Factors associated with utilization of emergency contraception among female students in Mizan-Tepi University, South West Ethiopia.
Shiferaw Bisrat Zeleke,Gashaw Bosena Tebeje,Tesso Fekadu Yadassa
BMC research notes
BACKGROUND:Unintended pregnancy poses a major health problem on female students in higher educations. One of the key interventions to reduce unintended pregnancy and unsafe abortion as outlined in the national youth strategy is making emergency contraception (EC) available for these risky population. However, despite its availability in many countries, EC has failed to have the desired impact on unintended pregnancy rates and its utilization is limited in colleges and universities. The objective of this study was to assess factors associated with utilization of emergency contraception among female students in Mizan-Tepi University (MTU), south west Ethiopia. METHODS:A cross-sectional, institution based study was conducted from March 10-30, 2014. Multistage sampling technique was used to select the participants for the quantitative method whereas; purposive and volunteer sampling techniques were used for the qualitative study. Quantitative data were cleaned, coded and entered into Epi-data 3.1 and analyzed using SPSS version 20:00. Binary and multiple logistic regression analysis were done to determine the association between the use of EC and the predicator variables. Data from focus group discussion were transcribed and translated to English then coded, and categorized into similar themes. RESULT:A total of 489 female students were participated in the quantitative study making a response rate of 90.6%. The finding shows that 46.3% of them have used EC following unprotected sex. Female students' knowledge about EC [AOR: 3.24; 95% CI 1.32, 7.98], age at first sexual intercourse (i.e. ≥20 years) [AOR: 4.04; 95% CI 1.72, 9.52], history of pregnancy [AOR: 3.12; 95% CI 1.34, 7.24] and previous use of regular contraceptives [AOR: 5.01; 95% CI 2.23, 11.27] were found to be significant predictors of EC utilization. In the focused group discussion, a total of 32 female students were participated and the result shows that lack of knowledge about EC and fear of being seen by others (information disclosure) were reported as main factors for not using EC. CONCLUSION:The study shows that the level of EC use was low. Female students' level of knowledge about EC, age at first sexual intercourse, previous use of regular contraceptives and history of pregnancy were major predictors of EC utilization. Therefore, designing strategies to enhance EC utilization by increasing female students' level of awareness on EC is recommended.
Awareness and Attitudes Toward Emergency Contraceptives Among College Students in South India.
Joseph Nitin,Shetty Bhavishya,Hasreen Fathima,Ishwarya R,Baniya Mukesh,Sachdeva Sahil,Agarwal Samarth
Journal of obstetrics and gynaecology of India
BACKGROUND:In India every year, a large number of pregnancies are unplanned resulting in unsafe abortion. This has tremendous implications both on health and survival of women. Usage of emergency contraceptive pills (ECPs) could be a solution provided the usage is as per guidelines and social issues do not cause objections. AIM:This study was done to assess the awareness and attitudes regarding ECPs. METHODS:Data were collected using self-administered questionnaire from the university students. RESULTS:Out of 449 students, 384(85.5 %) had heard about ECPs. The commonest source of information was television 299(77.9 %). Only 128(33.3 %) students knew that ECPs do not help in prevention of STDs. 209(54.4 %) participants knew the correct time frame for taking ECPs. 109(28.4 %) were unaware of its side effects. Only 149(33.2 %) had received reproductive health education (RHE) in the past. The awareness level of students about ECPs was moderate among 231(60.2 %) participants. Awareness was significantly more among males (p = 0.013), students with science background (p = 0.001) and those who had RHE previously (p = 0.043). 219(57 %) had average level of perception toward ECPs. 254(66.2 %) participants favored prescription before procuring ECPs from drug stores. 261(68 %) participants favored information about ECPs to be given in educational institutions, and a majority, 186(48.4 %), said they would recommend ECPs to their friends. Average-to-good perception about ECPs was seen in significantly greater proportion of females (p = 0.034). CONCLUSION:RHE is must at educational institutions so as to promote awareness and to remove misconceptions about ECPs among youth. This would help users in preventing unintended pregnancies and unsafe abortions.
Sex differences in the awareness of emergency contraceptive pills associated with unmarried Korean university students' intention to use contraceptive methods: an online survey.
