Being and feeling like a woman: Respectability, responsibility, desirability and safe sex among women of Afro-Surinamese and Dutch Antillean descent in the Netherlands
School of Anthropology, Oxford University, UK.Culture Health & Sexuality (Impact Factor: 1.55). 08/2008; 10(6):547-61. DOI: 10.1080/13691050802003014
The objective of this study was to describe and understand gender roles and the relational context of sexual decision-making and safe sex negotiation among Afro-Surinamese and Dutch Antillean women in the Netherlands. Twenty-eight individual in-depth interviews and eight focus group discussions were conducted. In negotiating safe sex with a partner, women reported encountering ambiguity between being respectable and being responsible. Their independence, autonomy, authority and pride inherent to the matrifocal household give them ample opportunity to negotiate safe sex and power to stand firm in executing their decisions. The need to be respectable burdens negotiation practices, because as respectable, virtuous women there would not be the need to use condoms. Respectable women will only participate in serious monogamous relationships, which are inherently safe. Women's desire to feel like a woman, 'to tame the macho-man' and constrain him into a steady relationship, limits negotiation space because of emotional dependency. Respectability seems to enforce not questioning men's sexual infidelity. In developing STI/HIV prevention programmes this ambiguity due to cultural values related to gender roles should be considered. Raising awareness of power differences and conflicting roles and values may support women in safe-sex decision-making.
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ABSTRACT: Success factors for STI/HIV prevention for women of Surinam and Antillean descent This study describes the evaluation of ‘Uma Tori’, a STI/HIV-prevention intervention for women of Afro-Surinamese and Dutch Antillean descent in three cities in the Netherlands. A recent study indicated that the intervention is still being used in Rotterdam and even extended to other target groups, while the municipal health service in Amsterdam stopped its implementation. In this article the possible relation between the differences in implementation and outcomes will be analyzed. The article will also elaborate on factors that possible caused this difference in current implementation, drawn from the process and outcome evaluation in the three cities. The intervention aimed at increasing awareness of sexual risk and power in relationships and improving sexual decision-making skills. Effects were evaluated in a pre–post-test design, using selfreport questionnaires. Data were analyzed using intention-to-treat, MANOVA with repeated measures. Additionally, a qualitative process evaluation, using logbooks and interviews, was conducted to assess fidelity and completeness of intervention implementation. The results showed positive effects on participants’ knowledge, risk perceptions, perceived norms and sexual assertiveness. In addition, after the programme, participants had stronger intentions to negotiate and practice safe sex. Furthermore participants communicated more with their partners about safe sex. Effects were largest in Rotterdam. Uma Tori was successful in mobilizing migrant women in the Netherlands. The results from the outcome evaluation show promising results; improved awareness, sexual assertiveness, intentions to negotiate safe sex, and communication about sexual behaviour with partners. According to the findings resources, time and support for implementation as well as the recruitment strategies differed between the three participating cities, which might have impacted on the effectiveness of the intervention. To guarantee long term effectiveness, it is key to promote participation of all stakeholders and support for up-scaled and quality implementation.
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ABSTRACT: This study describes the effectiveness of 'Uma Tori', an STI/HIV-prevention intervention for women of Afro-Surinamese and Dutch Antillean descent in the Netherlands, aimed at increasing awareness of sexual risk and power in relationships and improving sexual decision-making skills. Intervention effects were evaluated in a pre-post-test design, using self-report questionnaires among a sample of 273 women. Data were analysed using intention-to-treat, MANOVA with repeated measures and Bonferroni correction for multiple comparisons. Additionally, a qualitative process evaluation, using logbooks and interviews, was conducted to assess fidelity and completeness of intervention implementation. The results showed positive effects on participants' knowledge, risk perceptions, perceived norms and sexual assertiveness. In addition, after the programme, participants had stronger intentions to negotiate and practice safe sex. Furthermore participants communicated more with their partners about safe sex. The effects of 'Uma Tori' are promising and the intervention seems to support attempts to reduce sexual-risk behaviour among Afro-Caribbean women. The evaluation of the programme suggests that this interactive, multiple session, multi-faceted small-group intervention is successful in increasing participants' awareness, sexual assertiveness, intentions to negotiate safe sex, and communication about sexual behaviour with partners. This programme is applicable in practice, provided that it is gender specific and culturally appropriate.
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ABSTRACT: Newly single older women routinely have not been considered at risk for sexually transmitted infections (STIs). Divorce and separation have put many women back into the dating scene and into new sexual partner relationships. Recent studies have shown an increase in HPV, HSV, chlamydia, and gonorrhea infections in this population. Advanced practice nurses have a unique opportunity to anticipate needs and inform older women about safe sex, STIs and transmission, communication skills with new partners, as well as help them safely navigate through a turbulent time. A thorough analysis and review of this topic, with theoretical support, highlights this recently identified vulnerable population and identifies safe sex education strategies and interventions to increase health-promoting behaviors.
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