Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0507, USA.
Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0507, USA.
Drug Alcohol Depend. 2021 Apr 1;221:108566. doi: 10.1016/j.drugalcdep.2021.108566. Epub 2021 Feb 3.
This study examined the associations between feminine gender ideologies (i.e., socially constructed attitudes and beliefs of women's appropriate behavior and roles) and the syndemic comorbidities of harmful alcohol use, sexual violence, and sexually transmitted infections (STI), which disproportionately affect Black women.
Black women, aged 18-44 (n = 305) were recruited from STI clinics in Baltimore, MD into a retrospective cohort study. A survey assessed feminine gender ideologies using a measure of hyperfemininity and sexual hyperfemininity (subscale of sexual domains), harmful drinking (AUDIT), lifetime STI (Y/N and count), and syndemic burden (no burden [0-1 morbidity] and syndemic burden [2-3 comorbidities]). Multivariable regression models identified correlates of harmful drinking, STI, and syndemic burden. The analytic sample included (n = 231) women with complete data.
Nearly half of our sample reported high hyperfemininity and high sexual hyperfemininity, 23% reported harmful drinking, 39% experienced sexual violence as an adult, and 74% reported a lifetime STI. High sexual hyperfemininity (Adjusted Odds Ratio [AOR] = 1.94, 95% Confidence Interval [CI]: 1.00-3.76) and sexual violence (AOR = 2.82, 95%CI: 1.43-5.58) were associated with greater odds of harmful drinking. Experiencing sexual violence in adulthood was associated with an increased count of lifetime STIs (Adjusted Incidence Rate Ratio [AIRR] = 1.33, 95%CI: 1.06-1.68). Syndemic burden affected 41% of our sample. High sexual hyperfemininity was associated with experiencing syndemic burden in unadjusted models (OR = 1.98, 95%CI: 1.16-3.37), but was not significant after controlling for confounders.
Interventions to reduce harmful drinking and STIs among Black women in the U.S. should address sexual gender ideologies and sexual violence.
本研究探讨了女性性别意识形态（即女性行为和角色的社会建构态度和信念）与有害酒精使用、性暴力和性传播感染（STI）的综合征共病之间的关联，这些问题不成比例地影响到黑人女性。
从马里兰州巴尔的摩的性传播感染诊所招募了年龄在 18-44 岁之间的黑人女性（n=305），参与回顾性队列研究。一项调查使用过度女性化和性过度女性化（性领域的子量表）、有害饮酒（AUDIT）、终身性传播感染（是/否和数量）和综合征负担（无负担[0-1 发病率]和综合征负担[2-3 合并症]）来评估女性性别意识形态。多变量回归模型确定了有害饮酒、性传播感染和综合征负担的相关因素。分析样本包括（n=231）具有完整数据的女性。
我们的样本中近一半报告了高度的过度女性化和高度的性过度女性化，23%报告了有害饮酒，39%的人在成年后经历过性暴力，74%的人报告了终身性传播感染。高度的性过度女性化（调整后的优势比 [AOR] = 1.94，95%置信区间 [CI]：1.00-3.76）和性暴力（AOR = 2.82，95%CI：1.43-5.58）与更高的有害饮酒可能性相关。在成年后经历性暴力与终身性传播感染数量的增加相关（调整后的发病率比 [AIRR] = 1.33，95%CI：1.06-1.68）。综合征负担影响了我们样本的 41%。在未调整模型中，高度的性过度女性化与经历综合征负担有关（OR=1.98，95%CI：1.16-3.37），但在控制混杂因素后并不显著。
减少美国黑人女性中有害饮酒和性传播感染的干预措施应针对性别的社会意识形态和性暴力。
