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Culture, Medicine and Psychiatry

, Volume 17, Issue 4, pp 455–485 | Cite as

Inner-city women and AIDS: The psycho-social benefits of unsafe sex

  • E. J. Sobo
Article

Abstract

The paper describes and analyzes findings from a larger study of the links between low levels of condom use and impoverished, urban, African-American women's experiences and understandings of heterosexual relationships. The research identifies and explores psycho-social barriers to safer-sex. This article examines, in detail, HIV/AIDS risk denial and women's strategic use of unsafe (condomless) sex and “monogamy narratives” to build and to maintain this denial. The tendency to view urban African-American women's conjugal affiliations as instrumental is questioned.

Keywords

Large Study Heterosexual Relationship Conjugal Affiliation Risk Denial 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Abramson, P.R. 1992 Sex, Lies, and Ethnography.In The Time of AIDS: Social Analysis, Theory, and Method. G. Herdt and S. Lindenbaum, eds., pp. 101–123. Newbury Park, CA: Sage Publications.Google Scholar
  2. Anderson, E. 1990 Street Wise: Race, Class, and Change in an Urban Neighborhood. Chicago: University of Chicago Press.Google Scholar
  3. Bandura, A. 1977 Self-Efficacy: Toward a Unifying Theory of Behavioral Change. Psychological Review 84:191–215.Google Scholar
  4. Bower, B. 1991 Risky Sex and AIDS. Science News 140 (Aug. 31).Google Scholar
  5. Brown, M.S. 1987 Communicating Information about Workplace Hazards: Effects on Worker Attitudes Toward Risk.In The Social Construction of Risk. B.B. Johnson and V.T. Cavello, eds., pp. 251–274. Norwell, MA/Dordrecht, The Netherlands: D. Reidel Publishing Co.Google Scholar
  6. Carovano, K. 1991 More Than Mothers and Whores: Redefining the AIDS Prevention Needs of Women. International Journal of Health Services 21(1):131–142.Google Scholar
  7. Catania, J.A., S.M. Kegeles, and T.J. Coates 1990 Toward an Understanding of Risk Behavior: The AIDS Risk Reduction Model (ARRM). Health Education Quarterly 17(1):53–72.Google Scholar
  8. Cochran, S. 1989 Women and HIV Infection: Issues in Prevention and Behavioral Change.In Primary Prevention of AIDS: Psychological Approaches. V.M. Mays, G.W. Albee, and S.F. Schneider, eds., pp. 309–327. Newbury Park, CA: Sage Publications.Google Scholar
  9. Copelon, R. 1990 From Privacy to Autonomy: The Conditions for Sexual and Reproductive Freedom.In From Abortion to Reproductive Freedom: Transforming a Movement. M.G. Fried, ed., pp. 27–43. Boston: South End Press.Google Scholar
  10. Corea, G. 1992 The Invisible Epidemic: The Story of Women and AIDS. New York: Harper Collins.Google Scholar
  11. Coyle, S.L., R.F. Boruch, and C.F. Turner, eds. 1991 Evaluating AIDS Prevention Programs (Expanded ed.). Washington D.C.: National Academy Press.Google Scholar
  12. Dalton, H. 1989 AIDS in Blackface. Daedalus 118(3):205–227.Google Scholar
  13. Dorfman, L.E., P.A. Derish, and J.B. Cohen 1992 Hey Girlfriend: An Evaluation of Aids Prevention among Women in the Sex Industry. Health Education Quarterly 19(1):25–40.Google Scholar
  14. Evans-Pritchard, E.E. 1968 The Nuer: A Description of the Modes of Livelihood and Political Institutions of a Nilotic People. New York: Oxford University Press.Google Scholar
  15. Farmer, P. 1992 AIDS and Accusation: Haiti and the Geography of Blame. Los Angeles: University of California Press.Google Scholar
