Sexual Health Practices Research Articles

Breaking traditions: sexual health and ethnicity in nursing research: a literature review

The aim of this paper is to explore some reasons for the lack of focus on ethnicity and sexual health in nursing research, and suggest ways to advance the nursing evidence-base required for practice development. The United Kingdom National Strategy for Sexual Health and human immunodeficiency virus published in July 2001 highlighted the continued rise in sexual ill health amongst minority ethnic groups. In order to improve sexual health, research evidence is needed explain why particular ethnic groups appear to be at greater risk of sexual ill health. The Strategy identified nurses as key to bringing about improvements in sexual health. Nursing research includes many studies exploring links between ethnicity and health. However, with the exception of extensive work on human immunodeficiency virus/acquired immunodeficiency syndrome as a specific disease, nursing research into ethnicity has not systematically included sexual health. Literature searches were conducted using the BIDS database, World Wide Web and United Kingdom Department of health website between June 2000 and August 2003. Papers written in English incorporating the keywords 'sexual health', 'sexually transmitted infection' and 'health and ethnicity' in the title or abstract were selected for review. Nursing research into the association between sexual health and ethnicity is rare. It has been hampered by a variety of political and social constraints concerning the nature of sexual health practice in nursing, researching sexual health, and researching ethnicity and health. The result is a dearth of research evidence to support the development of sexual health practice and the education of healthcare professionals to underpin care of minority ethnic clients. Barriers to researching ethnicity and sexual health by nurses must be addressed through nursing education and practice. Without this, a detailed evidence base will fail to materialize and healthcare practices to implement the priorities to improve sexual health in minority ethnic communities will remain undeveloped.

Ethics, Government and Sexual Health: insights from Foucault

The work of Michel Foucault, the French philosopher who was interested in power relationships, has resonated with many nurses who seek a radically analytical view of nursing practice. The purpose of this article is to explore 'ethics' through a Foucauldian lens, in a conceptual and methodological sense. The intention is to provide a useful framework that will help researchers critically to explore aspects of nursing practice that relate to the construction of the self, morality and identity, be that nurse or patient related. The fundamentals of the research method of genealogy and the methods of ethics are reviewed. Using an example taken from the sexual health practice area, advice is given on how to structure data collection, incorporate interview data, avoid discourse determinism and measure resistance.

Twenty-five years

Having returned to Australia from the United Kingdom in late 1979, it has been my privilege to witness first-hand the quite dramatic changes in Sexual Health Medicine which have taken place during the final 25 years of my professional life. In this article I give a snapshot of my early experiences at the Melbourne Communicable Diseases Centre, highlighting some of the deficiencies that needed urgent attention. I wish I could say that this picture was an exaggeration to make the article more interesting but unfortunately that is not the case. I also attempt to examine some of the factors that brought about the much-needed improvements, especially the effect human immunodeficiency virus had on sexual health practice. It is impossible to mention all the individuals most involved in initiating change, but I have mentioned a couple of names, only because of close personal knowledge about their contribution.

'Partying hard', 'partying sometimes' or 'shopping': Young workers' socializing patterns and sexual, alcohol and illicit drug risk taking

This paper explores a neglected aspect of the context of illicit drug, alcohol and sexual risk taking practices in young workers' social lives. While personality-based theories for the links between risk practices have been developed, more sociological explanations, such as socializing patterns, have been neglected. Surveys were completed by 393 young people (aged 15-25) who are in the non-professional workforce in Melbourne, Australia. Three socializing patterns were identified using cluster analysis. The 'party hards' often socialized at a range of venues, the 'party sometimes' socialized less often at fewer venues and the 'shoppers' socialised mainly at shopping centres and cafés. These socializing patterns were significantly correlated with alcohol and illicit drug consumption and sexual health practices. The party hards engaged in risky practices at higher levels than their counterparts in the party sometimes and shoppers groups. The paper argues that socializing patterns are useful for understanding young people's health risks and for identifying new locations for health promotion.

Saúde sexual e reprodutiva com enfoque na transmissão do HIV: práticas de puérperas atendidas em maternidades filantrópicas do município de São Paulo

OBJETIVOS: caracterizar puérperas internadas em duas maternidades filantrópicas no município de São Paulo, quanto às características sócio-demográficas, comportamento para promoção da saúde sexual e reprodutiva, e informações e práticas relacionadas à AIDS. MÉTODOS: estudo descritivo, exploratório, com 384 puérperas entrevistadas durante a internação. Utilizou-se estatística descritiva. RESULTADOS: 85% da amostra iniciaram o relacionamento sexual na adolescência; 48% eram analfabetas ou possuíam o primeiro grau incompleto; 60% tinham renda familiar inferior a cinco salários mínimos; 71% eram católicas e 78% viviam em união consensual. Quando grávidas, 65% iniciaram consulta pré-natal no primeiro trimestre; 84% submeteram-se ao teste anti-HIV; 70% acreditavam na fidelidade do parceiro, 56% nunca usaram preservativo e 61% não modificaram seu comportamento em função da epidemia de AIDS. CONCLUSÕES: O risco de exposição ao HIV mostrou-se presente pelo reduzido número de mulheres que adotavam medidas de sexo mais seguro, desconhecimento do comportamento do parceiro fora do lar, início precoce do relacionamento sexual, pouca abrangência da cobertura do Papanicolaou, presença de DST e uso de drogas. Fatores culturais influenciam esta situação, bem como atitudes na prevenção e no controle da própria saúde.

