Towards a critical epidemiology approach for applied sexual health research

Abstract

Critical approaches may benefit epidemiological studies of sexual health. This paper proposes a critical approach, reconcilable with social epidemiological enquiry. Key aims of critical epidemiology for sexual health are identified, from which three criticisms of practice emerge: 1. Lack of attention to socio-cultural contexts; 2.Construction of 'risk' as residing in the individual; 3. Enactment of public health agendas which privilege and pathologise certain behaviours. These reflect and construct an apolitical understanding of population health. This paper proposes features of a critical epidemiology that represent a morally driven re-envisioning of the focus, analysis, and interpretation of epidemiological studies of sexual health.

Who has a problem with chemsex? Identity as a missing link in support services for men who engage in problematic use of psychoactive substances for sexual purposes.

“…Nevertheless, as they do not go beyond descriptions of behavior, they overlook the complexity of motivations, experiences and feelings, reducing men to the category of "problematic users," who generate "epidemiological risks" and "public health harms." The concentration on "risk-takers," the absence or marginalization of the social context, and the superiority of public health over individual health are the three main areas of interest of critical epidemiology, described in more detail, e.g., by Edelman [25]. The cause-and-effect narration around chemsex, presenting substance abuse which leads to an increase in the number of sexually transmitted infections in the population through disinhibition and loss of control, overlooks the complexity of the phenomenon, at the same time promoting epidemiological reductionism, which only slightly contributes to solving the problem.…”

Epidemiologia e emancipação humana: uma revisita aos princípios da justiça

“…No entanto, permanecem as ausências e a invisibilidade nesse processo, como a genealogia das políticas evidencia. As lutas fragmentam-se ora em relação ao imperialismo ora em relação ao racismo ora em relação ao machismo-patriarcalismo ou mesmo em algumas pautas combinadas, mas dificilmente em relação à totalidade das relações sociais vigentes no sistema capitalista 13,24, 38 .…”

Trauma and resilience informed research principles and practice: A framework to improve the inclusion and experience of disadvantaged populations in health and social care research

“…Full capture and analysis of socio-economic and structural quantitative variables would serve a longer-term goal of tackling inequalities, aligning with social and critical epidemiology. 20 It may also be possible to study social practices when the individual is the unit of analysis, as is commonly the case in quantitative studies.…”

“…Solicit participant input in the research process -PPI collaboration and dissemination Source: adapted from Campbell et al 4 epidemiology. 20 It may also be possible to study social practices when the individual is the unit of analysis, as is commonly the case in quantitative studies.…”