Sexual Inequalities and Social Justice
281
Sexual Inequalities and Social Justice
281Paperback(First Edition)
-
SHIP THIS ITEMTemporarily Out of Stock Online
-
PICK UP IN STORE
Your local store may have stock of this item.
Available within 2 business hours
Related collections and offers
Overview
Product Details
| ISBN-13: | 9780520246157 |
|---|---|
| Publisher: | University of California Press |
| Publication date: | 12/05/2006 |
| Edition description: | First Edition |
| Pages: | 281 |
| Product dimensions: | 6.00(w) x 9.00(h) x 0.70(d) |
About the Author
Read an Excerpt
Sexual Inequalities and Social Justice
University of California Press
Copyright © 2007 The Regents of the University of CaliforniaAll right reserved.
ISBN: 978-0-520-24614-0
Chapter One
Childhood Sexual Abuse and HIV among Latino Gay Men The Price of Sexual Silence during the AIDS Epidemic SONYA GRANT ARREOLA
In the mid-1980s, I worked as the director of an AIDS-prevention program in Long Beach, California. This program provided education and counseling to gay men who were struggling to avoid HIV infection or coping with being infected with HIV. The program evolved to include workshops for Spanish-speaking gay men, and I quickly learned that simply translating into Spanish the workshops designed for English-speaking gay men was woefully insufficient. Although the gay men who attended the clinic had much in common, it became clear that the differences between Latino gay men and non-Latino gay men went beyond the complexities of managing issues of discrimination, immigration, and language. Being Latino in a culture that did not value what they loved most about themselves led to feelings of invisibility. Over the years I was there, these men repeatedly tried to reveal themselves to me, hoping, and sometimes explicitly stating their wish, that I be able to capture their experiences and somehow give them voice.
Many years later, I still think of these young men fighting to be heard and wanting to make a difference for futuregenerations. Among many of the stories they would share, their accounts of sexual initiation were particularly salient and seemed to be inextricably linked to their adult sexual experiences. Many related experiences of forced sex in childhood that sounded more severe, longer in duration, and more buried in secrecy than those I would hear from the men in the English-speaking groups. At that time, I was unable to make sense of what I was witnessing. Since then, I have learned of the dramatic influence childhood sexual abuse has on later risky sexual behaviors that are related to risk for HIV infection, and I have begun a research agenda that asks why and how it is that early childhood sexual experiences (especially abusive ones) have such a strong effect on later sexual risk-taking behaviors among Latino gay men. Most important, I recognized the central role of the subjective experiences of those whose lives we intend to interpret.
In the summer of 2001, after researching what little was known about childhood sexual abuse among Latino gay men, I had the privilege of interviewing Latino gay men who were eager to influence the discourse about the sexuality of Latino gay men generally, and childhood sexual abuse specifically. In this essay I will present some of what I have learned about Latino gay men, childhood sexual abuse, and HIV, drawing from the existing literature, my own quantitative research, and the voices of Latino gay men themselves. I will begin by presenting some of the epidemiology of HIV infection among Latino gay men, as it is precisely the disproportionate representation of Latino gay men among those infected with HIV in the United States that has, among other issues, motivated me to focus on this vulnerable population.
Risk for HIV among Latino Gay Men in the United States
Latino gay men comprise one of the most vulnerable groups in the United States for transmission of HIV. Latino gay men have higher prevalence and incidence rates of HIV and are twice as likely to be infected with HIV as white gay men (Valleroy et al. 2000; Centers for Disease Control and Prevention 2001a). Further, Latino men who have sex with men have accounted for an increasing proportion of AIDS cases and have had smaller proportionate declines in AIDS incidence and deaths (Valleroy et al. 2000; Centers for Disease Control and Prevention 2001a). Even as high as these estimates are, the reported prevalence and incidence of HIV infection and AIDS among Latino gay/bisexual men probably underestimate the actual prevalence and incidence, owing to low rates of testing among ethnic minorities who engage in high-risk behaviors. Thirty-five percent of Latinos with perceived HIV risk or reported HIV risk behavior report never having been tested for HIV infection (Centers for Disease Control and Prevention 2001b). Nonetheless, the high rate of infection is consistent with the finding that Latino men report the highest rates of unprotected anal intercourse, compared to men from other ethnic minority groups (Díaz 1998).
