Jennifer S Hirsch

Columbia University | CU · Department of Sociomedical Sciences

Lesbian, bisexual, and queer (LBQ) women experience disproportionately high rates of unwanted sex, including sexual assault. The literature has noted LBQ women's elevated risk for sexual victimization compared to heterosexual women, but little research has compared LBQ women's processing of sexual violations to those of heterosexual women. To addre...

This paper reflects upon calls for “open data” in ethnography, drawing on our experiences doing research on sexual violence. The core claim of this paper is not that open data is undesirable; it is that there is a lot we must know before we presume its benefits apply to ethnographic research. The epistemic and ontological foundation of open data is...

Sexual and gender-based violence (SGBV) is a highly prevalent issue, both in North America and globally, with well-recognized adverse impact on survivors' physical, emotional, and economic well-being. The objective of this systematic review is to collect and synthesize empirical work on the effects of SGBV victimization on educational trajectories,...

Comprehensive sexuality education (CSE) has been shown to have a wide range of positive impacts for K-12 students. Despite its demonstrated benefits, many K-12 students in the USA do not receive CSE. Because of this, college may be an opportune time to teach this information. However, little is known about the impact of CSE in institutions of highe...

Background: U.S. college student drinking typologies often consider quantity and frequency but not the socio-environmental contexts in which students obtain alcohol and drink. Understanding context could be important for preventive interventions. Methods: We used latent class analysis (LCA), a person-centered approach to understanding behavior p...

Scholars of global health have embraced universal education as a structural intervention to prevent HIV. Yet the costs of school, including fees and other ancillary costs, create an economic burden for students and their families, indicating both the challenge of realising the potential of education for preventing HIV and the ways in which the desi...

This response to Campbell et al. makes three points. First, the commitment to "know more" must examine the full ecology of relationship violence and sexual misconduct (RVSM); that knowledge is essential for creating multilevel prevention strategies. Second, a full realization of an intersectional perspective requires attention to a broader range of...

Entering college is recognized as a developmental milestone. Completing college is difficult, however, and students who are first-generation (FG) or low-income (LI) or both (FGLI) encounter unique challenges. In secondary analysis of data from a population-based survey ( N=1671 undergraduates) at two interconnected highly-selective institutions of...

This article examines how gendered access to digital capital-in the form of the social and economic resources needed to own and use a mobile phone-is connected to key adult milestones, such as securing employment and engaging in romantic relationships. Descriptive statistical analysis of 11,030 young people aged 15-24 in Rakai, Uganda indicated tha...

Introduction This article examines recent moral panics over sex education in Uganda from historical perspectives. Public outcry over comprehensive sexuality education erupted in 2016 over claims that children were being taught “homosexuality” by international NGOs. Subsequent debates over sex education revolved around defending what public figures...

Violence researchers have highlighted a need to understand connections between campus characteristics and violent victimization among students. Responding to those calls, we systematically reviewed research examining the characteristics of secondary and post-secondary educational settings associated with sexual violence and related victimization ex...

Introduction In this article, we review research on the impact of young adult literature (YAL) on young people’s sexuality-related beliefs. This research points to the potential of YAL as a tool through which schools can offer sex education that is truly “comprehensive” by providing young people an opportunity to grapple with questions about gender...

Global health researchers often approach Traditional, Complementary, and Alternative Medicine (TCAM) from a health efficacy perspective, asking whether the presence of plural medical systems helps or hinders the uptake of biomedicine. Medical anthropologists, by contrast, typically emphasize how plural medical systems encourage us to rethink health...

In some Ugandan fishing communities, almost half the population lives with HIV. Researchers designate these communities “HIV hotspots” and attribute disproportionate disease burdens to “sex-for-fish” relationships endemic to the lakeshores. In this article, we trace the emergence of Uganda’s HIV hotspots to structural adjustment. We show how global...

This study explored how leaders of Black churches active in the fight against HIV conceptualised sex and sexuality when describing HIV interventions within their institutions. We analysed interviews with pastors and identified three frames through which leaders understood and communicated about sex and sexuality: (1) an evasive frame, in which part...

