Absence of holistic sexual health understandings among men and women in deprived areas of Scotland: qualitative study

McDaid, L. , Hunt, K. , McMillan, L., Russell, S., Milne, D., Ilett, R. and Lorimer, K. (2019) Absence of holistic sexual health understandings among men and women in deprived areas of Scotland: qualitative study. BMC Public Health, 19, 299. (doi:10.1186/s12889-019-6558-y) (PMID:30866882) (PMCID:PMC6417029)

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Abstract

Background: There is a growing evidence base for the need for a holistic approach to sexual health improvement, but the challenges for realising this in the ‘real world’ may be harder in some communities than others. We examined sexual health understandings and behaviours among adult men and women in deprived areas of Scotland. Methods: Thematic analysis, using the constant comparative method, of qualitative, semi-structured in-depth interviews with 19 men and 16 women aged 18–40 years from the most deprived areas of Glasgow, Edinburgh, Dundee, and three Highland towns. Results: Even though most had been shown images designed to facilitate discussion about sexual consent and verbal/physical abuse, when first asked, participants overwhelmingly equated ‘sexual health’ with the avoidance of sexually transmitted infections (STIs) and pregnancy. Most of the women interviewed went on to locate their accounts of sexual health within a broader, social account of relationships that in an ideal world, in contrast with their everyday lives, were based on respect and freedom from violence. They expressed desires for more positive relationships, based on open communication and trust, choice and freedom from coercion. A few men did accept a broader definition of sexual health, but others actively resisted it and placed the onus to enact choices and freedom from coercion on women rather than men. Conclusions: In the first UK study to examine understandings of holistic sexual health among adults living in deprived areas, we found a disjuncture between men and women. These findings suggest that, as a society, we are failing to equip people to enhance their own, and others’, sexual health and wellbeing in its broadest sense. New efforts to emphasise the breadth of sexual health are required, but addressing these complex issues, especially where there are negative underlying gender norms to challenge, will require multi-level interventions targeting individual, community and system levels.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Hunt, Professor Kate and Ilett, Dr Rosie and McDaid, Professor Lisa
Authors: McDaid, L., Hunt, K., McMillan, L., Russell, S., Milne, D., Ilett, R., and Lorimer, K.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:BMC Public Health
Publisher:BioMed Central
ISSN:1471-2458
ISSN (Online):1471-2458
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in BMC Public Health 19:299
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
727631SPHSU Core Renewal: Relationships & Health Improvement Research ProgrammeLisa McDaidMedical Research Council (MRC)MC_UU_12017/11IHW - MRC/CSO SPHU
727641SPHSU Core Renewal: Setting and Health Improvement Research ProgrammeKathryn HuntMedical Research Council (MRC)MC_UU_12017/12IHW - MRC/CSO SPHU
SPSHU11
SPSHU12

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