More than 50 percent of Latino gay men report having had unprotected anal sex within a year of being asked, in spite of substantial knowledge about HIV, accurate perceptions of personal risk, and strong intentions to practice safer sex (Díaz 1998). These findings indicate that knowledge and the intention to practice safer sex may not be sufficient causes for the actual practice of safer sex. As a result of the qualitative interviews I conducted with Latino gay men, I would suggest that a history of childhood sexual abuse alters boys' cognitive and emotional orientation to the world, thereby inhibiting their ability to integrate their intentions to practice safer sex with their actual behavior. In particular, I believe the silence around sex generally, and around sexual desire for men and childhood sexual abuse specifically, all contribute to impeding integration of intention with actual behavior. In the following sections, I will present quantitative and qualitative findings that illustrate the enormous cost of silence concerning sex, especially childhood sexual abuse, to the well-being of Latino gay men. First I will explain why this question is so important: because of overwhelming evidence of a link between childhood sexual abuse and risk for HIV infection.
Childhood Sexual Abuse and Risk for HIV Infection
There is compelling evidence that a history of childhood sexual abuse increases the likelihood of both psychological (e.g., depression, post-traumatic stress disorder) and biomedical (e.g., sexually transmitted infections) outcomes. One of the most robust findings is the link between childhood sexual abuse and HIV infection (Jinich et al. 1998; Paul et al. 2001). One explanation for this link is that men who have histories of childhood sexual abuse are more likely to engage in unprotected anal intercourse and to be infected with HIV (Jinich et al. 1998; Paul et al. 2001).
Compared to non-gay/bisexual men, the prevalence of childhood sexual abuse is higher among gay/bisexual men based on research comparing homosexual to heterosexual samples, as well as comparing sexual orientation in abused and nonabused samples (Cameron et al. 1986; Cunningham et al. 1994; Johnson and Shrier 1985). As high as the prevalence is among gay/bisexual men, it is even higher among Latino gay/bisexual men. Latino gay/bisexual men are twice as likely to have experienced childhood sexual abuse as non-Latino gay/bisexual men (Jinich et al. 1998; Arreola et al. In press). Not only is there a higher prevalence of childhood sexual abuse among Latino gay/bisexual men compared to non-Latino gay/bisexual men, the abuse is generally more severe among Latino boys: compared to African American boys, Latino boys are more likely to have been sexually abused by an extended family member such as a cousin or uncle, to have experienced more genital fondling, to have been exposed to more sexually abusive behaviors, and to have experienced more anal abuse (Moisan, Sanders-Phillips, and Moisan 1997; Lindholm and Willey 1986).
What struck me most about these findings is how they highlight some of the measurable costs of childhood sexual abuse (HIV infection, in this case) and make clear that Latino gay men are particularly vulnerable. However, they fail to explain how childhood sexual abuse may contribute to an increased likelihood of engaging in behaviors that lead to risk for HIV infection. Additionally, as I tried to understand these issues, I realized that researchers' assumptions varied regarding what constitutes childhood sexual abuse, and in some cases, researchers based their criteria for childhood sexual abuse on personal or political agendas.
Definitions of Childhood Sexual Abuse
Although researchers attempting to define childhood sexual abuse all struggle with the cut-off age that distinguishes childhood from adulthood, generally ranging from thirteen to eighteen, definitions tend to fall into three conceptual categories. The first category emphasizes age differences between the child and the perpetrator of the abuse, usually of five or more years, noting that this age difference creates a power differential that presumably constitutes an abusive relationship. The second category focuses primarily on the subjective experience or self-report of a coercive or forced sexual episode. This may include specific descriptions of the actions of the perpetrator that would constitute pressure or force. Finally, the third and most restrictive category combines both the age differential and the subjective report of the respondent. For example, an individual would be considered to have experienced childhood sexual abuse if he or she reported having had sex, which he or she considered to be forced, before age sixteen, with someone five or more years older.
