Papers by Jennifer S Hirsch
State and Local Policies as a Structural and Modifiable Determinant of HIV Vulnerability Among Latino Migrants in the United States
American Journal of Public Health, 2016
We explore how state and local policies in labor, health, education, language, community and neig... more We explore how state and local policies in labor, health, education, language, community and neighborhood environments, deportation, and state-authorized identification can reduce or exacerbate HIV vulnerability among Latino migrants in the United States. We reviewed literature on Latino migrants and HIV risk, on the structural–environmental contexts experienced by Latino migrants, and on the many domains in which policies influence those contexts. To illustrate the pathways through which policies across multiple sectors are relevant to HIV vulnerability, we describe how policies shape 2 mediating domains (a climate of hostility toward Latino migrants and the relative ease or difficulty of access to beneficial institutions) and how those domains influence behavioral risk practices, which increase vulnerability to HIV. This argument demonstrates the utility of considering the policy context as a modifiable element of the meso-level through which structural factors shape vulnerability...
A Courtship after Marriage: Sexuality and Love in Mexican Transnational Families
American Anthropologist, 2005
... Gillian Feeley-Harnik and Peggy Bentley also provided valuable input at various stages of thi... more ... Gillian Feeley-Harnik and Peggy Bentley also provided valuable input at various stages of this project, as did Ken Hill, Sidney Mintz ... Har-rington, formerly of Mercy Mobile Health Care, and others at MMHC, and Father Carlos García Carreras and María de Jesus Castro at the ...
‘No one saw us’: reputation as an axis of sexual identity 1
Understanding Global Sexualities, 2016
“Sex is supposed to be naturally more pleasurable”: Healers as providers of holistic sexual and reproductive healthcare in Uganda
Social Science & Medicine, 2022
Global health researchers often approach Traditional, Complementary, and Alternative Medicine (TC... more Global health researchers often approach Traditional, Complementary, and Alternative Medicine (TCAM) from a health efficacy perspective, asking whether the presence of plural medical systems helps or hinders the uptake of biomedicine. Medical anthropologists, by contrast, typically emphasize how plural medical systems encourage us to rethink health ontologies—that is, who and what comes to constitute the experience of health and illness, and through which practices. Building on both approaches, we explore the role of “healers,” a term we use to encompass several different kinds of TCAM providers, in the sexual and reproductive healthcare (SRH) of young people from southcentral Uganda, a region well known as an HIV/AIDS epicenter. Drawing from ethnographic data, we describe three reasons that young people seek SRH from healers. First, they associate stigma, scarcity, and high costs with biomedical SRH. Second, healers work across biomedical and non-biomedical therapeutic divides, prescribing herbs for sexually transmitted infections while simultaneously referring clients to biomedical HIV clinics. Third, healers provide counseling focused on pleasurable and economically-motivated sex. Because these therapies diverge from international and national HIV prevention messaging that frames non-marital and transactional sex in terms of danger and disease, healers’ holistic approach to SRH may help to reconstitute the meaning, practice, and experience of “sexual health” in contemporary Uganda. This has important implications for improving global SRH programs and for understanding the continued appeal of TCAM more generally.
Sex Education: Broadening the Definition of Relevant Outcomes
Journal of Adolescent Health, 2021
Repeat sexual victimization during college: Prevalence and psychosocial correlates
Psychology of Violence, 2020
International Journal of Sexual Health, 2020
Objectives: Research examining sex among college students has frequently focused on negative sexu... more Objectives: Research examining sex among college students has frequently focused on negative sexual experiences. This study aimed to understand situational predictors of various dimensions of students' sexual experiences. Methods: 427 college students participated in a 60-day daily survey; 213 reported sex and were asked questions about each sexual encounter. Results: 1,664 sexual encounters were reported. 72.5% were described as very pleasurable, 26.6% as lacking communication, and 9.1% as lacking control. Factors associated with pleasure, control, and communication included partner type and emotional closeness. Substance use and partner age were associated with outcomes differently by gender. Conclusions: Sexual health interventions for college students should focus on communication and pleasure.
