Sexual Behaviour Of Young People Research Articles

Sexual risk behaviour in young people with first episode psychosis

Previous studies have consistently reported high rates of risky behaviour for sexually transmitted infections (STIs) amongst individuals with persistent psychosis. Whether such behaviours are evident from the first presentation or relate to a chronic illness course remains largely undetermined, with limited research conducted amongst young people with first episode psychosis. The aim of the current study was to compare engagement in sexual risk behaviour amongst young people with first episode psychosis with their peers. Sixty-seven sexually active young people with first episode psychosis and 48 healthy control participants (aged 18-29 years) closely matched on sociodemographic characteristics completed a detailed questionnaire assessing a comprehensive range of sexual risk behaviours. There were few differences in the rates of sexual risk behaviour reported by the first episode sample and their peers. Compared with control participants, young people with first episode psychosis reported significantly more inconsistent condom use, less condom-related preparatory behaviour, more concern about HIV/STIs when sex was unprotected, less confidence discussing condom use and increased substance use by their last sexual partner. The sexual behaviour of young people with first episode psychosis appears similar to their peers. However, group differences, particularly increased frequency of unprotected sex amongst the first episode sample, suggest that those with psychosis are at increased STI risk and have distinct needs. The findings support the call for early intervention strategies that target reduction of sexual risk behaviour in the context of persistent mental illness.

Effectiveness of HIV prevention for youth in sub-Saharan Africa: systematic review and meta-analysis of randomized and nonrandomized trials

Systematically assess the effectiveness of HIV-prevention interventions in changing sexual behaviour of young people (10-25 years) in sub-Saharan Africa. Three online databases were searched using prespecified terms. Additional articles were identified on websites of international organizations and by searching bibliographies. Randomized and nonrandomized trials of interventions aiming to reduce risk behaviour were included as well as single-arm studies reporting effects of differential exposure to an intervention. Data were extracted independently in duplicate using predefined data fields. Thirty-one studies on 28 interventions met the inclusion criteria, including 11 randomized trials. Difficulties with implementing planned activities were reportedly common and differential exposure to intervention was high. Two hundred and seventeen outcome measures were extracted: 88 early (within 1 year of intervention) and 129 late outcomes (more than 1 year after the end of the intervention). Sex education and condom promotion among youth did not increase sexual behaviour as well as risky sexual behaviour. No positive effects on sexual behaviour were detected either and condom use at last sex only increased among males [relative risk = 1.46; 95% confidence interval = 1.31-1.64]. One study reported a reduction of herpes simplex virus-2, but not HIV incidence. There remains a stark mismatch between the HIV burden in youth and the number of attempts to design and test prevention interventions - only two trials report biological outcomes. More effective interventions targeting youth are needed. Attention should go to studying implementation difficulties, sex differences in responses to interventions, determinants of exposure to interventions and perhaps inclusion of other factors apart from HIV/AIDS which influence sexual behaviour.

The Impact of the African Youth Alliance Program on the Sexual Behavior of Young People in Uganda

This study evaluates the impact of the African Youth Alliance (AYA) program on the sexual behavior of young people aged 17-22 in Uganda. Between 2000 and 2005, the comprehensive multicomponent AYA program implemented behavior-change communication and youth-friendly clinical services, and it coordinated policy and advocacy. The program provided institutional capacity building and established coordination mechanisms between agencies that implemented programs for young people. The analysis of findings from both a self-reported exposure design and a static group comparison design indicated that AYA had a positive impact on sexual behavior among young females but not among young males. AYA-exposed girls were at least 13 percentage points more likely to report having used a condom at last sex, at least 10 percentage points more likely to report that they had consistently used condoms with their current partner, at least 10 percentage points more likely to have used contraceptives at last sex, and 13 percentage points more likely to have had fewer sex partners during the past 12 months, compared with girls who were not exposed to the AYA program. Scaling up the AYA program in Uganda could, therefore, be expected to improve significantly the sexual and reproductive health of young women. Effective strategies for promoting safer sexual behaviors among boys and young men must be identified, however.

