Testing a New Measure of Sexual Health Knowledge and Its Connections to Students' Sex Education,Communication, Confidence,and Condom Use

ABSTRACT

This study investigates the nature of college students' sexual health knowledge, prior sex education coverage, and sexual communication and confidence. We created a new, comprehensive sexual health knowledge measure to assess 347 undergraduates' knowledge of reproductive health, contraception, condom use, sexually transmitted diseases (STDs), and HIV/AIDS. Overall, students demonstrated a fairly poor understanding of sexual health issues. Women were more knowledgeable than men, specifically on the topics of contraception and STDs. Prior exposure to sex education covering mainstream reproductive health issues or newer contraception methods was correlated with greater knowledge across all domains, particularly for men. Greater knowledge was also correlated with greater sexual assertiveness and confidence with condoms among women.     

What College Students Do Not Know: Where Are the Gaps in Sexual Health Knowledge?

Abstract

Objective: This study aimed to understand the gaps in college students’ knowledge regarding sexual health information. Participants: A sample of 242 participants enrolled in an introductory college course participated in this study in the Fall 2009 semester. Methods: Students participated in 1 of 2 brief interventions and wrote a response paper about their experience. The papers were analyzed using conventional content analysis for information that was new to participants by looking for key words that suggested learning took place. Results: The findings indicated that the majority of participants learned new information. Most learning occurred regarding sexually transmitted infections (ie, types, symptoms, prevalence, treatment, testing) and correct condom use. There were also demographic differences regarding reported new information. Conclusions: Findings can be used to develop future sex education programs for college students by providing college educators with an understanding of where students lack knowledge of sexual health.     

Sexuality Information Seeking and Sexual Function Among Women Attending In-Home Sex Toy Parties

ABSTRACT. Outside traditional risk-oriented public health campaigns, few sexuality education opportunities exist for adult women, particularly those in partnered relationships, that address issues related to sexual desire and pleasure. Data were collected from 677 women attending in-home sex toy parties to assess whether they sought sexuality-related information at a recent party they attended. Participants reported asking 765 questions at parties. The questions were analyzed for their content and for relations with sexual function scores. Question topics were varied, related to various domains of sexual function, and provided insight into the contributions that these parties may make to women's sexual health.     

Sentencing Male Sex Offenders Under the Age of 14: A Law Reform Advocacy Journey in Hong Kong

The common law presumption that a boy under the age of 14 is incapable of sexual intercourse has provoked controversial debates in Hong Kong. This article describes a 6-step advocacy journey to examine how community efforts have helped modify this law so that juvenile male sexual offenders under the age of 14 who have committed the crime of having sexual intercourse with underage females can be sentenced to receive appropriate treatment. Seven court cases provided by the magistrates’ courts in Hong Kong were used in this advocacy effort for the removal of the presumption in July 2012. Although this effort has yet to reveal signs of effectiveness, it represents greater public awareness about providing rehabilitation appropriate for juvenile sex offenders through a formal sentence. Restorative justice, as opposed to retributive or punitive justice, places an emphasis on rehabilitation of the offender and restoration of victims to a place of wholeness.     

Chapter 8: AIDS Service Organziations:

AIDS Service Organizations (ASOs) adopted a mission that included advocacy for public policy and private service agency response to the AIDS epidemic, prevention education efforts and provision of personal social services to people with AIDS (PWAs). This mission was shaped by stigmatization and marginalization of PWAs, the inadequate response of governments and health and social service agencies, the developing relationship between ASOs and diverse populations, especially communities of color, and by developments in medical research and treatments for HIV disease. ASOs thus emerged as new contexts of helping and as such had to create organizational structures appropriate for the problems faced, arrange for constructive relationships between helpers and those receiving services, and establish and maintain constructive relationships between the ASO and the larger community. Future challenges facing these new contexts of helping are discussed.     

