My main focus of interest in this dissertation is to evaluate the relationship between known risk factor for HIV and HIV testing behavior, with a particular interest in women. Utilizing data from the National Survey of Family Growth, I conduct both descriptive and logistic regression analysis to evaluate this relationship. In addition to examining this relationship for women overall, I also evaluate the differences between White and Minority women, and compare and contrast this relationship for men versus women. In this dissertation, I did find some evidence to indicate that women with factors that put them at risk for HIV are more likely to be tested than are women without risk, however the strength of this relationship differed across types of risk factors. Drug use was consistently stronger in predicting the likelihood of testing than were sexual risk factors, indicating a ?lag? in public health perception of risk due to heterosexual risk factors. I also found that African-American women had significantly higher prevalence of risk than did White women, although no difference was found in the relationship between risk and testing. Finally, sexual risk factors were a substantially stronger predictor of testing for men than it was for women. The findings reported in this dissertation have the potential for significant public health implications and indicate the need for further policies that target the populations identified in this research. While the evidence in this dissertation and elsewhere does suggest that these efforts have been successful for homosexual men and drug users, and marginally successful for women at risk due to heterosexual behavior, it is important that efforts that target women, especially African-American women, are increased.

Dissertation (Ph.D.)--University of Toledo, 2009. / "In partial fulfillment of the requirements for the degree of Doctor of Philosophy in Biomedical Sciences." Title from title page of PDF document. Bibliography: p. 128-144.

Thesis (Ph. D.)--University of Washington, 2003. / Vita. Includes bibliographical references (leaves 65-75).

Disputats, Universitetet i Oslo, 2005. / Sammendrag på engelsk. Delvis opptrykk av artikler.

This thesis investigates the understanding of health needs of women in rural Nepal using a participatory action research (PAR) framework. This framework was evaluated using a multiple case study design. The cases were women's groups being observed and researched by the researcher. The thesis is concerned with developing and evaluating the PAR methodology and is thus second order research i.e. it considers the process of researching research and the issue of multiple perspectives is an important feature. The justification of the use of a PAR framework is to be found in the forms of research that takes place 'with' people. The distinction between PAR methods and other qualitative methods is a philosophical one (Tolley and Bentley, 1996) between the roles played by the researcher and researched. The researcher "outsider" and participants "informants" are partners, sharing and learning together. The work is divided into two stages. The first is to determine the usefulness of the PAR framework in helping participants make assessments of their health needs, analyse their situation, develop strategies for solving problems themselves, and implement their own action plans. The second is to reflect on the research process itself, which allows for generation and testing of the methodology. This thesis has enhanced the contribution to the literature in this field. A development of the PAR framework emerged called the Health Analysis and Action Cycle (HAAC), via evaluating the PAR framework. The HAAC was found to be useful in allowing women's groups to assess their health needs, plan and take action to improve their health situation. For example, five of the six groups considered the importance of diarrhoea and developed strategies to reduce the incidence of diarrhoea in their communities. The sixth group's work centred on reducing the incidence of respiratory illness in their community. All the groups were able to assess, plan and implement projects to improve their environmental and hence health situation. The research stimulated collective action and empowerment of women participating in the research as it was the first time women had worked together to identify issues of diarrhoeal disease and respiratory illness and introduced preventative measures within their community. The HAAC approach, an additional innovation in this field, has relevance to the current theory and practice debate within the development sector. The model developed has possible implications for t~e concept of developing 'partnership' within the health and development sector and the development of emergent evaluation through developmental decision science.

Body-related envy is an understudied emotion that may be linked with adverse psychophysiological outcomes such as stress (Smith & Kim, 2007). The purpose of this study was to explore body-related envy and psychophysiological response of stress among young adult females. Participants (N = 47; Mage = 21.6 ± 1.8 yrs) completed a weeklong assessment of phenomenological body-related envy, trait body image constructs and an acute laboratory stress-induction task. Findings support the hypothesis that negative body image constructs predict experiences of body-related envy (R2 = 0.17 - 0.54), and that envy can be reliability assessed using phenomenological ratings. Body-related envy was a significant predictor of psychological appraisals of stress (R2 = 0.24 - 0.31), but the proposed associations with physiological stress were not supported. Considering the adverse health outcomes associated with envy (Smith, et al., 1999) and stress (Anderson, 1998), this study has important implications for women’s psychological and physical health.

