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Try out PMC Labs and tell us what you think. Learn More. Gender inequalities in sexual behavior are explored from the perspective of the theory of gender and power. This study focused on the effect of sex partner type steady versus casualdrug use, and condom use self-efficacy regarding consistent condom use CCU among a community-based sample of adults. The sample included 1, African American men and women M age Among non-drug users, having a drug-using partner was associated with decreased odds of condom use for women only.
Women with drug-using partners, especially a steady partner, were least likely to report CCU. Therefore, interventions intended to empower CCU among women need to expand beyond acknowledging the reduced control that women who use drugs demonstrate to also consider those who have drug-using sexual partners. Building on the theory of gender and power Connell,research Women seeking casual sex Anglin Washington sexual behavior has expanded to include social and structural influences on sexual behavior, with an emphasis on gender-based inequalities. It highlights exposures created by sex partner characteristics, including high-risk partners such as those who have or had sex partners whose risk for HIV was unknown.
At the core of the gender and power paradigm is an emphasis on the inequality of power between men and women. Considering this inequality, women's opinions and requests may be taken less seriously or dismissed by their male partners and women. Moreover, women may be more likely to be emotionally and otherwise abused when suggesting protective sex if their male sex partners view it as a of disrespect or lack of trust. Reactions from the male partner may range from emotional to physical abuse, which, in turn, have been shown to decrease women's self-efficacy, increase the likelihood of alcohol and drug use, and reduce condom use self-efficacy DePadilla et al.
The main objective of this study was to examine if behavioral risk factors triggered by the sexual division of power were associated with consistent condom use CCU during vaginal sex. Key behavioral risk factors included sex partner type, drug use among the respondents as well as their sex partners, and condom use self-efficacy. In addition, the potential for the moderation by gender of the associations between these risk factors and CCU was also explored.
Connotations of love, commitment, trust, and similar qualities make condom use undesired among steady partners Bernstein et al. Even when one of the steady partners has been identified with a sexually transmitted disease STDincluding HIV, or when one of the partners is known to have had sex with individuals who may have engaged in unsafe sex with others, condom use remains perceived as in violation with the expectations and nature of the steady partnership Corbett et al.
In contrast to the characteristics associated with steady partners, casual partnerships are perceived as being more recent or short-term e. If the meaning of the casual partnership is mainly defined as someone to have sex with or a relationship that otherwise involves limited social investment, casual partners play a lesser role in a person's life, thereby allowing for acceptable condom use proposals and negotiations. Condom use in casual partnerships is more likely than in steady partnerships Nelson et al.
Awareness that the partner may engage in sex with others whose sexual history is risky or unknown may serve as triggers for condom use Hock-Long et al. The situation becomes more complex when a casual sex partner is thought of as a possible steady partner. If so, condom use may be or become more difficult to negotiate Gorbach et al.
These are partnerships in which sex is traded for money, drugs, or other material needs. The literature on condom use with transactional partners is divided.
Some researchers report higher intentions and actual condom use rates in such interactions. Other researchers found that transactional partners who have a long-standing arrangement act more like steady partners Sterk, in that they are less likely to use condoms, whereas others did not find an impact on condom use Reynolds et al. A more in-depth exploration of the differences between steady and casual partners is beyond the scope of this paper. This frames the intent of this study to explore if partner type and other associated characteristics are related to condom Women seeking casual sex Anglin Washington.
The disinhibiting influence of alcohol and other drugs often has been identified as an antecedent to sexual risk-taking, specifically to beliefs about inconsistent condom use being normative Calsyn et al. Research also shows the importance of considering the nuances of drug and alcohol use and sexual risk-taking among specific groups Scott-Sheldon et al. The theory also states that a woman's own use is a behavioral risk factor for HIV, potentially due to increased unsafe sex or involvement in situations that place her at higher risk.
Literature shows that drug use as a risk factor may also extend to men Von Haeften et al. It has been noted as the basis for the motivations and actions of people with regard to a of behaviors Bandura, DePadilla et al. Overall, efforts to enhance condom use self-efficacy have been recognized as important when aiming to increase safer sexual behaviors, specifically in HIV risk reduction studies DiIorio et al. Conceptualized as greater self-efficacy and therefore a protective factor, condom use self-efficacy represents an important proximal factor to consider when understanding condom use under a variety of conditions, including with different partner types and in the context of substance use.
Exposures such as partner type, a partner's drug use, one's own drug use, and condom use self-efficacy may vary by gender. In qualitative and quantitative research, men as well as women have reported being less likely to use condoms with a casual partner as compared to a steady partner, perceiving condom use with the former as less emotionally challenging e.
