Sexual Health Campaigns Research Articles

“It’s Your Body and Your Life:” Formative Audience Research to Develop a Sexual Health Campaign with Youth of Color

Young people account for over half of new STI cases and youth of color face increased sexual health disparities. In partnership with Fact Forward, researchers conducted qualitative formative audience research to develop a culture-centered health communication campaign to increase access to and use of sexual health services among youth of color in South Carolina. Grounded in a reproductive justice theoretical framework, this study employed innovative strategies, including training youth ambassadors to moderate peer-to-peer focus groups. A total of 134 participants were recruited for the study with 51 individuals participating in 9 focus groups and 83 respondents completing a web-based survey (ages 15-24). Qualitative data analyses used Nvivo 1.5.1. Statistical analyses used R Studio®. Findings revealed barriers including lack of education about risks. Participants identified dimensions of inequity and the importance of intersectional messaging to address intimacy, sexuality, and trust. They emphasized normalizing conversations about sexual health and the need for important others “in your corner” to provide support. Participants suggested an empowering storytelling approach to reduce shame surrounding sexual health services. Social media emerged as an optimal communication channel. UNC Perceived Message Effectiveness (PME) Scale scores ranged from 4.42 to 4.57 (out of 5) indicating that messages were well received by participants. Sex-positive campaign messaging focused on self-love, empowerment, and taking control of sexual health. This study offers practical suggestions to develop effective communication strategies to reach youth of color to increase use of sexual health services, including contraceptive counseling, STI prevention, screening, and treatment.

Let’s Talk About Condoms: Social Engagement in a Sexual Health Intervention Targeting Young Adults in Denmark

Objectives We tested whether social activities and interactions as part of a condom campaign strengthened young adults’ condom-use intentions and normative perceptions of condoms compared to simple exposure to campaign information. Method Data from 3,041 young adults collected after four annual condom campaigns were analyzed and combined into a meta-analysis. Results Interaction about the campaign and engagement in campaign-related activities was associated with higher condom use intention and more positive pro-condom norms. Conclusions The authors call for a greater emphasis on social influence in youth-aimed sexual health campaigns. Implications for the research are discussed.

Risky sexual practices and approaches to preventing sexually transmitted infections among urban dwelling older Yoruba men in Southwest Nigeria

Social and cultural norms and beliefs shape how men, as social actors, perceive and engage in sexual activities. Little is known about risky sexual practices and prevention strategies among older Yoruba men. As a growing concern in Nigeria, this paper explores risky sexual behaviours of older Yoruba men living in Ibadan, a metropolitan city, and their strategies for preventing sexually transmitted infections in old age. We held six focus groups and nine semi-structured interviews, with a total of 65 participants. The findings show that social norms allow older men to engage in multiple sexual relationships, which exposes them to sexually transmitted infections (STIs), and to use potent traditional medical protective and preventive measures to mitigate their vulnerability to sexually transmitted infections and the consequences of having sex with women under “magun.” Such measures include “magun” on men, incisions, amulets, and aseje (a traditionally prepared concoction). Additionally, the findings revealed that protective measures are against serious consequences of risky sexual behaviors, like sexual pleasures and death. The findings point to the need for more inclusive sexual health and HIV campaigns and strategies addressing the sexual health challenges of all men and women and must be culturally sensitive.

Incidence of unintended pregnancy and associated factors among adolescent girls and young women at risk of HIV infection in Kampala, Uganda.

