Sexual Health Practices Research Articles

Cultural Perceptions and Negotiations Surrounding Sexual and Reproductive Health Among Migrant and Non-migrant Indigenous Mexican Women from Yucatán, Mexico

Information regarding sexual and reproductive health of indigenous women from Mexican sending and US receiving communities is limited. This research aims to explore the perceptions of indigenous women from US migrant receiving and Mexican migrant sending communities regarding their sexual health experiences and reproductive health practices. From January to March 2012, two key informant interviews and 31 in-depth, semi-structured interviews were conducted among women ages 18-55 in Tunkás, Yucatán and Anaheim and Inglewood, California. Women reported challenges to obtaining routine reproductive clinical care, including accessto care barriers and lack of perceived power over their own sexual health. This was further compounded by migration processes and deficiencies in health care delivery systems. Socio-cultural beliefs and gendered power dynamics influence sexual and reproductive health decisions and behaviors of migrant and non-migrant women. Findings underscore existing gender-based reproductive health norms and serve to inform future transnational research and public health education to improve the health of indigenous migrant and non-migrant women in the US and Mexico.

ARSH 2: Reproductive and Sexual Health Knowledge, Attitude and Practices: Comparison Among Boys and Girls (10–24 y)

ARSH 2: Reproductive and Sexual Health Knowledge, Attitude and Practices: Comparison Among Boys and Girls (10–24 y)

Evaluating the effectiveness of personal resilience and enrichment programme (PREP) for HIV prevention among female sex workers: a randomised controlled trial.

BackgroundFemale sex workers (FSWs) are often considered as the vector, if not reservoir, of HIV and other sexually transmitted infections. Building upon the existing evidence on the role of psychological health in sexual health, the aim of this protocol is to describe a trial investigating the effectiveness of the Personal Resilience and Enrichment Programme (PREP), a resilience-promoting intervention that targets at psychological well-being i.e. self-esteem, self-efficacy and coping, to facilitate adaptation and ultimately safe sexual practices among FSWs, which could be an innovative strategy in controlling the spread of these infections.MethodsA total of 132 FSWs will be recruited and randomly assigned to either the intervention or usual care (control) groups in a multi-centred randomised controlled trial. Based on the resilience framework, this intervention is comprised of six weekly sessions focused on the awareness, expression and management of emotions, identifying roles and personal strengths, and effective problem-solving skills. Complex intervention assessment on both intervention process and effectiveness will be adopted when the primary outcome reduction of sexual risk behaviour and other psychological outcomes include their perceived stress, self-esteem, self-efficacy, coping overall resilience, and psychological distress will be measured at baseline, post-treatment and 3-month post-intervention and differences assessed by ANOVA. The relationship of resilience factors, psychological health and HIV preventive behaviours will be evaluated using structural equation modelling.DiscussionIt is anticipated that this study will increase our understanding of the relationships between individual resilience attributes, positive adaptation, psychological health and sexual health practices. If successful, this programme will provide an innovative direction for HIV prevention by applying the personal resilience factors to promote both psychological well-being and safe sex for this high risk population.Trial RegistrationChiCTR-PRC-13003091

Introduction of a sexual health practice nurse is associated with increased STI testing of men who have sex with men in primary care

BackgroundThe study objective was to investigate the effect of the introduction of a sexual health practice nurse on HIV and STI testing in a general practice that specialized in gay men’s health.MethodsThis observational study compared the proportion of gay and other men who have sex with men (MSM) tested for HIV, syphilis, chlamydia (urethral and anal) and gonorrhoea (anal), or all of the above (defined as a complete set of tests at a single visit), two years before and one year after the nurse was introduced (Clinic A). Clinic B, a general practice which also specialized in gay men’s health, but with no sexual health nurse, was used as a control.ResultsIn Clinic A, amongst HIV negative MSM the proportion of men who had a complete set of HIV and STI tests increased from 41% to 47% (p < 0.01) after the nurse was introduced. Amongst HIV positive MSM attending clinic A there was an increase in the proportion of men who had a complete set of tests after the nurse was introduced from 27% to 43% (p < 0.001). In Clinic B there was no significant increase in testing in the proportion of either HIV negative or HIV positive men who had a complete set of tests over the same time periods.ConclusionsThe introduction of the sexual health practice nurse resulted in significant increases in episodes of complete STI testing among MSM. The effect was most pronounced among HIV positive MSM.

