The literature on psychosexual development has predominately focused on sexual abuse

229 Pages·2013·3.87 MB·English

SEEING GREEN: GENDERED RELATIONSHIP EXPECTATIONS AND SEXUAL
RISK AMONG ECONOMICALLY UNDERSERVED ADOLESCENTS IN BRADDOCK,
PENNSYLVANIA

by

Kimberly Joy Rak

B.S., Syracuse University, 1994

M.A., University of Colorado at Denver, 2003

Submitted to the Graduate Faculty of

the Dietrich School of Arts and Sciences

in partial fulfillment

of the requirements for the degree of

Doctor of Philosophy

University of Pittsburgh

2013
UNIVERSITY OF PITTSBURGH

ARTS AND SCIENCES

This dissertation was presented

By

Kimberly Joy Rak

It was defended on

February 28, 2013

and approved by

Joseph S. Alter, PhD, Professor, Department of Anthropology

Martha Ann Terry, PhD, Assistant Professor, Department of Behavioral and Community Health

Sciences

Jessica G. Burke, PhD, Associate Professor, Department of Behavioral and Community Health

Sciences

Michael Yonas, Dr. P.H., Assistant Professor, Department of Family Medicine

Dissertation Advisor: Kathleen M. DeWalt, PhD, Professor, Department of Anthropology
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Copyright by Kimberly Rak

2013
iii
SEEING GREEN:
GENDERED RELATIONSHIP EXPECTATIONS AND SEXUAL RISK AMONG
ECONOMICALLY UNDERSERVED ADOLESCENTS IN BRADDOCK,
PENNSYLVANIA
Kimberly J. Rak, PhD

University of Pittsburgh, 2013

This dissertation examines adolescent sexual health disparities from the perspective of
economically underserved youth considered “at risk” living in the Mon Valley of southwestern
Pennsylvania. Adolescent discussions of relationship and sexual risk highlight social relations
and contexts in contrast to discrete behaviors and outcomes. While adolescents are aware of the
possibility for contracting a sexually transmitted disease or pregnancy from engaging in sex,
these risks are negated or mitigated in relation to other risks that threaten self esteem, group
belonging, and a moderate sense of security. In addition, variation by age and gender contribute
to complex constructions of romantic relationship expectations that inform the context for sexual
risk taking beliefs and behaviors. Adolescent risk taking is social, symbolic, and subjective and
not solely reducible to individualistic domains of knowledge or adoption of preventative
measures. Therefore, this qualitative study examines the ways in which poverty structures the
social meanings of risks.
This study is based on 18 months of ethnographic research including in-depth interviews,
creative arts-based data collection sessions, participant observation, and on-going dialogue with
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community stakeholders. In addition, this qualitative research provided an opportunity to
explore, investigate and document gender and age differences: there were two adolescent age
cohorts each including male and female participants. Older adolescents detailed the scope and
content of romantic relationships and perceptions of sexual risk while younger adolescents
detailed relationship dynamics.
The qualitative approach broadens the scope of inquiry from acts (e.g. use of protection)
or outcomes (e.g. STDs, teenage pregnancy) to include social and power dynamics influencing
gendered expectations in relationships. Additionally, this dissertation explores relationship
expectations among younger adolescents who are traditionally absent from research on sexual
health. Furthermore, discussions of sexual risk need to be contextualized to incorporate larger
social and cultural constructions of what is considered “risk” as well as the potential benefits
incurred by risk taking. Policy suggestions would include an explicit recognition of the role of
poverty in adolescent sexual health disparities (and health disparities more broadly), and a first
step would be to track adolescent sexual health information by socioeconomic status in addition
to geographic location and race/ethnicity.
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TABLE OF CONTENTS