South African teachers' reflections on the impact of culture on their teaching of sexuality and HIV/AIDS

This paper aims to explore South African Life Orientation teachers' perception and practice of teaching HIV/AIDS and sexuality in a cultural perspective. We aim to investigate how teachers respond to perceived cultural differences between the local community and the content of their teaching. Data were collected through interviews with teachers who taught students in grades 8 or 9 in public high schools. The teachers expressed differing viewpoints regarding the rationale for teaching about HIV/AIDS and sexuality. Many teachers saw teaching these topics as a response to declining moral standards, while others suggested that they were teaching issues that parents failed to address. The teachers were more concerned about young people's sexual behaviour than about preventing HIV/AIDS. They perceived that cultural contradictions between what was taught and local cultural values were an issue to which they needed to respond, although they differed in terms of how to respond. Some took an adaptive approach to try to avoid conflicts, while others claimed the moral neutrality of their teaching. Teaching about sexuality was perceived to be challenging in terms of language and communication norms. Teaching about HIV/AIDS was perceived as challenging because teachers often needed to convince students about the reality of AIDS.

Discrepancies between young people's self-reported sexual experience and their perceptions of 'normality'

Young people's sexual behaviour is influenced by their perceptions of peer norms. In this survey of 445 people aged 16 to 29 years, 69% of participants believed they had fewer lifetime sexual partners than average. The mean number of actual lifetime partners reported was 5.5 and the mean perceived 'average' partners for peers was 6.6 (P < 0.01). When broken down by age and sex, the discrepancy was only significant for females aged 16 to 19. Comparison to a national survey also showed that peers' average sexual experience was overestimated. Adolescents are highly susceptible to the influence of peer norms, hence it is concerning that their perceptions of these norms are so distorted.

Rites of passage to adulthood: traditional initiation schools in the context of HIV/AIDS in the Limpopo Province, South Africa

The HIV/AIDS epidemic and its disproportionate effect on the lives of young people has been a source of major concern in South Africa. Research has, until now, focussed on the broad cultural determinants of risky sexual behaviour among this group and on the barriers that impede the promotion of health seeking behaviour in the context of HIV/AIDS. Still missing is a dedicated investigation into the role of traditional rites of passage customs in influencing the sexual behaviour of young people. This article presents the findings from a study investigating the perceptions of young people from Venda, a former South African homeland under apartheid, of the cultural and educational importance of traditional initiation schools. The results of the study suggest that traditional initiation schools remain both an important rite of passage and source of sexual information for many young people. However, it is also discovered that initiation schools are not currently providing young people with the relevant information to adopt health-seeking behaviour in the era of HIV/AIDS.

“They Have Opened Our Mouths”: Increasing Women's Skills and Motivation for Sexual Communication With Young People in Rural South Africa

Communication between parents and young people about sex has been identified as a positive influence on young people's sexual behavior. This article presents findings from South Africa, where a social intervention to reduce levels of HIV and intimate partner violence actively promoted sexual communication between adults and young people. We assessed this component of the program using quantitative and qualitative methods, collecting data through surveys, direct observation, interviews, and focus group discussions. Women participating in intervention activities reported sexual communication with children significantly more often than matched women in the control group (80.3% vs. 49.4%, adjusted risk ratio 1.59 (1.31-1.93). The content of communication with young people also appears to have shifted from vague admonitions about the dangers of sex to concrete messages about reducing risks. The congruence between these findings and existing literature on parent-child sexual communication suggests that conceptual frameworks and programs from developed settings can be adapted effectively for resource-poor contexts.

