Unsafe abortion is one of the main causes of maternal mortality and severe morbidity in countries with restrictive abortion laws. In 2007, the International Federation of Gynecology and Obstetrics (FIGO) created a Working Group on the Prevention of Unsafe Abortion and its Consequences (WGPUA). This led to a FIGO initiative with that aim which has the active participation of 43 FIGO member societies. The WGPUA has recommended that the plans of action of the countries participating in the initiative consider several levels of prevention shown to have the potential to successfully reduce unsafe abortions: (1) primary prevention of unintended pregnancy and induced abortion; (2) secondary prevention to ensure the safety of an abortion procedure that could not be avoided; (3) tertiary prevention of further complications of an unsafe abortion procedure that has taken place already, through high-quality postabortion care; and (4) quaternary prevention of repeated abortion procedures through postabortion family planning counseling and contraceptive services. This paper reviews these levels of prevention and the evidence that they can be effective. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Sherman, D W; Kirton, C A
The purpose of this qualitative study was to examine the phenomenon of relapse to unsafe sexual behavior in human immunodeficiency virus (HIV)-positive, heterosexual, minority men. In-depth interviews were conducted by using a purposive sample of 18 HIV-positive, heterosexual, minority men who were recruited from an outpatient acquired immunodeficiency syndrome (AIDS) clinic in upstate New York and a community-based HIV/AIDS service organization in New York City. All participants expressed concern about the seriousness and health threat of unsafe sexual behaviors. The perceived benefits and barriers to unsafe sexual practices were identified. Content analysis revealed the following themes related to relapse to unsafe sexual behavior: drug and alcohol use, state of mind, "looking good" and "helping" fallacies, male-female relationship issues, influence of friends, weighing the risks, sexual preparation, uncontrollable sexual urges, and the symbolic meaning of condoms. Clinical implications related to health assessment, interventions, and health education and prevention programs for HIV-positive heterosexual, minority men and their sexual partners are presented.
care; PPFN, Planned Parenthood Federation of Nigeria; UNFPA, SOGON, Society of Gynaecology and Obstetrics of Nigeria, WHARC, Women. Health and Action Research Centre. Unsafe Abortion and its Ethical, Sexual and Reproductive Rights Implications. L'avortement à risque et de son éthique, sexuelle et reproductive ...
Unsafe abortion is an important cause of maternal mortality and morbidity, particularly marked in developing countries with restrictive abortion laws. It has both bioethical and human rights implications, violating their key principles and components. To highlight the magnitude of complications of unsafe abortion and examine the legal,bioethical, sexual and reproductive right implications of unsafe abortion as well as to review post abortion care (PAC) in Nigeria. Information derived from online web-search, literature review of articles from learned journals, serials and monographs from local and supra-national agencies working on abortion, and reproductive health. About 20 million unsafe abortions are performed annually globally resulting in about 80, 000 maternal deaths. Asia and Africa have the highest number of maternal deaths. In Nigeria, 760, 000 abortions are performed annually. Abortion law in Nigeria is restrictive. Unsafe abortion violates three key bioethical principles at micro and mega-ethical levels. It also violates eleven of the twelve components of sexual and reproductive rights. PAC is approved as an effective approach to reducing abortion morbidity and mortality and promoting women's reproductive rights. Stakeholders can promote the ethical, sexual and reproductive rights of women through the following interventions: advocacy, liberalization of restrictive abortion law, training of health workers on PAC services, inter-organisational collaboration, development of right based code of ethics and inclusion into medical training curriculum. Socio-economic empowerment of women, provision of PAC services equipments in health facilities, and improvement of access to quality family planning services will also help promote the rights of women.
Background: Unsafe abortion is an important cause of maternal mortality and morbidity, particularly marked in developing countries with restrictive abortion laws. It has both bioethical and human rights implications, violating their key principles and components. Objective: To highlight the magnitude of complications of ...
Adriaenssens, Stef; Hendrickx, Jef
Unsafe sexual practices are persistent in prostitution interactions: one in four contacts can be called unsafe. The determinants of this are still matter for debate. We account for the roles played by clients' preferences and the hypothetical price premium of unsafe sexual practices with the help of a large dataset of clients' self-reported commercial sexual transactions in Belgium and The Netherlands. Almost 25,000 reports were collected, representing the whole gamut of prostitution market segments. The first set of explanations consists of an analysis of the price-fixing elements of paid sex. With the help of the so-called hedonic pricing method we test for the existence of a price incentive for unsafe sex. In accordance with the results from studies in some prostitution markets in the developing world, the study replicates a significant wage penalty for condom use of an estimated 7.2 per cent, confirmed in both multilevel and fixed-effects regressions. The second part of the analysis reconstructs the demand side basis of this wage penalty: the consistent preference of clients of prostitution for unsafe sex. This study is the first to document empirically clients' preference for intercourse without a condom, with the help of a multilevel ordinal regression. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.
Liu, Yan; Gong, Huanyu; Yang, Guoli; Yan, Jin
To determine the relationship among perceived stigma, mental health and unsafe sexual behaviors of people living with HIV/AIDS. Cross-sectional research was used to interview people living with HIV/AIDS (PLWHA) from April 2012 to March 2013 in Changsha, China. The questionnaires included General Questionnaire, Sexual Behavior Questionnaire, Patient Health Questionnaire Depression Scale (PHQ-9), General Anxiety Disorder Scale (GAD-7) and Psychometric Assessment of the HIV Stigma Scale. The results were statistically analyzed with SPSS18.0. The total score of perceived stigma and its 4 dimensions were positively correlated with anxiety and depression. The total score of perceived stigma and its dimensions were associated with disclosure, but no significantly correlated with other sexual behaviors. Hierarchical regression showed perceived stigma had an effect on anxiety. The stigma perceived by PLWHA is above the average level. Perceived stigma has an effect on mental health, especially anxiety, but no effect on unsafe sexual behaviors.
Full Text Available Background: The problems associated with unsafe sexual behavior in adolescents are caused by premarital sexual intercourse with a partner of their own age. One of the problems caused by premarital sex is a pregnancy outside of marriage. Increased incidence of premarital sex is caused by the development through media depictions of sex scenes in the form of television, magazines, video clips, online media, and films. In Musi Banyuasin there are 7754 high school students, many students have dropped out of school because they get pregnant before marriage so that in adolescence their parents are forced to marry or have abortions. The aim study is determined the factors associated with unsafe sexual behavior in adolescents in high school. Method: Observational research with cross sectional and quantitative approach. The population is high school students. Sampling technique was using multistage random sampling obtained 393 samples. Bivariate analysis, chi-square Result: the result showed a correlation between the influence of peers with adolescent sexual behavior has p-value (0,000. There was no relationship between media pornography with sexual behavior because the result more than p-value (0,05. Conclusion: Necessary to be given knowledge and assistance to adolescents about positively and creatively thing and supervision of parents to their children in order to have a friends and avoid unsafe sexual behavior. Key words: The Influence of Peers, Pornographic Media, Unsafe Sexual, Adolescent
Leke, Robert J I; de Gil, Marina Padilla; Távara, Luis; Faúndes, Anibal
The Working Group of the International Federation of Gynecology and Obstetrics (FIGO) on the Prevention of Unsafe Abortion and its Consequences received a mandate to contribute to reduce the number of women who have to resort to induced abortion and the maternal mortality and morbidity associated with unsafe abortion by minimizing unintended pregnancies, improving access to safe abortion services, and increasing the quality of and access to post-abortion care, including post-abortion contraception. A project proposal was prepared and approved by an anonymous donor, funding a structure headed by a general coordinator, the Chair of the Working Group, together with 6 regional coordinators and 1 assistant regional coordinator, plus 43 focal points nominated by the participating societies. A situational analysis of induced/unsafe abortion for each country was prepared by the focal points with the technical support of the Guttmacher Institute, and a plan of action based on the findings of the analysis. The situational analysis and plans of action were discussed at 7 regional workshops held between June and August, 2008. Fifty-four member societies nominated a focal point, 48 attended the regional workshops, and 43 had a plan of action approved by their governments and respective societies. The plans of action are currently in the process of implementation, with the collaboration of a number of national and international agencies and organizations. (c) 2010. Published by Elsevier Ireland Ltd.
Snyder, Jamie A.; Fisher, Bonnie S.; Scherer, Heidi L.; Daigle, Leah E.
Few studies have examined sexual victimization among cadets and midshipmen at the three U.S. Military Academies. Self-report data from the 2005 Service Academy Sexual Assault Survey of Cadets and Midshipmen (n = 5,220) were used to examine the extent of unwanted sexual attention, sexual harassment, unwanted sexual contact, sexual coercion, and…
Lijster, G.P.A. de; Felten, H.; Kok, G.; Kocken, P.L.
Many adolescents experience sexual harassment and victims of sexual harassment have higher risks regarding well-being and health behaviors such as higher risks of suicidal thoughts, suicidal ideation and feeling unsafe at school. A peer-performed play and school lessons on preventing sexual
Zaidi, Shahida; Hassan, Ezzeldin Osman; Hodorogea, Stelian; Leke, Robert J I; Távara, Luis; de Gil, Marina Padilla
International collaboration with organizations and agencies is a basic requirement for the success of the FIGO Initiative for the Prevention of Unsafe Abortion and its Consequences. Many activities being carried out by the organizations form a part of the plans of action of all countries participating in the Initiative. It was, therefore, not difficult to obtain their collaboration in implementing the plans of action. The many ways in which they have collaborated and continue to do so are described in this article. This collaboration has saved time, avoided duplication of effort, and has also satisfied the Accra Agenda of Action by reducing fragmentation of funding. It has already contributed toward preventing unsafe abortion and reducing abortion-related maternal deaths and morbidities, and is expected to contribute even more significantly in the coming months and years. (c) 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
de Gil, Marina Padilla
Unsafe abortion is a very important public health issue in the Central America and Caribbean region, where the use of modern contraceptive methods remains low and the restrictive legal framework reduces access to safe abortion. The International Federation of Gynecology and Obstetrics (FIGO) Initiative for the Prevention of Unsafe Abortion and its Consequences is contributing toward resolving this problem by strengthening collaboration between medical societies, representatives of each country's Ministry of Health, and local and international agencies. In the 8 countries that decided to join this initiative in 2008, progress has been achieved in improving access to modern contraceptive methods, increasing the use of manual vacuum aspiration and misoprostol, and updating guidelines on postabortion care. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Leke, Robert J I
Unsafe abortion is a major public health issue in low-resource countries. In the countries of West and Central Africa, abortion-related maternal mortality rates are extremely high, the prevalence of modern contraceptive use is very low, and the unmet need for family planning is also high. The International Federation of Gynecology and Obstetrics (FIGO) Initiative for the Prevention of Unsafe Abortion and its Consequences has contributed substantially toward increasing awareness of the problem of abortion, bringing abortion-related issues to the attention of the professional societies, individual gynecologists and obstetricians, Ministries of Health, healthcare providers, and to the community in general. The promotion of quality postabortion care including the use of manual vacuum aspiration, misoprostol, and postabortion contraception has greatly improved access to services; however, there is still a long way to go. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Full Text Available This study is aimed to examine preschool teachers’ knowledge of, attitudes about, and training related to child sexual abuse (CSA prevention in Beijing, China. Two hundred and forty-five preschool teachers were administered the 16-item questionnaire that contained questions on CSA prevention knowledge, attitudes, and teacher training. Results showed that Chinese preschool teachers had limited knowledge on CSA prevention (M = 4.86, SD = 2.12. Less than 5% of the teachers ever attended CSA prevention training programs. Preschool teachers’ training on CSA prevention was the significant factor for their knowledge and attitudes. To help protect children against sexual abuse, there is an urgent need to develop appropriate prevention training programs for preschool teachers in China.
Briozzo, L; Vidiella, G; Rodríguez, F; Gorgoroso, M; Faúndes, A; Pons, J E
Worldwide, 13% of maternal deaths are caused by complications of spontaneous or induced abortion, 29% in Uruguay and nearly half (48%) in the Pereira Rossell Hospital. This paper describes a risk reduction strategy for unsafe abortions in Montevideo, Uruguay, where over one-fourth of maternal deaths are caused by unsafe abortion. Although abortion is not legal in Uruguay, women desiring abortions can be counseled before and immediately after to reduce the risk of injury. Women contemplating abortion were invited to attend a "before-abortion" and an "after-abortion" visit at a reproductive health polyclinic. At the "before-abortion" visit, gestational age, condition of the fetus and pathologies were diagnosed and the risks associated with the use of different abortion methods (based on the best available scientific evidence) were described. The "after-abortion" visit allowed for checking for possible complications and offering contraception. From March 2004 through June 2005, 675 women attended the "before-abortion" and 495 the "after-abortion" visit, the number increasing over time. Some women (3.5%) decided not to abort, others were either not pregnant, the fetus/embryo was dead or the woman had a condition that permitted legal termination of pregnancy in the hospital (7.5%). Most women, however, aborted. All women used vaginal misoprostol in the doses recommended in the medical literature. There were no serious complications (one mild infection and two hemorrhages not requiring transfusion). The strategy is effective in reducing unsafe abortions and their health consequences.
Bingham, Allison; Drake, Jennifer Kidwell; Goodyear, Lorelei; Gopinath, C Y; Kaufman, Anne; Bhattarai, Sanju
Legal, procedural, and institutional restrictions on safe abortion services-such as laws forbidding the practice or policies preventing donors from supporting groups who provide legal services-remain a major access barrier for women worldwide. However, even when abortion services are legal, women face social and cultural barriers to accessing safe abortion services and preventing unwanted pregnancy. Interpersonal communication interventions play an important role in overcoming these obstacles, including as part of broad educational- and behavioral-change efforts. This article presents results from an interpersonal communication behavior change pilot intervention, Dialogues for Life, undertaken in Nepal from 2004 to 2006, after abortion was legalized in 2002. The project aimed to encourage and enable women to prevent unplanned pregnancies and unsafe abortions and was driven by dialogue groups and select community events. The authors' results confirm that a dialogue-based interpersonal communication intervention can help change behavior and that this method is feasible in a low-resource, low-literacy setting. Dialogue groups play a key role in addressing sensitive and stigmatizing health issues such as unsafe abortion and in empowering women to negotiate for the social support they need when making decisions about their health.
Unsafe abortion is one of the most serious public health and human rights issues in South America. Rates are among the highest in the world and account for 13% of maternal deaths. Nine out of 10 South American countries have enrolled in the International Federation of Gynecology and Obstetrics (FIGO) Initiative for the Prevention of Unsafe Abortion and its Consequences. Each individual society of obstetrics and gynecology prepared a situational analysis, and an action plan was elaborated with the participation of their respective Ministries of Health, national and international agencies, and other collaborating institutions. Action plans were designed to respond to the problems identified in the situational analyses, with objectives corresponding with all or some of the 4 levels of prevention proposed in the FIGO initiative. This article reports the progress achieved in implementing the action proposed by each country, as well as some activities carried out in addition to those included in the formal plans. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
McCall, George J.
Sexual assault prevention programming remains a confused, scattered, and sporadic enterprise with little scientific underpinning. Sexual assault prevention suffers because it neither fits the traditional crime prevention model, nor the traditional public health model of prevention programming. Traces political and technical consequences, and…
... org/ 2016/ 05/ sexual- assault- prevention- on- u- s- college- campuses- a- national- scan/ n Not Alone www. notalone. gov n CDC’s Report to the White House Task Force to Protect Students from Sexual ... ...
Jaldesa, Guyo W
Maternal mortality and morbidity rates are very high in Africa. A large proportion of these deaths is attributed to unsafe abortion. The International Federation of Gynecology and Obstetrics, in collaboration with its member societies in each participating country, their respective Ministries of Health, and various non-governmental agencies, has developed an initiative to prevent unsafe abortion and the morbidity and mortality attributed to it. Over the past 5 years, these teams undertook situational analyses, and developed and implemented plans of action. The progress achieved in this region is described in this article. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Santelli, John S.; And Others
Special edition discusses adolescent sexuality, focusing on pregnancy, sexually transmitted diseases, and prevention. The articles focus on demographics, risk factors, school-based risk reduction programs, contraception, early intervention, options, school-based prenatal and postpartum care programs, teenage parenting, abortion, HIV and AIDS,…
Diarsvitri, Wienta; Utomo, Iwu Dwisetyani; Neeman, Teresa; Oktavian, Antonius
When it comes to sexuality and norms, young Indonesians are becoming more open. Concern about this is related to the rapid increase in HIV prevalence in Indonesia, especially in Papua and West Papua Provinces. While much research has been conducted among youth who have left school, little is known about senior high school students' sexuality and sexual practices in these provinces. Using qualitative and quantitative data, we explore perspectives on and experiences of sexuality, contraceptive use, unintended pregnancy and unsafe abortion among 1082 Year 11 students from 16 senior high schools in both provinces. Findings suggest that around 38.3% of students reported having had sexual intercourse and 36.5% of these having had their first sexual encounter before they were 15 years old. Furthermore, contraceptive use among sexually active students was very low. Around 32% of female students who reported having had sexual intercourse also reported having an unintended pregnancy and the majority of them had had unsafe abortions. The paper points to the implications of students' high-risk sexual behaviours for HIV prevention.
Pedersen, Bodil Maria; Sidenius, Katrine
Centre for Victims of Sexual Assault in Copenhagen is a centre for interdisciplinary research and practice. Goals of the centre are to contribute to the documentation of victimization and to prevent further victimization. Research at the centre aims at the examination of the diversity of conditio...... of women exposed to sexualized coercion and the diversity of perspectives on the events....
Limback, E. Rebecca; Bland, Zinna
To prevent sexual harassment, schools should have a written policy and should educate students about it. Suggested teaching activities include using current court cases, examining and refining school policy, roleplaying on video, inviting speakers, and using an "Is This Sexual Harassment?" questionnaire describing various behaviors. (SK)
Anderson, Patricia L.
School administrators should develop a clear policy statement prohibiting sexual harassment; create guidelines to implement the policy; and designate a key administrator to oversee and ensure compliance with laws related to sexual harassment. Lists steps for dealing with a claim, what teachers can do to protect themselves from claims, and what a…
Birkett, Michelle; Russell, Stephen T; Corliss, Heather L
We examined sexual-orientation identity disparities in truancy and academic achievement, and the mediational role of victimization in a large high-school sample. We utilized pooled data, measuring sexual identity, from the 2005 and 2007 Youth Risk Behavioral Surveillance System Surveys. Multilevel logistic regression modeling estimated the odds of low grades and truancy because of feeling unsafe comparing lesbian/gay, bisexual, (LGB) and unsure students to heterosexuals. We stratified models by gender. Indicators of victimization were examined to mediate the relationship between identifying as a sexual minority and school achievement or truancy. LGB-identified youths reported significantly elevated odds of truancy and low grades (odds ratios = 1.6-3.2; all P school outcomes, with greater victimization indicators being associated with increased truancy and lower grades, and the extent of mediation differed by gender. As early disparities in academic achievement and school engagement have indicated a lifetime of increased health and behavioral risk factors, early intervention targeting school victimization is necessary.
Sommarin, Clara; Kilbane, Theresa; Mercy, James A.; Moloney-Kitts, Michele; Ligiero, Daniela P.
Background Evidence linking violence against women and HIV has grown, including on the cycle of violence and the links between violence against children and women. To create an effective response to the HIV epidemic, it is key to prevent sexual violence against children and intimate partner violence (IPV) against adolescent girls. Methods Authors analyzed data from national household surveys on violence against children undertaken by governments in Swaziland, Tanzania, Kenya, and Zimbabwe, with support of the Together for Girls initiative, as well as an analysis of evidence on effective programmes. Results Data show that sexual and physical violence in childhood are linked to negative health outcomes, including increased sexual risk taking (eg, inconsistent condom use and increased number of sexual partners), and that girls begin experiencing IPV (emotional, physical, and sexual) during adolescence. Evidence on effective programmes addressing childhood sexual violence is growing. Key interventions focus on increasing knowledge among children and caregivers by addressing attitudes and practices around violence, including dating relationships. Programmes also seek to build awareness of services available for children who experience violence. Discussion Findings include incorporating attention to children into HIV and violence programmes directed to adults; increased coordination and leveraging of resources between these programmes; test transferability of programmes in low- and middle-income countries; and invest in data collection and robust evaluations of interventions to prevent sexual violence and IPV among children. Conclusions This article contributes to a growing body of evidence on the prevention of sexual violence and HIV in children. PMID:24918598
Kazimierczak, Małgorzata; Sipiński, Adam
At work we took up the matter of sexual harassment of children in the family. We presented the history of incest contacts, reasons, conditions causing incest, the perpetrator, his methods and kinds of his actions.We took into consideration description of victims, physical and psychological symptoms of sexual harassment and its effects. We paid attention to effective methods of prevention of incest behavior, diagnostic actions taken in order to confirm any offence and therapy of victims emphasizing role of health service staff.
Vera, Eduardo Gayón; Orozco, Hilda Hernández; Soto, Selene Sam; Aburto, Esther Lombardo
Sexual transmitted diseases (included HIV/AIDS) are a common and preventable cause of perinatal morbidity and mortality. When used consistently and correctly, condoms are effective to prevent these diseases, however, its protection does not account for 100%. To know the effectiveness of male condom, through bibliographic evidence, to prevent sexual transmitted infections in heterosexual serodiscordant partners. A bibliographical review of Medline/Pubmed, LILACS and Cochrane databases, and publications of the National Health Institutes, Centers for Disease Control and Prevention, World Health Organization, and WHO AIDS Global Program was done to analyze male condom effectiveness to prevent sexual transmitted diseases. Reports demonstrated that male condom protection against HIV/AIDS in heterosexual serodiscordant partners goes from 60 to 95%. Most recent information (2006) showed 80%. Two studies demonstrated no HPV protection with male condom, and another one 70% of protection. Male condom demonstrated no HPV-1 protection, but decrease of risk in HVS-2 transmission in women (0.85 of protection). Male condom protection against sexual transmitted diseases is not 100%. There must be used additional measures that have demonstrated its utility to decrease transmission risk.
Thacker, Rebecca A.
Keeping sexual harassment incidents at bay in the workplace involves prevention training that teaches people how to identify harassment and how to respond, using such techniques as role play and discussion. Trainees should also be informed of the organization's policy and procedures for reporting complaints. (JOW)
Sérgio Araujo Martins Teixeira
Full Text Available OBJETIVO: Identificar fatores associados à atividade sexual desprotegida em adolescentes femininas menores de 15 anos. MÉTODOS: Estudo observacional de corte transversal com adolescentes femininas menores de 15 anos e sexualmente ativas, atendidas em um ambulatório público de ginecologia. Os instrumentos de coleta de dados foram: entrevista semiestruturada para dados pessoais e de sexualidade, e exame clínico-laboratorial para diagnóstico de doenças sexualmente transmissíveis. Os dados foram analisados por meio de testes de frequência, de associação de variáveis com p OBJECTIVE: To identify factors associated with unprotected sexual activity in female adolescents younger than 15 years. METHODS: Observational cross-sectional trial with female teenagers less than 15 years-old and sexually active, attended at a public gynecology clinic. Instruments for data collection were: semi-structured interviews for personal data and about sexuality as well as clinical examination and laboratory tests for diagnosis of sexually transmitted diseases. Data were analyzed by testing of frequency, association of variables with p <0.05 and multiple correspondence analysis. RESULTS: One hundred adolescents between 11 and 14 years of age sexually active were interviewed and examined, 71% declared themselves black, one-third were behind in school, 80% began sexual activity before 13 years of age , 58% reported having been victims of violence in the intrafamily environment and 13% had suffered sexual abuse, 77% did not use condoms regularly and 22% had STDs. Unprotected sexual activity occurred more frequently with the first sexual intercourse before 13 years of age, commercial sexual exploitaion, multiple sexual partners, intrafamily violence and school delay, in addition to be black, to unexpected pregnancy and have STDs. CONCLUSION: The multiple violence suffered by teenagers, including structural, intrafamily and sexual, contribute to increase their
de Lijster, Gaby P A; Felten, Hanneke; Kok, Gerjo; Kocken, Paul L
Many adolescents experience sexual harassment and victims of sexual harassment have higher risks regarding well-being and health behaviors such as higher risks of suicidal thoughts, suicidal ideation and feeling unsafe at school. A peer-performed play and school lessons on preventing sexual harassment behavior were presented to secondary school students. We evaluated its effectiveness, using a cluster-randomized controlled design to assign schools to an experimental condition [n = 14 schools; 431 students (51 % female)] and a control condition [n = 11 schools; 384 students (51 % female)]. To measure the effects of the intervention at first post-test and 6-month follow-up, our multilevel analyses used a two-level random intercept model. Outcome measures were sexual harassment behaviors, behavioral determinants and distal factors influencing these behaviors. At post-test, students in the experimental group reported a reduced intention to commit sexual harassment behavior and higher self-efficacy in rejecting it. At post-test and follow-up there was a significant positive effect on social norms for rejecting sexual harassment behavior. At follow-up, sexual self-esteem was higher in students in the experimental group than in the control group. Effects on these determinants will benefit adolescents' future sexual behaviors. In combination, the play and lessons, possibly together with continued sexual health education and skills programs on social-emotional learning in subsequent school years, have potential for preventing sexual harassment behavior.
Surkan, Pamela J; Li, Ying; Jacobson, Lisa P; Cox, Christopher; Silvestre, Anthony; Gorbach, Pamina; Teplin, Linda; Plankey, Michael
The aim of this study was to determine the association between psychosocial determinants of unprotected receptive anal intercourse (URAI) and unprotected insertive anal intercourse (UIAI). Data from 417 HIV positive men who have sex with men (MSM) in the Multicenter AIDS Cohort Study from April 1999 to March 2012 were analyzed and adjusted odds were calculated. It was found that 66% (n = 277) and 72% (n = 299) reported any UIAI or URAI over follow-up, respectively. Cumulative cART-years (median = 5.30 years) was associated with 33 and 47% increases in UIAI and URAI, respectively. Not having reduced concern about HIV transmission (UIAI: OR 0.37, p-value = 0.0004; URAI: OR 0.57, p-value = 0.04), increased safe sex fatigue (UIAI: OR 2.32, 95% p-value = 0.0002; URAI: OR 1.94, p-value = 0.003), and sexual sensation seeking (UIAI: OR 1.76, p-value = 0.002; URAI: OR 1.56, p-value = 0.02) were associated with UIAI and URAI. Serosorting was associated with UIAI (OR 6.11, p-value sex with men.
Evaluating implementation of the World Health Organization's Strategic Approach to strengthening sexual and reproductive health policies and programs to address unintended pregnancy and unsafe abortion.
Rashid, Shusmita; Moore, Julia E; Timmings, Caitlyn; Vogel, Joshua P; Ganatra, Bela; Khan, Dina N; Sayal, Radha; Metin Gülmezoglu, A; Straus, Sharon E
We conducted a process evaluation to assess how the World Health Organization's (WHO) Strategic Approach to strengthening sexual and reproductive health policies and programs ("the SA") was used in 15 countries that requested WHO's technical support in addressing unintended pregnancy and unsafe abortion. The SA is a three-stage planning, policy, and program implementation process. We used the social ecological model (SEM) to analyze the contextual factors that influenced SA implementation. We used a two-phased sequential approach to data collection and analysis. In Phase A, we conducted a document and literature review and synthesized data thematically. In Phase B, we conducted interviews with stakeholders who used the SA in the countries of interest. We used a qualitative method triangulation technique to analyze and combine data from both phases to understand how the SA was implemented in each country. Data from 145 documents and 19 interviews described the SA process and activities in each country. All 15 countries completed Stage 1 activities. The activities of Stage 1 determined activities in subsequent stages and varied across countries. Following Stage 1, some countries focused on reforming policies to improve access to sexual and reproductive health (SRH) services whereas others focused on improving provider-level capacity to enhance SRH service quality and improving community-level SRH education. We identified factors across SEM levels that affected SA implementation, including individual- and community-level perceptions of using the SA and the recommendations that emerged from its use, organizational capacity to conduct SA activities, and how well these activities aligned with the existing political climate. Stakeholders perceived SA implementation to be country-driven and systematic in bringing attention to important SRH issues in their countries. We identified key success factors for influencing the individual, organization, and system change required
Lalor, Kevin; McElvaney, Rosaleen
This paper reviews the literature on the nature and incidence of child sexual abuse, explores the link between child sexual abuse and later sexual exploitation, and reviews the literature on prevention strategies and effective interventions in child sexual abuse services. Our understanding of the international epidemiology of child sexual abuse is considerably greater than it was just 10 years ago, and studies from around the world are examined. Childhood sexual abuse can involve a wide numbe...
Martella, Ronald C.; And Others
A two-stage problem-solving strategy involving cue cards and their gradual withdrawal was used to teach nine sheltered workshop employees how to prevent work-related accidents. Results indicated that participants used the strategy appropriately and generalized their skills to similar and dissimilar situations up to eight weeks after training.…
Sexual assault occurs commonly worldwide and is particularly pervasive in the developing world. The background to sexual violence is important in the understanding of the ramifications of the problem. Some elements that offer the means to the prevention of sexual assault in the community are important highlights ...
Smothers, Melissa Kraemer; Smothers, D. Brian
In this study, a nonprofit community mental health clinic developed a socioecological model of sexual abuse prevention that was implemented in a public school. The goal of the program was to promote and create community change within individuals and the school community by reducing tolerance of sexual violence and sexual harassment. Participants…
Lalor, Kevin; McElvaney, Rosaleen
This paper reviews the literature on the nature and incidence of child sexual abuse, explores the link between child sexual abuse and later sexual exploitation, and reviews the literature on prevention strategies and effective interventions in child sexual abuse services. Our understanding of the international epidemiology of child sexual abuse is considerably greater than it was just 10 years ago, and studies from around the world are examined. Childhood sexual abuse can involve a wide number of psychological sequelae, including low self-esteem, anxiety, and depression. Numerous studies have noted that child sexual abuse victims are vulnerable to later sexual revictimization, as well as the link between child sexual abuse and later engagement in high-risk sexual behaviour. Survivors of child sexual abuse are more likely to have multiple sex partners, become pregnant as teenagers, and experience sexual assault as adults. Various models which attempt to account for this inter-relationship are presented; most invoke mediating variables such as low self-esteem, drug/alcohol use, PTSD and distorted sexual development. Prevention strategies for child sexual abuse are examined including media campaigns, school-based prevention programmes, and therapy with abusers. The results of a number of meta-analyses are examined. However, researchers have identified significant methodological limitations in the extant research literature that impede the making of recommendations for implementing existing therapeutic programmes unreservedly.
... Sexual Health STD Teen Pregnancy Sexual Risk Behaviors: HIV, STD, & Teen Pregnancy Prevention Recommend on Facebook Tweet Share Compartir Many ... is the only 100% effective way to prevent HIV, other STDs, and pregnancy. The correct and consistent use of male latex ...
Edwards, Keith E.
The author examined the impact on resident assistants of a social change approach to sexual assault prevention. The interactive multi-media program focused on engaging men on sexual assault prevention, accurately defining rape for college men and women, identifying aspects of the rape culture in society and on-campus, and empowering college…
Walsh, Kerryann; Brandon, Leisa; Chirio, Lisa
Two hundred and twelve Australian mothers completed an online survey examining features of mother-child communication about child sexual abuse prevention. Two-thirds (67.5%) of respondents had discussed child sexual abuse prevention with their children, with proportions varying according to age range (highest for mothers with children aged 5-12…
In recent years, an accumulation of Japanese research about sexual harassment and a number of very public court cases involving prominent public figures placed the issue of sexual harassment in the media spotlight. Japan was forced to recognise sexual harassment as a national problem, and not an issue, which was confined to the Western world. In April 1999, the Japanese government realised the need to amend existing laws to include sexual harassment under article twenty-one of the Equal Oppor...
The phenomenon of child sexual abuse (CSA) remains topical in. Zimbabwe. Statistics, literature and debate reflect not only increased scientific interest in child sexual abuse and its potential effects but also growing public concern about this form of child maltreatment. The sexual abuse of children crosses cultural and.
The Mentors in Violence Prevention (MVP) model seeks to address the root causes of gender violence using a bystander approach and leadership training to challenge structures of patriarchy. Emerging research on adolescent relationship abuse and sexual violence points to key modifiable targets-transforming gender norms, addressing homophobia, integrating with comprehensive sexuality education, and acknowledging the needs of youth already exposed to violence. A social justice-based bystander approach such as the MVP model should be part of a multi-level approach to sexual violence prevention that addresses gender and power, encourages healthy sexuality conversations, and provides safety and support for survivors.
Lippy, Caroline; DeGue, Sarah
Sexual violence continues to be a significant public health problem worldwide with serious consequences for individuals and communities. The implementation of prevention strategies that address risk and protective factors for sexual violence at the community level are important components of a comprehensive approach, but few such strategies have been identified or evaluated. The current review explores one potential opportunity for preventing sexual violence perpetration at the community level: alcohol policy. Alcohol policy has the potential to impact sexual violence perpetration through the direct effects of excessive alcohol consumption on behavior or through the impact of alcohol and alcohol outlets on social organization within communities. Policies affecting alcohol pricing, sale time, outlet density, drinking environment, marketing, and college environment are reviewed to identify existing evidence of impact on rates of sexual violence or related outcomes, including risk factors and related health behaviors. Several policy areas with initial evidence of an association with sexual violence outcomes were identified, including policies affecting alcohol pricing, alcohol outlet density, barroom management, sexist content in alcohol marketing, and policies banning alcohol on campus and in substance-free dorms. We identify other policy areas with evidence of an impact on related outcomes and risk factors that may also hold potential as a preventative approach for sexual violence perpetration. Evidence from the current review suggests that alcohol policy may represent one promising avenue for the prevention of sexual violence perpetration at the community level, but additional research is needed to directly examine effects on sexual violence outcomes. PMID:25403447
The topic of this article is the use of unsafe abortion for unwanted pregnancies among adolescents. The significance of unsafe abortion is identified as a high risk of serious health problems, such as infection, hemorrhage, infertility, and mortality, and as a strain on emergency room services. The World Health Organization estimates that at least 33% of all women seeking hospital care for abortion complications are aged under 20 years. 50 million abortions are estimated to be induced annually, of which 33% are illegal and almost 50% are performed outside the health care system. Complications are identified as occurring due to the procedure itself (perforation of the uterus, cervical lacerations, or hemorrhage) and due to incomplete abortion or introduction of bacteria into the uterus. Long-term complications include an increased risk of ectopic pregnancy, chronic pelvic infection, and infertility. Mortality from unsafe abortion is estimated at 1000/100,000 procedures. Safe abortion mortality is estimated at 0.6/100,000. When infertility results, some cultures ascribe an outcast status or marriages are prevented or prostitution is assured. The risk of complications is considered higher for adolescents. Adolescents tend to delay seeking an abortion, lack knowledge on where to go for a safe procedure, and delay seeking help for complications. Peer advice may be limited or inadequate knowledge. Five studies are cited that illustrate the impact of unsafe abortion on individuals and health care systems. Abortions may be desired due to fear of parental disapproval of the pregnancy, abandonment by the father, financial and emotional responsibilities of child rearing, expulsion from school, or inability to marry if the child is out of wedlock. Medical, legal, and social barriers may prevent women and girls from obtaining safe abortion. Parental permission is sometimes a requirement for safe abortion. Fears of judgmental or callous health personnel may be barriers to
The paper examined the prevalence of sexual assault and the need for preventive measures in Nigeria. As currently being reported in most national daily newspapers, the incidence of sexual is daily in the increase and many cases are still not reported. As part of the objectives, the study involved the review of literature, ...
Cierniak, Katie; Heiman, Julia R.; Plucker, Jonathan A.
For roughly three decades, policymakers have sought to reduce sexual violence by reliance on a criminal justice approach in which sexually violent acts are dealt with after they occur. Recognizing that prevention efforts could be more valuable, as they work to stop the problem before it begins, researchers have begun to implement a primary…
The rising numbers of new HIV infections among young people ages 15-24 in many developing countries, especially among young women, signal an urgent need to identify and respond programmatically to behaviors and situations that contribute to the spread of HIV and other sexually transmitted infections in early adolescence. Quantitative and qualitative studies of the sexual knowledge and practices of adolescents age 14 and younger reveal that substantial numbers of boys and girls in many countries engage in unprotected heterosexual vaginal intercourse--by choice or coercion--before their 15th birthdays. Early initiation into male-male or male-female oral and/or anal sex is also documented in some populations. Educational, health, and social programs must reach 10-14-year-olds as well as older adolescents with the information, skills, services, and supplies (condoms, contraceptives) they need to negotiate their own protection from unwanted and/or unsafe sexual practices and to respect the rights of others.
Sexually Transmitted Diseases (STDs) remain an important public health challenge among Nigerian students. Abuja University is located in a region of high STDs prevalence. However, it is not clear what students do to minimize their risk of contracting STDs. The purpose of the study was to explore sexual practices that ...
Iverson, Susan V.; Issadore, Michelle N.
Policy can and should be used as a tool of sexual violence prevention and response. In this chapter, we explore the historical, social justice, compliance, and best practice rationales for approaching policy development and revision differently.
Almost all (95%) unsafe abortions occur in developing countries because the developed world has made it possible for women to easily prevent unwanted pregnancy by using contraceptives and having access to safe legal termination when needed(3,7). When carried out according to appropriate clinical guidelines and ...
Schwartz, I L
Sexual assault of women in the United States may have a prevalence rate of 25% or more. Moreover, the majority of survivors of sexual assault know their assailants. Consequences of assault may be severe and long-term, including fear and anxiety, depression, suicide attempts, difficulties with daily functioning and interpersonal relationships, sexual dysfunction, and a whole range of somatic complaints. Recent evidence implicates societal factors, such as acceptance of rape myths, rigid sex role stereotyping beliefs, and acceptance of violence as a legitimate means for obtaining compliance in interpersonal relationships, in the etiology of sexual violence against women. I present a model for primary, secondary, and tertiary prevention of rape. Primary prevention represents a program of anticipatory guidance in a developmental framework. Secondary prevention entails identification of and early intervention in dysfunctional families. Tertiary prevention consists of the appropriate treatment of the survivor of sexual assault to prevent or minimize subsequent physical and psychological problems. This preventive framework may be incorporated into the practice of clinical preventive medicine and primary care.
... 1-02. Emergency. A situation that requires immediate intervention to prevent the loss of life, limb... cases. (c) The Director of the Defense Human Resources Activity (DoDHRA), under the authority, direction... the development of investigative policy in support of sexual assault prevention and response. (f) The...
Baker, Tamara; Boyd, Cynthia
This paper discusses a program that uses the leadership and status of Greek system officers to prevent sexual assault at a large university. This program aims to prevent future assaults by altering the conditions of a rape-prone culture. The presentation comprises a definition and two examples of acquaintance rape situations, a discussion of…
Sex-workers play an important role in the spread of sexually trans:mitted diseases (STDs) and this article tries to show that they can also play an important role in their prevention. Community participation by sex-workers in the prevention of STDs can also decrease the incidence thereof.
Anderson, Gwendolyn D
Child sexual abuse affects thousands of children in the United States and is vastly underreported. Tertiary prevention policies, primarily in the form of sex offender registries and community notification programs, have received the most attention and funding. Few policies have focused on school-based prevention. One recently passed law in Illinois mandates all K-5 public schools to implement sexual abuse prevention programs. The law was championed by a young social worker, Erin Merryn. Through the multiple streams framework, this article examines the unique set of political circumstances, united with Merryn's advocacy, which created the opportunity for the law to pass.
Quilter, Laura; Dhanireddy, Shireesha; Marrazzo, Jeanne
Prevention of sexually transmitted infections (STIs) is an important part of the care of the HIV-infected individual. STIs have been associated with increased risk of transmission and acquisition of HIV. Among HIV-infected persons, treatment failures and high recurrence rates of some STIs are more common. Despite the recognized importance of prevention and discussion of sexual health, rates of screening for STIs are suboptimal. Moreover, rates of STIs such as syphilis continue to increase particularly in men who have sex with men (MSM). This review focuses on the most common STIs seen among HIV-infected individuals and recommendations for screening and prevention.
McKibbin, Gemma; Humphreys, Cathy; Hamilton, Bridget
Harmful sexual behavior carried out by children and young people accounts for about half of all child sexual abuse perpetration. The aim of this study was to draw on the insights of young people who had been sexually abusive to enhance the current prevention agenda. The study involved semi-structured interviews with 14 young people and six treatment-providing workers. Sampling was purposive and the young people had previously completed a treatment program for harmful sexual behaviour in Victoria, Australia. The young people were approached as experts based on their previous experience of engaging in harmful sexual behavior. At the same time, their past abusive behavior was not condoned or minimised. Constructivist Grounded Theory was used to analyse the qualitative data. Opportunities for preventing harmful sexual behavior were the focus of the interviews with young people and workers. The research identified three opportunities for prevention, which involved acting on behalf of children and young people to: reform their sexuality education; redress their victimization experiences; and help their management of pornography. These opportunities could inform the design of initiatives to enhance the prevention agenda. Copyright © 2017 Elsevier Ltd. All rights reserved.
Donovan, B; Ross, M W
AIDS has Invigorated and distorted the study of sexual behaviour. Because that study began so recently, there remain many unanswered questions about why we have sex at all, why we do sex one way rather than another, or even how we define sex. Yet in every instance in which well-designed and adequately resourced behavioural Interventions have been Implemented, these have netted success in the form of falling HIV incidences or prevalences. But, despite these successes, such interventions remain patchy and poorly supported. Perhaps humankind's traditional aversion for the public discussion of sexual matters underlies this reticence. Or maybe a new era of "creeping absolutism"--in which biomedical advances are given premature credit for what they can achieve in HIV control--has arrived.
35 3. Analyzing Rape, Abuse, and Incest National Network Website ....35 D. DEVLOPING THEMATIC WEBSITE ANALSIS METRIC (T- WAM...portable document format PLAIN Plain Language Action and Information Network RAINN Rape, Abuse, and Incest National Network SARC sexual assault...the literature review. The Rape, Abuse and Incest National Network (RAINN) website (http://www.rainn.org) was used to develop the WAM baseline and
Georgina Amayuela Mora
Full Text Available In Ecuador the profound social, have been creating the conditions for the development of new conceptions in the education of the sexuality. The necessity of taking actions in relation with the education of the sexuality is a challenge for the educators and the health personal. The objective of this paper is to offer psycho-pedagogical foundations for the prevention of adolescent pregnancy Theoretical and empiric methods were used in the present investigation, mainly. The work provides a system of psycho-pedagogical grounds to take into account in any proposal for adolescent pregnancy prevention.
Fuertes Martín, Antonio; Orgaz Baz, M Begoña; Vicario-Molina, Isabel; Martínez Alvarez, José Luis; Fernández Fuertes, Andrés; Carcedo González, Rodrigo J
This study's focus is to evaluate a sexual coercion prevention program in adolescents. Using a before-and-after design with both a treatment group (n = 93) and a control group (n = 76), an intervention of seven sessions was completed. Said sessions included such content as conceptualizing sexual freedom, sexual coercion and voluntary consent, analyzing different sexual coercion tactics and the contexts in which they occur, empathy toward the victim, and developing abilities to avoid risky situations. Other risk factors for coercive behavior and sexual victimization are explored as well, such as alcohol use, sexist attitudes and inadequate communication, among others. The intervention's results include a decrease in stereotypical beliefs about the opposite sex and increased empathy toward victims of sexual coercion. These changes were maintained with the passage of time. Also, in the treatment group, a more acute decline was observed in the proportion of young people engaging in sexually coercive behaviors, This article emphasizes the importance, necessity and efficacy of such interventions, and discusses and analyzes possible improvements to the program for its future implementation.
Rees Helen V
Full Text Available Abstract Sub-Saharan Africa carries a massive dual burden of HIV and alcohol disease, and these pandemics are inextricably linked. Physiological and behavioural research indicates that alcohol independently affects decision-making concerning sex, and skills for negotiating condoms and their correct use. More than 20 studies in Africa have reported higher occurrence of HIV among people with problem drinking; a finding strongly consistent across studies and similar among women and men. Conflation of HIV and alcohol disease in these setting is not surprising given patterns of heavy-episodic drinking and that drinking contexts are often coterminous with opportunities for sexual encounters. HIV and alcohol also share common ground with sexual violence. Both perpetrators and victims of sexual violence have a high likelihood of having drunk alcohol prior to the incident, as with most forms of violence and injury in sub-Saharan Africa. Reducing alcohol harms necessitates multi-level interventions and should be considered a key component of structural interventions to alleviate the burden of HIV and sexual violence. Brief interventions for people with problem drinking (an important component of primary health care, must incorporate specific discussion of links between alcohol and unsafe sex, and consequences thereof. Interventions to reduce alcohol harm among HIV-infected persons are also an important element in positive-prevention initiatives. Most importantly, implementation of known effective interventions could alleviate a large portion of the alcohol-attributable burden of disease, including its effects on unsafe sex, unintended pregnancy and HIV transmission.
Imhoff, Laurel R; Brown, Jeanette S; Creasman, Jennifer M; Subak, Leslee L; Van den Eeden, Stephen K; Thom, David H; Varma, Madhulika G; Huang, Alison J
-sectional design prevented evaluation of causality. Although most women with fecal incontinence are at high risk for several aspects of sexual dysfunction, the presence of fecal incontinence does not prevent women from engaging in sexual activity. This indicates that sexual function is important to women with anal incontinence and should be prioritized during therapeutic management.
Zhang, Wenjing; Chen, Jingqi; Feng, Yanan; Li, Jingyi; Liu, Chengfeng; Zhao, Xiaoxia
Objectives: The purpose of this study was to test the feasibility of a sexual abuse prevention education in a sample of Chinese preschool children in Beijing, China. Method: One hundred and fifty preschool children were randomly assigned to either the intervention group (N = 78) or the wait-list control group (N = 72). Children were posttested on…
rape her). Perhaps we proffer the reason for the rape as tied to the place she was raped, or the time of the day, or the clothes she was wearing, or the fact that .... cultural factors. I have no doubt that such specialized efforts will yield much dividend in the prevention of sexual assaults among the very vulnerable groups. It.
Banyard, Victoria L.; Eckstein, Robert P.; Moynihan, Mary M.
Increasing numbers of empirical studies and theoretical frameworks for preventing sexual violence are appearing in the research- and practice-based literatures. The consensus of this work is that although important lessons have been learned, the field is still in the early stages of developing and fully researching effective models, particularly…
Somers, Cheryl L.
This study evaluates the effectiveness of an experiential approach to teen pregnancy (TP) prevention called "Baby Think It Over," a computerized infant simulator, on adolescents' attitudes and behaviors regarding teen pregnancy and sexuality. Recently, a more realistic model called "Real Care Baby" was developed. The small amount of research on…
Allen, Ben T.
This booklet on sexual harassment on college campuses covers sexual harassment law, harassment prevention, protection from liability, and handling allegations. Chapter 1, "What Is Sexual Harassment?" defines the term and gives an overview of sexual harassment law. Chapter 2, "How Does Sexual Harassment Law Apply in Actual Situations?" illustrates…
The importance of the treatment of the unsafe acts for the prevention of accidents in petrochemical industry; A importancia do tratamento dos atos inseguros para a prevencao de acidentes na industria petroquimica
Meneguetti, Alexander A.; Santos, Helio R.F.; Alevato, Hilda; Lima, Luciana S. [Dupont do Brasil S.A., Paulinia, SP (Brazil)
Due to the fact that, the workers' behavior is characterized by its complexity and diversity, this issue has been seen as a great 'black box' in discussions regarding the Management Systems of SHE. Associated with this issue other arises: How conscious people? How to engage them with the process? How to improve the risk control? How to motivate the prevention? Most of these responses are discussed in the Social and Human Sciences for many years. However, it is necessary to closer the technical-operational knowledge and the human aspects, applying in the organizations' daily work, to make the working environment more safe. The purpose of this study, therefore, is examining the possibility of reducing accidents through the identification and treatment of deviations (unsafe acts and unsafe conditions), cause the whole accident, be it serious or not, begins with a small deviation. It was used as a reference tool, the Behavior audit and it is based on field's observations, applied into a production unit of a large petrochemical industry in northern Brazil, during the years 2006 and 2007. (author)
husband had been having a piercing sensation on deep penetration during sexual intercourse. There was associated dyspareunia. She was Para 1+ and had been delivered of a live male infant 6 years earlier at home by a traditional birth attendant. (TBA). The child was alive and well. About 6 months after the delivery, she ...
Hunt, Robyn; Walsh, Kerryann
This paper presents the results of a systematic review of literature on the topic of parents' views about child sexual abuse prevention education. It describes: i) what parents know about child sexual abuse prevention education; ii) what child sexual abuse prevention messages parents provide to their children and what topics they discuss; iii)…
José Barzelatto first distinguished himself as a leader with a vision in his years as a medical student. Later, principally as Director of the Reproductive Health Program at the World Health Organization and of the Ford Foundation program for women's sexual and reproductive rights, he contributed immensely toward the recognition of women's sexual and reproductive rights as part of their basic human rights. José Barzelatto's vision on abortion reflects his drive to promote social justice and respect individual rights, respect diversity, and promote a social consensus for a peaceful society. He believed that the fetus has moral value and did not accept abortion as a method of fertility control, but understood that abortion is a social phenomenon that cannot be changed with legal or moral condemnation. He accepted that condemning women who abort does not prevent abortion, is unfair, and causes great human suffering at a high social cost. José proposed nine points to form the basis for an overlapping consensus on abortion, on which to base a practical consensus that would allow societies to reduce the number of abortions and minimize their consequences. If we can agree on all or most of those points we would achieve the common objectives of: fewer women confronting the dilemma of how to deal with an unwanted pregnancy; fewer induced abortions; and fewer women suffering the consequences of unsafe abortion. Copyright 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Harris, Lisa H; Grossman, Daniel
Unsafe abortion accounts for approximately 13% of maternal deaths worldwide-roughly 47,000 deaths per year. Most deaths from unsafe abortion occur in low-resource countries. Second-trimester abortion carries a higher risk of morbidity and mortality compared with first-trimester abortion and, although the former comprises the minority of abortion procedures worldwide, it is responsible for the majority of serious complications and death where unsafe abortion is prevalent. Therefore, improving access to safe second-trimester abortion must be a priority in low-income regions of the world if the majority of deaths from unsafe abortion are to be prevented. In the present paper, we consider a variety of barriers to second-trimester care, including healthcare provider training and abortion stigma, which may lead to neglect of unmet need for second-trimester services. Copyright © 2011 International Journal of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Bränström, Richard; Hatzenbuehler, Mark L; Pachankis, John E; Link, Bruce G
To determine whether fundamental cause theory (which posits that, in societal conditions of unequal power and resources, members of higher-status groups experience better health than members of lower-status groups because of their disproportionate access to health-protective factors) might be relevant in explaining health disparities related to sexual orientation. We used 2001 to 2011 morbidity data from the Stockholm Public Health Cohort, a representative general population-based study in Sweden. A total of 66 604 (92.0%) individuals identified as heterosexual, 848 (1.2%) as homosexual, and 806 (1.1%) as bisexual. To test fundamental cause theory, we classified diseases in terms of preventability potential (low vs high). There were no sexual orientation differences in morbidity from low-preventable diseases. By contrast, gay or bisexual men (adjusted odds ratio [OR] = 1.48; 95% confidence interval [CI] = 1.13, 1.93) and lesbian or bisexual women (adjusted OR = 1.64; 95% CI = 1.28, 2.10) had a greater risk of high-preventable morbidity than heterosexual men and women, respectively. These differences were sustained in analyses adjusted for covariates. Our findings support fundamental cause theory and suggest that unequal distribution of health-protective resources, including knowledge, prestige, power, and supportive social connections, might explain sexual orientation health disparities.