In sub-Saharan Africa, one in every five young women becomes pregnant, and 50% of these are unintended. Pregnancies in adolescent girls and young women (AGYW) are associated with poorer maternal and neonatal outcomes and a high abortion rate, yet data are still limited on incident pregnancies among AGYW in vulnerable situations. We studied the incidence and factors associated with unintended pregnancy among AGYW who were frequently engaged in transactional sex in Kampala, Uganda. We analyzed data from a study that investigated the uptake of oral pre-exposure prophylaxis among AGYW from January 2019 to December 2020. Volunteers attended 3-monthly study visits for 12 months each. Contraceptive services were provided to interested volunteers free of charge. Interviewers collected data on sociodemographics, sexual behavior, reproductive health outcomes, and substance use. Pregnancy was determined by testing for beta-human chorionic gonadotropin hormone in urine. The pregnancy incidence rate was estimated using the Kaplan-Meier technique, and logistic regression was used to determine the correlates of pregnancy. We included 285 volunteers with a mean age of 19.9 [standard deviation (SD), ± 2.24] years; 54.7% had attained secondary school education or higher, 57.2% were single (never married), 92.6% reported engaging in transactional sex, 21.0% reported sex work as their main job, 51.9% consumed alcohol in the month prior to the interview, of whom 12.8% consumed alcohol daily, and 25.3% had Chlamydia trachomatis/Neisseria gonorrhoeae. The mean age at first sexual intercourse was 15.7 (SD, ±2.1) years. We recorded 44 pregnancies over 187.2 person-years of follow-up, an incidence of 23.5 per 100 person-years [95% confidence interval (CI), 17.5-31.6]. Incident pregnancies were more likely among volunteers who had ≥10 sexual partners in the past 3 months [adjusted risk ratio (aRR) 1.97; 95% CI, 1.05-3.70] and those who reported not using contraception (aRR 5.89; 95% CI, 2.74-12.66). Incident pregnancies were less likely among those who reported alcohol consumption in the past month (aRR 0.52; 95% CI, 0.30-0.90). The incidence of unintended pregnancy was high despite the availability of free contraceptive services. We recommend sociobehavioral studies to explore this further. Sexual and reproductive health campaigns should strengthen demand creation and motivation to use contraception among young women with multiple sexual partners.

A qualitative evaluation of a Nudgeathon event for the co-design of sexual health campaign images targeting overseas-born men who have sex with men.

Additional approaches to HIV prevention and management, such as Nudgeathons, are required to increase access to HIV pre-exposure prophylaxis (PrEP) among overseas-born men who have sex with men (MSM). In September 2021, we conducted a 4-h online Nudgeathon, wherein four teams co-designed behaviourally informed adverts to improve PrEP access and uptake for overseas-born MSM. After the Nudgeathon, eight of 17 invited Nudgeathon attendees were interviewed about their experience. We conducted a qualitative content analysis of interview data to highlight participants' experiences of the co-design process. We identified three major themes: (1) what worked well; (2) group dynamics; and (3) improvement and future directions. The Nudgeathon about PrEP was a positive learning experience, with valuable contributions and overall satisfaction with the end-products. The online format was perceived as less costly than if the Nudgeathon was hosted in person, and suitable for participants from different geographical regions. In-person Nudgeathons with international attendees would require costs for flights, accommodation, function room hire and catering. Within groups, sharing personal experiences essential to co-designing concepts. However, less information on how to create nudges and more information before the Nudgeathon was preferred. Our evaluation finds that Nudgeathons are fast and efficient in developing potential solutions to complex issues related to HIV prevention.

Sources of Information about Pre-Exposure Prophylaxis (PrEP) and Associations with PrEP Stigma, Intentions, Provider Discussions, and Use in the United States

ABSTRACT The amount and type of information individuals receive about HIV pre-exposure prophylaxis (PrEP) may influence PrEP uptake. We surveyed 331 HIV-negative sexual and gender minorities who have sex with men at a Midwestern Pride festival in 2018 (M age = 32, 68% White, 87% cisgender men) to assess sources and perceived tone of PrEP information and associated outcomes. Most participants (88%) had heard about PrEP. The most common sources were the internet (70%), social media (59%), and friends (54%). Messages from health campaigns were perceived as most positive and those from religious institutions as least positive. Sources differed based on demographics. Controlling for indications for PrEP use, those who heard about PrEP from health campaigns and those who heard more positive messages reported lower levels of PrEP stigma, βs = −0.27––0.23, ps < .05. Non-users who heard about PrEP from the internet had stronger intentions to use PrEP, β = 0.28, p < .05. Those who heard about PrEP from sexual partners and health campaigns were more likely to discuss PrEP with providers, PRs = 1.60–1.80, ps < .01. Finally, those who heard about PrEP from friends and partners were more likely to use PrEP, PRs = 2.01–2.24, ps < .05. Leveraging sexual partners, social network members, and health campaigns are promising avenues to advance PrEP implementation.