As a result of varying definitions or operationalizations of childhood sexual abuse in the literature, research findings attempting to document the effects of childhood sexual abuse in childhood also vary in their ability to capture the outcomes under investigation. Nevertheless, the finding that childhood sexual abuse increases risk for HIV-related outcomes is consistent regardless of how childhood sexual abuse is defined, though strongest when the most restricted definition is applied. My own research suggests that it is important to take into account the subjective experience of sexual encounters as well as age differential if we are to understand the mechanisms that explain the link between childhood sexual abuse and risk for HIV infection.
Childhood Sexual Abuse and Risky Sexual Situations When I performed preliminary quantitative analyses of a large representative sample of self-identified Latino gay men along a series of sexual-risk outcomes, I found no differences between Latino gay men who reported no sex before age sixteen and those who reported sex that was not against their will before age sixteen with someone five or more years older. These findings indicate how important it is to understand the subjective experiences of those whose lives we intend to interpret. It has been assumed that sex in childhood or adolescence with someone older is necessarily abusive, based on the implied power differential between the younger and older person. However, these data show that men's interpretation of early sexual experiences as voluntary predict outcomes that are similar to the outcomes for those who do not initiate sex until much later. In other words, those who initiate sex voluntarily before age sixteen, even if the partner is much older, are at no greater risk for HIV infection than those who do not initiate sex until much later.
I did, however, find significant differences between those reporting having had sex before age sixteen with someone five or more years older when it was against their will and those who had either no or voluntary sex before age sixteen. Specifically, compared to those who had no sex before age sixteen and those who had voluntary sex before age sixteen, those who reported nonvoluntary sex before age sixteen were significantly more likely to report sexual situations involving: (1) drug and or alcohol use, (2) an escape from loneliness or depression, (3) a nonmonogamous partner, and (4) difficulty maintaining an erection. Notably, there is a strong relationship between these risky sexual situations and actual sexual risk-taking behavior such as unprotected penetrative anal sex with someone whose HIV serostatus is unknown.
The findings that (1) sexual risk outcomes among Latino gay men who had voluntary sex before age sixteen are indistinguishable from those who had no sex before age sixteen, but (2) those who had nonvoluntary sex before age sixteen had riskier sexual profiles than the first two groups have political implications that go beyond the health implications mentioned earlier. They indicate that careful attention must be paid to the definition of childhood sexual abuse if we are to: (1) avoid betraying children abused in childhood by ignoring the abusive behavior and its effects, as well as (2) refrain from blindly labeling all juvenile sex as abusive and potentially providing ammunition for discrimination based on sexual orientation or ethnicity. I would argue that definitions of childhood sexual abuse must be specific and restrictive to include criteria based on actual subjective and objective empirical data.
The link between nonvoluntary or forced sex before age sixteen and later sexual risk profiles also led me to wonder what it was about these early childhood sexual abuse experiences that led to risk for HIV infection. The data are important, as they point to some of the situational risks that help explain the link between childhood sexual abuse and risk for HIV infection. However, they did not capture the subjective experiences of the men whose lives I wanted to understand.