SAFER SEXUAL DECISION MAKING IN ADOLESCENT WOMEN: PERSPECTIVES FROM THE CONFLICT THEORY OF DECISION-MAKING

Adolescent women are at risk for unintended pregnancies and sexually transmitted diseases, including human immune deficiency virus (HIV)/acquired immunodeficiency deficiency syndrome (AIDS), if they do not engage in safer sexual practices. Adolescent women are biologically, behaviorally, and socially more at risk for sexually transmitted diseases (STDs) and HIV than adolescent men. Although abstinence is the safest sexual health practice for adolescent women, once sexual activity begins, safer sexual practices involve condom and contraceptive use, and communicating with sexual partners to negotiate condom use. A number of implicit and explicit decisions are involved in these activities. A number of researchers have examined safer sexual decisions of adolescent women, some of whom have used theory models such as the Transtheoretical Model of Change. Although these findings have contributed to the knowledge base about safer sexual decision making, many questions remain unanswered about how adolescent women make safer sexual decisions. The Conflict Model of Decision Making is presented and discussed as a framework for enhanced understanding of safer sexual decision making by adolescent women.

Sexual health practices of homeless youth.

To describe the sexual health practices of homeless adolescents, examine relationships among variables in a conceptual model of sexual health practices, and determine direct and indirect effects of population characteristics, cognitive-perceptual factors, and behavioral factors on sexual health practices among homeless adolescents. Descriptive exploratory design. A survey was administered to a convenience sample of 414 homeless young men (244) and young women (170) aged 16-20 years, the majority of whom were Anglo American. Thirty-five percent reported homosexual or bisexual orientation, and sexual orientation was reported as a reason for leaving home. Over half reported a history of sexual abuse and nearly one in four had been treated for gonorrhea. Safe-sex behaviors were related to age, time away from home, assertive communication, social support, future time perspective, connectedness, perceived health status, intentions to use condoms, and condom self-efficacy. A parsimonious model with good fit indicated that the only direct paths to safe-sex behaviors were future time perspective, intentions to use condoms, and self-efficacy to use condoms, and the direct paths to sexual self-care behaviors were from assertive communication, social support, and self-efficacy to use condoms. As in other studies of homeless youth, respondents reported a high incidence of sexual abuse and homosexual and bisexual orientation. Their safe-sex behaviors were surprisingly similar to those of university students, were modestly related to cognitive-perceptual variables in the sexual health model, and might be amenable to brief culturally relevant interventions.

Planning a sexual health promotion intervention with homeless adolescents.

Homeless adolescents are at very high risk for sexually transmitted diseases (STDs), but few street-based interventions have been developed, tested, and made available to reduce risk and promote sexual health within this growing population. This study, part of a larger study of the sexual health practices of homeless adolescents, explores participants' perceived need for more knowledge about sexual health and their ideas about developing a brief intervention to promote positive sexual health practices that would reflect their perspective. Four focus groups with five to six participants each were conducted with 22 youth aged 16-20 years, randomly selected from the study sample of 425 homeless youth. Most participants (82%) were White, one was American Indian, two were Hispanic, and one did not indicate ethnicity. Local groups were audiotape recorded, transcribed, and analyzed for manifest and latent content. Participants were knowledgeable about symptoms, transmission, prevention, and treatment of STDs, but perceived the need for more knowledge about types of hepatitis, cancer, and long-term sequelae of untreated STDs. Participants identified barriers to seeking diagnosis and treatment for symptoms of STDs including cost, not knowing where to go, and lack of services specifically for females. They suggested developing a sexual health intervention based on respect that would provide concrete examples of how to promote their sexual health. Homeless adolescents were generally knowledgeable about symptoms and prevention of STDs and thought that street outreach interventions should be (a) brief, (b) gender-specific, (c) focused on the unique vulnerabilities and strengths of homeless youth, and (d) accessible.

Oncology nurses views on the provision of sexual health in cancer care

OBJECTIVE: To describe the current sexuality-related nursing practice of oncology nurses. DESIGN: Self-report survey to examine the practice of sexual health with a purposive sample of nurses working in cancer care. SETTING: Six nursing units within a large tertiary care centre were used to recruit study participants. The units included ambulatory care, medical oncology and surgical oncology. PATIENTS: Surveys were delivered to 155 oncology-registered nurses working on the identified nursing units. A response rate of 48% was achieved. RESULTS: The overall scale score (M=103.27) suggests that the oncology nurses who responded to the survey perceived sexuality to be a part of their nursing practice. While the majority of the subscale scores were above the midline, practice was slightly below. CONCLUSIONS: The oncology nurses who participated in the study were somewhat confident, responsible and valued sexuality; however, the delivery of care did not reflect those attributes. Issues raised by the oncology nurses are not limited to this discipline but have broad implications for the delivery of health care.