Increasing Condom Use and STI Testing: Creating a Behaviourally Informed Sexual Healthcare Campaign Using the COM-B Model of Behaviour Change

Sexually transmitted infections (STIs) are a major public health challenge. Although theoretically informed public health campaigns are more effective for changing behaviour, there is little evidence of their use when campaigns are commissioned to the commercial sector. This study describes the implementation of the COM-B model to a sexual health campaign that brought together expertise from academics, sexual healthcare, and marketing and creative professionals. Insights were gathered following a review of the relevant academic literature. Barriers and facilitators to condom use and STI testing were explored with the use of the COM-B model and the Behaviour Change Wheel in a workshop attended by academics, behavioural scientists, healthcare experts and creative designers. Feedback on the creative execution of the campaign was obtained from healthcare experts and via surveys. Barriers to psychological capability, automatic and reflective motivation, and social opportunity were identified as targets for the campaign, and creative solutions to these barriers were collaboratively devised. The final sexual health campaign was rated positively in its ability to change attitudes and intentions regarding the use of condoms and STI testing. This study describes the implementation of the COM-B model of behaviour change to a public sexual health campaign that brought together academics, public and commercial sector expertise. The barriers and facilitators identified in this collaborative process represent potential targets for future public health communication campaigns.

Investigación sobre el diseño y la evaluación de las campañas de prevención en salud sexual dirigidas a jóvenes en España desde 1987 a 2016

IntroductionNew HIV diagnoses and sexually transmitted infections (STIs) continue to be a public health problem in Spain. Since the beginning of HIV infection in our country, prevention campaigns have been developed by the Health Services regarding sexual and reproductive health. Several authors warn about the poor evaluation of these campaigns. ObjectiveTo evaluate the design and evaluation strategies of the sexual health campaigns developed in Spain from 1987 to 2016. MethodsObservational epidemiological study based on a detailed retrospective collection of data obtained from the National AIDS Plan, official agencies and Health Services about the design and evaluation of developed sexual health campaigns. Statistical analysis was performed using UNAIDS indicators system. Results82 campaigns have been developed since 1987, 27 have been aimed at young people. In 100% of campaigns aimed at young people, general information about HIV infection and the promotion of condom use has been addressed; however, other issues about risky sexual behavior have virtually not been included. The prevention of pregnancy in young people is present in less than 25% of campaigns. The quantity of planning and evaluation reports of the available campaigns is very low. ConclusionThe data indicate the need to improve actions aimed at sexually active young people, with more planned and evaluated actions for regarding UNAIDS criteria and efficacy indicators.

Experiences of women with Zika virus (ZIKV) versus the provision of health services in two cities in Colombia: A qualitative study.