Sexual Health Knowledge and Health Practices of Female Sex Workers in Liuzhou, China, Differ by Size of Venue

We conducted qualitative interviews with 48 female sex workers (FSW) recruited from entertainment venues in Liuzhou, China. Analyses found that HIV knowledge and sexual health seeking strategies differed by size of venue: (1) Women in smaller venues said they douched before/after sex and used condoms with all but their regular partners and clients. Most found the brochures distributed by Chinese CDC workers "irrelevant" or "boring" and relied on friends for health advice. (2) FSW in middle and large venues were less concerned about prevention, claiming their clients were "healthy." They relied more on the Internet for health information and were less concerned about the cost of seeing a doctor. (3) Pregnancies and abortions were frequent, especially among the younger women in large venues. This research documents the need to develop tailored HIV-related messages and prevention strategies with the help of FSW to address differences among FSW working in venues of different sizes.

133. Understanding Non-Responsiveness to Text Messages-Lessons From the Depotext Trial

Urban adolescents face economic, social, and behavioral challenges in adhering to long-term contraceptive use. A text messaging program can be used to remind adolescents of family planning appointments and educate patients about safe sexual health practices. Non-responsiveness to messages, however, is difficult to interpret and may jeopardize programmatic success. The objective of this study is to understand how adolescents who periodically are non-responsive via text use their cell phones to determine the viability of a text messaging program in standard practice.

The Effect of Sex Education on Teenage Pregnancy among Secondary School Students in Ibadan Metropolis.

Unplanned pregnancies among Nigerian teenagers and young women have risen despite improvements in educational levels. Though, over the same period the use of modern contraceptive methods among sexually active adolescent women in Nigeria had changed, yet this has not slowed down the rate of teenage pregnancy among the adolescents in Nigeria. The study utilized the survey research method using a self report questionnaire to gather the data. The revalidated Adolescent Sex Education And Teenage Pregnancy Questionnaire was used in the study. There is no significant influence of sex education received on teenage pregnancy (X = 1.203, df = 1, p>.05). However there was significant relationship between contraceptive and the sex education received. (X = 38.931, df = 5, p<.05). It was recommended that appropriate education regarding sexual health and socio-cultural practices need to be included in the school curriculum and sexual education in the public, private secondary schools, NGO and HIV/AIDS intervention programmes.

An exploration of knowledge, attitudes and behaviours of young multiethnic Muslim-majority society in Malaysia in relation to reproductive and premarital sexual practices

BackgroundThe increasing trend of premarital sexual experience and unintended pregnancies in Malaysia warrants sustained and serious attention. The sensitivities of sex-related issues in a Muslim-majority country create various types of barriers to sexual and reproductive health information, support and practices. This study aims to gain understanding of knowledge, attitudes and behaviours of young women in Malaysia concerning reproductive, contraception and premarital sexual practices.MethodsA cross-sectional study was performed, using an anonymous self-administered questionnaire carried out among 1695 female university students in a public university in Malaysia.ResultsRespondents had low scores for knowledge of reproduction and pregnancy (median=4, of maximum score 10), contraceptive uses (median=6, of maximum score 16) and contraceptive availability (median=3, of maximum score 13). The majority of women surveyed do not have liberal values in relation to premarital sexual behaviour (median=37, of maximum 40); higher scores on this scale corresponded to opposing premarital sex. The multivariate analyses showed that ethnic group was the strongest correlate of knowledge and attitude scores; being of Malay Muslim ethnicity was associated significantly with lower knowledge scores and premarital sex permissiveness. Other significant correlates were year of study, maternal occupational groups, level of religious faith, dating status and urban–rural localities. Level of premarital sex permissiveness was inversely correlated with reproduction and pregnancy knowledge score, and contraceptive knowledge scores.ConclusionReproductive health knowledge and attitudes were intricately linked to religious values and cultural norms differences surrounding sexual issues.

