The social construction and conceptualization of sexual health among Mexican American women.

Research on the social construction and contextualization of sexual health among Latina women is sparse. This ethnographic study was aimed to bridge this gap by exploring sexual health experiences and behaviors of a Latina subgroup, Mexican American women. A series of individual semistructured, in-depth interviews were conducted with 20 Mexican American women from a sexual and reproductive health clinic in a large Southwestern city with a predominantly Mexican American population. Through thematic analysis, sacrificing of self, sexual silence, and taking control of self emerged as themes. These themes reflect the context within which construction of sexual health occurs and sexual health behaviors are influenced. Study findings are discussed within a socio-cultural framework for sexual health promotion intervention for both adolescent and adult Mexican American women. Keywords: sexual health; culture; women; Mexican American Health-related research on Mexican Americans, a specific subgroup of the Latino population living within the United States, has primarily focused on issues affecting families, older adults, pregnant women, and children (Higgins & Learn, 1999). The sexual and reproductive health of nonpregnant Mexican American women between 20 and 50 years of age, however, remains understudied (Foulkes, Donoso, Fredrick, Frost, & Singh, 2005). The existing health-related research of this group often lacks a cultural perspective and is concentrated on disease and illness behaviors rather than on health promotion behaviors (Higgins & Learn, 1999). The emergence of HIV as a priority public health issue has stimulated the need for increased understanding of the cultural influence on the sexual health promotion behaviors of Mexican American women. The lack of curative HIV treatment further emphasizes the need for gender- and culture-specific health promotion interventions that are grounded in the cultural meaning and construction of Mexican American women's sexual health experiences and behaviors (Amaro, Vega, & Valencia, 2001; Faulkner & Mansfield, 2002; Harvey et al., 2004; Irwin, 1997). This ethnographic study was designed to bridge this research gap through exploration of the cultural meaning and construction of Mexican American women's sexual health experiences. Understanding this cultural construction is important as effective health promotion programs are need-driven and integrate both the individual and socio-cultural context of the targeted program population. This integration is crucial as the maintenance of an individual Mexican American woman's newly acquired sexual health promotion behaviors are facilitated by the environment in which she lives (Pick, Poortinga, & Givaudan, 2003). SEXUAL HEALTH, LATINO CULTURE, AND GENDER Central to this study is the definition of sexual health. While there is no universally accepted definition of the term, existing definitions are either negatively defined as the absence of sexually transmitted diseases (STD) and unintended pregnancy, or positively defined as a basic sexual right to enjoyment and pleasure (Edwards & Coleman, 2004; Irwin, 1997; Lewis, 2004). The most comprehensive definition of sexual health is provided by the World Health Organization (Pan American Health Organization, World Health Organization, & World Association for Sexology, 2000). Accordingly, sexual health is a state of physical, psychological, and social well-being as related to sexuality. Within this definition, sexual health is viewed as more than the absence of disease or dysfunction. This broad definition includes sexual enjoyment, positive and respectful sexual relationships, and safe sexual experiences that are based upon the universal human sexual rights of freedom from sexual coercion and violence, reproductive choice, and access to sexual and reproductive education and health care (World Health Organization, 2002). The construct of sexual health has varied in definition across cultures and time. …