Sexual Health Messages Research Articles

Engaging Adults in Sexual Health Messages: Examining the Posts of Pornographic Performers’ Social Media

Engaging Adults in Sexual Health Messages: Examining the Posts of Pornographic Performers’ Social Media

"Speak from a place of love": The family dynamics surrounding Black father-daughter sexual health communication.

Parent-child sexual health communication reduces sexual risk behaviors among youth, which in turn lowers the transmission rate of HIV and sexually transmitted infections. Despite being a known protective factor, gender differences persist with mothers being more likely to discuss sexual health with their children than fathers. Although individual characteristics, interpersonal familial factors and societal norms (e.g., communication self-efficacy, parent-child closeness, and cultural and gender norms) are associated with Black parents'likelihood to communicate about sex with their children, the current study seeks to explore which of these factors found among Black mother-child or father-son dyads extend to Black father-daughter dyads and how this phenomenon (i.e., Black father-daughter sexual health communication) relates to family structure. Seven father-daughter dyads (N = 7) and an additional five daughters (n = 5) in the United States completed individual in-depth semi-structured interviews. Daughters (Mage = 20.3) and fathers (Mage = 56.7) were biologically related, majority heterosexual, close, and lived together. Data were transcribed verbatim and analyzed using thematic analysis. Analysis revealed three themes centering around the role of authoritative parenting, the tactics and skills facilitating sexual health communication, and family structure. Black father-daughter sexual health communication is facilitated by close father-daughter relationships, non-authoritative parenting styles, and open, supportive, and non-judgmental communication. Fathers can be better supported in knowing how and when best to communicate sexual health messages, and to mitigate the possibly negative impacts on communication of divorce or having multiple children.

Sexual attitudes and utilization of sexual and reproductive health services among older women in southern China: a qualitative study.

Sexual health plays a vital role in healthy aging. However, little is known about the sexual attitudes of and the utilization of sexual and reproductive health services by older women in China. This article is based on a qualitative study of older Chinese women in suburban areas to examine their attitudes toward sexuality and their utilization of sexual and reproductive health services. Face-to-face semi-structured interviews were conducted with older women (ages 50 to 74) from suburbs of southern China. Participants were purposively sampled on a convenience basis and recruited when they were visiting community health facilities between June and December 2021. Inclusion criteria were older women aged 50 years and older who had sexual experience. A topic guide was used that focused on sexual activity, sexual attitudes, the utilization of sexual and reproductive health services, and the factors that influence these. Interviews were audio recorded and transcribed verbatim. We coded the data inductively and conducted a thematic analysis. Twenty-six Chinese women participated in the study. These older women had varying attitudes regarding sexual activity and its significance for older adults. The gender norms they held concerning sexual desire deemed that men had higher sexual desire than women. Most asymptomatic women did not actively seek sexual and reproductive health services. In most cases, women only sought professional services when they started to have sexual and reproductive health problems. Factors influencing the uptake of sexual and reproductive health services by older women were cost (affordability), availability, distance (accessibility), and conservative cultural norms towards sexuality. The attitudes of older women towards sexual activity are diverse. While some view sexual activity as common and essential for maintaining a sense of well-being in older age, others may hold different perspectives, considering it less significant. The utilization of sexual and reproductive health services by older Chinese women, except for when they were having a specific health issue, was low. Sexual health messages and services tailored for older women are needed.

Men’s Feminist Identification and Reported Use of Prescription Erectile Dysfunction Medication

ABSTRACT We analyzed data from the 2018 Sex in Canada survey (n = 1,015 cisgender men) to examine the association between feminist identification and reported use of prescription ED medication (EDM) during men’s last sexual encounter. Feminist-identified men were substantially more likely to report EDM use than non-feminist men, even after controlling for alcohol use before sex, erection difficulties, sexual arousal, sexual health, mental health, and physical health. One explanation is that feminist men may use EDM to bolster their masculinity when it is otherwise threatened by their identification as feminist. Another is that non-feminist men may be less likely to use prescription EDM because they view accessing healthcare services as a threat to their masculinity. It is also possible that feminist men are more likely to use EDM because they wish to maintain an erection to better please their partner. Lastly, feminist men may be more honest about EDM use than non-feminist men, even though rates are similar. Regardless of the exact reason, therapists can use these results to tailor sexual health messages to clients based on feminist identification. Future work could employ qualitative methods to understand why feminist men report higher rates of EDM use than non-feminist men.

