Sexual Health Practitioners Research Articles

Sexual Self-Esteem as a Predictor of Risky Sexual Behaviour among Female Students Attending Teacher Training Colleges in Kenya

This study sought to investigate sexual self-esteem as an indicator of risky sexual behaviour among female students attending teacher training colleges in Kenya. The study focused on second-year female students in the 29 public teacher training colleges in Kenya. Using ex post facto research design, data was collected through a personally delivered questionnaire from 350 female students in 13 public teachers’ training colleges in Kenya and subsequently analysed using simple regression statistic at 0.05 alpha level. The findings revealed a linear and significant relationship (F= 7.894; 1,345; P< .05) between sexual self-esteem and risky sexual behaviour. The study further revealed that the beta value (? = .150) was statistically (t = 2.810; P <.05), the findings implied that sexual self-esteem had a positive effect on risky sexual behaviour, and the impact was statistically significant. The adjusted R2 value (R2 = 0.22) further revealed that Sexual self-esteem could account for 22% of the variation in risky sexual behaviour among female students. These findings have important implications and lessons in regard to reducing incidences of risky sexual behaviour among female teacher trainees, specifically, stakeholders in teacher training colleges including, college administrators, counsellors, and sexual health practitioners, within the colleges. These should develop and adopt strategies suggested in this study to address the challenge of sexual risk-taking among female teacher trainees.

Perceptions of Young Women Who Engage in Anal Sex: A Sociological Inquiry

Despite data suggesting that anal sex is increasingly common among heterosexual individuals, women who engage in anal sex have had little attention in academic scholarship beyond medical fields. Research on anal sex is typically androcentric, with many key studies examining the dynamics of male-male sexual practices. Moreover, research reporting anal sex among young women is often accompanied with concerns around coercion and health risks. Taking a critical view, we argue that normative assumptions about anal sex may obscure or ignore other ways that women and others might engage in anal sex, and, given the emphasis on harm reduction, may obscure a range of reasons for involvement in anal sex. Through focus groups and individual interviews with a range of individuals (n=20) including sexual health practitioners and young people, aged 19-56 years, our qualitative pilot study generated detailed discussion on (1) how anal sex is perceived in general (‘what’ practices constitute anal sex, who might be involved, and why), and (2) specifically how it is perceived in relation to young women. This paper focuses on the second area and three resultant analytic themes: why women may engage in anal sex, women’s bodies and gendered agency, and sexual literacy. We conclude that meaningful sex and relationships education and sexual health services could usefully adopt a more nuanced appreciation of the range of practices that can comprise anal sex, and that some young women engage in anal sex for a variety of reasons (beyond coercion) including pleasure, bodily autonomy and relationship dynamics.

Sexual Coping Mechanisms During the COVID-19 Pandemic and Their Determinants of Use, Usefulness, and Effects on Sex Life.

The COVID-19 pandemic has taken a toll on many people's sex lives. The ways people cope with these adverse impacts are an urgent area that needs to be recognized by sexual health researchers, practitioners, and policymakers. Thus, this study investigated sexual coping mechanisms during the pandemic while clarifying their determinants of use and usefulness and examining their impacts on the quantity and quality of sex life. The cross-sectional data (N = 675) were collected using an online survey methodology in February-May 2021. The data were analyzed with one-sample and independent-samples t-tests, one-way between-subjects ANOVA, and multivariate multiple regression. This study identified eight sexual coping mechanisms during the pandemic, including creativity and pleasure, diversion, goal-setting, relational, educational, caution and logistical, online and technological, and innovation and experimentation strategies. All the coping mechanisms were used and rated significantly useful, albeit to different degrees. Gender, availability of a sex partner, the existence of children, and age served as determinants of different coping mechanisms' scope of use and degree of usefulness. The coping mechanisms predicted the frequency of sexual activity, sexual desire, and satisfaction with sex life during the pandemic. This study's results can help scholars and practitioners prevent or mitigate the deterioration of sex life during the pandemics and other crises and stressors. It is essential to train people concerning sexual coping resources and strategies to protect their sexual wellbeing and quality of life. Health researchers, practitioners, and policymakers must consider maintaining sexual health as an essential service. Recognizing sexual health, rights, education, and counseling is a prerequisite for appropriate prevention measures during the pandemic. It is vital to ensure the availability of proper resources supporting people's sexual coping processes during and after the pandemic.

