Intersectional harassment and deviant embodiment among Autistic adults: (dis)ability,gender and sexuality

Abstract

Harassment scholarship increasingly attends to the intersectional nature of harassment and its function within systems of domination. However, little of this work includes disability. In-depth interviews with 24 adults on the autism spectrum in the USA demonstrate the intersections of gender, sexuality and (dis)ability in the construction of deviant embodiments as targets for harassment. These intersections also shape how participants made sense of these experiences of violence. Participants’ disability characteristics were often read as gender or sexual variance, with harassers relying on sexist and heterosexist constructs to frighten, demean or humiliate them for disability characteristics. Participant experiences demonstrate the cisgender basis of ‘able-bodied’ identity as well as the ‘able-bodied’ basis of cisgender and heterosexual identities and experiences. The interdependency of gender, sexuality and (dis)ability embodiment point to how it is critical for scholars and activists to account for the role of gender and heterosexist harassment in ableist oppression and disability harassment in (hetero)sexist oppression, as well as the limits of current US law enforcement structures in providing redress for harassment.     

Factors associated with young people's attendance at an IPV prevention intervention in informal settlements in South Africa: A prospective analysis

ABSTRACT

Understanding factors shaping attendance at behavioural interventions is critical for programmatic planning. Through the Stepping Stones and Creating Futures intervention trial amongst young (18-30) women and men to reduce intimate partner violence and strengthen livelihoods, we prospectively assessed factors associated with intervention attendance. Baseline data were collected between September 2015 and September 2016 among 677 women and 675 men. For women, in multinomial models, compared to high attenders, medium (β?=??0.04, p?=?0.001) and low (β?=??0.05, p?=?0.003) attenders had lived less time in the community, medium attenders were more likely to have children (β?=?0.97, p?=?0.001), and low attenders had less gender-equitable attitudes (β?=??0.57, p?=?0.035). For men, in multinomial models, compared to high attenders, medium attenders were more likely to have completed secondary school (β?=?1.48, p?=?0.011) and to have worked in the past three months (β?=?0.64, p?=?0.021). Low attenders had lived for a shorter period in the community (β?=??0.06, p?=?0.005), and were more likely to have worked in the past three months (β?=?0.66, p?=?0.041) compared to high attenders. Attendance was shaped by structural factors, and gender-specific factors, and these need to be incorporated into future interventions.     

Prevalence and risk of violence against people with and without disabilities: findings from an Australian population‐based study

Objectives : There are no population‐based estimates of the prevalence of interpersonal violence among people with disabilities in Australia. The project aimed to: 1) estimate the prevalence of violence for men and women according to disability status; 2) compare the risk of violence among women and men with disabilities to their same‐sex non‐disabled counterparts and; 3) compare the risk of violence between women and men with disabilities. Methods : We analysed the 2012 Australian Bureau of Statistics Survey on Personal Safety of more than 17,000 adults and estimated the population‐weighted prevalence of violence (physical, sexual and intimate partner violence and stalking/harassment) in the past 12 months and since the age of 15. Population‐weighted, age‐adjusted, logistic regression was used to estimate the odds of violence by disability status and gender. Results : People with disabilities were significantly more likely to experience all types of violence, both in the past 12 months and since the age of 15. Women with disabilities were more likely to experience sexual and partner violence and men were more likely to experience physical violence. Conclusions : These results underscore the need to understand risk factors for violence, raise awareness about violence and to target policies and services to reduce violence against people with disabilities in Australia.     

Cultural Norms and Risk: Lessons Learned from HIV in Thailand

Cultural sensitivity has been identified as an important component of assessment and intervention for HIV risk. Recognizing cultural norms is important for selecting methods for assessment and intervention. The behavioral HIV literature in Thailand is reviewed to illustrate the importance of the localization of cultural norms and practices, the often fragmented or mediated character of broad social dynamics, and subtleties of drawing cross-cultural inferences. We also discuss the implications of cultural norms for selecting research methods and highlight the importance of participatory research approaches for adequately capturing and incorporating cultural elements in the design of assessments and interventions.     

Credit programs, patriarchy and men''s violence against women in rural Bangladesh

Although violence by men against women in Bangladesh occurs in most cases within the home, in a larger sense it does not originate in the home nor persist only within the home. It is simply one element in a system that subordinates women through social norms that define women's place and guide their conduct. This paper uses ethnographic and structured survey data from a study in rural Bangladesh to explore the relationship between domestic violence against women and their economic and social dependence. It describes some of the common situations in which violence against women occurs in Bangladeshi society, analyzes its larger context, and identifies factors that appear to lessen its incidence in this particular socio-economic setting. The study findings suggest that group-based credit programs can reduce men's violence against women by making women's lives more public. The problem of men's violence against women is deeply rooted, however, and the authors argue that much more extensive interventions will be needed to significantly undermine it.     