Kim Hae Won
BACKGROUND:Awareness of emergency contraceptive pills (ECP) associated with an intention to use other contraceptive methods has rarely been investigated. This study compared the ECP awareness of males and females and its associations with intention to use four other contraceptive methods (condoms, oral contraceptive pills, and withdrawal and rhythm methods) in unmarried university students in Korea. This study explores the importance of ECP awareness in university students' contraceptive education. METHODS:A descriptive cross-sectional study design was employed, in which 1372 unmarried university students (men, n = 755, women, n = 617) answered a Web-based survey. Sex differences in ECP awareness and four contraceptive intentions, and associations between ECP awareness and contraceptive intentions between sex were analysed using independent t-tests and χ (2) test. Variables yielding significant associations with contraceptive intentions (p < 0.05) were included in a logistic regression using the adjusted odds ratio (AOR) to estimate the impact of ECP awareness on students' contraceptive intentions. RESULTS:Awareness of ECP was found in 88.2 % of participants, which was generally positive. There were significant sex differences in some ECP awareness and students' contraceptive intentions, and in the associations between previous ECP use and ECP awareness between male and female university students. In men, the belief that "ECP can cause sex with multiple partners" was associated with intention to use the rhythm method (AOR = 1.61, 95 % confidence interval [CI] = 1.02-2.56). For women, the belief that "ECP is necessary in case of condom breakage" was associated with intention to use the withdrawal (AOR = 058, 95 % CI = 0.37-0.93) or rhythm (AOR = 0.36, 95 % CI = 0.16-0.84) methods, and "ECP should be prescribed by a doctor" was associated with the intention to use the rhythm method (AOR = 0.45, 95 % CI = 0.26-0.77). CONCLUSIONS:ECP awareness was associated with the intentions of students to use withdrawal or rhythm methods. The sex-specific approach in the examination of students' contraceptive intentions and their determinants was helpful.
Reproductive health knowledge among college students in Kenya.
Mbugua Samuel Mungai,Karonjo Jane Muthoni
BMC public health
BACKGROUND:Reproductive health knowledge is vital in the growth and development of young people and this impact greatly on their educational and personal outcome as they proceed to adulthood. There has been an increasing occurrence of sexually transmitted infections in institutions of higher learning. The study sought out the strategies used by university students to prevent unplanned pregnancy and determined their knowledge of contraception methods and sexually transmitted infections in Mount Kenya University, main campus. METHODS:Stratified sampling was employed. After a signed consent was obtained, a self-administered questionnaire was used to collect data. Data were explored, analyzed and percentages used to quantify the level of knowledge. Pearson's chi-square was used to measure associations between categorical variables and independent t-test used to measure the means and relationships of continuous variables. RESULTS:Condom use was established as the most prevalent strategy in prevention of unplanned pregnancy at 48.5 and 46.4% in prevention of STI and HIV/AIDS. Almost two thirds (58%) of respondents reported that they were conversant with only one method of contraception, 60% had knowledge of more than two types of STIs, and 62.4% indicated that they were conversant with only hospitals as facilities providing reproductive health services. CONCLUSION:Young people in college require educational initiatives to sensitize them on STI, methods of contraception and positive social behaviors. There is need to improve the accessibility of reproductive health services through strengthening of services provided at campus health clinics.
Knowledge and Attitudes toward Sexual Health and Common Sexual Practices among College Students - A Survey from Vellore, Tamil Nadu, India.
Mukherjee Arnab,Gopalakrishnan Rajesh,Thangadurai Packirisamy,Kuruvilla Anju,Jacob K S
Indian journal of psychological medicine
Background:Indian society is considered to have conservative attitudes regarding sex and is ambivalent about the concept of sex education. Previous reports suggest that a considerable proportion of Indian youth have inadequate sexual knowledge and hold a variety of sexual misconceptions. Methodological flaws limit the generalizability of some earlier studies. Aims:This study assessed knowledge and attitude toward sexual health and common sexual practices among college students in Tamil Nadu. Methodology:A total of 952 students from seven randomly selected colleges in Vellore district of Tamil Nadu participated in the survey. The survey questionnaire contained 51 questions on knowledge and attitude toward sexual health and common sexual practices and incorporated items from standardized questionnaires and additional questions suggested by a multidisciplinary group who work in the field. Results:Two hundred seventy-five students among those who completed the survey were women. Higher knowledge scores were associated with older age, male gender, being from a rural background, pursuing non-science streams, and being in postgraduate courses. Nonconservative attitudes were associated with older age, male gender, enrollment in non-science disciplines, discomfort with the family environment, and a religious family background. Conclusions:Sexual knowledge is inadequate and sexual misconceptions were widely prevalent in the population studied. School-based comprehensive sex education programs, which have been demonstrated to be effective in improving sexual health, could be used to deal with these lacunae in sexual health knowledge and attitudes.
Assessing the Knowledge Level, Attitudes, Risky Behaviors and Preventive Practices on Sexually Transmitted Diseases among University Students as Future Healthcare Providers in the Central Zone of Malaysia: A Cross-Sectional Study.