This article examined substance use and sexual behavior by conducting an analysis of college students’ reported behaviors using a daily diary approach. By isolating particular sexual events across a 2-month period, we examined situational predictors of engagement in sex and of negative sexual experiences (coerced sex and/or sex that lacks perceived...

Despite the burden of sexual assault on college campuses, few effective prevention programs exist. Understanding the socio-ecological context in which sexual assaults occur may illuminate novel pathways to augment prevention. We examined data from 349 students at two inter-connected urban universities who completed a population-based survey ( N = 1...

Introduction: Studies indicate that 20% to 25% of women and 7% to 8% of men will experience sexual assault during college, ranging from unwanted sexual contact through completed penetration. However, data on repeat victimization during college (i.e., exposure to two or more assaults) are scarce, with few studies examining correlates of repeat victi...

Objectives Research examining sex among college students has frequently focused on negative sexual experiences. This study aimed to understand situational predictors of various dimensions of students’ sexual experiences. Methods: 427 college students participated in a 60-day daily survey; 213 reported sex and were asked questions about each sexual...

A new and important contribution to the re-emergent field of comparative anthropology, this book argues that comparative ethnographic methods are essential for more contextually sophisticated accounts of a number of pressing human concerns today. The book includes expert accounts from an international team of scholars, showing how these methods can...

BACKGROUND In East and Southern Africa (ESA), where landlines are used by 1% of the population, and access to the internet is limited, owning a cell phone is rapidly becoming essential for acquiring information and resources. Our analysis illuminates the perils and potential promise of mobile phones with implications for future interventions to pro...

Background In East Africa, where landlines are used by 1% of the population and access to the internet is limited, owning a cell phone is rapidly becoming essential for acquiring information and resources. Our analysis illuminates the perils and potential promise of mobile phones with implications for future interventions to promote the health of a...

In this review, we provide an overview of the literature on sexual assault. First, we define sexual assault, noting its multiple dimensions and the consequences for operationalization—including reviewing strategies for such operationalization. Second, we outline different approaches to sexual assault, critically assessing those frameworks that rely...

The presence or absence of sexual consent distinguishes between sexual contact that is sexual assault and sex that is not assault. While temporality is an implicit focus in studies of sexual consent, it has received relatively little attention as an object of analysis. Drawing on in-depth ethnographic research conducted as part of a mixed methods s...

In Vietnam, HIV continues disproportionately to affect men who have sex with men and transgender women, and the increase in HIV prevalence in these populations may be related to a lack of tailoring of current prevention approaches, which often fail to address social diversity within these populations. To effectively respond to HIV in Vietnam, it is...

Undergraduate binge drinking, a well-documented problem at U.S. institutions of higher education, has been associated with a host of negative behavioral health outcomes. Scholars have extensively examined individual- and institutional-level risk factors for college binge drinking. However, these data have not been effectively translated into binge-...

Policy makers and public health practitioners rarely consider public libraries to be part of the health system, even though they possess several characteristics that suggest unrealized potential to advance population health. This scoping review uses an adapted social determinants framework to categorize current health-related work conducted by publ...

The primary aim of the current study was to examine the prevalence and correlates of self-reported sexual assault (SA) perpetration, defined as nonconsensual sexualized touching or attempted or completed oral, vaginal, or anal penetration since starting college among men, women, and gender nonconforming (GNC) students. A secondary aim was to examin...

Background: This article presents the experience of one community-based participatory research (CBPR) board and moves board feedback beyond its dialogue with affiliated researchers, expanding the conversations to the broad research community. Methods: The board member authors of this article were part of the Sexual Health Initiative to Foster Tr...

Background: Research has documented multilevel risk factors associated with experiencing incapacitated sexual assault among undergraduate women. Less is known about multilevel risk factors associated with nonincapacitated sexual assault. This study examines and compares the different settings, coercion methods, and relationships in which incapacit...

Purpose College-bound young people experience sexual assault, both before and after they enter college. This study examines historical risk factors (experiences and exposures that occurred prior to college) for penetrative sexual assault (PSA) victimization since entering college. Methods A cross-sectional study, including an online population-bas...