Giving condoms to school children: educators’ views on making condoms available in South African schools

One of the policy goals of the South African Department of Basic Education’s National Policy on HIV, STIs and TB of 2017 is to reduce the incidence of HIV and pregnancy among learners. This is expected to be achieved by improving access to prevention services, including the provision of condoms in schools. This study uses street- level bureaucracy theory to explain how educators can play a more productive role in ensuring that policy goals are achieved. Educators provide their views on their role as condom promotion agents, their perception of demand and utilisation among learners, as well as their insights on suitable distribution mechanisms in the school setting. Trepidation exists among educators about their roles in the promotion and education of condoms. Educator statements suggest that they see the value in their policy-ascribed role to deliver sexual health messages and are also open to performing a role in the distribution of condoms at schools. However, our findings reveal that their role as policy communicators or “street-level bureaucrats” is complicated by inadequate policy guidance. We therefore conclude that to achieve optimal outcomes in terms of safer sexual practices among learners, condom messaging and distribution mechanisms in school settings require evidence-informed implementation strategies.

Sexual Health Literacy and the Related Factors among Women in Qazvin, Iran

Aims: Sexual health literacy is a context-based variable affected by the ecosystem or a set of cultural and social factors of each community. This study aimed to determine sexual health literacy and the related factors. Instrument & Methods: This was a cross-sectional study. The population of this study was 305 women referring to the health centers of Qazvin, Iran. Sampling was done through a one-stage cluster method. The data collection tool was a demographic and the standard questionnaire sexual health literacy for adults. Data were analyzed using SPSS 22 and descriptive statistics and logistic regression. Findings: In this study, 44.9% of women were under 30 years old. The mean±SD of sexual health literacy was 76.89±18.32. Women had 7.9% inadequate sexual health literacy, 9.5% had inadequate sexual health literacy, 50.1% had adequate sexual health literacy, and 32.5% had excellent sexual health literacy. The results of the logistic regression test showed that the variables of education level, spouse education level, and use of contraceptives affect women's health literacy (p<0.05). Conclusion: Women with a lower education level, women whose spouses had low education levels, and women who did not use contraceptives had lower sexual health literacy. Therefore, according to the role of sexual health literacy in understanding, accepting, and applying sexual health messages, it is suggested that researchers and health providers pay more attention to the mentioned women in designing educational programs to promote women's sexual health literacy.

Understanding how young African adults interact with peer-generated sexual health information on Facebook and uncovering strategies for successful organic engagement

BackgroundThe use of social media for sexual health communication is gaining intense discussion both globally and in Africa. Despite this reality, it remains unclear whether and how young African adults use digital innovations like social media to access sexual health information. More importantly, the unique properties of messages that increase message reach and propagation are not well understood. This study aims to fill the gaps in scholarship by identifying post features and content associated with greater user engagement.MethodsWe analyzed a corpus of 3533 sexual and reproductive health messages shared on a public Facebook group by and for young African adults between June 1, 2018, and May 31, 2019, to understand better the unique features associated with higher engagement with peer-generated sexual health education. Facebook posts were independently classified into thematic categories such as topic, strategy, and tone of communication.ResultsThe participants generally engaged with posts superficially by liking (x̃ = 54; x̄ = 109.28; σ = 159.24) rather than leaving comments (x̃ = 10; x̄ = 32.03; σ = 62.65) or sharing (x̃ = 3; x̄ = 11.34; σ = 55.12) the wallposts. Messages with fear [IRR:0.75, 95% CI: 0.66–0.86] or guilt [IRR:0.82, 95% CI: 0.72–0.92] appeals received a significantly lower number of reactions compared to neutral messages. Messages requesting an opinion [IRR:4.25, 95% CI: 3.57–5.10] had a significantly higher number of comments compared to status updates. The use of multimedia and storytelling formats were also significantly associated with a higher level of engagement and propagation of sexual health messages on the group.ConclusionYoung adults in our sample tend to superficially interact with peer-communicated sexual health information through likes than engage (comments) or propagate such messages. Message features that increase engagements and propagation of messages include multimedia and engaging styles like storytelling. Our findings provide valuable insight and pave the way for the design of effective and context-specific sexual health information use of features that attract young African adults.