Folasayo Adigun Temiloluwa,Oluwasegun Afolayan John,Samsudin Suhailah,Saudi Siti Nor Sakinah,Osman Malina,Hamat Rukman Awang
International journal of environmental research and public health
This study was done to assess the knowledge, attitudes, risky behaviors and preventive practices related to sexually-transmitted diseases (STDs) among health and non-health sciences university students as future healthcare providers in Malaysia. A total of 700 health and non-health sciences university students (255 male; 445 female) aged between 17 and 30 years were surveyed by using a self-administered questionnaire. The majority (86.6%) had heard of STDs, and 50.4% knew STDs could present without symptoms. HIV remains the best known STD (83.6%) by the students, while chlamydia (26%) and trichomoniasis (21.0%) were rarely known. Gender, age group, educational level and faculty type were strongly associated with knowledge level (-values < 0.05). Most of them (88.8%) were aware that STD screening was important while use of condoms was protective (63.8%). The majority of them strongly felt that treatment should be sought immediately if they (85.5%) and their partners (87.4%) have symptoms. Among the sexually-active students, 66.7% and 18% had sexual intercourse with multiple partners and commercial sex workers, while 17.4% and 9.4% took alcohol and drugs before having sex, respectively. By logistic regression analysis, students aged 24-30 years old (an odds ratio (AOR) = 0.57, 95% confidence interval (CI) = 0.377-0.859) and faculty type (AOR = 5.69, 95% CI = 4.019-8.057) were the significant predictors for the knowledge level. Knowledge on the non-HIV causes of STDs is still lacking, and the risky behavior practiced by the sexually-active students in this study is alarming. There is a need to revisit the existing STD education curriculum in both schools and universities so that appropriate intervention on STDs can be implemented.
Effects of comprehensive sexuality education on the comprehensive knowledge and attitude to condom use among first-year students in Arba Minch University: a quasi-experimental study.
Boti Negussie,Hussen Sultan,Shegaze Mulugeta,Shibru Simon,Shibiru Tamiru,Zerihun Eshetu,Godana Wanzahun,Abebe Sintayehu,Gebretsadik Woyinshet,Desalegn Nathan,Temtime Zebene
BMC research notes
OBJECTIVE:To assess the effect of comprehensive sexuality education on the comprehensive knowledge and attitude to condom use among first-year students at Arba Minch University. RESULTS:A total of 832 students participated at a baseline, and 820 students participated at the posttest. This study found that there was a significant effect on changing students' knowledge and attitude towards a condom. In the education group, the students' average change of comprehensive condom knowledge score was 0.229 higher than the average score of students' in the control group (ATE = 0.229, 95% CI 0.132 to 0.328; p < 0.001). The average change of attitude toward condom score of students' in the education group was 1.834 higher than the average change score of students' in the control group (ATE = 1.834, 95% CI 1.195 to 2.772; p < 0.001).This study provides further evidence on the effectiveness of comprehensive sexuality education in terms of knowledge and attitude towards a condom. Therefore, the implementation of this education should be strengthened in order the prevent youths from STI/HIV and unintended pregnancies.
Deficits in young men's knowledge about accessing sexual and reproductive health services.
Bersamin Melina,Fisher Deborah A,Marcell Arik V,Finan Laura J
Journal of American college health : J of ACH
OBJECTIVE:The current study aimed to examine (1) gender differences in college students' knowledge of sexual and reproductive health care (K-SRHC) service access points, and (2) the relationship between demographic and psychosocial factors and college students' overall K-SRHC service access points. METHODS AND PARTICIPANTS:Self-report online surveys were administered to 18- and 19-year-old college students from a northern California public university (N = 183; 39.9% men; 32.2% Latino). RESULTS:Women reported higher overall K-SRHC service access point scores than men. Findings indicated that gender and family planning self-efficacy were the strongest correlates of K-SRHC service access points. Men with a regular source of health care had higher K-SRHC service access points than men without. CONCLUSIONS:Results suggest that college men need additional education about how to access sexual and reproductive health services to support their own and their partner's health.
Sexual behaviour, contraceptive knowledge and use among female undergraduates' students of Muhimbili and Dar es Salaam Universities, Tanzania: a cross-sectional study.