Gender stereotyping in holding women more than men able for both starting the conversation about safer sex as well as providing the means, a condom Amaro, ; Sterk, It is important to recognize such gender-based disparities in condom use negotiations Calsyn et al.
In addition to filling a void in HIV risk behavior research through the study of CCU across different partner types, we also contribute to the literature by applying concepts from the theory of gender and power to a non-institutionalized community-based sample of African American adults who reside in disadvantaged urban neighborhoods.
In this study, we examined 1 the prevalence of CCU with steady and casual partners in a community-based sample of urban African American adults in the Southern U. The data for this paper were collected as part of Be Healthya larger longitudinal study of multi-level factors related to health in disadvantaged neighborhoods in a major Southeastern metropolitan.
Here we present only the baseline data collected between January and October Eligibility criteria were being 18 years or older, self-identifying as African American or black, and having lived for the past 12 months prior to the interview in one of the 61 census block groups CBGs that comprised the study area. CBGs are small geographic areas, viewed as a suitable neighborhood proxy, for which the U. Census collects and provides data US Census Bureau, The study CBGs were selected based on social, economic and health indicators to address the Be Healthy study objectives, including aims to investigate the intersection between individual and neighborhood characteristics.
Two additional inclusion criteria for this paper were having reported vaginal sex at least one time in the past 90 days and having tested HIV-negative as part of the study protocol. This resulted in an eligible sample of 1, individuals. Active street outreach, passive recruitment strategies such as the posting of flyers, and referrals by participants were used to recruit respondents. Non-probability quota sampling was employed to ensure sufficient variability by age, gender, and illicit drug use i. Trained interviewers administered computer-assisted surveys in private rooms at a local research site.
The questionnaire included questions on social-demographic characteristics, reproductive health, recent sexual activity, including partner type and condom use, and substance use. The main outcome variable, the proportion of condom use, was calculated by dividing of vaginal sex acts during which a condom was used by the total of vaginal sex acts in the past 90 days. Subsequently, proportions of 1. For each participant, CCU was measured for two types of partners, defined as steady and casual partners. Given the low of participants reporting acts with paid or paying partners, these partners were included as casual partners.
This is consistent with the categorization applied to non-steady relationship partners e. Age was measured in years and treated as a continuous variable. Gender was coded as female 1 and male 0. Employment was categorized as employed, full or part-time 1 and unemployed 0. Education was measured as years of school. Stable living situation was conceptualized as owning or renting one's own home 1 and other living situations 0. Relationship status was assessed as being in a relationship and living together 1being in a relationship and not living together 2and not being in a relationship 0.
Caretaker described whether participants had caregiving responsibilities for children age 18 or younger 1 or did not have such responsibilities 0. Alternative contraception was coded as 1 if the participant reported using the pill, an intra-uterine device or a diaphragm in the past 90 days, if they reported a hysterectomy or a vasectomy, or if they reported being currently pregnant and coded as 0 if they reported none of those contraceptive options. Multiple sex partner status was categorized as having had more than one sex partner regardless of type of partner or sex act in the past 90 days 1 and having had one sex partner in the past Women seeking casual sex Anglin Washington days 0.
Illicit drug use assessed whether the participant had used crack cocaine, powder cocaine, methamphetamine or heroin in the past 90 days 1 or had not used any of these substances during that time period 0. Sex partner illicit drug use was defined as having had a sex partner in the past 90 days whom the participant described as a drug user 1 and not having had a sex partner known to be a drug user in the past 90 days 0.
This variable was Women seeking casual sex Anglin Washington computed separately for steady and casual partners in models that only included sex with a single partner type.
The items included measurements of both general and new partners and specific to the confidence in purchasing condoms, remembering to use condoms in different circumstances, suggesting condom use with partners, and persistence in one's efforts to use condoms. CCU was examined among all participants, with CCU coded as with steady partners and with casual partners. In the separate models for steady partners and casual partners it was possible that a participant reported only one type of partner; therefore, only a portion of the sample were included in these models.
Given the clustered nature of the data i. Preliminary crude associations with CCU for each partner type were tested using bivariate binomial regressions with a logit link. Exchange was applied as there was no substantive difference in between the two matrices. The mean age of the sample was Forty-three percent of participants reported that they were not partnered or in a relationship. Two-fifths of the sample reported having more than one sex partner in the past 90 days. In bivariate models of CCU for steady partners, older age, being female, and being partnered regardless of living situation were associated with decreases in CCU see Table 2.