Formative Study of Mobile Phone Use for Family Planning Among Young People in Sierra Leone: Global Systematic Survey.

BackgroundTeenage pregnancy remains high with low contraceptive prevalence among adolescents (aged 15-19 years) in Sierra Leone. Stakeholders leverage multiple strategies to address the challenge. Mobile technology is pervasive and presents an opportunity to reach young people with critical sexual reproductive health and family planning messages.ObjectiveThe objectives of this research study are to understand how mobile health (mHealth) is used for family planning, understand phone use habits among young people in Sierra Leone, and recommend strategies for mobile-enabled dissemination of family planning information at scale.MethodsThis formative research study was conducted using a systematic literature review and focus group discussions (FGDs). The literature survey assessed similar but existing interventions through a systematic search of 6 scholarly databases. Cross-sections of young people of both sexes and their support groups were engaged in 9 FGDs in an urban and a rural district in Sierra Leone. The FGD data were qualitatively analyzed using MAXQDA software (VERBI Software GmbH) to determine appropriate technology channels, content, and format for different user segments.ResultsOur systematic search results were categorized using Grading of Recommended Assessment and Evaluation (GRADE) into communication channels, audiovisual messaging format, purpose of the intervention, and message direction. The majority of reviewed articles report on SMS-based interventions. At the same time, most intervention purposes are for awareness and as helpful resources. Our survey did not find documented use of custom mHealth apps for family planning information dissemination. From the FGDs, more young people in Sierra Leone own basic mobile phones than those that have feature capablilities or are smartphone. Young people with smartphones use them mostly for WhatsApp and Facebook. Young people widely subscribe to the social media–only internet bundle, with the cost ranging from 1000 leones (US $0.11) to 1500 leones (US $0.16) daily. Pupils in both districts top-up their voice call and SMS credit every day between 1000 leones (US $0.11) and 5000 leones (US $0.52).ConclusionsmHealth has facilitated family planning information dissemination for demand creation around the world. Despite the widespread use of social and new media, SMS is the scalable channel to reach literate and semiliterate young people. We have cataloged mHealth for contraceptive research to show SMS followed by call center as widely used channels. Jingles are popular for audiovisual message formats, mostly delivered as either push or pull only message directions (not both). Interactive voice response and automated calls are best suited to reach nonliterate young people at scale.

Feasibility study of peer-led and school-based social network Intervention (STASH) to promote adolescent sexual health

BackgroundEffective sex education is the key to good sexual health. Peer-led approaches can augment teacher-delivered sex education, but many fail to capitalise on mechanisms of social influence. We assessed the feasibility of a novel intervention (STASH) in which students (aged 14–16) nominated as influential by their peers were recruited and trained as Peer Supporters (PS). Over a 5–10-week period, they spread positive sexual health messages to friends in their year group, both in-person and via social media, and were supported to do so via weekly trainer-facilitated meetings. The aims of the study were to assess the feasibility of STASH (acceptability, fidelity and reach), to test and refine the programme theory and to establish whether the study met pre-set progression criteria for continuation to larger-scale evaluation.MethodsThe overall design was a non-randomised feasibility study of the STASH intervention in 6 schools in Scotland. Baseline (n=680) and follow-up questionnaires (approx. 6 months later; n=603) were administered to the intervention year group. The control group (students in year above) completed the follow-up questionnaire only (n=696), 1 year before the intervention group. The PS (n=88) completed a brief web survey about their experience of the role; researchers interviewed participants in key roles (PS (n=20); PS friends (n=22); teachers (n=8); trainers (n=3)) and observed 20 intervention activities. Activity evaluation forms and project monitoring data also contributed information. We performed descriptive quantitative analysis and thematic qualitative analysis.ResultsThe PS role was acceptable; on average across schools >50% of students nominated as influential by their friends, signed up and were trained (n=104). This equated to 13% of the year group. Trained PS rarely dropped out (97% completion rate) and 85% said they liked the role. Fidelity was good (all bar one trainer-led activity carried out; PS were active). The intervention had good reach; PS were reasonably well connected and perceived as ‘a good mix’ and 58% of students reported exposure to STASH. Hypothesised pre-conditions, contextual influences and mechanisms of change for the intervention were largely confirmed. All bar one of the progression criteria was met.ConclusionThe weight of evidence supports continuation to full-scale evaluation.Trial registrationCurrent controlled trials ISRCTN97369178