Archives of Sexual Behavior, 2020
This article examined substance use and sexual behavior by conducting an analysis of college stud... more This article examined substance use and sexual behavior by conducting an analysis of college students' reported behaviors using a daily diary approach. By isolating particular sexual events across a 2-month period, we examined situational predictors of engagement in sex and of negative sexual experiences (coerced sex and/or sex that lacks perceived control) for college men and women. Data come from the daily diary sub-study of the Sexual Health Initiative to Foster Transformation. These data include 60 days of daily responses from 420 undergraduates at one New York City institution. This was a relatively diverse sample comprised of 49% women, 28% identifying as non-heterosexual, 60% non-white, and a roughly equal number of college freshman, sophomores, juniors, and seniors. Analyses examined the effects of alcohol use, binge drinking, marijuana use, and other drug use on sexual experiences. Between-person and within-person substance uses were related to an increased likelihood of having at least one sexual encounter during the study period. After adjusting for each participants' average substance use, both the number of alcoholic drinks consumed (AOR 1.13 (1.05-1.21)) and binge drinking scores (AOR 2.04 (1.10-3.79)) increased the likelihood of negative sex. Interaction analyses showed that compared to men, women were more likely to use alcohol and marijuana prior to sexual encounters. Given that sex and substance use are co-occurring, current prevention approaches should be paired with strategies that attempt to prevent negative sexual experiences, including sexual assault, more directly. These include consent education, bystander training, augmentation of sexual refusal skills, and structural change. Efforts promoting increased sex positivity might also help make all students, and women in particular, less likely to use substances in order to facilitate sex.
Journal of Drug Issues, 2019
Undergraduate binge drinking, a well-documented problem at U.S. institutions of higher education,... more Undergraduate binge drinking, a well-documented problem at U.S. institutions of higher education, has been associated with a host of negative behavioral health outcomes. Scholars have extensively examined individual- and institutional-level risk factors for college binge drinking. However, these data have not been effectively translated into binge-drinking interventions. To inform the development of additional evidence-based prevention programs, this article documents the varied social practices that constitute “binge drinking,” drawing on primarily ethnographic data. By disaggregating what survey research has largely examined as a unified outcome, we offer a descriptive account of the different reasons for and contexts in which students consume alcohol in amounts that constitute binge drinking. Our discussion points to modifiable social factors in university life as strategy for prevention. The implication of our argument is that acknowledging and responding to the varied motivatio...
The Advisory Board Perspective from a Campus Community-Based Participatory Research Project on Sexual Violence
Progress in Community Health Partnerships: Research, Education, and Action, 2019
Abstract:Background: This article presents the experience of one community-based participatory re... more Abstract:Background: This article presents the experience of one community-based participatory research (CBPR) board and moves board feedback beyond its dialogue with affiliated researchers, expanding the conversations to the broad research community.Methods: The board member authors of this article were part of the Sexual Health Initiative to Foster Transformation (SHIFT), which had some of the highest subject participation rates within the literature on college sexual assault—84% in a daily diary study (N = 427) and 67% in a survey of 2,500 randomly selected students—and enjoyed an overall positive sentiment.Results and Conclusions: Based on the experience of board members this article outlines four recommendations for the construction of CBPR studies: meeting frequently, co-education of board members and researchers, addressing power and privilege, and prioritizing highly valued participation, with mutual respect for and recognition of distinct roles and expertise.
