Pamela I. Erickson

Syndemics, sex and the city: Understanding sexually transmitted diseases in social and cultural context

Abstract This paper employs syndemics theory to explain high rates of sexually transmitted disease among inner city African American and Puerto Rican heterosexual young adults in Hartford, CT, USA. Syndemic theory helps to elucidate the tendency for multiple co-terminus and interacting epidemics to develop under conditions of health and social disparity. Based on enhanced focus group and in-depth interview data, the paper argues that respondents employed a cultural logic of risk assessment which put them at high risk for STD infection. This cultural logic was shaped by their experiences of growing up in the inner city which included: coming of age in an impoverished family, living in a broken home, experiencing domestic violence, limited expectations of the future, limited exposure to positive role models, lack of expectation of the dependency of others, and fear of intimacy.

Life histories, blood revenge, and reproductive success among the Waorani of Ecuador

The Waorani may have the highest rate of homicide of any society known to anthropology. We interviewed 121 Waorani elders of both sexes to obtain genealogical information and recollections of raids in which they and their relatives participated. We also obtained complete raiding histories of 95 warriors. An analysis of the raiding histories, marital trajectories, and reproductive histories of these men reveals that more aggressive warriors have lower indices of reproductive success than their milder brethren. This result contrasts the findings of Chagnon [Chagnon N (1988) Science 239:985–992] for the Yanomamo. We suggest that the spacing of revenge raids may be involved in the explanation of why the consequences of aggressiveness differ between these 2 warlike lowland South American peoples.

Acculturation, Gender Role Orientation, and Reproductive Risk-Taking Behavior among Latina Adolescent Family Planning Clients

This article explores the influence of demographic, sociocultural, and risk proneness indicators on age at first intercourse, number of lifetime sexual partners, and number of pregnancies in a sample of 670 Latina adolescents age 14-19 recruited from two publicly funded familyplanning clinics. Acculturation accounted for a small but statisticallysignificant amount of the variation explained for all three reproductive behaviors. Being less acculturated was associated with older age at initiation of sexual intercourse, fewer lifetime sexual partners, and fewer pregnancies. Substance experimentation was associated with earlier sexual debut and more sexual partners but with fewer pregnancies. Gender role orientation was significant onlyfor age at first intercourse. More traditional young women were older at sexual debut. These results suggest that gender role orientation is important for delaying first intercourse, but once sexually active, acculturation and substance experimentation become more important influences on sexual risk taking among Latina adolescents.

Maximizing Qualitative Responses about Smoking in Structured Interviews

This article addresses the important methodological issue of whether face-to-face or self-administered interviews elicit better qualitative data on reasons for smoking and quitting among 173 current and former smokers. The data are from a study of smoking behaviors among 601 African American and Latina women age 14 to 21 years recruited from family planning clinics in Los Angeles from 1995 to 1996. Results suggest that responses to closed questions about smoking behavior are similar in both methods but that self-administered surveys elicit more responses to open-ended questions than face-to-face interviews. The authors encourage the use of self-administered surveys in smoking research because they are cheaper to administer, yield similar data on closed-question items, and elicit richer and more provocative responses to open-ended questions.

Cultural Factors Affecting the Negotiation of First Sexual Intercourse among Latina Adolescent Mothers

In 1995, the Latina adolescent birth rate surpassed that of African Americans for the first time. This article investigates cultural and social factors affecting the initiation of sexual intercourse among Latina adolescent mothers in Los Angeles. The data are from life history interviews with forty young mothers and their partners conducted in 1994 to 1997. Results suggest that sexual intercourse is initiated within the context of the couples developing relationship, and that the course of relationships is highly scripted. Men pressure for sex and women resist. Women should be ignorant about sex, but control access to intercourse. Sex is never discussed. Thus, it is unexpected, and contraception other than withdrawal is not used. This script places young Latinas at enormous risk for pregnancy and STDs.

The influence of male care givers on child health in rural Haiti.

This study examines the relationship between a womans workload and the health of her pre-school children aged 24-59 months. The role of gender of alternate care givers when the woman is away from home is the specific focus of the research. Interviews were conducted with 106 women in rural Haiti, 44% of whom had malnourished children. Factors which significantly discriminated between normal and malnourished nutritional status were birth space between the index child and its next oldest sibling, number of children in the home, roof type (a proxy for socioeconomic status), and having a male substitute care giver. Further multivariate analysis produced a model which demonstrated that having a male care giver exacerbated the effect of birth space on nutrition status. Further research is necessary to determine characteristics of substitute care givers and their impact on nutritional status and child health in less developed countries. This is particularly important in light of the increased economic pressure on Third World rural women to work outside the home in order to meet the basic needs of their families.