PREFACE ................................................................................................................................... xiii
0.0 INTRODUCTION................................................................................................................ 1
0.1 RESEARCH FOCUS .......................................................................................... 1
0.2 COMMUNITY ENGAGEMENT AND IDENTIFICATION OF PROBLEM .. 3
0.3 OUTLINE OF THE DISSERTATION ............................................................... 5
1.0 CHAPTER 1: ADOLESCENT SEXUALITY ................................................................... 8
1.1 POLITICAL DISCOURSES .................................................................................... 9
1.2 POPULAR DISCOURSES ..................................................................................... 12
1.2.1 Parents ............................................................................................................. 12
1.2.2 Media .............................................................................................................. 13
1.3 THE STATE OF ADOLESCENT SEXUAL HEALTH IN THE U.S. .................. 15
1.4 INCLUDING YOUNGER ADOLESCENTS ........................................................ 19
1.5 CONTRIBUTIONS FROM THIS RESEARCH .................................................... 21
2.0 CHAPTER 2: REVIEW OF THE LITERATURE......................................................... 23
2.1 AN ANTHROPOLOGY OF CHILDHOOD .......................................................... 23
2.1.1 An Anthropology of Adolescence ................................................................. 26
2.1.2 Development of Sexual Scripts ....................................................................... 29
2.2 ADOLESCENCE .................................................................................................... 30
2.2.1 Adolescent Development: The Dominant View ............................................. 31
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2.2.2 Positive Sexual Development: What Does This Mean? ................................. 35
2.2.3 Adolescent Risk Taking .................................................................................. 40
2.3 DEVELOPMENTAL CONSIDERATIONS .......................................................... 45
2.3.1 Gender Implications ........................................................................................ 47
2.3.2 Social/Familial Influences .............................................................................. 48
2.3.3 Change Over Time .......................................................................................... 49
2.4 NEIGHBORHOOD CONTEXT ............................................................................. 49
2.5 ART AND DEVELOPMENT ................................................................................ 53
2.6 MULTI-THEORETICAL FRAMING.................................................................... 55
2.6.1 Political Economy & Social Marginalization ................................................. 56
2.6.2 Construction of Phallocentric Privilege .......................................................... 57
2.6.3 Cross-Cultural Variation in Adolescent Sexuality .......................................... 58
2.6.4 Future-Oriented Prospects .............................................................................. 59
2.6.5 “Sojourner Syndrome” .................................................................................... 60
2.6.6 “Kinscripts”..................................................................................................... 61
2.6.7 Theories of Sex(uality) ................................................................................... 62
2.7 LITERATURE REVIEW CONCLUSION............................................................. 65
3.0 CHAPTER 3: RESEARCH SETTING AND CONTEXT ............................................. 68
3.1 HISTORICAL INFORMATION ............................................................................ 69
3.2 CURRENT SETTING ............................................................................................ 74
4.0 CHAPTER 4: METHODOLOGY ................................................................................... 79
4.1 COMMUNITY INVOLVEMENT ......................................................................... 79
4.2 METHODS ............................................................................................................. 79
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4.3 ETHICAL CONSIDERATIONS ............................................................................ 89
4.4 SETTING THE STAGE ......................................................................................... 91
5.0 CHAPTER 5: RESULTS .................................................................................................. 92
5.1 RELATIONSHIPS .................................................................................................. 92
5.1.1 Types of “Relationships:” Hit it and Quit it, You’re My Possession ............. 92
5.1.2 Good and Bad Relationships. .......................................................................... 97
5.1.3 Messages and Communication about Dating and Relationships .................. 109
5.2 BECOMING SEXUALLY ACTIVE ................................................................... 112
5.2.1 What is Sex? ................................................................................................. 112
5.2.2 Initiating Sex ................................................................................................. 113
5.2.3 Parental Communication ............................................................................... 116
5.2.4 Peer Influence ............................................................................................... 118
5.2.5 Messages about Sex ...................................................................................... 119
5.2.6 Internet, Social Networking and Cell Phones ............................................... 123
5.2.7 Participant’ Views of Messages that Would be Good to Hear about Sex .... 125
5.3 SEXUAL HEALTH CONCERNS ....................................................................... 129
5.3.1 STDs ............................................................................................................. 129
5.3.2 HIV/AIDS ..................................................................................................... 132
5.3.3 Teen Pregnancy ............................................................................................. 135
5.4 HOPES AND DREAMS FOR THE FUTURE .................................................... 145
5.5 ADDITIONAL THEMES ..................................................................................... 148
5.5.1 Gendered Scripts ........................................................................................... 149
5.5.2 Same-Sex Relationships................................................................................ 151
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5.5.3 The Economics of Relationships .................................................................. 152
5.6 DISSEMINATION ............................................................................................... 157
5.6.1 Discussions with Community Members ....................................................... 157
5.6.2 Discussions with Local Service Providers .................................................... 161
6.0 CHAPTER 6: CONCLUSION........................................................................................ 162
6.1 KNOWLEDGE AND PRACTICE ................................................................. 162
6.2 ROLE MODELING AND MESSAGES ........................................................ 165
6.3 HOPES AND DREAMS................................................................................. 171
6.4 RELATIONSHIP EXPECTATIONS AND GENDER ROLES..................... 172
6.5 ECONOMCIS, RESOURCES, AND POWER .............................................. 175
6.6 YOUTH PERCEPTION OF RELATIONSHIP AND SEXUAL RISK ......... 178
7.0 CHAPTER 7: IMPLICATIONS AND FUTURE WORK ........................................... 182
7.1 SOCIAL DETERMINANTS OF HEALTH ................................................... 182
7.2 PROGRAM AND POLICY IMPLICATIONS ............................................. 184
7.2.1 YCB: Young Children Program.................................................................... 187
7.3 RESEARCH LIMITATIONS AND FUTURE RESEARCH ........................ 191
APPENDIX A ............................................................................................................................. 193
APPENDIX B ............................................................................................................................. 194
APPENDIX C ............................................................................................................................. 197
BIBLIOGRAPHY ....................................................................................................................... 200
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LIST OF TABLES

TABLE 1: SEXUAL HEALTH DISPARITIES AMONG YOUTH ............................................ 19
TABLE 2: THE EVOLVING SEXUAL SELF (SOURCE: (DANILUK 1998) .......................... 36
TABLE 3: BRADDOCK BUSINESSES (SOURCE: (POPTECH 2009) .................................... 71
TABLE 4: RACIAL/ETHNIC COMPOSITION OF BRADDOCK, NORTH BRADDOCK,
AND EAST PITTSBURGH (SOURCE: U.S. 2010 CENSUS) ........................................... 75
TABLE 5: COMPARISON ACROSS AGE AND GENDER .................................................... 111
TABLE 6: GENDER COMPARISONS .................................................................................... 128
TABLE 7: GENDER COMPARISONS ..................................................................................... 148

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