Qvist, Tavs; Engsig, Frederik; Kronborg, Gitte
Abstract Background: Sexual transmission continues to be the primary mode of human immunodeficiency virus (HIV) infection in Western Europe. We aimed to describe predictors of unsafe sex and reasons given for such behaviour. Methods: We performed a survey examining sexual risk behaviours...... and reasons for unsafe sex in a nationwide cohort of adult Danish HIV-1-positive patients. Differences in characteristics between those who practiced safe and unsafe sex were estimated by binary logistic regression. The fraction with detectable viral load was determined in the 2 groups, and reasons for unsafe...... sex were evaluated. Results: Of 812 eligible patients, a total of 275 (34%) had engaged in unsafe sex with an HIV-negative partner or a partner with unknown HIV status in the previous year. On multivariate analysis, men who have sex with men (MSM) was the only statistically significant risk factor...
Barger, Erin; Wacker, Julia; Macy, Rebecca; Parish, Susan
Although research has indicated that women with intellectual disabilities are significantly burdened with sexual violence, there is a dearth of sexual assault prevention research for them. To help address this serious knowledge gap, the authors summarize the findings of general sexual assault prevention research and discuss its implications for…
Jozkowski, Kristen N
Sexual assault is prevalent in the United States, particularly among college women. Prevention programs are implemented to combat assault, yet rates have not changed for five decades. A course designed to deconstruct contextualized factors contributing to assault was developed as an alternative prevention initiative. The current study assessed the effectiveness of the course compared with a traditional program via in-depth interviews with students. Findings indicated that students in the course were more likely to acknowledge underlying determinants of sexual assault and articulate how such behaviors could lead to assault. The course could be an effective approach to sexual assault prevention education. © The Author(s) 2015.
Sales, Jessica; Krause, Kathleen
Creating a normative campus environment intolerant to sexual violence is important for prevention. While prevention initiatives focusing on students are vital, faculty and staff have a central role in supporting and sustaining a comprehensive strategy for preventing campus sexual violence. Nationwide, colleges and universities recently implemented…
Bernardi, M M; Macrini, D J; Teodorov, E; Bonamin, L V; Dalboni, L C; Coelho, C P; Chaves-Kirsten, G P; Florio, J C; Queiroz-Hazarbassanov, N; Bondan, E F; Kirsten, T B
Prenatal undernutrition impairs copulatory behavior and increases the tendency to become obese/overweight, which also reduces sexual behavior. Re-feeding rats prenatally undernourished with a normocaloric diet can restore their physiological conditions and copulatory behavior. Thus, the present study investigated whether a hypercaloric diet that is administered in rats during the juvenile period prevents sexual impairments that are caused by maternal food restriction and the tendency to become overweight/obese. Female rats were prenatally fed a 40% restricted diet from gestational day 2 to 18. The pups received a hypercaloric diet from postnatal day (PND) 23 to PND65 (food restricted hypercaloric [FRH] group) or laboratory chow (food restricted control [FRC] group). Pups from non-food-restricted dams received laboratory chow during the entire experiment (non-food-restricted [NFR] group). During the juvenile period and adulthood, body weight gain was evaluated weekly. The day of balanopreputial separation, sexual behavior, sexual organ weight, hypodermal adiposity, striatal dopamine and serotonin, serum testosterone, and tumor necrosis factor α (TNF-α) were evaluated. The FRH group exhibited an increase in body weight on PND58 and PND65. The FRC group exhibited an increase in the latency to the first mount and intromission and an increase in serum TNF-α levels but a reduction of dopaminergic activity. The hypercaloric diet reversed all of these effects but increased adiposity. We concluded that the hypercaloric diet administered during the juvenile period attenuated reproductive impairments that were induced by maternal food restriction through increases in the energy expenditure but not the tendency to become overweight/obese. Copyright © 2017 Elsevier Inc. All rights reserved.
This digest reviews effective strategies currently used by schools to combat sexual harassment. Sexual harassment is considered any unwelcome behavior of a sexual nature that interferes with the life of the target individual. Experts agree that sexual harassment is about power, not sex. A serious effort to keep a school free of sexual harassment…
Letourneau, Elizabeth J.; Schaeffer, Cindy M.; Bradshaw, Catherine P.; Feder, Kenneth A.
Child sexual abuse (CSA) is a serious public health problem that increases risk for physical and mental health problems across the life course. Young adolescents are responsible for a substantial portion of CSA offending, yet to our knowledge, no validated prevention programs that target CSA perpetration by youth exist. Most existing efforts to address CSA rely on reactive criminal justice policies or programs that teach children to protect themselves; neither approach is well validated. Given the high rates of desistance from sexual offending following a youth’s first CSA-related adjudication, it seems plausible that many youth could be prevented from engaging in their first offense. The goal of this article is to examine how school-based universal prevention programs might be used to prevent CSA perpetrated by adolescents. We review the literature on risk and protective factors for CSA perpetration and identify several promising factors to target in an intervention. We also summarize the literature on programs that have been effective at preventing adolescent dating violence and other serious problem behaviors. Finally, we describe a new CSA prevention program under development and early evaluation and make recommendations for program design characteristics, including unambiguous messaging, parental involvement, multisession dosage, skills practice, and bystander considerations. PMID:28413921
Background: Proper contraception is a likely panacea to unsafe abortions often complicated by preventable deaths. This study identified sexual behaviours and associated patterns of contraceptive use among students of higher institutions in Delta State, Nigeria. Methodology: This was a cross-sectional analytic study of 420 ...
Shoop, Robert J.
A "boilerplate" sexual harassment policy embedded in the district policy manual is insufficient. Schools need a comprehensive sexual harassment prevention program addressing authority, accountability, responsibility, and training. Since the vast majority of sexual harassment in schools is student-to-student, training efforts should not be limited…
Jozkowski, Kristen N.; Geshnizjani, Alireza; Middlestadt, Susan E.
Sexual health concerns such as sexually transmitted infections and unintended pregnancy remain substantial health problems faced by young adults, especially college women. University healthcare providers may be instrumental in increasing female patients' involvement in preventative sexual health behaviors, however little research has examined this…
Young unmarried women bore the brunt of being stigmatized. They reported a lack of a supportive environment that provides guidance on correct information on how to prevent unwanted pregnancy and where to get help. Abortion-related stigma plays a major role in women's decision on whether to have a safe or unsafe ...
Zila M. Sanchez
Full Text Available OBJECTIVE: Alcohol and other drug use appears to reduce decision-making ability and increase the risk of unsafe sex, leading to possible unplanned pregnancies, sexually transmitted diseases/human immunodeficiency virus/HIV transmission, and multiple sexual partners. This study aimed to test the hypothesis that risky sexual behaviors among adolescents are associated with legal and illegal drug use. METHODS: A national cross-sectional survey of 17,371 high-school students was conducted in 2010. Students were selected from 789 public and private schools in each of the 27 Brazilian state capitals by a multistage probabilistic sampling method and answered a self-report questionnaire. Weighted data were analyzed through basic contingency tables and logistic regressions testing for differences in condom use among adolescents who were sexually active during the past month. RESULTS: Approximately one third of the high school students had engaged in sexual intercourse in the month prior to the survey, and nearly half of these respondents had not used a condom. While overall sexual intercourse was more prevalent among boys, unsafe sexual intercourse was more prevalent among girls. Furthermore, a lower socioeconomic status was directly associated with non-condom use, while binge drinking and illegal drug use were independently associated with unsafe sexual intercourse. CONCLUSION: Adolescent alcohol and drug use were associated with unsafe sexual practices. School prevention programs must include drug use and sexuality topics simultaneously because both risk-taking behaviors occur simultaneously.
Sanchez, Zila M; Nappo, Solange A; Cruz, Joselaine I; Carlini, Elisaldo A; Carlini, Claudia M; Martins, Silvia S
Alcohol and other drug use appears to reduce decision-making ability and increase the risk of unsafe sex, leading to possible unplanned pregnancies, sexually transmitted diseases/human immunodeficiency virus/HIV transmission, and multiple sexual partners. This study aimed to test the hypothesis that risky sexual behaviors among adolescents are associated with legal and illegal drug use. A national cross-sectional survey of 17,371 high-school students was conducted in 2010. Students were selected from 789 public and private schools in each of the 27 Brazilian state capitals by a multistage probabilistic sampling method and answered a self-report questionnaire. Weighted data were analyzed through basic contingency tables and logistic regressions testing for differences in condom use among adolescents who were sexually active during the past month. Approximately one third of the high school students had engaged in sexual intercourse in the month prior to the survey, and nearly half of these respondents had not used a condom. While overall sexual intercourse was more prevalent among boys, unsafe sexual intercourse was more prevalent among girls. Furthermore, a lower socioeconomic status was directly associated with non-condom use, while binge drinking and illegal drug use were independently associated with unsafe sexual intercourse. Adolescent alcohol and drug use were associated with unsafe sexual practices. School prevention programs must include drug use and sexuality topics simultaneously because both risk-taking behaviors occur simultaneously.
Mindel, Adrian; Sawleshwarkar, Shailendra
The present review assesses the protection that condoms offer against sexually transmissible infections (STI) and the impact that social, political and religious opinion in the USA has had in the past 8 years on promoting condoms for safer sex. Condoms offer protection against most STI. However, the degree of protection depends on correct and consistent use, the type of sexual activity and the biological characteristics of different infections. Cross-sectional and case-control studies and other observational data provide the majority of evidence for STI prevention. Condoms provide a high level of protection against those infections that are transmitted mainly via infected secretions, including HIV, gonorrhoea, chlamydia and trichomoniasis. Protection against those infections transmitted via skin and mucous membrane contact, including Herpes simplex virus infection and human papilloma virus, appears to be less. The Bush administration, driven by conservative political, social and religious elements in the USA, has mounted a concerted campaign to undermine the role of the condom in health-promotion activities in the USA and overseas by undervaluing and misrepresenting scientific data, and through a sustained and well-funded promotion of abstinence-only education. However, this has lead to considerable controversy and disillusionment with abstinence-only education, both at home and abroad, and there is now incontrovertible evidence that abstinence-only programs are ineffectual.
LeVasseur, J J
Many studies have suggested that merely warning people about the dangers of sexually transmitted diseases (STDs) and urging the use of condoms as protection will not result in widespread use of condoms. Regular condom use appears to be grounded in knowledge of its effectiveness, perception of STD risk, and belief in a partner's acceptance. But these are not the only barriers to condom use. Negotiating condom use often comes at a sensitive stage in intimate relationships, when individuals prefer to avoid such discussions and simply to trust the powerful and compelling feelings of mutual attraction. This review will consider (1) the effectiveness of condoms in preventing STD transmission, (2) barriers to the use of condoms, and (3) recommended strategies to promote acceptance and use of condoms by heterosexual women.
Tayo, Ajayi Beatrice; Olawuyi, B. O.
This study employed the survey design to investigate the relevance of parent communication in preventing sexual abuse among secondary school students in Nigeria. The instrument for data collection tagged "Parent Communication Strategy for Preventing Sexual Abuse questionnaire" (PCOSPSAQ), was a researcher designed instrument. It was…
McMahon, Sarah; Postmus, Judy L.; Koenick, Ruth Anne
Bystander intervention offers promise as a sexual violence prevention tool for student affairs administrators on college campuses, but the conceptualization and definition of the approach is in its infancy and needs further development. In an effort to emphasize the potential role of bystanders in the primary prevention of sexual violence, we put…
Paranal, Rechelle; Thomas, Kiona Washington; Derrick, Christina
The prevalence of child sexual abuse demands innovative approaches to prevent further victimization. The online environment provides new opportunities to expand existing child sexual abuse prevention trainings that target adult gatekeepers and allow for large scale interventions that are fiscally viable. This article discusses the benefits and…
Walsh, Kerryann; Berthelsen, Donna; Nicholson, Jan M.; Brandon, Leisa; Stevens, Judyann; Rachele, Jerome N.
The past four decades have seen increasing public and professional awareness of child sexual abuse. Congruent with public health approaches to prevention, efforts to eliminate child sexual abuse have inspired the emergence of prevention initiatives which can be provided to all children as part of their standard school curriculum. However,…
Iverson, Susan V.
Among the numerous approaches that are employed to prevent sexual violence, the performance of scenarios has become one of the "promising practices" in U.S. postsecondary education. This article describes findings from a pilot study to analyze scripts used for theatre-based sexual violence prevention programs. Employing the method of…
Berner, Wolfgang; Briken, P
Hostility towards relationships is one prominent characteristic symptom for disorders of sexual preference (ICD-10) and paraphilias (DSM-IV). Paraphilic symptoms sometimes progress to obsessive or addictive- like forms leading to a loss of self-control but can occur also as single incidents or as episodic events. Besides constitutional aspects, problems in the development of close relationships to primary caregivers (attachment) play an important role in the development of these disorders. Actual relationship- and self-confidence problems often trigger the severity of disturbance, especially in the episodic forms of paraphilia. For patients who are in conflict with the law, cognitive-behavioral therapeutic approaches with the aim to minimize self-deception regarding the effects of the paraphilic behavior have become more and more relevant. Regarding the medical treatment, anti-hormonal therapy plays an important role, but also treatment with serotonergic agents and naltrexone are used. Only little can be advised in terms of prevention; general psycho-hygiene (regarding the parent-child relationship) is recommended. Beside these general measures, institutions which offer special treatment for people in danger to become delinquents may be able to prevent serious harm for possible victims of abuse.
Seng, Rémonie; Rolland, Matthieu; Beck-Wirth, Geneviève; Souala, Faouzi; Deveau, Christiane; Delfraissy, Jean-François; Goujard, Cécile; Meyer, Laurence
In the current context of increasing unsafe sex, HIV incidence may have evolved, depending on HIV prevalence in sexual networks and, among HIV-infected persons who practice unsafe sex, on their infectivity and partners' HIV serostatus. We examined calendar trends in sexual behaviours at risk of HIV-1 transmission (SBR) among 967 adults followed since primary HIV infection (ANRS PRIMO cohort) and relationship with current treatments and viral load. Patients completed since 2000 self-administered questionnaires on sexual practices every 6 months. SBR with HIV-negative/unknown partners were analyzed among 155 heterosexual women, 142 heterosexual men and 670 MSM by using logistic generalized estimating equation models (6656 visits). During 2000-2009, the frequency of SBR did not increase significantly among women with steady partners; risk factors were a low education level and alcohol/smoking use. Among heterosexual men with steady partners, the frequency of SBR doubled since 2006; during this period, the only associated factor was combined antiretroviral treatment for at least 6 months or viral load less than 400 copies/ml. Among MSM, SBR increased gradually over time; SBR with steady partners was associated with a low education level and alcohol use. SBR was more frequent among MSM with casual partners; no association with viral load was found. In France, recent trends and risk factors in unprotected sex with HIV-negative/unknown partners differ according to sex/sexual preference. The recent increase in SBR among heterosexual men with low viral load may be related to increasing awareness of the 'treatment-as-prevention' concept. The lack of association between SBR and viral load among MSM supports use of treatment-as-prevention as part of diversified prevention strategies.
Sagrestano, Lynda M.; Paikoff, Roberta L.
Adolescent sexual activity and the resulting pregnancy and transmission of sexually transmitted diseases have been on the rise during the past several decades. This chapter addresses each of the three objectives regarding sexual behavior outlined in the Healthy People 2000 initiative. Background data and trends in adolescent sexual behavior are…
Schober, Daniel J.; Fawcett, Stephen B.; Thigpen, Sally; Curtis, Anna; Wright, Renee
Objective: This empirical case study describes Prevent Child Abuse Georgia's effort to prevent child sexual abuse (CSA) by educating communities throughout the state on supporting preventive behaviour. The initiative consisted of three major components: (1) dissemination of CSA prevention messages and materials; (2) a statewide helpline that…
Rink, Elizabeth; FourStar, Kristofer; Anastario, Michael P
We examined the relationship between American Indian men's attitudes toward pregnancy prevention, STI/HIV prevention, and sexual risk behavior. Attention was given to: (1) attitudes and intentions to use condoms and sexual risk behavior; (2) STI/HIV prevention characteristics and sexual risk behavior; (3) attitudes toward abstinence and monogamy and sexual risk behavior; and (4) decision-making in relationships and sexual risk behavior. Our sample included 120 heterosexual American Indian men aged 18 to 24 living on a reservation. Data were collected during in-depth interviews. A community-based participatory research framework was used to ensure the relevancy and acceptability of the study given the sensitivity of the topic. Results demonstrated that attitudinal factors were associated with sexual risk behavior, particularly inconsistent condom use. Attitudes associated with consistent condom use suggested greater levels of positive dispositions toward prevention and intention to use condoms. Consistent condom use was associated with more cautious attitudes toward sex with multiple sex partners. Study results suggested that American Indian men who reported sex with multiple partners exhibited a set of attitudes and beliefs toward pregnancy prevention and STI/HIV prevention that corresponded with a disposition resulting from their behaviors, in that engaging in sexual risk behavior elevated their levels of risk perception. Our findings suggest that heterosexual American Indian men living in rural environments need sexual and reproductive health programs and clinical services that address differing attitudes toward condom use within the context of multiple sex partners and sexual risk behavior. © 2015 National Rural Health Association.
Olson, Rose McKeon; Kamurari, Solomon
A 15-year-old girl at 18 weeks gestation by the last menstrual period presented to a rural Ugandan healthcare facility for termination of her pregnancy as a result of rape by her uncle. Skilled healthcare workers at the facility refused to provide the abortion due to fear of legal repercussions. The patient subsequently obtained an unsafe abortion by vaginal insertion of local herbs and sharp objects. She developed profuse vaginal bleeding and haemorrhagic shock. She was found to have uterine rupture and emergent hysterectomy was performed. Young and poor women are at high risk of unplanned pregnancy and subsequent mortality during pregnancy and childbirth. Unsafe abortion is a leading and entirely preventable cause of maternal mortality worldwide. Multiple barriers restrict access to safe abortions including social and moral stigma, gender-based power imbalances, inadequate contraceptive use and sexual education, high cost and poor availability, and restrictive abortion laws. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Muhammad, Noor Azimah; Shamsuddin, Khadijah; Sulaiman, Zaharah; Amin, Rahmah Mohd; Omar, Khairani
One of the popular approaches of preventing youth sexual activity in Malaysia is using religion to promote premarital sexual abstinence. Despite this intervention, youth continue to practise premarital sex. Thus, the purpose of this exploratory mixed methods study was to understand the role of religion on sexual activity among college students in Klang Valley, Malaysia. A self-administered questionnaire survey to determine the relationship between religiosity and youth sexual activity was carried out on 1026 students recruited from 12 randomly selected colleges. Concurrently, face-to-face interviews were conducted on 15 students to explore how religiosity had influenced their decision on sexual activity. The survey data were analysed using logistic regression, while the qualitative data from the interviews were examined using thematic analysis with separate analysis for each gender. Both quantitative and qualitative results were then compared and integrated. Religious activity significantly reduced the risk of continuing sexual activity among female students (AOR = 0.67, CI = 0.47, 0.95, p = 0.02) but not male students. There was no significant relationship of religious affiliation and intrinsic religiosity (inner faith) to sexual activity by gender. Having faith in religion and strong sexual desire were the main themes that explained participants' sexual behaviour. Engaging in religious activity might be effective at preventing female students from being sexually active. However, when sexual urges and desires are beyond control, religiosity might not be effective.
Full Text Available The aim of this paper is to present the essence of eff ective management to recall unsafe food. The implementation of the development is refl ected in its individual parts. Legal requirements oblige companies to take immediate action when an available product poses a threat to the consumer’s health or life. These actions imply blocking of a suspicious batch or a possible product recall, as well as eff ective communication with supervisory authorities and consumers, if a product has already been available to them. The scope of these regulations is scrupulously listed in private safety standards and food quality, such as BRC, IFS, or in an international norm ISO 22000. The article emphasized the importance of the traceability system to ensure eff ective recall, also analysed the results of the research into the causes and evaluated the eff ectiveness of the food recall.
Full Text Available Esther Mugweni,1 Stephen Pearson,2 Mayeh Omar2 1UCL Department of Infection and Population Health, University College London, London, 2The Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK Background: Concurrent sexual partnerships play a key role in sustaining the HIV epidemic in Zimbabwe. Married couples are at an increased risk of contracting HIV from sexual networks produced by concurrent sexual partnerships. Addressing these partnerships is an international HIV prevention priority. Methods: Our qualitative study presents the socioeconomic factors that contribute to the occurrence of concurrent sexual partnerships among married people in Zimbabwe. We conducted 36 in-depth interviews and four focus group discussions with married men and women in Zimbabwe in 2008 to understand the organizations of concurrent sexual partnerships. Data were analyzed using framework analysis. Results: Our study indicates that relationship dissatisfaction played a key role in the engagement of concurrent sexual partnerships. Depending on the source of the dissatisfaction, there were four possible types of concurrent sexual relationships that were formed: sex worker, casual partner, regular girlfriend or informal polygyny which was referred to as “small house”. These relationships had different levels of intimacy, which had a bearing on practicing safer sex. Participants described three characteristics of hegemonic masculinity that contributed to the sources of dissatisfaction leading to concurrent sexual activity. Similarly, various aspects of emphasized femininity were described as creating opportunities for the occurrence of concurrent sexual relationships. Economic status was also listed as a factor that contributed to the occurrence of concurrent sexual partnerships. Conclusion: Marital dissatisfaction was indicated as a contributing factor to the occurrence of concurrent sexual relationships. There were several
Jaime, M. C. D.; Stocking, M.; Freire, K.; Perkinson, L.; Ciaravino, S.; Miller, E.
"Coaching Boys into Men" is an evidence-based dating violence prevention program for coaches to implement with male athletes. A common adaptation of this program is delivery by domestic violence and sexual violence prevention advocates instead of coaches. We explored how this implementer adaptation may influence athlete uptake of program…
Bachanas, Pamela J; Morris, Mary K; Lewis-Gess, Jennifer K; Sarett-Cuasay, Eileen J; Sirl, Kimberly; Ries, Julie K; Sawyer, Mary K
To describe empirically the risky sexual behavior of an at-risk sample of adolescent girls, to assess psychosocial correlates of risky behavior, and to examine the utility of applying a risk and protective model to predicting teens' risky sexual behavior. Participants included 158 African American girls, ages 12 to 19, who were receiving medical care in an adolescent primary care clinic. Teens completed measures of depression, conduct problems, substance use, peer norms, social support, HIV knowledge, sexual self-efficacy, and sexual behavior. Teens in this sample reported high rates of risky sexual behaviors, including early sexual debuts and frequent unprotected sexual encounters with multiple partners. African American girls who reported high rates of substance use and who reported that their peers engaged in risky behaviors also reported engaging in high rates of risky sexual behaviors. Little support was obtained for protective factors (HIV knowledge, social support, sexual self-efficacy) moderating the relations between risk factors and adolescents' risky sexual behavior in this sample. Teens presenting in primary care settings in urban environments seem to be at high risk for HIV, STDs, and substance abuse, and risk reduction strategies should be introduced during the preteen years. An interdisciplinary model of care in primary care settings serving adolescents is clearly indicated, and prevention-oriented interventions aimed at reducing risky behaviors and preventing the development of more significant health, mental health, or substance abuse disorders are needed.
Kamal, S. M. Mostafa
This study examines sexuality and HIV/AIDS prevention knowledge among minority ethnic male youth of Bangladesh. A cross-sectional survey was conducted through a self-administered questionnaire on 800 young males aged 15-24 years in the Chittagong Hill Tracts region in 2009. Of the respondents, almost one-third were sexually active and of them…
Hobson, Charles J.; Guziewicz, Jennifer
Reports on a survey concerning thirteen recommended sexual harassment preventive/protective practices at U.S. colleges and universities. A majority of responding institutions had formal sexual harassment policies, offered counseling to student victims, and investigated all complaints. Relatively fewer schools provided student access to faculty…
Charles, Vignetta Eugenia; Blum, Robert Wm.
Adolescent sexual risk-taking behavior has numerous individual, family, community, and societal consequences. In an effort to contribute to the research and propose new directions, this chapter applies the core competencies framework to the prevention of high-risk sexual behavior. It describes the magnitude of the problem, summarizes explanatory…
A cross-sectional study design was used to assess sexual-risk behaviour and HIV-preventive practices among students at Hawassa University, Ethiopia, in 2009. Among 1 220 students eligible for the study, approximately 29% reported experience of sex (36.3% of the males and 9.3% of the females). Of the total sexually ...
Rispens, Jan; Aleman, Andre; Goudena, Paul P.
Meta-analysis of 16 evaluation studies of school programs aimed at the prevention of child sexual abuse victimization found significant and considerable mean postintervention and follow-up effect sizes, indicating that the programs were effective in teaching children sexual abuse concepts and self-protection skills. Program duration and content…
Mejia, Pamela; Cheyne, Andrew; Dorfman, Lori
News media coverage of child sexual abuse can help policymakers and the public understand what must be done to prevent future abuse, but coverage tends to focus on extreme cases. This article presents an analysis of newspaper coverage from 2007 to 2009 to describe how the daily news presents and frames day-to-day stories about child sexual abuse.…
Ounce of Prevention Fund.
This pamphlet discusses the problems of child sexual abuse, and introduces the Heart to Heart program created by the Ounce of Prevention Fund in Illinois. The pamphlet begins with reflections of adolescents who were sexually abused during childhood, and presents statistical information on this issue. It also discusses the various effects of…
Shoveller, Jean A.; Johnson, Joy L.; Savoy, Daphne M.; Pietersma, W. A. Wia
Most primary prevention research has attempted to explain sexual health outcomes, such as sexually transmitted infections, by focusing on individual characteristics (e.g. age), qualities (e.g. knowledge levels), and risk behaviour (e.g. unprotected intercourse). Emerging evidence indicates that population-level health outcomes are unlikely to be…
The sexual abuse of children crosses cultural and economic divides. Sexual abuse can lead to long-lasting, even life-long consequences and is a serious problem on individuals, families and societies. Social workers by nature of their work, intervene at the individual, family and societal level. This paper will explore the ...
Dating violence (also known as adolescent relationship abuse) and sexual violence are prevalent from the middle school years throughout adolescence, peak in young adulthood, and are associated with multiple poor physical and mental health consequences. By offering universal education and brief anticipatory guidance with all adolescent patients about healthy and unhealthy relationships and sexual consent, health care providers can help promote healthy adolescent sexual relationships, ensure youth know about available resources and supports for relationship abuse and sexual violence (including how to help a friend), and facilitate connections to victim service advocates, both for prevention and intervention. Copyright © 2016 Elsevier Inc. All rights reserved.
DeGue, Sarah; Valle, Linda Anne; Holt, Melissa K.; Massetti, Greta M.; Matjasko, Jennifer L.; Tharp, Andra Teten
This systematic review examined 140 outcome evaluations of primary prevention strategies for sexual violence perpetration. The review had two goals: 1) to describe and assess the breadth, quality, and evolution of evaluation research in this area; and 2) to summarize the best available research evidence for sexual violence prevention practitioners by categorizing programs with regard to their evidence of effectiveness on sexual violence behavioral outcomes in a rigorous evaluation. The majority of sexual violence prevention strategies in the evaluation literature are brief, psycho-educational programs focused on increasing knowledge or changing attitudes, none of which have shown evidence of effectiveness on sexually violent behavior using a rigorous evaluation design. Based on evaluation studies included in the current review, only three primary prevention strategies have demonstrated significant effects on sexually violent behavior in a rigorous outcome evaluation: Safe Dates (Foshee et al., 2004); Shifting Boundaries (building-level intervention only, Taylor, Stein, Woods, Mumford, & Forum, 2011); and funding associated with the 1994 U.S. Violence Against Women Act (VAWA; Boba & Lilley, 2009). The dearth of effective prevention strategies available to date may reflect a lack of fit between the design of many of the existing programs and the principles of effective prevention identified by Nation et al. (2003).
...-2012-0003] RIN 1653-AA65 Standards To Prevent, Detect, and Respond to Sexual Abuse and Assault in... regulations setting standards to prevent, detect, and respond to sexual abuse and assault in DHS confinement... Sexual Abuse and Assault in Confinement Facilities.'' 77 FR 75300. The NPRM required commenters to submit...
Nystrom, Robert J; Duke, Jessica E A; Victor, Brad
Oregon's work on teen pregnancy prevention during the previous 20 years has shifted from a risk-focused paradigm to a youth development model that places young people at the center of their sexual health and well-being. During 2005, the Oregon Governor's Office requested that an ad hoc committee of state agency and private partners develop recommendations for the next phase of teen pregnancy prevention. As a result of that collaborative effort, engagement of young people, and community input, the Oregon Youth Sexual Health Plan was released in 2009. The plan focuses on development of young people and embraces sexuality as a natural part of adolescent development. The plan's five goals and eight objectives guide the work of state agencies and partners addressing youth sexual health. Oregon's development of a statewide plan can serve as a framework for other states and entities to address all aspects of youth sexual health.
Rhodes, Frank H. T.
Discusses sexual harassment on college campuses. Focuses on harassing behavior that stems from power relationships and harassing behavior among peers. Describes how Cornell University is addressing these problems. (ABL)
Jozkowski, Kristen N; Peterson, Zoë D; Sanders, Stephanie A; Dennis, Barbara; Reece, Michael
Because sexual assault is often defined in terms of nonconsent, many prevention efforts focus on promoting the clear communication of consent as a mechanism to reduce assault. Yet little research has specifically examined how sexual consent is being conceptualized by heterosexual college students. In this study, 185 Midwestern U.S. college students provided responses to open-ended questions addressing how they define, communicate, and interpret sexual consent and nonconsent. The study aimed to assess how college students define and communicate consent, with particular attention to gender differences in consent. Results indicated no gender differences in defining consent. However, there were significant differences in how men and women indicated their own consent and nonconsent, with women reporting more verbal strategies than men and men reporting more nonverbal strategies than women, and in how they interpreted their partner's consent and nonconsent, with men relying more on nonverbal indicators of consent than women. Such gender differences may help to explain some misunderstandings or misinterpretations of consent or agreement to engage in sexual activity, which could partially contribute to the occurrence of acquaintance rape; thus, a better understanding of consent has important implications for developing sexual assault prevention initiatives.
Campbell, Cody; Kramer, Alaina; Woolman, Kendra; Staecker, Emma; Visker, Joseph; Cox, Carol
Administrators from three workplaces were interested in conducting evidence-based sexual harassment prevention training for their employees, but they could devote little time during the workday to the training. A pilot program to evaluate the use of a 1-hour workshop that followed best practice recommendations and adult learning principles using job-related scenarios was designed. Participants' overall sexual harassment prevention knowledge scores significantly increased from before to after the workshop and were significantly higher after the workshop than those of a control group. The majority of participants also perceived that their workplaces were committed to employees understanding the sexual harassment policy, and that the workplace would seriously investigate claims and take corrective action. Even a brief workshop covering essential content using adult learning principles can be effective in sexual harassment prevention knowledge acquisition. Copyright 2013, SLACK Incorporated.
Cooper, B; Toskin, I; Kulier, R; Allen, T; Hawkes, S
Throughout the last decade substantial research has been undertaken to develop evidence-based behaviour change interventions for sexual health promotion. Primary care could provide an opportunistic entry for brief sexual health communication. We conducted a systematic review to explore opportunistic sexual and reproductive health services for sexual health communication delivered at primary health care level. We searched for studies on PubMed, ProQuest, CINAHL, Jstor, Scopus/Science Direct, Cochrane database of systematic reviews, EBSCO, CINAHL, PsychoInfo, and Web of Knowledge. Both published and unpublished articles were reviewed. All randomised controlled trials and controlled clinical trials were included. Participants of all ages, from adolescence onwards were included. Brief (10-60 minutes) interventions including some aspect of communication on sexual health issues were included. Data were extracted by two reviewers independently using a standardised form. Interventions differed from each other, hence meta-analysis was not performed, and results are presented individually. A total of 247 articles were selected for full-text evaluation, 31 of which were included. Sexually transmitted infections (STIs)/HIV were less often reported in the intervention group compared with the control group. Condom use was higher in most studies in the intervention group. Numbers of sexual partners and unprotected sexual intercourse were lower in the intervention groups. There is evidence that brief counselling interventions have some effect in the reduction and prevention of STIs/HIV. Some questions could not be answered, such as the effect over time and in different settings and population groups. © 2014 Royal College of Obstetricians and Gynaecologists.
This IFR proposes standards and procedures to prevent, detect, and respond to sexual abuse and sexual harassment involving unaccompanied children (UCs) in ORR's care provider facilities. DATES: This IFR is effective on December 24, 2014. ORR care provider facilities must be in compliance with this IFR by June 24, 2015 but encourages care provider facilities to be in compliance sooner, if possible. HHS will work with facilities to implement and enforce the standards contained in this rule. Comments on this IFR must be received on or before February 23, 2015.
Saranrittichai, Kesinee; Sritanyarat, Wanapa; Ayuwat, Dusadee
Since adolescents are now engaging in sexual activity in their early years, sexual behavior needs to be explored to prevent contact with HPVs and other sexually transmitted diseases (STD), including cervical cancer. This qualitative study aimed to explore this question from adolescents' view points in their natural context. The participants were 19 individuals aged 13-19 years living in rural families in Khon Kaen province, Thailand. The preliminary findings indicated that factors contributing to low sexual risk behavior were helping family to do housework, an emphasis on learning, listening to parents, and following their advice. Adolescent behavior leading to high sexual risk included being very close to friends, having a wide social circle, going out for enjoyment at night time, returning home late at night, drinking alcohol, smoking, paying less attention to learning, not listening to parents, and not following their advice. Adolescent sexual behavior was found to comprise: 1) sexual activities themselves; 2) non-disclosure of having sex; and 3) protective behavior. Sexual activities were ranked from low risk to high risk of sexual health. Low risk included having a steady boy/girlfriend, hugging, and kissing. High risk sexual behavior featured unprotected sex, abuse or rape, and abortion. Important influences were: eagerness to learn and try to have sex, mens' sexual desire, peer group value of having sex, and material value. The adolescents demonstrated no willingness to disclose having a boy/girl friend, having sex and negative consequences like becoming pregnant. Sexual protective behavior was up to males, whether they were willing to use a condom, with females having little power to negotiate. The study suggests that inappropriate adolescent risk behavior and social values need to be a focus of attention for education. In particular, families need to take action by early detection of adolescent sexual risk behavior.
Robb, L A; Doverspike, D
The interaction between the likelihood of males engaging in sexual harassment and the effectiveness of a 1-hr. sexual harassment-prevention training was explored in a laboratory study. An interaction of scores on the Likelihood to Sexually Harass Scale and training condition for 90 undergraduate men was found, such that sexual harassment-prevention training had a small negative effect on the attitudes of males with a high proclivity to harass.
Scholes, Laura; Jones, Christian; Stieler-Hunt, Colleen; Rolfe, Ben
In spite of research demonstrating conceptual weakness in many child sexual abuse (CSA) prevention programmes and outdated modes of delivery, students continue to participate in a diversity of initiatives. Referring to the development of a games-based approach to CSA prevention in Australia, this paper examines empirically based attributes of…
Tucker, C.; Arandi, C. Galindo; Bolaños, J. Herbert; Paz-Bailey, G.; Barrington, C.
Sexual minority men and transgender women are disproportionately affected by HIV in Guatemala. Innovative prevention strategies are urgently needed to address these disparities. While social network approaches are frequently used to reach sexual minorities, little is known about the unique network characteristics among sub-groups. We conducted in-depth qualitative interviews with 13 gay-identifying men, eight non-gay-identifying men who have sex with men (MSM) and eight transgender women in Guatemala City. Using narrative and thematic coding procedures, we identified distinct patterns in the size, composition, and overlap between social and sexual networks across groups. Gay-identifying men had the largest, most supportive social networks, predominantly comprising family. For both non-gay-identifying MSM and transgender women, friends and sex clients provided more support. Transgender women reported the smallest social networks, least social support, and the most discrimination. HIV prevention efforts should be tailored to the specific sexual minority population and engage with strong ties. PMID:25418236
Pletcher, Beth A
The American Academy of Pediatrics is committed to working to ensure that workplaces and educational settings in which pediatricians spend time are free of sexual harassment. The purpose of this statement is to heighten awareness and sensitivity to this important issue, recognizing that institutions, clinics, and office-based practices may have existing policies.
Although illegal, sexual harassment is frequent in the American workplace and extremely disruptive and costly to employees and employers alike. Most organizational responses to the problem have been hard line, short term, after-the-fact measures that inform, threaten, or discipline employees. What is needed, however, is a training program with an…
Dec 1, 2006 ... Condom use with casual partners increased from 53% among the men and 46% among the women before the diagnosis ... Conclusions. The ART had an overall positive effect on health with no increase of sexual risk behaviour. ... were calculated by a statistician using the computer program for binominal ...
.... Ways to enhance the quality, utility, and clarity of the information to be collected; and d. Ways to... consent. There is no consent where the person is sleeping or incapacitated, such as due to age, alcohol or... information about a sexual assault comes to the commander's or law enforcement official's attention from a...
Matusitz, Jonathan; Breen, Gerald Mark
This paper is an examination of how Inoculation Theory can be applied in the prevention of sexual harassment in the medical setting. The basic tenet of the theory is the study of the processes through which we withstand and oppose attitude transformation during social interactions that may influence or change our attitudes. More importantly, this paper analyzes sexual harassment as a pervasive phenomenon in the medical setting. As such, it defines what sexual harassment is, explains the prevalence of sexual harassment between the physician and the patient, describes some of the general studies conducted in medical settings, provides a case scenario of doctor-patient sexual harassment, and identifies some key consequences to doctors, patients, and society.
Coles, Jan; Dartnall, Elizabeth; Astbury, Jill
Primary care professionals (PCPs) are increasingly being expected to identify and respond to family and sexual violence as the chronic nature and severity of the long-term health impacts are increasingly recognized. This discussion paper reports the authors' expert opinion from their experiences running international workshops to prevent trauma among those who work and research sexual violence. It describes the burnout and secondary traumatic stress literature which provides the evidence supp...
males is limited. The Department is now working to increase research-informed, gender -specific prevention techniques that address male specific...training must aim to prevent the broad range of sexual misconduct and unlawful discrimination . Gap between Standard and Existing Practices The Services...supervisor training to engage leaders in preventing male victimization and reducing associated stigma (objective 2) 11 • Gender -responsive treatment (to
On the basis of a representative survey carried out in 2007 of the Portuguese population aged between 18 and 65, this study investigates the impact of factors during the course of sexual life on risk-taking behavior and perceptions among 3055 heterosexual men and women. A number of sexual biography profiles were identified through cluster analysis of indicators related to the identity, number and sequence of partners throughout life. We discovered different profiles, from systematic occasional partnerships and use of paid sex, more frequent among men, to the single partner profile, which is more prevalent among women. By carrying out several linear regression analyses, we were able to evaluate the predictive impact of biographical factors on condom use and prevention behavior. Our results indicate that sexual biographies are more important in explaining the prevalence of condom use with different sexual partners. On the other hand, fear of infection and information on HIV transmission seem to influence the cognitive mobilization of prevention strategies and change of sexual behavior. However, condom use is still more dependent on sexual life pattern and interaction with sexual partners.
Abnormal vaginal discharge due to reproductive tract infections (RTIs) is widely prevalent in the country. According to WHO, over 300 million new cases of sexually-transmitted infections (excluding HIV) occur each year. In addition to these, HIV infection is spreading rapidly in the country with over 3.7 million sero-positive cases (from zero) within 15 years.. The predominant mode of transmission of HIV is by heterosexual route. The multidrug regime for treatment is expensive (about $...
Full Text Available Background: Emerging findings have shown that high parental monitoring of adolescents’ sexual and reproductive health (SRH communications between parents and adolescents and good parenting styles prevent adolescents from engaging in risky sexual practices. Objective: The aim of this study was to examine the associations of parental monitoring, parent–adolescent SRH communications, and parenting styles with risky sexual practices among adolescents in Harar, Ethiopia. Designs: This was a cross-sectional study conducted on adolescents aged 13–18 who had sexual initiations. Adolescents who failed to use any contraceptive method and/or condom during last sexual intercourse and who experienced multiple sexual partners in the 12 months prior to the study were taken as ‘at risk’. In view of these, the adolescents risk count ranged from zero to three – greater number indicates higher count of risky sexual practices. Poisson regression model was used to examine the associations and p<0.05 indicated a statistical significance. Results: It was found out that 301 of 633 (47.55%; 95% CI=43.62%, 51.45% adolescents experienced one or more risky sexual practices. High parental monitoring compared to low decreases the Incidence Rate of engaging in risky sexual practices by 28% (adjusted incidence rate ratio, or IRR=0.72; 95% CI=0.520, 0.986. Those who had a satisfactory level of SRH communications with their parents compared to poor communicators experianced less incidence rate of risky sexual practices which was marginal (adjusted IRR=0.82; 95% CI=0.637, 1.051. Conclusions: A significant proportion of the adolescents engaged in one or more risky sexual practices. Importantly, high parental monitoring decreases the likelihood of these risky practices. Therefore, parents need to be encouraged to keep an eye on their young children.
During the 1980’s and 1990’s several Sexual Assault Centers were established in the Nordic countries in order to counteract the health consequences of sexual assault. In Denmark the Western Danish Sexual Assault Center (WDSAC) was established in November 1999 in the town of Aarhus. The victims ar...... as the frequency of posttraumatic stress disorder in relation to sexual assault. Multidisciplinary centers as WDSAC may be the strategy for preventing the serious disability of the posttraumatic stress disorder following sexual assault.......During the 1980’s and 1990’s several Sexual Assault Centers were established in the Nordic countries in order to counteract the health consequences of sexual assault. In Denmark the Western Danish Sexual Assault Center (WDSAC) was established in November 1999 in the town of Aarhus. The victims...... are under the circumstances of trust, safety and interdependence offered care, treatment and medical examination including a standardized forensic examination. From 1999 to 2004 the Center has received 523 victims, 338 (64%) of who were seen by the physician. 349 (67%) victims have reported the case...
Lampert, Jo; Walsh, Kerryann
Children's picture books dealing with the topic of child sexual abuse appeared in the 1980s with the aim of addressing the need for age-appropriate texts to teach sexual abuse prevention concepts and to provide support for young children who may be at risk of or have already experienced sexual abuse. Despite the apparent potential of children's…
Gacoin, Andrée E.
Sexuality education as an HIV prevention strategy is positioned as a way to empower youth in relation to their sexual identities and behaviours. While the youth subject is recognized as complex, the underlying premise is that identity can be targeted "through" sexuality education. In this paper, I present data from an ethnographic…
Ekbia, Hamid R.
Abstract Objective: Sexual assault is prevalent among college students. In response, universities have implemented prevention education initiatives. These interventions, however, often ignore the broader sociocultural context in which sexual violence occurs. This calls for innovative approaches in prevention education, which address the broader context. Computer games provide such an opportunity by providing simulated real-life scenarios, nonlinear narratives, and an interactive medium. We report the development and pilot testing of “Campus Craft,” a game prototype that focuses, among other things, on sexual assault prevention. Materials and Methods: The prototype was developed through a participatory design process; students, educators, and subject matter experts helped design and develop scenarios, game mechanics, and learning objectives. The prototype was evaluated by college students (n=141) in a multi-method approach. The evaluation encompassed issues of usability, game mechanics, attitudes, and learning outcomes. Results: Findings indicated that participants rated various aspects of the game positively. Additionally, use of “Campus Craft” contributed to differences in student learning of prevention concepts between the pre- and post-test such that students scored higher on the post-test. Conclusions: Findings demonstrate that, on average, students learned several core concepts related to sexual consent and rape culture through gameplay. Results suggest that computer-based gaming may be a viable avenue for sexual assault prevention education. Findings demonstrate that this approach could be effective in increasing student knowledge and understanding of factors that contribute to sexual assault in college. Future research is needed to corroborate findings and better understand the feasibility of using this approach among larger samples of college students. PMID:26181803
Schwinn, Traci Marie; Thom, Bridgette; Schinke, Steven Paul; Hopkins, Jessica
Rates of drug use among sexual-minority youths are disproportionately high. Yet, expressly designed prevention programs targeting this population are absent. This study developed and tested a web-based drug abuse prevention program for sexual-minority youths. A sample (N = 236) of sexual-minority youths was recruited via Facebook. Online, all youths completed pretests; youths randomly assigned to the intervention received a 3-session prevention program; and all youths completed posttest and 3-month follow-up measurements. At 3-month follow-up and compared to youths in the control arm, intervention-arm youths reported less stress, reduced peer drug use, lower rates of past 30-day other drug use, and higher coping, problem solving, and drug-use refusal skills. Outcome data suggest the potential of tailored intervention content to address sexual-minority youths' drug use rates and related risk factors. Moreover, study procedures lend support to the feasibility of using the Internet to recruit sexual-minority youths, collect data, and deliver intervention. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Sexual Norms for Lesbian and Bisexual Women in a Culture Where Lesbianism Is Not Acceptable Enough: The Japanese Survey About Sexual Behaviors, STIs Preventive Behaviors, and the Value of Sexual Relations.
This study aimed to identify key factors preventing STIs among women who have sex with women in Japan. This description is based on survey and open-ended responses from participants. The questionnaire contained participants' background, sexual behavior, STI prevention behavior, experience and knowledge of STIs, and the value of sex with women. 104 responded, and 92 (88.5 %) reported having sexual experience with women. A variety of sexual behaviors were reported. Regarding STIs, 14.4% of participants had an STI in past. Almost half of the participants cited measures to prevent STIs included hygienic activities. Participants believed that sexual relations accompany partnership with females.
Syamtinningrum, M. D. P.; Partiwi, S. G.; Dewi, D. S.
One indicator of a good company is when a safe business environment can be well maintained. In this work environment, the number of industrial accidents is minimum. Industrial accidents are the incidents that occurred in the workplace, especially in industrial area. Industrial accidents are generally caused by two main reasons, unsafe actions & unsafe conditions. Some research indicates that unsafe actions significantly affect the incidence in the workplace. Unsafe action is a failure to follow the proper procedures and requirements, which is led into accidents. From several previous studies it can be concluded that personal factors & OHS management are two most influential factors that affect unsafe actions. However, their relationship in influencing unsafe actions is not fully understood. Based on this reason the authors want to investigate the effect of personal factors and OHS management toward unsafe actions to workers. For this purpose, a company is selected as a case study. In this research, analyses were done by using univariate test, bivariate correlation and linear regression. The results of this study proves that two indicators of personal factors (i.e. knowledge of OHS & OHS training) and OHS management have significant effect on unsafe actions but in negative direction, while two indicators of personal factors (i.e. workload & fatigue) have positive direction of effect on unsafe actions. In addition, this research has developed a mathematical model that can be used to calculate and predict the value of unsafe actions performed by the worker. By using this model, the company will able to take preventive actions toward unsafe actions to reduce workers accidents.
2014-2016 DoD Sexual Assault Prevention Strategy? e. Education and Training 1. Not at all 2. Small extent 3. Moderate extent 4. Large extent 5...challenges in implementing the elements of the DoD Sexual Assault Prevention Strategy? f. Not enough continuing education opportunities to enhance...continuing education credits for the Defense Sexual Assault Advocate Certification Program (D-SAACP). 43. Are you familiar with SAPR Connect
Weist, Mark D.; Bryant, Yaphet U.; Dantzler, Joyce; Martin, Saran; D'Amico, Marie; Griffith, Brian; Gallun, Betsy
Purpose: The purpose of this paper is to identify best practices in the implementation of school-based sexual violence prevention education. Design/methodology/approach: A three-phase plan was implemented to evaluate the Sexual Harassment/Assault Prevention Project (SHAPP) in one state in the USA. First, a structured review of the prevention…
Ogunfowokan, Adesola A.; Fajemilehin, Reuben B.
Sexual abuse has been considered a public health issue because of the various health implications resulting from it. The school nurse has a responsibility in assisting the high school girl to prevent victimization. This study adopted a quasi-experimental design in which a sexual abuse prevention education package was developed and used to educate…
Tharp, Andra Teten; DeGue, Sarah; Lang, Karen; Valle, Linda Anne; Massetti, Greta; Holt, Melissa; Matjasko, Jennifer
Foubert, Godin, and Tatum describe qualitative effects among college men of The Men's Program, a one-session sexual violence prevention program. This article and the program it describes are representative of many sexual violence prevention programs that are in practice and provide an opportunity for a brief discussion of the development and…
Lazarus, Jeff; Sihvonen-Riemenschneider, Henna; Laukamm-Josten, Ulrich
To examine the effectiveness of interventions seeking to prevent the spread of sexually transmitted infections (STIs), including HIV, among young people in the European Union.......To examine the effectiveness of interventions seeking to prevent the spread of sexually transmitted infections (STIs), including HIV, among young people in the European Union....
Cecen-Erogul, Ayse Rezan; Kaf Hasirci, Ozlem
In Turkey, there is neither systematic nor structured child sexual abuse prevention programs for school-aged children in school settings. The main purpose of this study was to investigate the effectiveness of a school-based child sexual abuse prevention program on elementary school (4th grade) students. Quasi-experimental design with pretest,…
The drug-related death of Dianne Brimble on the P&O cruise liner Pacific Sky in 2002 triggered a wide-ranging review of the safety on board cruise ships operating in the Australian market. This column assesses the frequency of recent sexual assaults on cruise ships and examines the findings and recommendations of the Brimble inquest, focusing on the Commonwealth government's response to those recommendations. The problem of jurisdiction on flag of convenience registered ships is discussed, with emphasis on a possible co-operative arrangement between Australian police and foreign flag states. It seems likely that the United States and Canadian models of cruise ship regulation to enhance passenger safety will in part be introduced in Australia.
Shepherd, J.; Harden, A.; Barnett-Page, E.; Kavanagh, J.; Picot, J.; Frampton, G. K.; Cooper, K.; Hartwell, D.; Clegg, A.
This article discusses how process indicators can complement outcomes as part of a comprehensive explanatory evaluation framework, using the example of skills-based behavioural interventions to prevent sexually transmitted infections and promote sexual health among young people in schools. A systematic review was conducted, yielding 12 eligible…
Nystrom, Robert J.; Duke, Jessica E.A.; Victor, Brad
Oregon's work on teen pregnancy prevention during the previous 20 years has shifted from a risk-focused paradigm to a youth development model that places young people at the center of their sexual health and well-being. During 2005, the Oregon Governor's Office requested that an ad hoc committee of state agency and private partners develop recommendations for the next phase of teen pregnancy prevention. As a result of that collaborative effort, engagement of young people, and community input,...