Somba Magreat J,Mbonile Milline,Obure Joseph,Mahande Michael J
BMC women's health
BACKGROUND:The rate of premarital sexual activity, unwanted pregnancies and illegal abortions remain higher among university students. This calls for understanding the knowledge on contraceptive use and sexual behaviours among this high risk group if the incidence of unintended pregnancy, illegal abortions and high sexual risky behaviour are to be minimized. This study aimed to assess ssexual behaviour, contraceptive knowledge and use among female undergraduates' students of Muhimbili and Dar es Salaam Universities in Tanzania. METHODS:A cross-sectional analytic study was conducted among undergraduate female students in the two Universities located in Dar es Salaam region, Tanzania. The study period was from June 2013 to October 2013. A self-administered questionnaire was given to 281 students. Of these, 253 were retrieved, giving a response rate of 90%. Data was analyzed using Statistical Package for Social Science (SPSS) for Windows version 17.0. Descriptive statistics were summarized. The chi square test was used to examine relationship between various sociodemographic and sexual behaviours variables with contraceptive use. A P-value of less than 0.05 was considered statistically significant. RESULTS:Results showed that majority (70.4%) of the students have had sexual intercourse. All participants had knowledge of contraception. More than half, 148 (58.5%) of sexually active women reported ever used contraception before while 105 (41.5%) were current contraceptive users. Majority (74.7%) of the sexually active group started sexual activity at young age (19-24 years). Condom, 221(24.3%) and pills, 153 (16.8%) were the known contraceptive methods. The most popular method of contraception used were condoms, withdrawal and periodic abstinence. The main sources of information about contraception were from friends, radio and school (39.5%, 36% and 24%) respectively. Forty (15.8%) women had pregnancies. Of these, 11 (27%) have had unwanted pregnancies among which 54.6% have had induced abortion. Marital status, age at first sex, ever had sex, ever been pregnant and unwanted pregnancies were associated with use of contraception. CONCLUSIONS:Most of the student's had knowledge of contraception. However, rate of contraception use is still low. Majority of the respondent were sexually active, with the majority started sexual activity at young age. This needs advocacy for adolescence reproductive health education to promote the use of the available contraceptive services amongst university students.
Knowledge and attitude towards sexual and reproductive health rights and associated factors among Adet Tana Haik College students, Northwest Ethiopia: a cross-sectional study.
Ayalew Mulat,Nigatu Dabere,Sitotaw Getachew,Debie Ayal
BMC research notes
OBJECTIVE:Sexual and reproductive health rights are the rights of all people regardless of their age, sex and other characteristics to make choices about their own sexuality and reproductive issues. However, little is known about the knowledge and attitude towards SRH rights in Ethiopia. Therefore, this study aimed to assess knowledge and attitude towards SRH rights and associated factors among Adet Tana Haik college students in northwest Ethiopia. RESULTS:Overall, about 59.6% students were knowledgeable and more than half (53.4%) had favorable attitude towards SRH rights. In this study, students attending third-year class (AOR = 2.20;95% CI 1.29, 3.33), discussion with parents (AOR = 3.35;95% CI 1.61, 6.96), respondent's mothers attended secondary/above school (AOR = 3.01; 95% CI 1.28, 7.13), participation in RH clubs (AOR = 1.72; 95% CI 1.09, 2.70) and favorable attitude towards SRH rights (AOR = 2.41; 95% CI 1.56, 3.74) were significantly associated with knowledge of participants. On the other hand, knowledge of students (AOR = 2.33; 95% CI 1.36, 7.07), participation in RH clubs (AOR = 1.41;95% CI 1.09, 2.20) and discussion with parents (AOR = 2.50; 95% CI 1.15, 5.47) were the predictors for the attitude of students towards SRH rights. Hence, strengthening women's education, encouraging discussions with parents and participation in RH clubs may improve the knowledge and attitude of students towards SRH rights.
Use of drinking protective behavioral strategies and sexual perceptions and behaviors in U.S. college students.
Logan Diane E,Koo Kelly H,Kilmer Jason R,Blayney Jessica A,Lewis Melissa A
Journal of sex research
Alcohol use among college students is linked to an increased likelihood of engaging in risky sexual behaviors, including casual sex and unprotected sex. These behaviors increase college students' risks for negative social and health-related consequences. This study examined the relationship between drinking behaviors and protective behavioral strategies (PBS), expectancies and perceptions of sexual risk, and actual alcohol-related sexual behaviors and consequences. Sexually active college students completed Web-based self-report measures of drinking behaviors and use of PBS, alcohol expectancies and perceptions of risk, and sexual behaviors and related consequences (n = 524; 57.1% women). Findings indicated that PBS were related to lower expectancies of sexual risk and sexual disinhibition, and among lighter drinkers, lower expectancies of sexual enhancement from alcohol. PBS were also related to decreased perceptions of sexual-related risks, some alcohol-related sexual behaviors, including number of drinks before/during sex, and number of sexual consequences, but were not related to abstaining during sex, frequency of alcohol-related sexual behaviors, or general condom use. These findings demonstrate a disconnect between perceived and actual risks among college students, such that decreased perceptions of risk may not be associated with protective behaviors. Prevention and intervention implications are discussed.
Sexual learning among East African adolescents in the context of generalized HIV epidemics: A systematic qualitative meta-synthesis.