Social Network Research contribution to evaluating process in a feasibility study of a peer-led and school-based sexual health intervention

There is growing interest in social network-based programmes to improve health, but rigorous methods using Social Network research to evaluate the process of these interventions is less well developed. Using data from the “STis And Sexual Health” (STASH) feasibility trial of a school-based, peer-led intervention on sexual health prevention, we illustrate how network data analysis results can address key components of process evaluations for complex interventions—implementation, mechanisms of impacts, and context. STASH trained students as Peer Supporters (PS) to diffuse sexual health messages though face-to-face interactions and online Facebook (FB) groups. We applied a Multilevel Exponential Random Graph modelling approach to analyse the interdependence between offline friendship relationships and online FB ties and how these different relationships align. Our results suggest that the creation of online FB communities mirrored offline adolescent groups, demonstrating fidelity of intervention delivery. Data on informal friendship networks related to student’s individual characteristics (i.e., demographics, sexual health knowledge and adherence to norms, which were included for STASH), contributed to an understanding of the social relational ‘building’ mechanisms that sustain tie-formation. This knowledge could assist the selection of opinion leaders, improving identification of influential peers situated in optimal network positions. This work provides a novel contribution to understanding how to integrate network research with the process evaluation of a network intervention.

Pathways to sexual decision making by Pentecostal church youths in Botswana

BackgroundThe ways church youth make sexual decisions are incompletely understood and yet important for public health interventions. This study aimed to examine personal religiosity influences on the sexual decisions by church youth from the country of Botswana, taking into account their sense of personal agency.MethodParticipants were 235 Botswana Pentecostal faith church youth (females = 67.2%, male = 32.8%; age range 12–23 years). They completed measures of personal religiosity, personal agency, sexual abstinence, and contraception use predisposition. We analysed the data applying Structural Equation Modelling to test five paths - personal religiosity to personal agency, personal agency to abstinence, personal religiosity to abstinence, personal agency to contraceptive use, and personal religiosity to contraceptive use.ResultsResults suggest that personal religiosity influences the youth in their sexual abstinence and contraception decisions through personal agency. High personal agency, but not personal religiosity, was associated with pro-sexual abstinence, and contraception use was associated with religiosity. Personal agency augmented the likelihood of both abstinence and contraception use decisions among the older church youth and with church youth with higher levels of formal education.ConclusionChurch youth likely adopt discretionary sexual behaviours over the developmental period from early to older adolescents, which would make them more receptive to public sexual health messages. Personal agency appears to be an important resource for public health interventions aimed at influencing church youth’s sexual decisions.

Peer-to-Peer Sharing of Social Media Messages on Sexual Health in a School-Based Intervention: Opportunities and Challenges Identified in the STASH Feasibility Trial.

BackgroundThere is a strong interest in the use of social media to spread positive sexual health messages through social networks of young people. However, research suggests that this potential may be limited by a reluctance to be visibly associated with sexual health content on the web or social media and by the lack of trust in the veracity of peer sources.ObjectiveThe aim of this study was to investigate opportunities and challenges of using social media to facilitate peer-to-peer sharing of sexual health messages within the context of STASH (Sexually Transmitted Infections and Sexual Health), a secondary school-based and peer-led sexual health intervention.MethodsFollowing training, and as a part of their role, student-nominated peer supporters (aged 14-16 years) invited school friends to trainer-monitored, private Facebook groups. Peer supporters posted curated educational sex and relationship content within these groups. Data came from a feasibility study of the STASH intervention in 6 UK schools. To understand student experiences of the social media component, we used data from 11 semistructured paired and group interviews with peer supporters and their friends (collectively termed students; n=42, aged 14-16 years), a web-based postintervention questionnaire administered to peer supporters (n=88), and baseline and follow-up questionnaires administered to students in the intervention year group (n=680 and n=603, respectively). We carried out a thematic analysis of qualitative data and a descriptive analysis of quantitative data.ResultsMessage sharing by peer supporters was hindered by variable engagement with Facebook. The trainer-monitored and private Facebook groups were acceptable to student members (peer supporters and their friends) and reassuring to peer supporters but led to engagement that ran parallel to—rather than embedded in—their routine social media use. The offline context of a school-based intervention helped legitimate and augment Facebook posts; however, even where friends were receptive to STASH messages, they did not necessarily engage visibly on social media. Preferences for content design varied; however, humor, color, and text brevity were important. Preferences for social media versus offline message sharing varied.ConclusionsInvitation-only social media groups formed around peer supporters’ existing friendship networks hold potential for diffusing messages in peer-based sexual health interventions. Ideally, interactive opportunities should not be limited to single social media platforms and should run alongside offline conversations. There are tensions between offering young people autonomy to engage flexibly and authentically and the need for adult oversight of activities for information accuracy and safeguarding.