Heterosexual Script in Italian Young Adults: Measurement Across Genders

IntroductionThe Heterosexual script has not yet received extensive scientific attention in, one of the countries in which gender stereotypes are particularly prominent. The purpose of this study was to examine adherence to sexual scripts among Italian young adults by first evaluating the dimensionality, psychometric properties, and gender invariance of the Italian version of the Heterosexual Script Scale (HSS), a 22-item self-report questionnaire measuring endorsement of sexual scripts in the context of heterosexual relationships.MethodA community sample of 2781 women and men (F = 50.5%) was recruited in 2021 (mean age = 22.32, SD = 3.53 years, age range: 18–35 years). Participants completed the Italian version of the HSS, measures of ambivalent sexism, and a socio-demographic questionnaire.ResultsExploratory factor analysis revealed that, after deletion of four items (items 4, 7, 16, 22), four factors should be extracted: Courtship Strategies, Women Depend on Men, Women’s Self-Sacrifice, and Sex Defines Masculinity; Women Set Sexual Limits. The confirmatory factor analysis indicated that the 18-item four-factor structure had a good fit (RMSEA [90% CI] = .06 [.06; .07]; CFI = .95; SRMR = .05). Good internal consistency (Cronbach’s alphas for the four factors ranged from .65 to .72), construct validity, and metric invariance across genders were demonstrated.ConclusionOverall, findings indicate that the HSS can be used to reliably assess the endorsement of gendered sexual scripts among young Italian women and men. Some specific cultural aspects emerged.Policy ImplicationsResearchers and sexual health practitioners should consider context-specific sexual scripts when designing research and intervention protocols. Sex education curricula could be improved by integrating modules aimed at promoting egalitarian gender scripts.

“Syndemic moral distress”: sexual health provider practices in the context of co-occurring, socially produced sexual and mental health epidemics

Background‘Syndemic’ refers to socially produced, intertwined, and co-occurring epidemics. Syndemic theory is increasingly used to understand the population-level relationships between sexual health (including HIV) and mental health (including problematic substance use) epidemics. Syndemic-informed clinical interventions are rare.MethodsWe therefore asked 22 sexual health practitioners from six sexual health clinics in British Columbia, Canada to define the word ‘syndemic’ and then asked how the theory related to their clinical practice.ResultsResponses to syndemic theory ranged widely, with some practitioners providing nuanced and clinically informed definitions, others expressing a vague familiarity with the term, and others still having no prior knowledge of it. Where practitioners acknowledged the relevance of syndemic theory to their practice, they articulated specific ways in which syndemics create moral distress, that is, feeling that the most ethical course of action is different from what they are mandated to do. While some practitioners routinely used open-ended questions to understand the social and economic contexts of patients’ sexual health needs, they described an uneasiness at potentially having surfaced concerns that could not be addressed in the sexual health clinic. Many observed persistent social, mental health, and substance use-related needs among their patients, but were unable to find feasible solutions to these issues.ConclusionsWe therefore propose that interventions are needed to support sexual health practitioners in addressing psychosocial health needs that extend beyond their scope of practice, thereby reducing ‘syndemic moral distress’.

Black people’s constructions of good sex: Describing good sex from the margins

Existing conceptualizations and measures of good sex are varied and inconclusive. Additionally, few studies have defined good sex from the margins, thus definitions are primarily informed from privileged perspectives. People with marginalized racial, gender, and sexual identities can offer culturally informed definitions of good sex that may expand current definitions. This study fills that gap by identifying factors that constitute good sex among Black people with diverse sexual and gender identities. Data were collected from 448 Black individuals who participated in an online Qualtrics survey with demographic, open-ended, and scaled questions. Results indicate a range of descriptors that align with existing sexual wellness literature and include the top 20 words to describe good sex as well as the top 10 words for demographics of interest. Differences in most frequent descriptors based on gender and sexual identities are reported. These results provide a foundation for sexual health practitioners, educators, and therapists to improve societal knowledge about what constitutes good sex among Black people.