Quantitative survey questions. (DOCX)

SHIFT in-depth interview guide. (PDF)

Cross tabulations of independent variables. (DOCX)

Research on gender and health, including research conducted among Black men who have sex with men (BMSM), has primarily focused on how gender norms and roles shape healthcare engagement. Here we advance that work by demonstrating how a broader theorization of gender, particularly one that moves beyond gender norms and performance to incorporate str...

Purpose: Nonconsensual sexual experiences on college campuses represent a serious public health problem. The preponderance of existing research on students' actual consent practices is quantitative, lab based, or focused on how single dimensions of social context shape consent practices. Filling those gaps and illustrating ethnography's potential...

Purpose This scoping study sought to provide an overview of existing interventions, programs and policies that address family-based stigma and discrimination against LGBTQ youth. Methods A keyword search in three online databases identified relevant scientific publications. Because it located a relatively small number of peer-reviewed publications...

This article deploys ethnographic data to explain why some students do not label experiences as sexual assault or report those experiences. Using ideas of social risks and productive ambiguities, it argues that not labeling or reporting assault can help students (1) sustain their current identities and allow for several future ones, (2) retain thei...

Sexual assault is a part of many students’ experiences in higher education. In U.S. universities, one in four women and one in ten men report being sexually assaulted before graduation. Bystander training programmes have been shown to modestly reduce campus sexual assault. Like all public health interventions, however, they have unintended social c...

Sexual violence (SV) represents a serious public health problem with high rates and numerous health consequences. Current primary prevention strategies to reduce SV perpetration have been shown to be largely ineffective—not surprisingly, since as others have pointed out current prevention largely fails to draw on existing knowledge about the charac...

Men who have sex with men (MSM) in Vietnam experience disproportionate rates of HIV infection. To advance understanding of how structural barriers may shape their engagement with HIV prevention services, we draw on 32 in-depth interviews and four focus groups (n = 31) conducted with MSM in Hanoi between October 2015- March 2016. Three primary facto...

This paper advances research on racism and health by presenting a conceptual model that delineates pathways linking policing practices to HIV vulnerability among Black men who have sex with men in the urban USA. Pathways include perceived discrimination based on race, sexuality and gender performance, mental health, and condom-carrying behaviors. T...

Despite current enthusiasm for biomedical approaches to HIV prevention, many populations at heightened risk have limited access to preventive health services of any kind. This situation is particularly true for labor migrants. This chapter reviews the factors that produce HIV vulnerability for migrant populations, in all their diversity, and develo...

Sexual assault on college campuses is a public health issue. However varying research methodologies (e.g., different sexual assault definitions, measures, assessment timeframes) and low response rates hamper efforts to define the scope of the problem. To illuminate the complexity of campus sexual assault, we collected survey data from a large popul...

Number of incidents of sexual assault since enrolling at CU/BC, among individuals with at least one incident. (DOCX)

There has been a great deal of state-level legislative activity focused on immigration and immigrants over the past decade in the United States. Some policies aim to improve access to education, transportation, benefits, and additional services while others constrain such access. From a social determinants of health perspective, social and economic...

Rationale: Despite abundant state-level policy activity in the U.S. related to immigration, no research has examined the mental health impact of the overall policy climate for Latinos, taking into account both inclusionary and exclusionary legislation. Objective: To examine associations between the state-level policy climate related to immigrati...

Black men who have sex with men in the USA face disproportionate incidence rates of HIV. This paper presents findings from an ethnographic study conducted in New York City that explored the structural and socio-cultural factors shaping men's sexual relationships with the goal of furthering understandings of their HIV-related vulnerability. Methods...

Research has demonstrated the clinical effectiveness of pre-exposure prophylaxis (PrEP) for HIV prevention, but little is known about how factors at the individual-, interpersonal-, community-, and structural levels impact PrEP use for black men who have sex with men (BMSM). We advance existing work by examining how all levels of the ecological fra...

In this paper, we discuss how life history drawings can serve as a valuable method for global health research. The introduction discusses qualitative approaches to concepts such as reliability, validity and triangulation, and situates the use of participatory visual methods within the broader field of participatory research. The paper reports on an...