  16. Farmer, P. and J.Y. Kim 1991 Anthropology, Accountability, and the Prevention of AIDS. Journal of Sex Research 28(2):203–221.Google Scholar
  17. Fischoff, B., S. Lichtenstein, P. Slovic, S.L. Derby, and R.L. Keeny 1981 Acceptable Risk. New York: Cambridge University Press.Google Scholar
  18. Flaskerud, J.H., and C.E. Rush 1989 AIDS and Traditional Health Beliefs and Practices of Black Women. Nursing Research 38(4):210–215.Google Scholar
  19. Freilich, M. 1968 Sex, Secrets, and Systems.In The Family in the Caribbean. S. Gerber, ed., pp. 47–62. Puerto Rico: Institute of Caribbean Studies.Google Scholar
  20. Fullilove, M.T., R.T. Fullilove III, K. Haynes, et al. 1990 Black Women and AIDS Prevention: A View Towards Understanding the Gender Rules. Journal of Sex Research 27(1):47–64.Google Scholar
  21. Gerbert, B., J. Sumser, and B.T. Maguire 1991 The Impact of Who You Know and Where You Live on Opinions About AIDS and Health Care. Social Science and Medicine 32(6):677–681.Google Scholar
  22. Geringer, L.S., and J.B. Jemmott 1993 Knowledge, Attitudes, and Behavior Related to Condom Use and STDs in a High Risk Population. The Journal of Sex Research 30(1):75–83.Google Scholar
  23. Glick Schiller, N. 1992 What's Wrong With This Picture? The Hegemonic Construction of Culture in AIDS Research in the United States. Medical Anthropology Quarterly. 6(3):237–254.Google Scholar
  24. Handwerker, P. 1993 Gender Power Differences may be STD Risk Factors for the Next Generation. Journal of Women's Health (forthcoming).Google Scholar
  25. Ingstad, B. 1990 The Cultural Construction of AIDS and Its Consequences for Prevention in Botswana. Medical Anthropology Quarterly 4(1):28–40.Google Scholar
  26. Institute of Medicine (U.S.A) 1988 Confronting AIDS: Update 1988. Washington D.C.:National Academy Press.Google Scholar
  27. Janz, N., and M.H. Becker 1984 The Health Belief Model: A Decade Later. Health Education Quarterly 11(1):1–47.Google Scholar
  28. Jemmott, L.S., and J.B. Jemmott 1991 Applying the Theory of Reasoned Action to AIDS Risk Behavior: Condom Use Among Black Women. Nursing Research 40(4):228–234.Google Scholar
  29. Jones, R. 1991 The Political and Economic Dynamics of STDs. Paper presented at the 90th Annual Meeting of the American Anthropological Association, Chicago, IL.Google Scholar
  30. Joseph, J.G., R.C. Kessler, C.B. Wortman, et al. 1989 Are There Psychological Costs Associated with Changes in Behavior to Reduce AIDS Risk?In Primary Prevention of AIDS: Psychological Approaches. V.M. Mays, G.W. Albee, and S.F. Schneider, eds., pp. 209–224. Newbury Park, CA: Sage Publications.Google Scholar
  31. Kane, S., and T. Mason 1992 ‘IV Drug Users’ and ‘Sex Partners’: The Limits of Epidemiological Categories and the Ethnography of Risk.In The Time of AIDS: Social Analysis, Theory, and Method. G. Herdt and S. Lindenbaum, eds., pp. 199–222. Newbury Park, CA: Sage Publications.Google Scholar
  32. Kilbride, P., and J.C. Kilbride 1990 Changing Family Life in East Africa: Women and Children at Risk. University Park: Penn State University Press.Google Scholar
  33. Kleinman, A., L. Eisenberg, and B. Good 1978 Culture, Illness, and Care: Clinical Lessons from Anthropologic and Cross-Cultural Research. Annals of Internal Medicine 88:251–258.Google Scholar
  34. Kline, A., E. Kline, and E. Oken 1992 Minority Women and Sexual Choice in the Age of AIDS. Social Science and Medicine 34(4):447–457.Google Scholar
