Browsing by Author "Relf, Michael"

Abstract

Background: Intimate partner violence is a preventable public health problem that disproportionality impacts women in Sub-Saharan Africa. Women with HIV have a higher burden due to HIV related stigma they may face. In Rwanda, women have higher incidences of HIV and intimate partner violence. This study aimed to estimate the prevalence of IPV among women living with HIV in Rwanda as well as measure the difference in psychological outcomes, demographic data, and HIV related outcomes. Methods: This study conducts a secondary data analysis of a Cross-sectional, descriptive observational study. 162 Rwandan women living with HIV were purposefully recruited to participate in the survey. The instrument measured demographic data, Intimate partner violence, depression, HIV related stigma, coping, self-esteem, and hope. Results: The prevalence of IPV in the sample was 26.61% with psychological being the most prevalent followed by physical then sexual. Demographic data had no statistical significance with the prevalence of IPV. Women with HIV who experienced IPV had higher HIV stigma, lower coping self-efficacy, lower self-esteem, and less hope levels. Conclusions: Women who experience IPV have worse HIV psychological outcomes which could lead to decreased overall health outcomes. Further studies are needed to look into the correlation between the two as well as interventions addressing IPV prevention and awareness.

Problem: Gay, bisexual, and queer (GBQ) adolescent males are disproportionately affected by negative sexual health outcomes compared to their heterosexual counterparts. Their sex education needs are not sufficiently addressed in the home and the larger ecological systems. The omission of their sex education needs at a time when they are forming a sexual identity during adolescence compels GBQ males to seek information in unsupervised settings. Evidence-based interventions aimed at ensuring positive sexual health outcomes through sex communication cannot be carried out with these youth as research on how parents and GBQ males discuss sex in the home has been largely uninvestigated.

Methods: This naturalistic qualitative study focused on the interpretive reports of 15- to 20-year-old GBQ males’ discussions about sex-related topics with their parents. From a purposive sample of 30 male adolescents who self-identified as GBQ, participants who could recall at least one conversation about sex with their parents were recruited for one-time interviews and card sorts. This strategy revealed, using Bronfenbrenners’ Bioecological Theory, their perceptions about sex communication in the context of their reciprocal relationship and the ecological systems that GBQ males and their parents navigate.

Results: Parents received poor ratings as sex educators, were generally viewed as not confident in their communication approach, and lacked knowledge about issues pertinent to GBQ sons. Nevertheless, participants viewed parents as their preferred source of sex information and recognized multiple functions of sex communication. The value placed by GBQ youth on sex communication underscores their desire to ensure an uninterrupted parent-child relationship in spite of their GBQ sexual orientation. For GBQ children, inclusive sex communication is a proxy for parental acceptance.

Results show that the timing, prompts, teaching aids, and setting of sex communication for this population are similar to what has been reported with heterosexual samples. However, most GBQ sons rarely had inclusive guidance about sex and sexuality that matched their attraction, behavior, and identities. Furthermore, the assumption of heterosexuality resulted in the early awareness of being different from their peers which led them to covertly search for sex information. The combination of assumed heterosexuality and their early reliance on themselves for applicable information is a missed parental opportunity to positively impact the health of GBQ sons. More importantly, due to the powerful reach of new media, there is a critical period of maximum receptiveness that has been identified which makes inclusive sex communication paramount in the pre-sexual stage for this population. Our findings also indicate that there are plenty of opportunities for systemic improvements to meet this population’s sexual education needs.