Knopf Amelia S,McNealy Kim R,Al-Khattab Halima,Carter-Harris Lisa,Oruche Ukamaka Marian,Naanyu Violet,Draucker Claire Burke
BACKGROUND:AIDS-related illness is the leading cause of mortality for adolescents in sub-Saharan Africa. Together, Kenya, Tanzania, and Uganda account for 21% of HIV-infected adolescents in sub-Saharan Africa. The United Nations framework for addressing the epidemic among adolescents calls for comprehensive sexual and reproductive health education. These HIV prevention efforts could be informed by a synthesis of existing research about the formal and informal sexual education of adolescents in countries experiencing generalized epidemics. The purpose of this study was to describe the process of sexual learning among East African adolescents living in the context of generalized HIV epidemics. METHODS:Qualitative metasynthesis, a systematic procedure for integrating the results of multiple qualitative studies addressing a similar phenomenon, was used. Thirty-two research reports met study inclusion criteria. The reports were assessed in a four-step analytic process: appraisal, classification of findings, synthesis of findings, and construction of a framework depicting the process of sexual learning in this population. RESULTS:The framework includes three phases of sexual learning: 1) being primed for sex, 2) making sense of sex, and 3) having sexual experiences. Adolescents were primed for sex through gender norms, cultural practices, and economic structures as well as through conversations and formal instruction. They made sense of sex by acquiring information about sexual intercourse, reproduction and pregnancy, sexually transmitted infections, and relationships and by developing a variety of beliefs and attitudes about these topics. Some adolescents described having sexual experiences that met wants or needs, but many experienced sex that was coerced or violent. Whether sex was wanted, coerced, or violent, adolescents experienced worry about sexually transmitted infections or premarital pregnancy. CONCLUSIONS:The three phases of sexual learning interact to shape adolescents' sexual lives and their risk for HIV infection. This framework will contribute to the development of sexual education programs that address HIV risk within the broader context of sexual learning.
'I learned to be okay with talking about sex and safety': assessing the efficacy of a theatre-based HIV prevention approach for adolescents in North Carolina.
Lightfoot Alexandra F,Taboada Arianna,Taggart Tamara,Tran Trang,Burtaine Amy
Adolescents are at increased risk of HIV and sexually transmitted infections (STIs) in the Southern states of the USA, where rates among youth are higher than in the rest of the nation. This paper reports on findings from a pilot study of an HIV prevention intervention that uses interactive theatre to educate young people about sexual health. The intervention was developed in Los Angeles and adapted for testing in the South of the USA, with its legacy of abstinence-based approaches to sexual health education. This study assessed intervention effects among a sample of young people in two public high schools in North Carolina. We used a pre-test, post-test quasi-experimental evaluation design to assess changes in 317 ninth grade participants' knowledge and attitudes about HIV. At post-test, we found statistically significant increases in participants' HIV knowledge (= 60.14; =.001), as well as changes in attitudes ( =8.23; =.042) and awareness ( =4.94; =.026). Focus group data corroborated increase in HIV knowledge and reduction in HIV stigma as successful outcomes of intervention participation. The findings make an important contribution to the literature on theatre-based interventions for sexual health education. Furthermore, they highlight the importance of considering socio-cultural and political context in implementing HIV prevention interventions in schools.
The Impact of a Sexual and Reproductive Health Intervention for American Indian Adolescents on Predictors of Condom Use Intention.
Tingey Lauren,Chambers Rachel,Rosenstock Summer,Lee Angelita,Goklish Novalene,Larzelere Francene
The Journal of adolescent health : official publication of the Society for Adolescent Medicine
PURPOSE:American Indian (AI) adolescents experience inequalities in sexual health, in particular, early sexual initiation. Condom use intention is an established predictor of condom use and is an important construct for evaluating interventions among adolescents who are not yet sexually active. This analysis evaluated the impact of Respecting the Circle of Life (RCL), a sexual and reproductive health intervention for AI adolescents, on predictors of condom use intention. METHODS:We utilized a cluster randomized controlled trial design to evaluate RCL among 267 AIs ages 13-19. We examined baseline psychosocial and theoretical variables associated with condom use intention. Generalized estimating equation regression models determined which baseline variables predictive of condom use intention were impacted. RESULTS:Mean sample age was 15.1 years (standard deviation 1.7) and 56% were female; 22% had initiated sex. A larger proportion of RCL versus control participants had condom use intention post intervention (relative risk [RR] = 1.39, p = .008), especially younger (ages 13-15; RR = 1.42, p = .007) and sexually inexperienced adolescents (RR = 1.44, p = .01); these differences attenuated at additional follow-up. Baseline predictors of condom use intention included being sexually experienced, having condom use self-efficacy, as well as response efficacy and severity (both theoretical constructs). Of these, the RCL intervention significantly impacted condom use self-efficacy and response efficacy. CONCLUSIONS:Results demonstrate RCL intervention efficacy impacting variables predictive of condom use intention at baseline, with greater differences among younger, sexually inexperienced adolescents. To sustain intervention impact, future RCL implementation should reinforce education and training in condom use self-efficacy and response efficacy and recruit younger, sexually inexperienced AI adolescents.
Adolescent Sex and Psyche in Brazil: Surveillance, Critique and Global Mental Health.
