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Choosing Unsafe Sex

AIDS-Risk Denial Among Disadvantaged Women

By E. J. Sobo

Publication Year: 1995

Choosing Unsafe Sex focuses on the ways in which condom refusal and beliefs regarding HIV testing reflect women's hopes for their relationships and their desires to preserve status and self-esteem. Many of the inner-city women who participated in Dr. Sobo's research were seriously involved with one man, and they had heavy emotional and social investments in believing or maintaining that their partners were faithful to them.

Uninvolved women had similarly heavy investments in their abilities to identify or choose potential partners who were HIV-negative. Women did not see themselves as being at risk for HIV infection, and so they saw no need for condoms. But they did recommend that other women, whom they saw as quite likely to be involved with sexually unfaithful men, use them.

Published by: University of Pennsylvania Press

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pp. vii-x

In this book, I describe the findings from an anthropological study of the links between inner-city women's condom use rates and their experiences and understandings of heterosexual relationships. I also discuss findings from a smaller project on seropositivity self-disclosure among HIV-positive individuals. ...

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1. Introduction

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pp. 1-7

The popular and scientific media often describe people who are at risk for human immunodeficiency virus (HIV) infection but fail to use condoms as being "in denial." Unfortunately, most authors, clinicians, and health officials—indeed, most people—take the specifics of the denial process for granted. Denial has become a blanket term in the most literal...

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2. Women and AIDS in the United States

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pp. 8-24

As I write, the cumulative total number of reported AIDS cases in the United States hovers at about 400,000. By the end of 1993, about 61 percent of all individuals who had been diagnosed with AIDS since its biomedical identification were dead (CDC 1994a). AIDS is the third leading cause of death among U.S. men and women aged twenty-five to forty- ...

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3. AIDS Education and the Perception of Risk

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pp. 25-50

The research for this book grew out of the concern that Cleveland's Maternity and Infant Health Care Program (M&I) clinic clients were not heeding the M&I safer sex message. There was nothing unique about the relative failure of the M&I AIDS education mission, which focused on the dissemination of factual information. Most studies conclude that no sig- ...

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4. Seropositivity Self-Disclosure and Concealment

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pp. 51-62

People who have tested negative for HIV or who have not been tested at all often fear being lied to or manipulated by unethical seropositive individuals. This fear, in turn, affects risk-related behavior. Urban legends abound warning of beautiful HIV-positive charmers who enchant and then have unprotected sex with unsuspecting seronegative1 people in ...

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5. The Condom Use Project

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pp. 63-74

My original research mission involved investigating the low efficacy of AIDS education in Cleveland's M&I clinics in order to improve it. My main aims were to find out why most clients neglected to comply with the safer-sex guidelines provided, and to identify the factors distinguishing the non-users from the few who did use condoms.1...

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6. Romance and Finance

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pp. 75-105

The common assumption that impoverished women engage in unprotected sex because of financial coercion and a lack of empowerment pervades a great deal of both popular and academic thinking about lower-income minority women and AIDS (cf. Kline et al. 1992; for examples of models that give economics a prime role see Carovano 1991; De ...

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7. The Psychosocial Benefits of Unsafe Sex

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pp. 106-139

This chapter uses study findings to show that unsafe sex is part of a psychosocial strategy for maintaining one's status and sense of self—a strategy that involves telling patterned narratives (as regarding a partner's faithfulness) and acting out scripts (as by engaging in unsafe sex) that optimistically confirm the quality of one's choice of a partner and so ...

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8. HIV Testing and Wishful Thinking

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pp. 140-156

Condomless sex supports the Monogamy Narratives women tell about themselves and their relationships. A positive HIV test leads a woman to replace this narrative with another: as Martha Ward (1993b) shows, many HIV-positive women tell of broken trust and partners that must not have really loved them. I call this narrative the "Betrayal Narrative."1...

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9. Self-Disclosure Self-Described

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pp. 157-179

The need for safer sex practice does not end with a negative HIV test; neither does it end with a positive diagnosis. Indeed, safer sex is as imperative for HIV-positive individuals as it is for HIV-negative individuals, not only because the former might otherwise pass the virus on but also because they are at risk for reinfection and for infection with other kinds of ...

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10. Circumventing Denial

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pp. 180-196

Neither the Midwesterners that Chapters 5-8 were expressly concerned with nor the Southwesterners who spoke through Chapter 9 thought that AIDS would affect them. But denial alone cannot hold HIV and AIDS at bay; indeed, denial sometimes acts as a catalyst that enables HIV to spread because denial keeps people from acting to reduce their risk for...

Appendix A: Interviewee Profiles

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pp. 197-203

Appendix B: Further Quantitative Findings

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pp. 204-208


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pp. 209-226


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pp. 227-232

E-ISBN-13: 9780812200379
Print-ISBN-13: 9780812215533

Page Count: 256
Publication Year: 1995