  35. Larson, A. 1989 Social Context of Human Immunodeficiency Virus Transmission in Africa: Historical and Cultural Bases of East and Central African Sexual Relations. Reviews of Infectious Diseases 2(5):716–731.Google Scholar
  36. Lewis, D.K., and J.K. Waters 1989 Human Immunodeficiency Virus Seroprevalence in Female Intravenous Drug Users: The Puzzle of Black Women's Risk. Social Science and Medicine 29(9):1071–1076.Google Scholar
  37. Liebow, E. 1967 Tally's Corner: A Study of Negro Streetcorner Men. Boston: Little, Brown and Company.Google Scholar
  38. Mays, V.M., and S.D. Cochran 1990 Methodological Issues in the Assessment and Prediction of AIDS Risk-Related Sexual Behaviors Among Black Americans.In AIDS and Sex. B. Voeller et al., eds., pp. 97–120. New York: Oxford University Press.Google Scholar
  39. 1988 Issues in the Perception of AIDS Risk and Risk Reduction Activities by Black and Hispanic/Latina Women. American Psychologist 43(11):949–957.Google Scholar
  40. McKusick, L., T. Coates, J. Wiley, S. Morin, and R. Stall 1984 Prevention of HIV Infection among Gay and Bisexual Men: Two Longitudinal Studies. Paper presented at the Third International Conference on AIDS, Washington D.C.Google Scholar
  41. Medalie, J.H., G.C. Kitson, and S.J. Zyzanski 1981 A Family Epidemiological Model: A Practice and Research Concept for Family Medicine. The Journal of Family Practice 12(1):79–87.Google Scholar
  42. Miller, H.G., C.F. Turner, and L.E. Moses, eds. 1990 AIDS: The Second Decade. Washington D.C.: National Academy Press.Google Scholar
  43. Muir, M. 1991 The Environmental Context of AIDS. New York: Praeger.Google Scholar
  44. New York Times 1992 The AIDS ‘Plot’ Against Blacks. May 14, 1992, p. A-14.Google Scholar
  45. Pelto, P., and G. Pelto 1990 Methods in Medical Anthropology.In Medical Anthropology: Contemporary Theory and Method. T.M. Johnson and C.F. Sargent, eds., pp. 269–297. New York: Praeger Publishers.Google Scholar
  46. Quimby, E. 1992 Anthropological Witnessing for African-Americans: Power, Responsibility, and Choice in the Age of AIDS.In The Time of AIDS: Social Analysis, Theory and Method. G. Herdt and S. Lindenbaum, eds., pp. 159–184. Newbury Park, CA: Sage Publications.Google Scholar
  47. Schmidt, D.D. 1978 The Family as The Unit of Medical Care. The Journal of Family Practice 7(2):303–313.Google Scholar
  48. Schneider, B.E. 1988 Gender and AIDS.In AIDS 1988: AAAS Symposia Papers. R. Kulstad, ed. Washington D.C.: American Association for the Advancement of Science.Google Scholar
  49. Schoepf, B., R. wa Nkera, C. Schoepf, W. Engundu, and P. Ntsomo 1988 AIDS and Society in Central Africa: A View from Zaire.In AIDS in Africa: The Social and Policy Impact. N. Miller and R.C. Rockwell, eds., pp. 211–233. Lewiston, NY: The Edwin Mellen Press.Google Scholar
  50. Schwartz, T. 1978 Where is the Culture? Personality as the Distributive Locus of Culture.In The Making of Psychological Anthropology. George D. Spindler, ed., pp. 419–441. Berkeley: University of California Press.Google Scholar
  51. Sibthorpe, B. 1992 The Social Construction of Sexual Relationships as a Determinant of HIV Risk Perception and Condom Use among Injection Drug Users. Medical Anthropology Quarterly 6(3):255–270.Google Scholar
  52. Sobo, E.J. 1993 One Blood: The Jamaican Body. Albany: State University of New York Press. n.d. Attitudes Toward HIV Testing Among Inner-City Women. (In files of author.)Google Scholar
  53. Spradley, J. 1980 Participant Observation. New York: Holt, Rinehart and Winston.Google Scholar