Community Influences on Young People's Sexual Behavior in 3 African Countries

I examined the role of community-level factors in the reporting of risky sexual behaviors among young people aged 15 to 24 years in 3 African countries with varying HIV prevalence rates. I analyzed demographic and health survey data from Burkina Faso, Ghana, and Zambia during the period 2001 through 2003 to identify individual, household, and community factors associated with reports of risky sexual behaviors. The mechanisms through which the community environment shaped sexual behaviors varied among young men and young women. Community demographic profiles were not associated with reports of risky sexual behavior among young women but were influential in shaping the behavior of young men. Prevailing economic conditions and the behaviors and attitudes of adults in the community were strong influences on young people's sexual behaviors. These results provide strong support for a focus on community-level influences as an intervention point for behavioral change. Such interventions, however, should recognize specific cultural settings and the different pathways through which the community can shape the sexual behaviors of young men and women.

HIV and Sexual Behavior Among Young People: The South African Paradox

HIV and Sexual Behavior Among Young People: The South African Paradox

Why embarrassment inhibits the acquisition and use of condoms: A qualitative approach to understanding risky sexual behaviour

This article is based on research commissioned by the UK Government's Teenage Pregnancy Unit. The Living on the Edge (LOTE) study qualitatively explored factors that shape young people's experiences and attitudes towards sexual behaviour and young parenthood in three linked seaside and rural areas in England. It identifies embarrassment as a key risk factor in young people's sexual behaviour and demonstrates why engaging in protective behaviour and seeking information and advice, can be constrained by fear of embarrassment and concerns about how they are regarded by others. This paper also argues that embarrassment around condom use is not necessarily restricted to adolescence. Embarrassment is a deeply unpleasant experience for everyone and people (young and old) are motivated to avoid it. Implications and recommendations for future policy and service provision are highlighted.

Monitoring HIV Risk and Evaluating Interventions among Young People in Urban West Africa: Development and Validation of an Instrument

We developed an instrument for HIV/AIDS behavioral surveillance applicable to youth living in urban West Africa. The instrument includes a comprehensive set of constructs borrowed from the sociocognitive theory of planned behavior as well as measures of parental and peer communication An exploratory (n=189) and validation sample (n=342) of young men and women living in Bamako were interviewed. Scale construct validity was assessed via factor analysis and multiple linear regressions and internal consistency was assessed using Cronbach's coefficient. All constructs had high internal consistency, scales' structure was relatively stable, and associations between different components of the questionnaire were in the predicted directions. Gender, sexual experience and education were significantly associated with attitudes and perception of control. Furthermore, attitudes, perceived behavioral control, perceived norms, and peer communication significantly predicted condom use. This questionnaire offers a valid and reliable tool for assessing young people's sexual behavior in an urban West African setting.

LINKING POVERTY AND INCOME SHOCKS TO RISKY SEXUAL BEHAVIOUR: EVIDENCE FROM A PANEL STUDY OF YOUNG ADULTS IN CAPE TOWN

Is there a link between household income and income stress, and risky sexual behaviour of young people? Anecdotal and qualitative evidence suggests this may be the case, but there is little quantitative research measuring this relationship. We use two waves of new data from the Cape Area Panel Study to investigate this link for 2,993 African and coloured youths aged 14 to 22 in 2002. In the process, we discuss one type of research design that could allow for a causal interpretation of the effect of income poverty on HIV risk. This design plausibly separates out the effect of income stress from the effect of living in a poor household by comparing behaviours across households with and without negative economic shocks, conditional on baseline income. Our results indicate that females in poorer households are more likely to be sexually active in 2002 and more likely to sexually debut by 2005. In addition, girls in households experiencing negative economic shocks are more likely to reduce condom use between 2002 and 2005. However, they are less likely to have multiple partners in 2002 or have transitioned to multiple partners by 2005. Males who experienced a negative shock are more likely to have multiple partners. Despite the tight research design for assessing shocks, the findings on the impacts of shocks do not generate clear recommendations for policy. There appears to be no systematic difference in condom use at last sex by household income levels or income shocks.