A qualitative exploration of perceptions of anal sex: implications for sex education and sexual health services in England

Existing research into anal sex has centred on androcentric, medicalised parameters that focus on risk and health implications, leading to a lack of focus on women's experiences. Research that has focused on women’s experiences has centred on concern around young women’s anal sex practices, with little exploration of why people participate in anal sex and neglect of its relational and pleasure-based dimensions. The present study sought to explore these concerns via data gathered using focus groups and individual interviews with a range of individuals including sexual health practitioners and young people. Data were thematically coded, with results centred on three themes: anal sex as deviance, anal sex as phallocentric, and anal sex as agentic. Results suggest a pattern of perceptions and narratives that has potential to undermine honest education, advice-giving and safer sex if they are not addressed and questioned in safe spaces, prior to work with young people. The implications of these findings for sexual health education are discussed.

Report From the National Academies of Sciences, Engineering and Medicine-STI: Adopting a Sexual Health Paradigm-A Synopsis for Sexually Transmitted Infection Practitioners, Clinicians, and Researchers.

Despite decades of medical, diagnostic, and public health advances related to diagnosis and management of sexually transmitted infections (STIs), rates of reportable STIs continue to grow. A 2021 National Academies of Sciences, Engineering, and Medicine report on the current state of STI management and prevention in the United States, entitled Sexually Transmitted Infections: Adopting a Sexual Health Paradigm, offers recommendations on future public health programs, policy, and research. This new report builds upon the 1997 Institute of Medicine report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases, and provides 11 recommendations organized under 4 action areas: (1) adopt a sexual health paradigm, (2) broaden ownership and accountability for responding to STIs, (3) bolster existing systems and programs for responding to STIs, and (4) embrace innovation and policy change to improve sexual health. We present our interpretive synopsis of this report, highlighting elements of particular interest to STI and sexual health practitioners, including clinicians, researchers, disease intervention specialists, community outreach workers, and public health staff. The report asserts that it is possible to create a healthier and more equitable future where fewer adolescents and adults are infected, fewer babies are born with STIs, and people entering their sexual debut and continuing throughout the life span are taught the language and skills to conceptualize and enact their own vision for what it means to be sexually healthy.

Partnered Sexual Behaviors, Pleasure, and Orgasms at Last Sexual Encounter: Findings from a U.S. Probability Sample of Black Women Ages 18 to 92 Years

The purpose of this study was to estimate the prevalence of sexual behaviors and experiences of Black women’s partnered behaviors at their most recent sexual event. Data were from a subset of 980 Black women ages 18 to 92 who participated in the 2018 National Survey of Sexual Health and Behavior. Findings provide a sex-positive view of Black women and their partnered experiences, indicating a range of activities; most wanted their sexual experiences, experienced orgasms, and reported pleasurable experiences. These results provide a foundation for sexual health practitioners, educators, and therapists to improve societal knowledge about Black women’s sexuality.

‘I love my job…it’s more the systems that we work in’: the challenges encountered by rural sexual and reproductive health practitioners and implications for access to care

This paper focuses on rural aspects of sexual and reproductive health and sexuality. Disadvantage of access to practitioners with expertise in sexual and reproductive health and sexuality is compounded for rural residents. Retaining and supporting the rural sexual and reproductive health workforce is important in addressing sexual health inequities and promoting the sexual and reproductive rights of rural residents. However, little is known about the role-related challenges encountered by rurally-based sexual and reproductive health practitioners. We draw on 15 qualitative interviews with general practitioners and nurses with recognised expertise in sexual and reproductive health working in three rural regions of Victoria, Australia. Findings highlight the precarious state of sexual and reproductive health delivery in rural contexts and draw attention to the unsustainability of current systems for providing access to care in rural settings. Problems stem from cultural processes and assumptions within the health sector. Adapting organisational cultures and how sexual and reproductive health is structured within the health system are critical to improving access for rural residents. Our findings have relevance for other high-income, Eurocentric and metrocentric countries with public health systems and similar geographies.