In February 2016, the World Health Organization (WHO) declared the epidemic of the ZIKA virus (ZIKV) in Latin America to be a public health emergency. In Colombia, 11,944 pregnant women registered a ZIKV infection during the epidemic. So far, little is known about the experiences of women infected with ZIKV during their pregnancy, especially those relating to the provision of health services during the period of the epidemic. To explore the experiences of pregnant women diagnosed with ZIKV infection about the provision of health services in two Colombian cities, considering the perspective of sexual and reproductive rights. Qualitative study under the grounded theory approach, which uses semi-structured interviews as tools to explore the biographical experience of mothers during their gestation process and ZIKV infection, dividing the interview into two broad categories: before and during pregnancy. Twenty-two women were interviewed, 10 in Cali and 12 in Villavicencio. The average age at the time of pregnancy was 27.6 years. Most women were not planning at the time of pregnancy and the pregnancy was unwanted. Most campaigns focused on mosquito eradication rather than on sexual and reproductive health campaigns. The quality of health care was not sufficient, adequate, or appropriate. Also, the breakdown of the health system to deal with the pandemic was also noted. Some women were treated with disrespect by health professionals. Voluntary termination of pregnancy was inadequately advised, and women lost autonomy regarding decisions about their health. In the health care of ZIKV epidemics, it is necessary to include the gender perspective, more specifically, sexual and reproductive rights. In addition, these epidemics must be addressed through a comprehensive, appropriate, and not fragmented health system, in which sexual and reproductive rights must be mainstreamed in all health promotion and prevention programs.

Got a Spark with Brook? Engaging Consumers in a Sexual Health Campaign through the Use of Creative (Metaphorical) Double Entendres

ABSTRACT This paper describes a study conducted in collaboration with a marketing agency and a nonprofit organization (NPO) providing regional sexual health services, which included advice on, and testing for, sexually transmitted infections (STIs). The study investigated the relative effectiveness of different formulations of double entendres on appeal, humor, the likelihood of social media engagement, and intention to seek more information about STIs. Advertisements containing double entendres were significantly more appealing and humorous if: (1) the grammatical formulation did not cue the intended meaning; (2) the double entendre involved a creative metaphorical expression; and (3) the double entendre referred to the middle part of the sexual scenario, referring to action rather than intent or result. Participants’ ratings varied very little according to their age, gender, and education. However, a qualitative investigation of the free-text responses revealed that there was some variation in the types of interpretations that were offered by participants depending on their age, gender, and education. The marketing agency incorporated our findings into their live campaign, which resulted in a notable increase in: (a) website traffic and social media engagement; (b) STI home-testing kits ordered; and (c) STI kits returned for testing, compared with previous campaigns.

Barriers to older adults seeking sexual health advice and treatment: A scoping review

BackgroundSexual health is an integral part of overall health in older age. Research consistently reports that heterosexual and queer older people tend not to disclose sexual concerns and difficulties which increases the risks for sexually transmitted diseases. Older people are often absent from policies and information programmes and healthcare providers experience difficulties in initiating conversations around sexual health and history. ObjectivesTo identify what are the barriers that stop older people seeking sexual health advice and treatment. Design and methodA scoping review methodology was employed. Published and unpublished literature was scoped through development of a research question, identification of potentially relevant studies, selection of relevant studies using an iterative team approach, charting data, collating, summarising and reporting findings, and considering the implications of study findings for further research. Data sourcesElectronic databases searches were run to identify published and unpublished literature, including Medline, Embase, PsycINFO, CINAHL, ASSIA, Social Sciences, RCN and Cochrane Libraries. Additional studies were located through hand searching. ResultsTwelve studies from: the USA (n = 6); the UK (n = 3); Australia (n = 2); and one shared paper between New Zealand and UK met the inclusion criteria. Four barriers that stop older people seeking sexual health advice and treatment were identified, including (1) Cultural and societal views and beliefs toward sexual health; (2) Stigma, embarrassment and discrimination; (3) Lack of education and training of healthcare professionals; (4) Quality of relationship between patients and health professionals. ConclusionBarriers to seeking and receiving advice and treatment for sexual health in later life clearly exist and are both related to cultural and social factors. Overall, the papers reviewed in this scoping review indicate that healthcare providers are reluctant to initiate conversations around sexual health or offer appropriate advice or clinical tests, and that older people tend to be hesitant to seek medical help. Later life age groups independently from their sexual orientation represent a hidden population and are absent from sexual health campaigns and government policies. Efforts need to be made by influential institutions and healthcare providers to recognise sexuality in older age and give older people the opportunity to open up regarding their sexual health and experiences.