Questioning Gender and Sexuality Binaries

Abstract

Social work has largely adopted the oppression model in our research, practice, education, policy and advocacy work. These essentialist constructions rely on the binary categorizations of male/female and heterosexuality/homosexuality. Largely missing from the mainstream social work literature are the perspectives of postmodern/queer theorists, the latest sex research, and the experience of transgendered individuals. These perspectives offer critiques of gender and sexuality binaries as well as libratory goals for social justice. Tensions between the postmodern perspective and the social work liberal model are discussed, and suggestions for incorporating the ideas emanating from queer theorists, new sex research, and the lived experiences of the transgendered into all areas of social work are offered.     

Bush's War on Sexual Health and Defensive Strategies Against It

Abstract

Since George W. Bush became President of the United States in 2001, his administration has presided over a far-reaching campaign attacking sexual and reproductive rights. This paper examines three facets of this campaign-the promotion of abstinence-only education; a general attack on condom use; and a campaign against sex workers-and offers strategies for advocates of sexual and reproductive rights to counter these measures.     

Antecedents of Condom-Protected Oral Sex Among Young Black MSM

Oral sex among men who have sex with men (MSM) is a common mode of STI transmission. This study identified the prevalence and antecedents of condom-protected oral sex among a sample of 526 young Black MSM having oral sex in the past 90 days. Men engaging in condomless anal receptive sex were less likely to report always using condoms for oral sex (p = .007). Men agreeing that “condoms help me have better sex” (p = .004) and those indicating always discussing condom use before sex were more likely to always use condoms for oral sex (p = .002). These identified antecedents may inform behavioral intervention efforts.     

Advocacy Evaluation for Counselors Serving LGBTQ Populations

ABSTRACT

Advocacy and social justice initiatives for lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ) clients in counseling emphasize counselor and client collaboration in challenging discrimination and oppression and promoting LGBTQ inclusive sociopolitical changes. Although researchers have highlighted the counseling and advocacy needs of LGBTQ populations, few have yet examined processes for assessing the outcomes of advocacy efforts. Advocacy evaluation may provide counselors and counseling organizations with a framework for monitoring and assessing the outcomes of LGBTQ advocacy initiatives. The authors discuss the goals and elements of advocacy evaluation and review the LGBTQ Counseling Advocacy Evaluation Self Assessment.     

School Violence and Adolescent Mental Health in South Africa: Implications for School Health Programs

This study examines the perceptions of high-school adolescents about gang violence in a periurban community near Cape Town and the implications for school health in South Africa. Using the qualitative focus group discussion (FGD) guide, data were collected from 60 high-school adolescents, between 10 and 20 years of age. Trained moderators conducted nine FGDs with small groups of six to eight students. The constant comparative ethnographic method was used to analyze the data. Results indicate that gang violence is very common among high-school adolescents living on the Cape Flat. Gangs, perceived by many as part of the rite of passage among adolescents, are a major threat to the public health, mental well-being, general welfare, happiness, and development of high-school populations on the Cape Flat. Gang activity interlock with many other social problems, including drug and alcohol abuse, school unrest and violence, and the increasing prevalence of sexually transmitted diseases, especially HIV and AIDS. These findings suggest an urgent need for concerted efforts to develop mechanism to protect school pupils from gangs and develop healthier social alternatives to gang-related activites. Ties among government, school, parents, and community education and participation are urgently necessary to implement a school-based approach to adolescent health promotion.     

No Easy Answers: Ethical Challenges Working with Sex Offenders

Therapeutic practice with sex offenders and similarly ostracized populations presents unique personal, clinical, and professional challenges for clinicians. This article examines four areas of difficulty—treatment efficacy, clinical competence, boundary maintenance, and stigmatizing policies—and reviews ethical and clinical standards for addressing these challenges. Specific recommendations for competent practice, supervision, research, and advocacy are given.     