Teaching Sexual History Taking in Health Care Using Online Technology: A PLISSIT-Plus Zoom Approach During the Coronavirus Disease 2019 Shutdown.

AimCancellation of university classes during the coronavirus disease 2019 pandemic challenges teaching inperson sexual history–taking skills to medical, physician assistant, and nursing students. We used commercial online electronic services for medical students to learn sexual history–taking skills.MethodsA total of 174 medical students viewed a lecture on sexual history taking and the PLISSIT model (Permission, Limited Information, Specific Suggestion, Intensive Therapy) and were then randomized into dyads. They arranged a time to meet online on Zoom with their partner, chose a simple sexual history case-history (male or female) from a small selection, and recorded the 5- to 6-minute sexual history within a 1-week time frame. Each student played a “provider” or “patient” and then switched roles with a new case. One of the course tutors, all sexual health practitioners, downloaded 10 videos randomly assigned to them asynchronously and viewed and commented on the interaction of each “provider” along with comments on what to improve in the sexual history. 2 weeks later after the remainder of the lectures in the course, a second, more complex set of 8 cases were provided, so students could move at their comfort pace and choose 1.Main Outcome MeasureStudents were required to make 1 online post and 1 comment on another student's post for each case, on the experience, and associated issues arising, positive or negative. All comments were downloaded and analyzed by theme.ResultsMajor themes included developing comfort in using sexual language, using simpler sexual terms suitable for patients, feeling confidence and mastery, excitement using technology developing clinical skills, surprise watching their performances and body language, observation of how they appeared to the “patient,” organizing sexual histories and incorporating PLISSIT model, ability to ask about context and relationships, and seeing the exercise as building on existing clinical skills training. Some expressed anxiety and nervousness, which by the second case had largely or completely dissipated.ConclusionA readily replicable, secure, cheap cloud-based model to integrate sexual history training asynchronously was provided, with tutors’ comments, and student skills development, and performance evaluated.Ross MW, Newstrom N, Coleman E. Teaching Sexual History Taking in Health Care Using Online Technology: A PLISSIT-Plus Zoom Approach During the Coronavirus Disease 2019 Shutdown. Sex Med 2021;9:100290

‘Somebody that looks like me’ matters: a qualitative study of black women’s preferences for receiving sexual health services in the USA

Research dedicated to understanding the sexual experiences of Black women has historically been framed around adverse outcomes. There are limited data that can be used to understand the lived experiences of Black women related to sexual health care. Twenty-five Black women aged 18- 35 from across nine US states were interviewed to gain insight into their experiences and preferences for receiving sexual health services. Three themes were developed from their accounts: individual and structural barriers affect access to and perceived quality of care; service provider race and gender impact sexual health care experiences; and personalised care improves engagement. Findings suggest the need for culturally informed training for sexual health practitioners working with Black women.

Skills Gap among Sexual and Reproductive Healthcare Professionals in Cameroon

Over the last 10 years, the state of sexual and reproductive health in Cameroon has been challenging with rising levels of sexually transmitted diseases, the high fertility rate, and high infant and maternal mortality rates. Some researchers attributed these challenges to the limited number and quality of sexual and reproductive health personnel working in health facilities across the country. The North West Region of Cameroon was taken as a unit of study to probe into the skills gap among sexual and reproductive health practitioners. A total of n = 302 participants at a confidence interval of 95 per cent were selected using a stratified random sampling technique to take part in the study. The results indicated that a good number of them have no prior experience in the field of sexual and reproductive health. On the other hand, most of the practitioners’ skills level is situated between intermediate and competent with very few of them being at the expert skills level. It was therefore recommended that most of the participants needs improvement in (i) computer or information technology skills; (ii) research skills; and (iii) leadership development of the specialty. These areas need to be dealt with, as a matter of priority, through training and professional development to enable these professionals to deliver better service in the sexual and reproductive healthcare sector. It was also recommended that, in line with the critical role that sexual and reproductive health practitioners play in Cameroon’s health system, the Ministry of Public Health and other role players in the health sector make sufficient investments in the improvement of the health workforce’s accessibility to information and communication technology.