Gevers, Aník; Dartnall, Elizabeth
In this short communication, we assert that mental health has a crucial role in the primary prevention of sexual and gender-based violence (SGBV). However, we found that most research and practice to date has focused on the role of mental health post-violence, and SGBV primary prevention is relying on public health models that do not explicitly include mental health. Yet, key concepts, processes, and competencies in the mental health field appear essential to successful SGBV primary preventio...
Full Text Available The current research took place at Saint Francis Hospital. It is a hospital based health survey using semi-structured questionnaire. A total number of 39 youths participated in the study, including 28 adolescents (71.8% and 11 older youths (28.2%. The majority were single and school going girls. 37% of adolescent had their first sex intercourse on the year following menarche. The average ages at menarche and first sex were 13 years and 15 years respectively for both groups. Most girls (61.5% did not know their HIV status while 38.5% were HIV negative. All pregnancies were unplanned and unwanted, resulting in induced abortions. The majority of abortions were unsafe and unsanitary, conducted in the bush, in homes/villages, at school, and sometimes in drug shops. They were either self induced or conducted by lay providers. Only 28.6% of adolescent had used contraceptives in the past, mostly condoms; as compared to 54.5% of older youths. 67.9% of adolescents and 81.8% of older youths were involved in risky, unstable relationships (multiple and/or concurrent sexual partners. The common complications of abortions were: retained product of conception, sepsis, haemorrhage, shock, pelvic infection, and lacerations of the cervix. Projects and programmes aiming at addressing unsafe sex and reproductive health needs among young people are urgently needed.
... victims, and hold offenders accountable. The Department of Justice's Office on Violence Against Women is... Proclamation Our Nation must continue to confront rape and other forms of sexual violence as a deplorable crime... Assault Awareness and Prevention Month, we recommit to building a society where no woman, man, or child...
Banyard, Victoria L.; Plante, Elizabethe G.; Moynihan, Mary M.
Recent research documents the problem of sexual violence across communities, often finding its causes to be embedded in community and cultural norms, thus demonstrating the need for community-focused solutions. In this article we synthesize research from community psychology on community change and prevention with more individually focused studies…
Menning, Chadwick; Holtzman, Mellisa
Objective: The object of this study is to extend prior evaluations of Elemental, a sexual assault protection program that combines primary prevention and risk reduction strategies within a single program. Participants and Methods: During 2012 and 2013, program group and control group students completed pretest, posttest, and 6-week and 6-month…
Wilkerson, J. Michael; Smolenski, Derek J.; Morgan, Richard; Rosser, B. R. Simon
HIV prevention educators frequently encourage gay and bisexual men (GBM) to negotiate condom use prior to sexual engagement. Identifying groups of GBM based on their presexual agreements can aid efforts to tailor interventions. Using cross-sectional data from 1,188 GBM who reported having sex with a nonprimary sex partner in the 90 days prior to…
Ige, Olusimbo K.; Fawole, Olufunmilayo I.
This study examined parents' perceptions of child sexual abuse as well as prevention practices in an urban community in southwest Nigeria. Questionnaires were collected from 387 parents and caregivers of children younger than 15 years of age. Results showed that many parents felt CSA was a common problem in the community, and most parents…
Schober, Daniel J.; Fawcett, Stephen B.; Bernier, Jetta
This case study describes the Enough Abuse Campaign, a multidisciplinary, statewide effort to prevent child sexual abuse in Massachusetts. The study uses the Institute of Medicine's Framework for Collaborative Community Action on Health to provide a systematic description of the campaign's process of implementation, which includes: (a) developing…
Walsh, Kerryann; Brandon, Leisa
In this descriptive focus group study, we investigated parents' views about child sexual abuse prevention education at home and in schools. Focus groups were conducted with a sample of 30 Australian adults who identified as the parent or caregiver of a child/children aged 0-5 years. The study explored (1) parents' "knowledge" about child…
Moynihan, Mary M.; Banyard, Victoria L.; Arnold, Julie S.; Eckstein, Robert P.; Stapleton, Jane G.
Objective: The object of this exploratory evaluation was to evaluate the "Bringing in the Bystander" sexual and intimate partner violence prevention program with a new sample of intercollegiate athletes. Participants and Methods: Fifty-three male and female athletes participated in the program (experimental group), and 86 were in the control…
Stewart, Clarence, M., Jr.
This article deals with a service-learning program focused on human sexuality and HIV/AIDS prevention and intervention at the Howard University Department of Health, Human Performance and Leisure Studies. Topics discussed include how this program was created, an overview of peer education, HIV/AIDS peer education training, and services provided to…
Kopp, Brandon; Miltenberger, Raymond G.
In research evaluating sexual abuse prevention programs, knowledge measures are typically used to assess the program's success. In other areas of research on child safety skills, however, skills are typically assessed through behavioral measures such as role-plays. The purpose of this study was to assess the validity and acceptability of a set of…
Boyd, Andrew T; Becknell, Kristin; Russell, Steven; Blanton, Curtis; Cookson, Susan T; Bilukha, Oleg O; Anderson, Mark
Following decades of armed conflict, Colombia remains highly affected by explosive device (ED) contamination, especially in rural areas. Many victims are injured by EDs despite knowing their dangers. Determining risk factors for unsafe behaviors toward EDs, including grenades, is critical for preventing injuries. In 2012, CDC assisted Colombian partners in conducting a multi-stage knowledge, attitudes, and practices survey in rural ED-affected areas. Within each of 40 clusters, 28 households were selected, and participants aged 10 years or older were asked about behaviors toward EDs. Participants reported actual behaviors toward past EDs encountered and theoretical behaviors toward EDs not encountered. Behaviors were a priori classified as unsafe or safe. This analysis focuses on behaviors toward the most commonly encountered device, grenades. Of 928 adult and 562 child participants, 488 (52.5%) adults and 249 (43.9%) children encountered ED, while 121 (13.7%) adults and 148 (26.9%) children received mine risk education (MRE). Among the 430 (46.7%) adults who encountered grenades, 113 (25.7%) reported unsafe behaviors; multivariable analysis showed that unsafe behavior was associated with working outdoors (adjusted odds ratio [aOR]: 1.7, 95% confidence interval [CI]: 1.1-2.7). Among the 429 (46.5%) adults who did not encounter ED, 61 (14.6%) described unsafe theoretical behaviors toward grenades; multivariable analysis showed that unsafe behavior was associated with older age (aOR: 1.02, 95% confidence limit [CL]: 1.00-1.05) and black or Afro-Colombian identity (aOR: 2.5, 95% CI 1.3-5.1). Among the 181 (32.0%) children who encountered grenades, 41 (23.8%) reported unsafe behaviors, while among the 311 (55.9%) children who did not encounter ED, 30 (10.2%) reported unsafe behavior. In both groups of children, multivariable analysis showed that unsafe behavior was associated with lower mean score on knowledge of ED, with aOR: 0.7, 95% CL: 0.6-0.9, and aOR: 0.8, 95
Rudolph, Julia; Zimmer-Gembeck, Melanie J; Shanley, Dianne C; Hawkins, Russell
To date, child sexual abuse (CSA) prevention has relied largely on child-focused education, teaching children how to identify, avoid, and disclose sexual abuse. The purpose of this article is to explore how prevention opportunities can include parents in new and innovative ways. We propose that parents can play a significant role as protectors of their children via two pathways: (i) directly, through the strong external barriers afforded by parent supervision, monitoring, and involvement; and (ii) indirectly, by promoting their children's self-efficacy, competence, well-being, and self-esteem, which the balance of evidence suggests will help them become less likely targets for abuse and more able to respond appropriately and disclose abuse if it occurs. In this article, we first describe why teaching young children about CSA protective behaviors might not be sufficient for prevention. We then narratively review the existing research on parents and prevention and the parenting and family circumstances that may increase a child's risk of experiencing sexual abuse. Finally, we make a number of recommendations for future approaches to prevention that may better inform and involve parents and other adult protectors in preventing CSA.
Date rape - prevention; Sexual assault - prevention ... Centers for Disease Control and Prevention website. Sexual assault and abuse and STDs. In: 2015 sexually transmitted diseases treatment guidelines 2015. www.cdc.gov/std/tg2015/sexual- ...
February 2004. EAST AFRICAN MEDICAL JOURNAL. 61. EDITORIAL. UNSAFE ABORTION AND MATERNAL MORTALITY: IS AFRICA PREPARED. TO FACE THE REALITY? Sub-Saharan Africa has, by far, the highest maternal mortality ratio today. It is estimated that the risk of dying from pregnancy-related cause for a girl ...
Mamo, Laura; Epstein, Steven
Vaccine development is a core component of pharmaceutical industry activity and a key site for studying pharmaceuticalization processes. In recent decades, two so-called cancer vaccines have entered the U.S. medical marketplace: a vaccine targeting hepatitis B virus (HBV) to prevent liver cancers and a vaccine targeting human papillomavirus (HPV) to prevent cervical and other cancers. These viruses are two of six sexually transmissible infectious agents (STIs) that are causally linked to the development of cancers; collectively they reference an expanding approach to apprehending cancer that focuses attention simultaneously "inward" toward biomolecular processes and "outward" toward risk behaviors, sexual practices, and lifestyles. This paper juxtaposes the cases of HBV and HPV and their vaccine trajectories to analyze how vaccines, like pharmaceuticals more generally, are emblematic of contemporary pharmaceuticalization processes. We argue that individualized risk, in this case sexual risk, is produced and treated by scientific claims of links between STIs and cancers and through pharmaceutical company and biomedical practices. Simultaneous processes of sexualization and pharmaceuticalization mark these cases. Our comparison demonstrates that these processes are not uniform, and that the production of risks, subjects, and bodies depends not only on the specificities of vaccine development but also on the broader political and cultural frames within which sexuality is understood. Copyright © 2013 Elsevier Ltd. All rights reserved.
Mallet, Pascal; Herbé, Dominique
Believing that rape is acceptable in some situations may account for adolescent boys' perpetration of forced sex on girls. This study was intended to examine two hypothesized cognitive factors of adolescents' rape-supportive beliefs: general knowledge, measured with grade point average (GPA); and specific knowledge about sexuality, measured with a newly devised questionnaire. Fourteen-year-old adolescents (N = 248) participated in a short-term longitudinal study. They completed questionnaires designed to assess sexual knowledge and rape-supportive beliefs, and six months later completed them again. Sexual knowledge increased sharply between Time 1 and Time 2, whereas rape-supportive beliefs decreased during the same time. Boys obtained higher rape-supportive belief scores than girls. Regression analyses showed that sexual knowledge significantly predicted the level of rape-supportive beliefs six months later, independent of GPA and sex of participants. GPA accounted for a greater part of the variance in rape-supportive beliefs. This article discusses the importance of paying attention to the level of academic achievement of adolescents, as well as to their sexuality-specific knowledge, as a way of improving the efficiency of programs specializing in the prevention of adolescent sexual violence.
McCartan, Kieran F; Merdian, Hannah L; Perkins, Derek E; Kettleborough, Danielle
This article discusses the ethical, practical, and moral issues surrounding secondary prevention efforts of child sexual abuse from a professional and practice-based perspective. Transcripts of a semistructured consultation event with n = 15 international experts on the secondary prevention of child sexual abuse were analysed using thematic qualitative analysis. The research identified four main critical areas linked to secondary prevention efforts, including, the psychology of self-reporting and disclosure; the interaction with and within existing legal, social, and professional frameworks; the scale and type of an appropriate response; and potential hurdles (i.e., within media, public, politics). The article outlines these areas, highlighting participant perspectives on risk-enhancing and mitigating factors for each domain.
Gevers, Aník; Dartnall, Elizabeth
In this short communication, we assert that mental health has a crucial role in the primary prevention of sexual and gender-based violence (SGBV). However, we found that most research and practice to date has focused on the role of mental health post-violence, and SGBV primary prevention is relying on public health models that do not explicitly include mental health. Yet, key concepts, processes, and competencies in the mental health field appear essential to successful SGBV primary prevention. For example, empathy, self-esteem, compassion, emotional regulation and resilience, stress management, relationship building, and challenging problematic social norms are crucial. Furthermore, competencies such as rapport building, group processing, emotional nurturing, modelling, and the prevention of vicarious trauma among staff are important for the successful implementation of SGBV primary prevention programmes. SGBV primary prevention work would benefit from increased collaboration with mental health professionals and integration of key mental health concepts, processes, and skills in SGBV research.
Full Text Available In this short communication, we assert that mental health has a crucial role in the primary prevention of sexual and gender-based violence (SGBV. However, we found that most research and practice to date has focused on the role of mental health post-violence, and SGBV primary prevention is relying on public health models that do not explicitly include mental health. Yet, key concepts, processes, and competencies in the mental health field appear essential to successful SGBV primary prevention. For example, empathy, self-esteem, compassion, emotional regulation and resilience, stress management, relationship building, and challenging problematic social norms are crucial. Furthermore, competencies such as rapport building, group processing, emotional nurturing, modelling, and the prevention of vicarious trauma among staff are important for the successful implementation of SGBV primary prevention programmes. SGBV primary prevention work would benefit from increased collaboration with mental health professionals and integration of key mental health concepts, processes, and skills in SGBV research.
Cruz, Theresa H; Hess, Julia Meredith; Woelk, Leona; Bear, Samantha
Sexual violence is of special concern in New Mexico because of the presence of large priority populations in which its prevalence is high. This article describes a 3-component approach to developing a strategic plan to prevent sexual violence in the state that consisted of an advisory group, subject matter experts, and focus groups from geographically and demographically diverse communities. Both common and community-specific themes emerged from the focus groups and were included in the strategic plan. By incorporating community needs and experiences, this approach fosters increased investment in plan implementation.
Moynihan, Mary M; Banyard, Victoria L; Cares, Alison C; Potter, Sharyn J; Williams, Linda M; Stapleton, Jane G
Colleges and universities are high-risk settings for sexual and relationship violence. To address these problems, institutions of higher education have implemented prevention programs, many of which train students as potential bystanders who can step in to help diffuse risky situations, identify and challenge perpetrators, and assist victims. The impact of bystander sexual and relationship violence prevention programs on long-term behavior of bystanders has remained a key unanswered question for those who seek to offer the most effective programs as well as for policy makers. In this study, the researchers experimentally evaluated the effectiveness of the Bringing in the Bystander® in-person program. Participants were 948 1st-year college students of whom 47.8% were women and 85.2% identified as White (15% also identified as Hispanic in a separate question) between the ages of 18 and 24 at two universities (one a rural, primarily residential campus and the other an urban, highly commuter campus) in the northeastern United States. To date, this is the first study to have found positive behavior changes as long-lasting as 1 year following an educational workshop focusing on engaging bystanders in preventing sexual and relationship violence. Even so, many questions remain to be answered about prevention and intervention of this type. More prospective research is needed on bystander-focused prevention of these forms of violence to help understand and better predict the complicated relationships both between and among the attitudes and behaviors related to preventing sexual and relationship violence. In this regard, we make specific recommendations for designing and evaluating programs based on our findings relating to the importance of moderators, especially two key understudied ones, readiness to help and opportunity to intervene. © The Author(s) 2014.
Unsafe abortion and its complications have been limited to adolescents lacking family and partner support without attention to older, married women and their peculiarities regarding unsafe abortions. Main objective of the study was to focus on uncommon contributing factors to unsafe abortion in older women. A 40year old ...
Worldwide, approximately 300,000 people have AIDS, and there are 50-100 infections for each case. Responsible sexual behavior is crucial for prevention, since sexual transmission is the principal route of contracting AIDS. The major causes of maternal mortality in the 15-39 year age group in Latin America are complications from induced abortion which is also responsible for 40% of global maternal mortality, i.e., 200,000 women die because of induced abortion complications out of 500,000 women who succumb to pregnancy- and birth-related caused annually. In the 1980s 38% of deaths in Chile were related to abortion of women who died in reproductive age. In developing countries almost 50% of hospital admissions occur because of abortion sequelae. Infant mortality is higher in 20-year old mothers giving birth compared with the 20-29 age group. 40,000 children are born/year in Chile to mothers 20. In 1980 these births made up 16.7% of all births. 45% of births of mothers 20 are illegitimate. These young mothers are often unprepared for the parental role: 80% of children hospitalized for malnutrition were children of adolescent mothers according to a survey. The Catholic Church's view opposing contraceptives and sexuality outside of marriage conflicts with contemporary opinion backed by mass media favoring sexuality as leading to personal enrichment and advocating contraception. More than 60% of boys and more than 30% of girls start sexual relations 20. Young people do not use contraceptives because of misinformation, difficulty in getting appropriate information, and male machismo. AIDS prevention mandate sex education stressing responsible sexuality with abstinence, condom use, and monogamy.
Odimegwu, Clifford O; Mutanda, Nyasha
Since the advent of HIV/AIDS, sexuality studies in sub-Saharan Africa (SSA) have focused mainly on the sexual behaviour of the younger generation (15-49 years) and little has been done to understand the sexual behaviour of those a 50 years and above. The objective of this study is therefore to examine the covariates of high-risk sexual behaviour among men aged 50 years plus within the SSA region. Data from Demographic and Health Surveys of 10 SSA countries were pooled together and a sample of 5394 men aged 50 years plus who have ever had sex was analysed. Findings show that in SSA, a large proportion of men aged 50 years plus (74%) were sexually active and a substantial proportion of these men engaged in unsafe sexual behaviours, such as having multiple sexual partners and unprotected sex. The multivariate logistic regression analysis showed that involvement with multiple sexual partners was significantly associated with older age, urban residence, religion, having primary or secondary education, and ever taken an HIV test. Condom use at last sex was significantly associated with age at first sex, multiple sexual partners, level of education and ever been tested for HIV. These results suggest that HIV prevention and intervention programmes should also target older men as they are also sexually active and at risk of being infected because of unsafe sexual practices.
Watson, Ryan J; Fish, Jessica N; Allen, Aerielle; Eaton, Lisa
Black men who have sex with men (BMSM) are disproportionately affected by the human immunodeficiency virus (HIV) epidemic, yet we know little about how HIV-negative BMSM of different sexual orientations access HIV prevention strategies. Identity development, minority stress, and disclosure theories suggest that for people of different sexual orientations, disclosure of sexual identity may be related to health behaviors. We performed a latent class analysis on a sample of 650 BMSM (M age = 33.78, SD = 11.44) from Atlanta, Georgia, to explore whether sexual orientation, disclosure of sexual identity, and relationship status were related to HIV prevention strategies, including awareness of PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) and frequency of HIV testing. We found three distinct BMSM classes referred to as (1) closeted bisexuals, (2) sexual identity managers, and (3) gay, out, and open; all classes primarily engaged in casual sex. Classes differed in their awareness and access to HIV prevention strategies. The closeted bisexual class was least aware of and least likely to access HIV prevention. Findings have important implications for future research, namely the consideration of sexual identity and disclosure among BMSM. With this knowledge, we may be able to engage BMSM in HIV/sexually transmitted infection (STI) prevention services.
Leichliter, Jami S; Seiler, Naomi; Wohlfeiler, Dan
Policies are an important part of public health interventions, including in the area of sexually transmitted disease (STD) prevention. Similar to other tools used in public health, policies are often evaluated to determine their usefulness. Therefore, we conducted a nonsystematic review of policy evidence for STD prevention. Our review considers assessments or evaluations of STD prevention-specific policies, health care system policies, and other, broader policies that have the potential to impact STD prevention through social determinants of health. We also describe potential policy opportunity in these areas. It should be noted that we found gaps in policy evidence for some areas; thus, additional research would be useful for public health policy interventions for STD prevention.
Been, L E; Hedges, V L; Vialou, V; Nestler, E J; Meisel, R L
Motivated behaviors, including sexual experience, activate the mesolimbic dopamine system and produce long-lasting molecular and structural changes in the nucleus accumbens. The transcription factor ΔFosB is hypothesized to partly mediate this experience-dependent plasticity. Previous research in our laboratory has demonstrated that overexpressing ΔFosB in the nucleus accumbens of female Syrian hamsters augments the ability of sexual experience to cause the formation of a conditioned place preference. It is unknown, however, whether ΔFosB-mediated transcription in the nucleus accumbens is required for the behavioral consequences of sexual reward. We therefore used an adeno-associated virus to overexpress ΔJunD, a dominant negative binding partner of ΔFosB that decreases ΔFosB-mediated transcription by competitively heterodimerizing with ΔFosB before binding at promotor regions on target genes, in the nucleus accumbens. We found that overexpression of ΔJunD prevented the formation of a conditioned place preference following repeated sexual experiences. These data, when coupled with our previous findings, suggest that ΔFosB is both necessary and sufficient for behavioral plasticity following sexual experience. Furthermore, these results contribute to an important and growing body of literature demonstrating the necessity of endogenous ΔFosB expression in the nucleus accumbens for adaptive responding to naturally rewarding stimuli. © 2013 John Wiley & Sons Ltd and International Behavioural and Neural Genetics Society.
These guidelines for the treatment of patients who have sexually transmitted diseases (STDs) were developed by the Centers for Disease Control and Prevention (CDC) after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on September 26-28, 2000. The information in this report updates the 1998 Guidelines for Treatment of Sexually Transmitted Diseases (MMWR 1998;47 [No. RR-1]). Included in these updated guidelines are new alternative regimens for scabies, bacterial vaginosis, early syphilis, and granuloma inguinale; an expanded section on the diagnosis of genital herpes (including type-specific serologic tests); new recommendations for treatment of recurrent genital herpes among persons infected with human immunodeficiency virus (HIV); a revised approach to the management of victims of sexual assault; expanded regimens for the treatment of urethral meatal warts; and inclusion of hepatitis C as a sexually transmitted infection. In addition, these guidelines emphasize education and counseling for persons infected with human papillomavirus, clarify the diagnostic evaluation of congenital syphilis, and present information regarding the emergence of quinolone-resistant Neisseria gonorrhoeae and implications for treatment. Recommendations also are provided for vaccine-preventable STDs, including hepatitis A and hepatitis B.
Full Text Available The objectives pursued within this paper aimed at the general examination of the European legislative act, and preventing child victimization by the enforcement of national and European law. Preventing victimization of children was approached on three main ways, namely the information, during the criminal proceedings, and at the end of these procedures. The conducted research is a novelty in the field, generally targeting the European normative act, the establishment and enforcement between Member States of complex of preventive measures, that needed to be taken internally first legislatively and then logistically by each Member State. Since internally the Romanian legislation does not provide many of the examined provisions, we believe that the work can be useful to the internal or European institutions working in the field, academic environment as a starting point in achieving other analysis and to the Romanian legislator. The essential contribution to the work, the originality, consists of the examined novelty items that will contribute to the improvement of future Romanian legislation in this particularly sensitive area.
Tragic incident of sexual violence and its dramatic conse- quences oblige the whole social community, and above all doctors and medical staff, to respecting, sympathy and care for the entire welfare of the injured person. For decades the issue of prevention of pregnancy after rape has been giving rise to medical and moral attention in the treatment of the victim, raising the questions Is such a practice justified and are the modern means, methods and procedures, kno...
This thesis explores cultural influences in high-risk behaviour among Egyptian substance users in the Middle Eastern, conservative, male-dominated and predominantly Muslim society in which they live. It investigates why they practice unprotected sex despite the risk of infection by blood-borne viruses (BBVs) and sexually-transmitted infections (STIs), and the factors influencing their risk practices. The study seeks to inform policy and to improve methods of preventing BBVs/STI...
Naranbhai, Vivek; Abdool Karim, Quarraisha; Meyer-Weitz, Anna
Homeless youth are at high risk for HIV infection as a consequence of risky sexual behaviour. Interventions for homeless youth are challenging. Assessment of the effectiveness of interventions to modify sexual risk behaviours for preventing HIV in homeless youth is needed. To evaluate and summarize the effectiveness of interventions for modifying sexual risk behaviours and preventing transmission of HIV among homeless youth. We searched electronic databases (CENTRAL, MEDLINE, EMBASE, AIDSearch, Gateway, PsycInfo, LILACS), reference lists of eligible articles, international health agency publication lists, and clinical trial registries. The search was updated January 2010. We contacted authors of published reports and other key role players. Randomised studies of interventions to modify sexual risk behaviour (biological, self-reporting of sexual-risk behaviour or health-seeking behaviour) in homeless youth (12-24 years). Data from eligible studies were extracted by two reviewers. We assessed risk of bias per the Cochrane Collaborations tool. None of the eligible studies reported any primary biological outcomes for this review. Reports of self-reporting sexual risk behaviour outcomes varied across studies precluding calculation of summary measures of effect; we present the outcomes descriptively for each study. We contacted authors for missing or ambiguous data. We identified three eligible studies after screening a total of 255 unique records. All three were performed in the United States of America and recruited substance-abusing male and female adolescents (total N=615) through homeless shelters into randomised controlled trials of independent and non-overlapping behavioural interventions. The three trials differed in theoretical background, delivery method, dosage (number of sessions,) content and outcome assessments. Overall, the variability in delivery and outcomes precluded estimation of summary of effect measures. We assessed the risk of bias to be high for
Ojo, Olumuyiwa; Verbeek, Jos H; Rasanen, Kimmo; Heikkinen, Jarmo; Isotalo, Leena K; Mngoma, Nomusa; Ruotsalainen, Eija
The workplace provides an important avenue to prevent HIV. To evaluate the effect of behavioral interventions for reducing HIV on high risk sexual behavior when delivered in an occupational setting. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and PsycINFO up until March 2011 and CINAHL, LILACS, DARE, OSH Update, and EPPI database up until October 2010. Randomised control trials (RCTs) in occupational settings or among workers at high risk for HIV that measured HIV, sexual transmitted diseases (STD), Voluntary Counseling and Testing (VCT), or risky sexual behaviour. Two reviewers independently selected studies for inclusion, extracted data and assessed risk of bias. We pooled studies that were similar. We found 8 RCTs with 11,164 participants but one study did not provide enough data. Studies compared VCT to no VCT and education to no intervention and to alternative education.VCT uptake increased to 51% when provided at the workplace compared to a voucher for VCT (RR=14.0 (95% CI 11.8 to16.7)). After VCT, self-reported STD decreased (RR = 0.10 (95% CI 0.01 to 0.73)) but HIV incidence (RR=1.4 (95% CI 0.7 to 2.7)) and unprotected sex (RR=0.71 (0.48 to 1.06)) did not decrease significantly. .Education reduced STDs (RR = 0.68 (95%CI 0.48 to 0.96)), unprotected sex (Standardised Mean Difference (SMD)= -0.17 (95% CI -0.29 to -0.05), sex with a commercial sex worker (RR = 0.88 (95% CI 0.81 to 0.96) but not multiple sexual partners (Mean Difference (MD) = -0.22 (95% CI -0.52 to 0.08) nor use of alcohol before sex (MD = -0.01 (95% CI of -0.11 to 0.08). Workplace interventions to prevent HIV are feasible. There is moderate quality evidence that VCT offered at the work site increases the uptake of testing. Even though this did no lower HIV-incidence, there was a decrease in self-reported sexual transmitted diseases and a decrease in risky sexual behaviour. There is low quality evidence that educational interventions decrease sexually
This paper is a report of a study of the consequences of illegal abortions experienced by Iranian women. Despite the increase in effective and safe methods of contraception and the distribution of information about these methods, unwanted pregnancy is still a problem in some societies. Induced abortion is a common procedure throughout the world and at least half of more than 45 million induced abortions which happen in a year are performed under unsafe circumstances. Unsafe abortions carry a high risk of maternal mortality and morbidity, accounting for more than 80,000 maternal deaths per year. In this qualitative study, 27 participants were interviewed in 2006. Some participants were women who had illegal abortions and others were people who had contact with those women. Content analysis was used to identify and categorize participants' responses to the interview questions. Four consequences of women's experiences of illegal abortion were identified: physical, psychological, socio-political and judicial. In Iran, as in some other developing countries intentional abortion, except for some special cases, is illegal because of social and religious beliefs. In these countries, offering services and support to women with unwanted pregnancies seems to be the best solution for reducing or preventing illegal abortion. © 2011 Blackwell Publishing Ltd.
Gacoin, Andrée E.
Globally, sexuality education is framed as a key programmatic strategy for achieving HIV prevention among youth. In particular, sexuality education is positioned as a way to address gender inequalities and promote youth empowerment in relation to gendered identities. In this paper, I argue that the focus on what content should be taught and…
Macaya Pascual, A; Ferreres Riera, J R; Campoy Sánchez, A
Countless sex education programs have been implemented worldwide in recent decades, but epidemiological data show no improvement in rates of sexually transmitted infections or unintended pregnancies. To summarize the evidence from higher-quality systematic reviews on the efficacy of behavioral interventions for the prevention of sexually transmitted infections and unintended pregnancies. We conducted an overview of reviews by selecting systematic reviews that met minimum quality criteria in terms of the design of the studies reviewed. We compared the results obtained when the effects of interventions were assessed on the basis of objective criteria (biological data) to those obtained when outcomes were assessed on the basis of subjective criteria (self-reports). The results of Cochrane and non-Cochrane reviews were also compared. We identified 55 systematic reviews. No overall effect on the sexual behavior of program participants was observed in 72.5% of the reviews that used objective criteria and in 48.1% of the reviews based on subjective criteria. In the Cochrane reviews, no evidence of an overall effect was observed in 86% of reviews based on objective variables and in 70.5% of those based on subjective variables. There is no evidence that behavioral interventions modify rates of sexually transmitted infections (including human immunodeficiency virus infections) or unintended pregnancies, particularly when effects are assessed using objective, biological data. Primary prevention strategies for sexually transmitted infections and unintended pregnancies need to be re-evaluated. Copyright © 2015 AEDV. Published by Elsevier España, S.L.U. All rights reserved.
Emilio PINTOR HOLGUÍN
Full Text Available Action takes place in Spain in the mid?eighties (1987 with the change in Spanish society and the appearance of the first cases of AIDS in our country. From a comical sight, the adventures of a dermatologist particularly interested on sexually transmitted diseases prevention; especially in patients with risk behaviors, such as homosexuals, prostitutes and drug addicts injecting. The entire film revolves around the importance of condom use in preventing all sexually transmitted diseases.
the commanding officer of an accused servicemember. 21Army Regulation 600-20 defines sexual harassment as a form of gender discrimination that...SEXUAL ASSAULT Better Resource Management Needed to Improve Prevention and Response in the Army National Guard and Army...Resource Management Needed to Improve Prevention and Response in the Army National Guard and Army Reserve What GAO Found The Army National Guard
Full Text Available In the world there are tendencies of early entering into sexual relations and simultaneous withdrawal of the age of marriage, an increase in the number of early pregnancies and abortions among minors. Existing programs for the prevention of risky sexual behavior are ineffective, since they are one-time, narrowly focused. The author presents the results of an experiment on the prevention of risky sexual behavior in adolescents based on the formation of their ideas of parenting and child-parent relations, and through the prism of this topic, allowing to build an image of reproductive behavior in the present and future. The program is designed taking into account the psychology of modern adolescents, in accordance with the principles of awareness and responsibility, is based on a restorative approach and resource approach to the formation of psychological readiness for parenthood M.E. Lantsburg. The program for the development of psychological preparedness for parenting in adolescents has two targets: the nearest: preventing adolescent pregnancy and reducing its negative consequences in the event of an early pregnancy, and strategic - preparing for the planning and birth of the coveted child in the future. The results prove that the adolescents' views about the family depend both on the experiences they experienced in their own childhood and on the trends in the social and political space discussed in this topic. The study showed that adolescents' views on sexual relations, family and parenthood can be purposefully influenced through a program based on the knowledge of age-related psychology, resource and recovery approaches and using interactive methods of teaching relevant to this age group.
Garrity, Stacy E
An unacceptably large percent of women experience sexual assault during their collegiate years and efforts to eliminate sexual assault exist in various forms at numerous universities. The only way to effectively decrease the occurrence of rape on college campuses is to stop the perpetrators. This review examined established sexual assault prevention programs designed for college men to determine if an ideal educational program exists, or if one can be established, to effectively change male attitudes and behaviors about sexual assault. A library search of scientific databases yielded seven studies, published from 2000 to 2007, that met inclusion criteria. Through a variety of interventions, a measurable number of formerly held attitudes about rape myth and the role of the bystanders in an assaultive situation were effectively changed immediately postintervention in several studies. In addition, one study demonstrated sustained behavioral change. These results can effectively be used to provide education for forensic and school-based nurses to guide practice for development of educational programs to successfully change harmful attitudes and beliefs that contribute to rape. © 2011 International Association of Forensic Nurses.
Gottlieb, Sami L; Low, Nicola; Newman, Lori M; Bolan, Gail; Kamb, Mary; Broutet, Nathalie
An estimated 499 million curable sexually transmitted infections (STIs; gonorrhea, chlamydia, syphilis, and trichomoniasis) occurred globally in 2008. In addition, well over 500 million people are estimated to have a viral STI such as herpes simplex virus type 2 (HSV-2) or human papillomavirus (HPV) at any point in time. STIs result in a large global burden of sexual, reproductive, and maternal-child health consequences, including genital symptoms, pregnancy complications, cancer, infertility, and enhanced HIV transmission, as well as important psychosocial consequences and financial costs. STI control strategies based primarily on behavioral primary prevention and STI case management have had clear successes, but gains have not been universal. Current STI control is hampered or threatened by several behavioral, biological, and implementation challenges, including a large proportion of asymptomatic infections, lack of feasible diagnostic tests globally, antimicrobial resistance, repeat infections, and barriers to intervention access, availability, and scale-up. Vaccines against HPV and hepatitis B virus offer a new paradigm for STI control. Challenges to existing STI prevention efforts provide important reasons for working toward additional STI vaccines. We summarize the global epidemiology of STIs and STI-associated complications, examine challenges to existing STI prevention efforts, and discuss the need for new STI vaccines for future prevention efforts. Copyright © 2014 Elsevier Ltd. All rights reserved.
Besoain, Felipe; Perez-Navarro, Antoni; Caylà, Joan A; Aviñó, Constanza Jacques; de Olalla, Patricia García
Advances in the development of information and communication technologies have facilitated social interrelationships, but also sexual contacts without appropriate preventive measures. In this paper, we will focus on situations in which people use applications to meet sexual partners nearby, which could increase their chance of exposure to sexually transmitted infections (STI). How can we encourage users to adopt preventive measures without violating their privacy or infringing on the character of the application? To achieve the goal of preventing STI, we have used the design and creation methodology and have developed a prototype software package. This prototype follows the RESTful services principles and has two parts: an Android OS application with emphasis on ubiquitous computing and designed according to General Responsibility Assignment Software Patterns (GRASP), and a server with a web page. To choose the preventive messages, we performed a test in 17 men who have sex with men (MSM). Our software sends preventive notifications to users when it detects situations such as the activation of particular applications on their smartphones, or their proximity to areas with a high probability of intercourse (hot zones). The underlying idea is the same as that for warning messages on cigarette packets, since users read the message just when they are going to smoke. The messages used have been selected from a list that has been rated by the users themselves. The most popular message is "Enjoy sex and enjoy life. Do not expose yourself to HIV". The user is unaware of the software, which runs in the background. Ubiquitous computing may be useful for alerting users with preventive and educational messages. The proposed application is non-intrusive because: 1) the users themselves decide to install it and, therefore, users' privacy rights are preserved; 2) it sends a message that helps users think about taking appropriate preventive measures; and 3) it works in the
Borges, Angela M; Banyard, Victoria L; Moynihan, Mary M
Although more universities are developing policies for students regarding consent for sexual behavior in response to the problem of sexual violence on campus, many students seem either unaware of these policies or what they mean for actual behavior. Policies are only as effective as peoples' understanding and use of them. The current study aimed to evaluate the utility of a prevention education program focused on teaching students about consent. Two hundred and twenty undergraduates, composing a control group, a shorter treatment group, and a longer one, participated in the study. The findings showed the greatest knowledge gain for participants in the longer treatment group that included a discussion of the policy and participation in an activity dealing with its implications. Implications and future research directions are discussed.
McKellar, Kerry; Little, Linda; Smith, Michael A; Sillence, Elizabeth
Objective Sexual health professionals are key stakeholders in implementing sexual health intervention programmes, yet their views are largely absent from the literature. Sexual health professionals provide a unique perspective on teen sexual health issues as they engage in confidential discussions with a wide range of teenagers. This study aimed to provide an in-depth exploration of professionals' perceptions of teenagers' sexual health information seeking practices and barriers. Furthermore, the research provided a unique re-examination of key predictors of risky sexual behaviours, which have been highlighted by previous research. Methods Nine semi-structured interviews were undertaken with sexual health professionals to explore their perceptions of teenagers' sexual health information seeking practises and barriers. Subsequently the professionals rank ordered the 57 factors identified in previous research in terms of their perceived importance in predicting risky sexual behaviours. Results Four themes emerged: "society and media"; "environment and family"; "peer influences"; and "the self". The rank order task confirmed that 33 of the 57 factors were perceived as highly important by sexual health professionals. Conclusion Society, peers, environment and family are perceived as barriers to teenagers seeking reliable sexual health information, but these are dependent on the individual person. An individual with higher self-esteem is more confident in seeking sexual health information and applying this knowledge appropriately. Self-esteem was also identified as a key perceived predictor of risky sexual behaviours. Therefore, there is scope for intervention programmes targeting self-esteem and knowledge, so teenagers have the confidence to seek out sexual health information and to make their own informed sexual health decisions.
Medline and other search engines. Results: Adolescents engage in unhealthy sexual behaviours, characterized by early age at sexual initiation, unsafe sex and multiple sex partners. Reasons given for this include curiosity, peer influence, ...
Arbeit, Miriam R
Sexual violence continues to present a problem on college campuses nationwide and among members of the U.S. military. This study attended to patterns of response in how students (cadets) at the U.S. Military Academy (West Point) discussed sexual and romantic relationships, both potential and actual, in order to examine how, if at all, they enact their sexuality-related values. Constructivist grounded theory was used to analyze semistructured interviews with three male and three female cadets from each of the 4 years of the undergraduate program, in which they are intended to become "leaders of character" who will serve as Army officers. Findings indicated limitations in cadets' access to developing and implementing sexuality-related skills within this context. Cadets' fear and distrust erected barriers to their pursuing their desires; the ways in which cadets avoided getting in trouble for sexual harassment or sexual assault shifted responsibility from a potential perpetrator onto a potential victim; and cadets were caught in dilemmas regarding romantic relationships as sources of both emotional support and social stigma. These findings have implications for promoting gender equity and for preventing sexual violence at this institution and at others like it, including both university campuses and other military settings.
M C Regmi
Full Text Available INTRODUCTION: Unsafe abortion is a significant cause of maternal morbidity and mortality in developing countries despite provision of adequate care and legalization of abortion. The aim of this study was to find out the contribution of unsafe abortion in maternal mortality and its other consequences. METHODS: A retrospective study was carried out in the Department of Obstetrics and Gynecology in BPKIHS between 2005 April to 2008 September analyzing all the unsafe abortion related admissions. RESULTS: There were 70 unsafe abortion patients. Majority of them (52.8% were of high grade. Most of them recovered but there were total 8maternal deaths. CONCLUSIONS: Unsafe abortion is still a significant medical and social problem even in post legalization era of this country. Keywords: abortion, legalization, maternal death, unsafe.
Stieler-Hunt, Colleen; Jones, Christian M.; Rolfe, Ben; Pozzebon, Kay
This paper presents a case study of the key decisions made in the design of Orbit, a child sexual abuse prevention computer game targeted at school students between 8 and 10 years of age. Key decisions include providing supported delivery for the target age group, featuring adults in the program, not over-sanitising game content, having a focus on building healthy self-concept of players, making the game engaging and relatable for all players and evaluating the program. This case study has im...
Schelar, Erin; Polis, Chelsea B; Essam, Timothy; Looker, Katharine J; Bruni, Laia; Chrisman, Cara J; Manning, Judy
Worldwide, women face sexual and reproductive health (SRH) risks including unintended pregnancy and sexually transmitted infections (STIs) including HIV. Multipurpose prevention technologies (MPTs) combine protection against two or more SRH risks into one product. Male and female condoms are the only currently available MPT products, but several other forms of MPTs are in development. We examined the global distribution of selected SRH issues to determine where various risks have the greatest geographical overlap. We examined four indicators relevant to MPTs in development: HIV prevalence, herpes simplex virus type 2 prevalence (HSV-2), human papillomavirus prevalence (HPV) and the proportion of women with unmet need for modern contraception. Using ArcGIS Desktop, we mapped these indicators individually and in combination on choropleth and graduated symbol maps. We conducted a principal components analysis to reduce data and enable visual mapping of all four indicators on one graphic to identify overlap. Our findings document the greatest overlapping risks in Sub-Saharan Africa, and we specify countries in greatest need by specific MPT indication. These results can inform strategic planning for MPT introduction, market segmentation and demand generation; data limitations also highlight the need for improved (non-HIV) STI surveillance globally. MPTs are products in development with the potential to empower women to prevent two or more SRH risks. Geographic analysis of overlapping SRH risks demonstrates particularly high need in Sub-Saharan Africa. This study can help to inform strategic planning for MPT introduction, market segmentation and demand generation. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Full Text Available Abstract Background HIV spread continues at high rates from infected persons to their sexual partners. In 2009, an estimated 2.6 million new infections occurred globally. People living with HIV (PLHIV receiving treatment are in contact with health workers and therefore exposed to prevention messages. By contrast, PLHIV not receiving ART often fall outside the ambit of prevention programs. There is little information on their sexual risk behaviors. This study in Mombasa Kenya therefore explored sexual behaviors of PLHIV not receiving any HIV treatment. Results Using modified targeted snowball sampling, 698 PLHIV were recruited through community health workers and HIV-positive peer counsellors. Of the 59.2% sexually-active PLHIV, 24.5% reported multiple sexual partners. Of all sexual partners, 10.2% were HIV negative, while 74.5% were of unknown HIV status. Overall, unprotected sex occurred in 52% of sexual partnerships; notably with 32% of HIV-negative partners and 54% of partners of unknown HIV status in the last 6 months. Multivariate analysis, controlling for intra-client clustering, showed non-disclosure of HIV status (AOR: 2.38, 95%CI: 1.47-3.84, p Conclusions High-risk sexual behaviors are common among PLHIV not accessing treatment services, raising the risk of HIV transmission to discordant partners. This population can be identified and reached in the community. Prevention programs need to urgently bring this population into the ambit of prevention and care services. Moreover, beginning HIV treatment earlier might assist in bringing this group into contact with providers and HIV prevention services, and in reducing risk behaviors.
Thomas, Rosalind; Bekan Homawoo, Brigitte; McClamroch, Kristi; Wise, Benjamin; Coles, F. Bruce
Objectives We assessed public views about the acceptability of and need for sexually transmitted disease (STD) and sexual health-related educational messaging in local campaigns. Methods A 28-item state-added module was included in the 2008 New York Behavioral Risk Factor Surveillance System survey (n=3,751). Respondents rated acceptability of venues/dissemination channels and messaging and agreement with attitudinal/need statements. Additional data were analyzed from a separate state survey with individual county samples (n=36,257). We conducted univariate, bivariate, and multivariable modeling analyses. Results Each venue was acceptable to more than three-quarters of respondents (range: 79% for billboards to 95% for teaching STD prevention in high school). All message areas were acceptable to at least 85% of respondents (acceptability rating range: 85% to 97%). More than 70% agreed that there is a need for more open discussion about STDs. Bivariate analyses identified areas where messaging tailored to specific subgroups may be helpful (e.g., 26% of white people, 44% of African Americans, and 45% of Hispanic people agreed with the statement, “I need ideas about how to talk to my partner about protection from STDs”). Little geographic variation was seen. Results of multivariable modeling on opposition showed limited interaction effects. Conclusion These data provide key information about current community norms and reflect the public's approval for hearing and seeing more about sexual health and STDs in a range of public forums. PMID:23450887
Walsh, Kerryann; Zwi, Karen; Woolfenden, Susan; Shlonsky, Aron
Child sexual abuse is a significant global problem in both magnitude and sequelae. The most widely used primary prevention strategy has been the provision of school-based education programmes. Although programmes have been taught in schools since the 1980s, their effectiveness requires ongoing scrutiny. To systematically assess evidence of the effectiveness of school-based education programmes for the prevention of child sexual abuse. Specifically, to assess whether: programmes are effective in improving students' protective behaviours and knowledge about sexual abuse prevention; behaviours and skills are retained over time; and participation results in disclosures of sexual abuse, produces harms, or both. In September 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE and 11 other databases. We also searched two trials registers and screened the reference lists of previous reviews for additional trials. We selected randomised controlled trials (RCTs), cluster-RCTs, and quasi-RCTs of school-based education interventions for the prevention of child sexual abuse compared with another intervention or no intervention. Two review authors independently assessed the eligibility of trials for inclusion, extracted data, and assessed risk of bias. We summarised data for six outcomes: protective behaviours; knowledge of sexual abuse or sexual abuse prevention concepts; retention of protective behaviours over time; retention of knowledge over time; harm; and disclosures of sexual abuse. This is an update of a Cochrane Review that included 15 trials (up to August 2006). We identified 10 additional trials for the period to September 2014. We excluded one trial from the original review. Therefore, this update includes a total of 24 trials (5802 participants). We conducted several meta-analyses. More than half of the trials in each meta-analysis contained unit of analysis errors.1. Meta-analysis of two trials (n = 102) evaluating protective behaviours favoured intervention (odds
Seidman, Dominika; Hemmerling, Anke; Smith-McCune, Karen
Worldwide, there continues to be a large unmet need for family planning and sexually transmitted infection (STI) prevention methods. Multipurpose prevention technology (MPT) is a general term encompassing any single prevention methodology targeting more than one STI (including HIV) and/or pregnancy. While innovation has been slow over the past several decades, recent scientific advances have resulted in new products entering clinical trials. This review focuses primarily on multipurpose technologies that are designed to prevent pregnancy and HIV. To examine the current state of MPTs, we outline key discoveries of biologic mechanisms that influence susceptibility of the female genital tract to HIV and STIs, and review the effects of hormonal contraception on HIV susceptibility. We discuss the state of currently available HIV prevention strategies for women, and their interactions with hormonal contraceptive products. Finally, we describe MPTs currently in preclinical and clinical trials and propose ongoing questions requiring research to help advance the field. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Rheingold, Alyssa A.; Zajac, Kristyn; Patton, Meghan
Recent prevention research has established the efficacy of some child sexual abuse prevention programs targeting adults; however, less is known about the feasibility of implementing such programs. The current study examines the feasibility and acceptability of a child sexual abuse prevention program for child care professionals provided in two…
Murphy, Molly; Bennett, Nicole; Kottke, Melissa
Commercial sexual exploitation of children (CSEC) is a persistent problem in the United States, yet few youth-oriented CSEC prevention tools exist. The objectives of this project were to develop an educational website about CSEC for adolescents and evaluate it through pre- and posttests of adolescents' knowledge and attitudes about CSEC. Results demonstrated increases in participants' CSEC knowledge and decreases in their tolerance of CSEC after navigating the website and viewing an embedded video. Qualitative and quantitative results suggest that CSEC is deemed an important issue by adolescents and web-based content is a relevant and useful mode through which to educate adolescents about CSEC. Consideration should be given to further exploration of this and other tools for CSEC prevention tailored to adolescents' needs and preferences.
Dembo, Richard; Rollie, Matthew; Childs, Kristina; Salvatore, Christopher
Studies of detained and incarcerated adolescent offenders in the United States indicate that these juveniles have an elevated risk of sexually transmitted diseases (STDs). However, many more arrestees enter the “front end” of the juvenile justice system than are detained or incarcerated, and research into the STD risk profiles and service needs of this larger group is lacking. An expansion of STD testing (including of asymptomatic youths), prevention, and treatment is needed, as is improved knowledge about gender- and race-specific services. A pilot program in Florida has shown that juvenile justice and public health systems can collaborate to implement STD testing among new arrestees. With integrated linkages to treatment and prevention after release, this model could greatly reduce the STD burden in this underserved, high-risk population. PMID:19372535
Forrest, J D; Silverman, J
Ninety-three percent of public school teachers in five specialties-biology, health education, home economics, physical education and school nursing--who teach grades 7-12 report that their schools offer sex education or AIDS education in some form. Almost all the teachers believe that a wide range of topics related to the prevention of pregnancy, AIDS and other sexually transmitted diseases (STDs) should be taught in the public schools, and most believe these topics should be covered by grades 7-8 at the latest. In practice, however, sex education tends not to occur until the ninth or 10th grades. Moreover, there is often a gap between what teachers think should be taught and what actually is taught. For example, virtually all the teachers say that school sex education should cover sexual decision-making, abstinence and birth control methods, but only 82-84 percent of the teachers are in schools that provide instruction in those topics. The largest gap occurs in connection with sources of birth control methods: Ninety-seven percent of teachers say that sex education classes should address where students can go to obtain a method, but only 48 percent are in schools where this is done. Forty-five percent of teachers in the five specialties currently provide sex education in some form. The messages they most want to give to their students are responsibility regarding sexual relationships and parenthood, the importance of abstinence and ways of resisting pressures to become sexually active, and information about AIDS and other STDs.(ABSTRACT TRUNCATED AT 250 WORDS)
Okomo, Uduak; Ogugbue, Miriam; Inyang, Elizabeth; Meremikwu, Martin M
Female sexual dysfunction is the persistent or recurring decrease in sexual desire or arousal, the difficulty or inability to achieve an orgasm, and/or the feeling of pain during sexual intercourse. Impaired sexual function can occur with all types of female genital mutilation (FGM) owing to the structural changes, pain, or traumatic memories associated with the procedure. To conduct a systematic review of randomized and nonrandomized studies into the effects of sexual counseling with or without genital lubricants on the sexual function of women living with FGM. Cochrane Central Register of Controlled Trials, MEDLINE, African Index Medicus, SCOPUS, LILACS, CINAHL, ClinicalTrials.gov, Pan African Clinical Trials Registry, and other databases were searched to August 2015. The reference lists of retrieved studies were checked for reports of additional studies, and lead authors contacted for additional data. Studies of girls and women living with any type of FGM who received counselling interventions for sexual dysfunction were included. No relevant studies that addressed the objective of the review were identified. Despite a comprehensive search, the authors could not find evidence of the effects of sexual counseling on the sexual function of women living with FGM. Studies assessing this intervention are needed. CRD42015024593. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.
Miedema, Stephanie S; Yount, Kathryn M; Chirwa, Esnat; Dunkle, Kristin; Fulu, Emma
Men's perpetration of gender-based violence remains a global public health issue. Violence prevention experts call for engagement of boys and men to change social norms around masculinity in order to prevent gender-based violence. Yet, men do not comprise a homogenous category. Drawing on probability estimates of men who report same-sex practices and preferences captured in a multi-country gender-based violence prevention survey in the Asia-Pacific region, we test the effects of sexuality-related factors on men's adverse life experiences. We find that sexual minority men face statistically higher risk of lifetime adversity related to gender-based violence, stemming from gender inequitable norms in society. Sexuality is thus a key axis of differentiation among men in the Asia-Pacific region, influencing health and wellbeing and reflecting men's differential engagement with dominant norms of masculinity. Integrating awareness of male sexual diversity into gender-based violence prevention interventions, particularly those that work with boys and men, and bridging violence prevention programming between sexual minority communities and women, are essential to tackle the root drivers of violence.
