An implication of impurity: The impact of feminine honor on human papillomavirus (HPV) screenings and the decision to authorize daughter’s HPV vaccinations.

Abstract

Due to the high prevalence of human papillomavirus (HPV) infections and their relationship with cervical cancer, it is of high interest to understand the processes that help (or hinder) women to receive HPV screenings. Unfortunately, prior research has demonstrated that due to the sexually transmitted nature of the infection, many women report a stigma of sexual impurity or promiscuity regarding HPV screening, which may prevent some women from seeking such screenings. While many women will experience stigma that prevents HPV screenings, this stigma was expected to be particularly strong in women from cultures of honor, cultures that place strong emphasis on the sexual purity and fidelity of women. Furthermore, we expected the endorsement of feminine honor to influence mothers’ resistance to vaccinating their daughters. In a sample of 257 women aged 30–45, feminine honor ideology endorsement was shown to decrease the likelihood of HPV screening intentions—this link was explained by participant’s beliefs that HPV screening would imply sexual impurity, along with the expected shame and embarrassment they would experience by receiving an HPV screening. Feminine honor beliefs also significantly predicted decreased support for vaccination of participants’ daughters, due to fear it might in some way endorse sexual promiscuity. These findings not only illustrate a cultural factor that heightens the stigma surrounding HPV screening, which may provide a barrier to care in honor-endorsing women, but also indicate a factor that may prevent women from having their children vaccinated against HPV.

Victims of virility: Honor endorsement, stigma, and men’s use of erectile dysfunction medication.

“…These findings add to a growing body of literature, which links honor endorsement to lower levels of help-seeking behaviors and likelihood to seek health procedures due to stigma (Brown et al, 2014; Crowder & Kemmelmeier, 2017; Foster, Carvallo, Lee, et al, 2020; Foster, Carvallo, Lee, & Bernier, 2020; Foster et al, 2021). Due to an individual’s worth in an honor culture stemming from what is externally recognizable, honor endorsers will be less likely to seek help in any context that would draw attention to potentially “dishonorable” personal qualities.…”

“…This research reveals that honor endorsers are less likely to seek mental health help, in large part, due to their belief that seeking psychological help means admitting “weakness,” which would ultimately compromise their reputation in front of others (Brown et al, 2014; Crowder & Kemmelmeier, 2017). Similar findings have emerged in the field of sexual health, where honor-endorsing women were less likely to seek HPV and STI screening out of fear it would imply that they were promiscuous, thereby compromising their reputation (Foster, Carvallo, Lee, et al, 2020; Foster et al, 2021).…”

“…These are specific to each gender, and thus honor is often referred to as having masculine and feminine “facets” (Brown, 2016). Women gain reputation by endorsing norms relating to sexual chastity and familial loyalty (Barnes et al, 2014; Foster, Carvallo, Lee, et al, 2020; King, 2008), whereas men gain reputation by endorsing norms related to and cultivating reputations for toughness, intolerance of disrespect, competence, and sexual virility (Barnes et al, 2012; Cihangir, 2013; Rodriguez Mosquera, 2016; Rodriguez Mosquera et al, 2002; Saucier et al, 2018).…”

Honor and Seeking Mental Health Services: The Roles of Stigma and Reputation Concerns

“…As in other honor-oriented cultures that exist in societies around the world, maintaining a reputation of self-reliance and willingness to partake in retaliatory aggression in response to insults and other reputation threats is paramount within the culture of honor in the U.S. (Brown, 2016). For men in cultures of honor, one strives to maintain a reputation of strength and virility (Brown et al, 2014), while for women, one’s reputation tends to center around sexual purity and loyalty (Foster et al, in press). For men and women in cultures of honor, strong reputational concerns drive the avoidance of dishonorable behavior, particularly given that one’s own honor, the honor of one’s partner, and the honor of one’s family tend to be linked together (McLean et al, 2018).…”

The role of honour in interpersonal, intrapersonal and intergroup processes

“…For example, Foster and colleagues (2021b) found that women who strongly (vs. weakly) endorsed feminine honor values reported decreased intentions to schedule sexually transmitted infections screenings, because of their increased negative beliefs and emotions (e.g., shame) associated with the screening. In another study, Foster et al (2021b) also showed that the more women valued feminine honor, the less likely they were to receive human papillomavirus (HPV) screenings, because they expected to feel shame and embarrassment if they are screened. Moreover, women with strong (vs. weak) feminine honor values were less likely to get their daughters vaccinated against HPV, because of their belief that HPV vaccination may encourage promiscuity, demonstrating that honor values can shape not only people's own health-related choices but also those of close others'.…”