A peer-led intervention to promote sexual health in secondary schools: the STASH feasibility study

BackgroundYoung people report higher levels of unsafe sex and have higher rates of sexually transmitted infections than any other age group. Schools are well placed to facilitate early intervention, but more effective approaches are required. Peer-led approaches can augment school-based education, but often fail to capitalise on mechanisms of social influence. The potential of using social media in sexual health has not been tested in school settings.ObjectivesFinalise the design of the Sexually Transmitted infections And Sexual Health (STASH) intervention; assess the recruitment and retention of peer supporters, and acceptability to participants and stakeholders; assess the fidelity and reach, in addition to the barriers to and facilitators of, implementation; refine programme theory; understand the potential of social media; determine design parameters for a future randomised controlled trial, including economic evaluation; and establish whether or not progression criteria were met.DesignThis was a feasibility study comprising intervention development and refinement of the STASH pilot and non-randomised feasibility trial in six schools. Control data were provided by students in the year above the intervention group.SettingSecondary schools in Scotland.ParticipantsStudents aged 14–16 years, teachers and intervention delivery partners.InterventionsThe STASH intervention was adapted from A Stop Smoking In Schools Trial (ASSIST) (an effective peer-led smoking intervention). Based on diffusion of innovation theory, the STASH study involves peer nomination to identify the most influential students, with the aim of recruiting and training 15% of the year group as peer supporters. The peer supporters deliver sexual health messages to friends in their year group via conversations and use of Facebook (www.facebook.com; Facebook, Inc., Menlo Park, CA, USA) to share varied content from a curated set of web-based resources. Peer supporters are given support themselves via follow-up sessions and via trainer membership of Facebook groups.Main outcome measuresThe primary outcome was whether or not progression criteria were met in relation to intervention acceptability and feasibility. The study also piloted indicative primary outcomes for a full-scale evaluation.Data sourcesPeer supporter questionnaire; observations of activities; interviews with trainers, teachers, peer supporters and students; monitoring log of peer supporter activities (including on Facebook and meeting attendance); questionnaire to control year group (baseline characteristics, social networks, mediators and sexual health outcomes); baseline and follow-up questionnaire (approximately 6 months later) for intervention year group.ResultsA total of 104 students were trained as peer supporters (just over half of those nominated for the role by their peers). Role retention was very high (97%). Of 611 students completing the follow-up questionnaire, 58% reported exposure to STASH study activities. Intervention acceptability was high among students and stakeholders. Activities were delivered with good fidelity. The peer supporters were active, representative of their year group and well connected within their social network. Carefully managed social media use by peer supporters augmented conversations. A primary outcome of ‘always safer sex’ was identified, measured as no sex or always condom use for vaginal or anal sex in the last 6 months. The intervention cost £42 per student. Six progression criteria were met. A seventh criterion (regarding uptake of role by peer supporters) was not.LimitationsSmall feasibility study that cannot comment on effectiveness.ConclusionsThe STASH intervention is feasible and acceptable within the context of Scottish secondary schools. The results support continuation to a full-scale evaluation.Future workSmall-scale improvements to the intervention, refinement to programme theory and funding sought for full-scale evaluation.Trial registrationCurrent Controlled Trials ISRCTN97369178.FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 8, No. 15. See the NIHR Journals Library website for further project information.