Having more than one sex partner was associated with an increase in the odds of CCU with steady partners. Only older age was associated with a decrease in CCU with casual partners. Being partnered and living together compared to not having a partner was associated with an increase in the odds of CCU with casual partners. Participant non-drug use and sex partner drug use compared to neither the participant or the partner being a drug user was associated with a decrease in the odds of CCU with steady partners.
Reporting that both the participant and at least one sex partner were drug users compared to neither being users was associated with decreases in the odds of CCU with both steady and casual partners. Condom use self-efficacy was positively associated with an increase in the odds of CCU for both partner types.
Table 2 also includes crude models that for the possibility of each participant having both Women seeking casual sex Anglin Washington and steady partners. Sex with casual partners compared to steady partners was associated with increases in the odds of CCU. Younger age, being female, being partnered regardless of living situation, and having children under the age of 18 living at home were associated with reductions in the odds of CCU. Having more than one sex partner in the past 90 days was associated with an increase in the odds of CCU.
Reporting that both they and at Women seeking casual sex Anglin Washington one sex partner were drug users compared to neither being users was associated with a decrease in the odds of CCU. Condom use self-efficacy was associated with an increase in the odds of CCU. The role of gender in moderating the associations between partner type, drug use status, condom use self-efficacy, and CCU also was explored.
To compare differences in CCU across gender by condom use self-efficacy, a median split was performed. Table 3 also displays CCU for gender by drug use and gender by condom use self-efficacy for both steady and casual partners. Additionally, a greater percentage of men compared to women reported CCU when a sex partner but not themselves was a drug user.
Separate multivariable models for CCU for steady and casual partner types are displayed in Table 4. Only the interaction between drug use and gender was ificant and this was true only for steady partners. Therefore, the interaction model is described for steady partners and the main effect model is described for casual partners. Being partnered and living together and being partnered and not living together were associated with decreases in the odds of CCU compared to not having a partner in the model of CCU with steady partners OR : 0.
This was not the case in the model of CCU with casual partners, which showed an increase in the odds of CCU for those partnered and living together OR : 1. In the model of sex with steady partners, once the interaction term was included, having a sex partner who used drugs compared to neither the participant nor their sex partners being users was associated with a ificant decrease in the odds of CCU but only for women OR : 0. In the model of sex with casual partners, being a drug user and having a sex partner who was a drug user was associated with a decrease in the odds of CCU OR : 0.
Finally, condom use self-efficacy was associated with increased odds of CCU in the models of sex with steady partners OR : 1.
Consistent with the theory of gender and power, having a steady partner was associated with decreased odds of CCU and higher condom use self-efficacy was associated with increased odds of CCU. However, at odds with the theory, these associations were not moderated by gender.
Women seeking casual sex Anglin Washington generally indicates that condom use does tend to be lower with steady partners, often justified by perceptions that condoms create emotional and physical distance and challenge the meaning of the relationship Bernstein et al. The theory of gender and power asserts that having a steady partner who does not want to use condoms represents a background risk for STDs, including HIV.
Research findings with casual partners has been less consistent, but has indicated that condom use with casual partners may be more common than what is reported with steady partners Gorbach et al. Findings from this study also showed CCU to be reported more frequently with casual than steady partners. However, although more men reported CCU with steady partners, the difference was not statistically ificant and the likelihood of condom use with casual partners was equivalent across genders.
Thus, these relationship labels appeared to have a similar association with condom use for men and women in this sample although there are potentially subsets of steady and casual partners associated with different barriers to condom use Kapadia et al.
It is noteworthy that two-fifths of the current sample reported having more than one sex partner in the past 90 days. Further, nearly one-third of those reporting a steady partner during that same time period reported more than one sex partner. Although reporting multiple partners was associated with an increase in condom use, such a large percentage makes it more difficult to include monogamy as one of the meaningful aspects of steady partnerships that differentiates them from other kinds of partnerships.
This is important because the absence of monogamy may not always prompt condom use. The theory of gender and power asserts that having a high-risk partner increases a woman's background risk for HIV. The current study found that having a drug-using partner while not being a drug user oneself was associated with decreased odds of condom use, but only for women. Having a drug-using partner was another exposure for inconsistent condom use in this study and the risk was realized in two ways. Both the participant and their partner being drug users compared to neither using drugs was associated with a reduction in the odds of CCU for casual partners.Women seeking casual sex Anglin Washington
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