The Latino Gay Men's Sexuality Study
After learning as much as I could from the existing literature and conducting some of my own preliminary analyses, I realized that I knew only other researchers' theories regarding the link between childhood sexual abuse and HIV, and that in my own investigations I asked questions using these same assumptions. I did not have any sense of how Latino gay men experienced childhood sexual abuse or how and whether they felt it was related to their current sexual lives. In the summer of 2001, I had the privilege of interviewing thirty self-identified Latino gay men living in the San Francisco Bay Area in two-hour-long individual in-depth interviews. The men were invited to participate in a study on Latino men's sexuality, and they were recruited from gay venues such as clubs, bars, social gatherings, and groups in the San Francisco Bay Area. I had thought that I would have to oversample for childhood sexual abuse in order to get a sufficient number of interviews with men who had experienced childhood sexual abuse. However, I accepted the first thirty men who met the criteria for the study, including: (1) age between twenty and forty, (2) self-identified as nonheterosexual, and (3) Latino or Hispanic. I was surprised to find that these first thirty men fell into three categories in thirds: Those who had had no sex before age sixteen; those who had had sex before age sixteen that they described as having been volitional; and those who had had sex before age sixteen that was forced. Their stories were consistent with the quantitative findings reported earlier, in that the first two groups described similar narratives regarding their adult sexuality, whereas the third group (those who reported forced sex before age sixteen) reported the most difficulty negotiating their adult sexual lives. I was struck by how often the men explained that they rarely or never talked about some aspect of their sexual development or the concerns they had about it with anyone. I was intrigued by their theories of how this silence influenced their adult sexual lives.
SEXUAL SILENCE
All the men described some degree of silence about sex generally when growing up, and about gay sex particularly. Some men were able to articulate how this affected the way they approached sex as adults. For example, Juan, who had never been forced to have sex, explained that the silence around what it meant to love or have sex with another man led to his initiating sex with a young man his age (twelve years old) with the conviction that it was dirty and bad. He contrasted this with how proud he thought his father would have been if he had initiated sex with a girl. Juan tried to explain how this affected his adult sexual life: "The idea of keeping it a secret and feelings of guilt and shame around it are still really present when I start having sex as an adult." Juan went on to describe how he "never talked to anybody about it [sex] and it's something that I did in secret." This resulted in his sexuality becoming "kind of separate from my-my sexuality with men was separate from how-my individuality. It was like another persona."
(Continues...)
Excerpted from Sexual Inequalities and Social Justice Copyright © 2007 by The Regents of the University of California. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
ForewordAcknowledgments
Introduction: The Analysis of Sexual Inequality
NIELS TEUNIS AND GILBERT HERDT
Part One: Sexual Coercion and Sexual Stigma
1. Childhood Sexual Abuse and HIV among Latino Gay Men: The Price of Sexual Silence during the AIDS Epidemic
SONYA GRANT ARREOLA
2. In Our Own Backyard: HIV/AIDS Stigmatization in the Latino Gay Community
RAFAEL M. DÍAZ
3. Knowing Girls: Gender and Learning in School-Based Sexuality Education
JESSICA FIELDS
4. Sexual Enslavement and Reproductive Health: Narratives of Han among Korean Comfort Women Survivors
CHUNGHEE SARAH SOH
Part Two: Seeking Sexual Pleasure
5. Where Does Oppression End and Pleasure Begin? Confronting Sexual and Gender Inequality in HIV Prevention Work
HÉCTOR CARRILLO
6. Circuit Culture: Ethnographic Reflections on Inequality, Sexuality, and Life on the Gay Party Circuit
CHRISTOPHER CARRINGTON
7. Confesiones de Mujer: The Catholic Church and Sacred Morality in the Sex Lives of Mexican Immigrant Women
GLORIA GONZÁLEZ-LÓPEZ
8. Disability and Sexuality: Toward a Constructionist Focus on Access and the Inclusion of Disabled People in the Sexual Rights Movement
RUSSELL P. SHUTTLEWORTH
Part Three: Sexual Inequality and Sociality
9. The Family-Friends of Older Gay Men and Lesbians
BRIAN DE VRIES AND PATRICK HOCTEL
10. Sexual Inequality, Youth Empowerment, and the GSA: A Community Study in California
GILBERT HERDT, STEPHEN T. RUSSELL, JEFFREY SWEAT, AND MICHELLE MARZULLO
Contributors
Index