Choosing Unsafe Sex: AIDS-Risk Denial Among Disadvantaged Women

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Pokharel 2 and Birendra K. Yadav 3. Background: The number of people going abroad for work from Nepal has increased in the last few years, especially since the onset of armed conflict in Nepal. Most of the studies conducted in Nepal regarding migrant and sexual behaviour have focussed on the migrants moving to India and not enough studies in Nepal have been done focused on sexual behaviour of migrants going to overseas. Conclusion: HIV related awareness raising activities should focus on both male and female migrants in country of origin and destination.

There is growing recognition that migration is an essential and inevitable component of the economic and social life of every State, and that orderly and properly managed migration can be beneficial for both individuals and societies. Nepal today is well recognized as the country of origin for labour migrants mainly to the Gulf Cooperation Council and Malaysia. Migrants' remittances make up about 21 per cent of GDP of Nepali economy.

Migration has been identified as an independent individual risk factor for the acquisition of HIV. 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.

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All kinds of sexual behaviour seem to be possible abroad, as long as other people do not find out. Migrant males, uniformed service and transport workers have also been identified as at risk groups. However, the data demonstrate that in the case of migrants this is true only when they are clients of sex workers both in country and abroad. In Nepal, hundreds of migrant workers leave country for overseas employment every day.

They are vulnerable to HIV which becomes more important when they return to their country and then may transmit the infection to their family. And also an examination of perceived risk of getting AIDS may have important implications for health if the perceptions are rational and lead to a willingness to avoid risky behaviour.


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In addition, an understanding of the association between perception of risk and sexual behaviour may facilitate the design of AIDS-preventive measures necessary to check the spread of the disease among different population subgroups. A cross sectional study was carried out from 1 st September to 28 th February in different cities of Nepal. Returnee migrants were identified from different recruitment agencies using purposive technique whereas snow ball technique was used to trace out returnees in different houses and hotels.

The tools were prepared and finalized by incorporating the variables that were included in the related studies done by Saggurti et al. The respondents were not forced to participate in the study. Questions were not asked in a way that would hurt their dignity. The purpose of the study was explained to the participants. The respondents were assured that their answers would remain private, unanimous and confidential. Microsoft Excel was used for data entry. Descriptive statistics was used for analysis of data using frequency table, percentage, and cross tabulation.

The respondents ranged from those aged 20 years to 53 years with mean age Thus, our findings suggest implications for the design of small-group interventions that seek to reduce female adolescents' STD risk. Clearly, these programs could promote a multitude of skills. Based on findings of this study, clinic-based STD counseling and small-group interventions designed for high-risk African American female adolescents should emphasize several key points. In clinic-based settings, implementation of these strategies is limited by the time made available for clinician-client interactions.

Findings suggest that female adolescents being treated for an STD or who are at risk for STDs need to hear messages debunking the myth that familiarity qualifies a person to judge the STD safety of a male sex partner. This myth can be dispelled by briefly describing the asymptomatic nature of highly prevalent STDs eg, genital herpes, most strains of human papillomavirus, and chlamydia and by emphasizing that the male partner may not be aware that he has an STD.

The findings also suggest that portraying condom use as a normative behavior is likely to reduce adolescents' frequency of UVS. Thus, African American adolescent female clients need to know that condom use is common among their peers, with this population being more likely to report condom use at last intercourse than their white or Hispanic counterparts. African American adolescent female clients diagnosed as having an STD can benefit from this experience.

Choosing Unsafe Sex Aids Risk Denial Among Disadvantaged Women 1995

Thus, clinicians and educators should view diagnosis of an STD as a window of opportunity to engage adolescents in a discussion of STD preventive strategies and attempt to modify adolescents' perceived peer norms regarding frequency of condom use. This point is especially important for clients with multiple infections, a clear signal for intensifying prevention efforts.

These messages are most likely to be effective when delivered interactively. The important relationship dynamic for female adolescents was partner control over the decision to have sex. Thus, teaching female clients at risk for STDs how to negotiate whether sex will occur may prove valuable in lowering their frequency of UVS.

Addressing personal barriers to condom use may also be an important means of reducing UVS with casual partners among African American female adolescents. These adolescents may benefit from counseling designed to enhance perceptions of condom use as part of a satisfying sexual experience. Also, as with steady partners, using the diagnosis of an STD as a teachable moment is likely to be a beneficial strategy to reduce UVS. We thank Susan L. We also thank Jane R. Reprints: Richard A. Arch Pediatr Adolesc Med. All Rights Reserved. Save Preferences. Privacy Policy Terms of Use. Twitter Facebook Email.

This Issue. Citations View Metrics. Richard A. Crosby, PhD ; Ralph J. Participants and methods. Study sample.

Choosing Unsafe Sex Aids Risk Denial Among Disadvantaged Women

Data collection. View Large Download. Data analysis and hypotheses. Characteristics of the sample.

Choosing Unsafe Sex Aids Risk Denial Among Disadvantaged Women 1995

Bivariate relationships. Regression model for adolescents with steady partners. Regression model for adolescents with casual partners. Implications for prevention. Contraceptive Technology. Sexually Transmitted Diseases.

The Kenyan Sex Trade Fuelling An Aids Epidemic

HIV infection in disadvantaged out-of-school youth: prevalence for U. Job Corps entrants, through Sexual mixing patterns in the spread of gonococcal and chlamydial infections. Am J Public Health. Sex Transm Dis. Am Psychol. Philadelphia University of Pennsylvania Press;. J Sex Res. J Sex Educ Ther. HIV risk behaviors among women living in low-income, inner-city housing developments. Fam Plann Perspect. Health Psychol. Stud Fam Plann. J Adolesc Res. African-American adolescents residing in high-risk urban environments do use condoms: correlates and predictors of condom use among adolescents in public housing developments.

Soc Sci Med. Parental influence on adolescent sexual behavior in high-poverty settings. Teenage partners' communication about sexual risk and condom use: the implications of parent-teenage discussions. Interpartner reliability of reporting of recent sexual behaviors. Am J Epidemiol. Rev Gen Psychol. J Consult Clin Psychol. J Adolesc Health. Subsequent sexually transmitted infections among adolescent women with genital infection due to Chlamydia trachomatis, Neisseria gonorrhoeae, or Trichomonas vaginalis.

Ethn Dis. Efficacy of risk reduction counseling to prevent human immunodeficiency virus and sexually transmitted diseases: a randomized controlled trial.


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A randomized, controlled trial of a behavioral intervention to prevent sexually transmitted disease among minority women. Sobo's research were seriously involved with one man, and they had heavy emotional and social investments in believing or maintaining that their partners were faithful to them.

Choosing Unsafe Sex: AIDSā€Risk Denial among Disadvantaged Women

Uninvolved women had similarly heavy investments in their abilities to identify or choose potential partners who were HIV-negative. Women did not see themselves as being at risk for HIV infection, and so they saw no need for condoms. But they did recommend that other women, whom they saw as quite likely to be involved with sexually unfaithful men, use them. Visit Seller's Storefront. We guarantee the condition of every book as it's described on the Abebooks web sites.