New England Journal of Medicine, 2019
Journal of Adolescent Health, 2018
Nonconsensual sexual experiences on college campuses represent a serious public health problem. T... more Nonconsensual sexual experiences on college campuses represent a serious public health problem. The preponderance of existing research on students' actual consent practices is quantitative, lab based, or focused on how single dimensions of social context shape consent practices. Filling those gaps and illustrating ethnography's potential to lay the groundwork for innovative prevention, this paper draws on research conducted with undergraduates on two interconnected campuses to examine multiple social dimensions of sexual consent practices. Methods: Data include in-depth interviews with over 150 students, 16 months of participant observation, 17 focus groups, and key informant interviews. Research conducted for this study took place between September 2015 and January 2017 at Columbia University and Barnard College. Results: Although sexual consent is often approached as an individual or interpersonal practice, this research highlights potentially modifiable social dimensions of consent. These seven dimensions of sexual consent practices are as follows: (1) gendered heterosexual scripts; (2) sexual citizenship; (3) intersectionality; (4) men's fear of "doing" consent wrong; (5) "drunk sex"; (6) peer groups; and (7) spatial/ temporal factors shaping when consent is assumed. Conclusions: Effective promotion of consensual sex, as a strategy to prevent assault, will likely require understanding and modifying the social structures that shape consent practices, rather than just legislation that mandates the promotion of affirmative consent. We describe seven potential modifiable social contextual dimensions of consent practices, along with related strategies to promote consensual sex and prevent sexual assault.
Global public health, Jan 7, 2018
Sexual assault is a part of many students' experiences in higher education. In U.S. universit... more Sexual assault is a part of many students' experiences in higher education. In U.S. universities, one in four women and one in ten men report being sexually assaulted before graduation. Bystander training programmes have been shown to modestly reduce campus sexual assault. Like all public health interventions, however, they have unintended social consequences; this research examines how undergraduate men on one campus understand bystander interventions and how those understandings shape their actual practices. We draw on ethnographic data collected between August 2015 and January 2017 at Columbia University and Barnard College. Our findings show that university training and an earnest desire to be responsible lead many men to intervene in possible sexual assaults. However, students' gendered methods target more socially vulnerable and socially distant men while protecting popular men and those to whom they are socially connected. Students' actual bystander practices thus...
Long-Term Health Correlates of liming of Sexual Debut : Results From a National US Study
American Journal of Public Health, 2008
A public health approach to campus sexual assault prevention
Introducing the New Sexuality Studies
A Qualitative Analysis of Intermittent Contraceptive Use And Unintended Pregnancy
CONTEXT: Although pregnancy ambivalence is consistently associated with poorer contraceptive use,... more CONTEXT: Although pregnancy ambivalence is consistently associated with poorer contraceptive use, little is known about the sexual, social and emotional dynamics at work in pregnancy ambivalence. METHODS: During in-depth sexual and reproductive history interviews conducted in 2003, 36 women and men were asked about the relational and emotional circumstances surrounding each pregnancy, as well as their thoughts about conceiving a babywith both current and previous partners. An ethnographic, inductive approachwas used to analyze the data. RESULTS: Half of respondents had experienced at least one unintended pregnancy. Respondents described three categories of pleasure related to pregnancy ambivalence: active eroticization of risk, in which pregnancy fantasies heightened the charge of the sexual encounter; passive romanticization of pregnancy, in which people neither actively sought nor prevented conception; andanescapist pleasure in imagining that apregnancywould sweeponeaway from hard...
Best, Worst, and Good Enough
Comparing Cultures, 2020
Culture, Health & Sexuality, 2021
This study explored how leaders of Black churches active in the fight against HIV conceptualised ... more This study explored how leaders of Black churches active in the fight against HIV conceptualised sex and sexuality when describing HIV interventions within their institutions. We analysed interviews with pastors and identified three frames through which leaders understood and communicated about sex and sexuality: (1) an evasive frame, in which participants avoided discussing behaviours and populations that have historically been disparaged within the church by emphasising involuntary risk exposure; (2) an agentic frame, which recognised sexual behaviour that differed from heteronormative conduct; and, (3) a pluralist frame, which allowed individuals to maintain their own beliefs about appropriate sexual conduct. Participants used frames to engage in a range of HIV interventions while upholding stigmatising beliefs about sexual behaviour and identity.
6. “En el Norte la Mujer Manda” (In the North, the Woman Gives the Orders): How Migration Changes Marriage
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Papers by Jennifer S Hirsch