Navigating Risks and Professional Roles: Research with Lesbian, Gay, Bisexual, Trans, and Queer Young People with Intellectual Disabilities

We examine ethical issues that emerged during a community-based participatory research (CBPR) study in Toronto, Canada, exploring sexual health attitudes and practices among lesbian, gay, bisexual, trans, queer, and questioning (LGBTQ) young people (ages 17-26) labeled with intellectual disabilities. These ethical concerns included: (1) managing the risk of coercion, (2) consent to participate in the study, (3) issues of confidentiality and disclosure, (4) balancing beneficence with self-determination, and (5) role conflict for researcher-practitioners who participate in CBPR projects. Incorporating critical disability perspectives and a heightened awareness of professional role conflict into CBPR practices has the potential to foster development of more inclusive and accessible sexual health initiatives and research environments.

What About the Boys? The Importance of Including Boys and Young Men in Sexual and Reproductive Health Research

Throughout the past 50 years, when governments, researchers, and clinicians have discussed adolescent sexual and reproductive health, they have almost overwhelmingly focused on girls and young women. Even limiting to recent work, a perusal of the research literature since 2000 finds thousands of studies that focus only on girls and young women, compared with hundreds of studies that include both genders, but only tens of studies in sexual and reproductive health that focus exclusively on boys and young men. Within the Journal of Adolescent Health, such coverage is better, but still disproportionate; there are more studies in this journal that include both boys and girls, young women and young men, with several studies still exclusively focused on girls and young women, and relatively few studies that focus on populations of boys and young men. Most of the sexual health studies about male subjects are found in published abstracts in this journal, not in full articles or research briefs, and among the full-length articles, they have generally focused on subgroups of male subjects whose sexual health (although maybe not reproductive health) is considered problematic, for example, young men who have sex with men. Although there has been a recent review of sexual and reproductive clinical care for male adolescents in primary care settings [1], even this article acknowledged the relatively sparse literature focused on boys’ and young men’s sexual and reproductive health needs.

Let’s talk about sex

Taking a sexual history and doing a sexually transmitted infection risk assessment are the cornerstone of good sexual health practice

Women on men’s sexual health and sexually transmitted infection testing: a gender relations analysis

Sexual health and sexually transmitted infection (STI) testing is typically portrayed as a women's issue amid men's estrangement from healthcare services. While the underreporting of men's STIs has been linked to masculinities, little is known about how women interpret and respond to heterosexual men's sexual health practices. The findings drawn from this qualitative study of 34 young women reveal how femininities can be complicit in sustaining, as well as being critical of and disrupting masculine discourses that affirm sexual pleasure and resistance to health help-seeking as men's patriarchal privileges. Our analysis revealed three patterns: looking after the man's libido refers to women's emphasised femininity whereby the man's preference for unprotected sex and reticence to be tested for STIs was accommodated. Negotiating the stronger sex refers to ambivalent femininities, in which participants strategically resist, cooperate and comply with men's sexual health practices. Rejecting the patriarchal double standard that celebrates men as 'studs' and subordinates women as 'sluts' for embodying similar sexual practices reflects protest femininities. Overall, the findings reveal that conventional heterosexual gender relations, in which hegemonic masculinity is accommodated by women who align to emphasised femininity, continues to direct many participants' expectations around men's sexual health and STI testing.

Condom Negotiations among Female Sex Workers in the Philippines: Environmental Influences

