaire, the SCL-90 mental health symptoms checklist, the Rosenberg self-esteem (SE) scale, the Diener et al. (1985), a life satisfaction scale, and a basic socio-demographic scale, including the degree of agreement of the practice of polygamy., Results: The findings revealed significant differences between senior wives in polygamous marriages and wives in monogamous marriages with regard to family functioning, marital satisfaction, self-esteem and life satisfaction. Likewise, many of the mental health symptoms were different. Particularly noteworthy were somatization, depression, hostility psychotism and the General Severity Index (a global index of distress). More women in polygamous marriages agreed with the practice of polygamy than their monogamous counterparts., Conclusion: Practitioners and policy makers need to be aware of the consequences of polygamy on first wives and on society as whole.

In the context of ready access to contraceptives, we sought to determine which individual and socio-cultural factors were most important in the dramatic fertility decline seen in an impoverished rural Balinese community. The study built on a 2002 longitudinal survey of 1528 Balinese reproductive-age married women that four years later found a significant proportion did not meet their expressed fertility aspirations. Four case studies of women whose expressed fertility intentions evolved over the study period are described. Culturally specific contextual factors (notably son preference), in interaction with increasing poverty, helped explained when and why their expressed fertility intentions changed. Moreover, many categorized in the second survey as not having meet their previously reported fertility aspirations were, in fact, intentionally spacing births. Although many women opted for smaller families than they actually wanted, and a decades-long, aggressive, two-child government campaign helped make them socially acceptable, contraception enabled the women to engage in strategic birth planning. We conclude that it is unrealistic to expect women in such settings, or indeed any setting, to give meaningful answers to questions in demographic surveys regarding future fertility aspirations.