Béhague Dominique P
Culture, medicine and psychiatry
Drawing on a historical ethnography conducted in Southern Brazil, this article explores how public health programs for adolescent reproductive and mental health have emerged in Brazil and begun to intersect with the growing field of "global mental health" (GMH). The story I recount begins not in the 2010s with the rapid rise of expert interest in adolescent health within GMH, but in the 1990s, the decade when young teens in Brazil were first coming into contact with practices and approaches in research, schools and clinics that have both underpinned and critiqued the production of an adolescent mental and reproductive health sub-field. In parsing what young women's encounters with the then newly-emerging questionnaires, measurement tools, school-based programs and clinical practices came to mean to them, I use a genealogical approach to consider how histories of education reform, population control, psychoanalysis, social medicine, the transition to democracy, feminism and grass-roots politics all entered the fold, shaping the way adolescent sex-and-psyche materialized as a contested object of expertise. I end by exploring what this case can teach global mental health advocates and social theorists about practices of critique.
'Hu Hong' (bad thing): parental perceptions of teenagers' sexuality in urban Vietnam.
Do Lan Anh Thi,Boonmongkon Pimpawun,Paek Seung Chun,Guadamuz Thomas E
BMC public health
BACKGROUND:Teenagers under 18 years old in Vietnam are considered as minors who usually lack the autonomy to make decisions. They are also sometimes viewed as contributors to social evils including crime, violence and substance use. Moreover, most Vietnamese teenagers have unsafe sex before marriage. The objective of this study is to explore the parental perceptions relating to their teenagers' sexuality, particularly the social and cultural forces, that may hinder access to sexuality information. METHODS:Guided by a Community Advisory Board (CAB), this qualitative study uses four focus group discussions (FGDs) consisting of 12 mothers and 12 fathers, as well as twelve individual in-depth interviews (IDIs) with a diverse sample of parents of teens in Ho Chi Minh City (HCMC), Vietnam. Content and discourse analysis were conducted, based on Foucauldian concepts. RESULTS:Four themes emerged: 1) Meanings of sexuality and sexuality education, 2) Early sexual intercourse destroys teenagers' future, 3) Teenagers are not hu hong (spoil/bad thing), are innocent and virgin, and 4) Policing and controlling of sexual intercourse among teens. Parents did not view their teenage children as sexual beings; those who are sexual are considered hu hong. Parents believed that teens need to be policed and controlled to prevent them from becoming hu hong, particularly girls. Controlling of sexuality information by parents was therefore common in HCMC, but differed by gender and educational levels of parents. For example, fathers more than mothers were not comfortable teaching their teenage children about sex and sexuality. Parents with higher education police their teenage children's usage of the Internet and social media, while parents with lower education control who can be friends with their teenage children. CONCLUSIONS:Vietnamese parents in general have negative views of sex and sexuality education for their teenage children. Recognizing that many Vietnamese teenagers have unsafe sex before marriage, parents need to change their perceptions and understand the importance of comprehensive sexuality education (CSE), which are included in UNESCO, UNFPA and UNICEF-developed CSE tools.
Community factors shaping early age at first sex among adolescents in Burkina Faso, Ghana, Malawi, and Uganda.
Stephenson Rob,Simon Calleen,Finneran Catherine
Journal of health, population, and nutrition
Using data from the National Survey of Adolescents (2004), we examine the community-level factors associated with early age at first sex among adolescents 14-19 years old in four African countries. Regression models are fitted separately by sex for each country for an outcome measuring early age at first sex, with a focus on community-level factors as potential influences of age on sexual debut. The community-level factors associated with adolescents' sexual debut vary widely by both country and gender. Community influences that emerge as risk or protective factors of early sexual debut include community levels of adolescent marriage, wealth, religious group affiliation, sex education, parental monitoring, reproductive health knowledge, media exposure, membership in adolescent social group, and use of alcohol. Results indicate the importance of context-specific understanding of adolescents' sexual behaviour and suggest how elements of place should be harnessed in the development of effective HIV and sexual health interventions.
Discourse on Exposure to Pornography Content Online Between Arab Adolescents and Parents: Qualitative Study on its Impact on Sexual Education and Behavior.
