Partnerships in Sexual and Reproductive Health

Abstract

One of the elements of successful access to youth friendly sexual and reproductive health services consists of effective partnerships between the civil society, Government, and the corporate world. Key elements that define successful partnerships for any organisation are trust, openness, respect and interdependence.     

Emotional Health and Well‐being in Schools: Involving Young People

Prevalence studies of emotional health and well‐being (EHWB) of young people indicate that that there is cause for concern. Very few studies have examined EHWB from the perspective of young people. This study examined the views of young people about their EHWB in the context of secondary education in the UK. Eight focus groups were conducted in five secondary schools with pupils in year 10 (aged 13–14). The findings suggested that whilst pupils thought some aspects of EHWB are well provided for in the school curriculum, there were problems with coherence of EHWB policy. Mental health topics were thought to be neglected in the EHWB curriculum especially in relation to self‐harm. Three problems regarding talking about EHWB were identified. Firstly, the quality of EHWB lessons depended on the enthusiasm and creativity of the teacher taking the lesson. Secondly, pupils were concerned about confidentiality. Thirdly, many pupils preferred to talk to friends about EHWB issues. The findings of the study suggest a need for greater involvement of young people in the planning, implementation and evaluation of the EHWB curriculum.     

Young people and drugs: on navigation in the drug landscape

In today's popular culture, critical messages intending to counteract drug use exist side by side with messages aiming to promote drugs. Nobody knows exactly what influence this exposure and constant shifts between the light and the dark sides of drug use have on young people's life worlds, and on their attitudes and behaviours in relation to drugs and drug use.

The main objective of this article is to analyze how young people navigate between different messages in the drug landscape, and what kind of knowledge and practical strategies they use and develop in relation to drugs and drug use.

The study was performed in Sweden. The empirical data consist of qualitative interviews with young adults, ages 18–26. On the basis of this data, we identify four interactive and partly overlapping themes that constitute ‘junctions’ of navigation: (1) knowledge as compass; (2) the power of the drug – the individual's power to resist; (3) the power of context and relationships; and (4) legal frameworks and personal morals. We also discuss what the implications of the results of this study are for the work with young people.     

Sexual Functioning in Spanish and Portuguese Young Adults: Initial Validation of the Arizona Sexual Experience Scale

Objectives: The authors conducted an initial validation of the Arizona Sexual Experience Scale (ASEX) and examined the sexual function of Spanish and Portuguese young adults. Methods: Participants were 523 Spanish and 595 Portuguese heterosexual young adults who completed a background questionnaire, the ASEX, and measures of sexual sensation seeking, excitation, and inhibition. Results: The ASEX showed good reliability and validity. Participants reported good sexual function. The most prevalent difficulties in men were related to desire and orgasm, and to orgasm and satisfaction in women. Conclusions: This is a psychometrically sound instrument to assess sexual functioning in Spanish and Portuguese young adults.     

Young people,social workers and social work education: the role of digital skills

ABSTRACT

This paper addresses a key issue in the development of youth-focused social work: the role of digital skills in the relationship between young people and social workers who work with these native digital users. To this end, we analysed data from the International Digital Economy and Society Index 2019 and Eurostat. Information from the sixth European Working Conditions Survey and a survey conducted by the Social Care Institute for Excellence and the British Association of Social Workers supported the empirical analysis. The main findings reveal a gap between the level of digital skills required in the labour market and the actual level of digital skills in both young people and social workers, despite efforts by both groups to improve their skills. Initiatives to foster digital skills are therefore recommended to bridge this digital divide. Lastly, it was concluded that both groups could act as mutual drivers of digital transformation.     

Gender Differences in the Sexual Well-Being of Mexican Adolescents

Objective: This study examines the associations of gender roles and sexual power with the sexual wellbeing of Mexican adolescents. Particularly we look at the role played by adolescent’s attitudes toward gender roles and sexual power regarding three aspects of their sexual well-being: satisfaction with one’s sex life; consistent condom use; and the refusal of unwanted sexual contact with one’s partner. Methods: we used logistic regression models to analyze possible associations between attitudes toward gender roles, and sexual power, with the sexual well-being of adolescents, using a random and representative sample of 4,738 sexually active teenagers from three Mexican states. Results: egalitarian attitudes are positively associated to high sexual satisfaction for female adolescents, whereas for males they favor the refusal of unwanted sex. Sexual power shows significant associations with consistent condom use for both males and females, and it also significantly increases the likelihood of high sexual satisfaction and refusal of unwanted sex among females. Conclusions: the findings suggest the relevance of overcoming traditional sex roles to achieve adolescent sexual well-being. In this sense, health and population policies should direct more substantial efforts in the promotion of gender equality among the adolescents and in the development of critical attitudes towards traditional gender norms.     

