Fifty Shades: ambivalence about birth control in an erotic bestseller and its cultural implications

Abstract

The Fifty Shades trilogy by E.L. James has taken the world by storm and become a cultural phenomenon. The lack of contraceptive use in the erotic fiction, first pointed out by bloggers, is analysed in this article and compared to medical information. James may be praised for sexualising condom use. However, her protagonist makes poor choices in terms of hormonal contraception and is negligent about its use, resulting in an unintended pregnancy and resolved in marital bliss and motherhood. What is of more interest here than a possible message about contraceptive use, is the outcome that the fiction’s negligence in birth control and responsibility affirms an ideology in which female sexuality and sexual experimentation can only be tolerated within the context of procreation and affirmation of motherhood. Subsequently, the cultural significance of the trilogy’s popularity and its tension between sexual exploration, birth control and fertility is explored. In a globally popular fantasy published more than five decades after the introduction of the pill, the protagonist’s lack of attention to reliable birth control leads to a telling dichotomy that combines adventurous exploration of female sexuality and affirmation of the nuclear family.     

Gender norms in South Africa: implications for HIV and pregnancy prevention among African and Indian women students at a South African tertiary institution

In post‐Apartheid South Africa, women are constitutionally guaranteed protections and freedoms that were previously unknown to them. These freedoms may have positive implications for women's ability to negotiate sexual protection with partners and hence prevent unintended pregnancy and decrease their risk of HIV. Among tertiary institution students, who are a relatively ‘privileged’ group, there is little information on gender norms that might shape responses to HIV‐prevention programmes. To elicit gender norms regarding women's and men's roles, condom and contraceptive use, sexual communication and sexual pleasure, we conducted 10 semi‐structured focus group discussions with African and Indian female tertiary institution students in order to understand how norms might be used to buttress HIV‐ and pregnancy‐prevention. Participants reported dramatic changes in the structure of gender norms and relations with the formal recognition of women's rights in the post‐Apartheid context. These generational shifts in norms are supported by other research in South Africa. At the same time, women recognized the co‐existence of traditional constructions of gender that operate to constrain women's freedom. The perceived changes that have taken place provide an entry point for intervention, particularly for reinforcing emerging gender norms that promote women's protection against unintended pregnancy and HIV/STIs.     

Sexual risk behaviour for women working in recreational venues in Mwanza,Tanzania: considerations for the acceptability and use of vaginal microbicide gels

Qualitative research was conducted to explore the social context of sexual-risk behaviour among women working in recreational occupations, during a feasibility study in preparation for the Phase III clinical trial of vaginal microbicides in Mwanza, Tanzania. Participant observation was conducted in 68 recreational venues. Six focus group discussions were conducted with women working in recreational occupations and two with male customers at these venues. Findings revealed that these women are at risk of HIV due their dependence on sexual transactions to improve their economic circumstances, which take place in environments and relationships where condom use is difficult. However, the findings revealed that, in spite of constraints, women did take actions to prevent HIV by negotiating for condom use or avoiding perceived risky practices or partnerships, in particular moving to more casual partnerships where condom negotiation is more acceptable. This indicates that, given their perception of their own risk, women working in recreational occupations will welcome an effective microbicide. However, sustained use will depend on how formulations overcome the difficulties women currently experience with condom negotiation and the specific environments and relationships in which they engage in sex.     

Emerging discourse: Islamic teaching in HIV prevention in Kenya

Islamic values portraying sex outside of marriage as sinful are often believed to contribute to HIV transmission as they reject safe-sex practices. Moreover, stigma associated with sinful behaviour is frequently assumed to interfere with access to care for those infected. In contrast, adherence to religious values such as abstinence is viewed as an explanation for the relatively low incidence of HIV infection in Islamic populations. Inspired by this debate, a study was conducted into the possibilities of using Islamic texts as a starting point for health promotion addressing HIV infection and HIV/AIDS-related stigma in Lamu, a Muslim community in Kenya. The study also explored the potential role of Lamu's Islamic leaders in the delivery of that health promotion. In collaboration with Islamic leaders, texts were identified that applied to sexual conduct, health, stigma and the responsibilities of Islamic leaders towards their congregations. In spite of the association of HIV with improper sexual behaviour, Islamic texts offer a starting point for tackling HIV transmission and HIV/AIDS-related stigma. Under particular conditions, the identified Islamic texts may even justify the promotion of safer-sex methods, including condom use.     