Gesser-Edelsburg Anat,Abed Elhadi Arabia Munawar
Journal of medical Internet research
BACKGROUND:The internet revolution of the 21st century has made sexual content available and accessible on a scale that has never existed before. Many studies have indicated that the use of pornography was associated with more permissive sexual attitudes and tended to be linked with stronger gender-stereotypical sexual beliefs. It also seemed to be associated with other risky behaviors and sexual promiscuity. Pornography exposure in conservative societies leads to conflicts with religious and cultural taboos. OBJECTIVE:The aim of this study was to characterize the barriers and difficulties that prevent sexual discourse in the Arab society and enable pornography viewing according to the perceptions of adolescents and mothers. METHODS:This study involved qualitative research methods and in-depth interviews with 40 participants. This study included 20 Arab adolescents, sampled by 2 age groups (14-16 years and 16-18 years), and 20 mothers of adolescents from both sexes. RESULTS:The findings indicate that mothers "turn a blind eye" to porn viewing and sexual activity by boys; however, they show a sweeping prohibition and denial of such behavior by girls. Boys reported viewing porn routinely, whereas girls denied doing so, but admitted that their female friends watched porn. The study also found that boys experienced guilt during and after viewing porn as a result of the clash between modernity and traditional values. The mothers and adolescents emphasized the need for an open sexual discourse to reduce violent behaviors such as Web-based sexual harassment, including sending videos and pictures of naked girls, often accompanied by threats and blackmail. CONCLUSIONS:It is necessary to find a way to encourage a significant sexual discourse to prevent the violent consequences of its absence in the Arab society. A controlled, transparent, and critical sexual discourse could help youth make more informed decisions concerning the search for sexual content, porn viewing, and sexual behavior.
Adolescent Sexual Health Education: Parents Benefit Too!
Dinaj-Koci Veronica,Deveaux Lynette,Wang Bo,Lunn Sonya,Marshall Sharon,Li Xiaoming,Stanton Bonita
Health education & behavior : the official publication of the Society for Public Health Education
The inclusion of parents in adolescent-targeted interventions is intended to benefit the adolescent. Limited research has explored whether parents participating in these programs also benefit directly. We examined the impact of Caribbean Informed Parents and Children Together, the parenting portion of an adolescent-targeted HIV prevention intervention, on parent-reported measures. Bahamian parent-youth dyads (N = 1,833) participating in the randomized control trial were assigned to receive one of four conditions. Parents were assessed longitudinally at baseline and 6 and 12 months later. Through 12 months follow-up, parents exposed to Caribbean Informed Parents and Children Together showed higher knowledge of condom use skills, perceptions of improved condom use competence on the part of their youth, and perceived improved parent-child communication about sex-related information. Although youth were the targeted beneficiary, parents also benefited directly from the sexual risk reduction parenting program. Parents demonstrated improved perceptions and knowledge that would enable them to more effectively guide their child and also protect themselves from sexual risk.
School-based sexual health education interventions to prevent STI/HIV in sub-Saharan Africa: a systematic review and meta-analysis.
Sani A Sadiq,Abraham Charles,Denford Sarah,Ball Susan
BMC public health
BACKGROUND:School-based sexual health education has the potential to provide an inclusive and comprehensive approach to promoting sexual health among young people. We reviewed evaluations of school-based sexual health education interventions in sub-Saharan Africa to assess effectiveness in reducing sexually transmitted infections and promoting condom use. METHODS:We searched ten electronic databases, hand-searched key journals, and reference lists of included articles for potential studies. Data were extracted on outcomes, intervention characteristics, methods and study characteristics indicative of methodological quality. Where possible, data were synthesized using random effect meta-analysis. Intervention features found predominantly in effective interventions were noted. RESULTS:The initial search retrieved 21634 potentially relevant citations. Of these, 51 papers reporting on 31 interventions were included. No evaluation reported statistically significant effects on the incidence or prevalence of Human Immunodeficiency Virus and Herpes Simplex Virus 2 infections. However, intervention participants reported statistically significant greater condom use in both randomised controlled trials and non-randomised trials for short (less than 6 months) follow-up periods (OR = 1.62, 95 % CI = 1.03-2.55 and OR = 2.88, 95 % CI = 1.41-5.90 respectively). For intermediate (6-10 months) and long-term (more than 10 months) follow-up periods, the effect was statistically significant (OR = 1.40, 95 % CI = 1.16-1.68) and marginally significant (OR = 1.22, 95 % CI = 0.99-1.50) among the randomised trials respectively. Only 12 of the 31 interventions reported implementation details, out of which seven reported on fidelity. CONCLUSION:School-based sexual health education has the potential to promote condom use among young people in sub-Saharan Africa. However, further work is needed to develop and evaluate interventions that have measurable effects on sexually transmitted infections.
Video Intervention to Increase Perceived Self-Efficacy for Condom Use in a Randomized Controlled Trial of Female Adolescents.
Downs Julie S,Ashcraft Amie M,Murray Pamela J,Berlan Elise D,Bruine de Bruin Wändi,Eichner Joan,Fischhoff Baruch,Leary Janie M,McCall Robert B,Miller Elizabeth,Salaway Jennifer,Smith-Jones Janell,Sucato Gina S
Journal of pediatric and adolescent gynecology
STUDY OBJECTIVE:To assess the effects of the Seventeen Days interactive video on young women's perceived self-efficacy for using condoms 6 months after being offered the intervention, relative to a control. DESIGN:Multisite randomized controlled trial. SETTING:Twenty participating health clinics and county health departments in Ohio, Pennsylvania, and West Virginia. PARTICIPANTS:Sexually active female adolescents ages 14 to 19 years. INTERVENTIONS:Seventeen Days (treatment intervention; sex education) vs Driving Skills for Life (control intervention; driving education). MAIN OUTCOME MEASURES:Perceived self-efficacy for condom use. RESULTS:Participants in the Seventeen Days group reported higher perceived condom acquisition self-efficacy after 6 months than those in the driving group. This finding held after controlling for baseline self-efficacy scores and other covariates. CONCLUSION:The Seventeen Days program shows promise to improve perceived self-efficacy to acquire condoms among sexually active female adolescents-an important precursor to behavior change.