An Essential Component in Promoting Sexual Health in Europe is Training in Sexology

ABSTRACT

Training programs for sexologists are core activities to promote higher professional standards in sexology and to educate a new generation of sexologists. The summary information from 25 European countries provides evidence that training in sexology consists today of different models. The existing different national training models in sexology in Europe are: (1) a medical model, (2) a clinical model integrating medical and psychological approaches, (3) separated education in clinical sexology and human sexology, (4) sex therapy model, (5) human sexuality model, and (6) the Nordic human sexology model. This information provides basis for future collaboration between training institutes in Europe.     

Electronic Media Access and Use for Sexuality and Sexual Health Education Among Men Who Have Sex With Men in Four Cities in Tanzania

Abstract

Background: Electronic media use is an important avenue for reaching stigmatized populations. We examined Internet access and use of sexually related electronic media among men who have sex with men (MSM) in 4 cities in Tanzania. Methods: A questionnaire was administered to 231 MSM in Dar es Salaam, Mwanza, Arusha, and Tanga regarding electronic media type, times of use, type of use and frequency of use of sexually-related media. Results: Mean age was 25.7?years, and 52% had completed high school. Half had access to the internet through personal electronic devices, a further quarter had access through work, 10% through friends’ devices, and only 2% had no access to the internet. Most frequently used electronic devices were personal computer followed by work smartphone, with work computer a close third. These patterns were consistent for both seeking other men for sex and finding sexual health information. All respondents had accessed sexual material electronically at some time. Substantial logged-in time was reported each week seeking/chatting with potential sexual partners (median?=?48 hr), looking at “porn” (median?=?24 hr), and searching for health information (median?=?7 hr). Over 98% indicated that they would use an anonymous/confidential online service for HIV and sexually transmitted infection testing. The majority (79%) had found sexual partners throughout the Internet in the last 24?hours, and 52% sought sexual health education online 2–3 times per week. Peak search time was evenings, increasing during weekends. Discussion: For Tanzanian MSM in cities, sexual electronic media use is high and includes work devices. Sexual health information seeking, and openness to electronic counseling and testing was almost universal. Electronic sites for sexual health access should be explored and evaluated.     

Addressing Sexually Transmitted Infections (STIs), including HIV/AIDS,in the Context of Sexual Health

ABSTRACT

Sexually transmitted infections (STIs) have occupied a central place in public health agendas for at least the past 500 years, but have been the subject of opinions, decrees and “moral positions” for much longer. Societies have long tried to control the sexual behaviors of their populations, not only for reasons of social control, but also with the objective of controlling the spread of disease—HIV is the latest example of how societies respond to infections spread through the most private of individual behaviors. The article outlines the burden of disease associated with sexually transmitted infections including HIV, and explores their impact on efforts to achieve the Millennium Development Goals (MDGs). A large number of options for prevention and care of the sexually transmitted infections and HIV are currently available in both resource-rich and resource-constrained settings. In this article I move beyond the narrow focus of biomedical interventions concentrated on the individual and explore the evidence for public health measures aimed at controlling these infections. Using a public health framework I outline the various measures that can be implemented for STI/HIV control, and in addition to exploring the evidence for their public health effectiveness, I also look at how each of these interventions can be delivered within a paradigm of sexual health more generally. Finally, the article proposes recommendations for which effective strategies should be incorporated into a broader framework for promoting sexual health.     

Will It Be Silence and Violence or Safety and Prevention for the Next Generation of Gay Youth?

Rates of unprotected anal intercourse and HIV infection are alarmingly high among young gay males. This second wave of infection indicates that traditional models for AIDS education are not working. AIDS educators need to rethink HIV-prevention efforts. Studies consistently find a high level of knowledge about HIV transmission and high levels of commitment to safer sex among gay males, but what accounts for the breakdown between safer sex intentions and practices among them? This article employs social constructionist and queer theoretical assertions that sexuality is socially and culturally produced in complicated and pluralist ways. The analysis examines how risky sexual situations shape young gay males' sexualities by exploring two examples selected to represent, alternatively, models of safer sexual and unsafe sexual trajectories. Implications for HIV prevention practices and policies are discussed.     

