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AJPH First Look, published online ahead of print Aug 13, 2008
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October 2008, Vol 98, No. 10 | American Journal of Public Health 1803-1813
© 2008 American Public Health Association
DOI: 10.2105/AJPH.2007.115790

FRAMING HEALTH MATTERS

Pleasure, Power, and Inequality: Incorporating Sexuality Into Research on Contraceptive Use

Jenny A. Higgins, PhD, MPH and Jennifer S. Hirsch, PhD

Jenny A. Higgins is with the Office of Population Research and the Center for Health and Wellbeing, Princeton University, Princeton, NJ. Jennifer S. Hirsch is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY.

Correspondence: Requests for reprints should be sent to Jenny A. Higgins, Office of Population Research, 218 Wallace Hall, Princeton University, Princeton, NJ 08544 (e-mail: jennyh{at}princeton.edu).

We know surprisingly little about how contraception affects sexual enjoyment and functioning (and vice versa), particularly for women. What do people seek from sex, and how do sexual experiences shape contraceptive use? We draw on qualitative data to make 3 points. First, pleasure varies. Both women and men reported multiple aspects of enjoyment, of which physical pleasure was only one.

Second, pleasure matters. Clear links exist between the forms of pleasure respondents seek and their contraceptive practices. Third, pleasure intersects with power and social inequality. Both gender and social class shape sexual preferences and contraceptive use patterns. These findings call for a reframing of behavioral models that explain why people use (or do not use) contraception.






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