A Resource Guide for Signs of Sexual Assault. A Supplement to: Preventing Sexual Abuse of Persons with Disabilities: A Curriculum for Hearing Impaired, Physically Disabled, Blind and Mentally Retarded Students.
Part of a curriculum unit on preventing sexual abuse of persons with disabilities, the manual is intended to help instructors present the material to hearing impaired students. Illustrations of sign language are presented for such terms as sexual contact, sexual assault, incest, same sex assault (man/woman), rape (acquaintance/marital), exposer,…
Svetlana V. Doubova
Full Text Available Abstract Background Risky sexual behaviors of adolescents in Mexico are a public health problem; 33.4 % of adolescent girls and 14.7 % of boys report not having used any protection at their first intercourse. The fertility rate is 77 births/1000 girls aged 15–19 years. The infrequent contact of adolescents with health services and the limited extent of school sex and reproductive health education require the support of innovative strategies. The objective of this paper is to present the design of an internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents. Methods A field trial with intervention and comparison group and with ex-ante and ex-post measurements will be conducted in two public secondary schools. Adolescents between 14 and 15 years of age will participate. The intervention will be conducted in one school and the second school will serve as a comparison group where the investigators will observe the usual sex education provided by the school. The intervention will be delivered using an internet web page that includes four educational sessions provided during a 4 week period. Follow-up will last 3 months. Information on the study variables will be obtained through an Internet-based self-applied questionnaire and collected on three occasions: 1 when the adolescents enter the study (baseline, 2 once the intervention is completed (at 1 month and 3 after 3 months of follow-up (at the fourth month. There will be three outcome variables: 1 knowledge in regard to sexually transmitted infections, 2 attitudes regarding condom use, and 3 self-efficacy toward consistent condom use. The generalized linear model will be used to assess changes in each outcome variable controlling for baseline measures and for study covariates. Discussion The design and evaluation of an Internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents is important in order to provide a new, large
Doubova, Svetlana V; Infante-Castañeda, Claudia; Pérez-Cuevas, Ricardo
Risky sexual behaviors of adolescents in Mexico are a public health problem; 33.4 % of adolescent girls and 14.7 % of boys report not having used any protection at their first intercourse. The fertility rate is 77 births/1000 girls aged 15-19 years. The infrequent contact of adolescents with health services and the limited extent of school sex and reproductive health education require the support of innovative strategies. The objective of this paper is to present the design of an internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents. A field trial with intervention and comparison group and with ex-ante and ex-post measurements will be conducted in two public secondary schools. Adolescents between 14 and 15 years of age will participate. The intervention will be conducted in one school and the second school will serve as a comparison group where the investigators will observe the usual sex education provided by the school. The intervention will be delivered using an internet web page that includes four educational sessions provided during a 4 week period. Follow-up will last 3 months. Information on the study variables will be obtained through an Internet-based self-applied questionnaire and collected on three occasions: 1) when the adolescents enter the study (baseline), 2) once the intervention is completed (at 1 month) and 3) after 3 months of follow-up (at the fourth month). There will be three outcome variables: 1) knowledge in regard to sexually transmitted infections, 2) attitudes regarding condom use, and 3) self-efficacy toward consistent condom use. The generalized linear model will be used to assess changes in each outcome variable controlling for baseline measures and for study covariates. The design and evaluation of an Internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents is important in order to provide a new, large-scale, easily implemented preventive tool. The
Yah, Clarence S; Simate, Geoffrey S; Hlangothi, Percy; Somai, Benesh M
The human immunodeficiency virus (HIV) is among the utmost destructive viruses humankind has ever faced in almost four decades. It carries with it profound socioeconomic and public health implications. Unfortunately, there is, currently, no effective cure for HIV infections. This review discusses the various types of condoms, microbicides, and the potential use of nanoparticle-coated condoms as a means of diminishing the risk of HIV transmission and sexually transmitted infections (STIs) during sexual intercourse. We identified 153 articles from 1989 to 2015 indexed in various journal platforms, reports, and magazines. Using the PRISMA guidelines as proxy in performing the research review process, only 53 articles were selected. Ideally, articles that failed to describe the nature and types of condoms, condom failures, nanoparticle-coated condoms, microbicides, and HIV prevention were excluded. In general, it has been shown that antiretroviral therapy (ART) currently available can only limit transmission and acquisition of HIV strains. Apart from ART treatment, the use of condoms has been identified globally as a cost-effective intervention for reducing the spread of HIV and other STIs. However, while condoms are supposed to be effective, reliable, and easy to use, research has shown that they are attributable to 20% failures including breakages. Nevertheless, other studies have shown that coating condoms with nanoparticles is an important and effective method for reducing condom breakage and HIV/STI transmission during sexual intercourse. A review of literature cited in this paper has shown that nanotechnology-based condom systems have the potential to prevent the spread of HIV and STIs. Furthermore, the antimicrobial nature of some nanoparticles could provide a safe and efficient way to disrupt and/or inactivate different STIs - including viral, bacterial, and fungal diseases.
Yah, Clarence S.; Simate, Geoffrey S.; Hlangothi, Percy; Somai, Benesh M.
Objective: The human immunodeficiency virus (HIV) is among the utmost destructive viruses humankind has ever faced in almost four decades. It carries with it profound socioeconomic and public health implications. Unfortunately, there is, currently, no effective cure for HIV infections. This review discusses the various types of condoms, microbicides, and the potential use of nanoparticle-coated condoms as a means of diminishing the risk of HIV transmission and sexually transmitted infections (STIs) during sexual intercourse. Methods: We identified 153 articles from 1989 to 2015 indexed in various journal platforms, reports, and magazines. Using the PRISMA guidelines as proxy in performing the research review process, only 53 articles were selected. Ideally, articles that failed to describe the nature and types of condoms, condom failures, nanoparticle-coated condoms, microbicides, and HIV prevention were excluded. Results and Discussion: In general, it has been shown that antiretroviral therapy (ART) currently available can only limit transmission and acquisition of HIV strains. Apart from ART treatment, the use of condoms has been identified globally as a cost-effective intervention for reducing the spread of HIV and other STIs. However, while condoms are supposed to be effective, reliable, and easy to use, research has shown that they are attributable to 20% failures including breakages. Nevertheless, other studies have shown that coating condoms with nanoparticles is an important and effective method for reducing condom breakage and HIV/STI transmission during sexual intercourse. Conclusions: A review of literature cited in this paper has shown that nanotechnology-based condom systems have the potential to prevent the spread of HIV and STIs. Furthermore, the antimicrobial nature of some nanoparticles could provide a safe and efficient way to disrupt and/or inactivate different STIs – including viral, bacterial, and fungal diseases. PMID:29536957
Faride Peña; Teresita Castillo; Concepción Campo
Sexual violence, and particularly child sexual abuse, is a serious problem all over the world, México included. Given its importance, there are several preventive and care programs done by the government and the civil society all over the country but most of them are developed in urban areas even though these problems are especially serious in rural areas. Yucatán, a state in southern México, occupies one of the first places in child sexual abuse. Considering the above, the University Unit of...
Beier, Klaus M; Oezdemir, Umut C; Schlinzig, Eliza; Groll, Anna; Hupp, Elena; Hellenschmidt, Tobias
The Berlin Project for Primary Prevention of Child Sexual Abuse by Juveniles (PPJ) offers diagnostic and therapeutic help to 12-to-18-year-old juveniles with a sexual preference for the prepubescent and/or early pubescent body of children and who apply for treatment on a voluntary basis. The project goal is to prevent primary or recurrent child sexual abuse as well as primary or recurrent use of child abuse images. Treatment aims to enable affected juveniles to obtain control over their conflictual sexual behaviors. In the present article, the origin of the PPJ; its main approach, including the conception of a media campaign; as well as results from the first year of a three-year study are presented. Further, initial characterizations of juveniles taking part in the project for the first 12 months are provided. The results confirmed that the group of 12-to-18-year-old juveniles with a sexual preference for prepubescent and/or early pubescent minors exists as a target group for primary preventive measures and that they can be assessed for their sexual preferences. Copyright © 2015 Elsevier Ltd. All rights reserved.
Weingarten, Christine; Rabago, Jina; Reynolds, Jasmine; Gates, Kalani; Yanagida, Evie; Baker, Charlene
Rates of childhood sexual abuse are unacceptably high, with potentially long-lasting consequences for those who have been victimized. Currently, there are a number of sexual violence prevention programs that have been developed to lower rates of victimization, increase awareness, and connect victims with resources. Within this area of research, there has been less focus on effective methods of program dissemination. For example, school-based sexual violence prevention programs have had positive outcomes; however, little is known about how these programs are disseminated. The train-the-trainer model of dissemination utilizes master trainers to equip others to implement programs, thereby allowing more adults to teach and subsequently more children to receive the program. This study used survey data from teachers and other school personnel (n = 127) to analyze the utility of a train-the-trainer model of dissemination for a sexual violence prevention program in the state of Hawai'i. Through responses of people who were trained to implement the program (59.8% of whom did implement), aspects of the training, the program itself, and factors affecting whether a person implemented the program were explored. Results suggest that time spent in training, job position, and time in that position predicted whether a person trained to implement the sexual violence prevention program followed through with teaching the program to students. Additionally, 54.7% of people who did implement the program had at least one student disclose sexual violence to them, indicating the importance of sexual violence prevention programming and dissemination of these programs. Copyright © 2018 Elsevier Ltd. All rights reserved.
Jacobson, Gloria; Riesch, Susan K.; Temkin, Barbara Myers; Kedrowski, Karen M.; Kluba, Nina
Children of late elementary school age (fifth grade) provide evidence that many do not feel safe in their schools. The purpose of this study was to examine how children express their experiences of feeling unsafe in school. Questions guiding the study were What percentage of children in this sample report feeling unsafe at school? What are the…
developing world. This study aims to determine the pattern of complicated unsafe abortions in Niger delta. University Teaching Hospital (NDUTH) Okolobiri. Methods: The study is a four-year retrospective analysis of cases of complicated unsafe abortion managed at the. Niger Delta University Teaching Hospital Okolobiri,.
... 46 Shipping 4 2010-10-01 2010-10-01 false Report of unsafe machinery. 109.419 Section 109.419 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS OPERATIONS Reports, Notifications, and Records Reports and Notifications § 109.419 Report of unsafe machinery. If a boiler, unfired pressure vessel, or...
an unsafe abortion, of which 18.5 million alone were from developing nations, with the highest contributions from Asian (10.8 million) ... Department of Community Medicine, Shri Sathya Sai Medical College & Research Institute, Kancheepuram. Abstract. Background: Unsafe abortion refers to a procedure for terminating an ...
Unsafe abortion remains a major reproductive health problem in Nigeria. These are 2 case reports of unsafe abortion, one performed by a patent medicine dealer where a false passage was created in the substance of the cervix to evacuate the uterus using a cannula. A piece of the cannula was left in situ for five years ...
Estimating the burden of disease attributable to unsafe water and lack of sanitation and hygiene in South Africa in 2000. ... Disease burden from diarrhoeal diseases, intestinal parasites and schistosomiasis, measured by deaths and disability-adjusted life years (DALYs). Results. 13 434 deaths were attributable to unsafe ...
Jørgensen, Marianne Johansson; Andersen, Berit; Olesen, Frede
were identified: 1) alcohol consumption which was associated with lack of condom use, 2) one-night stands after a night out partying, at festivals or on vacations, 3) low self-esteem which increased the risk of pushing one's personal boundaries, thus resulting in promiscuous sexual behaviour, 4...... AND METHODS: We conducted four semi-structured focus group interviews with a total of 19 sexually -experienced adolescents aged 18-23 years who attended a Danish Folk High School. Data were transcribed verbatim and analysed using qualitative description. RESULTS: Four main categories of sexual risk behaviour...
Lasry, Arielle; Sansom, Stephanie L; Wolitski, Richard J; Green, Timothy A; Borkowf, Craig B; Patel, Pragna; Mermin, Jonathan
The number of strategies to prevent HIV transmission has increased following trials evaluating antiretroviral therapy (ART), preexposure prophylaxis (PrEP) and male circumcision. Serodiscordant couples need guidance on the effects of these strategies alone, and in combination with each other, on HIV transmission. We estimated the sexual risk of HIV transmission over 1-year and 10-year periods among male-male and male-female serodiscordant couples. We assumed the following reductions in transmission: 80% from consistent condom use; 54% from circumcision in the negative male partner of a heterosexual couple; 73% from circumcision in the negative partner of a male-male couple; 71% from PrEP in heterosexual couples; 44% from PrEP in male-male couples; and 96% from ART use by the HIV-infected partner. For couples using any single prevention strategy, a substantial cumulative risk of HIV transmission remained. For a male-female couple using only condoms, estimated risk over 10 years was 11%; for a male-male couple using only condoms, estimated risk was 76%. ART use by the HIV-infected partner was the most effective single strategy in reducing risk; among male-male couples, adding consistent condom use was necessary to keep the 10-year risk below 10%. Focusing on 1-year and longer term transmission probabilities gives couples a better understanding of risk than those illustrated by data for a single sexual act. Long-term transmission probabilities to the negative partner in serodiscordant couples can be high, though these can be substantially reduced with the strategic use of preventive methods, especially those that include ART.
Mugwanya, Kenneth K.; Donnell, Deborah; Celum, Connie; Thomas, Katherine K.; Ndase, Patrick; Mugo, Nelly; Katabira, Elly; Ngure, Kenneth; Baeten, Jared M.
Background Limited data are available to assess sexual behavior by persons using antiretroviral pre-exposure prophylaxis (PrEP) for HIV prevention. Increased sexual risk taking by persons using effective HIV prevention strategies, like PrEP, could offset HIV prevention benefits. Methods The Partners PrEP Study, a randomized, placebo-controlled trial of daily oral PrEP among heterosexual HIV-uninfected members of HIV serodiscordant couples, publicly reported efficacy for HIV prevention in July 2011 and participants continued monthly follow-up thereafter. We used regression analyses to compare the frequency of sex unprotected by a condom during the 12 months after compared to before July 2011 to assess whether knowledge of PrEP efficacy for HIV prevention resulted in increased sexual risk behavior. Results We analyzed 56, 132 person-months from 3024 HIV-uninfected subjects (64% male). The average frequency of unprotected sex with the HIV-infected study partner was 59 per 100 person-months pre- versus 53 post-unblinding, reflecting no immediate change or change over time after July 2011 (p=0·66 and 0·25, respectively). There was a statistically significant increase in unprotected sex with outside partners over time after July 2011 but the effect was modest (average of 6.8 unprotected sex acts per year versus 6.2 acts in a predicted counterfactual scenario had unblinding not occurred, p=0·04). Compared to pre-July 2011, there was no significant increase in incident sexually transmitted infections or pregnancy after July 2011. Interpretation The transition from a blinded, placebo-controlled efficacy trial to all participants aware they were receiving active, efficacious PrEP in the Partners PrEP Study provided a “natural experiment” to evaluate sexual risk compensation. PrEP, provided as part of a comprehensive prevention package, may not result in substantial changes in risk-taking sexual behavior for heterosexual couples. PMID:24139639
Dunlap, Shannon L.; Taboada, Arianna; Merino, Yesenia; Heitfeld, Suzanne; Gordon, Robert J.; Gere, David; Lightfoot, Alexandra F.
We examined the sexual health change process experienced by 26 college student sexual health educators from three geographic regions of the United States who participated in a multisite arts-based sexual health prevention program. We conducted eight focus groups and used a phenomenological approach to analyze data. We drew from social cognitive…
Do, Lan Anh Thi; Boonmongkon, Pimpawun; Paek, Seung Chun; Guadamuz, Thomas E
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. 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. 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. 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
Mason-Jones, Amanda J; Sinclair, David; Mathews, Catherine; Kagee, Ashraf; Hillman, Alex; Lombard, Carl
Background School-based sexual and reproductive health programmes are widely accepted as an approach to reducing high-risk sexual behaviour among adolescents. Many studies and systematic reviews have concentrated on measuring effects on knowledge or self-reported behaviour rather than biological outcomes, such as pregnancy or prevalence of sexually transmitted infections (STIs). Objectives To evaluate the effects of school-based sexual and reproductive health programmes on sexually transmitted infections (such as HIV, herpes simplex virus, and syphilis), and pregnancy among adolescents. Search methods We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for published peer-reviewed journal articles; and ClinicalTrials.gov and the World Health Organization's (WHO) International Clinical Trials Registry Platform for prospective trials; AIDS Educaton and Global Information System (AEGIS) and National Library of Medicine (NLM) gateway for conference presentations; and the Centers for Disease Control and Prevention (CDC), UNAIDS, the WHO and the National Health Service (NHS) centre for Reviews and Dissemination (CRD) websites from 1990 to 7 April 2016. We handsearched the reference lists of all relevant papers. Selection criteria We included randomized controlled trials (RCTs), both individually randomized and cluster-randomized, that evaluated school-based programmes aimed at improving the sexual and reproductive health of adolescents. Data collection and analysis Two review authors independently assessed trials for inclusion, evaluated risk of bias, and extracted data. When appropriate, we obtained summary measures of treatment effect through a random-effects meta-analysis and we reported them using risk ratios (RR) with 95% confidence intervals (CIs). We assessed the certainty of the evidence using the GRADE approach. Main results We included eight cluster-RCTs that enrolled 55,157 participants. Five trials were conducted in
Zwi, K J; Woolfenden, S R; Wheeler, D M; O'brien, T A; Tait, P; Williams, K W
Child sexual abuse is a significant problem that requires an effective means of prevention. To assess: if school-based programmes are effective in improving knowledge about sexual abuse and self-protective behaviours; whether participation results in an increase in disclosure of sexual abuse and/or produces any harm; knowledge retention and the effect of programme type or setting. Electronic searches of Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycINFO, CINAHL, Sociological Abstracts, Dissertation Abstracts and other databases using MESH headings and text words specific for child sexual assault and randomised controlled trials (RCTs) were conducted in August 2006. RCTs or quasi-RCTs of school-based interventions to prevent child sexual abuse compared with another intervention or no intervention. Meta-analyses and sensitivity analysis, using two imputed intraclass correlation coefficients (ICC) (0.1, 0.2), were used for four outcomes: protective behaviours, questionnaire-based knowledge, vignette-based knowledge and disclosure of abuse. Meta-analysis was not possible for retention of knowledge, likelihood of harm, or effect of programme type and setting. Fifteen trials measuring knowledge and behaviour change as a result of school-based child sexual abuse intervention programmes were included. Over half the studies in each initial meta-analysis contained unit of analysis errors. For behaviour change, two studies had data suitable for meta-analysis; results favoured intervention (OR 6.76, 95% CI 1.44, 31.84) with moderate heterogeneity (I(2)=56.0%) and did not change significantly when adjustments using intraclass coefficients were made. Nine studies were included in a meta-analysis evaluating questionnaire-based knowledge. An increase in knowledge was found (SMD 0.59; 0.44, 0.74, heterogeneity (I2=66.4%). When adjusted for an ICC of 0.1 and 0.2 the results were SMD 0.6 (0.45, 0.75) and 0.57 (0.44, 0.71) respectively. Heterogeneity decreased
Ybarra, Michele L; Prescott, Tonya L; Phillips, Gregory L; Bull, Sheana S; Parsons, Jeffrey T; Mustanski, Brian
Guy2Guy (G2G) is the first comprehensive HIV prevention program developed for sexual minority males as young as 14 years old and is delivered nationally via text messaging. Here, we report the results of the pilot randomized control trial. G2G was tested against an attention-matched "healthy lifestyle" control (eg, self-esteem). Both programs lasted 5 weeks and delivered 5 to 10 text messages daily. A 1-week booster was delivered 6 weeks subsequently. Participants were cisgender males ages 14 to 18 years old who were gay, bisexual, and/or queer and had an unlimited text messaging plan. Youth were recruited across the United States via Facebook and enrolled by telephone from October 2014 to April 2015. Ninety-day postintervention outcomes were condomless sex acts (CSA) and abstinence and, secondarily, HIV testing. We also examined these outcomes at intervention end and stratified them by sexual experience. At 90 days postintervention, there were no significant differences in CSAs or abstinence noted. Among participants who were sexually active at baseline, intervention participants were significantly more likely to report getting an HIV test (adjusted odds ratio = 3.42, P = .001). They were also less likely than control youth to be abstinent (adjusted odds ratio = 0.48, P = .05). CSAs were significantly lower for those in the intervention versus control at intervention end (incident rate ratio = 0.39, P = .04), although significance was lost once age was added to the analysis (incident rate ratio = 0.58, P = .26). G2G appears promising in increasing adolescent HIV testing rates. Sex-positive intervention messages appear to have increased the participants' comfort with having sex (ie, less abstinence) while not increasing their potential for HIV transmission (ie, more CSAs). Additional content or features may be needed to invigorate condom use. Copyright © 2017 by the American Academy of Pediatrics.
Advani, Pragati; Brewster, Abenaa M; Baum, George P; Schover, Leslie R
A randomized pilot trial evaluated the hypothesis that early intervention lessens sexual dysfunction in the first year on aromatase inhibitors. A secondary aim was comparing the efficacy of two vaginal moisturizers. Fifty-seven postmenopausal women with early stage breast cancer starting aromatase inhibitors were randomized to three treatment groups. All received a handout on managing sexual and other side effects. The Usual Care group received no additional therapy. The Active Treatment groups received a 6-month supply of a vaginal moisturizer (hyaluronic acid-based in Active Group-H and prebiotic in Active Group-P) and a vaginal lubricant and dilator, plus access to an educational website and phone coaching. Questionnaires completed at baseline, 6, and 12 months included the Female Sexual Function Index (FSFI), Menopausal Sexual Interest Questionnaire (MSIQ), Female Sexual Distress Scale-Revised (FSDS-R), and a menopausal symptom scale. Forty-nine women (86%) provided follow-up data. Mean age was 59 and 77% were non-Hispanic Caucasian. Sexual function was impaired at baseline, but remained stable over 12 months for all groups. The combined active treatment group had less dyspareunia (P = 0.07) and sexual distress (P = 0.02) at 6 months than the Usual Care group. At 6 months, the Active-H group improved significantly more than the Active-P group on FSFI total score (P = 0.04). Sexual counseling helped women maintain stable sexual function on aromatase inhibitors. Active intervention resulted in better outcomes at 6 months. This promising pilot trial suggests a need for more research on preventive counseling to maintain sexual function during aromatase inhibitor treatment.
The origins of the International Federation of Gynecology and Obstetrics (FIGO) Initiative for the Prevention of Unsafe Abortion and its Consequences began in 1969 when a young British medical student encountered a young woman in Canada with complications of unsafe abortion. Through evolving understanding of the context of women's lives, including the role of family planning and access to safe abortion globally in preventing the deaths and imprisonment of women, I was able to contribute to FIGO's advocacy through a collaborative initiative with country-led action plans based on a situational analysis. Forty-six member associations rapidly agreed to participate with results of situational analyses-an unprecedented result in FIGO's history. Professor Anibal Faúndes' role has been pivotal to the success of this initiative, including the establishment of a working group of regional coordinators and collaborating agencies to oversee the implementation of action plans involving in-country partners and the Ministry of Health. Deaths from unsafe abortion and its complications are preventable. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Child trafficking, including commercial sexual exploitation (CSE), is one of the fastest growing and most lucrative criminal activities in the world. The global enslavement of children affects countless numbers of victims who are trafficked within their home countries or transported away from their homes and treated as commodities to be bought, sold, and resold for labor or sexual exploitation. All over the world, girls are particularly likely to be trafficked into the sex trade: Girls and women constitute 98% of those who are trafficked for CSE. Health and safety standards in exploitative settings are generally extremely low, and the degree of experienced violence has been linked with adverse physical, psychological, and social-emotional development. The human-rights-based approach to child trafficking provides a comprehensive conceptual framework whereby victim-focused and law enforcement responses can be developed, implemented, and evaluated. This article highlights promising policies and programs designed to prevent child trafficking and CSE by combating demand for sex with children, reducing supply, and strengthening communities. The literature reviewed includes academic publications as well as international and governmental and nongovernmental reports. Implications for social policy and future research are presented. © 2013 American Orthopsychiatric Association.
Colleen Joy Stieler-Hunt
Full Text Available This paper presents a case study of the key decisions made in the design of Orbit, a child sexual abuse prevention computer game targeted at school students between 8 and 10 years of age. Key decisions include providing supported delivery for the target age group, featuring adults in the program, not over-sanitising game content, having a focus on building healthy self-concept of players, making the game engaging and relatable for all players and evaluating the program. This case study has implications for the design of Serious Games more generally, including that research should underpin game design decisions, game designers should consider ways of bridging the game to real life, the learning that arises from the game should go beyond rote-learning, designers should consider how the player can make the game-world their own and comprehensive evaluations of Serious Games should be undertaken.
Gao, Daozhou; Lou, Yijun; He, Daihai; Porco, Travis C.; Kuang, Yang; Chowell, Gerardo; Ruan, Shigui
The ongoing Zika virus (ZIKV) epidemic in the Americas poses a major global public health emergency. While ZIKV is transmitted from human to human by bites of Aedes mosquitoes, recent evidence indicates that ZIKV can also be transmitted via sexual contact with cases of sexually transmitted ZIKV reported in Argentina, Canada, Chile, France, Italy, New Zealand, Peru, Portugal, and the USA. Yet, the role of sexual transmission on the spread and control of ZIKV infection is not well-understood. We introduce a mathematical model to investigate the impact of mosquito-borne and sexual transmission on the spread and control of ZIKV and calibrate the model to ZIKV epidemic data from Brazil, Colombia, and El Salvador. Parameter estimates yielded a basic reproduction number 0 = 2.055 (95% CI: 0.523-6.300), in which the percentage contribution of sexual transmission is 3.044% (95% CI: 0.123-45.73). Our sensitivity analyses indicate that 0 is most sensitive to the biting rate and mortality rate of mosquitoes while sexual transmission increases the risk of infection and epidemic size and prolongs the outbreak. Prevention and control efforts against ZIKV should target both the mosquito-borne and sexual transmission routes.
Masilo, Daniel Tuelo
Children have the right to be brought up in safe environments. However, this right is often infringed by people who are supposed to provide love, care, and protection to children. These people can include biological fathers, step-fathers, brothers, cousins, aunts, mothers, and uncles. Violation of children takes place in a variety of ways, however, for the purpose of this paper, the focus is on child sexual abuse within the family system. A literature review is adopted as the methodology for the discussions in this paper. The purpose of this paper is firstly to demonstrate that child sexual abuse happens within the family system in South Africa, and secondly, to argue that the prevention of child sexual abuse should start within the family system and this can be achieved by conducting educational social group work sessions on child sexual abuse with the family members.
Kinuthia, John; Richardson, Barbra A; Drake, Alison L; Matemo, Daniel; Unger, Jennifer A; McClelland, Raymond S; John-Stewart, Grace
Understanding sexual behaviors and vaginal practices of pregnant and breastfeeding women in sub-Saharan Africa is critical to inform HIV prevention strategies during these periods. HIV-uninfected women presenting for antenatal care in western Kenya were enrolled and followed through 36 weeks postpartum. Sexual behavior and vaginal practices were ascertained by structured questionnaires. Logistic regression was used to assess correlates of unprotected sex, vaginal washing, and vaginal drying. Among 1252 women enrolled, 78.4% were married (of whom 15.1% were in polygamous unions), 1.4% had a known HIV-infected partner, and 33.6% had a partner of unknown HIV status. At enrollment, 58.5% reported sex in the past month (94.3% unprotected) and 4.5% reported forced sex. Odds of unprotected sex at enrollment was >11-fold higher in married than in unmarried women (P < 0.001) and lower among women who reported partners of unknown HIV status or HIV-infected compared with HIV-uninfected partners. Median time to postpartum resumption of sex was 7 weeks (interquartile range 4-12). Prevalence of unprotected sex in the past week increased from 6.6% to 60.0% between 2 and 36 weeks postpartum (P < 0.001). Vaginal washing was reported by 60.1% of women at enrollment and prevalence remained stable postpartum; vaginal drying was reported by 17.9% at enrollment and decreased to 6.1% at 36 weeks postpartum (P < 0.001). Vaginal washing and drying were associated with forced sex. High rates of unknown partner HIV status, polygamy, and less frequent condom use among pregnant/postpartum women underscore the need for female-controlled HIV prevention interventions. Vaginal washing and drying may present challenges to microbicide use.
Deniaud, F; Melman, C
Over the past few years in France, the incidence of human immunodeficiency virus (HIV) has not decreased. Among the most frequent sexually transmissible diseases (STD) in France (condyloma, genitoanal herpes, chlamydia infections), certain STD, considered as negligible, have reappeared: gonorrhoea and syphilis affect male homosexuals and, to a lesser degree, men and women whose epidemiological profile remains to be determined. The health organization is not in favour of associating STD with HIV in its anti-aids strategy. However, acute STD are not only indicator of habits at risk for HIV, but are also potent co-factors of its sexual transmission. Fighting against HIV without creating a dialogue on STD is a waste of time and efficiency. From our experience with the STD, anonymous and free screening and the inter-disciplinary health education centres, we recommend the following: improved screening for HIV and other STD: concomitantly whenever possible, less invasive, free or reimbursed STD sampling, reliable and standardized techniques (polymerisation chain reaction or PCR and derivatives), itinerant screening for STD for persons who do not consult; ensured early, medical, social and psychological care of HIV and STD, emphasising the importance of compliance to treatment and prevention; ensured easy access and low cost of the male and female condoms; renewal and diversification of health relays, particularly in the private sector; staff training on STD and their epidemiological novelty; insisting on a transversal (HIV-other STD, curative-preventive, among others) and pragmatic approach (intervention studies resulting in local action); renewal of the information and advice for the public: information on the relationship between HIV and other STD, on the frequent STD that are lesser known, such as condyloma and chlamydia infections, emphasis on compliance to prevention measures (abstinence or use of condoms) during at least three months after a risk of HIV
Page, Kathleen R; Martinez, Omar; Nieves-Lugo, Karen; Zea, Maria Cecilia; Grieb, Suzanne Dolwick; Yamanis, Thespina J; Spear, Kaitlin; Davis, Wendy W
Sexual and gender minority Hispanics/Latinxs (henceforth: Latinxs) continue to be disproportionately impacted by HIV/AIDS in the U.S. Pre-exposure prophylaxis (PrEP) is a biomedical prevention approach which holds significant promise for at risk and vulnerable populations. We discuss barriers and facilitators to uptake of PrEP among sexual and gender minority Latinxs living in the U.S. through an ecosocial lens that takes into account structural, community, and individual contexts. The impact of immigration status on PrEP uptake emerges as a major and recurrent theme that must be understood and addressed by HIV prevention programs aiming to promote an inclusive strategy for sexual and gender minority Latinxs living in the U.S.
Sanz-Lorente, María; Wanden-Berghe, Carmina; Castejón-Bolea, Ramón; Sanz-Valero, Javier
The internet is now the primary source of information that young people use to get information on issues related to sex, contraception, and sexually transmitted infections. The goal of the research was to review the scientific literature related to the use of Web 2.0 tools as opposed to other strategies in the prevention of curable sexually transmitted diseases (STDs). A scoping review was performed on the documentation indexed in the bibliographic databases MEDLINE, Cochrane Library, Scopus, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, PsycINFO, Educational Resources Information Center, the databases of Centro Superior de Investigaciones Científicas in Spain, and the Índice Bibliográfico Español de Ciencias de la Salud from the first available date according to the characteristics of each database until April 2017. The equation search was realized by means of the using of descriptors together with the consultation of the fields of title register and summary with free terms. Bibliographies of the selected papers were searched for additional articles. A total of 627 references were retrieved, of which 6 papers were selected after applying the inclusion and exclusion criteria. The STDs studied were chlamydia, gonorrhea, and syphilis. The Web 2.0 tools used were Facebook, Twitter, Instagram, and YouTube. The 6 papers used Web 2.0 in the promotion of STD detection. Web 2.0 tools have demonstrated a positive effect on the promotion of prevention strategies for STDs and can help attract and link youth to campaigns related to sexual health. These tools can be combined with other interventions. In any case, Web 2.0 and especially Facebook have all the potential to become essential instruments for public health. ©María Sanz-Lorente, Carmina Wanden-Berghe, Ramón Castejón-Bolea, Javier Sanz-Valero. Originally published in the Journal of Medical Internet Research (http
Connolly, Jennifer; Josephson, Wendy; Schnoll, Jessica; Simkins-Strong, Emily; Pepler, Debra; MacPherson, Alison; Weiser, Jessica; Moran, Michelle; Jiang, Depeng
Although youth-led programs (YLP) have been successful in many areas of public health, youth leadership is rarely used in the prevention of peer aggression. A YLP to reduce bullying, sexual harassment, and dating aggression was compared experimentally with the board-mandated usual practice (UP). Four middle schools in an urban Canadian school…
Walsh, Kerryann; Zwi, Karen; Woolfenden, Susan; Shlonsky, Aron
Objective: To assess evidence of the effectiveness of school-based education programs for the prevention of child sexual abuse (CSA). The programs deliver information about CSA and strategies to help children avoid it and encourage help seeking. Methods: Systematic review including meta-analysis of randomized controlled trials (RCTs), cluster…
Jozkowski, Kristen N.; Henry, Dayna S.; Sturm, Ashley A.
Introduction: Sexual assault continues to be a pervasive health issue among college students in the USA. Prevention education initiatives have been implemented to address this concern. However, little is known about college students' perceptions of such programming. The purpose of this study was to assess predictors of college students'…
Arbeit, Miriam R.
The United States Military Academy at West Point develops cadets into "leaders of character" who will become Army officers. This focus on character presents an opportunity for the prevention of sexual violence through an emphasis on military values. Using constructivist grounded theory, this study examined how cadets experience their own…
Black, Beverly M.; Weisz, Arlene N.; Jayasundara, Dheeshana S.
A dating violence and sexual assault prevention program was presented to 396, predominately African American, middle schoolers in two inner city schools in the United States. In one school the program was offered with a same-gender group composition; in the other school, the same program was offered with mixed-gender group composition. A…
Cain, Demetria; Schensul, Stephen; Mlobeli, Regina
Communicating about sex is a vital component of human immunodeficiency virus (HIV) prevention and influences how HIV educators convey messages to communities and how couples negotiate safer sex practices. However, sexual communication inevitably confronts culturally based behavioral guidelines and linguistic taboos unique to diverse social…
.Conclusion: The results of this study showed the importance of safety competency, prevention focus, safety rules and procedures, safety efficiency and consciousness as predictors of unsafe work behaviors. Therefore, it is recommended to rely on these variables in the safety training courses and also in selecting people for high risk environments.
Jørgensen, Marianne J; Andersen, Berit; Olesen, Frede
were identified: 1) alcohol consumption which was associated with lack of condom use, 2) one-night stands after a night out partying, at festivals or on vacations, 3) low self-esteem which increased the risk of pushing one's personal boundaries, thus resulting in promiscuous sexual behaviour, 4...
Cohen, Myron S; Gay, Cynthia; Kashuba, Angela D M; Blower, Sally; Paxton, Lynn
Antiretroviral therapy (ART) has prolonged and improved the lives of persons infected with HIV. Theoretically, it can also be used to prevent the transmission of HIV. The pharmacology of ART in the male and female genital tract can be expected to affect the success of the intervention, and ART agents differ considerably in their ability to concentrate in genital tract secretions. Emergency ART is considered to be the standard of care after occupational exposures to fluids or tissues infected with HIV. More recently, ART for prophylaxis after nonoccupational HIV exposures has been widely used and most countries have developed specific guidelines for its implementation. However, developing clinical trials to prove the efficacy of ART postexposure prophylaxis has not been possible. Experiments with rhesus macaques suggest that therapy must be offered as soon as possible after exposure (within 72 hours) and must be continued for 28 days. Additional nonhuman primate experiments have demonstrated protection from HIV infection with ART preexposure prophylaxis, and several clinical trials are under way to evaluate the safety and efficacy of this approach. The degree to which ART offered to infected persons reduces infectiousness is of considerable public health importance, but the question has not been sufficiently answered. This article provides a review of the data on the use of ART to prevent the sexual transmission of HIV and identify challenges to improving and clarifying this approach.
Abstract. Background: Cross-generational sexual practices are considered unsafe sexual behaviors. The risk of acquiring sexually transmitted infections including HIV is believed to be high among those involved in cross-generational sexual relationship. However, studies addressing why and how people are engaged in ...
This report presents the findings of a preliminary investigation of drivers' motivations for selected unsafe driving actions (UDAs). The general objective of the study was to develop the test methods, procedures, and materials for collecting data for...
Glenn, Lily; Fidler, Laura; O'Connor, Meghan; Haviland, Mary; Fry, Deborah; Pollak, Tamara; Frye, Victoria
Sexual violence is a public health problem associated with short- and long-term physical and mental health consequences. Most interventions that aim to prevent sexual violence before it occurs target individual-level change or promote bystander training. Community-level interventions, while increasingly recommended in the sexual violence prevention field, are rarely documented in peer-reviewed literature. This paper is a targeted process evaluation of Project Envision, a 6-year pilot initiative to address social norms at the root of sexual violence through coalition building and community mobilization in three New York City neighborhoods, and reflects the perspectives of those charged with designing and implementing the program. Evaluation methods included a systematic literature review, archival source document review, and key informant interviews. Three themes emerged from the results: community identity and implications for engagement; capacity and readiness for community mobilization and consequences for implementation; and impacts on participants. Lessons learned include the limitations of using geographic boundaries to structure community interventions in urban settings; carefully considering whether communities should be mobilized around an externally-identified issue; translating theoretical frameworks into concrete tasks; assessing all coalition partners and organizations for readiness; critically evaluating available resources; and recognizing that community organizing is a skill that requires investment from funders. We conclude that Project Envision showed promise for shifting institutional norms towards addressing root causes of sexual violence in addition to providing victim services. Copyright © 2017 Elsevier Ltd. All rights reserved.
Leander, Else-Marie Buch; Larsen, Per Lindsø; Munk, Karen
This article presents the first research study of guidelines in Danish childcare institutions for protecting children against sexual abuse (CSA), and staff against wrongful allegations of CSA. Worldwide, it represents one of few empirical studies of the unintended consequences of contemporary...
Bunnell, Rebecca; Ekwaru, John Paul; Solberg, Peter; Wamai, Nafuna; Bikaako-Kajura, Winnie; Were, Willy; Coutinho, Alex; Liechty, Cheryl; Madraa, Elizabeth; Rutherford, George; Mermin, Jonathan
The impact of antiretroviral therapy (ART) on sexual risk behavior and HIV transmission among HIV-infected persons in Africa is unknown. To assess changes in risky sexual behavior and estimated HIV transmission from HIV-infected adults after 6 months of ART. A prospective cohort study was performed in rural Uganda. Between May 2003 and December 2004 a total of 926 HIV-infected adults were enrolled and followed in a home-based ART program that included prevention counselling, voluntary counseling and testing (VCT) for cohabitating partners and condom provision. At baseline and follow-up, participants' HIV plasma viral load and partner-specific sexual behaviors were assessed. Risky sex was defined as inconsistent or no condom use with partners of HIV-negative or unknown serostatus in the previous 3 months. The rates of risky sex were compared using a Poisson regression model and transmission risk per partner was estimated, based on established viral load-specific transmission rates. Six months after initiating ART, risky sexual behavior reduced by 70% [adjusted risk ratio, 0.3; 95% confidence interval (CI), 0.2-0.7; P = 0.0017]. Over 85% of risky sexual acts occurred within married couples. At baseline, median viral load among those reporting risky sex was 122 500 copies/ml, and at follow-up, transmission from cohort members declined by 98%, from 45.7 to 0.9 per 1000 person years. Providing ART, prevention counseling, and partner VCT was associated with reduced sexual risk behavior and estimated risk of HIV transmission among HIV-infected Ugandan adults during the first 6 months of therapy. Integrated ART and prevention programs may reduce HIV transmission in Africa.
Bowman, Rachel A.; Scotti, Joseph R.; Morris, Tracy L.
Persons with developmental disabilities are at an increased risk for becoming victims of sexual abuse. Research has revealed that the largest group of identified perpetrators of sexual abuse is developmental disability service providers. The purpose of the present study was to develop, implement, and evaluate the effectiveness of a sexual abuse…
Colombino, Nicole; Mercado, Cynthia Calkins; Levenson, Jill; Jeglic, Elizabeth
Recently, legislative initiatives to prevent sex crime recidivism include the passage of child safety zones (also called loitering zones) that prohibit sex offenders from lingering near places where children congregate. The ability of policies such as these or residence restrictions to curb sexual recidivism depends on the empirical reality of sex offender perpetration patterns. As such, the current study sought to examine locations where sex offenders first come into contact with their victims and whether sex crime locations differ among those who perpetrate offenses against children as compared to those who perpetrate offenses against adults. Further, this study examined actuarial risk scores and recidivism rates among offenders who met victims in child-dense public locations to determine if these offenders are more at risk of re-offense. Descriptive analyses, based on archival sex offender file review (N=1557), revealed that offenders primarily cultivated their offenses in private residential locations (67.0%); relatively few offenders (4.4%) met their victims in child-dense public locations. Further, offenders who perpetrated crimes against children were more likely to meet victims within a residence, while those who perpetrate crimes against adults were more likely to encounter victims in a more public type of location (e.g., bar, workplace). Though only 3.7% of all offenders in this sample sexually recidivated, those who recidivated were more likely to have met their victim in a child-dense public location than those who did not recidivate. Current sex crime policies that focus only on where offenders live may fail to focus on where offenders go and, further, may misdirect efforts away from the place where sex crimes most often occur, namely, in the home. Copyright © 2011 Elsevier Ltd. All rights reserved.
Beier, Klaus M; Grundmann, Dorit; Kuhle, Laura F; Scherner, Gerold; Konrad, Anna; Amelung, Till
Sexual interest toward prepubescents and pubescents (pedophilia and hebephilia) constitutes a major risk factor for child sexual abuse (CSA) and viewing of child abusive images, i.e., child pornography offenses (CPO). Most child sexual exploitation involving CSA and CPO are undetected and unprosecuted in the "Dunkelfeld" (German: "dark field"). This study assesses a treatment program to enhance behavioral control and reduce associated dynamic risk factors (DRF) in self-motivated pedophiles/hebephiles in the Dunkelfeld. Between 2005 and 2011, 319 undetected help-seeking pedophiles and hebephiles expressed interest in taking part in an anonymous and confidential 1-year-treatment program using broad cognitive behavioral methodology in the Prevention Project Dunkelfeld. Therapy was assessed using nonrandomized waiting list control design (n=53 treated group [TG]; n=22 untreated control group [CG]). Self-reported pre-/posttreatment DRF changes were assessed and compared with CG. Offending behavior characteristics were also assessed via self-reporting. No pre-/postassessment changes occurred in the control group. Emotional deficits and offense-supportive cognitions decreased in the TG; posttherapy sexual self-regulation increased. Treatment-related changes were distributed unequally across offender groups. None of the offending behavior reported for the TG was identified as such by the legal authorities. However, five of 25 CSA offenders and 29 of 32 CPO offenders reported ongoing behaviors under therapy. Therapy for pedophiles/hebephiles in the Dunkelfeld can alter child sexual offending DRF and reduce-related behaviors. Unidentified, unlawful child sexual exploitative behaviors are more prevalent in this population than in officially reported recidivism. Further research into factors predictive of problematic sexual behaviors in the Dunkelfeld is warranted. © 2014 International Society for Sexual Medicine.
Lazarus, Jeffrey V; Sihvonen-Riemenschneider, Henna; Laukamm-Josten, Ulrich; Wong, Fiona; Liljestrand, Jerker
To examine the effectiveness of interventions seeking to prevent the spread of sexually transmitted infections (STIs), including HIV, among young people in the European Union. For this systematic review, we examined interventions that aimed at STI risk reduction and health promotion conducted in schools, clinics, and in the community for reported effectiveness (in changing sexual behavior and/or knowledge) between 1995 and 2005. We also reviewed study design and intervention methodology to discover how these factors affected the results, and we compiled a list of characteristics associated with successful and unsuccessful programs. Studies were eligible if they employed a randomized control design or intervention-only design that examined change over time and measured behavioral, biologic, or certain psychosocial outcomes. Of the 19 studies that satisfied our review criteria, 11 reported improvements in the sexual health knowledge and/or attitudes of young people. Ten of the 19 studies aimed to change sexual risk behavior and 3 studies reported a significant reduction in a specific aspect of sexual risk behavior. Two of the interventions that led to behavioral change were peer-led and the other was teacher-led. Only 1 of the 8 randomized controlled trials reported any statistically significant change in sexual behavior, and then only for young females. The young people studied were more accepting of peer-led than teacher-led interventions. Peer-led interventions were also more successful in improving sexual knowledge, though there was no clear difference in their effectiveness in changing behavior. The improvement in sexual health knowledge does not necessarily lead to behavioral change. While knowledge may help improve health-seeking behavior, additional interventions are needed to reduce STIs among young people.
Full Text Available Introduction: The passage from childhood to adulthood is the period when health habits and sexual behaviors start to form. Thus, the topics of sexual health and reproductive health should be approached with priority during this period. The objective of the study is to evaluate the knowledge and behavior of students of the medical faculty with respect to sexually transmitted diseases and prevention methods.Methods: The questionnaire that contains 23 headings created by the researchers after relevant literature reviews was administered to the third-semester students of the Izmir Katip Celebi University Medical Faculty in face-to-face interviews after obtaining their verbal consent. The study data was analyzed using the SPSS 20.0 demo software bundle. Conditions in which the p-value was under 0.05 were regarded as statistically significant.Results: The mean age of the students that participated in the study (n=104 was 21.88 ± 1.9 years of age, 51% (n=53 of the students were female, and 49.0% (n=51 were male. Among the students, 93% stated that they had received education about preventing pregnancy. Two of the most well-known prevention methods by the participants were condoms in 99.0% (n=103 and oral contraceptives in 95.2% (n=99. The rate of correct answers given about all of the risk factors for sexually transmitted diseases (sex workers, polygamy, homosexuality, being sexually active, substance addiction was 22.1% (n=23.Conclusion: Identifying the level of knowledge in the youth about STDs in early periods, determining the services they require, cooperating with related institutions to review the adequacy of information online, and educating youth about STDs are important in preventing these diseases and also in the treatment of existing diseases before they lead to more problems.
Esser, Stefan; Krotzek, Judith; Dirks, Henrike; Scherbaum, Norbert; Schadendorf, Dirk
Rising incidence rates of HIV and STIs (sexually transmitted infections) among MSM (men who have sex with men) in Germany since 2001 call for new approaches in medical prevention. The present study addresses appropriate parameters to identify those HIV-positive MSM who are at high risk for transmitting HIV and STIs. Over a two-year period, 223 HIV-positive MSM attending the HIV outpatient clinic at the University Medical Center Essen (Germany) were systematically surveyed with respect to their sexual behavior, substance abuse, and psychological well-being in the preceding year. Data analyzed included laboratory and clinical data from the time of the initial HIV diagnosis until January 2014. In HIV-positive MSM, a history of substance abuse, promiscuity, younger age, and known STIs was associated with a greater incidence of unprotected sexual intercourse and STIs. Apart from a detectable viral load, additional HIV-specific parameters associated with an increased HIV transmission risk included untreated HIV infection, adherence problems, changes in antiretroviral treatment over the preceding twelve months, known multiresistant HIV infection, and a higher CD 4 nadir. Despite routine quarterly monitoring of viral loads - the result thereof was communicated to patients - only 60 % of individuals assessed their HIV transmission risk correctly. In HIV-positive MSM, patient history and routine laboratory tests allow for the establishment of patient profiles that suggest sexual behavior associated with a high risk of HIV and STI transmission, thus offering new approaches for medical prevention. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.
Mugwanya, Kenneth K; Donnell, Deborah; Celum, Connie; Thomas, Katherine K; Ndase, Patrick; Mugo, Nelly; Katabira, Elly; Ngure, Kenneth; Baeten, Jared M
Scarce data are available to assess sexual behaviour of individuals using antiretroviral pre-exposure prophylaxis for HIV prevention. Increased sexual risk taking by individuals using effective HIV prevention strategies, like pre-exposure prophylaxis, could offset the benefits of HIV prevention. We studied whether the use of pre-exposure prophylaxis in HIV-uninfected men and women in HIV-serodiscordant couples was associated with increased sexual risk behaviour. We undertook a longitudinal analysis of data from the Partners PrEP Study, a double-blind, randomised, placebo-controlled trial of daily oral pre-exposure prophylaxis among HIV-uninfected partners of heterosexual HIV-serodiscordant couples (n=3163, ≥18 years of age). Efficacy for HIV prevention was publicly reported in July 2011, and participants continued monthly follow-up thereafter. We used regression analyses to compare the frequency of sex-unprotected by a condom-during the 12 months after compared with the 12 months before July 2011, to assess whether knowledge of pre-exposure prophylaxis efficacy for HIV prevention caused increased sexual risk behaviour. We analysed 56 132 person-months from 3024 HIV-uninfected individuals (64% male). The average frequency of unprotected sex with the HIV-infected study partner was 59 per 100 person-months before unmasking versus 53 after unmasking; we recorded no immediate change (p=0·66) or change over time (p=0·25) after July, 2011. We identified a significant increase in unprotected sex with outside partners after July, 2011, but the effect was small (average of 6·8 unprotected sex acts per year vs 6·2 acts in a predicted counterfactual scenario had patients remained masked, p=0·04). Compared with before July, 2011, we noted no significant increase in incident sexually transmitted infections or pregnancy after July, 2011. Pre-exposure prophylaxis, provided as part of a comprehensive prevention package, might not result in substantial changes in risk
Villar-Loubet, Olga M; Bruscantini, Laura; Shikwane, Molatelo Elisa; Weiss, Stephen; Peltzer, Karl; Jones, Deborah L
HIV-seroconversion during pregnancy is a serious concern throughout South Africa, where an estimated 35 to 40% of pregnant women have HIV/AIDS and drop-out is high at all stages of the prevention-of-mother-to-child-transmission (PMTCT) process. The likelihood of PMTCT success may be linked to partner support, yet male involvement in antenatal care remains low. This qualitative study examined the influence of pregnant couples' expectations, experiences and perceptions on sexual communication and male involvement in PMTCT. A total of 119 couples participated in a comprehensive intervention in 12 antenatal clinics throughout South Africa. Data were collected between December 2010 to June 2011 and analysed using a grounded theory approach. Findings point to the importance of sexual communication as a factor influencing PMTCT male involvement. Analysis of themes lends support to improving communication between couples, encouraging dialogue among men and increasing male involvement in PMTCT to bridge the gap between knowledge and sexual behaviour change.