  54. Stack, C. 1974 All Our Kin: Strategies for Survival in a Black Community. New York: Harper.Google Scholar
  55. Thomas, S.B., and S.C. Quinn 1991 The Tuskegee Syphilus Study, 1932 to 1972: Implications for HIV Education and AIDS Risk Education Programs in the Black Community. American Journal of Public Health 81(11):498–505.Google Scholar
  56. Treichler, P.A. 1992 AIDS, HIV and the Cultural Construction of Reality.In The Time of AIDS: Social Analysis, Theory, and Method. G. Herdt and S. Lindenbaum, eds., pp. 65–98. Newbury Park, CA: Sage Publications.Google Scholar
  57. Tunstall, C., S. Kegeles, P. Darney, M. Tervalon, and G. Oliva 1991 Women at Risk for Perinatal HIV Transmission: The San Francisco Perinatal HIV Reduction and Education Demonstration Activities (PHREDA) Project. Paper presented at the 99th Annual Meeting of the American Psychological Association, San Francisco CA.Google Scholar
  58. Turner, C.F., H.G. Miller, and L.E. Moses, eds. 1989 AIDS: Sexual Behavior and Intravenous Drug Use. Washington D.C.: National Academy Press.Google Scholar
  59. Walker, R.S. 1991 AIDS Today, Tomorrow: An Introduction to the HIV Epidemic in America. New Jersey: Humanities Press International.Google Scholar
  60. Ward, M. 1993 A Different Disease: HIV/AIDS and Health Care for Women in Poverty. Culture, Medicine, and Psychiatry (this issue).Google Scholar
  61. 1991a Cupid's Touch: The Lessons of the Family Planning Movement for the AIDS Epidemic. Journal of Sex Research 28(2):289–346.Google Scholar
  62. Ward, M. 1991b Poor and Positive: Two Contrasting Views From Inside the HIV/AIDS Epidemic. Paper presented at the 90th Annual Meeting of the American Anthropological Association, Chicago IL.Google Scholar
  63. Ward, M. The Politics of Adolescent Pregnancy: Turf and Teens in Louisiana.In Births and Power: Social Change and the Politics of Reproduction. W.P. Handwerker, ed., pp. 147–164. San Francisco: Westview Press.Google Scholar
  64. Weinberg, M.S., and C.J. Williams 1988 Black Sexuality: A Test of Two Theories. Journal of Sex Research 25(2):197–218.Google Scholar
  65. Weinstein, N.D. 1989 Perceptions of Personal Susceptibility to Harm.In Primary Prevention of AIDS: Psychological Approaches. V.M. Mays, G.W. Albee, and S.F. Schneider, eds., pp. 142–167. Newbury Park, CA: Sage Publications.Google Scholar
  66. Wildavsky, A. 1988 Searching for Safety. New Brunswick: Transaction Books.Google Scholar
  67. Wilson, W.J. 1987 The Truly Disadvantaged. Chicago: University of Chicago Press.Google Scholar
  68. Winkelstein, W., D.M. Lyman, N. Padian, R. Grant, M. Samuel, J.A. Wiley, R.E. Anderson, W. Lang, J. Riggs, and J.A. Levy 1987 Sexual Practices and Risk of Infection by the Human Immunodeficiency Virus: The San Francisco Men's Health Study. Journal of the American Medical Association 257:321–325.Google Scholar
  69. Worth, D. 1990 Minority Women and AIDS: Culture, Race, and Gender.In Cultural Aspects of AIDS. D. Feldman, ed., pp. 111–136. New York: Praeger.Google Scholar
  70. 1989 Sexual Decision-Making and AIDS: Why Condom Promotion among Vulnerable Women is Likely to Fail. Studies in Family Planning 20(6):297–307.Google Scholar
  71. Zimet, G.D. 1992 Attitudes of Teenagers who Know Someone with AIDS. Psychological Reports (70):1–2.Google Scholar

Copyright information

© Kluwer Academic Publishers 1993

Authors and Affiliations

  • E. J. Sobo
    • 1
  1. 1.Department of Sociology/Anthropology Dept. 3BVNew Mexico State UniversityLas Cruces

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