Stakeholder involvement in the systematic optimisation of two school-based relationships and sex education interventions, Project Respect and Positive Choices

BackgroundThere is increasing emphasis on involving intended beneficiaries and other stakeholders in the development of public health interventions to maximise acceptability and remove barriers to adoption, implementation, and maintenance before costly implementation. Yet the processes whereby key actors are engaged in intervention development are rarely reported, and frameworks for carrying out such work remain limited. We outline our approach to involving stakeholders in the optimisation of two school-based relationships and sex education programmes (Project Respect and Positive Choices) and reflect on the challenges of co-producing with teachers, students, and other partners. MethodsSystematic optimisation of both interventions involved a review of existing literature on effective approaches; consultation with staff and students on intervention content and delivery; drafting of intervention materials; further consultation with schools; and then intervention refinement in preparation for a pilot. Seven focus groups took place in southeast and southwest England involving 75 students aged 13–15 years and 22 school staff. A group of young people trained to advise on public health research were consulted on two occasions and a wide range of sexual health and sex education practitioners and policy makers shared their views at a stakeholder event. FindingsConsultation provided useful insights to inform intervention adaption in relation to who should deliver the programmes in schools; whether lessons should be taught in single sex classes; the format that guidance and lesson plans should take; the relevance and acceptability to students and teachers; and the need for the flexibility for materials to adapt to different school contexts. Genuine consultation and incorporation of school stakeholder views was challenging where stakeholder availability was limited and intervention development and implementation timelines were tight. Challenges also arose in relation to the weight to give divergent opinions among stakeholders and between stakeholders and researchers. InterpretationCarrying out structured stakeholder engagement activities can yield valuable insights that can improve the applicability of interventions to local contexts before they are formally trialled. To genuinely engage stakeholders in intervention development requires sufficient time to both consult and adapt. In such consultations, it is important to attend not just to the voices of those who are the loudest and most powerful. FundingNational Institute for Health Research (NIHR).

Where Youth Live, Learn, and Play Matters: Tackling the Social Determinants of Health in Adolescent Sexual and Reproductive Health

The body of evidence supporting a relationship between the social determinants of health and adolescent sexual and reproductive health is vast. To advance health and have a greater impact on adolescent health outcomes, sexual and reproductive health practitioners need to take into account the relationships, community, and society within which adolescents live, learn, and play. With this review, we aim to provide practitioners with a clear understanding of the value of adopting a more comprehensive approach and we provide concrete recommendations for actualizing social determinants of health through programs and services. Recommendations are provided for each of the five social determinants of health categories outlined by Healthy People 2020, including Neighborhood and Built Environment, Economic Stability, Health and Healthcare, Social and Community Context, and Education.

The pleasure imperative? Reflecting on sexual pleasure’s inclusion in sex education and sexual health

This article offers an empirically grounded contribution to scholarship exploring the ways in which pleasure is ‘put to work’ in sex and sexuality education. Such research has cautioned against framing pleasure as a normative requirement of sexual activity and hence reproducing a ‘pleasure imperative’. This paper draws on interviews with sexual health and education practitioners who engaged with Pleasure Project resources and training between 2007 and 2016. Findings suggest that practitioners tend to understand pleasure within critical frameworks that allow them to avoid normalising and (re)enforcing a pleasure imperative. Accounts also show negotiations with, and strategic deployments of, values surrounding sexual pleasure in society and culture. While some accounts suggest that a pleasure imperative does run the risk of being reproduced by practitioners, notably this is when discussing more ‘contentious’ sexual practices. Interviews also demonstrate that practitioners attempting to implement a pleasure agenda are faced with a range of challenges. While some positive, holistic, and inclusive practice has been afforded by a pleasure approach, we argue that the importance of a critical framework needs to be (re)emphasised. The paper concludes by highlighting areas for further empirical research.