BackgroundSocial and structural influences of condom negotiation among female sex workers (FSWs) remain understudied. This study assesses environmental and individual factors associated with condom negotiation among FSWs at high risk for acquiring HIV in a large urban setting of Metro Manila, Philippines.MethodsFemale bar/spa workers (N = 498), aged 18 and over, underwent interview-led surveys examining their sexual health practices in the context of their risk environments. Data were collected from April 2009-January 2010 from 54 venues. Multiple logistic regressions were conducted to assess socio-behavioral factors (e.g., age, education, length of time employed as an entertainer, and alcohol/drug use) and socio-structural factors (e.g., venue-level peer/manager support, condom rule/availability, and sex trafficking) associated with condom negotiation, adjusting for individuals nested within venues.ResultsOf 142 FSWs who traded sex in the previous 6 months (included in the analysis), 24% did not typically negotiate condom use with venue patrons. Factors in the physical environment - trafficked/coerced into work (AOR = 12.92, 95% CI = 3.34–49.90), economic environment - sex without a condom to make more money (AOR = 1.52, 95% CI 1.01–2.30), policy environment - sex without a condom because none was available (AOR = 2.58, 95% CI = 1.49–4.48), and individual risk - substance use (AOR = 2.36, 95% CI = 1.28–4.35) were independently associated with FSWs' lack of condom negotiation with venue patrons.ConclusionsFactors in the physical, economic, and policy environments, over individual (excepting substance use) and social level factors, were significantly associated with these FSWs' condom negotiations in the Philippines. Drawing upon Rhodes' risk environment framework, these results highlight the need for policies that support safer sex negotiations among sex workers in the context of their risk environments. Interventions should reduce barriers to condom negotiation for FSWs trafficked/coerced into their work, substance using, and impacted by economic conditions and policies that do not support condom availability.

Invited Editorial Comment

<h3>Background</h3> Among certain communities and nations, the sexual health rights of women living with HIV (WLHIV) are often neglected and considered less important. Social, cultural, and religious believes may restrict safer sexual practices. This study examines the sexual health knowledge, attitude, and practices of WLHIV in Banten Province, Indonesia, and the factors influencing these practices. <h3>Methods</h3> A cross-sectional written survey of 209 WLHIV aged 18 to 50 years from seven Banten Province regions, was conducted between May and November 2017 using five peer recruiters. Descriptive and binary regression analysis were performed. <h3>Results</h3> The majority were Muslim (87.6%), married (58.9%), and high-school graduated (88.6%). 31.4% experienced intimate partner violence (IPV). 77% had some knowledge of sexually transmitted infection (STI), sourcing information from health care providers (56.9%) and the internet (23.0%). Most believed that a woman could refuse sexual intercourse with their partner because of postpartum/menstruation (78.9%), tiredness/unwillingness (67.7%), partner’s STI (64.1%), and his infidelity (62.7%). However, only 49.3% believed that they might refuse sex if the partner opposed condom use. Of the 171 sexually active participants, 78.4% had only one sexual partner. Condoms were the primary contraceptive used; however, 68.4% reported inconsistent condom use which was significantly associated with women’s inability to buy condoms (aOR6.54, 95%CI:2.29–18.74), negotiate condom use (aOR6.11%CI:1.69–22.15), and being unmarried (aOR3.04, 95%CI:1.14–8.13). 33.3% self-reported a history/symptoms of STI which was significantly associated with new HIV-diagnosis (aOR=4.53, 95%CI=2.07–9.91), multiple sex-partners (aOR=4.25, 95%CI=1.73–10.43), lack of internet exposure (aOR=4.24, 95%CI=1.55–11.55), IPV (aOR=3.04, 95%CI=1.22–7.55), or unprotected sex (aOR=2.97, 95%CI=1.33–6.60). <h3>Conclusion</h3> The sexual health of WLHIV in Indonesia is affected by their relationship status, access to condoms, and ability to negotiate their use. Strategies focused on building a women’s capability and support to defend their sexual rights are needed to improve the women’s health, facilitate choice and reduce risk of onward HIV transmission. <h3>Disclosure</h3> No significant relationships.

Targeted sexual exploitation of children and women in India: Policy perspectives on Devadasi system