Sex in Health Education: Official Guidance for Schools in England, 1928–1977

Abstract  This article examines official policy discourses on sex within the health education curriculum of schools during the period 1928–77. The article begins with an account of the origins of sex education in schools, and of why, in the early twentieth century, its inclusion in the health education curriculum was problematical. In the main section, the article examines the content of consecutive editions of the government published "handbooks of health education", and of an important supplementary guidance pamphlet, published during the Second World War. It traces the gradual shifts over time in official discourses of "sex education", and in the sets of understandings about children, sexuality and the role of parents, for example, which underlay them. The shifts in official guidance discourses on sex within the health education curriculum of schools are explained through locating changes in their broader social and political contexts, especially the impact of the Second World War on sexual morality and the post-war emergence of youth as a significant social grouping. The article concludes by evaluating the handbooks as a source for the history of school-based health and sex education and by drawing attention to the wider historical and sociological significance of official discourses on sex education.     

The sexuality scale: An instrument to measure sexual‐esteem,sexual‐depression,and sexual‐preoccupation

This article describes the development of the Sexuality Scale, an instrument designed to measure three aspects of human sexuality: sexual‐esteem, defined as positive regard for and confidence in the capacity to experience one's sexuality in a satisfying and enjoyable way; sexual‐depression, defined as the experience of feelings of depression regarding one's sex life; and sexual‐preoccupation, defined as the tendency to think about sex to an excessive degree. The procedure involved (a) item construction, selection and subsequent validation through item analysis; and (b) a factor analysis of the items on the Sexuality Scale and the establishment of factorial validity. The results indicated that the three subscales were psychometrically sound, that males reported more sexual‐preoccupation than did females, and that the three subscales have unique intercorrelation patterns. The exploratory nature of these findings are discussed.     

Endorsement for Civil Rights for Lesbian,Gay, Bisexual,and Transgender People Among Heterosexual College Students: Informing Socially Just Policy Advocacy

In the past decade, advocacy efforts to establish social policies that legally recognize same-sex relationships and protect lesbian, gay, bisexual, and transgender (LGBT) people from employment discrimination have increased considerably throughout the country. To inform these advocacy campaigns, we investigate endorsement for LGBT civil rights among heterosexual college students (n = 1,714). Students, overall, were moderately supportive of LGBT rights. Twenty-one variables were found to be significant in the initial analyses; however, only seven retained significance in the final analysis which controlled for all variables. Results suggest that political ideology and specific LGBT attitudes are most influential. Religiosity and having LGBT extended family members are also important. Implications for LGBT advocacy efforts are discussed.     

Response to Comartin,Kernsmith, and Miles' (2010) Michigan Sex Offender Registration Study

We investigated demographic predictors of support for juvenile sex offender registration policies, including education level, gender, political orientation, and age. Participants were 168 individuals recruited from public places in a Midwest community (45% women; M age = 42). In line with hypotheses, as education level increased, support for juvenile registration decreased, as did the belief that juvenile registration protects the community. In addition, as education level increased, belief that the juvenile understood his actions decreased, as did support for juvenile registration when it is framed as ineffective at reducing sex crime. These beliefs mediated the relationship between education level and diminished support for juvenile registration. Implications of these results for the advancement of effective juvenile sex offender policy are discussed.     

Predictors of HIV Sexual Risk Behavior Among Men Who Have Sex with Men,Men Who Have Sex with Men and Women,and Transgender Women

ABSTRACT

Men who have sex with men, men who have sex with men and women, and transgender women are at high risk for HIV infection. This study seeks to clarify which known HIV risk factors (partner type, sex location, serodiscordance, multiple sex partners, substance use during sex) contribute to engagement in high-risk (unprotected receptive anal) sex in each population. Data collected from June 2005 through June 2008 indicate all three populations display different HIV sexual risk profiles. The data suggest that HIV-prevention interventions should be individually tailored to address the specific needs of these three highly vulnerable and impacted populations.