Sexual behaviour in young people

The purpose of this review was to synthesize major research findings in relation to young people and sexual behaviour from the period 2006-2007. We found several key reviews that advance knowledge in the field of young people and sexual behaviour, including observational studies, both qualitative and quantitative, and intervention studies designed to reduce sexual transmission of HIV in both developed and developing countries. Other reviews focused on same-sex behaviours, victimization within relationships, HIV infection/sexually transmitted infection in travellers, prevention of HIV/sexually transmitted infection and the determinants of sexual behaviour in young people. Powerful and consistent forces sustain gender differences in sexual behaviour. The design of interventions to reduce sexual risk behaviour should take account of these forces that help explain young people's sexual behaviour. Knowledge about the kind of interventions that reduce risk behaviour and should be implemented has improved, although the impact on health outcomes such as pregnancy and HIV/sexually transmitted infection is often uncertain. Effective school sex education needs to be part of much broader strategies to improve sexual health, and there is an urgent need for better evaluation of interventions, especially community interventions. Further longitudinal studies are needed to provide insight into the development of relationships and sexual behaviour as well as the course of acculturation.

Factors that shape young people's sexual behaviour: a systematic review

Factors that shape young people's sexual behaviour: a systematic review

Factors that shape young people's sexual behaviour: a systematic review

Since nearly half of new HIV infections worldwide occur among young people aged 15-24 years, changing sexual behaviour in this group will be crucial in tackling the pandemic. Qualitative research is starting to reveal how social and cultural forces shape young people's sexual behaviour and can help explain why information campaigns and condom distribution programmes alone are often not enough to change it. We undertook a systematic review to identify key themes emerging from such research, to help inform policymakers developing sexual health programmes, and guide future research. We reviewed 268 qualitative studies of young people's sexual behaviour published between 1990 and 2004. We developed a method of comparative thematic analysis in which we coded each document according to themes they contained. We then identified relations between codes, grouping them accordingly into broader overall themes. Documents were classified as either primary or secondary depending on their quality and whether they contained empirical data. From the 5452 reports identified, we selected 246 journal articles and 22 books for analysis. Seven key themes emerged: young people assess potential sexual partners as "clean" or "unclean"; sexual partners have an important influence on behaviour in general; condoms are stigmatising and associated with lack of trust; gender stereotypes are crucial in determining social expectations and, in turn, behaviour; there are penalties and rewards for sex from society; reputations and social displays of sexual activity or inactivity are important; and social expectations hamper communication about sex. The themes do not seem to be exclusive to any particular country or cultural background, and all themes were present, in varying degrees, in all countries assessed. This study summarises key qualitative findings that help in understanding young people's sexual behaviour and why they might have unsafe sex; policymakers must take these into account when designing HIV programmes. Considerable overlap exists between current studies, which indicates the need to broaden the scope of future work.

Loving with irony: young Bombay viewers discuss clothing, sex and their encounters with media

The media landscape in urban India has changed so rapidly in the past 10 years that it is not easy to consider the ways in which these changes interact with people's lives and beliefs. Apocalyptic pronouncements about the ways in which MTV‐style television, films and the Internet are destroying ‘genuine’ Indian culture by promoting western sexual values abound in journalistic and political circles. But what are the realities of young people's encounters with media in a thriving Indian metropolis? How do they make sense of all the vastly different images of sexuality embodied in community/religious edicts and modern media? And how are their interpretations of all these supposed ‘messages’ played out in their everyday lives? Emerging from a three‐year study of youth audiences of Hindi films in London and Bombay, this article explores the ways in which young people's sexual attitudes, values and behaviours are inflected by encounters with films, television and the Internet. By focusing on understandings of sex and love within the context of statements about community norms, sex education and personal sexual practices, this article also engages with ideas and myths about representations of women that have dominated recent debates on sex, censorship and the media in India.