Harper, Gary W; Riplinger, Andrew J; Neubauer, Leah C; Murphy, Alexandra G; Velcoff, Jessica; Bangi, Audrey K
Most new HIV infections in Kenya occur among young people. The purpose of this study was to understand ecological factors that influence HIV-related sexual risk and resilience among young people in rural Kenya and to elicit their ideas for HIV prevention interventions. Nine focus groups (N = 199) were conducted with both female (55%) and male (45%) participants (ages 14-24 years) living in rural communities in Kenya. Findings were organized into thematic areas related to the following systems of influence: (i) intrapersonal (substance use, HIV knowledge), (ii) interpersonal (peer pressure, lack of parent-child communication, interpersonal sexual violence), (iii) institutional/community (pornography, transactional sex, 'idleness', lack of role models) and (iv) socio-cultural/policy (Kikuyu culture, Western influence, religious beliefs, HIV-related stigma and gendered sexual scripts). Results regarding the types of HIV prevention programs that participants believed should be developed for young people in rural Kenya revealed seven primary themes, including (i) HIV prevention community/group workshops, (ii) condom distribution, (iii) job skills trainings, (iv) athletic and social clubs, (v) HIV-related stigma reduction campaigns, (vi) community-wide demonstrations and (vii) other HIV/AIDS activities led by young people. Implications for the development of culturally and developmentally appropriate HIV prevention interventions for young people in rural Kenya are discussed.
Sedgh, Gilda; Filippi, Veronique; Owolabi, Onikepe O; Singh, Susheela D; Askew, Ian; Bankole, Akinrinola; Benson, Janie; Rossier, Clementine; Pembe, Andrea B; Adewole, Isaac; Ganatra, Bela; MacDonagh, Sandra
Until recently, WHO operationally defined unsafe abortion as illegal abortion. In the past decade, however, the incidence of abortion by misoprostol administration has increased in countries with restrictive abortion laws. Access to safe surgical abortions has also increased in many such countries. An important effect of these trends has been that, even in an illegal environment, abortion is becoming safer, and an updated system for classifying abortion in accordance with safety is needed. Numerous factors aside from abortion method or legality should be taken into consideration in developing such a classification system. An Expert Meeting on the Definition and Measurement of Unsafe Abortion was convened in London, UK, on January 9-10, 2014, to move toward developing a classification system that both reflects current conditions and acknowledges the gradient of risk associated with abortion. The experts also discussed the types of research needed to monitor the incidence of abortion at each level of safety. These efforts are urgently needed if we are to ensure that preventing unsafe abortion is appropriately represented on the global public health agenda. Such a classification system would also motivate investment in research to accurately measure and monitor abortion incidence across categories of safety. Copyright © 2016. Published by Elsevier Ireland Ltd.
Lee, Eun Ju; Ko, Byoung Chul; Nam, Jae-Yeal
Pedestrian behavior recognition is important work for early accident prevention in advanced driver assistance system (ADAS). In particular, because most pedestrian-vehicle crashes are occurred from late of night to early of dawn, our study focus on recognizing unsafe behavior of pedestrians using thermal image captured from moving vehicle at night. For recognizing unsafe behavior, this study uses convolutional neural network (CNN) which shows high quality of recognition performance. However, because traditional CNN requires the very expensive training time and memory, we design the light CNN consisted of two convolutional layers and two subsampling layers for real-time processing of vehicle applications. In addition, we combine light CNN with boosted random forest (Boosted RF) classifier so that the output of CNN is not fully connected with the classifier but randomly connected with Boosted random forest. We named this CNN as randomly connected CNN (RC-CNN). The proposed method was successfully applied to the pedestrian unsafe behavior (PUB) dataset captured from far-infrared camera at night and its behavior recognition accuracy is confirmed to be higher than that of some algorithms related to CNNs, with a shorter processing time.
Stahlman, Shauna; Hargreaves, James R; Sprague, Laurel; Stangl, Anne L; Baral, Stefan D
The levels of coverage of human immunodeficiency virus (HIV) treatment and prevention services needed to change the trajectory of the HIV epidemic among key populations, including gay men and other men who have sex with men (MSM) and sex workers, have consistently been shown to be limited by stigma. The aim of this study was to propose an agenda for the goals and approaches of a sexual behavior stigma surveillance effort for key populations, with a focus on collecting surveillance data from 4 groups: (1) members of key population groups themselves (regardless of HIV status), (2) people living with HIV (PLHIV) who are also members of key populations, (3) members of nonkey populations, and (4) health workers. We discuss strengths and weaknesses of measuring multiple different types of stigma including perceived, anticipated, experienced, perpetrated, internalized, and intersecting stigma as measured among key populations themselves, as well as attitudes or beliefs about key populations as measured among other groups. With the increasing recognition of the importance of stigma, consistent and validated stigma metrics for key populations are needed to monitor trends and guide immediate action. Evidence-based stigma interventions may ultimately be the key to overcoming the barriers to coverage and retention in life-saving antiretroviral-based HIV prevention and treatment programs for key populations. Moving forward necessitates the integration of validated stigma scales in routine HIV surveillance efforts, as well as HIV epidemiologic and intervention studies focused on key populations, as a means of tracking progress toward a more efficient and impactful HIV response. ©Shauna Stahlman, James R Hargreaves, Laurel Sprague, Anne L Stangl, Stefan D Baral. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 26.04.2017.
Sundaram, Aparna; Vlassoff, Michael; Mugisha, Frederick; Bankole, Akinrinola; Singh, Susheela; Amanya, Leo; Onda, Tsuyoshi
Although Uganda has a restrictive abortion law, illegal abortions performed under dangerous conditions are common. Data are lacking, however, on the economic impact of postabortion complications on women and their households. Data from a 2011-2012 survey of 1,338 women who received postabortion care at 27 Ugandan health facilities were used to assess the economic consequences of unsafe abortion and subsequent treatment. Information was obtained on treatment costs and on the impact of abortion complications on children in the household, on the productivity of the respondent and other household members, and on changes in their economic circumstances. Most women reported that their unsafe abortion had had one or more adverse effects, including loss of productivity (73%), negative consequences for their children (60%) and deterioration in economic circumstances (34%). Women who had spent one or more nights in a facility receiving postabortion care were more likely than those who had not needed an overnight stay to experience these three consequences (odds ratios, 1.6-2.8), and women who had incurred higher postabortion care expenses were more likely than those with lower expenses to report deterioration in economic circumstances (1.6). Wealthier women were less likely than the poorest women to report that their children had suffered negative consequences (0.4-0.5). The impact of complications of unsafe abortion and the expense of treating them are substantial for Ugandan women and their households. Strategies to reduce the number of unsafe procedures, such as by expanding access to contraceptives to prevent unintended pregnancies, are urgently needed.
Li, Wenwei; Jiang, Junjun; Su, Jinming; Liang, Bingyu; Deng, Wei; Huang, Jiegang; Qin, Bo; Upur, Halmurat; Zhong, Chaohui; Wang, Qianqiu; Wang, Qian; Zang, Ning; Liao, Yanyan; Meng, Sirun; Ye, Li; Liang, Hao
Rural-to-urban migrants are at high risk of HIV infection. The goal of this survey was to explore the commercial sexual behavior and condom use among male rural-to-urban migrants in western China. A cross-sectional survey on male rural-to-urban migrants in western China was conducted. Among all the subjects surveyed, 140 (7.4%) had commercial sexual behavior, which is associated with being aged older than 24 years, being of Han or other ethnic minorities, being divorced, separated, or widowed, having experienced drug abuse, having had heterosexual behavior, having had casual sexual partners, having had sex with a homosexual, and being from Xinjiang. A total of 31.4% of them never use condoms when buying sex. Not using condoms is associated with being from Chongqing, having a high school or above education, and having commercial sex monthly. Commercial sexual behavior and not using condoms are common among male rural-to-urban migrants in western China. Strategies and appropriate education should be developed to prevent HIV transmission due to high-risk sexual behaviors.
Enns, Eva Andrea; Kao, Szu-Yu; Kozhimannil, Katy Backes; Kahn, Judith; Farris, Jill; Kulasingam, Shalini L
Mathematical models are important tools for assessing prevention and management strategies for sexually transmitted infections. These models are usually developed for a single infection and require calibration to observed epidemiological trends in the infection of interest. Incorporating other outcomes of sexual behavior into the model, such as pregnancy, may better inform the calibration process. We developed a mathematical model of chlamydia transmission and pregnancy in Minnesota adolescents aged 15 to 19 years. We calibrated the model to statewide rates of reported chlamydia cases alone (chlamydia calibration) and in combination with pregnancy rates (dual calibration). We evaluated the impact of calibrating to different outcomes of sexual behavior on estimated input parameter values, predicted epidemiological outcomes, and predicted impact of chlamydia prevention interventions. The two calibration scenarios produced different estimates of the probability of condom use, the probability of chlamydia transmission per sex act, the proportion of asymptomatic infections, and the screening rate among men. These differences resulted in the dual calibration scenario predicting lower prevalence and incidence of chlamydia compared with calibrating to chlamydia cases alone. When evaluating the impact of a 10% increase in condom use, the dual calibration scenario predicted fewer infections averted over 5 years compared with chlamydia calibration alone [111 (6.8%) vs 158 (8.5%)]. While pregnancy and chlamydia in adolescents are often considered separately, both are outcomes of unprotected sexual activity. Incorporating both as calibration targets in a model of chlamydia transmission resulted in different parameter estimates, potentially impacting the intervention effectiveness predicted by the model.
Hall, Grace Chela; Young, Alicia; Krakauer, Chloe; Watson, Christopher Chauncey; Cummings, Vanessa; Mayer, Kenneth; Koblin, Beryl
HIV Prevention Trials Network (HPTN 061) study data of Black MSM were analyzed to determine characteristics associated with having transgender sexual partners (TGP) and the association of having TGP with sexual risk. Of 1,449 cisgender MSM, 343(24%) reported also having TGP. MSM with TGP were more likely to be older, have a sexual orientation other than homosexual, have a history of incarceration, or have insufficient funds for necessities, but less likely to be HIV positive or report sex with men to health care providers. MSM with TGP were 3.67 times more likely to recently have 5+ new partners and 2.02 times more likely to report 6+ condomless sexual acts. Since MSM with TGP reported not disclosing sex with men to health care providers, these men may need tailored HIV prevention and care. Future studies should examine differing sexual risks MSM take with sexual partners with different gender identities.
education so SARCs and VAs can maximize the tools they have for supporting male survivors of sexual assault. Familiarity with SAPRO Resources...an area where ongoing education about the value of the SVC/VLC program may ultimately bolster support options for survivors of sexual assault...Lower Response SARCs Demonstrate awareness of the impact of sexual assault on survivors 85 83 87 81 91 Facilitate education and training 82 81 77
Yin, Lu; Wang, Na; Vermund, Sten H; Shepherd, Bryan E; Ruan, Yuhua; Shao, Yiming; Qian, Han-Zhu
Prevention intervention trials have been conducted to reduce risk of sexual transmission among people living with HIV/AIDS (PLWHA), but the findings were inconsistent. We performed a systematic review and meta-analysis to evaluate overall efficacy of prevention interventions on unprotected vaginal or anal intercourse (UVAI) among PLWHA from randomized clinical trials (RCTs). RCTs of prevention interventions among PLWHA published as of February 2012 were identified by systematically searching thirteen electronic databases. The primary outcome was UVAI. The difference of standardized mean difference (SMD) of UVAI between study arms, defined as effect size (ES), was calculated for each study and then pooled across studies using standard meta-analysis with a random effects model. Lower likelihood of UVAI was observed in the intervention arms compared with the control arms either with any sexual partners (mean ES: -0.22; 95% confidence interval [CI]: -0.32, -0.11) or with HIV-negative or unknown-status sexual partners (mean ES and 95% CI: -0.13 [-0.22, -0.04]). Short-term efficacy of interventions with ≤ 10 months of follow up was significant in reducing UVAI (1-5 months: -0.27 [-0.45, -0.10]; 6-10 months: -0.18 [-0.30, -0.07]), while long-term efficacy of interventions was weaker and might have been due to chance (11-15 months: -0.13 [-0.34, 0.08]; >15 months: -0.05 [-0.43, 0.32]). Our meta-analyses confirmed the short-term impact of prevention interventions on reducing self-reported UVAI among PLWHA irrespective of the type of sexual partner, but did not support a definite conclusion on long-term effect. It is suggested that booster intervention sessions are needed to maintain a sustainable reduction of unprotected sex among PLWHA in future risk reduction programs.
Grewe, Mary E.; Taboada, Arianna; Dennis, Alexis; Chen, Elizabeth; Stein, Kathryn; Watson, Sable; Barrington, Clare; Lightfoot, Alexandra F.
Theatre-based interventions have been used in health promotion with young people to address HIV and sexual health. In this study, we explored the experience of undergraduate student performers participating in a theatre-based HIV prevention and sexual health education intervention for high school students in the USA. Undergraduate students…
Singh, Susheela; Bankole, Akinrinola; Woog, Vanessa
Young people's need for sex education is evidenced by their typically early initiation of sexual activity, the often involuntary context within which they have sexual intercourse, high-risk sexual behaviours and the inadequate levels of knowledge of means of protecting their sexual health. The earliness of initiation of sexual intercourse has…
Steiner, Riley J; Liddon, Nicole; Swartzendruber, Andrea L; Rasberry, Catherine N; Sales, Jessica M
Long-acting reversible contraception (LARC), specifically intrauterine devices and implants, offers an unprecedented opportunity to reduce unintended pregnancies among adolescents because it is highly effective even with typical use. However, adolescent LARC users may be less likely to use condoms for preventing sexually transmitted infections compared with users of moderately effective contraceptive methods (ie, oral, Depo-Provera injection, patch, and ring contraceptives). To compare condom use between sexually active female LARC users and users of moderately effective contraceptive methods. Cross-sectional analysis using data from the 2013 national Youth Risk Behavior Survey, a nationally representative sample of US high school students in grades 9 through 12. Descriptive analyses were conducted among sexually active female students (n = 2288); logistic regression analyses were restricted to sexually active female users of LARC and moderately effective contraception (n = 619). The analyses were conducted in July and August 2015. Contraceptive method at last sexual intercourse was assessed by 1 item-respondents could select birth control pills; condoms; an intrauterine device or implant; injection, patch, or ring; withdrawal or other method; or not sure. A separate item asked whether respondents used a condom at last sexual intercourse. We created an indicator variable to distinguish those reporting use of (1) LARC (intrauterine device or implant), (2) oral contraceptives, and (3) Depo-Provera, patch, or ring. Among the 2288 sexually active female participants (56.7% white; 33.6% in 12th grade), 1.8% used LARC; 5.7% used Depo-Provera, patch, or ring; 22.4% used oral contraceptives; 40.8% used condoms; 11.8% used withdrawal or other method; 15.7% used no contraceptive method; and 1.9% were not sure. In adjusted analyses, LARC users were about 60% less likely to use condoms compared with oral contraceptive users (adjusted prevalence ratio [aPR], 0.42; 95
McEachern, Adriana G.
Sexual abuse of individuals with disabilities occurs in alarming proportions, although the prevalence and incidence of such abuse is difficult to determine. Although all states maintain statistics on child sexual abuse, the rate of victimization for individuals with disabilities is not specific. This paper reviews several studies conducted on…
Chan, Lai Fong; Tan, Susan Mooi Koon; Ang, Jin Kiat; Kamal Nor, Norazlin; Sharip, Shalisah
Adolescent sexual abuse is not an uncommon phenomenon in Malaysia. It is a traumatic experience that complicates the psychosocial development of young people on the threshold of adulthood. This case report highlights the psychosocial sequelae of adolescent sexual abuse by a traditional healer and discusses management issues in the context of…
Children (N=73) in grades two, four, and six were interviewed concerning their comprehension and response to a special comic book on child sexual abuse. Although the comic made some children anxious, one child spoke up about having been sexually abused and how the comic would have helped him. (DB)
Chan, Lai Fong; Tan, Susan Mooi Koon; Ang, Jin Kiat; Kamal Nor, Norazlin; Sharip, Shalisah
Adolescent sexual abuse is not an uncommon phenomenon in Malaysia. It is a traumatic experience that complicates the psychosocial development of young people on the threshold of adulthood. This case report highlights the psychosocial sequelae of adolescent sexual abuse by a traditional healer and discusses management issues in the context of unique cultural and belief systems.
Faley, Robert H.
Reviewed 52 court cases to determine standards set by the courts for establishing a claim of sexual harassment under Title VII of the Civil Rights Act. Examined the gender-based nature of sexual harassment at work, employment-related consequences, and the extent of employer liability for acts of their employees. (Author)
Farrell, Brenda S; Wasleski, Marilyn K; Chan, Joanna; Davis, Pawnee A; Harms, K. N; Johnson, Wesley A; La Due Lake, Ronald; Miller, Amanda K; Weissman, Cheryl A
.... Though not required to do so, the Coast Guard has established a similar policy. This statement addresses implementation and oversight of DoD's and the Coast Guard's programs to prevent and respond to sexual assault incidents...
Yu, Buyi; Chen, Jingqi; Jin, Yichen; Zhang, Wenjing; Feng, Yanan; Zhao, Xiaoxia
The prevalence of any child sexual abuse (CSA) experience before the age of 16 years ranges from 10.2 to 35.2% in China, 1-5 but there has been no research so far exploring the level of awareness of CSA prevention and self-protection skills among Chinese children with hearing loss. The school based survey examines the CSA prevention knowledge and self-protection skills in Chinese children with hearing loss. Fifty-one students (30 boys, 21 girls) from 10 to 16 years old participated in the study. Children's CSA prevention knowledge and self-protection skills were tested by using anonymous self-administered questionnaire which was mainly designed based on previous Chinese CSA research questionnaires, the Personal Safety Questionnaire, and the 'What If' Situations Test (WIST). There were ten questions assessing the knowledge of CSA but none of the children could correctly answer all and seventy percent of the students could not answer more than five questions correctly. Only three students got the maximum skills score. If sexual abuse occurs, about fifty two percent of the children would report it to trusted adults and most of them would report it to their relatives. Girls received significantly higher scores than boys. Chinese children with hearing loss lack knowledge regarding child sexual abuse and the way to protect themselves. There is an urgent need to develop CSA prevention programs in the school for children with hearing loss in China. Parental training and parent-child interaction on CSA prevention should be developed and promoted as well. Copyright © 2017 Elsevier Inc. All rights reserved.
Meijs, Suzan; Sørensen, Søren; Rechendorff, Kristian
The effect of unsafe stimulation on charge injection limits (Qinj) and pulsing capacitance (Cpulse) was investigated. Four stimulation protocols were applied: 20 mA – 200 and 400 Hz, 50 mA – 200 and 400 Hz. Increasing Qinj and Cpulse were observed for all stimulation protocols. Corrosion was not ......The effect of unsafe stimulation on charge injection limits (Qinj) and pulsing capacitance (Cpulse) was investigated. Four stimulation protocols were applied: 20 mA – 200 and 400 Hz, 50 mA – 200 and 400 Hz. Increasing Qinj and Cpulse were observed for all stimulation protocols. Corrosion...
Magowe, Mabel K M; Seloilwe, Esther; Dithole, Kefalotse; St Lawrence, Janet
The qualitative research findings are reported on the perceptions of key participants in Botswana about adolescent sexuality problems and the feasibility (with suggestions) of an adolescent prevention intervention. Twenty adult key participants who were selected through purposive sampling from schools and youth centers responded to open-ended questions during face-to-face individual in-depth interviews that were conducted between December, 2011 and January, 2012 in Gaborone, Botswana. The data were analyzed by using an inductive content analysis. Five major themes and 12 subthemes emerged from the interviews. The key participants discussed situations that exposed adolescents to HIV, sexually transmitted infections, and pregnancy. They also discussed unsafe sexual practices, the consequences of unprotected sex, poor parent-adolescent communication on sexuality, and the need for a sexuality education program. Policy changes are needed to improve collaboration between adolescents, parents, teachers, and youth officers in order to address adolescent sexuality problems. Further research is needed to explore the ways in which to improve sexuality communication between these groups. The results of the study provide valuable information on the sexuality risks that expose adolescents to HIV, pregnancy, and sexually transmitted infections and the strategies for the prevention of these risks, thus informing targeted interventions for risk reduction for adolescents. © 2017 Japan Academy of Nursing Science.
Willie, Tiara C; Callands, Tamora A; Kershaw, Trace S
The transition to parenthood is a stressful time for young couples and can put them at risk for acquiring STDs. Mechanisms underlying this risk-particularly, intimate partner violence (IPV) and sexual autonomy-have not been well studied. Between 2007 and 2011, a prospective cohort study of the relationships and health of pregnant adolescents and their male partners recruited 296 couples at four hospital-based obstetrics and gynecology clinics in the U.S. Northeast; participants were followed up six and 12 months after the birth. Structural equation modeling identified associations among IPV at baseline and six months, sexual autonomy at six months and STD acquisition at 12 months. Mediating effects of sexual autonomy were tested via bootstrapping. Females were aged 14-21, and male partners were 14 or older. For females, IPV victimization at baseline was positively associated with the likelihood of acquiring a postpartum STD (coefficient, 0.4); level of sexual autonomy was inversely associated with the likelihood of acquiring an STD and of having a male partner who acquired one by the 12-month follow-up (-0.4 for each). For males, IPV victimization at baseline was negatively correlated with a female partner's sexual autonomy (-0.3) and likelihood of acquiring an STD (-0.7); victimization at six months was positively related to a partner's sexual autonomy (0.2). Sexual autonomy did not mediate these relationships. Females' sexual autonomy appears to protect against postpartum STDs for both partners. Future research should explore the efficacy of IPV-informed approaches to improving women's sexual and reproductive health. Copyright © 2018 by the Guttmacher Institute.
Fleming, Paul J; Barrington, Clare; Pearce, Lisa D; Lerebours, Leonel; Donastorg, Yeycy; Brito, Maximo O
Ethnographic studies from numerous societies have documented the central role of male circumcision in conferring masculinity and preparing boys for adult male sexuality. Despite this link between masculinity, sexuality, and circumcision, there has been little research on these dynamics among men who have been circumcised for HIV prevention. We employed a mixed methods approach with data collected from recently circumcised men in the Dominican Republic (DR) to explore this link. We analyzed survey data collected six to 12 months post-circumcision (N = 293) as well as in-depth interviews conducted with a subsample of those men (n = 30). We found that 42% of men felt more masculine post-circumcision. In multivariate analysis, feeling more masculine was associated with greater concern about being perceived as masculine (OR = 1.70, 95% CI: 1.25-2.32), feeling more potent erections post-circumcision (OR = 2.25, 95% CI: 1.26-4.03), and reporting increased ability to satisfy their partners post-circumcision (OR = 2.30, 95% CI: 1.11-4.77). In qualitative interviews, these factors were all related to masculine norms of sexually satisfying one's partner, and men's experiences of circumcision were shaped by social norms of masculinity. This study highlights that circumcision is not simply a biomedical intervention and that circumcision programs need to incorporate considerations of masculine norms and male sexuality into their programming.
Asampong, Emmanuel; Langmagne, Sussan; Ahiedeke, Clement
To understand the role of religion in the sexual behaviours of adolescents, the views of parents who are key agents of socialization were examined from two south-eastern communities in Ghana. Focus Group interviews were conducted with mothers (and female caregivers) of adolescents and one with fathers (and male caregivers) of adolescents. Thematic analysis was used to analyse the data. Findings indicated that parents from one community perceived religion as playing a double-edged role in adolescents’ sexual behaviours as on one hand it played a protective role by restraining adolescents from risky sexual behaviours; on the other hand it disparaged the existing traditional measures that regulated adolescents’ sexual behaviour. However, parents from the other community found a collaborative interface between the existing social control measures—communal socialization and proscriptive morality with religious ethics. Religious socialization, social capital theory and the concept of social suffering are used to explain some of the findings of this study. Implications for HIV and AIDS education and prevention are also discussed. PMID:23440475
In view of challenges of HIV/AIDS, unwanted pregnancy, unsafe abortion, Sexually Transmitted Infections (STIS) facing Nigerian adolescents there is need for greater political will in implementing a nation-wide program of Comprehensive Sexuality Education (CSE) which transcends the 'ABC' that promotes 'Abstinence', 'Be ...
Studies in South Africa have reported unsafe levels of risky sexual behvaiours among adolescents and young adults, with the country reporting the highest burden of HIV/AIDS globally, as well as a high rate of teenage pregnancy. While determinants of risky sexual behaviours have been investigated for factors occurring at ...
Braun, V; Gavey, N
Cervical cancer is a very common but largely preventable cancer. Despite considerable medical knowledge of risk and even causal factors, possible social-behavioural strategies for the primary prevention of cervical cancer have rarely been explored as a viable addition to cervical screening. We examine key policy documents and interview 18 key informants on cervical cancer prevention in New Zealand. Using a discourse analytic approach we identify and discuss two discourses (which we have labelled 'protectionism' and 'right to know') which inform positions on whether or not women should be provided with information regarding sexual risk factors for cervical cancer. Cervical cancer prevention policy in New Zealand, which largely reflects a protectionist discourse, suppresses sexual risk factor information and focuses exclusively on cervical screening. The right to know discourse informs an alternative position, which contends that women have a right to be informed about risk factors. We discuss these positions in relation to questions about women's rights, the principle of informed choice, and attempts to judge what is in women's 'best interests.'
Mawji, Elysha; Wachihi, Charles; Chege, Duncan; Thottingal, Paul; Kariri, Anthony; Plummer, Francis; Ball, T Blake; Jaoko, Walter; Ngugi, Elizabeth; Kimani, Joshua; Gelmon, Lawrence; Nagelkerke, Nico; Kaul, Rupert
Objectives Although antiretroviral therapy (ART) prolongs life and reduces infectiousness, in some contexts, it has been associated with increased sexual risk taking. Design Retrospective case–control study. Setting Nairobi-based dedicated female sex worker (FSW) clinic. Participants HIV-infected FSWs before and after ART initiation (n=62); HIV-infected and -uninfected control FSWs not starting ART during the same follow-up period (n=40). Intervention Initiation of ART. Primary outcome measures Self-reported condom use, client numbers and sexually transmitted infection incidence over the study period (before and after ART initiation in cases). Results Sexual risk-taking behaviour with casual clients did not increase after ART initiation; condom use increased and sexually transmitted infection incidence decreased in both cases and controls, likely due to successful cohort-wide HIV prevention efforts. Conclusions ART provision was not associated with increases in unsafe sex in this FSW population. PMID:22466157
Rhodes, Scott D; Alonzo, Jorge; Mann, Lilli; Downs, Mario; Simán, Florence M; Andrade, Mario; Martinez, Omar; Abraham, Claire; Villatoro, Guillermo R; Bachmann, Laura H
The burden of HIV is disproportionate for Guatemalan sexual minorities (e.g., gay and bisexual men, men who have sex with men [MSM], and transgender persons). Our bi-national partnership used authentic approaches to community-based participatory research (CBPR) to identify characteristics of potentially successful programs to prevent HIV and promote sexual health among Guatemalan sexual minorities. Our partnership conducted Spanish-language focus groups with 87 participants who self-identified as male (n=64) or transgender (n=23) and individual in-depth interviews with ten formal and informal gay community leaders. Using constant comparison, an approach to grounded theory, we identified 20 characteristics of potentially successful programs to reduce HIV risk, including providing guidance on accessing limited resources; offering supportive dialogue around issues of masculinity, socio-cultural expectations, love, and intimacy; using Mayan values and images; harnessing technology; increasing leadership and advocacy skills; and mobilizing social networks. More research is clearly needed, but participants reported needing and wanting programming and had innovative ideas to prevent HIV exposure and transmission.
Souleymanov, R; Huang, Y-T
MISM (i.e. men who use the Internet to seek sex with men) has emerged in public health literature as a population in need of HIV prevention. In this paper, we argue for the importance of rethinking the dominant notions of the MISM category to uncover its ethnocentric and heteronormative bias. To accomplish this, we conducted a historical, epistemological and transnational analysis of social sciences and health research literature (n = 146) published on MISM between 2000 and 2014. We critically unravel the normative underpinnings of 'westernised' knowledge upon which the MISM category is based. We argue that the essentialist approach of Western scholarship can homogenise MISM by narrowly referring to behavioural aspects of sexuality, thereby rendering multiple sexualities/desires invisible. Furthermore, we argue that a Eurocentric bias, which underlies the MISM category, may hinder our awareness of the transnational dynamics of sexual minority communities, identities, histories and cultures. We propose the conceptualisation of MISM as hybrid cultural subjects that go beyond transnational and social boundaries, and generate conclusions about the future of the MISM category for HIV prevention and health promotion.
Full Text Available Background & aim: The most important risk factor for one’s sexual health is high-risk sexual behavior. Implementation of educational programs has been considered as one of the most crucial interventions in the prevention and treatment of these behaviors. Therefore, this study aimed to determine the effect of an educational program on the knowledge and attitude of female sex workers toward preventing high-risk sexual behaviors. Methods:This pretest-posttest, one-group study was conducted on 40 female sex workers, imprisoned in Mashhad Vakil Abad prison in 2013. Data were collected using a questionnaire including demographic characteristics, as well as knowledge- and attitude-related data. An educational program was designed after the pretest and conducted in four 70-minute sessions. Immediately and four weeks after the educational program, post-test was performed. Data were analyzed by Friedman and Wilcoxon tests, using SPSS version 16. Results: A positive significant increase was found in the mean scores of knowledge and attitude of female sex workers immediately and four weeks after the program (P
... even today, too many women, men, and children suffer alone or in silence, burdened by shame or unsure... of sexual assault during college. For some groups, the rates of violence are even higher--Native...
Hayes, Richard; Watson-Jones, Deborah; Celum, Connie; van de Wijgert, Janneke; Wasserheit, Judith
Observational and biological data provide compelling evidence of the importance of sexually transmitted infections (STIs) in HIV transmission, but only one of nine intervention trials has shown an effect. This article reviews the observational studies, critically examines the nine randomized
... FISHING INDUSTRY VESSELS General Provisions § 28.65 Termination of unsafe operations. (a) A Coast Guard... Flotation Devices (PFDs), serviceable immersion suits, or adequate survival craft capacity. (2) An... commercial fishing vessel. An individual is intoxicated when he/she is operating a commercial fishing vessel...
Siddique, S.; Hafeez, M.
To describe the demographic and clinical profile of patients admitted as a result of complicated unsafe abortion. The study was carried out in the Department of Obstetrics and Gynaecology, Jinnah Hospital, Lahore from August 2001 to July 2002. Patients admitted with complicated unsafe abortion were evaluated regarding age, parity, marital and educational status, indication for abortion, method used, qualification of abortion providers, contraceptive usage, complications and death rate in abortion seekers. Descriptive statistics was used for describing variables. Fiftynine patients were admitted with complicated unsafe abortion. The mean age was 29 years, 95% were married and multiparous, 40% had secondary and higher education, 85% approached unqualified abortion providers who used instrumentation in more than 40% of cases for termination of pregnancy resulting in visceral trauma. More than 50% were using contraception and 5% died due to postabortion complications. Unsafe abortion is a major health problem. The associated morbidity is much higher than mortality. This study focus on the need of postabortion care and easy accessibility to contraception to improve quality of health. (author)
Hong, Jun Sung; Eamon, Mary Keegan
In the aftermath of several school shooting incidents in recent years, students' perceptions of unsafe schools has been a major concern for parents, teachers, school officials, school practitioners, and policy-makers. Using Bronfenbrenner's ecological systems framework, we examined the micro-, meso-, and exosystem level factors associated with…
Objectives. To estimate the burden of disease attributable to unsafe water, sanitation and hygiene (WSH) by age group for South Africa in 2000. Design. World Health Organization comparative risk assessment methodology was used to estimate the disease burden attributable to an exposure by comparing the observed risk ...
Stoneman, Zolinda; Jinnah, Hamida Amirali; Rains, Glen C.
The study discussed in this article examined the extent to which fathers were aware of unsafe farm behaviors engaged in by their youth. Fathers and youth provided information about the youth's behaviors on the farm, particularly related to tractors/large equipment. Fathers indicated whether they were familiar with the North American Guidelines for…
In Ghana, despite the availability of safe, legally permissible abortion services, high rates of morbidity and mortality from unsafe abortion persist. Through interviews with Ghanaian physicians on the front lines of abortion provision, we begin to describe major barriers to widespread safe abortion. Their stories illustrate the ...
Background: Unsafe abortion refers to a procedure for terminating an unintended pregnancy performed either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both. Objectives: The objectives of the study are to assess the factors attributing to practice of ...
To explore the policy implications of increasing access to safe abortion in Nigeria and Ghana, we developed a computer-based decision analytic model which simulates induced abortion and its potential complications in a cohort of women, and comparatively assessed the cost-effectiveness of unsafe abortion and three ...
AJRH Managing Editor
Little is known about the role of social networks in promoting clandestine abortions. This study investigated the role social networks play in decision making for and facilitation of clandestine abortions. It was a mixed method study in which 320 women treated for complications of unsafe abortions were interviewed in a cross ...
countries where women do not have legal access to abortion. Postabortion care focuses on treatment of incomplete abortion and provision of postabortion contraceptive services. To enhance women's access to postabortion care, focus is increasingly being placed on upgrading midlevel providers to provide...... emergency treatment as well as implementing misoprostol as a treatment strategy for complications after unsafe abortion....
Unsafe abortion is still a major cause of maternal morbidity and mortality in Africa. To assess whether the introduction of legal abortions in South Africa has decreased admissions resulting from mid-trimester abortions, a prospective study of abortion cases admitted to the King Edward VIII Hospital, Durban, South Africa, over ...
... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS INSPECTION, REPAIR, AND MAINTENANCE § 396.7 Unsafe operations forbidden. (a) General. A motor vehicle shall not be operated in such a condition as to likely cause an accident or a breakdown of the vehicle. (b) Exemption. Any motor vehicle...
Shrivastava, Saurabh RamBihariLal; Shrivastava, Prateek Saurabh; Ramasamy, Jegadeesh
Unsafe abortion refers to a procedure for terminating an unintended pregnancy performed either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both. The objectives of the study are to assess the factors attributing to practice of unsafe abortion and to suggest feasible and cost-effective measures to counter the same. An extensive search of all materials related to the topic was made using library sources including Pubmed, Medline and World Health Organization. Keywords used in the search include unsafe abortion and unintended pregnancy. Multiple socio-demographic determinants and barriers such as illiterate women, poor socio-economic status, poor awareness about abortion services, associated stigma, and untrained health professionals have been identified resulting in restricted utilization/access of women to safe abortion services. Consequences of unsafe abortion have been alarming, seriously questioning the quality of health care delivery system. Concerted and dedicated efforts of government in collaboration with the private sector, community members and non-governmental organizations are needed to ensure that women have a better access to contraceptives, abortion services, and post-abortion care that are safe, affordable, and free from stigma.
. Conclusion Wealthy men in Cameroon are more likely to start sexual activity early and have both multiple concurrent and lifetime sex partners, and are less likely to (consistently use a condom in sex with a non-spousal non-cohabiting partner. These unsafe sexual behaviours may explain the higher HIV prevalence among wealthier men in the country. While these findings do not suggest a redirection of HIV prevention efforts from the poor to the wealthy, they do call for efforts to ensure that HIV prevention messages get across all strata of society.
Kuete, Martin; Yuan, Hongfang; He, Qian; Tchoua Kemayou, Aude Laure; Ndognjem, Tita Pale; Yang, Fan; Hu, ZhiZong; Tian, BoZhen; Zhao, Kai; Zhang, HuiPing; Xiong, ChengLiang
The sexual and reproductive health of people living with HIV is fundamental for their well-being. Antiretroviral therapy and reproductive technologies have significantly improved quality of life of people living with HIV in developed countries. In sub-Saharan Africa, the epicenter of HIV, the sexual practices and fertility of women infected with HIV have been understudied. To assess the sexual behavior, fertility intentions, and awareness of preventing mother-to-child transmission of HIV in pregnant women with HIV-negative partners in Yaounde Central Hospital (Yaounde, Cameroon). A cross-sectional survey using a semistructured, interviewer-administered questionnaire was conducted at the antenatal unit and HIV clinic in 2014. Ninety-four pregnant women infected with HIV provided consistent information on (i) sociodemographic characteristics, (ii) sexual and fertility patterns, (iii) awareness of preventing mother-to-child transmission of HIV, and (iv) their unmet needs. Although sexual desire had significantly changed since their HIV diagnosis, the women were highly sexually active. Approximately 19% of women had more than one sexual partner and 40% had regular unprotected sex during the 12-month period before the interviews (P sexual intercourse and inconsistent condom use to delay pregnancy, but the abortion rate remained high. Age, marital status, and education affected women's awareness of mother-to-child transmission (P children and future pregnancies (rs = -0.217; P = .036). HIV-infected women living with HIV-negative partners in Cameroon expressed high sexual and fertility intentions with several unmet needs, including safer sexual practices and conception. Incorporating and supporting safe sexual educational practices and conception services in maternal care can decrease risky sexual behavior and vertical transmission. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Anyanwu, Philip Emeka; Fulton, John
Although sexually transmitted infections (STIs) are a global health problem affecting every region of the world, the higher prevalence and mortality rate of STIs in developing countries of the world, like Nigeria, make them serious public health issues in this region. The aim of this study is to assess the knowledge and perception of young adults in Nigeria on the role of condom (both male and female condoms) as a preventive measure against STIs during heterosexual and homosexual intercourse. Data was collected from participants selected from the northern and southern Nigeria using self-administered questionnaire specifically designed for this study. Knowledge of condom efficacy in STI prevention was satisfactory. However, knowledge and practice of the correct use of condom was poor. Only 47.1% of the 102 participants in this study reported correct condom use of wearing condoms before staring intercourse and removing condoms after ejaculation. As a strategy to include the experiences, knowledge and perception of men who have sex with men, this study asked the question on condom use during anal sex. Only 24.4% of the male participants indicated they have never had anal sex while for females, the percentage was more than half (53.5%). Condom use during anal sex was low with only 20.6% of participants reporting condom use during anal sex. Negative perceptions about condom use - such as that condom use promotes sexual promiscuity, and not using condoms with steady sexual partners - were significant in this study. Also, condom use errors were common in this study. There is a wide gap in knowledge of correct condom use in this population. There is need for interventions that address the issue of condom use during anal and same-sex sexual intercourse in this population.
Muchomba, Felix M; Chan, Christine; El-Bassel, Nabila
The socioeconomic status (SES) of women is increasingly considered an important factor for HIV/STI risk. The HIV/STI literature has largely focused on women's absolute levels of SES, and therefore, the importance of their SES relative to their male sexual partners remains understudied. This paper examines the association between women's relative SES and frequency of safer sex communication among heterosexual couples. A convenience sample of 342 couples (N = 684) recruited in New York City was asked about frequency of discussions with their partner about the need to use male condoms, about HIV prevention, and about STI prevention in the previous 90 days. Differences between partners in education, income, employment, housing, and incarceration history were combined using principal component analysis to form an index of women's relative SES. Negative binomial regression models assessed associations between woman's relative SES and communication frequency controlling for age, sex, race, ethnicity, education, and relationship type using a generalized estimating equation framework. On average, participants had 2.5, 4.2, and 4.8 discussions regarding the need to use male condoms, about HIV prevention, and about STI prevention, respectively. A one standard deviation increase in a woman's relative SES score was associated with increased frequency of discussions about male condom use (adjusted rate ratio [aRR], 1.15; 95% confidence interval [CI], 1.03-1.29), about HIV prevention (aRR, 1.25; CI, 1.14-1.37), and about STI prevention (aRR, 1.29; CI, 1.18-1.41). Women's relative SES may be an important factor for sexual communication, and further research on its role in HIV/STI risk may uncover avenues for intervention.
Schilder, Arn J; Lampinen, Thomas M; Miller, Mary Lou; Hogg, Robert S
Poly-substance use in gay social ('club') settings is common. Recent studies suggest a link between 'club' drug use and sexual risk behaviours. In this qualitative study, we compare and contrast two 'club' drugs: crystal methamphetamine and ecstasy (MDMA). Life history interviews were conducted with 12 HIV seroconverters and 12 age-matched controls recruited from a prospective cohort study of young gay and bisexual men in Vancouver, British Columbia. Textual data concerning illicit substance use and unsafe sex were analyzed using NUDIST software. Most men related a substantial knowledge of and experience with crystal and ecstasy. Both drugs had attributes that enhanced gay socialization and were used in the same venues. Crystal was used to remain awake and increase energy. Ecstasy was used to induce euphoria and group connectedness. However, unlike ecstasy, crystal was associated with a distinct pattern of sexual arousal that frequently included unprotected (sometimes group) sex, was more likely to be used regularly by HIV-positive men, and was reportedly highly addictive and problematic. Crystal and ecstasy are used in the same social venues but differ markedly in relation to sexual risk behaviour.
Full Text Available Background: The United Nations Political Declaration on HIV and AIDS of 2006 stressed the need to strengthen policy and programme linkages between HIV and Sexual and Reproductive Health (SRH. However, the effectiveness and best practices for strengthening SRH and HIV linkages are poorly researched in the context of family-planning services. In Cape Town, HIV-prevention services have been integrated into family-planning services. There are two models of service configuration: dedicated stand-alone reproductive health clinics and family planning services located in comprehensive primary-care facilities.Objective: To describe how reproductive health services are integrating HIV prevention and care strategies and to measure the coverage and quality of these integrated services.Methods: A cross-sectional study was conducted using structured interviews with facility managers; a facility-based checklist; and a patient record review to assess the availability of resources, training, access, quality and integration.Results: Facilities in Cape Town are equipped adequately to offer integrated HIV-prevention and SRH services. Overall there was poor coverage of integrated services with 54% of family planning clients having a known HIV status; 47% being screened for a sexually transmitted infection and 55% being offered HIV counselling and testing and receiving condoms. Quality and continuity of care seemed better at the dedicated clinics than at the comprehensive facilities,supported by better training coverage.Conclusion: Engaging middle-level management is crucial with regard to improving integration within a well-resourced setting.
Robbers, Gianna Maxi Leila; Morgan, Alison
Continuing international conflict has resulted in several million people seeking asylum in other countries each year, over half of whom are women. Their reception and security in overburdened camps, combined with limited information and protection, increases their risk and exposure to sexual violence (SV). This literature review explores the opportunities to address SV against female refugees, with a particular focus on low-resource settings. A systematic literature review of articles published between 2000 and 2016 was conducted following PRISMA guidelines. Databases including Medline (Ovid), PubMed, Scopus, PsychINFO, CINAHL and the Cochrane Library. Grey literature from key refugee websites were searched. Studies were reviewed for quality and analysed according to the framework outlined in the UNHCR Guidelines on Prevention and Response of Sexual Violence against Refugees. Twenty-nine studies met the inclusion criteria, of which 7 studies addressed prevention, 14 studies response and 8 addressed both. There are limited numbers of rigorously evaluated SV prevention and response interventions available, especially in the context of displacement. However, emerging evidence shows that placing a stronger emphasis on programmes in the category of engagement/participation and training/education has the potential to target underlying causes of SV. SV against female refugees is caused by factors including lack of information and gender inequality. This review suggests that SV interventions that engage community members in their design and delivery, address harmful gender norms through education and advocacy, and facilitate strong cooperation between stakeholders, could maximise the efficient use of limited resources.
Full Text Available Abstract Background This paper describes the results of an exploratory qualitative study on Muslim adolescents' views on sexuality in the Netherlands. Methods Data were gathered from an Internet forum on which 44 Muslim and 33 non-Muslim adolescents discussed sexuality as it relates to Islam. These discussions were subsequently analyzed for content using Nvivo 2.0. Results Our analysis revealed several issues that are relevant for the design of future sex education programs targeting Muslim youth. Apart from some expected outcomes regarding, for example, taboos on sexuality, sex outside marriage, abortion, homosexuality and conservative gender roles, our analyses showed that in cases of disputes 1 discussions were polarized, 2 opponents used the same Qur'anic passages to support their views, and 3 the authority of an Imam was questioned when his interpretation of Qur'anic passages was not in line with the views of participants. Conclusions Our findings show that current approaches to sex education among Muslim youth are likely to be unsuccessful given the rigidity of sexual norms in Muslim society. In addition, we also identified new barriers to sex education among Muslim youth (e.g. lack of respect for an Imam who opposes a youth's views on sexuality.
Sbraga, T P; O'Donohue, W
We review the current state of sexual harassment theory, research, treatment, and prevention. Definitional problems and implications are discussed. An examination of the epidemiology of sexual harassment is presented, highlighting correlates that include characteristics of the organizational environment, the perpetrator, and the recipient of unwanted sexual behavior. Normative responses to sexual harassment and consequences are discussed. Descriptions of the most prevalent models of sexual harassment are offered and the empirical evidence for them is briefly reviewed. From there, the effect of model development and evaluation on the prevention and treatment of sexual harassment is considered. We comment on the steps that would need to be taken to develop viable prevention and treatment programs. Suggestions for fruitful avenues of research and theory development are offered.
F. Fatemi; I. Mohammadfam
Background and aims Vehicle manufacturing industries are as critical sites from points of safety. Unsafe acts and unsafe conditions have been recognized as effective factors in increasing the risk of occupational accidents. In order to promote of safety conditions, it's necessary to evaluate unsafe acts of workers as the main reason of accidents. The main goal of research is evaluation of relationship between unsafe Acts with occupational accidents. Methods Safety behavior sampling (SBS...
Crisci, George S.
Supreme Court decisions to date underscore school boards' responsibility to take action against on-campus sexual harassment. The high court will support employers who issue, communicate, and enforce policies prohibiting unlawful gender discrimination. Such policies need a clear "no tolerance" statement, detailed legal definitions, and a…
Stahlman, Shauna; Hirz, Alanna E; Stirland, Ali; Guerry, Sarah; Gorbach, Pamina M; Javanbakht, Marjan
Our objectives were to describe women's reasons for engaging in anal intercourse (AI), contextual factors surrounding AI, and how these vary by current rectal sexually transmitted infection (STI) status, and to assess women's knowledge and concerns about rectal infections. Between January 2011 and June 2013, we conducted semistructured, qualitative interviews among 40 women attending public sexually transmitted disease clinics in Los Angeles County, California. Women were eligible if they were at least 18 years of age, reported AI in the past 90 days, and were tested for rectal Chlamydia trachomatis and Neisseria gonorrhoeae. Interviews, which were guided by the theory of gender and power, were transcribed and coded to explore contextual factors surrounding AI. On average, participants reported having 3 AI partners in their lifetime and most (n = 30) reported being in a serious relationship with a main/regular sex partner at the time of the interview. Motivations for engaging in AI and feelings about AI varied by rectal STI status. Women with a rectal STI more prominently conveyed the idea that AI was intended to please their sexual partner, whereas those who did not have a rectal STI reported AI more as a way to increase intimacy and personal sexual gratification. Almost all women (regardless of rectal STI status) reported limited to no knowledge about the risk of rectal STIs. Among women, risk of acquiring rectal STIs may vary by reason for engaging in unprotected AI as well as other contextual factors. Providers should consider addressing these contextual factors to reduce risk.
Coates, Thomas J.
Outlines models for health education and community interventions targeted at reducing human immunodeficiency virus-Type 1 transmission. Notes significant gains made with regard to sexual practices among homosexual and bisexual men in some acquired immunodeficiency syndrome epicenters. Stresses need for more programs to address other high-risk…
formalized the individual states’ responsibilities to protect women from violence. Which included recognizing women as an equal gender in society...clear definition of violence against women as “any act of gender -based violence that results in, or is likely to result in, physical, sexual, or
The purpose of this study is to determine to what extent private school athletic administrators have implemented programming specifically aimed at combatting the problem of childhood sexual abuse in sport. The study examined published policies and procedures overseen by private school athletic administrators to determine to what extent their…
sanctions or foregoing these rewards and thus are most vulnerable to their men folk. We argue that the goals of HIV prevention and optimizing of care can best be achieved through change in gender identities, rather than through a focus on individual sexual behaviours. PMID:20181124
Swendeman, Dallas; Rotheram-Borus, Mary Jane
Efficacious behavioral interventions and practices have not been universally accepted, adopted, or diffused by policy makers, administrators, providers, advocates, or consumers. Biomedical innovations for sexually transmitted disease (STD) and HIV prevention have been embraced but their effectiveness is hindered by behavioral factors. Behavioral interventions are required to support providers and consumers for adoption and diffusion of biomedical innovations, protocol adherence, and sustained prevention for other STDs. Information and communication technology such as the Internet and mobile phones can deliver behavioral components for STD/HIV prevention and care to more people at less cost. Recent innovations in STD/HIV prevention with information and communication technology-mediated behavioral supports include STD/HIV testing and partner interventions, behavioral interventions, self-management, and provider care. Computer-based and Internet-based behavioral STD/HIV interventions have demonstrated efficacy comparable to face-to-face interventions. Mobile phone STD/HIV interventions using text-messaging are being broadly utilized but more work is needed to demonstrate efficacy. Electronic health records and care management systems can improve care, but interventions are needed to support adoption. Information and communication technology is rapidly diffusing globally. Over the next 5-10 years smart-phones will be broadly disseminated, connecting billions of people to the Internet and enabling lower cost, highly engaging, and ubiquitous STD/HIV prevention and treatment support interventions.
