title: Moving beyond safe sex to women-controlled safe sex: a concept analysis.
abstract: OBJECTIVE
  This paper is a report of a conceptual analysis of women-controlled safe sex.
  
  
  BACKGROUND
  Women bear disproportionate burdens from sexually related health compromising outcomes. Imbalanced societal gender and power positions contribute to high morbidities. The expression, women-controlled safe sex, aims to empower women to gain control of their sexual lives. Few researchers focus on contextualized socio-cultural definitions of sexual safety among women.
  
  
  METHODS
  The sample included scientific literature from Scopus, CINAHL, PubMed, PsychINFO and Sociological Abstracts. Papers were published 2000-2010.
  
  
  METHODS
  Critical analyses of literature about women-controlled safe sex were performed in May 2011 using Rodgers' evolutionary concept analysis methods. The search focused on social and cultural influences on sexual practices aimed at increasing women's control over their sexual safety.
  
  
  RESULTS
  The analysis uncovered five attributes of women-controlled safe sex: technology; access to choices; women at-risk; 'condom migration' panic; and communication. Three antecedents included: male partner influence; body awareness; and self-efficacy. Consequences were categorized as positive or negative. Nine surrogate terms included: empowerment; gender power; female-controlled sexual barrier method; microbicides; diaphragm; sexual negotiation and communication; female condom; women-initiated disease transmission prevention; and spermicides. Finally, a consensus definition was identified: a socio-culturally influenced multi-level process for initiating sexual safety by women deemed at-risk for sexually related dangers, usually sexually transmitted infections and/or HIV/AIDS.
  
  
  CONCLUSIONS
  This concept analysis described current significance, uses, and applications of women-controlled safe sex in the scientific literature. The authors clarified its limited nature and conclude that additional conceptual refinement in nursing is necessary to influence women's health.
authors: Center for Health Equity Research University of Pennsylvania School of Nursing, Pennsylvania, USA. kamilaa@nursing.upenn.edu
authors: Kamila A
authors: KA
authors: Alexander
authors: Christopher L
authors: CL
authors: Coleman
authors: Janet A
authors: JA
authors: Deatrick
authors: Loretta S
authors: LS
authors: Jemmott
mesh_terms: D003210:Concept Formation; D019111:Single-Use Internal Condom; D042121:Contraception, Barrier; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D054624:Health Status Disparities; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D015399:Nursing Research; D011209:Power, Psychological; D011247:Pregnancy; D021841:Safe Sex; D012747:Sexual Partners; D019529:Sexuality; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D014930:Women; D016387:Women's Health