Associations between source of information about sex and sexual health outcomes in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3).
Macdowall Wendy,Jones Kyle G,Tanton Clare,Clifton Soazig,Copas Andrew J,Mercer Catherine H,Palmer Melissa J,Lewis Ruth,Datta Jessica,Mitchell Kirstin R,Field Nigel,Sonnenberg Pam,Johnson Anne M,Wellings Kaye
OBJECTIVES:To examine variation in source of information about sexual matters by sociodemographic factors, and associations with sexual behaviours and outcomes. DESIGN:Cross-sectional probability sample survey. SETTING:British general population. PARTICIPANTS:3408 men and women, aged 17-24 years, interviewed from 2010-2012 for third National Survey of Sexual Attitudes and Lifestyles. MAIN OUTCOME MEASURES:Main source of information (school, a parent, other); age and circumstances of first heterosexual intercourse; unsafe sex and distress about sex in past year; experience of sexually transmitted infection (STI) diagnoses, non-volitional sex or abortion (women only) ever. RESULTS:Citing school was associated with younger age, higher educational level and having lived with both parents. Citing a parent was associated, in women, with lower educational level and having lived with one parent. Relative to other sources, citing school was associated with older age at first sex (adjusted HR 0.73 (95% CI 0.65 to 0.83) men, 0.73 (0.65 to 0.82) women), lower likelihood of unsafe sex (adjusted OR 0.58 (0.44 to 0.77) men, 0.69 (0.52 to 0.91) women) and previous STI diagnosis (0.55 (0.33 to 0.91) men, 0.58 (0.43 to 0.80) women) and, in women, with lower likelihood of lack of sexual competence at first sex; and experience of non-volitional sex, abortion and distress about sex. Citing a parent was associated with lower likelihood of unsafe sex (0.53 (0.28 to 1.00) men; 0.69 (0.48 to 0.99) women) and, in women, previous STI diagnosis. CONCLUSIONS:Gaining information mainly from school was associated with lower reporting of a range of negative sexual health outcomes, particularly among women. Gaining information mainly from a parent was associated with some of these, but fewer cited parents as a primary source. The findings emphasise the benefit of school and parents providing information about sexual matters and argue for a stronger focus on the needs of men.
Can Teenage Men Be Targeted to Prevent Teenage Pregnancy? A Feasibility Cluster Randomised Controlled Intervention Trial in Schools.
Lohan Maria,Aventin Áine,Clarke Mike,Curran Rhonda M,McDowell Clíona,Agus Ashley,McDaid Lisa,Bonell Chris,Young Honor
Prevention science : the official journal of the Society for Prevention Research
The World Health Organisation advocates a direct focus on adolescent men in reducing adolescent pregnancy; however, no trials have been conducted. This trial (ISRCTN11632300; NCT02092480) determines whether a novel Relationship and Sexuality Educational intervention, If I Were Jack, is acceptable and feasible to implement in mixed sex UK classrooms. The intervention is a teacher-delivered intervention that emphasises male alongside female responsibility in preventing unintended pregnancies and is designed to prevent unprotected sex. The trial was a parallel-group cluster randomised controlled feasibility trial with embedded process and cost evaluation in eight secondary schools (unit of randomisation) among 831 pupils (mean age 14) in Northern Ireland, alongside a qualitative evaluation of transferability in ten schools in Scotland, Wales and England. The sampling strategy was a maximum variation quota sample designed to capture a range of school management types. Four schools were randomised to each arm and the control arm continued with usual practice. Study duration was 12 months (from November 2014), with follow-up 9 months post-baseline. Results demonstrated that the intervention was acceptable to schools, pupils and teachers, and could be feasibly implemented, cost-effectively, with minor enhancements. The between-group difference in incidence of unprotected sex (primary outcome at pupil level) of 1.3% (95% CI 0.5-2.2) by 9 months demonstrated a potential effect size consistent with those reported to have had meaningful impact on teenage pregnancy. The study responds to global health policy for a paradigm shift towards inclusion of men in the achievement of sexual and reproductive health goals in a practical way by demonstrating that a gender-sensitive as well as a gender transformative intervention targeting males to prevent teenage pregnancy is acceptable to adolescent men and women and implementable in formal education structures. If I Were Jack now merits further effectiveness testing.