Challenges in the Practice of Sexual Medicine in the Time of COVID-19 in the United Kingdom

BackgroundOn 23rd March 2020, the UK government released self-isolation/social distancing guidance to reduce the risk of transmission of SARS-CoV-2. The influence such guidance has on sexual activity is not known. AimTo investigate levels and correlates of sexual activity during COVID-19 self-isolation/social distancing in a sample of the UK public. MethodsThis paper presents preplanned interim analyses of data from a cross-sectional epidemiological study, administered through an online survey. OutcomesSexual activity was measured using the following question: “On average after self-isolating how many times have you engaged in sexual activity weekly?” Demographic and clinical data were collected, including sex, age, marital status, employment, annual household income, region, current smoking status, current alcohol consumption, number of chronic physical conditions, number of chronic psychiatric conditions, any physical symptom experienced during self-isolation, and number of days of self-isolation/social distancing. The association between several factors (independent variables) and sexual activity (dependent variable) was studied using a multivariable logistic regression model. Results868 individuals were included in this study. There were 63.1% of women, and 21.8% of adults who were aged between 25 and 34 years. During self-isolation/social distancing, 39.9% of the population reported engaging in sexual activity at least once per week. Variables significantly associated with sexual activity (dependent variable) were being male, a younger age, being married or in a domestic partnership, consuming alcohol, and a higher number of days of self-isolation/social distancing. Clinical ImplicationsIn this sample of 868 UK adults self-isolating owing to the COVID-19 pandemic, the prevalence of sexual activity was lower than 40%. Those reporting particularly low levels of sexual activity included females, older adults, those not married, and those who abstain from alcohol consumption. Strength and LimitationsThis is the first study to investigate sexual activity during the UK COVID-19 self-isolation/social distancing. Participants were asked to self-report their sexual activity potentially introducing self-reporting bias into the findings. Second, analyses were cross-sectional and thus it is not possible to determine trajectories of sexual activity during the current pandemic. ConclusionInterventions to promote health and well-being during the COVID-19 pandemic should consider positive sexual health messages in mitigating the detrimental health consequences in relation to self-isolation/social distancing and should target those with the lowest levels of sexual activity.Jacob L, Smith L, Butler L, et al. Challenges in the Practice of Sexual Medicine in the Time of COVID-19 in the United Kingdom. J Sex Med 2020;17:1229–1236.

Sexual Health in the SARS-CoV-2 Era.

Sexual contact carries some risk for exposure to infection with severe acute respiratory syndrome coronavirus 2 during the coronavirus disease 2019 pandemic. This commentary provides clinicians wit...

There's an App for That: Using Geosocial Networking Apps to Access Young Black Gay, Bisexual, and other MSM at Risk for HIV.

Young black gay, bisexual, and other MSM (YBMSM) that carry a disproportionate HIV burden in the US Geosocial networking applications (GSN apps) are environments that may increase HIV risk among users. This study explored the acceptability and feasibility of using these apps for HIV/sexually transmitted infection (STI) public health outreach. Semi-structured in-depth qualitative interviews. A frequently reported GSN app for meeting sex partners by newly diagnosed HIV-infected MSM in Baltimore. Seventeen YBMSM aged 18 to 24 (mean = 21.5/SD = 1.8) who were logged-on to the GSN app in venues or census tracts in high HIV transmission areas. Participants completed 60 to 90 minute semi-structured interviews, which were audio-recorded and transcribed. Interview data were analyzed in NVivo10 using categorical analysis and double-coded until consistency was achieved. Participants described GSN apps as acceptable and feasible resources for public health practitioners seeking to access YBMSM to provide HIV/STI treatment and prevention services and resources. Three themes emerged: (1) the need to authenticate public health messages to distinguish from spam; (2) improved access to YBMSM including opportunities to identify and access virtual congregations of youth in non-gay-related spaces; and (3) the importance of avoiding stigmatizing YBMSM when targeting sexual health messages. GSN apps have great potential as tools for identifying and engaging at-risk YBMSM. Additional work is needed to understand limitations of this medium, to develop strategies to engage YBMSM without further stigmatizing them, and to maximize their outreach potential.