María Luisa Preinfalk-Fernández
Full Text Available In general terms, higher education institutions not only face the challenge of teaching some discipline to their students, but also of strengthening their life skills. Since university students are majorly young, the desire to provide them with comprehensive training is particularly relevant, since it is at this stage of life when they model their behavior for adulthood. In this training challenge, sex education plays a decisive role. This research paper aims to show that factors such as information gaps, unsafe sexual practices, myths, prejudices and stereotypes persist in the university student population and do not allow them to live sexuality safely and pleasurable. Moreover, these factors show Costa Rica’s need for higher education institutions to strengthen their actions in sex education. A brief tour is made from various angles through the sexual experiences of the university student population, namely: their perceptions about the training requirements they face, their main concerns, their unsafe sexual practices, their inability to negotiate sexual and reproductive health care, their knowledge and preventive practices in terms of sexual and reproductive health, the existence of forms of violence within university life, among others. The findings set out are part of a larger research, based on contributions from the theory of gender and social constructionism. Such data derives from the application of a questionnaire to a sample stratified by unequal conglomerates composed of 766 regular students of undergraduate courses, enrolled in the first cycle of 2011, at Universidad Nacional de Costa Rica. The margin of error is 1.5% and the confidence level, 95%. The data was tabulated using the software CSPRO and analyzed with software R. After obtaining the results of the instrument’s application, a focus group was created with the participation of professionals who teach sexuality courses in this university, and two other groups with
Sieving, Renee E.; McRee, Annie-Laurie; McMorris, Barbara J.; Beckman, Kara J.; Pettingell, Sandra L.; Bearinger, Linda H.; Garwick, Ann W.; Oliphant, Jennifer A.; Plowman, Shari; Resnick, Michael D.; Secor-Turner, Molly
Importance Preventing early pregnancy among vulnerable adolescents requires innovative and sustained approaches. Prime Time, a youth development intervention, aims to reduce pregnancy risk among adolescent girls seeking clinic services who are at high risk for pregnancy. Objective To evaluate sexual risk behaviors and related outcomes with a 24-month postbaseline survey, 6 months after the conclusion of the Prime Time intervention. Design Randomized controlled trial. Setting Community and school-based primary care clinics. Participants Of 253 sexually active 13- to 17-year-old girls meeting specified risk criteria, 236 (93.3%) completed the 24-month follow-up survey. Intervention Offered during an 18-month period, Prime Time includes case management and youth leadership programs. Main Outcome Measures Self-reported consistency of condom, hormonal, and dual-method contraceptive use with most recent male sex partner and number of male sex partners in the past 6 months. Results At 24-month follow-up, the intervention group reported significantly more consistent use of condoms, hormonal contraception, and dual-method contraception than the control group. Intervention participants also reported improvements in family connectedness and self-efficacy to refuse unwanted sex, and reductions in the perceived importance of having sex. No between-group differences were found in the number of recent male sex partners. Conclusions and Relevance This study contributes to what has been a dearth of evidence regarding youth development interventions offered through clinic settings, where access to high-risk adolescents is plentiful but few efforts have emphasized a dual approach of strengthening sexual and nonsexual protective factors while addressing risk. Findings suggest that health services grounded in a youth development framework can lead to long-term reductions in sexual risk among vulnerable youth. PMID:23440337
Cooper, Keith; Shepherd, Jonathan; Picot, Jo; Jones, Jeremy; Kavanagh, Josephine; Harden, Angela; Barnett-Page, Elaine; Clegg, Andrew; Hartwell, Debbie; Frampton, Geoff; Price, Alison
Reducing sexually transmitted infections (STI) and teenage pregnancy through effective health education is a high priority for health policy. Behavioral interventions which teach skills to practice safer sex may reduce the incidence of STIs. We evaluated the cost-effectiveness of school-based behavioral interventions in young people. We developed an economic model to estimate the total number of STI cases averted, consequent gain in health related quality of life (HRQoL) and savings in medical costs, based on changes in sexual behavior. The parameters for the model were derived from a systematic literature search on the intervention effectiveness, epidemiology of STIs, sexual behavior and lifestyles, HRQoL and health service costs. The costs of providing teacher-led and peer-led behavioral interventions were €5.16 and €18 per pupil, respectively. For a cohort of 1000 boys and 1000 girls aged 15 years, the model estimated that the behavioral interventions would avert two STI cases and save 0.35 Quality Adjusted Life Years (QALYs). Compared to standard education, the incremental cost-effectiveness of the teacher-led and peer-led interventions was €24,268 and €96,938 per QALY gained, respectively. School-based behavioral interventions which provide information and teach young people sexual health skills can bring about improvements in knowledge and increased self-efficacy, though these may be limited in terms of impact on sexual behavior. There was uncertainty around the results due to the limited effect of the intervention on behavioral outcomes and paucity of data for other input parameters.
Alta C. van Dyk
Full Text Available The purpose of this study was to investigate how clergy are dealing with HIV prevention and sexuality education of young people in their congregations. An electronic questionnaire was filled in by 142 clergy from white Afrikaans-speaking churches in the Reformed tradition. Results showed that 77% clergy believed that unmarried young people in their congregations are sexually active. More than 85% clergy agreed that it is the task of the church to provide sexuality and HIV prevention education to young congregants. However, not many clergy (13% offered HIV prevention programmes for young people in their own congregations. The main HIV prevention message 85% of clergy were prepared to share with young congregants was �abstinence only� or �your body is the temple of God�. Only 15% clergy (significantly more female clergy were prepared to offer comprehensive sexuality education (abstinence PLUS programmes. The HIV prevention message of the church should at least be in line with the lived experiences and reality of its youth in today�s society. The church can no longer afford to alienate young people through moralism only. She needs an approach that satisfies both morality and reality.Intradisciplinary and/or interdisciplinary implications: This article has implications for the fields of psychology, HIV and AIDS research and pastoral care. It challenges the way the church prepares young people to cope with HIV in a modern society and suggests change in terms of a greater participation in the sexuality education of young people.
Sayonara Lays Umbelino Souto
Full Text Available Objective: To identify relevant evidence to the peculiarities of nursing care to women in situation of unsafe abortion. Method: This is a survey of integrative review of literature, where the databases used were LILACS, BDENF, MEDLINE and SCOPUS. The data collection occurred during the months of September and October 2016, articles were in Portuguese, English and Spanish, from 2006 to 2016. The sample was composed of 14 studies. Results: Studies have shown that nursing care is carried out in a technicist and without quality service; contrary to the norms of the Code of Ethics for nurses. There were willing two thematic categories: reasons that led the women to practice unsafe abortion and the nursing care provided to women in a situation of abortion. Conclusion: Trials, prejudice, religiosity and moral values of nurses, contribute to the precariousness of quality assistance to these women. Descriptors: abortion; induced abortion; caused abortion; nursing; nursing care.
Friedman, Allison L; Kachur, Rachel E; Noar, Seth M; McFarlane, Mary
Despite the ubiquity of sex in the media, a culture of silence surrounds sexual health in the United States, serving as a barrier to sexually transmitted disease (STD) prevention, testing, and treatment. Campaigns can increase STD-related knowledge, communication, and protective behaviors. This review assesses the effectiveness of STD prevention and testing campaigns in the United States to inform the field on their use as a strategy for affecting behavior change. A comprehensive literature search was conducted to identify original research articles, published between 2000 and 2014, which report on US media campaigns promoting community- or population-level STD testing or prevention behaviors and are evaluated for impact on one or more behavioral outcomes. Titles and abstracts were independently reviewed by 2 researchers. The review yielded 26 articles representing 16 unique STD testing and/or prevention campaigns. Most campaigns were developed using formative research and social marketing or behavioral theory. Most campaigns (68.75%) used posttest-only or pretest-posttest designs without comparison groups for evaluation; only 5 campaigns used control groups, and these proved challenging (i.e., achieving necessary exposure and avoiding contamination). Nearly all campaigns found differences between exposed and unexposed individuals on one or more key behavioral outcomes. Several campaigns found dose-response relationships. Among evaluations with uncontaminated control groups whose campaigns achieved sufficient exposure, sustained campaign effects were observed among targeted populations. Current findings suggest that campaigns can impact targeted STD-related behaviors and add to the evidence that greater exposure is associated with greater behavior change.
Wetherill, Reagan R; Neal, Dan J; Fromme, Kim
Several decades of research have identified the contributions of psychosocial influences on adolescent and young adult sexual behavior; however, few studies have examined parental and peer influence and sexual values during the transition from high school to college. The current study tested the influence of sexual values and perceived awareness and caring (PAC), or beliefs about how much parents and peers know and care about students' behavior, on sexual behavior during this transitional period. Using data from a longitudinal study, generalized estimating equations and the generalized linear model were used to examine the associations among sexual values, parental and peer PAC, and sexual behavior, both cross-sectionally and longitudinally. Participants (N = 1,847; 61% female) completed web-based surveys the summer before college matriculation and at the end of the first semester in college. Results indicated that individuals with high levels of both parental and peer PAC engaged in less frequent sexual behaviors and that PAC moderated the effect of sexual values on sexual behaviors. Furthermore, both PAC variables decreased during the transition from high school to college, and high school sexual values, parental PAC, and their interaction predicted the number of sexual partners during the first semester of college. Only sexual values and high school unsafe sexual behaviors predicted unsafe sexual behavior in college. Findings suggest that complex associations exist among perceived awareness and caring, sexual values, and sexual behaviors, and that the transition from high school to college may be an ideal time for safer-sex interventions.
Huerga, Helena; Venables, Emilie; Ben-Farhat, Jihane; van Cutsem, Gilles; Ellman, Tom; Kenyon, Chris
Efficacy of Treatment as Prevention Strategy depends on a variety of factors including individuals' likelihood to test and initiate treatment, viral load and sexual behaviour. We tested the hypothesis that people with higher risk sexual behaviour are less likely to know their HIV-positive status and be virologically suppressed. A cross-sectional population-based survey of individuals aged 15-59 years old was conducted in 2013 in KwaZulu-Natal, South Africa. A two-stage cluster probability sampling was used. After adjustment for age and sex, lack of awareness of HIV-positivity was strongly associated with having more than one sexual partner in the preceding year (aOR: 2.1, 95%CI: 1.5-3.1). Inconsistent condom use was more common in individuals with more than one sexual partner (aOR: 16.6, 95%CI: 7.6-36.7) and those unaware (aOR: 3.7, 95%CI: 2.6-5.4). Among people aware of their HIV-positivity, higher risk sexual behaviour was associated with lack of viral suppression (aOR: 2.2, 95%CI: 1.1-4.5). Risky sexual behaviour seems associated with factors linked to poor health-seeking behaviour which may have negative implications for HIV testing and Treatment as Prevention. Innovative strategies, driven by improved epidemiological and anthropological understanding, are needed to enable comprehensive approaches to HIV prevention.
behaviors and their relationship to one another. In addition, public health and safety organizations around the world employ this model to combat cancer ...level abusive sexual contact is common within predominantly male commands (e.g., “nut-tapping” – grabbing testicles ) Perceptions Regarding Training...Breast Cancer Awareness Month, Armed Forces Day, holiday runs), which target junior enlisted and single airman, civilians and dependents. This has
Simon, Cristiane Paulin; Silva, Rosalina Carvalho da; Paiva, Vera
To investigate perception of AIDS and to obtain information for developing AIDS prevention programs targeting female juvenile prostitution. Thirteen young women aged 18 to 21 years working as prostitutes in the city of Ribeirão Preto, Brazil, were interviewed using semi-structured interviews. The questionnaire focused on sociodemographic aspects, HIV-related knowledge, sexual behavior, relations with clients and other sexual partners, and suggestions for sexually transmitted diseases (STD) and AIDS prevention programs. Though all subjects demonstrated knowledge of safe sex and HIV transmission, this contrasted with their belief that destiny determines who gets infected and their search for affection in their relationships with partners and clients. These contradictions act as possible factors preventing safe sex behavior. The strategies of HIV/AIDS prevention should incorporate the need of allowing room for discussion in order to clarify this group's social imaginary beliefs and concepts about AIDS. In addition, discussions about the belief in the safety of affective relationships should take place since this encourages unsafe sexual practices. Another key issue is how to approach this group and strategies sensitive to their individualities should be applied.
Full Text Available Socio-demographic predictors about safe sex behaviours in individual suffering from immune deficiency virus (HIV had been tried to understand in this cross-sectional study. It was conducted on 120 individuals having immune deficiency virus (HIV. Collection of the data were based on socio-demographic and a safe sex behaviour questionnaire. To determine the socio-demographic the general linear model was used. Result revealed mean (SD of the total score of safe sexual behaviour among men and women was 66.5 (13.1, 62.2 (13.0 respectively and (Score limit: 0-100. Status of sexual partners, unprotected vaginal sex, drugs and alcohols, as well as employment status, were considered as predictors of safe sex behaviours. About 50 percent of the participants pose unsafe sexual practices, thus, it is advisable that the health promotion programs and HIV prevention should implement in various groups of the society.
Ch. Megawati Tirtawinata
Lack of sex education in children could cause the violence or sexual abuse done by adults. Parents should give the lesson about early sex education to the children so that they had the right knowledge about it and knew how to treat and look after it. The method in this research was a discourse analysis of the literature in which the readings were taken in context with the research topic. Besides that, it included the observations and everyday practical experience in social life. This article ...
Hsieh, Hsiu-Fen; Wang, Hsiu-Hung; Chang, Shu-Chen
Forensic nursing is a new nursing specialty that provides forensic nursing service to domestic violence victims and offenders. Development of the role of forensic nurses has become urgent and necessary. The high rates of domestic violence and sexual assault in Taiwan suggest that forensic nurses have an important role to play in domestic healthcare. This article highlights the significance of forensic nursing in Taiwan in the future in terms of its origin, definitions, models, roles and functions, training and education, and previous studies. Through cooperation among academia, government, industry, and law enforcement agencies, it is expected that forensic nursing will be a positive and important area of expansion for professional nursing.
Robertson, Angela; Levin, Martin L.
Examined AIDS knowledge, condom attitudes, and sexual risk taking behavior among 193 juvenile offenders on probation or parole who were substance abusers. Surveys indicated that most youths were sexually active. Many reported unsafe sexual practices. General attitudes toward condoms and reported use of condoms at first sexual intercourse were the…
Streng, Tara K.; Kamimura, Akiko
Objective: Sexual violence within the collegiate environment is a pressing issue within American society. One way to address sexual violence is through the adaptation and implementation of a sexual assault policy by colleges and universities. The purpose of this study is to review sexual misconduct and assault policies of ten public universities…
Anderson, James E; Kanters, Steve
This study set out to assess the relationship between variation in human rights for sexual minorities in Asian countries and indicators of HIV prevention among men who have sex with men (MSM) and transgender women. To quantitatively measure the relationship between variation in HIV prevention and variation in human rights for sexual minorities, this study developed the Sexual Orientation and Gender Identity (SOGI) Human Rights Index (an original index with scores ranging from 0.0 to 1.0). Subsequently, this study collected 237 epidemiological and behavioral studies from 22 Asian countries and performed a series of meta-analyses in order to calculate national averages for five indicators of HIV prevention: HIV prevalence, inconsistent condom use, recent HIV testing, adequate HIV knowledge, and exposure to HIV prevention services. A change of human rights for sexual minorities from a score of 0.0 to 1.0 as measured by the SOGI Human Rights Index was correlated with a decrease in unprotected anal intercourse by 25.5% (p=0.075), and increases in recent HIV testing by 42.9% (p=0.011), HIV knowledge by 29.5% (p=0.032), and exposure to HIV prevention services by 37.9% (p=0.119). The relationship between HIV prevalence and variation in human rights for sexual minorities was not statistically significant. Our study found correlations between human rights and indicators of HIV prevention, further supporting the need for increased rights among marginalized populations. The paucity of studies from many Asian countries as well as the disparity in how indicators of HIV prevention are measured reveals a need for increased coverage and standardization of MSM serological and behavioral data in order to better inform evidence-based policymaking.
Hill, Mandy; Granado, Misha; Stotts, Angela
HIV continues to be a major public health problem for African-American (AA) women, and the burden of new cases to our society is significant because each case is at risk of infecting others. Substance use worsens the risk of HIV transmission to AA women. We provide specific recommendations to move the concept of tailoring HIV prevention interventions for substance users forward by focusing on young, sexually active, substance-using AA women and applying a culturally relevant revision to existing theoretical frameworks to include the Sexual Script Theory and the Theory of Gender and Power. We encourage use of these theories to guide adaptation of interventions to demonstrate efficacy within this hard-to-reach population. Consistent use of theories designed to exploit powerlessness and sexual scripts as barriers to adoption of protective sexual behaviors has potential to permeate sexual and substance use networks among African-Americans. This recommendation is being made because this theoretical framework has not been used in HIV prevention interventions targeting young, sexually active, substance-using AA women.
Lan Anh Thi Do
Full Text Available Abstract 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
Full Text Available Despite the fact that HIV epidemic is mainly driven by injection drug use in Iran, partners of People Who Inject Drugs (PWID have been seriously neglected in terms of effective preventive interventions. Currently, sexual partners of PWID might have access to some harm reduction services at Voluntary Counselling and Testing (VCT centers; however, their needs have not been effectively targeted and met. Unfortunately, the current programs implemented by the Ministry of Health have overlooked the importance of this population in the course of the HIV epidemic throughout the country. In this policy brief, we are trying to draw the health policy-makers’ attention to this overlooked population and while reviewing the advantages and disadvantages of some of the readily available options on the table, come up with a recommended action to tackle this problem. Our recommended action that seems to have had promising results elsewhere in Asia would try to implement preventive interventions targeting this particular population through peer prevention programs.
Oliveira, Giselly Oseni Barbosa; Cavalcante, Luana Duarte Wanderley; Pagliuca, Lorita Marlena Freitag; de Almeida, Paulo César; Rebouças, Cristiana Brasil de Almeida
ABSTRACT Objective: to validate an educational text in the context of Sexually Transmitted Diseases (STD) for visually impaired persons, making it accessible to this population. Method: a validation study, in a virtual environment. Data collection occurred from May to September 2012 by emailing the subjects, and was composed by seven content experts about STDs. Analysis was based on the considerations of the experts about Objectives, Structure and Presentation, and Relevance. Results: on the Objectives and Structure and Presentation blocks, 77 (84.6%) and 48 (85.7%) were fully adequate or appropriate, respectively. In the Relevance block, items 3.2 - Allows transfer and generalization of learning, and 3.5 - Portrays aspects needed to clarify the family, showed bad agreement indices of 0.42 and 0.57, respectively. The analysis was followed by reformulating the text according to the relevant suggestions. Conclusion: the text was validated regarding the content of sexually transmitted diseases. A total of 35 stanzas were removed and nine others included, following the recommendations of the experts. PMID:27556880
This article dicusses the use of scientific facts as argument for a 1999 Brazilian debate about the legitimacy of an official aids prevention policy. It seeks to defamiliarized a common aids argumentative practice which uses a classification of a scientific public health measure as a main legitimacy judgement. It is argued that it is peoples? negotiations and objects? mobilization that gives legitimacy to the implementation of a prevention estrategy ? acccording to a Social Psicology of scien...
Witte, Susan S.; Batsukh, Altantsetseg; Chang, Mingway
SUMMARY This study examines HIV/STI risk behaviors, alcohol abuse, intimate partner violence, and psychological distress among 48 female sex workers in Mongolia to inform the design of a gender-specific, HIV/STI prevention intervention for this population. Quantitative findings demonstrate that over 85% of women reported drinking alcohol at harmful levels; 70% reported using condoms inconsistently with any sexual partner; 83% reported using alcohol before engaging in sex with paying partners, and 38% reported high levels of depression. Focus group findings provide contextual support and narrative descriptions for the ways that poverty, alcohol abuse, interpersonal violence, and cultural norms that stigmatize and marginalize women are intertwined risk factors for STIs, including HIV, among these vulnerable women. PMID:20391057
Full Text Available Abstract Background Cardiac pacing is a recognized and widely used treatment for patients presenting with bradycardia. Physicians expect patients to return to normal activities almost immediately post implantation. However, patients themselves may perceive interference to pacemaker function by various routine activities and devices, and hence continue to lead restricted, disabled lives. The aim of this study is to determine if routine activities are perceived by pacemaker patients to interfere with their device function. Methods A descriptive cross sectional survey was carried out on consecutive patients at the pacemaker clinic at a public hospital in Karachi, Pakistan. A 47-question tool was developed and tested. Patients' perceptions of safety of performing various routine activities, along with socio-demographic data were recorded. Results The final sample included 93 adult patients (45% males. 41% were illiterate. 77.4% recalled receiving counselling at implantation, predominantly from the implanting physician and house staff. A considerable proportion of patients considered many routine activities unsafe including driving automobiles (28%, passing through metal detectors (31%, bending over (37%, and sleeping on the side of the pacemaker (30%. Also considered unsafe were operation of household appliances- TV/VCR (television/video cassette recorders (53%, irons (55% and electrical wall switches (56%. For nearly all variables neither literacy nor history of counselling improved incorrect perceptions. Conclusion This study shows that our pacemaker patients perceive many routine activities as unsafe, potentially leading to disabling life style modifications. The tremendous investment in pacemaker technology to improve patient performance is not going to pay dividends if patients continue to remain disabled due to incorrect perceptions. Further studies are required to determine the reasons for these misperceptions, and to determine if these
Naqvi, Kaniz Zehra; Edhi, Muhammad Muzzammil
Every year 42 million women with unintended pregnancies choose abortion, and fifty percent of these procedures, 20 million are unsafe. An unsafe abortion is defined as a procedure for terminating an unintended pregnancy carried out either by person lacking the necessary skills or in an environment that does not conform to minimal medical standards or both.Pakistan is the one of the six countries where more than 50% of the world's all maternal deaths occur. It is estimated that 890,000 induced abortions are performed annually in Pakistan, and estimate an annual abortion rate of 29 per 1000 women aged 15-49. Here we present a case report of a 29-year old woman who underwent an unsafe abortion for unintended pregnancy resulting in uterine perforation. The unskilled provider pulled out her bowel through vagina after perforating the uterus, as a result she lost major portion of her small intestine resulting in short bowel syndrome. The law of Pakistan only allows abortion during early stages of pregnancy for purpose of saving the life of a mother but does not cater for cases of rape, incest and fetal abnormalities or social reasons.Only legalization of abortion is not sufficient, preventing unintended pregnancy should be the priority of all the nations and for this reason contraception should be widely accessible.Practitioners need to become better trained in safer abortion methods and be to able transfer the patient to health facility when complications occur.
Friedman, Allison L; Brookmeyer, Kathryn A; Kachur, Rachel E; Ford, Jessie; Hogben, Matthew; Habel, Melissa A; Kantor, Leslie M; Clark, Elizabeth; Sabatini, Jamie; McFarlane, Mary
Youth in the United States bear a disproportionate burden of sexually transmitted diseases (STDs). Stigma, misconceptions, and access challenges keep many from getting tested or treated. The GYT: Get Yourself Tested campaign was launched in 2009 to reduce stigma and promote STD communication and testing. This evaluation sought to assess the first 2 years of campaign engagement and associations with STD testing among youth. Campaign engagement with select GYT on-the-ground events, social media sites, and STD testing locator tools was measured through process/media tracking metrics. Sexually transmitted disease testing patterns were assessed using data from Planned Parenthood affiliates (2008-2010) and national trend data from clinics participating in national infertility prevention activities (2003-2010). On-the-ground events reached an estimated 20,000 youth in 2009 and 52,000 youth in 2010. Across 2009 to 2010, GYT's Facebook page gained 4477 fans, Twitter feed gained 1994 followers, and more than 140,000 referrals were made to the STD testing locator. From April 2008 to 2010, there was a 71% increase in STD testing and a 41% increase in chlamydia testing at reporting Planned Parenthood affiliates (representing ∼118 health centers). Chlamydia case positivity rates during this period were stable at 6.6% (2008) and 7.3% (2010). Trend data indicate that testing was higher in spring 2009 and 2010 compared with other periods during those years; this pattern is commensurate with STD Awareness Month/GYT activities. Data quality is limited in a manner similar to many STD prevention efforts. Within these limitations, evidence suggests that GYT reaches youth and is associated with increased STD testing.
Factores psicosociales y culturales en la prevención y tratamiento de las enfermedades de transmisión sexual Psychosocial and cultural factors in the prevention and treatment of sexually transmitted diseases
Full Text Available El artículo trata de las dimensiones psicosociales y culturales de las enfermedades de transmisión sexual. Sobre la base de resultados de una investigación cualitativa realizada entre hombres y mujeres de sectores populares (jóvenes y adultos en el Gran Buenos Aires, la autora discute cómo las nociones legas acerca de las ETS (sus síntomas, vías de transmisión, consecuencias y las normas culturales sobre el comportamiento sexual y las relaciones de género afectan la habilidad de las personas para considerarse en riesgo y/o adoptar conductas de prevención. También se discuten las implicancias de estos hallazgos en términos de estrategias apropiadas para promover conductas de cuidado de la salud sexual y reproductiva.The article deals with the psychosocial and cultural dimensions of sexually transmitted diseases. Based on results from a qualitative study with lower-class males and females (young and adult from a neighbourhood in the metropolitan area of Buenos Aires, the author discusses how lay beliefs (about symptoms, transmission, consequences and norms regarding sexual matters and gender relations affect people's ability to consider themselves at risk and/or adopt preventive behaviors. Implications of research results for the design of culturally appropriate strategies to promote sexual and reproductive health are also provided.
Kim, Shin-Jeong; Kang, Kyung-Ah
Child sexual abuse (CSA) threatens children's safety and even their lives. CSA is increasing steadily, despite the government's efforts to decrease and prevent its incidence. The purpose of this study was to evaluate the effects of the Child Sexual Abuse Prevention Education (C-SAPE) program on fifth-grade elementary school students' competence in…
Tamburro, Robert F; Gordon, Patricia L; D'Apolito, James P; Howard, Scott C
likelihood of viewing by children after 9:00 PM. For example, afternoon telecasts of the National Collegiate Athletic Association Regional Final and National Semifinal games were assessed in place of the Championship game, which started after 9:00 PM. Weekend afternoon telecasts of the Winter Olympics (3 successive weekends) were assessed as surrogates for all Olympics telecasts. For the World Series, the Super Bowl, and the National Basketball Association Conference Championship games, which began before 9:00 PM but ended after that time, we evaluated only commercials that aired before 9:00 PM. All commercials that were aired during these programs were reviewed at standard speed for unsafe behavior or violence. Commercials that were aired during pregame, postgame, or halftime periods were not assessed. Commercials were categorized according to the product being advertised. Unsafe behavior was simply defined as any action that could have harmful consequences or that contravened the injury prevention recommendations of national organizations. Violence was defined as any intentional physical contact by an aggressor that had the potential to inflict injury or harm or the legitimate threat of such action. All commercials were reviewed by at least 2 investigators; when the 2 could not agree on the findings, a third investigator was used to resolve differences. The percentage of commercials and of commercial breaks that portrayed violent or unsafe behavior was determined for each category of event and advertised product. A commercial break was defined as a series of commercials shown during a single break from the sporting event. chi2 analysis was used for all analyses, and relative risks with 95% confidence intervals were determined. The proportion of commercials that depicted unsafe behavior and/or violence during each sporting event was compared with the proportion of such commercials that were observed during the Masters Golf Tournament (which had the lowest proportion of
Suicide is currently the second leading cause of death in the U.S. among youth ages 10 to 24. Sexual and gender minority (SGM) youth face heightened risk for suicide and report greater odds of attempting suicide than their heteronormative peers. Contributing factors of experience, which are distinctly different from the experiences of heteronormative youth, place SGM youth at heightened risk for suicide. While interventions aimed at addressing suicide risk factors for all youth are being implemented and many have proven effective in the general population, no evidence-based intervention currently exists to reduce suicide risk within this special population. This perspective article discusses this need and proposes the development of an evidence-based suicide risk reduction intervention tailored to SGM youth. Creating a supportive school climate for SGM youth has been shown to reduce suicide risk and may provide protective effects for all youth while simultaneously meeting the unique needs of SGM youth.
Stahlman, Shauna; Grosso, Ashley; Ketende, Sosthenes; Sweitzer, Stephanie; Mothopeng, Tampose; Taruberekera, Noah; Nkonyana, John; Baral, Stefan
Social stigma is common among men who have sex with men (MSM) across Sub-Saharan Africa, and may influence risks for HIV and sexually transmitted infections (STIs) via its association with depression. We conducted a cross-sectional study of 530 MSM in Lesotho accrued via respondent-driven sampling. Using generalized structural equation models we examined associations between stigma, social capital, and depression with condom use and testing positive for HIV/STIs. Depression was positively associated with social stigma experienced or perceived as a result of being MSM. In contrast, increasing levels of social cohesion were negatively associated with depression. Social stigma was associated with testing positive for HIV; however, this association did not appear to be mediated by depression or condom use. These data suggest a need for integrated HIV and mental health care that addresses stigma and discrimination and facilitates positive social support for MSM.
Introduction: Sexually transmitted infections are among the most important public health problems in the world. People who indulge in unsafe sex, such as female sex workers are the most at risk population groups due to multiple sexual partners and inconsistent condom use. The aim of this study was to assess condom ...
Leonardi, Bethy; Staley, Sara
Schools tend to be unsafe, unsupportive places for LGBTQ youth. Generally, teachers and administrators are provided little professional development (professional development) focused on gender and sexual diversity. Efforts to provide educators with gender and sexual diversity-focused professional development are slowly expanding, but still too…
This study assesses the correlations of participation in a prevention program, Men Creating Attitudes for Rape-free Environments (Men CARE), and participants' attitudes and behavior toward sexual violence. The t-tests were used to determine the association, either by the intervention or the cohort, on attitudes and behaviors between the groups,…
Until recently, teen pregnancy and birth rates had declined in the United States. Despite these declines, U.S. teen birth and sexually transmitted infection (STI) rates remain among the highest in the industrialized world. Given the need to focus limited prevention resources on effective programs, Advocates for Youth undertook exhaustive reviews…
K. I. Nikolaeva
Full Text Available The article presents the results of a survey held among orphaned children and children without parental care with regard to the prevention of sexually transmitted infections as well as results showing the efficacy of awareness-raising workshops regarding reproductive health.
Jin, Y.; Chen, J.; Jiang, Y.; Yu, B.
The aim of this present study was to evaluate the effectiveness of a child sexual abuse (CSA) prevention curriculum toward children and to compare the knowledge gains between children who were taught by teachers and their parents. Four hundred and eighty-four school-age children recruited from one primary school in Beijing, China, were randomly…
Sclafane, Jamie Heather
Dialogue journaling is a technique that is useful for enhancing the goals of sexual health promotion and HIV/STI prevention programs with 14-to 17-year-old at-risk youth. Included is a detailed lesson plan on how to implement dialogue journaling in this context, a discussion of advantages and concerns about using them, and future implications for…
Full Text Available This article dicusses the use of scientific facts as argument for a 1999 Brazilian debate about the legitimacy of an official aids prevention policy. It seeks to defamiliarized a common aids argumentative practice which uses a classification of a scientific public health measure as a main legitimacy judgement. It is argued that it is peoples? negotiations and objects? mobilization that gives legitimacy to the implementation of a prevention estrategy ? acccording to a Social Psicology of science with a construcionist point of view.
Patterson, Sophie; Carter, Allison; Nicholson, Valerie; Webster, Kath; Ding, Erin; Kestler, Mary; Ogilvie, Gina; de Pokomandy, Alexandra; Loutfy, Mona; Kaida, Angela
Sexual HIV transmission does not occur with sustained undetectable viral load (VL) on antiretroviral therapy (ART). Awareness of ART prevention benefits and its influence on condom use among women with HIV (WWH) remain unexplored. We estimated prevalence and correlates of condomless sex with regular HIV-serodiscordant partners among WWH with undetectable VL on ART. We used baseline questionnaire data from the community-based longitudinal Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS). We included WWH self-reporting vaginal/anal sex with ≥1 HIV-negative/unknown status regular partner within 6 months, and undetectable VL (prevention benefits. Logistic regression identified factors independently associated with condomless sex. Of 271 participants (19% of the CHIWOS cohort), median age was 41 (interquartile range: 34-47), 51% were in a relationship, 55% reported condomless sex, and 75% were aware of ART prevention benefits. Among women aware, 63% reported condomless sex compared with 32% of women not aware (P prevention benefits (adjusted odds ratio: 4.08; 95% confidence interval: 2.04 to 8.16), white ethnicity, ≥high-school education, residing in British Columbia, and being in a relationship. Virally suppressed women aware of ART prevention benefits had 4-fold greater odds of condomless sex. Advancing safer sex discussions beyond condoms is critical to support women in regular serodiscordant partnerships to realize options for safe and satisfying sexuality in the Treatment-as-Prevention era.
Gamma-hydroxybutyric acid (GHB) has become increasingly popular on the campuses of American colleges and universities. In this paper, the characteristics of GHB and the effects of both voluntary and involuntary abuse are described. Further, implications for prevention efforts related to involuntary GHB ingestion and GHB-facilitated rape are…
Chamroonsawasdi, Kanittha; Suparp, Jarueyporn; Kittipichai, Wirin; Khajornchaikul, Piyathida
To enhance positive attitude and life skills on gender roles to prevent physical and sexual violence. A whole school-based participatory learning program using a quasi-experimental study with pre and post test design was conducted among 2 schools during June-September, 2005. The experimental group, were 134 students in a primary school and 179 students in a secondary school. While the control group, were 122 students in a primary school and 95 students in a secondary school. Means score of attitude toward gender roles before implementation in the experimental group was significantly lower than the control group (p 0.05). Means paired different score (after-before) between the two groups was significantly different (p = 0.002). A whole school-based program on gender roles and violence prevention is suitable for youths and should be merged as school curricula and expanded as a nationwide program at all level of education. Gender equity should be taught at an early childhood. Parental involvement in school-based activities should be negotiated.
A thorough understanding of the environmental and structural factors that precipitate unsafe sexual practices is necessary for HIV/AIDS-prevention research among high-risk population groups like commercial sex workers. I examined how poverty contextualizes sexual health behavior, including condom compliance among commercial female sex workers in a red light district in Calcutta, India. For my research I did an ethnographic study and conducted in-depth interviews of 37 commercial female sex workers. I found that poverty, instead of serving as a catalyst for poor health choices among sex workers, acted as an impetus for pursuing safe sex practices and remaining healthy. The results indicate that sex work, poverty, and health do not always have a paradoxical relationship.
Salvatierra, Javier; Segura, Eddy; Salazar, Ximena; Konda, Kelika; Perez-Brumer, Amaya; Hall, Eric; Klausner, Jeffrey; Caceres, Carlos; Coates, Thomas
Role-based sexual identities structure male same-sex partnerships and influence HIV/STI epidemiology among MSM in Latin America. We explored shifting relationships between sexual roles, identities and practices among MSM in Lima, Peru, and implications for HIV/STI prevention. Patterns of HIV/STI epidemiology reflected differential risks for transmission within role-based partnerships with relatively low prevalences of HIV, syphilis, and HSV-2 but higher prevalences of urethral gonorrhea/chlamydia among activo MSM compared with moderno and pasivo participants. Qualitative analysis of how MSM in Peru integrate sexual identities, roles, and practices identified four key themes: pasivo role as a gay approximation of cultural femininity; activo role as a heterosexual consolidation of masculinity; moderno role as a masculine reconceptualization of gay identity; and role-based identities as social determinants of partnership, network, and community formation. The concept of role-based sexual identities provides a framework for HIV prevention for Latin American MSM that integrates sexual identities, practices, partnerships, and networks. PMID:22614747
Venkatesh, Kartik K; de Bruyn, Guy; Lurie, Mark N; Modisenyane, Tebogo; Triche, Elizabeth W; Gray, Glenda E; Welte, Alex; Martinson, Neil A
We studied 1163 sexually-active HIV-infected South African men and women in an urban primary care program to understand patterns of sexual behaviors and whether these behaviors differed by partner HIV status. Overall, 40% reported a HIV-positive partner and 60% a HIV-negative or status unknown partner; and 17.5% reported >2 sex acts in the last 2 weeks, 16.4% unprotected sex in the last 6 months, and 3.7% >1 sex partner in the last 6 months. Antiretroviral therapy (ART) was consistently associated with decreased sexual risk behaviors, as well as with reporting a HIV-negative or status unknown partner. The odds of sexual risk behaviors differed by sex; and were generally higher among participants reporting a HIV-positive partner, but continued among those with a HIV-negative or status unknown partner. These data support ART as a means of HIV prevention. Engaging in sexual risk behaviors primarily with HIV-positive partners was not widely practiced in this setting, emphasizing the need for couples-based prevention.
Full Text Available Background and aims Vehicle manufacturing industries are as critical sites from points of safety. Unsafe acts and unsafe conditions have been recognized as effective factors in increasing the risk of occupational accidents. In order to promote of safety conditions, it's necessary to evaluate unsafe acts of workers as the main reason of accidents. The main goal of research is evaluation of relationship between unsafe Acts with occupational accidents. Methods Safety behavior sampling (SBS technique was employed to conduct this study. After doing a pilot study, the number of samples and views were determined 195 and 3456 respectively. The information was then analyzed using Excel, SPSS and statistic tests. Results The results of the study showed that the rate of unsafe acts of studying workers was 35.4% .The study of the relationship between unsafe acts and occupational accidents via Regression Logistic test showed that if one percent increases on unsafe acts, the rate of accidents multiply three. Conclusion Therefore in view of this significant correlation between unsafe acts and occupational accidents and kind of unsafe acts, reducing or eliminating requires the investment and implementation of a program. It should be associated with behavioral safety principles and emphasis should be placed on implementing safety culture fundamentals at all organizational levels.
Oliveira, Giselly Oseni Barbosa; Cavalcante, Luana Duarte Wanderley; Pagliuca, Lorita Marlena Freitag; Almeida, Paulo César de; Rebouças, Cristiana Brasil de Almeida
to validate an educational text in the context of Sexually Transmitted Diseases (STD) for visually impaired persons, making it accessible to this population. a validation study, in a virtual environment. Data collection occurred from May to September 2012 by emailing the subjects, and was composed by seven content experts about STDs. Analysis was based on the considerations of the experts about Objectives, Structure and Presentation, and Relevance. on the Objectives and Structure and Presentation blocks, 77 (84.6%) and 48 (85.7%) were fully adequate or appropriate, respectively. In the Relevance block, items 3.2 - Allows transfer and generalization of learning, and 3.5 - Portrays aspects needed to clarify the family, showed bad agreement indices of 0.42 and 0.57, respectively. The analysis was followed by reformulating the text according to the relevant suggestions. the text was validated regarding the content of sexually transmitted diseases. A total of 35 stanzas were removed and nine others included, following the recommendations of the experts. validar texto educativo no contexto das doenças sexualmente transmissíveis para pessoas com deficiência visual para torná-lo acessível a essa população. estudo de validação, em ambiente virtual. Coleta de dados de maio a setembro de 2012, por meio da utilização dos e-mails eletrônicos dos sujeitos, compostos por sete especialistas em conteúdo na temática, através de instrumento próprio. Análise ocorreu com base nas considerações dos especialistas sobre os Objetivos, Estrutura e Apresentação e Relevância. nos blocos de Objetivos e Estrutura e Apresentação, 77 (84,6%) e 48 (85,7%) eram totalmente adequados ou adequados, respectivamente. No bloco de Relevância, os itens 3.2 - Permite transferência e generalização da aprendizagem, e 3.5 - Mostra aspectos necessários para informar a família, revelaram índices de concordância ruins de 0,42 e 0,57, respectivamente. Após a análise, o texto foi
Full Text Available Abstract With the continuing march of the AIDS epidemic and little hope for an effective vaccine in the near future, work to develop a topical strategy to prevent HIV infection is increasingly important. This stated, the track record of large scale "microbicide" trials has been disappointing with nonspecific inhibitors either failing to protect women from infection or even increasing HIV acquisition. Newer strategies that target directly the elements needed for viral entry into cells have shown promise in non-human primate models of HIV transmission and as these agents have not yet been broadly introduced in regions of highest HIV prevalence, they are particularly attractive for prophylaxis. We review here the agents that can block HIV cellular entry and that show promise as topical strategies or "virustats" to prevent mucosal transmission of HIV infection
Ian W Holloway
Full Text Available The present study addresses gaps in the literature related to theory development for young men who have sex with men (YMSM sexual practices through the application and modification of Social Action Theory. Data come from the Healthy Young Men study (N = 526, which longitudinally tracked a diverse cohort of YMSM ages 18-24 to characterize risk and protective factors associated with drug use and sexual practices. Structural equation modeling examined the applicability of, and any necessary modifications to a YMSM-focused version of Social Action Theory. The final model displayed excellent fit (CFI = 0.955, TLI = 0.947, RMSEA = 0.037 and suggested concordance between social support and personal capacity for sexual health promotion. For YMSM, practicing health promotion and avoiding practices that may put them at risk for HIV was associated with both social isolation and psychological distress (β = -0.372, t = -4.601, p<0.001; psychological distress is an internalized response to environmental and cognitive factors and sexual practices are an externalized response. Results point to the utility of Social Action Theory as a useful model for understanding sexual practices among YMSM, the application of which shows health protective sexual practices are a function of sociocognitive factors that are influenced by environmental contexts. Social Action Theory can help prevention scientists better address the needs of this vulnerable population.
Holloway, Ian W.; Traube, Dorian E.; Schrager, Sheree M.; Tan, Diane; Dunlap, Shannon; Kipke, Michele D.
The present study addresses gaps in the literature related to theory development for young men who have sex with men (YMSM) sexual practices through the application and modification of Social Action Theory. Data come from the Healthy Young Men study (N = 526), which longitudinally tracked a diverse cohort of YMSM ages 18–24 to characterize risk and protective factors associated with drug use and sexual practices. Structural equation modeling examined the applicability of, and any necessary modifications to a YMSM-focused version of Social Action Theory. The final model displayed excellent fit (CFI = 0.955, TLI = 0.947, RMSEA = 0.037) and suggested concordance between social support and personal capacity for sexual health promotion. For YMSM, practicing health promotion and avoiding practices that may put them at risk for HIV was associated with both social isolation and psychological distress (β = -0.372, t = -4.601, pcognitive factors and sexual practices are an externalized response. Results point to the utility of Social Action Theory as a useful model for understanding sexual practices among YMSM, the application of which shows health protective sexual practices are a function of sociocognitive factors that are influenced by environmental contexts. Social Action Theory can help prevention scientists better address the needs of this vulnerable population. PMID:28886128
mission readiness, and raises financial costs. DOD data show that reported sexual assaults involving servicemembers more than doubled from about 2,800...fiscal year 2014.1 However, recent data suggest that these reports represent a fraction of the sexual assault incidents that are actually occurring...Corporation, Sexual Assault and Sexual Harassment in the U.S. Military: Volume 2. Estimates for Department of Defense Service Members from the 2014
van Lieshout, Sanne; Mevissen, Fraukje E F; van Breukelen, Gerard; Jonker, Marianne; Ruiter, Robert A C
Sexual harassment-unwanted sexual comments, advances, or behaviors-and sexual violence are still prevalent worldwide, leading to a variety of physical, cognitive, and emotional problems among those being harassed. In particular, youth in care are at risk of becoming perpetrators (and victims) of
Sales, Jessica M.; Spitalnick, Josh; Milhausen, Robin R.; Wingood, Gina M.; Diclemente, Ralph J.; Salazar, Laura F.; Crosby, Richard A.
This study examined the psychometric properties of a new scale to measure adolescents' worry regarding outcomes of risky sexual behavior (i.e. sexually transmitted infections, including HIV [STI/HIV], and unintended pregnancy). The 10-item worry about sexual outcomes (WASO) scale, resulting in two subscales STI/HIV worry and pregnancy worry, was…
Sieving, Renee E.; McMorris, Barbara J.; Beckman, Kara J.; Pettingell, Sandra L.; Secor-Turner, Molly; Kugler, Kari; Garwick, Ann W.; Resnick, Michael D.; Bearinger, Linda H.
Purpose Prime Time, a youth development intervention, aims to reduce pregnancy risk among adolescent girls seeking clinic services who are at high risk for pregnancy. This paper examines sexual risk behaviors and hypothesized psychosocial mediators after 12 months of the Prime Time intervention. Methods Randomized controlled trial with 253 girls ages 13-17 years meeting specified risk criteria. Intervention participants were involved in Prime Time programming plus usual clinic services for 18 months, control participants received usual clinic services. The intervention employed a combination of case management and peer leadership programs. Participants in this interim outcomes study completed self-report surveys at baseline and 12 months following enrollment. Surveys assessed sexual risk behaviors and psychosocial factors targeted for change by Prime Time. Results At the 12-month interim, the intervention group reported more consistent use of condoms, hormonal contraception and dual contraceptive methods with their most recent partner than did the control group. The intervention group also reported greater stress management skills with trends towards higher levels of pro-social connectedness at school and with family. No between-group differences were noted in psychosocial measures specific to sex and contraceptive use. Conclusions Preventing early pregnancy among high-risk adolescents requires multifaceted, sustained approaches. An important research focus involves testing youth development interventions offered through clinic settings, where access to high-risk adolescents is plentiful and few efforts have emphasized a dual approach of building protective factors while addressing risk. Findings suggest that youth development interventions through clinic settings hold promise in reducing pregnancy risk among high-risk youth. PMID:21783050
Full Text Available Abstract Background Sexually transmitted infection (STI prevention programs can mitigate the health and economic burden of STIs. A tool to estimate the economic benefits of STI programs could prove useful to STI program personnel. Methods We developed formulas that can be applied to estimate the direct medical costs and indirect costs (lost productivity averted by STI programs in the United States. Costs and probabilities for these formulas were based primarily on published studies. Results We present a series of formulas that can be used to estimate the economic benefits of STI prevention (in 2006 US dollars, using data routinely collected by STI programs. For example, the averted sequelae costs associated with treating women for chlamydia is given as (Cw(0.16(0.925(0.70($1,995, where Cw is the number of infected women treated for chlamydia, 0.16 is the absolute reduction in the probability of pelvic inflammatory disease (PID as a result of treatment, 0.925 is an adjustment factor to prevent double-counting of PID averted in women with both chlamydia and gonorrhea, 0.70 is an adjustment factor to account for the possibility of re-infection, and $1,995 is the average cost per case of PID, based on published sources. Conclusion The formulas developed in this study can be a useful tool for STI program personnel to generate evidence-based estimates of the economic impact of their program and can facilitate the assessment of the cost-effectiveness of their activities.
Notario-Pérez, Fernando; Martín-Illana, Araceli; Cazorla-Luna, Raúl; Ruiz-Caro, Roberto; Bedoya, Luis-Miguel; Tamayo, Aitana; Rubio, Juan; Veiga, María-Dolores
The main challenges facing efforts to prevent the transmission of human immunodeficiency virus (HIV) are the lack of access to sexual education services and sexual violence against young women and girls. Vaginal formulations for the prevention of sexually transmitted infections are currently gaining importance in drug development. Vaginal mucoadhesive tablets can be developed by including natural polymers that have good binding capacity with mucosal tissues, such as chitosan or guar gum, semisynthetic polymers such as hydroxypropylmethyl cellulose, or synthetic polymers such as Eudragit® RS. This paper assesses the potential of chitosan for the development of sustained-release vaginal tablets of Tenofovir and compares it with different polymers. The parameters assessed were the permanence time of the bioadhesion—determined ex vivo using bovine vaginal mucosa as substrate—the drug release profiles from the formulation to the medium (simulated vaginal fluid), and swelling profiles in the same medium. Chitosan can be said to allow the manufacture of tablets that remain adhered to the vaginal mucosa and release the drug in a sustained way, with low toxicity and moderate swelling that ensures the comfort of the patient and may be useful for the prevention of sexual transmission of HIV. PMID:28230790
Hust, Stacey J T; Adams, Paula M; Willoughby, Jessica Fitts; Ren, Chunbo; Lei, Ming; Ran, Weina; Marett, Emily Garrigues
Among the existing sexual assault prevention efforts on college campuses, few use mass communication strategies designed to simultaneously entertain and educate. Although many entertainment-education efforts are guided by social cognitive theory, other theories may be useful in entertainment-education design. Previous research has found that social cognitive theory and social norms theory can successfully influence participants' perceived norms and efficacy related to sexual assault reduction; however, whether such results can be replicated in a naturalistic setting and the extent to which the guiding theoretical foundation may influence outcomes remain unknown. We used a pre- and posttest field experiment with college students in residence halls to assess how different theoretical foundations may influence effects. Over the course of a semester, the participants viewed eight mini-magazines developed using (1) social cognitive theory, (2) social norms theory, (3) a combination of both theoretical frameworks, or (4) a control condition with no sexual assault prevention messaging. Participants in the combined content condition had greater levels of self-efficacy related to sexual assault prevention and more accurate norm perceptions. There were also effects for the mini-magazines developed with only one theoretical framework. Overall, we found that multiple theories can effectively guide entertainment-education message development.
Notario-Pérez, Fernando; Martín-Illana, Araceli; Cazorla-Luna, Raúl; Ruiz-Caro, Roberto; Bedoya, Luis-Miguel; Tamayo, Aitana; Rubio, Juan; Veiga, María-Dolores
The main challenges facing efforts to prevent the transmission of human immunodeficiency virus (HIV) are the lack of access to sexual education services and sexual violence against young women and girls. Vaginal formulations for the prevention of sexually transmitted infections are currently gaining importance in drug development. Vaginal mucoadhesive tablets can be developed by including natural polymers that have good binding capacity with mucosal tissues, such as chitosan or guar gum, semisynthetic polymers such as hydroxypropylmethyl cellulose, or synthetic polymers such as Eudragit ® RS. This paper assesses the potential of chitosan for the development of sustained-release vaginal tablets of Tenofovir and compares it with different polymers. The parameters assessed were the permanence time of the bioadhesion-determined ex vivo using bovine vaginal mucosa as substrate-the drug release profiles from the formulation to the medium (simulated vaginal fluid), and swelling profiles in the same medium. Chitosan can be said to allow the manufacture of tablets that remain adhered to the vaginal mucosa and release the drug in a sustained way, with low toxicity and moderate swelling that ensures the comfort of the patient and may be useful for the prevention of sexual transmission of HIV.
Full Text Available The main challenges facing efforts to prevent the transmission of human immunodeficiency virus (HIV are the lack of access to sexual education services and sexual violence against young women and girls. Vaginal formulations for the prevention of sexually transmitted infections are currently gaining importance in drug development. Vaginal mucoadhesive tablets can be developed by including natural polymers that have good binding capacity with mucosal tissues, such as chitosan or guar gum, semisynthetic polymers such as hydroxypropylmethyl cellulose, or synthetic polymers such as Eudragit® RS. This paper assesses the potential of chitosan for the development of sustained-release vaginal tablets of Tenofovir and compares it with different polymers. The parameters assessed were the permanence time of the bioadhesion—determined ex vivo using bovine vaginal mucosa as substrate—the drug release profiles from the formulation to the medium (simulated vaginal fluid, and swelling profiles in the same medium. Chitosan can be said to allow the manufacture of tablets that remain adhered to the vaginal mucosa and release the drug in a sustained way, with low toxicity and moderate swelling that ensures the comfort of the patient and may be useful for the prevention of sexual transmission of HIV.
O'Brien, Eileen M.
Date and acquaintance rape may be more prevalent on college campuses than in other environments, and colleges are struggling to confront the issue. Sexism and racism contribute to underreporting of and misconceptions about sexual abuse in college settings. Policies, programs, and procedures for combating sexual assaults on campus are recommended.…
first sexual intercourse. RESULTS: Males and residents of urban areas reported greater sexual activity and condom use. Typically, adolescents who used condoms during the first sexual intercourse were male, older, resided in urban areas, non-speakers of an indigenous language, and with higher schooling. CONCLUSIONS: New policies should be framed to prevent sexually transmitted infections to span the gap between knowledge and practice, targeting adolescents starting sexual activity earlier, those who speak an indigenous language, living in rural areas, with less schooling, and females.
de Wit, J B; van Griensven, G J; Kok, G; Sandfort, T G
To assess predictors of relapse into unprotected anogenital intercourse with casual partners among homosexual men in Amsterdam, The Netherlands. A prospective study ongoing since October 1984. Self-reported data on sexual behaviour were obtained at 12 semi-annual intervals. Participants who reported unprotected anogenital intercourse with casual partners at wave 12 but not at wave 11 were considered to have relapsed into unsafe sex (n = 47). Men who did not report unprotected anogenital intercourse at wave 11 or at wave 12 were considered to have maintained behaviour change (n = 197). Relapse into unsafe sex with casual partners occurred more frequently among men with a less positive attitude towards condom use, lower personal efficacy with respect to using condoms with casual partners, a weaker intention to avoid anogenital intercourse with casual partners and those who were not involved in a primary relationship. Intention to avoid anogenital intercourse with casual partners was related to an individual's attitude, normative beliefs and personal efficacy with respect to avoiding anogenital intercourse. In order to improve motivation it is important to support homosexual men in their personal decision-making process, which may be more resolute when the outcome is in accordance with individual preferences. Therefore, health education should be community-based and sensitive to individual needs.