SEXUAL HEALTH PRACTICES OF HOMELESS YOUTH: A Model for Intervention

This article presents a conceptual model of sexual health practices and outcomes among homeless adolescents. The model provides a framework for understanding what is known about homeless youth and how community-based interventions might be developed and tested to curb the rising number of sexually transmitted diseases among this vulnerable population. Research measures are presented and discussed to promote further development and testing of the model for interventions.

Developing an interactive STD-prevention program for youth: lessons from a north Indian slum.

An intervention developed to teach young men in the urban slums of Lucknow, India, about sexually transmitted diseases is described in detail. This community-based intervention was designed to impart core educational messages and to address preexisting ideas about sexual health and STD-prevention practices among participants. Indicators of knowledge recorded before and after the intervention are presented and evaluated against the scores of a control group. Levels of sexual activity and factors associated with risky sex are discussed. The intervention was successful in raising the young men's awareness of STDs significantly in all areas except for the length of time that symptoms take to manifest following risky sex and the ineffectiveness of washing one's genitals after sex to avoid acquiring STDs. Lessons learned during the intervention are described as a means of informing future STD-education programs, and issues requiring prompt attention are identified.

Sexual health and the practice nurse: a survey of reported practice and attitudes

BackgroundPractice nurses have an important role in the provision of sexual health services in general practice.AimThis study set out to determine practice nurses' reported practice and training in sexual health,...

Sex education for boys

An account of how the author has developed his method of delivering sex education to boys. The emphasis is on moving away from traditional teaching methods and interacting with pupils. The aim is to work with boys in a way which does not conspire to maintain traditional expectations in sexual health and contraceptive practices. This is increasingly described as encouraging men to embrace the contraceptive culture. The article should be read by all those interested in developing their skills and knowledge when delivering sex education to adolescent boys.

Demografía informal : cómo utilizar las redes sociales para construir una muestra etnográfica sistemática de mujeres mexicanas en ambos lados de la frontera

En este artículo se discute cómo el muestreo etnográfico sistemático puede fortalecer la posibilidad de hacer una generalización etnográfica y ayudar a promover la comunicación interdisciplinaria. El estudio al cual se refiere este trabajo examina las diferencias en las prácticas sexuales y de salud reproductiva, así como las ideas de dos grupos de mujeres provenientes de la misma área en México: la primera generación de inmigrantes en Atlanta, y sus hermanas y amigas que permanecen en la comunidad de expulsión en el occidente de México.Se comenzará con la exposición de un estudio etnográfico sobre la sexualidad que ha utilizado este método de muestreo, para argumentar en la siguiente sección por qué el muestreo fue particularmente importante en este contexto específico de la investigación. En la siguiente sección se revisan algunas de las diferencias teóricas (y epistemológicas subyacentes) entre la manera como los demógrafos y los antropólogos eligen a los sujetos para ser entrevistados. Finalmente, la última sección comprende la construcción de una muestra etnográfica sistemática, incluyendo la descripción de algunas dificultades enfrentadas durante el proceso.

Sexual health: a survey of knowledge, attitudes and practice of sexual health in adolescent females.

Sexual health: a survey of knowledge, attitudes and practice of sexual health in adolescent females.

Safe Motherhood Initiative: getting our priorities straight

Developing countries, nongovernmental organizations, and the international development community support the Safe Motherhood Initiative. These partners know why they need to take action to assure safe motherhood, but do not agree on how to make motherhood safe. The dominant view is that the 1st priority is to provide and/or improve needed obstetric care at the 1st referral level and manage complications once they occur. It is based on the fact that the medical community cannot yet identify most women with pregnancy complications in time to prevent their occurrence. 2 safe motherhood advocates challenge this view. They point out that it only centers on reducing maternal mortality. 2nd they believe that prenatal care and health education do play a strategic role in making motherhood safe because they can inform, motivate, and empower women to use formal emergency care services. 3rd health workers should not dismiss prenatal care since some interventions are indeed effective, e.g., prevention, detection, and investigation of anemia and hypertensive disease of pregnancy and prevention and treatment of sexually transmitted diseases. Finally some areas in developing countries do not have the resources to establish or upgrade referral level health facilities so they must maximize existing resources to intervene and treat complications such as training midwives, nurses, and traditional birth attendants. The advocates propose 3 tired strategies to bring about safe motherhood. The provision of prenatal care, trained attendance at delivery, accessible emergency services, and family planning and abortion services comprise the 1st tier. The 2nd tier of activities targets youth. These activities include sexual and reproductive health programs, education, female employment opportunities, and legislation on age of marriage. The 3rd tier embraces all factors that influence women's health and status: sexual and reproductive health, education, income, social and cultural practices, and laws that govern women and their social position.