Women with chronic vulvar pain report reduced sexual function in comparison to non-affected women, including decreased sexual arousal. Experimentally induced sexual arousal has been examined in women with and without chronic vulvar pain, with contradictory results: some studies have found that only subjective arousal is affected in women with versus without vulvar pain, while other research has suggested that only genital responsiveness is affected in women with pain. As a result of these inconsistent findings, the role of arousal mechanisms in the causation and maintenance of provoked vestibulodynia (PVD) remains unclear. Thirty women with (n = 15) and without PVD (n = 15) were recruited to examine the relationship among physiological and subjective arousal, pain sensitivity and psychological/sexual function. Laser Doppler imaging (LDI) directly measured blood flow to the external genitals in response to an erotic film, and pain sensitivity was assessed before and after imaging. The PVD group had significantly lower blood flow than the control group during the erotic film when baseline blood flow levels were controlled; there were, however, no group differences in ratings of subjective arousal during the erotic film. Vestibular pain thresholds were significantly lower in the PVD group before and after the erotic film compared to the control group. In contrast, pain intensity ratings were significantly higher pre-erotic film in the PVD group, but there was no group difference post-erotic film. Pain thresholds did not significantly change in either group following exposure to the erotic film. Lastly, the PVD group had significantly lower sexual and psychological function in comparison to the control group, and intercourse frequency and pain catastrophizing significantly predicted genital responsiveness in the PVD group. The results suggest that women with PVD show an attenuated physiological response to erotic stimuli in an experimental setting, in the absence of differences in subjective arousal. The findings thus support the role of arousal in the maintenance of PVD, potentially in interaction with other physical and psychological factors. The study also has implications for the assessment and treatment of PVD, whereby arousal processes should be explicitly and separately managed in women with this condition. / Thesis (Master, Psychology) -- Queen's University, 2009-09-10 12:17:44.952

Body-related envy is an understudied emotion that may be linked with adverse psychophysiological outcomes such as stress (Smith & Kim, 2007). The purpose of this study was to explore body-related envy and psychophysiological response of stress among young adult females. Participants (N = 47; Mage = 21.6 ± 1.8 yrs) completed a weeklong assessment of phenomenological body-related envy, trait body image constructs and an acute laboratory stress-induction task. Findings support the hypothesis that negative body image constructs predict experiences of body-related envy (R2 = 0.17 - 0.54), and that envy can be reliability assessed using phenomenological ratings. Body-related envy was a significant predictor of psychological appraisals of stress (R2 = 0.24 - 0.31), but the proposed associations with physiological stress were not supported. Considering the adverse health outcomes associated with envy (Smith, et al., 1999) and stress (Anderson, 1998), this study has important implications for women’s psychological and physical health.

The gym has the potential to be a valuable resource for adult physical activity. Yet, despite this, the gym environment remains a particularly underdeveloped area of study. Women’s gym experiences in particular is an area of research that needs a greater focus, as currently the literature tends to focus on women’s gym experiences in extreme or isolated contexts. Thus, this research sought to illuminate the female, gendered experience within a traditional, mixed gendered gym context. Through the use of unstructured life story interviews, this research illuminated the dominant gendered expectations that women perceive within the gym space and how these expectations interact with/in women’s gym use. Through this exploration this research also discussed what women perceived could be changed in order to benefit their gendered gym use.

There is a significant issue in society today regarding the lack of knowledge about and positive regard attributed to women’s bodies, but more specifically female genitalia. This is detrimental to women in that it causes us to see ourselves in a negative light, or to overly sexualize certain aspects of ourselves, which may lead to severe psychological damage (American Psychological Association Task Force on the Sexualization of Girls, 2010). The 1970’s Women’s Health Movement presented a way for women to get to know their own bodies in a way that was private from society in order to make their own judgments free from the pressures and input of the larger public: vaginal self-examinations. This study proposed a modified exam, a genital self-exam, as a way to counteract the negative attitudes projected on women’s genitals by giving women a chance to examine and decide for themselves. Participants were encouraged to practice mindfulness, a mental state achieved through focusing one’s awareness on the present moment while calmly accepting one’s feelings, during the exam as accounts of the 1970’s vaginal exams suggest a mindfulness-like attitude was also adopted during exams. This was done by randomly assigning participants to either complete a self-exam or to not and then measuring genital self-image and satisfaction, sexual body esteem, and mindfulness. The results were largely non-significant, save a few interesting minor findings. However, there is evidence to suggest a biased sample; recommendations for further research in this area are suggested.