This paper introduces an alternative comprehensive approach to reduce sexual exploitation and child prostitution. The paper focuses on female devadasi temple prostitutes (Child sex workers but popularly understood as temple prostitutes in the name of dedication to deity) children in South India and the provision of support to integrate devadasi girls into the community and improve their psychosocial situation. The paper is designed broadly, taking cultural practices into consideration and also with a community participatory approach to achieve the goal. The broad objective of the paper is to promote alternative policy approaches, such as: 1. Community participation to integrate current devadasi girls into regular community life, 2. Community participation to avoid future initiation of young girls into the devadasi system, 3. Meeting the psychosocial needs through health, counseling and economical needs of devadasi girls in the community, 4. Assistance to devadasi girls as an alternative to devadasi service in the community. The policy advocacy includes participation by key community members and women's local Self-Help Groups (SHG's) networking to support existing devadasi girls to overcome stigma, social discrimination through cleansing rituals, and organizing vocational training skills to enhance their economic status. Other policy issues are integration of primary healthcare services to these girls and extending counseling services on sexual health and behavioral practices and also to introduce a micro credit system to existing devadasi girls. The paper draws its conceptual framework from psychosocial working group to provide comprehensive strategies to address community complexities. A community participatory approach has been proposed to adopt, in order to build a sustainable strategy to provide the psychosocial needs of the girls initiated into devadasi services, especially in South Indian states where it is prevalent.

Representation and Social Construction of HIV and AIDS in the Mainstream Hindi Cinema in India: A Study on the Discourses of Normative Sexual Health

In a country like India, films play an important role in constructing and shaping the public sphere on various social issues such as Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS). However, not many films have dealt with this pertinent issue. Only few films have brought in this social reality within their discourse and have attempted to pass on the messages on normative sexual health practices, social ostracisation of HIV/AIDS affected persons and address the issues of transmission of HIV. Eventually, these films also tend take a high moral seat when the messages emanate about shattering of family bondages in the elite classes. Though, they never touch upon the impact of HIV and AIDS and social outcasts in the rural population. Thus, the films end up as ‘sermons’ for the urban as well as rural population, who according to it are to be ‘morally taught’ about. This paper critically examines the representation and social construction of HIV/AIDS in three Hindi mainstream films, looking at the aspect of how the HIV/AIDS subject is constructed amongst the urban populations; how the various stigmas, misconceptions and acceptance levels are addressed through the narratives; and the manner in which the politics of normative sexual health is challenged through the cinematic medium.

Identifying predictors of variability in sexual health knowledge, attitudes and practices among UK youth

Identifying predictors of variability in sexual health knowledge, attitudes and practices among UK youth

Identifying predictors of variability in sexual health knowledge, attitudes and practices among Eastern and Western European youth

Identifying predictors of variability in sexual health knowledge, attitudes and practices among Eastern and Western European youth

O5-S4.05 Introduction of a sexual health practice nurse increases STI testing among MSM in general practice

IntroductionIncreased screening among MSM could improve STI control in this population; however published data on interventions that improve screening rates is limited. The aim of this study was to determine...

Edad de la gestante adolescente como factor de riesgo para complicaciones en el embarazo. Cartagena (Colombia) 2009. Estudio de corte transversal

Objetivo: estimar las diferencias entre los subgrupos de adolescentes embarazadas de 13 a 15 años; y 16 a 18 años, con respecto a las complicaciones presentes durante el embarazo en la ciudad de Cartagena (Colombia).Materiales y métodos: estudio de corte transversal en 100 adolescentes embarazadas, vinculadas a una fundación durante el año 2008. Se indagaron variables sociodemográficas, estado nutricional, afiliación al servicio de salud, ocupación, prácticas de salud sexual y reproductiva, control prenatal, anemia, infección urinaria y vaginal, preeclampsia, eclampsia, diabetes gestacional, hipertensión, semanas de embarazo y vía del parto. Los resultados se presentan mediante medidas de tendencia central y dispersión o proporciones según el tipo de variable. Las características basales de los grupos se compararon mediante la prueba de chi cuadrado. Se estimó la asociación entre los dos grupos de edad y las complicaciones del embarazo por medio del odds ratio (OR).Resultados: las adolescentes de 13 a 15 años tienen más riesgo que las adolescentes de 16 a 18 años de presentar parto pretérmino [OR 5,0 (IC 95%: 1,86 -13,7)] y parto vía cesárea [OR 3,57 (IC 95%: 1,25 – 10,5)].Conclusiones: se concluye que el embarazo a edad temprana conlleva a complicaciones durante la gestación en el grupo de adolescentes de 13 a 18 años.