Child Sexual Abuse and Intimate Partner Violence Victimization in Adulthood: Sex-Differences in the Mediating Influence of Age of Sexual Initiation

Child sexual abuse is a major public health concern in the United States with devastating sequelae. Although the relationship between child sexual abuse and intimate partner violence victimization in adulthood is known, little is known about the mediating influence of the age of sexual initiation on the association, or whether sex differences exist. Using data from waves I, III, and IV of the National Longitudinal Study of Adolescent to Adult Health (N = 1,163), we aimed to examine the mediating influence of age of sexual initiation on the association between child sexual abuse and intimate partner violence victimization in adulthood and identify sex differences. Findings reveal that in female survivors, age of sexual initiation partially mediated the association between child sexual abuse and physical intimate partner violence victimization in adulthood. In male survivors, no mediational effect was observed. Public health practitioners should be aware of sex differences in the effect of early sexual initiation on intimate partner violence victimization in adulthood among child sexual abuse survivors.     

What Pediatric Subspecialists Need to Know About Sexual and Reproductive Health: A Review of the American Board of Pediatrics Content Outlines for Subspecialty Certifying Examinations

ABSTRACT

Many adolescents with complex medical conditions regard their subspecialty providers as an important source of clinical information including sexual and reproductive health information related to their medical condition. Thus, training for pediatric subspecialty providers should include clinically relevant sexual and reproductive content. The purpose of this study is to understand what disease-relevant sexual and reproductive health information is currently included in content outlines for each of the available pediatric subspecialty certifying examinations. The American Board of Pediatrics (ABP) offers 17 subspecialty certifying examinations; 13 content outlines are available on the ABP website which defines the body of knowledge to be tested. Each available outline underwent content analysis for sexual and reproductive health information. A team of adolescent medicine physicians identified seven thematic areas including: 1) puberty; 2) sexual behavior and identity; 3) fertility; 4) contraception; 5) sexually transmitted infections; 6) other genital pathology; 7) pregnancy. Across disciplines, learning objectives related to sexual behavior, sexual identity, fertility, contraception and pregnancy were the most limited. However, content related to puberty, sexually transmitted infections and other genital pathology was better represented. Overall, disease-and treatment-specific sexual and reproductive health information was sparse. Most subspecialty content outlines contain very little disease-specific sexual and reproductive health information despite the growing adolescent and young adult population with complex medical conditions in the care of pediatric subspecialists. Further studies are needed to explore if lack of sexual and reproductive information on board exams relates to the knowledge base and skill set of pediatric subspecialists.     

Regional Prevalence,Patterns and Correlates of Sexual Coercion Among Women in Sub-Saharan Africa: A Multi-Country Population-Based Study

Abstract

Objective: This study investigates the prevalence, perpetrators, and factors associated with forced sexual acts. Methods: Pooled secondary data from the most recent Demographic and Health Survey (DHS) in 22 sub-Saharan African countries was used in this study. The individual woman components of the questionnaire involving 148,720 women of reproductive age (15-49?years) were analyzed. Percentages and graphs were used to present distribution of study variables. Multivariable logistic regression was used to examine factors associated with sexual coercion. Results: Forced sexual acts were prominent in Rwanda (15.7%), Gabon (12.3%) and Democratic Republic of Congo (10.9%). The lowest mean age at first forced sexual acts was recorded in Gabon (14.1?years), Comoros and Mali (14.9?years each), whereas the maximum was recorded in Namibia (25.9?years). Results from adjusted logistic regression models identified that factors such as high women decision making power, large spousal age difference, rural residence, Islamic religious beliefs and listening to radio were significantly associated with reduction in the odds of forced sexual acts. Conversely, high-risk partner’s behavior, older age at start of first marriage, early age at sexual debut, most disadvantaged community, education, and the use of newspapers were significantly associated with higher odds of forced sexual acts. Conclusion: Based on the findings of this study, policies should be reinforced to handle perpetrators of sexual violence especially non-intimate partners. Population-based preventive measures of sexual coercion are essential to complement justice system responses. Our findings also showed the importance of building gender equity as part of sexual violence prevention approach.     