Background Up-to-date, genuine sexual and reproductive health (SRH) education programmes have been possible in Romania only since communism collapsed in 1990. Since 2006, Romania has had no national strategy in this field. Under current global circumstances (high labour mobility, internationally mixed marriages), issues previously considered solely national have become worldwide concerns. Methods In 2011–2012, 1215 respondents homogeneously distributed on background, gender, educational level and age group (18–74) were sampled. This article uses a 96-item questionnaire about family and SRH, presenting results on nine items: first intercourse (FI), virginity, knowing first sexual partner, safe sex, number of sexual partners and sexual education. The data were analysed using Pearson chi-square tests and latent class analysis. Results Some participants (7.2%) engaged in FI at age 15 or earlier. The average age at FI was lower for men (18.08), for individuals with a lower education level (18.07) and for those in rural areas (18.27), compared with that for women, those with more education and those in urban areas, respectively. The average age at FI was over 2.5 years lower for people aged 18–24 (16.99) than for those aged 60–74 (p sex at FI, with higher proportions for the urban sample, those with an average level of education and those aged 18–35 (p education (p source. Conclusions Unsafe sex, early initiation of sexual activity and poor SRH education from schools, experts and parents require a multidisciplinary approach within prevention programmes, especially among the populations at risk: rural residents, those with low levels of education and youth. PMID:24957900
Hojilla, J. Carlo; Koester, Kimberly A.; Cohen, Stephanie E.; Buchbinder, Susan; Ladzekpo, Deawodi; Matheson, Tim; Liu, Albert Y
Pre-exposure prophylaxis (PrEP) is a viable HIV prevention strategy but risk compensation could undermine potential benefits. There are limited data that examine this phenomenon outside of clinical trials. We conducted a qualitative analysis of counseling notes from the San Francisco site of the US PrEP Demonstration Project to assess how men who have sex with men (MSM) used PrEP as a prevention strategy and its impact on their sexual practices. Four major themes emerged from our analysis of 130 distinct notes associated with 26 participants. Prevention strategy decision-making was dynamic, often influenced by the context and perceived risk of a sexual encounter. Counselors noted that participants used PrEP in conjunction with other health promotion strategies like condoms, asking about HIV status of their sex partners, and seroadaptation. With few exceptions, existing risk reduction strategies were not abandoned upon initiation of PrEP. Risk-taking behavior was ‘seasonal’ and fluctuations were influenced by various personal, psychosocial, and health-related factors. PrEP also helped relieve anxiety regarding sex and HIV, particularly among serodiscordant partners. Understanding sexual decision-making and how PrEP is incorporated into existing prevention strategies can help inform future PrEP implementation efforts. PMID:25835463
Ullman, Sarah E; Vasquez, Amanda L
This study examined sexual risk behaviors and sexual refusal assertiveness in relationship to child sexual abuse, emotion dysregulation, and adult sexual revictimization. Path analyses of 1,094 survivors who had sex in the past year were done to examine sexual risk behavior and sexual refusal assertiveness mediational pathways by which child sexual abuse severity and emotion dysregulation may affect revictimization over one year in adult female sexual assault survivors. Exchanging sex for money and sexual refusal assertiveness were significantly associated with emotion dysregulation, whereas exchanging sex for money, and not sexual refusal assertiveness, was only significantly related to child sexual abuse severity. Both exchanging sex for money and sex refusal assertiveness mediated the relationship between emotion dysregulation and adult sexual revictimization. Exchanging sex for money mediated the child sexual abuse severity-revictimization relationship. These findings demonstrate the importance of considering both risky and protective sexual behaviors in research and prevention programming that address sexual revictimization in women.
... 29 Labor 9 2010-07-01 2010-07-01 false Abatement of unsafe or unhealthful working conditions. 1960.30 Section 1960.30 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH... unhealthful working conditions. (a) The agency shall ensure the prompt abatement of unsafe and unhealthful...
Arizon Peretz, Renana; Luria, Gil
In order to reduce road accidents rates, studies around the globe have attempted to shed light on the antecedents for unsafe road behaviors. The aim of the current research is to contribute to this literature by offering a new organizational antecedent of driver's unsafe behavior: The driver's relationships with his or her peers, as reflected in three types of social networks: negative relationships network, friendship networks and advice networks (safety consulting). We hypothesized that a driver's position in negative relationship networks, friendship networks, and advice networks will predict unsafe driving. Additionally, we hypothesized the existence of mutual influences among the driver's positions in these various networks, and suggested that the driver's positions interact to predict unsafe driving behaviors. The research included 83 professional drivers from four different organizations. Driving behavior data were gathered via the IVDR (In-Vehicle Data Recorder) system, installed in every truck to measure and record the driver's behavior. The findings indicated that the drivers' position in the team networks predicts safe driving behavior: Centrality in negative relationship networks is positively related to unsafe driving, and centrality in friendship networks is negatively related to unsafe driving, while centrality in advice networks is not related to unsafe driving. Furthermore, we found an interaction effect between negative network centrality and centrality in friendship networks. The relation between negative networks and unsafe behavior is weaker when high levels of friendship network centrality exist. The implications will be presented in the Discussion section. Copyright © 2017 Elsevier Ltd. All rights reserved.
Abstract. Little is known about maternal near-miss (MNM) due to unsafe abortion in Nigeria. We used the WHO criteria to identify near-miss events and the proportion due to unsafe abortion among women of childbearing age in eight large secondary and tertiary hospitals across the six geo-political zones. We also explored ...
Tweed, Mike; Wilkinson, Tim
Marking of multiple choice type examinations often just takes account of the correct responses. This may encourage guessing of incorrect and potentially unsafe responses. Ideally responses should contain a high proportion of correct, unsafe and the use of 'don't know' response rather than incorrect. This study explored the effect of instructions on responses. Fourth- and fifth-year students sitting for an optional multiple choice examination were randomized to receive one of four instruction options: number-correct marking (the control group); alert to unsafe; mark deduction for unsafe; or correction for guessing. A total of 210 students sat the test. For the fourth-year cohort, compared with the control group, being alerted to unsafe and mark deduction for unsafe or incorrect responses were associated with graduated increases in the use of 'don't know' and reductions in incorrect responses. For the fifth-year cohort, there were no differences in responses between options. The fifth-year cohort, gave more correct, and fewer incorrect, unsafe and 'don't know' responses. Both the year group and instructions had an effect. Being alerted to potentially unsafe responses, even when there is no mark deduction penalty, had an effect, although mark deduction still had the greatest effect. Assessment instructions may give subliminal messages that have important consequences.
Fayemi Mojisola M
Full Text Available Abstract Background Young people are becoming increasingly exposed to the risk of HIV infection. According to the 2008 HIV/Syphilis sentinel survey in Nigeria, 3.3% of young people aged 15-19 years are infected. Primary prevention especially abstinence, remains one of the most realistic interventions for reducing further spread of the virus. However, the adoption of sexual abstinence as a prevention strategy among adolescents remains low and factors influencing its practice among urban young people in Nigeria are relatively unknown. The aim of the study was to document the sexual abstinence behaviour of in-school adolescents, the factors influencing or obstructing abstinence, and knowledge of HIV and AIDS in Ibadan, South-West Nigeria. Methods The study was a descriptive cross-sectional survey of students in Ibadan South-West Local Government Area. A total of 420 respondents (52% males and 48% females, selected through a multistage sampling technique, completed a semi-structured questionnaire. This was supplemented with eight focus group discussions (FGDs which had an average of 9 respondents within the 10 and 19 years age group. The data from the FGDs were transcribed and summarized manually while the quantitative data was analyzed using the Statistical Package for the Social Sciences to generate frequencies, cross tabulations of variables and logistic regression analysis. Results Twelve percent of the entire sample had ever had sex. Overall, knowledge of HIV transmission and prevention was high and most respondents favoured the promotion of abstinence as an HIV prevention strategy. A smaller proportion of male respondents (79% abstained compared with the females (98%. Major predictors of sexual abstinence were being a female, not having a boyfriend or girl friend, not using alcohol and having a positive attitude towards abstinence (P Sexual abstinence was also significantly associated with perceived self efficacy to refuse sex and negative
Tobian, Aaron A R; Kacker, Seema; Quinn, Thomas C
Randomized trials have demonstrated that male circumcision (MC) reduces heterosexual acquisition of HIV, herpes simplex virus type 2, human papillomavirus (HPV), and genital ulcer disease among men, and it reduces HPV, genital ulcer disease, bacterial vaginosis, and trichomoniasis among female partners. The pathophysiology behind these effects is multifactorial, relying on anatomic and cellular changes. MC is cost effective and potentially cost saving in both the United States and Africa. The World Health Organization and Joint United Nations Program on HIV/AIDS proposed reaching 80% MC coverage in HIV endemic countries, but current rates fall far behind targets. Barriers to scale-up include supply-side and demand-side challenges. In the United States, neonatal MC rates are decreasing, but the American Academy of Pediatrics now recognizes the medical benefits of MC and supports insurance coverage. Although MC is a globally valuable tool to prevent HIV and other sexually transmitted infections, it is underutilized. Further research is needed to address barriers to MC uptake.
Eaton, Lisa A; Kalichman, Seth C; Kalichman, Moira O; Driffin, Daniel D; Baldwin, Robert; Zohren, Larissa; Conway-Washington, Christopher
Novel interventions to address sexual risk taking and slow rates of STIs are urgently needed, in particular among black men who have sex with men (MSM) in the USA. Serosorting, or limiting condomless sex acts to partners of the same HIV status, is commonly practised among MSM, yet can lead to STI and remains largely unaddressed by public health agencies. A two-arm, randomised controlled trial was conducted from 2012 to 2015. This trial assessed the effects of a single-session, sexual partner selection and risk decision intervention (experimental arm) versus a single-session, Centers for Disease Control and Prevention-based, sexual risk reduction intervention (control arm) on psychosocial measures, sexual risk taking and STI. At study follow-ups, multiple beneficial changes were observed on sexual risk beliefs measures (ie, changes in serosorting and condom use beliefs, and HIV risk perceptions) and sexual risk taking among the experimental arm relative to the control arm. Overall main effects, however, of the intervention on STI outcomes on year-long follow-ups were non-significant. There was evidence for short-term effects on STI outcomes, and self-report of multiple STIs and STI symptoms demonstrated positive effects over the follow-up period. Brief interventions to address sexual risk taking can result in short-term beneficial outcomes and can be incorporated into currently existing infrastructure at healthcare agencies. Additional intervention will be necessary for demonstrating long-term results. NCT02128594. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Nelson, Deborah B; Zhao, Huaqing; Corrado, Rachel; Mastrogiannnis, Dimitrios M; Lepore, Stephen J
Ineffective contraceptive use among young sexually active women is extremely prevalent and poses a significant risk for unintended pregnancy (UP). Ineffective contraception involves the use of the withdrawal method or the inconsistent use of other types of contraception (i.e., condoms and birth control pills). This investigation examined violence exposure and psychological factors related to ineffective contraceptive use among young sexually active women. Young, nonpregnant sexually active women (n = 315) were recruited from an urban family planning clinic in 2013 to participate in a longitudinal study. Tablet-based surveys measured childhood violence, community-level violence, intimate partner violence, depressive symptoms, and self-esteem. Follow-up surveys measured type and consistency of contraception used 9 months later. Multivariate logistic regression models assessed violence and psychological risk factors as main effects and moderators related to ineffective compared with effective use of contraception. The multivariate logistic regression model showed that childhood sexual violence and low self-esteem were significantly related to ineffective use of contraception (adjusted odds ratio [aOR] = 2.69, confidence interval [95% CI]: 1.18-6.17, and aOR = 0.51, 95% CI: 0.28-0.93; respectively), although self-esteem did not moderate the relationship between childhood sexual violence and ineffective use of contraception (aOR = 0.38, 95% CI: 0.08-1.84). Depressive symptoms were not related to ineffective use of contraception in the multivariate model. Interventions to reduce UP should recognize the long-term effects of childhood sexual violence and address the role of low self-esteem on the ability of young sexually active women to effectively and consistently use contraception to prevent UP.
Best, Connie L; Smith, Daniel W; Raymond, John R; Greenberg, Raymond S; Crouch, Rosalie K
There is a high incidence of sexual harassment and gender discrimination in academic health center (AHC) settings according to multiple surveys of medical students. Therefore, it is incumbent on AHCs to develop programs both to educate faculty, residents, and students and to handle complaints of possible episodes of sexual harassment or gender discrimination. Despite the apparent high prevalence of gender discrimination and sexual harassment, and the importance of handling complaints of gender discrimination and sexual harassment in a prompt, consistent, and rational manner, there are few descriptions of programs that address those concerns in AHCs.Herein, the authors describe their experiences in dealing with complaints of sexual harassment and gender discrimination for a 10-year period of time (late 1997 to early 2007) at the Medical University of South Carolina, through an Office of Gender Equity. They describe their complaint process, components of their prevention training, and the outcomes of 115 complaints. Key elements of their policies are highlighted. The authors offer an approach that could serve as a model for other AHCs.
An intersectional approach for understanding the vulnerabilities of English-speaking heterosexual Caribbean youth to HIV/AIDS and sexually transmitted infections: Prevention and intervention strategies
Marcia Elizabeth Sutherland
Full Text Available Caribbean youth comprise about 30 percent of the English-speaking Caribbean population, and about 81,000 Caribbean and Latin American youth are HIV infected. AIDS is the leading cause of death for 15- to 24-year-old English-speaking Caribbean youth. This article relies on intersectionality theory in the assessment of the macro-level, or structural variables, and micro-level, or individual level, variables that influence the risk-taking sexual behaviors of heterosexual English-speaking Caribbean youth and increase their vulnerability to HIV/sexually transmitted infections. This article offers macro- and micro-level prevention/intervention strategies for reducing the prevalence of sexually transmitted infections in English-speaking Caribbean youth, including the promotion of condom use, voluntary male circumcision, and HIV testing and counseling. Suggestions are offered for future research investigations to explore the contributing factors to youth’s vulnerability to sexually transmitted infections and to empirically verify the relationship between and among variables that account for desired outcomes, including decreases in risky sexual behaviors.
Orquidea Castilla Ramos
Full Text Available Observation of unsafe and safe behaviors at work is used in many companies, to known unsafe acts related with personal or industrial accidents and to design improvement or prevention strategies. This technique at natural contexts requires as much rigor in the design of the behavioral inventory or checklist as in its application. Methodological problems, as well as advantages and disadvantages to use this technique at organizational contexts are analyzed. How the results from to apply observations affect organizational psychosocial interventions, are discussed too. Observations could use with other techniques from another approaches. Probably technique utility depends somehow to the organizational safety culture, culture that itself procedure promote to prevent and to control the occurrence of future accidents in the companies.
Rudrum, Sarah; Oliffe, John L; Benoit, Cecilia
This paper analyses discourses of masculinity, femininity and sexuality in Stand Proud, Get Circumcised, a public health campaign promoting circumcision as an HIV-prevention strategy in Uganda. The campaign includes posters highlighting the positive reactions of women to circumcised men, and is intended to support the national rollout of voluntary medical male circumcision. We offer a critical discourse analysis of representations of masculinity, femininity and sexuality in relation to HIV prevention. The campaign materials have a playful feel and, in contrast to ABC (Abstain, Be faithful, Use condoms) campaigns, acknowledge the potential for pre-marital and extra-marital sex. However, these posters exploit male anxieties about appearance and performance, drawing on hegemonic masculinity to promote circumcision as an idealised body aesthetic. Positioning women as the campaign's face reasserts a message that women are the custodians of family health and simultaneously perpetuates a norm of estrangement between men and their health. The wives' slogan, 'we have less chance of getting HIV', is misleading, because circumcision only directly prevents female-to-male HIV transmission. Reaffirming hegemonic notions of appearance- and performance-based heterosexual masculinity reproduces existing unsafe norms about masculinity, femininity and sexuality. In selling male circumcision, the posters fail to promote an overall HIV-prevention message.
Leclerc, Benoit; Smallbone, Stephen; Wortley, Richard
The main aim of this study was to examine the effect of a potential guardian on the severity of child sexual abuse. Using data obtained on crime events from adult child sexual offenders incarcerated in Queensland (Australia), mixed-effects logistic regression analyses were conducted to examine the effect of potential guardianship on the severity of abuse. Controlling for victim and situational characteristics, the analyses showed that the presence of a potential guardian reduced the duration of sexual contact and the occurrence of penetration. Presence of a potential guardian decreased the risk of sexual penetration by 86%. The study highlights the importance of the presence of a potential guardian for reducing the severity of child sexual abuse, and suggests more broadly that guardianship may be an important protective factor in sexual offending. © The Author(s) 2013.
It has been well documented that young people are more likely to engage in high-risk sexual activity. Appropriate understanding of safe sex, sexual practices, and related behaviors must recognize the importance of socioeconomic and cultural factors in prevention efforts related to HIV and other sexual transmitted infections (STIs). To examine and summarize the opportunities and challenges of sexual health services among young people in Nepal. Review of literature--assessing knowledge, attitudes, and understanding of sex, sexual health, and related sexual risk behaviors, among young people (15-24), in line with the current sociocultural and health service practices. Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Science, Cochrane database, and Google were searched. Similarly, documents published at the WHO, United Nations Population Fund, United Nations Development Program, and at national/local level--Ministry of Health, National Center for AIDS, and STD Control were also assessed to access the relevant reports and articles. Published and gray articles were also reviewed. This study contends growing expansion of communication and transportation networks, urbanization, and urban in-migration is creating a different sociocultural environment, which is conducive to more social interactions between young girls and boys in Nepal. Rising age at marriage opens a window of opportunity for premarital and unsafe sexual activity among young people and this creates risks of unwanted pregnancy, STIs/HIV and AIDS. Socioeconomic, demographic, and cultural factors have been identified as encouraging factors for risk-taking behaviors among young people. Understanding safer sex and responsible sexual/reproductive behavior is important. Effective and appropriate interventions on sexual and reproductive health education directed at young people and the whole family, including fathers, could have significant effect on reducing risk and related risk
Chiodo, Debbie; Wolfe, David A; Crooks, Claire; Hughes, Ray; Jaffe, Peter
To examine gender differences in prevalence and types of sexual harassment victimization experienced in grade 9 and how it contributes to relationship victimization and psychological adjustment 2.5 years later. A total of 1734 students from 23 schools completed self-report surveys at entry to grade 9 and end of grade 11. Self-report data were collected on victimization experiences (sexual harassment, physical dating violence, peer violence, and relational victimization) and adjustment (emotional distress, problem substance use, self-harm, suicidal thoughts, maladaptive dieting, feeling unsafe at school, and perpetration of violent delinquency). Separate analyses by sex were prespecified. Sexual harassment victimization was common among boys (42.4%) and girls (44.1%) in grade 9, with girls reporting more sexual jokes, comments, and unwanted touch than among boys, and with boys reporting more homosexual slurs or receiving unwanted sexual content. For girls, sexual harassment victimization in grade 9 was associated with elevated risk of self-harm, suicidal thoughts, maladaptive dieting, early dating, substance use, and feeling unsafe at school. A similar pattern of risk was found for boys, with the exception of dieting and self-harm behaviors. Adjusted odds ratios (AOR) indicated these students were significantly more likely than nonharassed students to report victimization by peers and dating partners 2.5 years later (AOR for boys and girls, respectively; all p sexual harassment (AOR: 2.45; 2.9), physical dating violence (AOR: 2.02; 3.73), and physical peer violence (AOR: 2.75; 2.79). Gr 9 sexual harassment also contributed significantly to emotional distress (AOR: 2.09; 2.24), problem substance use (AOR: 1.79; 2.04), and violent delinquency perpetration (AOR: 2.1; 3.34) 2.5 years later (boys and girls, respectively; all p Sexual harassment at the beginning of high school is a strong predictor of future victimization by peers and dating partners for both girls and
Ryan, Caroline A; Conly, Shanti R; Stanton, David L; Hasen, Nina S
HIV prevention in the President's Emergency Plan for AIDS Relief (PEPFAR) began when both data on HIV prevalence and the toolbox of interventions for prevention of sexual transmission were relatively limited. PEPFAR's early focus was on scaling-up information, education, and communication programs that included messaging on abstinence for youth and faithfulness primarily through nongovernmental organizations, including faith-based organizations. Additional activities included condom promotion, distribution, and social marketing. In epidemics concentrated within key populations, PEPFAR's prevention efforts focused on a minimum package of services including outreach, information, education, and communication programs, STI treatment (where appropriate), and condom promotion and distribution. As more epidemiological data became available and with experience gleaned in these early efforts, the need for tailored and flexible approaches became evident. The next iteration of prevention efforts still emphasized behavioral interventions, but incorporated a sharper focus on key epidemic drivers, especially multiple partners; a data-driven emphasis on high transmission areas and populations, including prevention with people living with HIV; and a more strategic and coordinated approach at the national level. Recently, the paradigm for prevention efforts has shifted yet again. Evidence that biomedical interventions such as male circumcision, treatment for prevention of vertical and horizontal transmission, and treatment itself could lead to declines in incidence has refocused PEPFAR's prevention portfolio. New guidance on sexually transmitted HIV focuses on combination prevention, emphasizing biomedical, behavioral and structural approaches. Landmark speeches by the President and the Secretary of State and new ambitious targets for PEPFAR point toward a new goal: an AIDS-free generation.
Using the Health Belief Model as a conceptual framework, this study examined university students who may seek access to healthcare through an on-campus student clinic for screening and treatment of sexually transmitted infections. A cross-sectional research design was used to collect data from students enrolled in a general health education…
Tschann, Mary; Salcedo, Jennifer; Soon, Reni; Elia, Jennifer; Kaneshiro, Bliss
To assess the values and beliefs regarding sexual behavior, sexual decision-making, and reproductive health learning preferences among teens in Hawaii. Survey regarding teens' knowledge, attitudes, and beliefs about sexual behaviors and preferences for learning about reproductive health. University of Hawaii Department of Obstetrics and Gynecology clinics in Honolulu, Hawaii. Female patients and their male or female companions ages 14-19 years. A 30-question anonymous survey. The main outcome was to describe the norms, attitudes, beliefs, and preferences of teens in this setting with regard to sexual health and sexual health education. For this, we provide a description of response frequencies and a comparison of mean scores across demographic characteristics. We analyzed a total of 100 surveys. Teens endorsed more values and norms protective against sexually transmitted infection than those protective against pregnancy. Younger teens expressed more protective values as a result of the influence of perceived parental values, whereas older teens expressed less protective values on the basis of the influence of peers. Respondents expressed comfort talking with their clinician about sexual health, and also expressed a slight preference that their clinicians initiate these conversations. The influence of parental values and peer norms on sexual behavior must be taken into consideration when designing interventions to address adolescent sexual health. Additionally, teens' greater concern about the consequences of sexually transmitted infection could be leveraged by clinicians to initiate broader conversations about sexual health, and a variety of modalities, including online resources and in-person conversations, should be used to meet the diversity of preferences expressed by teens across demographic groups. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Duby, Zoe; Hartmann, Miriam; Montgomery, Elizabeth T; Colvin, Christopher J; Mensch, Barbara; van der Straten, Ariane
Sexual risk-taking is influenced by individual, interpersonal and social factors. This paper presents findings from a qualitative follow-up study to a clinical trial evaluating biomedical HIV prevention products among African women, explored participants' perceptions and experiences of heterosexual penile-anal intercourse, as well as the gendered power dynamics and relationship contexts in which this sexual behaviour occurs. In-depth interviews were conducted with 88 women from South Africa, Uganda and Zimbabwe. Findings reveal that despite its social stigmatisation, women engage in penile-anal intercourse for reasons including male pleasure, relationship security, hiding infidelity, menstruation, vaginal infections, money and beliefs that it will prevent HIV transmission. In addition, participants described experiences of non-consensual penile-anal intercourse. We used sexual scripting theory as an analytical framework with which to describe the sociocultural and relationship contexts and gendered power dynamics in which these practices occur. These data on the distinct individual, dyadic and social contexts of heterosexual penile-anal intercourse, and the specific factors that may contribute to women's HIV risk, make a unique contribution to our understanding of heterosexual behaviour in these sub-Saharan countries, thereby helping to inform both current and future HIV prevention efforts for women in the region.
Lederman, Regina P; Chan, Wenyaw; Roberts-Gray, Cynthia
In this study, the authors compared differences in sexual risk attitudes and intentions for three groups of youth (experimental program, n = 90; attention control, n = 80; and nonparticipant control, n = 634) aged 12-14 years. Two student groups participated with their parents in programs focused on strengthening family interaction and prevention of sexual risks, HIV, and adolescent pregnancy. Surveys assessed students' attitudes and intentions regarding early sexual and other health-risk behaviors, family interactions, and perceived parental disapproval of risk behaviors. The authors used general linear modeling to compare results. The experimental prevention program differentiated the total scores of the 3 groups (p < .05). A similar result was obtained for student intentions to avoid sex (p < .01). Pairwise comparisons showed the experimental program group scored higher than the nonparticipant group on total scores (p < .01) and on students' intention to avoid sex (p < .01). The results suggest this novel educational program involving both parents and students offers a promising approach to HIV and teen pregnancy prevention.
The purpose of this study was to determine sexual risk behaviors among Zimbabwean adolescents with and without disabilities. Participants included 456 Zimbabwean high school students. Results indicated that more males than females engaged in sexual activities as early as nine years of age or younger. Females who reported having had sex, also…
Cooper, Alison; Edwards, Adrian; Williams, Huw; Evans, Huw P; Avery, Anthony; Hibbert, Peter; Makeham, Meredith; Sheikh, Aziz; J Donaldson, Liam; Carson-Stevens, Andrew
older adults are frequent users of primary healthcare services, but are at increased risk of healthcare-related harm in this setting. to describe the factors associated with actual or potential harm to patients aged 65 years and older, treated in primary care, to identify action to produce safer care. a cross-sectional mixed-methods analysis of a national (England and Wales) database of patient safety incident reports from 2005 to 2013. 1,591 primary care patient safety incident reports regarding patients aged 65 years and older. we developed a classification system for the analysis of patient safety incident reports to describe: the incident and preceding chain of incidents; other contributory factors; and patient harm outcome. We combined findings from exploratory descriptive and thematic analyses to identify key sources of unsafe care. the main sources of unsafe care in our weighted sample were due to: medication-related incidents e.g. prescribing, dispensing and administering (n = 486, 31%; 15% serious patient harm); communication-related incidents e.g. incomplete or non-transfer of information across care boundaries (n = 390, 25%; 12% serious patient harm); and clinical decision-making incidents which led to the most serious patient harm outcomes (n = 203, 13%; 41% serious patient harm). priority areas for further research to determine the burden and preventability of unsafe primary care for older adults, include: the timely electronic tools for prescribing, dispensing and administering medication in the community; electronic transfer of information between healthcare settings; and, better clinical decision-making support and guidance. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: email@example.com
Choi, Sun Yeong; Kim, Yochan; Park, Jinkyun; Kim, Seunghwan; Jung, Wondea
In this research, UA is defined as an inappropriate human behavior that has a potential for leading the safety of NPPs to a negative direction. The purpose of this paper is to describe a process of UA analysis through a case study under a simulated emergency and the analysis results. In this paper, we described the process for UA identification and demonstrated examples of UA accompanied by consequence by a case study on ISLOCA scenario. It is well known that the contribution of human performance related problems (or human error) to the safety of sociotechnical systems is critical. Moreover, it is reported that about 75% of all accidents and/or incidents that have occurred in the complicated process control systems are attributable to human error. Therefore lots of efforts to perform an HRA (Human Reliability Analysis) based on various approaches made to enhance their safety. HRA data is an important prerequisite for improving HRA quality. For this reason, KAERI (Korea Atomic Energy Research Institute) developed a standardized guideline is to specify how to gather HRA data from simulator training records and crated IGT (Information Gathering Template) specifying what kinds of measures should be observed during the simulations. Based on the data collection framework, we have performed data collection to analyze inappropriate human behavior (or UA; Unsafe Act) with simulator training data about various scenario needed AOP (Abnormal Operation Procedure) or EOP (Emergency Operation Procedure) operations for HEP (Human Error Probability) calculation
Kleiner, Brian M.; Hettinger, Lawrence J.; DeJoy, David M.; Huang, Yuang-Hsiang; Love, Peter E.D.
Theoretical and practical approaches to safety based on sociotechnical systems principles place heavy emphasis on the intersections between social–organisational and technical–work process factors. Within this perspective, work system design emphasises factors such as the joint optimisation of social and technical processes, a focus on reliable human–system performance and safety metrics as design and analysis criteria, the maintenance of a realistic and consistent set of safety objectives and policies, and regular access to the expertise and input of workers. We discuss three current approaches to the analysis and design of complex sociotechnical systems: human–systems integration, macroergonomics and safety climate. Each approach emphasises key sociotechnical systems themes, and each prescribes a more holistic perspective on work systems than do traditional theories and methods. We contrast these perspectives with historical precedents such as system safety and traditional human factors and ergonomics, and describe potential future directions for their application in research and practice. Practitioner Summary: The identification of factors that can reliably distinguish between safe and unsafe work systems is an important concern for ergonomists and other safety professionals. This paper presents a variety of sociotechnical systems perspectives on intersections between social–organisational and technology–work process factors as they impact work system analysis, design and operation. PMID:25909756
Claudet, Isabelle; Cortey, Caroline; Honorat, Raphaele; Franchitto, Nicolas
Minoxidil hair formulation is commonly used for the treatment of male or female androgenic alopecia. This over-the-counter product is wrongly considered safe. The ingestion of a few milliliters by a child can lead to significant intoxication. We report a case of significant intoxication after the ingestion of topical minoxidil (Alopexy; Pierre Fabre Laboratoires, SA, Switzerland). A 7-year-old girl, who accidentally ingested a teaspoon of minoxidil hair solution, presented to the pediatric emergency department for emesis. At admission, she had a blood pressure of 86/56 mm Hg and a pulse of 149 beats per minute. Hypotension lasted 40 hours with the lowest value 24 hours after ingestion (79/33 mm Hg). She presented electrocardiogram changes (sinus tachycardia and flattening T-waves) but normal cardiac enzymes. Infusion of 20 mL/kg of normal saline fluid had no hemodynamic effect. Her blood pressure normalized on day 2. Minoxidil topical solution is an unsafe product for children. This formulation should be strictly kept out of reach of children and manufacturers should enhance child-resistance security of packaging. The over-the-counter availability must be questioned.
Doyle, Joseph S; Degenhardt, Louisa; Pedrana, Alisa E; McBryde, Emma S; Guy, Rebecca J; Stoové, Mark A; Weaver, Emma R; Grulich, Andrew E; Lo, Ying-Ru; Hellard, Margaret E
Increased global access and use of antiretroviral therapy (ART) for human immunodeficiency virus (HIV) has been postulated to undermine HIV prevention efforts by changing individual risk-taking behavior. This review aims to determine whether ART use is associated with changes in sexual or injecting risk-taking behavior or diagnosis of sexually transmitted infections (STIs). A systematic review and meta-analysis was conducted of HIV-seropositive participants receiving ART compared with no ART use in experimental or observational studies. Primary outcomes included (1) any unprotected sexual intercourse, (2) STI diagnoses, and (3) any unsafe injecting behavior. Fifty-eight studies met the selection criteria. Fifty-six studies containing 32 857 participants reported unprotected sex; 11 studies containing 16 138 participants reported STI diagnoses; and 4 studies containing 1600 participants reported unsafe injecting behavior. All included studies were observational. Unprotected sex was lower in participants receiving ART than in those not receiving ART (odds ratio [OR], 0.73; 95% confidence interval [CI], .64-.83; P bias. STI diagnoses were also lower among individuals on ART (OR, 0.58; 95% CI, .33-1.01; P = .053; I(2) = 92%); however, there was no difference in injecting risk-taking behavior with antiretroviral use (OR, 0.90; 95% CI, .60-1.35; P = .6; I(2) = 0%). Despite concerns that use of ART might increase sexual or injecting risk-taking, available research suggests that unprotected sex is reduced among HIV-infected individuals on treatment. The reasons for this are not yet clear, although self-selection and mutually reinforcing effects of HIV treatment and prevention messages among people on ART are likely. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: firstname.lastname@example.org.
G. V. Mane
Full Text Available Many automobile drivers having knowledge of the driving behaviours and habits that can lead to inefficient and unsafe driving. However it is often the case that these same drivers unknowingly manifest these inefficient and unsafe driving behaviours in their everyday driving activity. The proposed system proposes a practical and economical way to capture measure and alert drives of inefficient and unsafe driving as well as highly efficient system aimed at early detection and alert of dangerous vehicle maneuvers typically related to drunk driving. The upcoming solution consists of a mobile application running on a modern smartphone device paired with a compatible OBDII On-board diagnostics II reader.
van Lieshout, Sanne; Mevissen, Fraukje E F; van Breukelen, Gerard; Jonker, Marianne; Ruiter, Robert A C
Sexual harassment-unwanted sexual comments, advances, or behaviors-and sexual violence are still prevalent worldwide, leading to a variety of physical, cognitive, and emotional problems among those being harassed. In particular, youth in care are at risk of becoming perpetrators (and victims) of sexual harassment. However, in general, there are very few interventions targeting this at-risk group, and no such programs exist in the Netherlands. To this end, a group intervention program-Make a Move-targeting determinants of sexual harassment was developed. This program was implemented and evaluated among boys (N = 177) in Dutch residential youth care (20 institutions). A pre-test, post-test, and 6-month follow-up design including an intervention and a waiting list control group with randomized assignment of institutions (cluster randomized trial) was used to measure the effects of the intervention on determinants of sexual harassment. Multilevel (mixed) regression analysis with Bonferroni correction for multiple testing (α = .005) showed no significant effects of Make a Move on determinants of sexual harassment (ps > .03, Cohen's ds < .44). Results are discussed in light of a three-way explanatory model focusing on intervention content, evaluation, and implementation as potential explanations for not finding any measurable intervention effects. © The Author(s) 2016.
... Error processing SSI file About Heart Disease & Stroke Prevention Heart disease and stroke are an epidemic in ... secondhand smoke. Barriers to Effective Heart Disease & Stroke Prevention Many people with key risk factors for heart ...
Richard C. Cervantes
Full Text Available Behavioral health is defined as the absence of mental illness or substance use problems and the presence of positive emotional well being. Although many U.S. Hispanic youth are at increased risk for substance abuse, suicidality, teen pregnancy, unsafe sexual practices and HIV, there exists a lack of available evidence-based practices for Hispanic youth which promotes behavioral health and HIV prevention. The objective of the current research was to adapt and revise the Familia Adelante (FA Program, a behavioral health, drug intervention and prevention program to incorporate an HIV prevention component. Through qualitative community based participatory methods, including an expert panel and members of the target population, the curriculum was redesigned to integrate effective HIV risk reduction strategies. The process of adapting the intervention is described in this paper, as well as recommendations for future research in program adaptation.
Fleming, Paul J.; Barrington, Clare; Pearce, Lisa D.; Lerebours, Leonel; Donastorg, Yeycy; Brito, Maximo O.
Ethnographic studies from numerous societies have documented the central role of male circumcision in conferring masculinity and preparing boys for adult male sexuality. Despite this link between masculinity, sexuality, and circumcision, there has been no research on these dynamics among men who have received a circumcision for HIV prevention. We employed a mixed methods approach with data collected from recently circumcised men in the Dominican Republic (DR) to explore this link. We analyzed survey data collected 6-12 months post-circumcision (N = 293) and in-depth interviews with a sub-sample of those men (n = 30). We found that 42% of men felt more masculine post-circumcision. In multivariate analysis, feeling more masculine was associated with greater concern about being perceived as masculine (OR = 1.70, 95% CI: 1.25-2.32), feeling more potent erections post-circumcision (OR = 2.25, 95% CI: 1.26-4.03), and reporting increased ability to satisfy their partner post-circumcision (OR = 2.30, 95% CI: 1.11-4.77). In qualitative interviews, these factors were all related to masculine norms of sexually satisfying one's partner and men's experiences of circumcision were shaped by social norms of masculinity. This study highlights that circumcision is not simply a biomedical intervention and that circumcision programs need to incorporate considerations of masculine norms and male sexuality into their programming. PMID:26942550
Valentine, Jo A
Compared to whites, blacks experience significant health disparities for sexually transmitted diseases, particularly in the rates of chlamydia, gonorrhea, and syphilis. To develop more effective interventions to control and prevent STDs, public health practitioners should better understand and respond to factors that facilitate sexual risk-taking behaviors and impede access to STD health care and make use of factors that promote sexual health. Legacies of slavery, racism, and economic or class discrimination leave many blacks suspicious of interventions aimed at improving the welfare of their communities. Sexual behavior, in particular, has been used to justify social oppression of blacks in the United States. Although efforts to engage affected black communities in improving STD health care delivery have been undertaken, bias, prejudice, and stereotyping continue to contribute to negative experiences for many blacks across health care settings, including those involving STD care. Implementing more effective interventions to reduce the disparate burden of bacterial STDs in black communities requires accessible and acceptable STD health care. Understanding and addressing the potential impact of both provider and patient attitudes can improve these service delivery outcomes.
This review, with 21 figures and 1 video, aims to clarify some important aspects of the anatomy and physiology of the female erectile organs (triggers of orgasm), which are important for the prevention of female sexual dysfunction. The clitoris is the homologue of the male's glans and corpora cavernosa, and erection is reached in three phases: latent, turgid, and rigid. The vestibular bulbs cause "vaginal" orgasmic contractions, through the rhythmic contraction of the bulbocavernosus muscles. Because of the engorgement with blood during sexual arousal, the labia minora become turgid, doubling or tripling in thickness. The corpus spongiosum of the female urethra becomes congested during sexual arousal; therefore, male erection equals erection of the female erectile organs. The correct anatomical term to describe the erectile tissues responsible for female orgasm is the female penis. Vaginal orgasm and the G-spot do not exist. These claims are found in numerous articles that have been written by Addiego F, Whipple B, Jannini E, Buisson O, O'Connell H, Brody S, Ostrzenski A, and others, have no scientific basis. Orgasm is an intense sensation of pleasure achieved by stimulation of erogenous zones. Women do not have a refractory period after each orgasm and can, therefore, experience multiple orgasms. Clitoral sexual response and the female orgasm are not affected by aging. Sexologists should define having sex/love making when orgasm occurs for both partners with or without vaginal intercourse. Copyright © 2012 Wiley Periodicals, Inc.
Postrado, L T; Nicholson, H J
The Girls Incorporated, formerly Girls Clubs of America, program in Preventing Adolescent Pregnancy, which was initiated in 1985, was evaluated to obtain information about sexual behavior and attitudes related to pregnancy, educational and career expectations, and sociodemographic characteristics, and to ascertain the effectiveness of 2 components for girls aged 12-14 in delaying early sexual involvement. The theoretical base of intervention is discussed and delineation of 3 themes recurrent in the literature. Program interventions are also described. The 2 program components evaluated were Will Power/Won't Power which taught skill in general and specific assertiveness, and Growing Together, which facilitated communication between parents and daughters. The sample consisted of 412 virgin girls 12-14 years, of which 25% did not participate in either program, from communities in which the adolescent pregnancy rate was higher than the national average. Participants were required to have completed 1 complete year which included before and after surveys. 257 participated in Will Power/Won't Power; 84 in Growing Together; and 46 in both programs. Participants and nonparticipants were similar in background characteristics. The profile was one of primarily African American 12 year olds of a Protestant religion. Growing Together participants were slightly different and less likely to engage in early sexual intercourse. The findings of the bivariate and logistic regression analyses were that nonparticipants were 2.5 times more likely to initiate sexual intercourse during the study year than participants in Growing Together, but this was only marginally statistically significant. It is suggested however that when controlling for age, religion, race and having contact with a pregnant teen that Growing Together participation contributed to a delay in the initiation of sexual intercourse. Participation in Will Power did not account for any differences in likelihood of initiating
Lewis, John F.; And Others
As in many other areas of society, sexual harassment has become an important issue in education. It has left the educational community with many questions about what constitutes sexual harassment, how to prevent it, and how to deal with the legal problems that may arise concerning it. This report dispels several myths about sexual harassment in…
... Problems Diabetes & Sexual & Urologic Problems Clinical Trials Preventing Diabetes Problems View or Print All Sections Heart Disease & ... prevent or delay sexual and urologic problems. Depression & Diabetes Depression is common among people with a chronic, ...
Lee, David S.; Guy, Lydia; Perry, Brad; Sniffen, Chad Keoni; Mixson, Stacy Alamo
This article reviews approaches for developing comprehensive strategies that stop violence before initial perpetration occurs. Using feminist theory and public health perspectives as its foundation, the use of educational sessions, community mobilization, social norms, social marketing, and policy work are all explored. (Contains 1 table.)
Roy, T; Anderson, C; Evans, C; Rahman, M S
Human immunodeficiency virus (HIV) research in Bangladesh has mainly focused on key vulnerable groups (e.g. sex workers, drug users). In order to develop appropriate HIV prevention strategies in an evolving epidemic, there is a need for evidence on sexual practices in other population groups. This research aims to describe the prevalence of risky behaviours and factors affecting sexual behaviour/practices among rural-to-urban migrant taxi drivers in Dhaka. Cross-sectional study. This paper reports on the cross-sectional survey component of a mixed methods research study amongst migrant workers in Bangladesh. The sample (n = 437) comprised rural-to-urban migrant taxi drivers in Dhaka (aged 18-35 years). The survey data were analysed statistically using Statistical Package for the Social Sciences. Very high levels of pre- and extramarital sexual behaviour were found (84% and 51%, respectively) amongst the sample (n = 437). The reported sexual activity included high levels of risky/unsafe sex in the past year: 64% of the sample reported sex with multiple commercial sex partners (mean = 13.21), and 21.7% reported sex with other males/transgenders (mean = 2.53). Protection against risk was low: 78.2% reported that their last commercial sexual encounter was unprotected, and only 5.6% used condoms consistently. Multivariate analysis revealed that the odds of risky sexual behaviour were higher in migrant men who were not married (odds ratio 35.3, P driver of risky sexual practices. This study provides important new information for understanding the dynamics of sexual behaviour in Bangladesh, and suggests that migrant men should be a key population for HIV prevention efforts. Nonetheless, the fact that most men were having unprotected sex with sex workers reinforces the importance of continuing to target interventions towards commercial sex contexts. Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
The Australian Royal Commission Into Institutional Responses to Child Sexual Abuse has identified multiple systemic failures to protect children in government and non-government organizations providing educational, religious, welfare, sporting, cultural, arts and recreational activities. Its recommendations for reform will aim to ensure organizations adopt more effective and ethical measures to prevent, identify and respond to child sexual abuse. However, apart from the question of what measures institutions should adopt, an under-explored question is how to implement and regulate those measures. Major challenges confronting reform include the diversity of organizations providing services to children; organizational resistance; and the need for effective oversight. Failure to adopt theoretically sound strategies to overcome implementation barriers will jeopardize reform and compromise reduction of institutional child sexual abuse. This article first explains the nature of the Royal Commission, and focuses on key findings from case studies and data analysis. It then analyzes public health theory and regulatory theory to present a novel analysis of theoretically justified approaches to the implementation of measures to prevent, identify and respond to CSA, while isolating challenges to implementation. The article reviews literature on challenges to reform and compliance, and on prevention of institutional CSA and situational crime prevention, to identify measures which have attracted emerging consensus as recommended practice. Finally, it applies its novel integration of regulatory theory and public health theory to the context of CSA in institutional contexts, to develop a theoretical basis for a model of implementation and regulation, and to indicate the nature and functions of a regulatory body for this context. Copyright © 2017 The Author. Published by Elsevier Ltd.. All rights reserved.
SORIN M. RĂDULESCU
Full Text Available This article presents a short “history” of the evolution over time of internationallegal regulations concerning child rights and the protection of children against any actof physical, emotional or sexual abuse. The concerns of European bodies in this respectare also highlighted, as are the objectives of the legislation in different countries, whichare mainly aimed at sanctioning abuses committed against children and, in particular,the punishment of acts of sexual abuse.
Smit, Nadine M; Morgan, Ruth M; Lagnado, David A
Evidence has the potential to be misleading if its value when expressing beliefs in hypotheses is not fully understood or presented. Although the knowledge base to understand uncertainties is growing, a challenge remains to prioritise research and to continuously assess the magnitude and consequences of misleading evidence in criminal cases. This study used a systematic content analysis to identify misleading evidence, drawing information from case transcripts of rulings argued unsafe by the Court of Appeal of England and Wales. In the 7-year study period, 218 applications were successful on appeal, containing 235 cases of misleading evidence. The majority (76%) of successful appeals were based upon the same materials available in the original trial, rather than the presentation of new relevant information. Witness (39%), forensic (32%), and character evidence (19%) were the most commonly observed evidence types, with the validity of witnesses (26%), probative value of forensic evidence (12%), and relevance of character evidence (10%) being the most prevalent combinations of identified issues. Additionally, the majority (66%) of misleading evidence types relate to their interpretation at activity level. The findings suggest that many of these misleading aspects could have been prevented by providing more transparency in the relationship between evidence and hypotheses. Generally, the results contribute to gaining a more complete picture of the role of misleading evidence in the criminal justice system. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.
Full Text Available the cause was roof and sidewall accidents. The primary objective of this project was to identify the causes of unsafe acts or neglect resulting in roof and sidewall accidents in coal mines....
Salahuddin, Lizawati; Ismail, Zuraini; Hashim, Ummi Rabaah; Raja Ikram, Raja Rina; Ismail, Nor Haslinda; Naim Mohayat, Mohd Hariz
The objective of this study is to identify factors influencing unsafe use of hospital information systems in Malaysian government hospitals. Semi-structured interviews with 31 medical doctors in three Malaysian government hospitals implementing total hospital information systems were conducted between March and May 2015. A thematic qualitative analysis was performed on the resultant data to deduce the relevant themes. A total of five themes emerged as the factors influencing unsafe use of a hospital information system: (1) knowledge, (2) system quality, (3) task stressor, (4) organization resources, and (5) teamwork. These qualitative findings highlight that factors influencing unsafe use of a hospital information system originate from multidimensional sociotechnical aspects. Unsafe use of a hospital information system could possibly lead to the incidence of errors and thus raises safety risks to the patients. Hence, multiple interventions (e.g. technology systems and teamwork) are required in shaping high-quality hospital information system use.
Francisco Rogerlândio Martins-Melo
Full Text Available OBJECTIVE To analyze temporal trends and distribution patterns of unsafe abortion in Brazil. METHODS Ecological study based on records of hospital admissions of women due to abortion in Brazil between 1996 and 2012, obtained from the Hospital Information System of the Ministry of Health. We estimated the number of unsafe abortions stratified by place of residence, using indirect estimate techniques. The following indicators were calculated: ratio of unsafe abortions/100 live births and rate of unsafe abortion/1,000 women of childbearing age. We analyzed temporal trends through polynomial regression and spatial distribution using municipalities as the unit of analysis. RESULTS In the study period, a total of 4,007,327 hospital admissions due to abortions were recorded in Brazil. We estimated a total of 16,905,911 unsafe abortions in the country, with an annual mean of 994,465 abortions (mean unsafe abortion rate: 17.0 abortions/1,000 women of childbearing age; ratio of unsafe abortions: 33.2/100 live births. Unsafe abortion presented a declining trend at national level (R2: 94.0%, p < 0.001, with unequal patterns between regions. There was a significant reduction of unsafe abortion in the Northeast (R2: 93.0%, p < 0.001, Southeast (R2: 92.0%, p < 0.001 and Central-West regions (R2: 64.0%, p < 0.001, whereas the North (R2: 39.0%, p = 0.030 presented an increase, and the South (R2: 22.0%, p = 0.340 remained stable. Spatial analysis identified the presence of clusters of municipalities with high values for unsafe abortion, located mainly in states of the North, Northeast and Southeast Regions. CONCLUSIONS Unsafe abortion remains a public health problem in Brazil, with marked regional differences, mainly concentrated in the socioeconomically disadvantaged regions of the country. Qualification of attention to women’s health, especially to reproductive aspects and attention to pre- and post-abortion processes, are necessary and urgent strategies to
Kaushal, Rishabh; Saha, Srishty; Bajaj, Payal; Kumaraguru, Ponnurangam
YouTube draws large number of users who contribute actively by uploading videos or commenting on existing videos. However, being a crowd sourced and large content pushed onto it, there is limited control over the content. This makes malicious users push content (videos and comments) which is inappropriate (unsafe), particularly when such content is placed around cartoon videos which are typically watched by kids. In this paper, we focus on presence of unsafe content for children and users who...
This podcast discusses sexual violence - what it is, the long-term health problems it can contribute to, and tips to stop it before it begins. Created: 4/4/2011 by National Center for Injury Prevention and Control (NCIPC). Date Released: 4/4/2011.
Joseph Davey, Dvora; Farley, Elise; Gomba, Yolanda; Coates, Thomas; Myer, Landon
HIV acquisition in pregnancy and breastfeeding contributes significantly toward pediatric HIV infection. However, little is known about how sexual behavior changes during pregnancy and postpartum periods which will help develop targeted HIV prevention and transmission interventions, including pre-exposure prophylaxis (PrEP). Cross-sectional study in HIV-infected and uninfected pregnant and postpartum women in Cape Town, South Africa. Interviewers collected survey data on demographic, sexual behaviors, and alcohol use among pregnant and post-partum women. We report descriptive results of sexual behavior by trimester and postpartum period, and results of multivariable logistic regression stratified by pregnancy status. We enrolled 377 pregnant and postpartum women (56% pregnant, 40% HIV-infected). During pregnancy, 98% of women reported vaginal sex (8% anal sex, 44% oral sex) vs. 35% and 88% during the periods 0-6 and 7-12 months postpartum, respectively (p1 partner in the past 12-months compared to postpartum women (18% vs. 13%, respectively, p6-months postpartum (13 mean sex acts in first trimester; 17 mean sex acts >6-months postpartum). Pregnant women had increased odds of reporting condomless sex at last sex (aOR = 2.96;95%CI = 1.84-4.78) and ever having condomless sex in past 3-months (aOR = 2.65;95%CI = 1.30-5.44) adjusting for age, HIV status, and sex frequency compared to postpartum women. We identified that sexual behaviors and risk behaviors were high and changing during pregnancy and postpartum periods, presenting challenges to primary and secondary HIV prevention efforts, including PrEP delivery to pregnant and breastfeeding women.
Jørgensen, Marianne Johansson
and often lead to unsafe sex. 3) Low self-esteem increases the risk of ignoring crossing of one’s personal boundaries and thereby resulting in promiscuous sexual behavior. 4) Increased sexual experience was found to be associated with lack of condom use. Surprisingly, the informants did not consider drug...
