Vol.:(0123456789) 1 3
Archives of Sexual Behavior
https://doi.org/10.1007/s10508-020-01678-y
ORIGINAL PAPER
Efects of a Sexual Health Interview among Arab American Women:
An Experimental Disclosure Study
Hannah J. Holmes
1,3
· Jolin B. Yamin
1
· Shoshana Krohner
1
· Lisa J. Rapport
1
· Emily R. Grekin
1
· Howard Schubiner
2
·
Mark A. Lumley
1
Received: 4 September 2019 / Revised: 2 March 2020 / Accepted: 4 March 2020
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract
Although sexuality is an important aspect of peoples’ health and well-being, many people—professionals and patients alike—fnd
sexuality uncomfortable to discuss. In Arab culture, certain sexual thoughts and behaviors are taboo, particularly for women, and
it is not known whether an interview in which Arab American women disclose their sexuality to a health professional would be
well-received and benefcial or upsetting and harmful. This experimental study tested whether engaging in a disclosure-oriented
sexual health interview afects Arab American women’s sexual and psychological health. A sample of 134 Arab American women,
ages 18–35 years (M = 20.6), completed self-report measures of sexual health and attitudes and psychological symptoms, and then
were randomized to an interview or control (waitlist) condition. The 60-min disclosure interview inquired about sexual attitudes,
experiences, and conficts. Five weeks later, all participants completed follow-up measures. Post-interview reports suggest that
participants responded favorably to the interview and generally benefted from participation. Analyses of covariance (controlling
for baseline levels of the outcome measure) indicated that the interview led to signifcantly greater sexual satisfaction and less
discomfort with sexual self-disclosure at 5-week follow-up, compared to controls; the two conditions did not difer on follow-
up sexual self-schema, sexual self-esteem, or psychological symptoms. Moderation analyses revealed that participation in the
interview diferentially improved the sexual self-schema of women with no past sexual experience, compared to women with
sexual experience. These experimental fndings suggest the value, rather than the risk, of clinicians encouraging Arab American
women to openly disclose and discuss their sexual experiences and attitudes in a confdential, empathic setting.
Keywords Arab American · Sexual health · Interview · Disclosure · Moderation analyses
Introduction
Sexuality is a sensitive, often stigmatized topic, which many
individuals fnd difcult or uncomfortable to discuss. Health-
care providers, including mental health professionals, may be
reluctant to assess or discuss sexual matters with patients due
to fear of ofending patients or making them uncomfortable
(Fennell & Grant, 2019; Hanzlik & Gaubatz, 2012). Individual
characteristics such as cultural background further compli-
cate sexual communication between providers and patients,
as providers may hesitate to broach sexual topics with patients
from relatively conservative cultural backgrounds. For exam-
ple, Asian American women have reported perceiving stigma
around discussion of sexuality in their families and communi-
ties, which serves as a barrier to sexual and reproductive health
care (Frost, Cares, Gelman, & Beam, 2016). Arab Americans
comprise another group with relatively conservative sexual
norms, which may cause providers to fear the potential con-
sequences of broaching the topic of sexuality with their Arab
American patients.
Electronic supplementary material The online version of this
article (https://doi.org/10.1007/s10508-020-01678-y) contains
supplementary material, which is available to authorized users.
* Hannah J. Holmes
holmeshj1@appstate.edu
1
Department of Psychology, Wayne State University, Detroit,
MI, USA
2
Department of Internal Medicine, Ascension Providence
Health and Michigan State University, Southfeld, MI, USA
3
Department of Psychology, Appalachian State University, 222
Joyce Lawrence Lane, Boone, NC 28608, USA