Integrating Sexual Health Services Into Primary Care: An Overview of Health Systems Issues and Challenges in Developing Countries

ABSTRACT

Current attempts to address the high burden of sexual health morbidity and mortality in developing countries remain limited in scale due to a range of health system constraints. We conducted a literature review of the policy and programmatic issues that influence the integration of sexual health into primary care services in developing countries. Forty-seven reports were identified from a search of both peer-reviewed and gray literature. Key issues identified were intersectoral and intergovernmental coordination; management and organizational issues including decentralization, health sector reform, logistics, and referral systems; human resources, including training and support required to increase service scope; relationships between the public and private sectors; and scaling-up and financing issues.     

Intensified inequities: Young people's experiences of Covid-19 and school closures in Uganda

Uganda had the longest period of school closures worldwide as a response measure during the Covid-19 pandemic. Drawing on longitudinal qualitative data from the Contexts of Violence in Adolescence Cohort Study (CoVAC) (2018–2023), we examine how this has affected the lives of adolescents in Uganda. Our analysis showcases how intersecting inequities based on socioeconomic circumstances, gender and location have intensified, with detrimental effects on young people's educational paths and life circumstances. Strategies that take the intersections of these inequities into account are urgently needed to help the most disadvantaged and marginalized young people return to school.     

Sexual Attitudes and Behavior of University Students at a Rural South African University: Results of a Pilot Survey

A cross sectional qualitative and quantitative pilot survey, using self-administered questionnaire and focus group discussions, was conducted to assess the feasibility of a health promotion programme implemented at the university. About 73 students participated in the survey and the discussion. We examined gender and cultural differences on sexual attitude and behaviour. There was a strong belief that unprotected sex can lead to pregnancy and STIs. Overall participants were not sure if condom use had any negative effects, although female respondents felt that condoms affect the pleasure of sexual intercourse.

The results suggest that there is a need for health promotion programmes aimed at young adults, who attend university. The programme should improve general health knowledge, targeting health promotion and sexual risk behaviour among university students. Such a programme would have to consider gender, socio-economic circumstances as well as national and cultural background of the target population.     

Alcohol and Substance Use in Adolescence and Young Adulthood: The Role of Siblings

Interpersonal relationships within and outside the family have been a central part of alcohol and substance use research. Many studies have focused on the role of parents and peers; fewer studies have focused on siblings. This article examines siblings’ roles in alcohol, tobacco, and other drug (ATOD) use patterns and trajectories in the context of familial and nonfamilial factors across time. First, intraclass correlations were used to examine the degree to which older siblings’ ATOD use was associated with younger siblings’ ATOD use. Second, hierarchical regression analyses were conducted to examine the degree to which individual, parent, sibling, and peer factors over time were associated with adolescents’ and young adults’ ATOD use. It should be noted that developmentally proximal predictors were utilized in these models and within-family replication was also examined. Results demonstrate strong associations between older and younger siblings’ ATOD use. Moreover, the developmentally proximal sibling variables were predictive of younger sibling ATOD use in the context of other variables across all substances. Study findings are discussed in terms of identifying promising and potentially malleable points of intervention for future investigators.     

Young people and social networking sites: exploring the views and training opportunities of CAMHS social workers in Ireland

ABSTRACT

Social Networking Sites (SNS) (e.g. Facebook, Instagram) have become a fundamental part of the daily lives of many young people. SNS engagement has been associated with a number of risks and benefits, some of which are particularly relevant to young people who access child and adolescent mental health services (CAMHS). Consequently, understanding how and why young people engage with SNS, and the associated risks and benefits, may become an increasingly important part of CAMHS social work.

This small-scale study (n = 15) utilised an online survey to explore the importance that a sample of Irish CAMHS social workers attribute to maintaining an awareness of how young people use SNS, whether they, in their professional lives, have been offered the opportunity to learn about SNS engagement among young people, and whether they have taken it upon themselves to learn about this topic.

Findings suggest that participants consider an understanding of SNS to be an important part of CAMHS practice. However, participants report that they do not feel sufficiently aware of SNS trends among young people, suggesting that there is scope for SNS-focused training/learning opportunities among this sample of CAMHS social workers. Implications for practice and suggestions for future research are outlined.     