BOOK REVIEW THE ISSUES AT STAKE – THEORIES AND PRACTICES IN THE CONTEMPORARY WOMEN’S MOVEMENTS IN INDIA BY NANDITA GANDHI AND NANDITA SHAH

The authors begin the book with „Who “we” are‟….which puts them in the context of their childhood and young age which was influenced by the Nationalist Movement, Charisma od Gandhiji, Alexander Dumas, Maxim Gorky, Mulk Raj Anand, and many other worlds and national phenomena. They also talk about their detachment for the first-hand experiences of the troubled and tortured as they were coming from the upper middle class Hindu savarna families. In the process of narrowing down the whole idea of movements related to women‟s issues, the authors have selected four major areas namely sexual violence, health, work, and legal campaigns. They also excluded the collection of case studies form their preview. By 1984, they came up with their first office with the name” the Women‟s Decade Research Collective- WDRC. In 1985, they got a grant from the ISS Holland. By 1986 their struggle started in the various parts of India to collect the stories/ data/ cases and documents. Their train journey from Assam to Benaras to Madhya Pradesh taught them to be a part of the daily struggle put up by the women across India. The action program got strengthened by the little surveys they took and the information and advice they picked up during the journey. The women‟s movement has no beginning or “origin”. It exists as an emotion, anger deep within us. The women‟s movement history also is like notes in a cycle of rhythm; each is a eparate piece, yet a part of the whole.

English

This paper presents a literature review of the sexual reproductive health campaign messages and highlights the milestones in the existing literature. The review begins with definition of health campaign messages and other key concepts. The subject is then situated within the discipline of communication studies particularly within the branch of health communication. A review of relevant theories follows after which previous research on health campaign messages is highlighted. The paper concludes by pointing out the potential areas of further research on the subject of health campaign messages in Kenya. This paper highlights the key concerns cited among the literature to demonstrate the milestones achieved in sexual reproductive health issues and identifies gaps in research to underscore the need, within a uniquely Kenyan context, for subsequent studies. &nbsp; Key words: Communication studies, Health communication, Health campaign messages, Kenyan sexual reproductive health.

Crowdsourcing to Improve HIV and Sexual Health Outcomes: a Scoping Review.

This review synthesizes evidence on the use of crowdsourcing to improve HIV/sexual health outcomes. We identified 15 studies, including four completed randomized controlled trials (RCTs), one planned RCT, nine completed observational studies, and one planned observational study. Three of the four RCTs suggested that crowdsourcing is an effective, low-cost approach for improving HIV testing and condom use among key populations. Results from the observational studies revealed diverse applications of crowdsourcing to inform policy, research, and intervention development related to HIV/sexual health services. Crowdsourcing can be an effective tool for informing the design and implementation of HIV/sexual health interventions, spurring innovation in sexual health research, and increasing community engagement in sexual health campaigns. More research is needed to examine the feasibility, acceptability, and effectiveness of crowdsourcing interventions, particularly in low- and middle-income countries.

Quantitative evaluation of an innovation contest to enhance a sexual health campaign in China

BackgroundCrowdsourcing method is an excellent tool for developing tailored interventions to improve sexual health. We evaluated the implementation of an innovation contest for sexual health promotion in China.MethodsWe organized an innovation contest over three months in 2014 for Chinese individuals < 30 years old to submit images for a sexual health promotion campaign. We solicited entries via social media and in-person events. The winning entry was adapted into a poster and distributed to STD clinics across Guangdong Province. In this study, we evaluated factors associated with images that received higher scores, described the themes of the top five finalists, and evaluated the acceptability of the winning entry using an online survey tool.ResultsWe received 96 image submissions from 76 participants in 10 Chinese provinces. Most participants were youth (< 25 years, 85%) and non-professionals (without expertise in medicine, public health, or media, 88%). Youth were more likely to submit high-scoring entries. Images from professionals in medicine, public health, or media did not have higher scores compared to images from non-professionals. Participants were twice as likely to have learned about the contest through in-person events compared to social media. We adapted and distributed the winning entry to 300 STD clinics in 22 cities over 2 weeks. A total of 8338 people responded to an acceptability survey of the finalist entry. Among them, 79.8% endorsed or strongly endorsed being more willing to undergo STD testing after seeing the poster.ConclusionsInnovation contests may be useful for soliciting images as a part of comprehensive sexual health campaigns in low- and middle-income countries.

