One useful but relatively unexamined window into the way in which contextual aspects of heterosexual relationships operate is known as the sexual script. To ensure masked coding of the interviews, a random generator was used to replace original participant identifiers. Here, women indicated that they would bring up condoms before sexual intimacy began, and reported themes such as:. The formula is: the of that are correctly coded by a single rater divided by the total of final codes plus the of omissions of total codes that a single rater did not originally code plus the of comissions of codes that a single rater initially coded but that were not included in the final set of total codes.
The trial was effective and women in the eight-session intervention arm were ificantly more likely to report decreased unsafe sex or no unsafe sex compared to controls at one month and one year post-intervention.
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Some totals may not add up to the total N due to rounding or missing data. Cultural scenarios are derived from diverse social and institutional sources media, peers, family, schools, religion and are the norms that guide sexual behavior at the societal level, helping to determine the who, what, where, when, why, and how of sexual interactions. Baseline: Sexual initiation, sexual pacing, and sexual decision-making. We examined the domains of sexual initiation, pace setting, sexual decision-making, communication about sexual needs, and the timing of condom introductions in the experimental and control arms at baseline and one year follow-up.
At one year follow-up, among both the experimental and control arms, showed changes away from male-dominated and toward female-dominated sexual initiation and sexual decision-making. Efficacy of the trial was assessed comparing women randomly ased to an 8-session condition vs. The same 45 women were analyzed at baseline and one year follow-up in order to provide a qualitative analysis of change. At one year follow-up, the smallest category overall remained those women who reported using both direct and indirect body language.
One-year follow-up: Communication about sexual needs, do condoms ruin sex? The interpersonal script includes individual interpretation of cultural norms, and allows for the way in which mutual interactions shape sequences of sexual action. The domains of sexual initiation, pacing, and decision-making were coded by drawing on the same that were developed in the ly published qualitative study Ortiz-Torres et al.
Communication about sexual needs and communication about condoms were coded both in terms of timing e. The sample was constituted by randomly selecting equal s from the three intervention arms: 15 from the eight-session arm, 15 from the four-session arm, and 15 from the control group.
At both time points, most women described male sexual initiation, female-led pace keeping, and mutual sexual decision-making as an ideal sexual script, as is often the case in traditional scripts. For the women who did not spontaneously bring up condoms in their description of an ideal encounter, they were probed about condoms to see if they could imagine it as a part of the encounter. Other noteworthy qualitative changes occurred in terms of the timing of condom introductions.
Examination of whether and how traditional scripts are modified and changed through intervention sessions is particularly crucial as researchers have become increasingly adept at understanding the ways in which overconformity to traditional gender norms may exacerbate HIV risk.
At baseline and follow-up, the overall trends in this subsample of participants were similar in the domains of sexual initiation, pacing, and sexual decision-making. Keeping these deations allowed the research team to keep standardized definitions over time, facilitating an analysis of change. Summary of sexual scripts domains: sexual initiation, pacing, decision-making, communication, condom use, and condom timing at baseline and 1 year follow-up.
Sexual scripts of women: a longitudinal analysis of participants in a gender-specific hiv/std prevention intervention
At one year follow-up, this percentage increased among both the control and experimental arms to more than 1 in 5 women. To be eligible for participation in FIO, women had to be a client of the above clinic, report heterosexual activity within the prior year, be between 18 and 30 years old, have unknown or negative HIV serostatus, have no history of receiving a blood transfusion from toreport that they were not currently pregnant or planning to become pregnant, report no intravenous drug use in the past year, and be comfortable with spoken English.
Sixty-seven percent of women reported at least one lifetime STD diagnosis. Control participants were scheduled to be interviewed during the same time intervals as their respective intervention group participants. Both the control and experimental arms reported increases in the percentage of women who would bring condoms up at an earlier point in the sexual scenario rather than right before penetration. Two coders who were external to the interviewing process for the parent study, but who were formally trained in qualitative methods, carried out the coding and analysis.
A ly published qualitative analysis explored sexual scripts in Project FIO at baseline, and compared the proceptive aspects of courtship that preceded sexual encounters with the sexual phase itself Ortiz-Torres et al. Using a chi-square test, we found no ificant differences at baseline between the control and experimental arms across the domains of communication about sexual needs, whether women perceived that condoms would ruin sex, or the timing of condom introductions.
Eligible women who were willing to participate had a baseline interview and were subsequently randomized into one of three study arms: an eight-week or a four-week intervention condition or an assessment-only control group for details on the theories, randomization procedures, and subject flows from the parent study, see Ehrhardt, Exner, Hoffman, Silberman, Leu, et al. As coding were straight-forward, discrepancies were not common.
In nearly all cases, discrepancies were simple miscodes and did not involve substantive discussions. While The random sample that was selected for the current analysis was drawn from the same pool of interviews that were randomly selected from the qualitative baseline analysis Ortiz-Torres et al. At one year follow-up, there was some shift away from a description of no communication or direct communication about sexual needs and a tendency to imagine carrying out more indirect communication among both the experimental and control arms.