We explore how state and local policies in labor, health, education, language, community and neighborhood environments, deportation, and state-authorized identification can reduce or exacerbate HIV vulnerability among Latino migrants in the United States. We reviewed literature on Latino migrants and HIV risk, on the structural-environmental contex...

The USA faces disproportionate and increasing HIV incidence rates among Black men who have sex with men (BMSM). New biomedical technologies such as pre-exposure prophylaxis (PrEP) have been developed to address their HIV risk. Very little consideration, however, has been given to the diversity obscured by ‘BMSM’ as a category, to how this diversity...

Black men who have sex with men (BMSM) experience among the highest rates of HIV infection in the United States. We conducted a community-based ethnography in New York City to identify the structural and environmental factors that influence BMSMs vulnerability to HIV and their engagement with HIV prevention services. Methods included participant ob...

Although HIV interventions and clinical trials increasingly report the use of mixed methods, studies have not reported on the process through which ethnographic or qualitative findings are incorporated into RCT designs. We conducted a community-based ethnography on social and structural factors that may affect the acceptance of and adherence to ora...

Black men who have sex with men (BMSM) bear an increasingly disproportionate burden of HIV in the United States. The Centers for Disease Control and Prevention recommends high-impact combination prevention for populations at high risk for HIV infection, such as BMSM. However, few scholars have considered the types of behavioral interventions that c...

In recent years, the menstrual hygiene management challenges facing schoolgirls in low-income-country contexts have gained global attention. We applied Gusfield's sociological analysis of the culture of public problems to better understand how this relatively newly recognized public health challenge rose to the level of global public health awarene...

Drawing on the changing landscape of responses to HIV in Vietnam, this article describes the key players and analyzes the relationships between global players and local interests, including both the omnipresent state and an emerging civil society presence. We discuss the critical importance of timing for policy intervention and the role of health p...

Background: Black men who have sex with men (BMSM) have the highest HIV incidence rates in the U.S. and it is vital to explore how new prevention approaches might reduce those rates. Research has demonstrated the clinical effectiveness of pre-exposure prophylaxis (PrEP), but little is known about how BMSM understand, talk about, and experience PrEP...

Background: Black Men who have Sex with Men (BMSM) have the highest incidence rates of HIV in the US. Sexual relationships for BMSM entail not only health risks but significant social risks. Physical and virtual spaces influence the way in which BMSM perceive and prioritize different kinds of social and health risks. Methods: Twenty-six BMSM from...

This paper presents five concepts that articulate specific processes through which political and economic factors shape sexuality, drawing on ethnographic research on changing notions of marriage, love, and sexuality conducted in migrant-exporting rural Mexico and with Mexican migrants in Atlanta and New York. The first section describes how changi...

This paper focuses on the interactions between medical professionals in Hanoi, Vietnam, and their HIV-positive patients who desire children. Drawing on ethnographic research, we argue that despite ongoing state and civil society efforts to reduce discrimination against people living with HIV (PLHIV), doctors do stigmatize patients who choose to rep...

Using in-depth interviews with 20 probation youth (60% female; 35% White; 30% Hispanic; mean age: 15 years, range = 13–17), their caregivers (100% female; mean age: 44 years, range = 34–71), and 12 female probation officers (100% White; mean age: 46 years, range = 34–57), we explored how family and probation systems exacerbate or mitigate sexual ri...

Abstract Migration and geographic mobility increase risk for HIV infection and may influence engagement in HIV care and adherence to antiretroviral therapy. Our goal is to use the migration-linked communities of Santo Domingo, Dominican Republic, and New York City, New York, to determine the impact of geographic mobility on HIV care engagement and...

This paper discusses labor migration as an example of how focusing on the meso-level highlights the social processes through which structural factors produce HIV risk. Situating that argument in relation to existing work on economic organization and HIV risk as well as research on labor migration and HIV vulnerabilities, the paper demonstrates how...

Social science research can enhance the response to Vietnam's growing HIV epidemic by capturing the country's rapidly changing social and political context. The present paper reviews the published, peer-reviewed and English-language social science literature on HIV in Vietnam in order to identify critical theoretical and substantive gaps, while lay...