Quantitative evaluation of an innovation contest to enhance a sexual health campaign in China

Quantitative evaluation of an innovation contest to enhance a sexual health campaign in China

Improving the sexual lives of older Australians: Perspectives from a qualitative study.

To examine older Australian's perspectives on how their sexual lives can best be supported and/or improved. Fifty-three, semi-structured interviews were conducted with Australian men (n = 30) and women (n = 23) aged 60 and over. Participants identified a range of key issues and areas where their sexual lives could be further supported or improved upon, including normalising the occurrence of sex and sexual desire in later life; increasing and improving on the quality of, cultural representations of older adults; introducing policy, educational and practice-based changes in age care facilities to support the consensual sexual expression of residents; and ensuring that sexual health campaigns and education are inclusive of older people. Our findings present clear implications for further developing sexuality education and public health campaigns, training and education of health-care professionals, and generating social and cultural change pertaining to the acceptability of the diversity of sexual expression in later life.

Culture Clash: Shona (Zimbabwean) Migrant Women's Experiences with Communicating about Sexual Health and Wellbeing across Cultures and Generations.

This paper discusses the influence of cross-cultural modes of communication on perceptions of sexual health and wellbeing for Shona (Zimbabwean) women living in Australia and their children. Data was collected using focus groups in South Australia with fourteen women, between the ages of 29 and 53. Transcripts were analysed thematically. The women primarily constructed sexual health and wellbeing in customary Shona ways, which not only maintain secrecy about sexual health and wellbeing discourse, but also prohibit parents from talking to children about sexual health as such talk is reserved for particular kin and non-kin relationships. These constructions however became more fluid the longer the women resided in Australia. For these women the notions of sexual health and wellbeing are a negotiation between Australian constructs and those from Shona culture, especially when applied to their children. This research highlights the potential influence of various cultural world views on sexual health communication among African migrant women and their children and questions the appropriateness of sexual health and wellbeing campaigns and their responsiveness for cross-cultural youth.

Using Facebook for Sexual Health Social Marketing in Conservative Asian Countries: A Systematic Examination

Social marketing related to sexual health is a problematic task, especially in religiously and/or culturally conservative countries. Social media presents a possible alternative channel for sexual health efforts to disseminate information and engage new users. In an effort to understand how well sexual health campaigns and organizations have leveraged this opportunity, this study presents a systematic examination of ongoing Facebook-based sexual health efforts in conservative Asian countries. It was discovered that out of hundreds of sexual health organizations identified in the region, less than half had created a Facebook page. Of those that had, only 31 were found to have posted sexual health–relevant content at least once a month. Many of these 31 organizations were also unsuccessful in maintaining regular official and user activity on their page. In order to assess the quality of the Facebook pages as Web-based information resources, the sexual health–related official activity on each page was analyzed for information (a) value, (b) reliability, (c) currency, and (d) system accessibility. User responsiveness to official posts on the pages was also used to discuss the potential of Facebook as a sexual health information delivery platform.

Creative Contributory Contests to Spur Innovation in Sexual Health: 2 Cases and a Guide for Implementation.

Sexual health campaigns are often designed "top-down" by public health experts, failing to engage key populations. Using the power of crowdsourcing to shape a "bottom-up" approach, this note describes 2 creative contributory contests to enhance sexual health campaigns. We provide guidance for designing creative contributory contests to improve HIV and other sexually transmitted disease testing.