There was no change from baseline to follow-up across the study arms concerning the percentage of women who desired mutual sexual initiation. There is some suggestion that sexual scripts may be changing in contemporary U. Moving away from dominant cultural scripts may not only be rewarding at the individual or interpersonal level, but might also have important health implications given the ways in which overconformity to traditional gender norms has been found to be associated with HIV risk Campbell,; Ortiz-Torres et al.
Using a chi-square test, we found no ificant differences at baseline between the control and experimental arms across the domains of sexual initiation, pacing, and decision-making. Not all women saw condoms as part of the ideal encounter at baseline whether they discussed this spontaneously or when probed.
These actions are partly shaped by unequal economic and social status, which have been found to put women at a distinct disadvantage in terms of negotiating safer sex Exner et al. Here, several women also mentioned male resistance to condom use, and described an ideal scenario as one where men did not resist. Among both the experimental and control arms, also showed that trial participants shifted from a late condom introduction right before intercourse toward much earlier mention of condoms e.
Finally, since this was a small qualitative study, it was not powered to quantitatively discern whether there were statistically ificant differences over time on script domains.
To calculate concordance, we drew upon a formula developed internally by our senior-level qualitative research methods consultants. Such consultations did not involve adding larger to the analysis, but involved refining more minor subcodes.
Sexual scripts are mutually shared conventions that guide individuals to interdependently carry out sexual scenarios. One year follow-up: Sexual initiation, sexual pacing, and sexual decision-making.
Once the full range of was established, the remaining interviews were double coded independently by the first and second authors. Coders were masked to condition throughout the coding process. Project FIO was an HIV prevention intervention that sought to reduce sexual risks by combining social psychological and gender-specific strategies. Additionally, the one month or six month follow-up assessment points were not selected for the analysis given a central concern with the types of changes that participants maintained at the time point farthest from baseline.
As a result, strong emphasis has been placed on understanding and changing the contexts that shape risk in heterosexual relationships. From this initial process of broad category generation, an additional six randomly selected interviews were coded.
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Despite these recent approaches, empirical analysis of sexual scripts within HIV prevention trials remains scant Ortiz-Torres et al. At one year follow-up, there was some movement away from male-dominated and towards female-led sexual initiation and pacing, with changes occurring evenly in both the control and experimental arms. The control condition did not receive any of the intervention workshops, but did receive an in-depth two hour psychosocial assessment interview at baseline and one month, 6 month, and 12 month follow-ups.
However, if any new themes emerged during the coding process, these were only added in consultation with the research team.
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The largest group of women used gendered gatekeeping language to indicate that men would press the sexual pace and that women would then determine how far things would go in the encounter. Lastly, there is the intrapsychic realm, which is defined as the motivational elements that produce commitments to a particular sequence of events, including desires and fantasies. The goal of the current study was to examine whether and how changes in sexual scripts occurred for a randomly selected subgroup of women who participated in Project FIO and, if so, to assess if such changes were different for the experimental and control arms.
In six instances where follow-up data were not available for both baseline and one year follow-up time points, six new interviews were randomly selected, and transcription of interviews was carried out.
We made this methodological choice given our main interest in whether those exposed to the intervention arms differed from controls. In this qualitative study, we sought to examine whether changes in sexual scripts occurred across study arms and, if so, to assess if such changes were different across experimental and control arms, holding possible implications for safer sex practices. The fact that shifts in sexual scripts at one year follow-up occurred in both groups is likely reflective of the degree to which a lengthy assessment interview facilitated comfort with discussing and imagining new sexual behaviors, even for control group participants who did not receive the intervention.
In fact, many of these women spontaneously brought condoms up as part of the ideal encounter before they were even asked the specific question about condoms. The proceptive phase has been deemed vital in terms of defining the contextual features that surround sexual scenarios Beach, Specifically, we examined the domains of sexual initiation, sexual pacing, sexual decision-making, communication about sexual needs, and the timing of condom introductions at both baseline and one year follow-up.
Thus, overall, there was some shift in both the experimental and control arms from baseline to one year follow-up in the direction of moving from a traditional script of male sexual initiation to a more female-dominated one.
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Baseline: Communication about sexual needs, do condoms ruin sex? The next part of the interview is more like a conversation. In terms of communication about sexual needs, women were most likely to report at baseline that they used direct communication with male partners.
Few have empirically examined whether sexual scripts can be intervened upon and how scripts might change over time as part of the goals of a risk reduction trial. The mean age was Most women Approximately one third of the women The randomly selected subsample of women used in the current analysis also reflects the risk profile of the participants in the trial, which was a group of women who were at risk for HIV and other sexually transmitted diseases.
This risk occurs not only through gender-based power imbalances, but through larger cultural norms that encourage passivity in women during sexual initiation and decision-making, by encouraging women to place the centrality of male pleasure at the center of sexual scenarios at the expense of safer sex needs, and by encouraging women to leave condom initiation and use to men.