Advancing Sexual and Reproductive Health and Rights
 
Perspectives on Sexual and Reproductive Health
Volume 41, Number 3, September 2009

IN THIS ISSUE

Anal sex can be a very risky activity. So, why do women participate in it? Moreover, why do they participate in it without using protection? Emily Maynard and colleagues got some answers to these questions by conducting in-depth interviews with a sample of Boston-area women. The investigators report in this issue of Perspectives on Sexual and Reproductive Health (see article) that the women in their sample seldom were the ones to initiate anal sex, and that some said that they had been forced into it or they found it painful or uncomfortable.

Yet, the women participated in the activity out of a desire to experience pleasure or heighten intimacy with their partner, to please their partner or to engage in a sexual behavior with no risk of pregnancy. Similarly, they decided against condom use to avoid decreasing pleasure (their own or their partner’s) or because of their familiarity with their partner, among other reasons. “Unfortunately,” the authors write, “missing from their decision-making process was a consideration of STD risk.” Women’s desire for and ways of seeking pleasure through sexual activity are beginning to make their way into research on women’s sexual risk-taking. Maynard and colleagues urge researchers and educators to explore both pleasure and risk “to help guide efforts to assist women in achieving the intimacy they desire in their sexual relationships while safeguarding their health.”

Also in This Issue

•Jenny A. Higgins and coauthors also focus on the element of plea-sure in their study of arousal patterns and their links to sexual health outcomes (see article). In an Internet-based survey, substantial proportions of respondents indicated that safer-sex practices and concerns about the risk of unintended pregnancy undermine their arousal. Moreover, loss of arousal for these reasons was associated with adverse outcomes—unprotected intercourse and involvement in unintended pregnancy, respectively—and the strength of the associations differed for men and women. The researchers conclude that “arousal profiles should be taken seriously in behavioral models of risky sex.”

•In-depth interviews with women in the San Francisco Bay Area revealed, to an extent that previous studies have not, how important family planning providers’ interactions with their clients are to women’s perceptions of their care. According to Davida Becker and her team (see article), for these women, the most important features of family planning visits included having providers who exhibit warmth and friendliness, remember them from previous visits, make them feel comfortable when discussing personal issues, are non- judgmental, respect their autonomy, and are caring and empathetic. The only difference in service experiences and preferences among racial, ethnic and language groups was that Spanish-speaking women wanted to receive language-appropriate care and information.

•Latinas’ high levels of out-of-wedlock childbearing may limit their social and economic prospects, yet as Felicia Yang DeLeone and coauthors observe (see article), the demographic factors underlying nonmarital childbearing in this group have not received close attention. DeLeone and colleagues use national natality and census data to examine the contribution of three main demographic factors to nonmarital fertility. They find that between 1994 and 2005, the proportion of births to Latinas that were nonmarital increased and that the change was explained mainly by a decline in the proportion of women who were married; changes in fertility rates and the age distribution of the population played little role. Thus, the authors suggest that efforts to reduce nonmarital childbearing among Latinas should promote healthy marriages.

•Societal norms and widespread disapproval of teenage child bearingmay leave Swedish teenagers with little choice but to terminate an unintended pregnancy: This is one of the main themes that emerged from in-depth interviews Maria Ekstrand’s team conducted with a sample of adolescents who had recently had abortions (see article). The teenagers’ stories revealed that contraception is generally treated as the woman’s responsibility, but that pregnancy is greeted with overwhelmingly negative reactions from partners, as well as parents and peers. As a result, women who had been ambivalent about their pregnancy had felt pressured into terminating it. In the authors’ view, “it is time for sexual responsibility to be considered a gender-neutral issue” and for males to be more involved in prevention practices.

•For better or worse, Wendy D. Manning and colleagues have found(see article), the dynamics between adolescents and their dating partners are strongly related to the consistency of their condom use. The operative phrase here is “for better or worse”: In the researchers’ sample of Ohio youngsters, consistent condom use was negatively associated not only with such relationship features as jealousy and mistrust, but also with ones like love and enmeshment; the associations held even in models that controlled for social and demographic characteristics and basic features of the relationship, such as its duration. The study serves as a good reminder that, in the authors’ words, “adolescents in all types of relationships are at risk of STDs and pregnancies, and programmatic response should attend to the full range of risk.”

—The Editors