Discourses of sexual relationships in a sample of German and British young people: a Q methodological study

Young people live in an environment that sexualises them, particularly women, along traditional gender roles. This, in parallel with a silence about positive sexuality in policy development, means that sexual double standards prevail in young people’s lives. The aim of this study was to explore the discourses young women and men from two European countries, Germany and England, draw on when making sense of sexual relationships and how these are steeped in the local cultural climate and messages. The study used Q methodology and included 65 German and English young people between 16 and 19 years of age. Six accounts emerged: sex as responsible, intimate and shared experience; sex as joint fun; ideal versus reality; sex has to be responsible, consensual and shared; caring relationships offer the perfect context for fulfilling sex; and equality between partners. The importance of cultural context in the availability of specific dominant and alternative discourses is discussed with a focus on how this influences young people’s sense-making with regard to sexuality and sexual relationships. Future directions for research are highlighted.     

Make love not war? Sex,sexual meanings,and violence in a sample of university students

Some previous studies show that sexual arousal heightens aggression, some show no relationship, and others show that sex inhibits aggression. It is suggested that the contradictions can be explained by the failure of these studies to consider the subjective meaning of sexual acts. To empirically test this notion, questionnaires were given to 190 students in three New England colleges. It was found that a high level of sexual activity is associated with a low level of violence, but only if the meaning of that activity is one of a warm, affectionate act. For men who follow the traditional male stereotype of sex as a dominant and exploitative act, higher levels of sexual activity are associated with the aggression and violence typically associated with attempts to dominate. For women, these relationships were weak or nonexistent. Reasons for the sex differences are discussed.     

Local narratives of sexual and other violence against children and young people in Zanzibar

Understandings of violence, and especially sexual violence against children, must be situated within the local context. The 2009 Violence against Children Survey in Zanzibar indicated that 6% of girls and 9% of boys reported having experienced sexual violence before the age of 18 years. This paper reports on an in-depth qualitative study conducted in Zanzibar to provide further insights to these findings by examining the circumstances for sexual and other violence against children in Zanzibar. Twenty-four in-depth interviews with young people and 18 focus-group discussions with young people and adults were conducted in rural and urban Zanzibar. A further 8 interviews were conducted with parents and key stakeholders in government and NGO offices that provide services for children. The findings revealed that religious and cultural practices, which form the foundation of Swahili culture in Zanzibar, provide a moral frame for childhood development, but structural factors make children vulnerable to sexual violence. Both boys and girls are vulnerable to sexual violence in the home, neighbourhood, at school and, in particular, at madrasa or Qur’anic schools. As religion and culture are strong influences on childhood, preventing sexual violence at madrasa schools would strengthen the positive aspects of religious teachings for ensuring a safe childhood.     

Performance,power and condom use: reconceptualised masculinities amongst Western male sex tourists to Thailand

Each year large numbers of Western men travel to Thailand for sex tourism. Although many will use condoms during their sexual encounters, others will not, potentially exposing themselves to the risk of acquiring sexually transmitted infections, including HIV. Although sex tourism in Thailand has been well documented, the social drivers underpinning voluntary sexual risk-taking through the avoidance of condoms remain poorly understood. Engaging with R.W. Connell’s concept of hegemonic masculinity and drawing on data collected from 1237 online discussion board posts and 14 face-to-face interviews, this study considers the ways in which understandings and performances of masculinities may inform the sexual risk-taking behaviours of Western male sex tourists. It argues that for some of these men, unprotected sex is viewed not as a reckless behaviour but, instead, as a safe and appropriate masculine practice, supported by relationships that are often framed as romantic and within a setting where HIV is still largely considered a homosexual disease. With sex workers often disempowered to request safer sexual practices, and some men’s attitudes towards unprotected sex resistant to external health promotion advice, the paper concludes by considering what this might mean for policy and practice.     

