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Another barrier?: the effect of sociocultural ideas of sexuality on adolescent sexual practices in Jamaica » Family Planning

Another barrier?: the effect of sociocultural ideas of sexuality on adolescent sexual practices in Jamaica

November 14th, 2008 by jliebner@stanford.edu Leave a reply »

Last week I talked about some of the barriers adolescent girls face when obtaining contraception.  Conservative ideas about the age of sexual activity appeared to discourage sexual health providers from giving contraception to young girls, while they were willing to provide contraception to boys of the same age.  This week, I would like to examine this gender disparity in greater detail.  How do sociocultural ideas of gender and sexuality affect adolescent sexual practices in Jamaica?

Part of the disparity, seen in many cultures, is that sexual prowess is viewed differently for men and women. In a study conducted in a rural parish in Jamaica among 15-18 year olds, participants were interviewed about the attitudes they believed affected their decisions to engage in sexual activities.  For men, early sexual onset is seen as sign of manhood, multiple partners as admirable, a sign of virility.  It appears that sex is an important element of masculinity, associated with feelings of dominancy and achievement.  Sex is an expression of masculinity not just in terms of coming of age, but in proving that a man is not homosexual.  Homosexuality appears to be a hypersensitive topic among adolescents: failure to make advances when expected to is perceived as an indication of queerness.

For women, however, early sexual behavior is viewed diametrically differently – early sexual activity is a sign of promiscuity and seeking contraception is only a manifestation and a way of enabling this behavior, something shunned by parents and elders.  Girls report feeling more constrained sexually that their males peers, yet they face conflicting societal pressures.  They are praised by society for practicing abstinence, yet they are pressured by their male peers to have sex in order to prove their love, because among Jamaican adolescents, sex is perceived as an important way to demonstrate love in a relationship.  Yet, unlike boys, when girls have sex with someone they are not in a relationship, they are not praised for this behavior with, but rather considered licentious.  Females appear to face a double standard in this respect.

Abstinence, although advocated, appears unrealistic due to negative social perception, because for adolescents, sexual activities are tied to sexual identity.  For men, to refuse or refrain from having sex is an indication of homosexuality.  Girls reported that their reasons for staying abstinent were the fear of pregnancy, moral/religious beliefs, risk of contracting STIs and for preserving their reputation.  However, the prevalence of abstinence is low.  While some girls (and most males) reported that they felt most males would respect a girl’s decision to remain abstinent, girls reported that sex is difficult to refuse because it was difficult to say no, because according to some, they feared they would lose their partner.

This result appears troubling.  Women report that it is difficult to say no to sex, while men consider themselves “pushy,” but in the end “cooperative” towards their partners’ sexual decisions.  What strikes me is that women appear to have more power than they realize and that men are not being proactive.  It appears that men are receptive towards their partners’ sexual concerns (abstinence and contraception use) but will not take initiative unless their partners actively advocate for it, which the women don’t appear to be doing.  I guess its hopeful sign in one respect, that men are more respectful of women’s sexual concerns than commonly believed.  However, I feel that both women and men need to be more proactive (ie men offering to use a condom rather than waiting for their partner to request it or women to be more firm about their decisions not to have sex).  However, adolescents report that communication about these issues appears to be difficult.

Fear of sexually transmitted infections did not appear to be a deterrent to sexual behavior.  Knowledge and perceived vulnerability to sexual transmitted infections like HIV/AIDS in fact was low and often mistaken, and effected the perception of contraception use. Many thought that STIs are apparent based on outward appearance or behavior so it would be easy to avoid contracting.  However, rather recognizing that condom use is meant to prevent unwanted pregnancy or the possibility of disease transmission, males perceived that the request to wear a condom is an indication that their partner is infected or believed that he is infected, rather than a general safety precaution.  A major problem with this belief system, however, is that adolescents do not see themselves as vulnerable and are thus unlikely to adopt precautionary behavior.  These surprising results indicate that more education is needed to understand the risks of infections like HIV (when the average length of life after diagnosis is only 16 months) and the importance of contraception use to prevent transmission.

Peer pressure appears to be another facilitator of early sex, an influential source dependent upon the perceptions of the opposite sex (which always makes things tricky).  Boys are concerned with not appearing masculine enough and not worthy of associating with certain girls, because girls want someone with experience.  Yet girls feel like they cannot refuse sex, because their boyfriend will leave them for another girl who is more willing.  However, I think peers can be a good source of positive influence and should be a target population for contraception advocacy.  Peer opinion bears an incredible influence upon adolescent lifestyles and one study found that adolescents who felt their peers believed in using condoms were twice as likely to use condoms themselves during intercourse.  This avenue, including peer education, should be explored as a way of promoting health education and awareness of safe sexual practices, regarding both abstinence and contraception.  I think peers will have a greater impact on their peers than anyone else.

This study, and other like it, address influences on the decision to engage in sexual activity, but they do not address decision to use or not use contraception, or practice “safe sex”.  While I believe that understanding the social and cultural influences on sexual initiation is critical, I think these influences not only affect the decision to have sex, but the decisions to use contraception.  The rate of unwanted pregnancies (which seems to be the source of the problem here) is due unprotected sex, which is indeed a function of the decision to have sex, but also the decision to not use contraception.   And I think understanding this decision is what is really key.  One answer is lack of access to contraception (as we saw last week, girls are finding it hard to get contraception in some situations).

After reading a lot on adolescent sexual behavior, something crossed my mind. Can we define sex as being appropriate for an age group?  Is sex among early adolescents still a problem or is it only a problem because of sexually transmitted infections or unwanted pregnancies (because contraception use is low)?

D Smith, M Roofe, J Ehirl, S Campbell-Forrester, C Jolly, P Jolly. Sociocultural contexts of adolescent sexual behavior in rural Hanover, Jamaica. Journal of Adolescent Health (33) july 2003, 41-48.

SF Brown. Small successes, big ideas – Jamaica’s adolescent reproductive health focus. Population References Bureau, May 2003.

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2 comments

  1. mjromano says:

    I likd your discussion of power dynamics in sexual relationships. Regarding contraceptive use in adolescent sex, you mentioned that “women appear to have more power than they realize,” but can you call it power if forces prevent them from acting on it? Maybe it is more like the potential for power. And anyway, should men have to be asked to use contraception? I also liked your point that unwanted pregnancies depend on both initiating sex and not using contraception, and both of those areas deserve study. Providing a lot of contraceptives will not prevent all unwanted pregnancies unless the power dynamics that influence a woman’s decision to use those contraceptives are addressed. Thanks for a great blog!

  2. Maggie Chen says:

    I liked your questions at the end. I had some pretty strong reactions to them…
    For me, the answer is no, we can’t define sex as being appropriate for an age group, although we can generally say that sex is not appropriate for adolescent girls who have not reached reproductive maturity yet. I think that another question we need to add to the excellent ones you posed is how we can address sex that is not wanted, i.e. regardless of how old girls are when they have sex, how can we ensure that consent from both partners is given?

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