Editing the project of the self: sustained Facebook use and growing up online

Now in operation for 12 years, Facebook comes to serve as a digital record of life for young people. With significant parts of their lives played out on the site, users are able to turn to these profiles to reflect on how their use of Facebook has come to constitute a life narrative. In this paper, we report on findings from qualitative research into sustained use of Facebook by young people in their twenties in Australia and the UK. We focus on the ‘editing’ or re-ordering of narratives that our participants engage in while they scroll back through their years of disclosures – and the disclosures of others – that make up their Facebook Timelines. We present our analysis through three arenas (employment, family life and romantic relationships) subject to what we argue is a reflexive re-ordering of life narratives. We argue that Facebook profiles represent visual manifestations of Giddens [1991. Modernity and Self-Identity: Self and Society in the Late Modern Age. Stanford, CA: Stanford University Press] reflexive project of the self, that serve not only to communicate a sense of self to others, but that also act as texts of personal reflection and of growing up, subject to ongoing revision.     

Young people's reproductions of the ‘father as provider’ discourse: intersections of race,class, culture and gender within a liberal democracy

ABSTRACT

Despite a plurality of paternal forms available to men, certain enactments of fathering remain immobile. In South Africa the ‘father as provider’ discourse, which establishes the legitimate father as one who provides financially for his family, continues to be regarded as the primary mark of a good father. Using photo-elicitation interviews to interrogate the persistence of this discourse, this paper examines how adolescents from two low-resourced South African communities construct fathering. Using a critical intersectional discursive framework, the analysis focuses on how gender, race, class and culture are implicated in the reproduction of the ‘father as provider’ discourse. Participants’ constructions suggest that the father’s duty to provide is intensified within marginalised contexts. Central to participants’ reproductions of the ‘father as provider’ discourse was a neoliberal conception of ‘freedom of choice’. The paper concludes that South Africa’s post-apartheid reliance on discourses around liberal democracy has cast the low-income father’s ability to fulfil the provider role as a conscious choice. While the father is made responsible for his failure to provide, broader structural oppressions are in turn rendered largely invisible by such discourse.     

Formation of European identity: ethnic minority groups in Central and Eastern Europe in generational perspective

Research into European identity has mostly focused on majority populations in Western European countries, neglecting new member states in Central and Eastern Europe (CEE) as well as ethnic minority groups. This paper contributes to filling this gap by exploring and investigating processes of European identity formation of five ethnic minority groups in four CEE countries. A generational perspective was applied by conducting qualitative in-depth interviews with three generations of ethnic minority group members. The results support the instrumental approach of identity construction. In all minority groups researched, the young generation, due to more positive personal experiences and perceived benefits from the European Union, have developed more positive images and perceptions of Europe and a greater sense of European identity than older generations. Furthermore, ethnic group-specific processes of identity formation were found.     

An Episodic Analysis of Substance Use and Risky Sexual Behavior in a Racially Diverse Sample of Young Men Who Have Sex with Men

Many studies have examined the relations between drug use and sexual behaviors; however, few have utilized episodic data to examine the co-occurrence of both behaviors within the same episode. This study surveyed 403 racially and ethnically diverse gay, bisexual, and other young men who have sex with men (YMSM; ages 18–29) in New York City. Men were surveyed about their sexual behavior and concurrent use of illicit substances and alcohol during their most recent sexual encounter with their main and/or casual partner(s). Logistic regression models were built to analyze predictors of unprotected oral and anal intercourse with main and casual partners. Results suggest that use of inhalant nitrates and alcohol increased the odds of men engaging in unprotected receptive anal intercourse (URAI) and men who identified as middle or high socioeconomic status (SES) were at lower odds of engaging in URAI with their main partner. Use of other illicit substances was not associated with unprotected sexual intercourse. These findings indicate a need to further consider the role of licit substances used by YMSM as a means of further reducing the incidence of HIV infection in this population. In addition, the high rates of unprotected anal intercourse among men reporting a main partner has the potential to be a significant source of HIV risk, and should be further explored among YMSM.     

Experiences of Young People with Harmful Sexual Behaviors in Services: A Qualitative Study

ABSTRACT

Young people are responsible for a significant number of the sexual offenses that are committed every year. These young people are generally referred to specialist services for treatment. This article explores the health characteristics and service experiences of 117 young people with sexual behavior problems, and the issues that services face when working with them. The study is based on analysis of 117 case files, identified from nine specialist services in the UK. The case files were thematically analyzed. Case files provided information on the following topics: the reasons why the young people were referred to harmful sexual behavior services; the young people’s personal characteristics; their medical and mental health problems; the young people’s interests and aspirations; their attitudes toward services and interventions; continued problematic sexual incidents in services; progress in services; and post-service experiences. Overall, the findings of the study indicate that these young people have a number of strengths, but often have problems across a range of personal and health domains. A number of them continue to remain sexually and generally violent in services, particularly in residential settings, which has risk management implications for staff.