A review of measures used to assess HIV-related stigma among young people living with HIV: missing accounts of sex and gender

Most studies of HIV-related stigma focus on adult populations. This study reviews empirical studies that measure HIV-related stigma among young people living with HIV (YLHIV). Using Earnshaw and Chaudoir’s (2009) framework, studies that assessed, enacted, internalized, perceived and anticipated stigma were coded and then evaluated on their use of sex or gender according to the following criteria: (i) recruiting equal number of young men and women; (ii) asking some questions/subsections of young men/women only; (iii) treating sex/gender as a covariate, or stratifying by or controlling for sex/gender; (iv) acknowledging the importance of sex/gender considerations in the discussion. Of the 2272 abstracts initially screened, 27 papers were eligible for analysis. While several studies (n = 12) measured all four types of stigma, four measured anticipated and internalized stigma and one measured perceived and internalized stigma. Moreover, two measured perceived and enacted stigma and two others measured only enacted stigma. Two studies measured only perceived stigma, and two assessed only internalized stigma. Most (n = 15) studies did not account for sex- or gender-based differences regarding HIV-related stigma and 10 did not report on participants’ sexual orientation. Of the 19 studies that included both male and female YLHIV, 6 did not account for sex/gender in their analyses. Very few (n = 6) studies reported on transgender YLHIV. Overall, a limited amount of HIV-related stigma research involved young people, despite the fact that this population experiences over 40% of annual incident rates globally. Additionally, overlooking sex- and gender-based differences is concerning given the evidence on gender differences regarding perceived HIV stigma and social rejection, discrimination, shame and psychological distress. Gender-specific stigma should be considered in future studies. A failure to do so leaves open the possibility of missing (or misunderstanding) relevant considerations (e.g. sex/gender-based differences or similarities) that may be amenable to stigma-reduction interventions.     

Intervening in masculinity: work,relationships and violence among the intimate partners of female sex workers in South India

Although health researchers have begun to examine the forms of violence and power dynamics that play out in the intimate relationships of female sex workers (FSWs) in India, this knowledge has tended to focus on the perspectives of women, leaving men’s motivations and attitudes relatively unexamined. This paper examines the contours of masculinity and gender norms from the perspective of the intimate partners of FSWs. Based on six months of ethnographic research in Northern Karnataka, the study employed two focus group discussions (FGDs) with Devadasi FSWs (N = 17), as well as four FGDs (N = 34) and 30 in-depth interviews with their intimate partners. Given the precarious labour conditions in this region, tensions developed in the participants’ relationships with FSWs, as these men were unable to meet local ideals of manhood. Violence became a way that men attempted to re-secure a sense of control in their relationships with women, and to fulfil fantasies of male power. We recommend that programs engaging men not only address intimate partner violence but also attend to the social and structural realities surrounding these men’s daily lived experiences.     

Substance use,gender inequity,violence and sexual risk among couples in Cape Town

Alcohol and other drug use, gender power inequities and violence are key contributors to sexual risks for HIV among South African men and women. Little is known about the intersection between these sex-risk behaviours among couples in established heterosexual relationships. We conducted 10 focus-group discussions with men and women in relationships of 1 year or longer recruited from shebeens (informal taverns) in Cape Town, South Africa. Participants described: high levels of alcohol consumption at shebeens; low levels of condom use with main and casual sex partners; gender roles disfavouring women's condom negotiating power that also promoted economic dependency on male partners; men often spending a portion of the household income on alcohol and other drugs and sex with others in shebeens; loss of household income driving women to trade sex to provide for their families; and sexual violence and the exploitation of women occurring in shebeens. Findings highlight how the social contexts of alcohol and other drug use, gender inequitable norms and gender violence promote HIV risk within established heterosexual relationships in South African communities. Evidence of this kind should inform the design of HIV-risk-reduction interventions tailored to heterosexual couples who drink alcohol in shebeens.     

Acceptance,attitude, and factors affecting the intention to accept COVID-19 vaccine among Thai people and expatriates living in Thailand