Over the course of more than three decades now, social and behavioural research on HIV and AIDS has evolved in a range of important ways within the field of global public health. From its origins during the first decade of the epidemic primarily in resource-rich industrialised countries such as the USA, Australia and Canada, and the key countries o...

Abstract Health research capacity strengthening (HRCS) is a strategy implemented worldwide to improve the ability of developing countries to tackle the persistent and disproportionate burdens of disease they face. Drawing on a review of existing HRCS literature and our experiences over the course of an HRCS project in Vietnam, we summarise major ch...

The Vietnamese press continues to be an influential medium in Vietnamese culture, both shaping and reflecting official and mainstream views on major national issues. This study examines discourses around HIV/AIDS in the mainstream news media in order to characterize trends in the representation of the epidemic, two decades after Vietnam's first HIV...

Background: Youth in the juvenile justice system (JJS) are at considerable risk for HIV/STI yet there are few targeted interventions. Family-based HIV/STI prevention programs have been effective with other vulnerable populations, but we know little about the influence of family on HIV/STI risk in JJS youth. We explored family factors influencing se...

Abstract Stigma reduction efforts in Vietnam have been encumbered by contradictory and dynamic views of people living with HIV and the epidemic over the past two decades. World AIDS Day 2010 saw the launch of Pain and Hope, a museum exhibition showcasing the lives and experiences of Vietnamese people living with AIDS at the Vietnam Museum of Ethnol...

This chapter explores sources of HIV risk at the structural level, looking at the influence of policies across multiple sectors. The authors connect multisectoral determinants of risk to the robust critique that has emerged of individual-level behavioral interventions, arguing that a structural approach to HIV prevention should encompass policy ref...

The health consequences for HIV-affected families of insufficient access to safe water and sanitation are particularly dire: inadequate access complicates medication adherence and increases vulnerability to opportunistic infections for persons living with HIV. The gendered nature of water collection and HIV care—with women disproportionately bearin...

For many women around the world, their greatest risk of HIV infection comes from having sex with the very person with whom they are supposed to have sex: their spouse. The Secret situates marital HIV risk within a broader exploration of marital and extramarital sexuality in five diverse settings: Mexico, Nigeria, Uganda, Vietnam, and Papua New Guin...

The interaction between geographic mobility and risk for human immunodeficiency virus infection is well recognized, but what happens to those same individuals, once infected, as they transition to living with the infection? Does mobility affect their transition into medical care? If so, do mobile and nonmobile populations achieve similar success wi...

Risk reductions behaviors are especially important during acute/early HIV infection, a period of high transmission risk. We examined how sexual behaviors changed following diagnosis of acute/early HIV infection. Twenty-eight individuals completed structured surveys and in-depth interviews shortly after learning of their infection and 2 months later...

Gender has been recognized as a significant influence on sexual health behaviors. Labor migration presents an important context of vulnerability for sexual health. To understand how the context of migration affects risk-related practices, both cultural and social aspects of gender need to be explored. In the quantitative part of a mixed-methods stu...

HIV/AIDs risk among migrant workers is often examined through individual determinants with limited consideration of social context. We used data from systematic ethnographic observations, structured interviews (n = 50), and life history interviews (n = 10) to examine the relationship between loneliness and HIV/AIDS risk for recently arrived (within...

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, o...

Although pregnancy ambivalence is consistently associated with poorer contraceptive use, little is known about the sexual, social and emotional dynamics at work in pregnancy ambivalence. During in-depth sexual and reproductive history interviews conducted in 2003, 36 women and men were asked about the relational and emotional circumstances surround...

Research on how religion shapes contraceptive practices and fertility has paid insufficient attention to how people interpret religious teachings. This study draws on ethnographic fieldwork in Degollado, Mexico, to describe generational and social-contextual differences in how women interpret and use religious doctrine to achieve their fertility de...

We explored long-term health consequences of age at sexual initiation and of abstinence until marriage to evaluate empirical support for the claim that postponing sexual initiation has beneficial health effects. We analyzed data from the 1996 National Sexual Health Survey, a cross-sectional study of the US adult population. We compared sexual healt...