The impact of socio-cultural context on young people's condom use: evidence from two Pacific Island countries

Young people are a key group for HIV prevention in the Pacific region where levels of STIs are high and condom use is low. During 2008, 62 in-depth interviews were conducted with people aged between 18 and 25 years in Tonga and Vanuatu. The research was aimed at understanding factors impacting on young peoples’ condom use in two Pacific Island nations. The data show a marked disjuncture between attitudes and practice with regard to condoms. This paper discusses factors underpinning that inconsistency and directs attention to the effect of social and cultural influences on young people's condom use. The authors conclude that individual-level approaches to improving rates of condom use will be inadequate unless they are informed by an understanding of the role of identity, culture and tradition in young peoples’ decisions around condom use. The findings also underline the need for country-specific approaches to condom promotion efforts in the Pacific.     

‘Female condoms give women greater control’: A qualitative assessment of the experiences of commercial sex workers in Swaziland

ABSTRACT

Objectives To explore commercial sex workers’ experiences with the female condom in Swaziland.

Methods This is a qualitative study that draws on two focus group discussions and ten individual in-depth interviews with female commercial sex workers in Lavumisa, Swaziland.

Results The findings suggest that the majority of female sex workers prefer to use the female condom with their clients because it offers them greater control over the sexual encounter. Other factors that facilitate its use include the absence of side effects, the enhancement of sexual pleasure and protection against the risk of STIs (including HIV). In addition, the women reported that the female condom is stronger and more resistant to breakage than the male condom. Moreover, the female condoms can be inserted well in advance of sexual intercourse. Difficulties of insertion, partner objection and limited product availability were some of the barriers to the use of the device. There was also a tendency to reuse the female condoms because of lack of product availability and privacy to insert it.

Conclusion Although female condom use involves negotiation with clients, the fact that it offers sex workers an independent method of protection gives them more power and also, increases their ability to control their sexual and reproductive health.     

HIV感染者配偶或固定性伴安全套使用影响因素分析

目的 分析影响人类免疫缺陷病毒(HIV)感染者配偶或固定性伴安全套使用的影响因素.方法 将HIV感染者的配偶或固定性伴作为研究对象,采用问卷调查方法收集一般资料及安全套使用情况资料,以等级资料的秩和检验和logistic回归方法分析使用安全套的影响因素.结果 共纳入395位研究对象,其中72.66％的人与配偶或固定性伴发生性行为时每次都使用安全套,15.70％的人从不使用安全套.经统计分析,民族、是否有小孩、艾滋病知识知晓情况、配偶或固定性伴查出感染HIV的时间和自认为从配偶或固定性伴处感染HIV的可能性是安全套使用的影响因素.结论 我国HIV感染者配偶或固定性伴安全套的使用状况仍不甚理想,其影响因素是多方面的.在以后的工作中,应针对重点人群,加强艾滋病的干预工作,并按时进行高危人群的筛查,以便及早采取预防措施.     

Differences in Sexual Risk Behaviors Between College Students with Same-Sex and Opposite-Sex Experience: Results from a National Survey

The goal of this study was to identify differences in the sexual health behaviors (condom use and number of sexual partners) between college students with same-sex sexual experiences and those with only opposite-sex partners. Data from a random sample of American university students were gathered as part of the 1997 College Alcohol Study. Odds ratios were estimated for consistent condom use and multiple sex partners for students with same-sex or both-sex sexual partners compared to those with exclusively heterosexual contacts. Five percent of respondents reported ever having a same-sex partner. Significant differences in safer-sex practices were found between groups. Females with both-sex experience and males with both-sex or only same-sex experiences were more likely to report multiple recent sexual partners than their peers with only opposite-sex partners. Odds ratios of consistent condom use were lower for men with only same-sex experience than among those with only opposite-sex partners. Findings have implications for sexual health education on the college campus. Consistent condom use remains low among college students. Education programs should emphasize the importance of limiting the number of lifetime sex partners, especially among students with same-sex experiences.     

Seeking the female (internal) condom in retail pharmacies: Experiences of adolescent mystery callers

BackgroundFemale (internal) condoms could be viable alternatives to male (external) condoms. Our objective was to describe barriers that adolescent mystery callers encountered when trying to access female condoms in U.S. pharmacies.MethodsIn mid-2016, university students seeking “condoms for girls” called retail pharmacies in Arizona, California, New Mexico and Utah. We evaluated differences in product availability and callers’ experiences by pharmacy type.ResultsOf our final sample (n=1475), only eight outlets (0.5%), all national chains, definitely stocked female condoms. Of those not (or probably not) stocking female condoms, 11% tried to be helpful (e.g., offered to special order), 59% made no substantive comment, and 30% were unhelpful (e.g., dismissive, rude, gave wrong information). National chain employees were significantly more unhelpful (34% vs 22%, p< .01).ConclusionAlmost no pharmacies in four southwestern states stocked female condoms in mid-2016. Pharmacy staff frequently were unhelpful, which could deter adolescent use of female condoms even if new types become available.