BackgroundCOVID-19 pandemic is a worldwide problem. Vaccination as primary prevention is necessary. Thailand is in the initial phase of the vaccination program. However, the demand for this vaccine among Thais and expatriates living in Thailand is still unknown. This study aims to assess acceptance, attitude, and determinants for COVID-19 vaccination among Thai people and expatriates living in Thailand.MethodsThis was a cross-sectional study conducted in Thailand during May 2021. An online survey (REDcap) was distributed through online social media platforms. Adult (>18 years old) Thai and expatriates living in Thailand were invited. Any person who already received any COVID-19 vaccine was excluded from this study.ResultOne thousand sixty-six responses were collected in this survey. A total of 959 were available for analysis. Six hundred thirty-seven 637 responses were from Thais and 322 responses from expatriates living in Thailand. The acceptance rate was significantly higher among expatriates than local people (57.8% vs 41.8%, p-value < 0.001). The acceptance rate increased up to 89.0–91.3% if they could select the vaccine brand, and 80.7–83.2% when they were recommended by the health care professionals. Both groups had a similar mean attitude score toward COVID-19 vaccination. Being Thai, health care worker, good compliance to social distancing, accepting serious side effects at level 1 per 100,000, and having a good attitude toward COVID-19 vaccination were associated with vaccine acceptance.ConclusionThailand's COVID-19 vaccination program could improve the acceptance rate by informing the public about vaccine efficacy, vaccine benefit, and vaccine safety. Moreover, supplying free of charge high efficacy alternative vaccines and letting all people living in Thailand make their own vaccine choices could increase the acceptance rate.     

‘Our life is pointless … ’: Exploring discrimination,violence and mental health challenges among sexual and gender minorities from Brazil

ABSTRACT

Worldwide, Brazil has the highest prevalence of violence and hate crimes against sexual and gender minorities (SGMs) among countries with available data. To explore the impact of this scenario, we conducted a qualitative study with 50 SGMs from Rio de Janeiro, Brazil. Among the participants, 66% screened positive for generalised anxiety disorder, 46% for major depressive disorder and 39% for PTSD. A third reported low self-esteem (32%) and one quarter low social support (26%). Experiences of interpersonal discrimination were highly prevalent (>60%), while institutional discrimination related to employment or healthcare was reported by 46% of participants. Verbal abuse is very common (80%), followed by physical assault (40%). Sexual violence is highly frequent among women. Focus groups analysis highlighted three major domains: (1) stigma and discrimination (family, friends and partners, in schools and health services, influencing social isolation); (2) violence (bullying, harassment, physical and sexual violence); and (3) mental suffering (alcohol and drug abuse, depression, suicidality, anxiety). Our findings suggest a close synergy between experiences of discrimination and violence with selected mental disorders. This complex synergy might be better addressed by longer-term individual and group-level interventions that could foster social solidarity among the different groups that comprise SGMs.     

Moving towards universal health insurance in China: performance, issues and lessons from Thailand

China is now in the course of implementing a new round of health system reforms. Universal health insurance coverage through the basic social medical insurance system is high on the reform agenda. This paper examines the performance of China's current social medical insurance system in terms of revenue collection, risk pooling, the benefit package, and provider payment mechanisms based on a literature review and publicly available data. On the basis of critical assessment, the paper attempts to address the issues challenging China as it moves towards universal coverage. Focusing in particular on the reform experience in Thailand as it implemented universal coverage, the following policy implications for further reform in China are articulated, taking into account China's particular circumstances: firstly, the gaps in the benefit package across different schemes should be further reduced; secondly, the prevailing fee-for-service payment system needs to be transformed; thirdly, the primary health care delivery and referral system needs to be strengthened in coordination with the reform of the health insurance system; and fourthly, raising the risk pooling level and integrating fragmented insurance schemes should be long-run objectives of reform.     

Challenging Pentecostal moralism: erotic geographies,religion and sexual practices among township youth in Cape Town

Research on constructions of sexuality in Pentecostalism often struggles with the fact that the research setting is defined ex ante in terms of church communities, which imposes upon ethnographic accounts the same limitations Pentecostal morality imposes upon church members' discourse. Taking young Pentecostals operating in a space that is not explicitly religious as the methodological entrance to the field, this paper explores negotiations over sexuality, intimate relationships and love among Xhosa-speaking township youth. It introduces the notion of erotic geographies to consider how possible influences of religious discourses on sexuality are refracted by alternative cultural orientations and material contexts. Findings suggest that premarital abstinence appears as a highly exceptional ideal for youth. Even among Pentecostal youth, notions of sexuality are largely severed from religiosity and faithfulness and romanticism are dominant ideals. Future research on Pentecostalism and sexuality should be less religious-centric and rooted more firmly in ethnographies of youth sexual cultures.     