Teaching the Teachers: Education Strategies for Subjective Competence Among Sexual Health Practitioners (USA)

Teaching the Teachers: Education Strategies for Subjective Competence Among Sexual Health Practitioners (USA)

Occurrence and impact of domestic violence and abuse in gay and bisexual men: A cross sectional survey.

This cross-sectional survey measured adult experience and perpetration of negative and potentially abusive behaviours with partners and its associations with mental and sexual health problems, drug and alcohol abuse in gay and bisexual men attending a UK sexual health service. Of 532 men, 33.9% (95% CI: 29.4-37.9) experienced and 16.3% (95% CI: 13.0-19.8) reported carrying out negative behaviour. Ever being frightened of a partner (aOR 2.5; 95% CI: 2.0-3.1) and having to ask a partner's permission (aOR 2.7; 95% CI: 1.6-4.7) were associated with increased odds of being anxious. There were increased odds of cannabis use in the last 12 months amongst men who reported ever being physically hurt (aOR 2.4; 95% CI: 1.7-3.6). Being frightened (aOR 2.2; 95% CI: 1.5-3.2), being physically hurt (aOR 2.3; 95% CI: 1.4-3.8), being forced to have sex (aOR 2.5; 95% CI: 1.3-4.9) and experiencing negative behaviour in the last 12months (aOR 1.7; 95% CI: 1.2-2.5) were associated with increased odds of using a Class A drugs in the last 12 months. Sexual health practitioners should be trained with regards to the risk indicators associated with domestic violence and abuse, how to ask about domestic violence and abuse and refer to support.

“It’s Always Good to Ask”: A Mixed Methods Study on the Perceived Role of Sexual Health Practitioners Asking Gay and Bisexual Men About Experiences of Domestic Violence and Abuse

Development of joint displays is a valued approach to merging qualitative and quantitative findings in mixed methods research. This study aimed to illustrate a case series mixed methods display and the utility of using mixed methods for broadening our understanding of domestic violence and abuse. Using a convergent design, 532 gay and bisexual men participated in a Health and Relationship Survey in a U.K. sexual health service and 19 in an interview. Quantitative and qualitative data were analyzed separately and integrated at the level of interpretation and reporting. There were inconsistencies in perceptions and reports of abuse. Men were supportive of selective enquiry for domestic violence and abuse by practitioners (62.6%; 95% confidence interval = 58.1% to 66.7%) while being mindful of contextual factors.

HIV and Men.

Since the initial description of HIV and AIDS, monumental efforts have been made both in the developed and developing countries to devise strategies and medications to control the disease. The advent of highly active antiretroviral therapy has now meant that the diagnosis of HIV is no longer a life-sentence and compliant patients with HIV can expect life expectancy similar to their noninfected peers. Consequently new challenges have arisen in the management of benign conditions. To provide an overview of the key conditions and issues that HIV/AIDS patients may present with to an andrological service. Using PubMed, we screened the literature for studies on common andrological conditions specifically pertaining to HIV and AIDS. The urological manifestations of HIV/AIDS in men have been summarized in an attempt to provide a useful guide for sexual health practitioners dealing with HIV-positive men. As a result of advancements in pharmaceuticals, life expectancy of men infected with HIV has improved almost to that of the general population in developed countries. Therefore, clinicians are faced with non-life-threatening urological problems that affect the quality of life of men with HIV. The majority of these problems can be managed easily, by adapting a "patient-centered" approach, instead of "disease-centered" algorithms. With improved survival and understanding, patients with HIV/AIDS can and do expect to enjoy a healthy sex life. With appropriate counseling around safe sex and careful management with consideration for disease-specific issues as well as the influence of medical therapy, patients can achieve a good quality of life.