Sexual safety and sexual security : broadening the sexual health discourse / Kamila A. Alexander.

Alexander, Kamila A.
xii, 186 p. : col. ill. ; 29 cm.
Local subjects:
Penn dissertations -- Nursing.
Nursing -- Penn dissertations.
Sexual health scientists narrowly conceptualize sexual safety as cognitive negotiations of biological risk. Risk-based frameworks, therefore, often provide a one-dimensional understanding of sexual phenomena and unintended health consequences. Assumptions that individuals interpret sexual experiences and make behavioral decisions using systematic, rational mechanisms downplay the affective processes that drive sexual activity. Little is known about the varied ways individuals manage sexual safety while experiencing emotions such as affection, loneliness, trust, or disappointment. Women, especially Black emerging adult women (BEAW) ages 18–25 experience vulnerabilities to unintended sexual health outcomes such as HIV, sexually transmitted infections, and unintended pregnancies. Integrating affective processes within current frameworks provides greater visibility for BEAW's sexual health needs. Informed by feminist and interactionist theories, I describe and interpret meanings of sexual safety from the perspectives of BEAW involved in primary sexual relationships with men. Using beauty salons as recruitment sites, I conducted in-depth, semi-structured interviews and performed thematic and structural narrative analyses. Sexual security, distinct from sexual safety, emerged as a foundational narrative underpinning participants' sexual health. Sexual safety described behaviors that preserved emotional as well as physical well-being. Whereas, sexual security represented the patterned states of emotional well-being and resilience to diverse relationship experiences. I identified the following themes describing sexual safety: 1) Learning about and developing the authentic self, 2) Setting rules, and 3) Negotiating emotional vulnerabilities. Typologies of sexual security emerged from the structural narrative analysis, resembling movements of: 1) a Roller coaster; 2) a Springboard, or 3) a Revolving door. Emotionally-motivated sexual safety behaviors were central to participants' stories, demonstrating shifts between states of sexual security and insecurity. Descriptions of sexual safety and sexual security illuminate the varied ways young women negotiate sexual relationships. The scope of what are considered sexual safety and risk behaviors were individualized and dynamic, and therefore must be broadened. Further, sexual health scientists should infuse concepts of emotional well-being into interventions that capitalize on young women's active participation in achieving optimal sexual health.
Adviser: Loretta S. Jemmott.
Thesis (Ph.D. in Nursing) -- University of Pennsylvania, 2012.
Includes bibliographical references.
Jemmott, Loretta S., advisor.
D'Antonio, Patricia committee member.
Teitelman, Anne M. committee member.
University of Pennsylvania. Nursing.
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