Sex, lives and videotape

Various areas of the healthcare system are under pressure to find solutions to what are seen as the 'problems' of teenage pregnancy and the behaviours displayed by young people around sexual health issues. In many cases this has seen organizations such as Primary Care Trusts (PCTs) and Hospital Trusts charged with producing strategies and policies to influence the sexual behaviour of young people and to impact on the prominence of teenage pregnancy. It becomes clear, however, that any attempt to create policies or delivery systems to intervene in these areas will have a much greater chance of success if attempts are made to maximize the involvement of the young people in the process of constructing the delivery and content of health promotion approaches and service provision. This article outlines a process developed in Ashfield in Nottinghamshire whereby video interviews with community members, healthcare professionals and local young people formed the structure for focus groups. These were used to involve the community, and teenagers in particular, in the design of the service delivery. Videotaped interviews were conducted with local community members, local healthcare professionals and young people from the locality. The same interview schedule was used for each group but the responses showed marked differences of viewpoint between groups. Excerpts from the video interviews were used at externally facilitated focus groups firstly for young people, then for community members and then for healthcare professionals. A final large meeting brought the three groups together to discuss the important elements that a strategy should contain. The information gathered from the project influenced the development of the policy adopted by the PCT to engage with young people in the areas of teenage pregnancy and sexual health.

SEXUAL PRIVACY AND EARLY SEXUAL DEBUT IN NAIROBI INFORMAL SETTLEMENTS1

The purpose of this paper is to examine sexual privacy as a factor that may influence the relatively earlier sexual debut among the urban poor in Nairobi. 40 focus group discussions were held with people aged 13–17, 18–24, 25–49 and 50+ years, community leaders and service providers in four informal settlements of Nairobi. Lack of sexual privacy was identified as a major problem. Although adults were reported to use various means to acquire some measure of privacy, such as waiting for children to fall asleep, switching off the lights and separating the sleeping areas using curtains, these measures were found inadequate. The participants therefore associated young people's early initiation of sexual activity with lack of sexual privacy. Sexual privacy has not received adequate research attention as a dimension of poverty that influences young people's sexuality. More studies are called for to unravel the specific association between sexual privacy among adults and young people's sexual behaviour. The living conditions of the urban poor should also be addressed to mitigate the effects of lack of sexual privacy.

Thrills and spills: Young people's sexual behaviour andattitudes in seaside and rural areas

This paper reports on a qualitative study which explored attitudes to sexual risk-taking among young people in rural and seaside areas in England. The research was undertaken in three sites, each comprising a seaside resort and its rural hinterland. Data were collected through group discussions with 341 young people in secondary schools in England and through individual interviews with young people outside school settings, with young parents and with professionals working in the field of sexual health and education. Data analysis adopted a grounded theory approach and incorporated the views of local young people's advisory groups. Key features of the study which appeared specific to the locales studied were the influence of the seaside entertainment industry on young people's sexual behaviour and the high visibility experienced by young people in rural areas. Gender was also identified as playing a crucial role in determining perceptions of risk and influencing behaviour. Sexual health services and health promotion strategies need to acknowledge the relevance of factors such as gender and stigma for young people as well as being responsive to the specific features of local contexts.

Gender and Relationship Differences in Condom Use Among 15–24-Year-Olds in Angola

The sexual behavior of young people in Angola will play a major role in the future spread of HIV, yet few young people use condoms consistently, and reported rates of condom use are low. It is important to identify determinants of condom use among Angolan adolescents and young adults. Data for analysis came from 1,995 sexually experienced youth aged 15-24 who participated in a 2001 knowledge, attitudes and practices survey in Luanda, Angola. Logistic regression analysis was performed to identify predictors of consistent condom use by gender and determinants of condom use at last intercourse by type of relationship. For both males and females, consistent condom use was positively associated with higher levels of education (odds ratios, 1.7-2.6) and believing that condoms did not diminish sexual pleasure (1.8 for both genders). It was negatively associated with being married or in a cohabiting relationship (0.1-0.5). Females who equated condom use with lack of trust were less likely to use condoms consistently (0.5), and males who believed that condoms were safe and those who had multiple partners were more likely to be consistent users (1.6 and 1.7, respectively). Urban residence, higher education, being in school and not equating condom use with lack of trust were important predictors of use at last intercourse in regular and casual relationships, whereas access to condoms was the most important factor in spousal relationships (4.5). Intervention programs aimed at less educated, periurban and unemployed young people should be part of an effective HIV-prevention strategy. Such programs must address misperceptions among youth about condom use and the need for protection from HIV and other STIs.