Academic journal article The Canadian Journal of Human Sexuality

Discussing Sexual Health with a Partner: A Qualitative Study with Young Women

Academic journal article The Canadian Journal of Human Sexuality

Discussing Sexual Health with a Partner: A Qualitative Study with Young Women

Article excerpt

ABSTRACT: Twenty-two female, heterosexual, undergraduate students were interviewed about the health protective sexual communication (HPSC) that did or did not occur with their most recent sexual partner prior to first intercourse. The narratives derived from this qualitative study provided insight into the content and extent of HPSC occurring prior to intercourse, the perceived barriers and facilitators to HPSC, and to the strategies used to initiate such discussions. The analysis of the narratives resulted in the development of ten themes that appeared to encompass the various influences on this communication process. The findings revealed that typically, very little (if any) HPSC occurred prior to first intercourse, that there were numerous perceived barriers to this communication process, and that most of the participants did not have the communication skills necessary to initiate such discussion.

Key words: Sexual communication Condom use ST1 STD

INTRODUCTION

Health protective sexual communication (HPSC) refers to communication content that includes discussion about sexually transmitted infections (STIs), human immunodeficiency virus (HIV) and birth control (Catania, Binson, Dolcini, Moskowitz & van der Straten, 2001). In an instructive discussion of the behavioural epidemiology of HIV/STIs, Catania et al. (2001) identified several reasons for the importance of HPSC:

(1) HPSC may facilitate the translation of shared intention into action (e.g. mutual intention to use condoms);

(2) HPSC may act as a reminder of HIV and influence the saliency of safer sex concerns over other sexual desires;

(3) HPSC may have a persuasive function, for example, by changing the mind of an unmotivated person;

(4) HPSC may, in fact, reduce uncertainties regarding safer sex behaviour, and increase social support by allowing an expression of support, perhaps even encouragement, for safer sex and;

(5) HPSC may reinforce subjective norms about condom use which, in turn, facilitates the enactment of the behaviour (p. 25).

Some may argue that as long as individuals are using condoms there is very little utility in HPSC. This belief is challenged when we recognize that although there are enormous health benefits associated with condom usage, there are also two well-established limitations. These are: user failure (non-usage, incorrect usage, breakage, slippage) (Lindberg, Sonenstein, Ku, & Levine, 1997), and method (condom) failure (Davis & Weller, 1999). Taking the widely documented inconsistency in the use of condoms (Civic, 2000) together with the current rates of (HIV), STIs and unwanted pregnancies among heterosexual young adults (Dryburgh, 2000; Health Canada 1999a, 1999b, 2001), these data indicate that there are important reasons to talk about sexual health issues with a new partner.

It is important to note that these discussions do not ensure that people will be honest about their STI history, especially if they are (or have been) infected. Pliskin (1997) found that among her sample of adults infected with genital herpes, 49% reported never discussing STDs with a potential partner. For this particular sample, this lack of communication could have put them at risk for contracting another STD or transmitting herpes to their partner. In addition, Payn, Tanfer, Billy and Grady (1997) found that 25% of the 466 participants in their study (all of whom had had an STI) reported having sex while infected. The importance of HPSC, however, is illustrated by the fact that 85% of the men in Payn et al.'s study (who were aware that they had an STI) did report informing their partner prior to intercourse. Although having health-related discussions with a potential partner is not a guarantee that you will receive accurate information, the likelihood of being able to make more informed decisions does increase. …

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