The Social Context and Meaning of Virginity Loss among African American and Puerto Rican Young Adults in Hartford

We describe virginity loss experiences of inner-city minority youth to understand the meaning attributed to first sex and the social and structural factors that contribute to early sexual debut. We interviewed 62 18-25-year-old African American and Puerto Rican Hartford men and women about their sexual and romantic life histories. Transcripts were coded in ATLAS.ti and analyzed for themes about virginity and sexual debut. We found different conceptions of virginity as a stigma to be lost, a normal part of growing up, and a gift to be given. The normative experience was consensual, early, and unplanned sexual debut. Inner-city minority youth have similar feelings, motivations, and experiences of sexual debut as non-ethnic youth reported in the literature except they are far younger. We discuss structural factors that affect inner-city sexual scripts for early sexual debut and identify it as a health inequity.

(CEREMONIAL TOBACCO USE IN THE ANDES: IMPLICATIONS FOR SMOKING PREVENTION AMONG INDIGENOUS YOUTH)

The purpose of this study was to identify Andean youths beliefs regarding ceremonial tobacco use and to discuss potential applications of findings in tobacco control interventions. The study was conducted in the Province of Jujuy, Argentina among 202 boys and girls, 10 to 20 years of age, living in rural and urban areas. The world of beliefs and meanings became accessible by asking youth to focus on tangible experiences regarding the Pachamama ceremony, a ritual honoring Mother Earth. Concepts such as reciprocity, the unity of material and spiritual realms, and the complementary nature of opposite forces were linked to beliefs about ceremonial tobacco use. Three domains for understanding smoking behaviour beliefs and norms were identified including mechanisms of production, conceptual tenants and behavioural expressions. These findings suggest that tobacco control interventions based on solidarity, reciprocity, and non-rational ways of learning are more culturally appropriate for native populations in the Andes than the current individual behaviour change models and have the potential applications with other indigenous populations. The research methods also have the potential for generalized application in cross-cultural studies of health behaviours in understudied populations in middle and low-income countries.

A Culture of Future Planning: Perceptions of Sexual Risk Among Educated Young Adults

In this study we examined how social processes, specifically the acquisition of postsecondary education and capital, shaped perceptions of sexual risk and impacted sexual practices and sexual health among young adults. Using qualitative research methods we collected and analyzed data among students attending a 4-year university in the northeastern region of the United States over a 1-year period. By analyzing participants’ narratives, we found that the reproduction of shared norms and values encouraged educated young adults to focus on educational and professional success, pressing many of them to be concerned about preventing pregnancy rather than preventing disease transmission, and increasing their risk for sexually transmitted infections, including HIV/AIDS. Sexual-health educators need to address how social processes shape sexual practices, encourage educated young adults to challenge unequal gender expectations, and consider how sexually transmitted infections might also interfere with life plans.

A cultural model of infidelity among African American and Puerto Rican young adults

Having concurrent sexual partners is a risk factor for STIs and HIV/AIDS, yet few studies have investigated the cultural meanings and functions of concurrency. A multi-method qualitative/quantitative study of sexual ideas, attitudes, and behaviors among inner-city Puerto Rican and African American emergent adults (age 18–25) in Hartford, Connecticut, USA, suggests that having concurrent partners is common in this population. Using data from 12 focus groups and 40 participants in systematic data collection techniques (e.g., pile sorts), the underlying cognitive structure of concurrency and cheating/infidelity are explored. Results suggest that participants are less tolerant of multiple partners in more committed relationships, but that very few relationships can be considered committed. Furthermore, participants see cheating as inevitable even in committed relationships. Sexual transgressions are considered the most severe form of cheating. Having an outside partner for emotional reasons or to have access to ones child were seen as more acceptable/forgivable than doing so for sexual satisfaction, social status or material goods. Multiple partnerships must be seen in the context of the inner city where resources and opportunities are scarce and young adults attempt to protect themselves from emotional injury. Documenting new and changing social constructions of infidelity is important for understanding the social context of sexual behavior in our global world and for designing culturally appropriate health interventions.