Using Mobile Technology to Access Sexual and Reproductive Health Information and Services by Adolescent & Young Persons: Findings from Nigeria

Sexual and Reproductive Health (SRH) issues are important aspects of adolescent health and development. Increasing access to newer mobile technologies such as computers and cell phones makes it possible to reach adolescents with sexual, reproductive and other health messages via these media. The study was designed to determine young people's knowledge and use of media technologies in the provision of SRH information and services. A cross-sectional study that employed a mixed methods approach was conducted. This involved both quantitative and qualitative methods. 1342 young persons were questioned: 53.1% males and 46.9% females with an overall mean age of 17.1 ± 3.5 years. Almost 66% of the adolescents had access to the internet and mostly at home (87.3%). More of those in the rural (approximately 70.5%) then urban (61.4%) had internet access and <50% of all the young people were aware that one could obtain information on locations of youth friendly centres from electronic media. Desires to improve their knowledge on the SRH issues were some reasons mentioned by the young persons for their choice of the internet as a source of SRH information. The findings shows that it is imperative for potential providers to ensure that SRH information made available through these mobile technologies is accurate and up-to-date and that information on reliable sources of care are also provided to facilitate linkages to reliable SRH care.

Re-Assembling “Risky” Subjects: African Migrant Youth in Winnipeg, Canada

ABSTRACT Drawing upon ethnographic research in Winnipeg, Manitoba, we complicate simplistic epidemiological and sexual health discourses that position African newcomer teen girls and young women as “at-risk” for HIV/AIDS and other consequences of being sexually active. By tracing the trajectories of sexual health messages and utilizing the concept of assemblage, we seek to account for the ways in which risk is actively made and negotiated in practice by African newcomer youth. By highlighting the perspectives and experiences of participants in relationship to Canadian literature on the subject of sexual risk, culture, and education, we work to counter essentializing, racializing, and pathologizing discourses.

Distribution of sexual health knowledge and attitudes in adolescent social networks: social network analysis of data from the STIs and Sexual Health feasibility study

BackgroundThe social patterning of important precursors to sexual behaviour could help inform the potential reach of social network interventions. We aimed to investigate how peer networks might influence diffusion of sexual health messages in the context of a school-based peer-led sexual health intervention. MethodsWe used data from the control arm of the STIs And Sexual Health (STASH) study, an ongoing cross-sectional survey of Scottish secondary school pupils (4th year, age 14–16 years), to measure sexual health knowledge, attitudes, confidence, and sexual experience. We constructed social networks using questions about friends within the school year. There were 696 respondents from 864 enrolled pupils (response rate 81%, 346 [50%] boys), recruited from six schools. There were no power calculations for this feasibility study. Exponential random graph models were used to assess whether the log odds of two individuals having a friendship tie varied according to similarity between individuals on key characteristics. Random-effects meta-analysis combined preliminary results across six schools. The University of Glasgow Medicine Veterinary and Life Sciences Ethics committee approved the study, and participants gave informed consent online before completing the survey. FindingsThere was some evidence that friendship ties were more common among those with similar knowledge (difference coefficient −0·01, 95% CI −0·04 to 0·01) and attitudes (−0·02, −0·04 to 0·00), but not confidence (0·30, −0·31 to 0·91), with considerable heterogeneity between schools (I2 knowledge 27%, attitudes 2%, confidence 100%). A negative difference coefficient means that two pupils with different levels of knowledge or attitudes are less likely to have a friendship tie than those with the same level. Ties were more common among those with similar sexual experience: two pupils who were both sexually active had 0·35 greater log odds of a friendship tie than did a sexually active and not active pupil pair (95% CI 0·21 to 0·50, I2=23%). InterpretationOur finding that adolescent school friendships cluster according to sexual experience, knowledge, and attitudes strengthens the evidence-base for peer-led sexual health interventions using social diffusion approaches. FundingNone.

Sexual dysfunction or sexual discipline? Sexuopharmaceutical use by men as prevention and proficiency

In the first decade following Viagra’s appearance, feminist and critical scholars documented the sexuopharmaceutical expansion of definitions of erectile dysfunction and its target consumer. As we approach Viagra’s 30th anniversary, while feminist scholarship on the medicalization of sexuality flourishes, the impact of erectile medication has received much less attention. This paper (re)casts a critical lens on popularized erectile medication sexual health messages in the context of current pharmaceutical marketing targeting users as neoliberal aspirational sexual subjects. Discourse analysis reveals that online advice about erectile medication use leverages the increased preoccupation with health risk assessment and prevention technologies to normalize erectile dysfunction as a risk for all men, irrespective of age and health status. Erectile dysfunction is presented as inevitable, pathological, and requiring vigilance and expert consultation; penile performance acts as a predictive health gauge. Erectile medication users are situated as model masculine subjects, (medically) augmenting sexual proficiency in romantic or sexually experimental contexts.