Kojima, Noah; Krupp, Karl; Ravi, Kavitha; Gowda, Savitha; Jaykrishna, Poornima; Leonardson-Placek, Caitlyn; Siddhaiah, Anand; Bristow, Claire C; Arun, Anjali; Klausner, Jeffrey D; Madhivanan, Purnima
In rural India, mobile medical clinics are useful models for delivering health promotion, education, and care. Mobile medical clinics use fewer providers for larger catchment areas compared to traditional clinic models in resource limited settings, which is especially useful in areas with shortages of healthcare providers and a wide geographical distribution of patients. From 2008 to 2011, we built infrastructure to implement a mobile clinic system to educate rural communities about maternal child health, train community health workers in common safe birthing procedures, and provide comprehensive antenatal care, prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV), and testing for specific infections in a large rural catchment area of pregnant women in rural Mysore. This was done using two mobile clinics and one walk-in clinic. Women were tested for HIV, hepatitis B, syphilis, and bacterial vaginosis along with random blood sugar, urine albumin, and anemia. Sociodemographic information, medical, and obstetric history were collected using interviewer-administered questionnaires in the local language, Kannada. Data were entered in Microsoft Excel and analyzed using Stata SE 14.1. During the program period, nearly 700 community workers and 100 health care providers were trained; educational sessions were delivered to over 15,000 men and women and integrated antenatal care and HIV/sexually transmitted infection testing was offered to 3545 pregnant women. There were 22 (0.6%) cases of HIV, 19 (0.5%) cases of hepatitis B, 2 (0.1%) cases of syphilis, and 250 (7.1%) cases of BV, which were identified and treated. Additionally, 1755 (49.5%) cases of moderate to severe anemia and 154 (4.3%) cases of hypertension were identified and treated among the pregnant women tested. Patient-centered mobile medical clinics are feasible, successful, and acceptable models that can be used to provide quality healthcare to pregnant women in rural and
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Background: An educational intervention on Sexually Transmitted Diseases (STDs accompanied by a multimedia exhibition was proposed in order to verify the effectiveness of an exhibition as a tool for prevention, to increase awareness in youth and to evaluate whether it yielded changes in the sexual behaviour of its’ visitors. The Target population were high schools and university students.
Methods: The Exhibition consisted of a historical overview and four other sections: biological and clinical aspects, epidemiology, prevention and a section called the Red Zone with clear and explicit images relating to STDs. The exhibition was supported by three observational studies carried out on about2000 students of two High Schools and the university in the city of Cassino, Italy. Data collection took place through three different types of “ad hoc” questionnaires. The Statistical analysis carried out was that typical of cross-sectional surveys. We utilized the statistical program Epi-Info 3.5.
Results: Regarding survey 1, 48% of 529 students taking part said that the exhibition had contributed “enough” for them to acquire new knowledge, 75.2% had already had sexual intercourse and 37.7% of them did not change their sexual habits. Relative to survey 2, 583 responded to the pre test and 403 posttests returned. Regarding knowledge, data obtained from processing of pre-tests showed how 63.9% of the sample did not know how many STDs existed, whilst this value dropped in post test answers to 49.2% . AIDS was the best known disease (96% whilst other STDs were little known. The educational intervention partly increased these percentages. With regard to sexual practices although 43% of the sample claimed to have already had sexual intercourse (66% male and 34% female. The family doctor is seen by a high percentage of young people (70% - 68.6% as the first figure which should address an
Full Text Available The unsafe acts of workers are considered as major contributors of work-related accidents and injuries on construction sites. However, not much work has been done to address the reasons why unsafe acts of workers occur particularly in construction industry. The aim of this paper therefore, is to investigate the major unsafe acts (i.e., at-risk behavior, and the decision-to-err factors causing unsafe acts. A questionnaire survey was conducted to collect data from a total of 214 workers from 20 building construction projects in Thailand. The findings revealed that the failure of workers to wear personal protective equipment (PPE, improper lifting or handling of materials, and keeping sharp objects in dangerous locations, are the major unsafe acts which frequently occur on construction sites in Thailand. In addition, the paper reported that the top three most frequent unsafe acts are statistically associated with several decision-to-err factors, including lack of management support, management pressure, group norms, overconfidence, being uncomfortable, past experience and laziness.
Yegon, Erick Kiprotich; Kabanya, Peter Mwaniki; Echoka, Elizabeth; Osur, Joachim
brunt of being stigmatized. They reported a lack of a supportive environment that provides guidance on correct information on how to prevent unwanted pregnancy and where to get help. Abortion-related stigma plays a major role in women's decision on whether to have a safe or unsafe abortion.
Aptitud de padres para prevenir abuso sexual en menores después de una intervención educativa participativa Parental aptitude to prevent child sexual abuse after a participatory education intervention
Martha Alicia Higareda-Almaraz
Full Text Available OBJETIVO: Evaluar la aptitud en los padres sobre el impacto de educar con equidad a los menores, para prevenir abuso sexual infantil con una estrategia educativa participativa. MATERIAL Y MÉTODOS: Diseño cuasiexperimental. Se incluyó a 92 padres con hijos menores en preescolar que recibieron una intervención educativa con estrategia promotora participativa por una hora durante 20 días. Para evaluar el cambio de aptitud se construyó previamente un cuestionario estructurado con 20 enunciados, que fue validado por expertos en educación y sexología infantil. Para comparar la diferencia intragrupos se utilizó Wilcoxon. RESULTADOS: Se encontraron diferencias estadísticamente significativas en las respuestas de los padres antes/después de la intervención educativa con un valor en la mediana (rango 10(2-12/18(6-20, pOBJECTIVE: To evaluate the aptitude of parents regarding the educational impact of equity education for children to prevent child sexual abuse using participatory strategies. MATERIAL AND METHODS: Quasi-experimental design. Ninety-two parents with children in preschool were included in the study. The parents were given a course using participatory educational strategies for one hour daily over a period of 20 days. Prior to the course, a group of experts in child education and sexology prepared a questionnaire with 20 sentences. A Wilcoxon test was used to compare intergroup differences RESULTS: We found statistically significant differences in the parents' responses before and after the educational intervention, with a median (range of 10(2-12/18(6-20, p<0.01. CONCLUSIONS: A significant change in aptitude was noted when parents attended classes using a participatory strategy to learn about the impact of educational equity for the prevention of child sexual abuse. Thus, it is imperative to continue evaluating different educational strategies.
(InVisibilidade do género na sexualidade juvenil: propostas para uma nova concepção sobre a educação sexual e a prevenção de comportamentos sexuais de risco Gender (invisibility in juvenile sexuality: proposals for a new conception about sexual education and prevention against risky sexual behaviors
Full Text Available Neste artigo pretendemos mostrar como o género é um conceito determinante e imprescindível quando se trabalham as questões da sexualidade juvenil, particularmente quando se aborda a sexualidade das jovens adolescentes. A literatura feminista tem alertado para a continuidade dos discursos de vitimização, de medo e de moralidade que continuam a servir, em muitos casos e em muitos países, para justificar conteúdos de programa de educação sexual nas escolas e de campanhas de prevenção de doenças sexualmente transmissíveis, essencialmente sobre o HIV. Contudo, depois de analisar esses discursos, nota-se claramente a ausência de um discurso emancipador sobre a sexualidade feminina adolescente. Apesar da epidemia do HIV e de o número crescente de mulheres heterossexuais (de todas as faixas etárias, das mais jovens às mais idosas a serem infectadas implicar a necessidade de uma atenção redobrada, esse problema não pode justificar discursos reguladores e tradicionais da sexualidade feminina. São necessários novos discursos emancipadores e de empowerment das jovens adolescentes, de responsabilização de jovens do sexo masculino pelas questões da reprodução e da construção de um projecto igualitário e, ao mesmo tempo, de programas e de campanhas informadas pelo conhecimento existente relativamente às questões do género e à assimetria entre os sexos na vivência da sexualidade.In this article we intend to show how gender is a determining and indispensable concept when juvenile sexual issues are discussed; particularly when we approach the adolescent female sexuality. The feminist literature has been alerting us for the discourse on victimization, fear and morality which, in many cases and in many countries, still justifies contents of sexual education programs in schools and campaigns for prevention against sexually transmissible diseases, especially HIV. However, after analyzing those speeches, it is very clear that they
Speaker | "The Effects of Prostate Cancer Treatment on the Sexual Behavior of Gay and Bisexual Men: Key Results from the 'Restore' Study" will be presented by B.R. Simon Rosser, PhD, MPH, Professor of the Division of Epidemiology & Community Health and Director of HIV/STI Intervention & Prevention Studies at the University of Minnesota School of Public Health in Minneapolis, MN. Date: February 13, 2018; Time: 11:00am - 12:00pm; Location: NCI Shady Grove, Conference Room: Seminar 110, Terrace Level East.
Choi, Sun Yeong; Park, Jinkyun; Kim, Yochan; Kim, Seunghwan; Jung, Wondea
Highlights: • The procedure driven operation was divided into four stages by considering the crew relations such as instructions and responses. • Ten patterns of UA occurrence paths and the related operators per path were identified. • The UA type classification scheme was proposed based on the ten patterns of UA occurrence paths. • A case study to implement the UA type classification and to define the related operators per UA was performed. • The UA type classification scheme can be practical in that it prevents bias by subjective judgment. - Abstract: In this study, a method for UA (Unsafe Act) classification under a simulated procedure driven operation was proposed. To this end, a procedure driven operation was divided into four stages by considering the crew relations such as instructions and responses. Based on the four stages of a procedure driven operation, ten patterns of UA occurrence paths and the related operators per path were identified. From the ten types of UA occurrence paths including related operators, it is practicable to trace when and by whom a UA is initiated during a procedure driven operation, and the interaction or causality among the crew after the UA is initiated. Therefore, the types of UAs were classified into ‘Instruction UA’, ‘Reporting UA’, and ‘Execution UA’ by considering the initiation time and initiator of UA. A case study to implement the UA type classification and to define the related operators per UA was performed with the ISLOCA scenario simulator training data. The UA classification scheme proposed in this paper can be practical in that it does not require expertise relatively in a human performance analysis and it prevents bias by subjective judgment because it is based on an observation-based approach to exclude subjective judgment.
Ullman, Sarah E.; Vasquez, Amanda L.
This study examined sexual risk behaviors and sexual refusal assertiveness in relationship to child sexual abuse (CSA), emotion dysregulation, and adult sexual revictimization. Path analyses of 1,094 survivors who had sex in the past year were done to examine sexual risk behavior, and sexual refusal assertiveness mediational pathways by which CSA severity and emotion dysregulation may affect revictimization over one year in adult female sexual assault survivors. Exchanging sex for money and sexual refusal assertiveness were significantly associated with emotion dysregulation, whereas exchanging sex for money, and not sexual refusal assertiveness, was only significantly related to CSA severity. Both exchanging sex for money and sex refusal assertiveness mediated the relationship between emotion dysregulation and adult sexual revictimization. Exchanging sex for money mediated the CSA severity-revictimization relationship. These findings demonstrate the importance of considering both risky and protective sexual behaviors in research and prevention programming that address sexual revictimization in women. PMID:25942287
Youths in Bolgatanga municipality in the Upper East Region in the rural north of Ghana suffer health and social problems that are caused by their premarital and unsafe sexual behaviour. This study provides more knowledge of and insight into the youths' conceptions, motives and practices concerning premarital sex in the ...
Sexual and Reproductive Rights, Social Inequality and Politics in Latin America. Paradoxically, Latin America has some of the most stringent legal restrictions against and highest rates of abortion in the world. The co-existence of legal restrictions and unsafe abortions affects society unequally. While middle- and upper-class ...
Kalina, O.; Madarasova-Geckova, A.; Klein, D.; Jarcuska, P.; Orosova, O.; van Dijk, J.P.; Reijneveld, S.A.
Objectives To compare the psychosocial characteristics of sexually inexperienced adolescents with those of youths who had had sex, whether safe or unsafe. Methods We gathered information on self-esteem, well-being, social support, family structure, educational aspiration, parental education and
Ramirez-Ferrero, Eric; Lusti-Narasimhan, Manjula
Despite ample evidence documenting the positive impact of men on the prevention of mother-to-child transmission (PMTCT) and other sexual and reproductive health programs, men's engagement remains very low. This paper examines the current level and nature of male involvement and identifies opportunities for the advancement of men's constructive engagement in PMTCT and sexual and reproductive health. Conceptual and policy barriers have encouraged the inadvertent exclusion of men from PMTCT and other reproductive health services. The historic institutionalization of reproductive health as women's health has generally resulted in health services that are not welcoming of men and has undermined efforts to engage couples. This paper argues that to maximize the health outcomes of PMTCT and sexual and reproductive health programs for women and men, we must move beyond seeing men as simply "facilitating factors" that enable women to access health-care services. Men need to instead be recognized as a constituent part of reproductive health policy and practice. The paper proposes strategies for policy makers and program leaders to engage men and couples to foster communication and shared decision-making. This approach can both help to achieve health goals and engender more equitable relationships between men and women. Copyright © 2012 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
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Tynan, Anna; Vallely, Andrew; Kelly, Angela; Kupul, Martha; Neo, James; Naketrumb, Richard; Aeno, Herick; Law, Greg; Milan, John; Siba, Peter; Kaldor, John; Hill, Peter S
The motivation of health workers (HWs) to deliver services in developing countries has been described as a critical factor in the success of health systems in implementing programmes. How the sociocultural context of Papua New Guinea (PNG) affects the values, motivation and actions of HWs involved in sexual and reproductive health services is important for policy development and programme planning. With interest in male circumcision (MC) as an HIV prevention option in PNG, this study explored the perceptions and motivations of HWs involved in sexual and reproductive health services in PNG, examining their implications for the possible future roll out of a national MC programme. A multi-method qualitative study was conducted with HWs across a range of health care professions working in sexual health facilities. A total of 29 in-depth interviews and one focus group discussion were completed. Qualitative thematic analysis of the transcripts and field notes was undertaken using a social constructivist approach and complemented by documentary organizational, programme and policy analysis. Introduction of new health programmes, such as a MC programme for HIV prevention, are likely to impact upon one or more of the many motivational determinants. Social-cultural and individual factors influencing HW motivation to be involved in sexual and reproductive health services in PNG included community expectation and concern, sense of accomplishment and religious conviction. Strong links to community responsibility outweighed organizational ties. Faced with an often dysfunctional work environment, HWs perceived themselves as responsible to compensate for the failed health system. The impact of community influence and expectation needs to be considered when introducing a MC programme, particularly to communities in PNG where penile foreskin cutting is a common and accepted practice. The potential contribution to the success of a MC programme that HWs may have means that taking into
Islam, Mahfuza; Ercumen, Ayse; Ashraf, Sania; Rahman, Mahbubur; Shoab, Abul K; Luby, Stephen P; Unicomb, Leanne
Young children frequently defecate in the living environment in low-income countries. Unsafe child feces disposal has been associated with risk of diarrhea. Additionally, reported practices can underestimate socially undesirable unhygienic behaviors. This analysis aimed to assess (1) the sensitivity of reported child feces disposal practices as an indicator for observed presence of human feces in the domestic environment, (2) household characteristics associated with reported unsafe feces disposal and (3) whether unsafe feces disposal is associated with fly presence and diarrhea among children flies in the compound and recorded caregiver-reported child diarrhea prevalence among 803 rural Bangladeshi households. We assessed associations using generalized estimating equations (GEE) and generalized linear models (GLM) with robust standard errors. Unsafe disposal of child feces was reported by 80% of households. Reported disposal practices had high sensitivity (91%) but low positive predictive value (15%) as an indicator of observed feces in the compound. Unsafe disposal was more common among households that reported daily adult open defecation (PR: 1.13, 1.02-1.24) and had children defecating in a nappy or on the ground versus in a potty (PR: 2.92, 1.98-4.32), and less common in households where adults reported always defecating in latrines (PR: 0.91, 0.84-0.98). The presence of observed human feces was similarly associated with these household characteristics. Reported unsafe feces disposal or observed human feces were not associated with fly detection or child diarrhea. Despite access to on-site sanitation, unsafe child feces disposal was reported by the majority of households. However, this practices was not associated with diarrhea; suggesting that child feces may not be the most important fecal exposure. Before resources are invested to improve child feces management practices, studies should explore whether these contribute meaningfully to risk of enteric
Thomas, Charles L.; Dimitrov, Dimiter M.
The purpose of this study was to examine the effects of program interventions in a school-based teen pregnancy program on hypothesized constructs underlying teens' attitudes toward sexuality. An important task related to this purpose was the validation of the constructs and their stability from pre- to postintervention measures. Data from 1,136…
Sexual violence (SV) negatively impacts women with disabilities disproportionately, especially those with intellectual and/or developmental disabilities (IDD). The 2 populations are included in this article as there are overlaps in diagnostic criteria as well as similar risk factors associated with the experience of SV. Despite lacking…
Ngugi, Elizabeth N; Chakkalackal, Michelle; Sharma, Anjali; Bukusi, Elizabeth; Njoroge, Betty; Kimani, Joshua; MacDonald, Kelly S; Bwayo, Job J; Cohen, Craig R; Moses, Stephen; Kaul, Rupert
Behavioral interventions in female sex workers (FSWs) are associated with changes in sexual behavior and reduced rates of sexually transmitted infections (STIs) and HIV We examined the sustainability of such interventions. HIV-uninfected Kenyan FSWs were enrolled in a clinical trial that provided free male condoms, community and clinic-based counseling, and STI management. After trial completion, scaled-back community-based resources remained in place. More than a year later, women were invited to complete a follow-up behavioral questionnaire and to undergo STI/HIV counseling and testing. Individual changes in sexual behavior were assessed by paired analysis. One hundred seventy-two women participated in the resurvey 1.2 years after trial termination. Client numbers had risen (paired t test, P < 0.001), but condom use had also increased (P < 0.001); both remained substantially lower than at enrollment. Regular partners accounted for a greater proportion of unprotected FSW sexual encounters (35% vs. 10%; P < 0.001). Only 9 (5.2%) of 172 women had a conventional STI, and the follow-up HIV incidence of 1.6 per 100 person-years (PYs) was similar to that during the trial period (3.7 per 100 PYs). Incident STIs and HIV were associated with the frequency of unprotected sex and younger age. Less intensive community-based risk reduction services after clinical trial termination may support ongoing reductions in STIs and HIV among high-risk FSWs.
Discusses the international problem of commercial sexual exploitation of children (CSEC) and efforts to stop the practice and assist the victims. Considers initiatives to formulate a worldwide policy against CSEC, and anti-CSEC efforts in the United States, including law enforcement and education, and advocacy efforts and services for youth.…
Blake, Susan M.; Ledsky, Rebecca; Lehman, Thomas; Goodenow, Carol; Sawyer, Richard; Hack, Tim
Compared the sexual risk taking behaviors of gay, lesbian, and bisexual (GLB) and heterosexual adolescents, evaluating associations between gay-sensitive school HIV instruction and GLB adolescents' risk behaviors. Surveys indicated that GLB students had more high risk behaviors than heterosexual students, and those in schools with gay-sensitive…
Royster, Leigh-Anne A.
Gender based violence is experienced at higher rates on college campuses than in other communities. One in five women experience acquaintance rape during their academic career and less than 5% of college women who have experienced sexual assault report their victimization (Fisher, Cullen, & Turner, 2000). Recent federal guidance is meant to…
Margolis, Stephen; Kaetz, Susan
A nationwide network of clinics to educate health care providers about clinical aspects of sexually transmitted diseases has succeeded and led to development of a 13-clinic network for training in the clinical, epidemiological, psychological, and social aspects of Acquired Immune Deficiency Syndrome (AIDS), drawing on the earlier clinic…
Full Text Available ABSTRACTA spectrum of diverse prevention methods that offer high protection against HIV has posed the following challenge: how can national AIDS policies with high coverage for prevention and treatment make the best use of new methods so as to reverse the current high, and even rising, incidence rates among specific social groups? We conducted a narrative review of the literature to examine the prevention methods and the structural interventions that can have a higher impact on incidence rates in the context of socially and geographically concentrated epidemics. Evidence on the protective effect of the methods against sexual exposure to HIV, as well as their limits and potential, is discussed. The availability and effectiveness of prevention methods have been hindered by structural and psychosocial barriers such as obstacles to adherence, inconsistent use over time, or only when individuals perceive themselves at higher risk. The most affected individuals and social groups have presented limited or absence of use of methods as this is moderated by values, prevention needs, and life circumstances. As a result, a substantial impact on the epidemic cannot be achieved by one method alone. Programs based on the complementarity of methods, the psychosocial aspects affecting their use and the mitigation of structural barriers may have the highest impact on incidence rates, especially if participation and community mobilization are part of their planning and implementation.
Smith, Tamara; Clark, Judith F; Nigg, Claudio R
Hawai'i Youth Services Network (HYSN) was founded in 1980 and is incorporated as a 501(c) (3) organization. HYSN plays a key role in the planning, creation, and funding of local youth services. One of HYSN's focuses is teen pregnancy and sexually transmitted infections (STI) prevention among foster youth. Foster youth are at a greater risk for teen pregnancy and STI due to a variety of complex factors including instability, trauma, and emancipation from the foster care system. This article highlights how HYSN is leveraging both federal and local funding, as well as other resources, in order to implement an evidence-based teen pregnancy and STI prevention program adapted for foster youth.
Muck, Christoph; Schiller, Eva-Maria; Zimmermann, Maria; Kärtner, Joscha
Numerous school-based prevention programs have been developed by scientists and practitioners to address sexual violence in adolescence. However, such programs struggle with two major challenges. First, the effectiveness of many well-established practitioner programs has not been rigorously evaluated. Second, effective scientific programs may be hard to implement into everyday school practice. Combining the knowledge of scientists and practitioners in a scientist-practitioner program could be a helpful compromise. The aim of the present study is to evaluate the effects of a scientist-practitioner program and a practitioner program using a cluster-randomized experimental design. Twenty-seven school classes were randomly assigned to either one of two programs or a control group. Outcome variables (knowledge, attitudes, behavior, and iatrogenic effects) were assessed at pretest, posttest, and a 6-month follow-up for 453 adolescents (55% female, Mage = 14.18). Short-term effects were found in both programs regarding general knowledge, knowledge of professional help, and victim-blaming attitudes. Long-term effects were found in both programs regarding general knowledge and knowledge of professional help and, in the practitioner program, in a reduction of victimization. No other effects were found on attitudes and behavior. No iatrogenic effects in the form of increased anxiety were found. Both the scientist-practitioner and the practitioner program show promise for the prevention of sexual violence in adolescence; in particular, the practitioner program may be a more cost-effective method.
Marks, Gary; Crepaz, Nicole; Senterfitt, J Walton; Janssen, Robert S
To compare the prevalence of high-risk sexual behaviors in HIV persons aware of their serostatus with that in HIV persons unaware of their status in the United States and to discuss implications for HIV prevention programs. A meta-analysis was conducted on 11 independent findings. Six findings compared HIV(+) aware persons with independent groups of HIV(+) unaware persons (between-group comparisons), and 5 findings compared seroconverting individuals before and after being notified of their HIV status (within-subject comparisons). Outcomes were self-reported unprotected anal or vaginal intercourse (UAV) during specified recall periods. The analysis integrating all 11 findings indicated that the prevalence of UAV with any partner was an average of 53% (95% confidence interval [CI]: 45%-60%) lower in HIV persons aware of their status relative to HIV(+) persons unaware of their status. There was a 68% reduction (95% CI: 59%-76%) after adjusting the data of the primary studies to focus on UAV with partners who were not already HIV(+). The reductions were larger in between-group comparisons than in within-subject comparisons. Findings for men and women were highly similar. The prevalence of high-risk sexual behavior is reduced substantially after people become aware they are HIV(+). Increased emphasis on HIV testing and counseling is needed to reduce exposure to HIV(+) from persons unaware they are infected. Ongoing prevention services are needed for persons who know they are HIV(+) and continue to engage in high-risk behavior.
Full Text Available Introduction: Industrial accident is one of the most minatory elements for worker’s health, productivity and organizational performance. Unsafe behavior is the main reason associated with occurrence of accidents. The main goal of this study was application of participatory techniques to achieve control measures of these behaviors. .Material and Method: Using safety behavior sampling technique in this study, behaviors of staffs were evaluated and then the most risky behaviors were determined by paired comparison method. By application of participatory approach of dotmocracy in six steps, controlling ideas were derived by participation of operators, supervisors, engineers, HSE team and managers. .Result: 48.8% of the behaviors were unsafe. Misuse or notusing of the personal protective equipments with 63.4% was the most frequent unsafe behavior. Awkward postures, aggregation or passing under suspended loads were also followed by the unsafe behaviors. By application of participatory approach of dotmocracy, several applicable ideas in personal protective equipment, education, reinforcementand punishment, aggregation or passing under suspended loads and other ideas were achieved. . Conclusion: Dotmocracy participatory technique is an effective way to achieve various practical solutions in control of worker’s unsafe behaviors.
Halken, S; Høst, A
, breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented extensively hydrolysed formula is recommended if exclusive breastfeeding is not possible for the first 4 months of life. There is no evidence for preventive dietary intervention neither during pregnancy nor lactation...... populations. These theories remain to be documented in proper, controlled and prospective studies. Breastfeeding and the late introduction of solid foods (>4 months) is associated with a reduced risk of food allergy, atopic dermatitis, and recurrent wheezing and asthma in early childhood. In all infants....... Preventive dietary restrictions after the age of 4-6 months are not scientifically documented....
Sales, Jessica M.; Smearman, Erica; Brody, Gene H.; Milhausen, Robin; Philibert, Robert A.; DiClemente, Ralph J.
Sexuality-related constructs such as sexual arousal, sexual sensation seeking (SSS) and sexual satisfaction have been related to sexual behaviors that place one at risk for adverse consequences such as sexually transmitted infections (STIs), HIV, and unintended pregnancy. The biopsychosocial model posits an array of factors, ranging from social environmental factors, biological, and psychological predispositions that may be associated with these sexuality constructs in adolescent samples. African-American females aged 14-20 were recruited from reproductive health clinics for an HIV intervention. Baseline survey and follow-up DNA data (N=304) was used to assess biological, psychological and social environmental associations with the sexuality constructs of arousal, SSS, and sexual satisfaction. In multivariable linear regressions, a higher depressive symptom rating was associated with higher arousability while short serotonin allele(s) status was associated with lower arousability. Impulsivity and perceived peer norms supportive of unsafe sexual behaviors were associated with increased SSS, and short serotonin allele(s) status was associated with lower SSS. Higher social support was also associated with higher levels of sexual satisfaction while short serotonin allele(s) status was associated with lower satisfaction. The sexuality constructs were also significantly related to number of sex partners, frequency of vaginal sex, and number of unprotected vaginal sex acts in the past six months. These findings emphasize the importance of understanding biopsychosocial factors, including the role of serotonin as an indicator of natural variations in sexual inclination and behaviors, that influence sexuality constructs, which in turn are associated with sexual behaviors, to allow further refinement of sexual health clinical services and programs and promote the development of healthy sexuality. PMID:24262218
Adolescents and young adults are highly impacted by sexually transmitted infections (STIs) and unplanned pregnancy in the United States and globally. Consistent and correct use of male latex condoms is associated with protection against both STIs and pregnancy. Providing adolescents and young adults with access to free condoms in schools may increase the use of condoms by improving condom availability, eliminating cost, and decreasing embarrassment associated with purchasing condoms. Studies demonstrate that condom availability in schools is associated with the increased use of condoms and improved overall sexual health. The Society for Adolescent Health and Medicine encourages schools to make condoms available to students as part of efforts to decrease rates of STIs and unplanned pregnancy in adolescents and young adults. The Society for Adolescent Health and Medicine also encourages health care providers to advocate for and support the availability of condoms in local schools. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Osafo, Joseph; Asampong, Emmanuel; Langmagne, Sussan; Ahiedeke, Clement
To understand the role of religion in the sexual behaviours of adolescents, the views of parents who are key agents of socialization were examined from two south-eastern communities in Ghana. Focus Group interviews were conducted with mothers (and female caregivers) of adolescents and one with fathers (and male caregivers) of adolescents. Thematic analysis was used to analyse the data. Findings indicated that parents from one community perceived religion as playing a double-edged role in adol...
Fisher, Celia B; Arbeit, Miriam R; Dumont, Melissa S; Macapagal, Kathryn; Mustanski, Brian
This project examined the attitudes of sexual and gender minority youth (SGMY) toward guardian permission for a pre-exposure prophylaxis (PrEP) adherence trial and their preparedness to provide informed, rational, and voluntary self-consent. Sixty sexually active SGMY (ages 14-17) participated in online survey and asynchronous focus group questions after watching a video describing a PrEP adherence study. Youth responses highlighted guardian permission as a significant barrier to research participation, especially for those not "out" to families. Youth demonstrated understanding of research benefits, medical side effects, confidentiality risks, and random assignment and felt comfortable asking questions and declining participation. Reasoning about participation indicated consideration of health risks and benefits, personal sexual behavior, ability to take pills every day, logistics, and post-trial access to PrEP. Results demonstrate youth's ability to self-consent to age- and population-appropriate procedures, and underscore the value of empirical studies for informing institutional review board (IRB) protections of SGMY research participants. © The Author(s) 2016.
Schneider, J A; Dude, A; Dinaker, M; Kumar, V; Laumann, E O; Holloway-Beth, A; Oruganti, G; Saluja, G S; Chundi, V; Yeldandi, V; Mayer, K H
The relationships between hygiene, sexual behaviour and HIV infection are poorly understood. We examine these relationships in Indian truck drivers, a group at high risk for HIV infection. Truck drivers (n = 189) were recruited into an integrated HIV and hygiene Information Motivation (IM) programme. Sociodemographic characteristics, sexual and hygiene behaviour and HIV prevalence were determined. Multivariate logistic regression and linear generalized estimating equation models were utilized. At baseline, 2.1% of drivers were HIV infected and 34% who reported having contact with female sex workers (FSWs) had contact within the previous six months. Those who washed their hands postdefecation were less likely to report genital symptoms (OR 0.02; P = 0.01) and have sex with an FSW (OR [odds ratio] 0.21; P = 0.05). After an IM intervention, there were no changes in sexual risk-taking behaviour (coefficient -0.15 to -0.02; P = 0.13-0.75); however, hygiene behaviour improved from baseline (coefficient 0.09-0.31; P hygiene habits, like handwashing, seem to be a modifiable behaviour after a modest intervention, whereas HIV risk-taking behaviour was not. The association between hygiene and HIV risk-taking suggests the need for further evaluation of the relationship and that of other hygiene practices in high-risk men in India.
Levandowski, Brooke A; Kalilani-Phiri, Linda; Kachale, Fannie; Awah, Paschal; Kangaude, Godfrey; Mhango, Chisale
Malawian women in all sectors of society are suffering from social implications of unwanted pregnancy and unsafe abortion. Unwanted pregnancies occur among women who have limited access to family planning and safe abortion. A legally restrictive setting for safe abortion services leads many women to unsafe abortion, which has consequences for them and their families. In-depth interviews were conducted with 485 Malawian stakeholders belonging to different political and social structures. Interviewees identified the impact of unwanted pregnancy and unsafe abortion to be the greatest on young women. Premarital and extramarital pregnancies were highly stigmatized; stigma directly related to abortion was also found. Community-level discussions need to focus on reduction of stigma. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Kuhn, Eric; Drescher, Kent; Ruzek, Josef; Rosen, Craig
Aggressive and unsafe driving was examined in 474 male veterans receiving Veterans Affairs residential treatment for posttraumatic stress disorder (PTSD). Specifically, the authors evaluated if PTSD was associated with aggressive and unsafe driving and if Iraq and Afghanistan War veterans were at higher risk than other war veterans. Approximately two thirds of the sample reported lifetime aggressive driving and one third reported current aggressive driving. Posttraumatic stress disorder severity was associated with aggressive driving, but not other forms of unsafe driving. Iraq and Afghanistan veterans endorsed higher rates of and more frequent aggressive driving than did other veterans. After accounting for PTSD severity, age, income, and marital status being an Iraq and Afghanistan War veteran predicted aggressive driving frequency and infrequent seatbelt use.
Li, Hongxia; Di, Hongxi; Tian, Shuicheng; Li, Jian
The aim of this study is research the impact of management level's charismatic leadership style on miners' unsafe behavior by using the questionnaires on charismatic leadership style, safety attitude and the miners' unsafe behavior measurement to investigate 200 employees in Shen Dong Company. The research results suggest that management level's charismatic leadership style have very important influence on miners' unsafe behavior and the influence is affected by the safety attitude which is the intermediary function. In the end, this study propose advice on how to improve the coal mine enterprise managers charismatic leadership style in the coal mine enterprise's safety management work, including attach great importance to a variety of incentive methods, set up safety moral models, practice of inductive leadership concept, create a good atmosphere of safety, etc for reference for coal mining enterprises.
Khosravi, Yahya; Asilian-Mahabadi, Hassan; Hajizadeh, Ebrahim; Hassanzadeh-Rangi, Narmin; Bastani, Hamid; Khavanin, Ali; Mortazavi, Seyed Bagher
There can be little doubt that the construction is the most hazardous industry in the worldwide. This study was designed to modeling the factors affecting unsafe behavior from the perspective of safety supervisors. The qualitative research was conducted to extract a conceptual model. A structural model was then developed based on a questionnaire survey (n=266) by two stage Structural Equation Model (SEM) approach. An excellent confirmed 12-factors structure explained about 62% of variances unsafe behavior in the construction industry. A good fit structural model indicated that safety climate factors were positively correlated with safety individual factors (Pconstruction workers' engagement in safe or unsafe behavior. In order to improve construction safety performance, more focus on the workplace condition is required.
Martin, Erin K; Silverstone, Peter H
Here we describe the development of an evidence-based education program for adults about childhood sexual abuse (CSA), called Prevent It! Uniquely, the primary goal of this program was to change the behavior of participants, as well as to increase knowledge about CSA and positive attitudes toward it. A comprehensive review shows no previous similar approach. The program includes a detailed manual to allow standardized administration by trained facilitators, as well as multiple video segments from CSA survivors and professionals. A total of 23 program workshops were run, with 366 adults participating. Of these, 312 (85%) agreed to take part in the study. All completed baseline ratings prior to the program and 195 (63% of study sample) completed follow-up assessments at 3-months. There were no significant differences between the demographic make-up of the baseline group and the follow-up group. Assessments included demographic data, knowledge, attitudes, and several measures of behavior (our primary outcome variable). Behavioral questions asked individuals to select behaviors used in the previous 3-months from a list of options. Questions also included asking "how many times in the previous 3-months" have you "talked about healthy sexual development or Child sexual abuse (CSA) with a child you know"; "suspected a child was sexually abused"; "taken steps to protect a child"; or "reported suspected sexual abuse to police or child welfare"? The majority of attendees were women, with the commonest age group being between 30 and 39 years old. Approximately 33% had experienced CSA themselves. At 3-month follow-up there were highly statistically significant improvements in several aspects of behavior and knowledge, and attitudes regarding CSA. For example, the number of subjects actively looking for evidence of CSA increased from 46% at baseline to 81% at follow-up, while the number of subjects who actively took steps to protect children increased from 25% at baseline to 48
Erin K Martin
Full Text Available Here we describe the development of an evidence-based education program for adults about childhood sexual abuse (CSA, called Prevent It! Uniquely, the primary goal of this program was to change the behaviour of participants, as well as to increase knowledge about CSA and positive attitudes towards it. A comprehensive review shows no previous similar approach. The program includes a detailed manual to allow standardized administration by trained facilitators, as well as multiple video segments from CSA survivors and professionals. A total of 23 program workshops were run, with 366 adults participating. Of these, 312 (85% agreed to take part in the study. All completed baseline ratings prior to the program and 195 (63% of study sample completed follow-up assessments at 3-months. There were no significant differences between the demographic make-up of the baseline group and the follow-up group. Assessments included demographic data, knowledge, attitudes, and several measures of behaviour (our primary outcome variable. Behavioural questions asked individuals to select behaviours used in the previous 3-months from a list of options. Questions also included asking how many times in the previous 3-months have you talked about healthy sexual development or child sexual abuse with a child you know; suspected a child was sexually abused; taken steps to protect a child; or reported suspected sexual abuse to police or child welfare? The majority of attendees were women, with the commonest age group being between 30 – 39 years old. Approximately 33% had experienced CSA themselves. At 3-month follow-up there were highly statistically significant improvements in several aspects of behaviour and knowledge, and attitudes regarding CSA. For example, the number of subjects actively looking for evidence of CSA increased from 46% at baseline to 81% at follow-up, while the number of subjects who actively took steps to protect children increased from 25% at baseline
Vera, Alicia; Abramovitz, Daniela; Lozada, Remedios; Martinez, Gustavo; Rangel, M Gudelia; Staines, Hugo; Patterson, Thomas L; Strathdee, Steffanie A
Female sex workers who inject drugs (FSW-IDUs) are at risk of acquiring HIV, sexually transmitted infections (STI) and blood-borne infections through unprotected sex and sharing injection equipment. We conducted a 2×2 factorial randomized controlled trial to evaluate combination interventions to simultaneously reduce sexual and injection risks among FSW-IDUs in Tijuana and Ciudad Juarez, Mexico. FSW-IDUs ≥18 years reporting sharing injection equipment and unprotected sex with clients within the last month were randomized to one of four conditions based on an a priori randomization schedule, blinding interviewer/counselors to assignment. Due to the extreme vulnerability of this population, we did not include a control group that would deny some women access to preventive information. All women received similar information regardless of group allocation; the difference was in the way the information was delivered and the extent to which women had an interactive role. Each condition was a single 60-minute session, including either an interactive or didactic version of an injection risk intervention and sexual risk intervention. Women underwent interviewer-administered surveys and testing for HIV, syphilis, gonorrhea, Chlamydia, and Trichomonas at baseline and quarterly for 12 months. Combined HIV/STI incidence will be the primary outcome. Secondary outcomes are proportionate reductions in sharing of injection equipment and unprotected sex with clients. Of 1,132 women, 548 (48.4%) were excluded (88.9% were ineligible; 11.1% refused to participate or did not return); 584 eligible women enrolled (284 in Tijuana; 300 in Ciudad Juarez). All 584 participants completed the baseline interview, provided biological samples and were randomized to one of the four groups. During follow-up, 17 participants (2.9%) were lost to follow-up, of whom 10 (58.8%) had died, leaving 567 participants for analysis. This study appears to be the first intervention to attempt to simultaneously
Full Text Available Abstract Background Sexually transmitted diseases (STDs, especially the Chlamydia trachomatis bacterial infection, a common cause of infertility, are highly prevalent in developed countries, and a worrying problem in North Norway, where the incidence of chlamydia twice the Norwegian average. Seventy percent of reported chlamydia cases are found in people below 25 years of age, and although its spread could be controlled with proper prevention, young people are more aware of the risks of unwanted pregnancy than their risk of acquiring a STD. Information and Communication Technologies, including, the Internet, social media and/or smartphones, should be valued for sexual health promotion for their potential to engage young audiences. And in these media, avatars guarantee anonymity to users when handling sensitive information. The main objective of this project is to achieve that North Norwegian youngsters become more aware of STDs through the use of popular technologies among young people. Methods A Virtual Clinic for Sexually Transmitted Diseases (VCSTD will be developed. The VCSTD will provide early guidance and reliable information sources concerning reproductive health, delivered in a novel and innovative way to the younger population. The VCSTD consists of an “avatar” supported intervention in a serious gaming and e-learning environment, which will bypass direct physical access (in person to reliable medical information, as well as allowing the youngsters to share that information in social media, and thus helping the VCSTD to be disseminated to more people. Data analyses will be conducted on publically available health data relevant to STDs in Troms and Finnmark, like the absolute number of chlamydia tests, the amount of emergency contraception medication sold, and the number of abortions. Also, usage data of the system and experiences of usefulness will be explored through participants’ voluntary responses to a feedback form available
Full Text Available Abstract Background Assessing people's ability to drive has become a public health concern in most industrialized countries. Although age itself is not a predictive factor of an increased risk for dangerous driving, the prevalence of medical conditions that may impair driving increases with age. Because the implementation of a screening for unsafe driving due to medical conditions is a public health issue, its usefulness should be judged using standardised criteria already proposed for screening for chronic disease. The aim of this paper is to propose standardised criteria suitable to assess the scientific validity of screening for unsafe driving due to medical conditions, and identify potential issues to be clarified before screening can be implemented and effective. Discussion Using criteria developed for screening for chronic diseases and published studies on driving with medical conditions, we specify six criteria to judge the opportunity of screening for unsafe driving due to medical conditions. This adaptation was needed because of the complexity of the natural history of medical conditions and their potential consequences on driving and road safety. We then illustrate that published studies pleading for or against screening for unsafe driving due to medical conditions fail to provide the needed documentation. Individual criteria were mentioned in 3 to 72% of 36 papers pleading for or against screening. Quantitative estimates of relevant indicators were provided in at most 42% of papers, and some data, such as the definition of an appropriate unsafe driving period were never provided. Summary The standardised framework described in this paper provides a template for assessing the effectiveness (or lack of effectiveness of proposed measures for screening for unsafe driving due to medical conditions. Even if most criteria were mentioned in the published literature pleading for or against such a screening, the failure to find quantitative and
Shah, N.; Hossain, N.; Khan, N.H.
Objective: To study the mortality and morbidity of unsafe abortion in a University Teaching Hospital. Methods: A cross-sectional, descriptive study was conducted in Department of Obstetrics and Gynaecology, Unit III, Dow Medical College and Civil Hospital Karachi from January 2005 to December 2009. Data regarding the socio demographic characteristics, reasons and methods of abortion, nature of provider, complications and treatment were collected for 43 women, who were admitted with complications of unsafe abortion, and an analysis was done. Results: The frequency of unsafe abortion was 1.35% and the case fatality rate was 34.9%. Most of the women belonged to a very poor socioeconomic group (22/43; 51.2%) and were illiterate (27/43; 62.8%). Unsafe abortion followed an induced abortion in 29 women and other miscarriages in 14 women. The majority of women who had an induced abortion were married (19/29, 65.5%). A completed family was the main reason for induced abortion (14/29; 48.2%) followed by being unmarried (8/29, 27.5%) and domestic violence in 5/29 cases (17.2%). Instruments were the commonest method used for unsafe abortion (26/43;68.4%).The most frequent complication was septicaemia (34; 79%) followed by uterine perforation with or without bowel perforation (13, 30.2%) and haemorrhage (9; 20.9%). Majority of induced abortions were performed by untrained providers (22/26; 84.6%) compared to only 3/14 cases (21.4%) of other miscarriages (p=0.0001). Conclusion: The high maternal mortality and morbidity of unsafe abortion in our study highlights the need for improving contraceptive and safe abortion services in Pakistan. (author)
Shah, Nusrat; Hossain, Nazli; Noonari, Mukhtiar; Khan, Nusrat Hassan
To study the mortality and morbidity of unsafe abortion in a University Teaching Hospital. A cross-sectional, descriptive study was conducted in Department of Obstetrics and Gynaecology, Unit III, Dow Medical College and Civil Hospital Karachi from January 2005 to December 2009. Data regarding the sociodemographic characteristics, reasons and methods of abortion, nature of provider, complications and treatment were collected for 43 women, who were admitted with complications of unsafe abortion, and an analysis was done. The frequency of unsafe abortion was 1.35% and the case fatality rate was 34.9%. Most of the women belonged to a very poor socioeconomic group (22/43; 51.2%) and were illiterate (27/43; 62.8%). Unsafe abortion followed an induced abortion in 29 women and other miscarriages in 14 women. The majority of women who had an induced abortion were married (19/29, 65.5%). A completed family was the main reason for induced abortion (14/29; 48.2%) followed by being unmarried (8/29, 27.5%) and domestic violence in 5/29 cases (17.2%). Instruments were the commonest method used for unsafe abortion (26/43; 68.4%).The most frequent complication was septicaemia (34; 79%) followed by uterine perforation with or without bowel perforation (13, 30.2%) and haemorrhage (9; 20.9%). Majority of induced abortions were performed by untrained providers (22/26; 84.6%) compared to only 3/14 cases (21.4%) of other miscarriages (p = 0.0001). The high maternal mortality and morbidity of unsafe abortion in our study highlights the need for improving contraceptive and safe abortion services in Pakistan.
Côté-Lussier, Carolyn; Fitzpatrick, Caroline; Séguin, Louise; Barnett, Tracie A.
This study applied socioecological and cumulative risk exposure frameworks to test the hypotheses that 1) the experience of poverty is associated with feeling less safe at school, and 2) feeling less safe is associated with engaging in poorer weight-related behaviors, as well as an increased probability of being overweight or obese. Data were from the ongoing Québec Longitudinal Study of Child Development, initiated in 1998 with a population-based cohort of 2,120 Québec (Canada) infants 5 months of age and their parent or primary caregiver. Measures of youths' (age, 13 years) self-reported feelings of safety, screen time, physical activity, and objectively assessed not overweight/obese (70%), overweight (22%), and obese (8%) weight status were collected in 2011. Family poverty trajectory from birth was assessed by using latent growth modeling. As hypothesized, exposure to poverty was associated with feeling less safe at school and, in turn, with an increased probability of being overweight or obese. The association was most pronounced for youths who experienced chronic poverty. Compared with youths who experienced no poverty and felt unsafe, those who experienced chronic poverty and felt unsafe were nearly 18% more likely to be obese (9.2% vs. 11.2%). Although feeling unsafe was associated with screen time, screen time did not predict weight status. PMID:25921649
Boksun Yang, RN, PhD
Conclusion: The results of the study can provide school nurses and sex educators with useful knowledge grounded in actual sexual offense cases, not only to refine the interventions for sexual offenders but also to prevent future sexual offenses.
How Setswana Cultural Beliefs and Practices on Sexuality Affect Teachers' and Adolescents' Sexual Decisions, Practices, and Experiences as well as HIV/AIDS and STI Prevention in Select Botswanan Secondary Schools.
Nleya, Paul T; Segale, Emelda
The article reports on the aspects of a Botswana Ministry of Education and Skills Development (MoE & SD) HIV/AIDS Instructional Television (ITV) project modeled on a similar HIV/AIDS program implemented in Brazil. This Teacher Capacity Building Project (TCBP) in Botswana is in its initial years of implementation. Its overall goal is to contribute to the prevention and mitigation of the impact of HIV and AIDS by strengthening the capacity of the education and communication sectors to deliver interactive, distance HIV/AIDS education primarily to teachers so that they act as agents of behavior change among the in-school youth. One of the components of the TCBP program is a live teacher education television HIV/AIDS program called Talk Back program. Talk Back is a collaborative effort of the MoE & SD and the Botswana national television station. The Talk Back program involves development and implementation of weekly 1 hour live HIV/AIDS education interactive TV broadcasts for teachers. The development of the live programs is guided by a curriculum that provides a wide range of themes related to HIV/AIDS and education. This article reports the results of a survey of a sample of teachers and students at junior secondary schools and senior secondary schools, first, on their views and opinions regarding the Talk Back program as a TCBP. Second, how Setswana cultural beliefs, myths, and practices on sexuality affect teachers' and adolescents' sexual decisions, practices, and experiences as well as HIV/AIDS and sexually transmitted infection prevention. A questionnaire survey and focus group interviews were used as data collection instruments in selected secondary schools. The findings of the study suggest that the Talk Back program has not met much success as a TCBP. The findings further suggest that several myths, beliefs, misconceptions, and attitudes about HIV/AIDS exist among Botswana teachers and students and thus make it difficult for the Talk Back program to impart
Rasch, Vibeke; Lyaruu, Mathias A
Targeting male partners involved in unsafe abortions for contraceptive counseling could be an important strategy for decreasing the incidence of unwanted pregnancies, yet few postabortion-care programs have attempted to involve these men. To assess the need for and determine the content of postab......Targeting male partners involved in unsafe abortions for contraceptive counseling could be an important strategy for decreasing the incidence of unwanted pregnancies, yet few postabortion-care programs have attempted to involve these men. To assess the need for and determine the content...... counseling, which should be sensitive to the nature of the partners' relationship, the risk of HIV transmission, and the importance of promoting gender...
Rasch, Vibeke; Massawe, Siriel; Yambesi, Fortunata
OBJECTIVE: To assess the need for post-abortion contraception and to determine if women who had an unsafe abortion will use a contraceptive method to avoid repeated unwanted pregnancies and STDs/HIV. METHOD: Women attending Temeke Municipal Hospital, Dar es Salaam, after an unsafe abortion...... or an induced abortion performed at the hospital (n=788) were counselled about contraception and the risk of contracting STDs/HIV. A free ward-based contraceptive service was offered and the women were asked to return for follow-up. RESULTS: Participants (90%) accepted the post-abortion contraceptive service...
Ranapurwala, Shabbar I; Wing, Steve; Poole, Charles; Kucera, Kristen L; Marshall, Stephen W; Denoble, Petar J
Recreational scuba diving involves the use of complex instruments and specialized skills in an unforgiving environment. Errors in dive preparation in such an environment may lead to unsafe conditions, mishaps, injuries and fatalities. Diving mishaps can be major and minor based on their potential to cause injury and the severity of the resulting injury. The objective of this study is to assess the incidence of diving mishaps and unsafe conditions, and their associations with the participants' routine use of their own checklists. Between June and August 2012, 426 divers participated in the control group of a randomized trial to evaluate the effectiveness of an intervention pre-dive checklist. The current nested analysis prospectively follows the control participants, who did not receive the intervention checklist. Poisson regression models with generalized estimating equations were used to estimate rate ratios comparing written checklist use with memorized and no checklist use. The overall incidence of major mishaps and minor mishaps was 11.2 and 18.2 per 100 dives, respectively. Only 8% participants reported written checklist use, 71% reported using memorized checklists, and 21% did not use any checklist. The rate ratio for written checklist use as compared to using a memorized or no checklist was 0.47 (95%CI: 0.27, 0.83) for all mishaps (major and minor combined), and 0.31 (95% CI: 0.10, 0.93) for major mishaps. The rate of mishaps among memorized checklist users was similar to no checklist users. This study reinforces the utility of written checklists to prevent mishaps and, potentially, injuries and fatalities.
Reid Savanna R
Full Text Available Abstract Background Unsafe reuse of injection equipment in hospitals is an on-going threat to patient safety in many parts of Africa. The extent of this problem is difficult to measure. Standard WHO injection safety assessment protocols used in the 2003 national injection safety assessment in Cameroon are problematic because health workers often behave differently under the observation of visitors. The main objective of this study is to assess the extent of unsafe injection equipment reuse and potential for blood-borne virus transmission in Cameroon. This can be done by probing for misconceptions about injection safety that explain reuse without sterilization. These misconceptions concern useless precautions against cross-contamination, i.e. "indirect reuse" of injection equipment. To investigate whether a shortage of supply explains unsafe reuse, we compared our survey data against records of purchases. Methods All health workers at public hospitals in two health districts in the Northwest Province of Cameroon were interviewed about their own injection practices. Injection equipment supply purchase records documented for January to December 2009 were compared with self-reported rates of syringe reuse. The number of HIV, HBV and HCV infections that result from unsafe medical injections in these health districts is estimated from the frequency of unsafe reuse, the number of injections performed, the probability that reused injection equipment had just been used on an infected patient, the size of the susceptible population, and the transmission efficiency of each virus in an injection. Results Injection equipment reuse occurs commonly in the Northwest Province of Cameroon, practiced by 44% of health workers at public hospitals. Self-reported rates of syringe reuse only partly explained by records on injection equipment supplied to these hospitals, showing a shortage of syringes where syringes are reused. Injection safety interventions could