Abstract
This paper examines how physicians’ beliefs about risk factors for cervical cancer compare with Mexican and Salvadoran immigrant women's views (hereafter Latina immigrants). Between August 15, 1991 and August 15, 1992, we conducted ethnographic interviews with 39 Mexican immigrant women, 28 Salvadoran immigrant women, and 30 physicians in northern Orange County, California. Physicians and Latina immigrants converge on their beliefs that sexual behavior is a predominant risk factor for cervical cancer. They diverge, however, on their reasons. Latina immigrants’ perceptions of health risks are embedded in a larger set of cultural values centering around gender relations, sexuality, and morality. Latina immigrants also emphasized men's behavior as risk factors. Physicians’ views, on the other hand, are largely based on the epidemiology of cervical cancer risk factors. They emphasized beginning sexual relations at an early age, multiple sexual partners, and infection with sexually transmitted viruses. Some physicians, however, displayed moral interpretations of the sex‐based risk factors for cervical cancer through the use of the culturally‐loaded term “promiscuous” in place of “multiple sexual partners,” through specific references to morality, and through characterizations of women at risk for cervical cancer. Both the physicians and the Latina immigrants in our study paid considerably less attention to sodoeconomic factors. Our results have important implications for physicians who provide health care for Latina immigrants. Physicians should be clear to point out that women need not be “promiscuous” to get cervical cancer.
Highlights
Anthropology's concern with the human body as a cultural construct has a long history
More of the Salvadorans than Mexicans had not had a medical check-up within the last year, but many of the Mexicans had sought care in Mexico, which may account for this difference
Physicians and Latina immigrants in this study both converged and diverged in their views concerning cervical cancer risk factors. They both focused on sexual behavior as the predominant factor increasing a woman's risk for cervical cancer
Summary
Anthropology's concern with the human body as a cultural construct has a long history. Cervical cancer's characterization as a sexually transmitted disease is based on the epidemiological research on risk factors. We explore the extent to which cultural notions about sexual behavior enter into physicians' and Latina immigrants' beliefs about the risk factors for cervical cancer. The women and physicians are not in direct dialogue in this analysis, they inhabit the same local environment and seek and provide medical services in that same environment We believe this analysis will provide important information for helping to understand the communication, or lack thereof, that occurs when Latina immigrants and primary care physicians do dialogue about cervical cancer.[3] An important corollary question for us is: What are the implications of characterizing cervical cancer as an STD for Latina immigrants who may already perceive the disease within a broad cultural framework of morality and sexuality? Among the many features of AskSam is the ability to count the instances of word use by interview in order to arrive at a frequency
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