Quality of life among people living with HIV/AIDS in northern Thailand: MOS-HIV Health Survey

OBJECTIVES: Translation and psychometric evaluation of a Thai version of the Medical Outcomes Study HIV Health Survey (MOS-HIV) in Thailand. METHODS: A cross-sectional survey in Chiang Mai province, northern Thailand, with data collected in face-to-face interviews using a structured questionnaire designed to measure 10 scales of quality of life (QOL). We recruited 200 people with HIV/AIDS attending self-help groups in the municipal area. Standard guidelines were followed for questionnaire translation and psychometric evaluations. RESULTS: Item-level internal consistency and discriminant validity were reasonably established. Success rates were 93.8 and 97.4%, respectively. Scale-level internal consistency reliability of multi-item scales was satisfactory, ranging from 0.74 to 0.88, with all exceeding inter-scale correlations. Principal components analysis of item and scale scores identified two hypothesized dimensions of the MOS-HIV. The mental health component was strongly loaded by health distress, mental health, vitality and cognitive function scales, and physical health by role, physical and social functions, and pain scales. Respondents manifesting symptoms or reporting worsening health status scored significantly lower on all scales. CONCLUSIONS: These preliminary studies have shown the Thai version of the MOS-HIV to have psychometric properties comparable with those reported in previous surveys. Further testing and modification should make it useful as an HIV-specific QOL measure in Thailand.     

Sexual and gender harassment in Swedish workplaces: A prospective cohort study on implications for long-term sickness absence

Objectives:This prospective cohort study aimed to investigate gender harassment and sexual harassment as risk factors for prospective long-term sickness absence (LTSA, ≥21 days). Furthermore, support from colleagues was investigated as a moderating factor of this association.Methods:Information on gender harassment, sexual harassment and support by colleagues were derived from the biannual Swedish Work Environment Survey 1999–2013, a representative sample of the Swedish working population (N=64 297). Information on LTSA as well as demographic and workplace variables were added from register data. Relative rates of LTSA the year following the exposure were determined using modified Poisson regression.Results:Monthly to daily exposure to gender harassment was a risk factor for prospective LTSA among women [rate ratio (RR) 1.04, 95% confidence interval (CI) 1.02–1.05] and men (RR 1.07, 95% CI 1.04–1.10). Monthly to daily exposure to sexual harassment was also a risk factor for LTSA among women (RR 1.05, 95% CI 1.01–1.10) and men (RR 1.07, 95% CI 1.02–1.13). Exposure to sexual or gender harassment once in the last 12 months was not associated with LTSA. There was no support for an interaction between either of the exposures and support from colleagues in relation to LTSA.Conclusions:Sexual harassment and gender harassment appear to contribute to a small excess risk for LTSA among women and men. For both kinds of offensive behaviors, the pervasiveness appears to be important for the outcome. The role of support by colleagues was inconclusive and needs further investigation.     

Improving livelihoods and gender equitable attitudes of street-connected young people in Eldoret,Kenya: Results from a pilot evidence-based intervention

Street-connected young people (SCY) in Eldoret, Kenya, experience substantial gender inequities, economic marginalization and are highly vulnerable to acquiring HIV. This study sought to explain and explore how participation in a pilot-adapted evidence-based intervention, Stepping Stones and Creating Futures, integrated with matched savings, changed SCY's economic resources, livelihoods and gender equitable attitudes. We piloted our adapted intervention using a convergent mixed-methods design measuring outcomes pre- and post-intervention with 80 SCY in four age- and gender-stratified groups of 20 participants per group (young women aged 16–19 years and 20–24 years, young men aged 16–19 years and 20–24 years). The pilot occurred at MTRH-Rafiki Centre for Excellence in Adolescent Health in Eldoret, Kenya, from September 2017 to January 2018. Through street outreach, Peer Facilitators created four age- and gender-stratified sampling lists of SCY whom met the eligibility criteria and whom indicated their interest in participating in the intervention during outreach sessions. Simple random sampling was used to select eligible participants who indicated their interest in participating in the intervention. The adapted intervention, Stepping Stones ya Mshefa na Kujijenga Kimaisha, included 24 sessions that occurred over 14 weeks, focused on sexual and reproductive health, gender norms in society, livelihoods and included a matched-savings programme conditional on attendance. The primary outcome of interest was gender equitable attitudes measured using the Gender Equitable Men scale and secondary outcomes included economic resources and livelihoods. Participants had a significant change in gender equitable attitudes from pre- to post-intervention from 43 (IQR 38–48) to 47 (IQR 42–51) (p < .001). Quantitatively and qualitatively participants reported increases in daily earnings, changes in street involvement, housing and livelihood activities. Overall, this study demonstrated that the adapted programme might be effective at changing gender equitable attitudes and improving livelihood circumstances for SCY in Kenya.