scholarly journals “I Always Prefer To Withdraw Than Use A Condom”: A Phenomenological Study of Condomless Sexual Practice Among International Students in Sydney

2021 ◽  
Author(s):  
Sylvester Reuben Okeke
Keyword(s):  
International Students ◽  
Health Services ◽  
Sexual Health ◽  
Phenomenological Study ◽  
Population Based ◽  
Sexual Practices ◽  
Consistent Condom ◽  
Sexual Practice ◽  
Condomless Sex ◽  
Sexually Transmissible Infections

Abstract Background: Incidence and prevalence of blood-borne viruses and sexually transmissible infections among young people continue to necessitate population-based studies to understand how contextualised sexual health services can be developed and implemented to promote protective behaviours such as consistent condom use. This study examined condomless sexual practice among a sample of East Asian and sub-Saharan African international university students in Sydney, Australia. Methods: This phenomenological qualitative study involved face-to-face and telephone semi-structured in-depth interviews with 20 international students from various universities in Sydney. The interview sessions were audio-recorded, transcribed verbatim, coded using NVivo and analysed using reflexive thematic analysis. Results: Condomless sexual practices appear to be common among the study group based on participants’ self-reports and social practices of friends and peers. Themes describing contexts where condomless sex occur among the participants are classified into three: (1) unanticipated sex, condom related stigma and alcohol use (2) pleasure-seeking, curiosity and intimacy (3) condomless sex as a gendered practice. Conclusions: The results of this study add to growing evidence for multi-layered and population-specific sexual health services for international students from traditional sexual cultures.

scholarly journals “I always prefer to withdraw than use a condom”: contextualising condomless sex among East Asian and sub-Saharan African international students in Sydney

2022 ◽  
Vol 80 (1) ◽  
Author(s):  
Sylvester R. Okeke
Keyword(s):  
International Students ◽  
Health Services ◽  
Sexual Health ◽  
Interpretative Phenomenological Analysis ◽  
East Asian ◽  
Sexual Practices ◽  
Consistent Condom ◽  
Condomless Sex ◽  
Sexually Transmissible Infections ◽  
Sub Saharan

Abstract Background Incidence and prevalence of blood-borne viruses and sexually transmissible infections among young people continue to necessitate population-based studies to understand how contextualised sexual health services can be developed and implemented to promote protective behaviours such as consistent condom use. This study examined condomless sexual practice among a sample of East Asian and sub-Saharan African international university students in Sydney, Australia. Methods This qualitative study was methodologically guided by interpretative phenomenological analysis. Data was provided by 20 international students sampled from five universities in Sydney, who participated in either face-to-face or telephone semi-structured in-depth interviews. The interview sessions were audio-recorded, transcribed verbatim, coded in NVivo and analysed using reflexive thematic analysis. Results Condomless sexual practices appear to be common among the study group based on participants’ self-reports of their own practices and the practices of friends and peers. Three themes contextualising condomless among the study participants were generated from the interview transcripts: (1) unanticipated sex, condom related stigma and alcohol use (2) pleasure-seeking, curiosity and intimacy (3) condomless sex as a gendered practice. Conclusions The result of this study has implications for public health research, practice and policy around design, implementation and evaluation of multi-layered and population-specific sexual health services that are tailored to addressing the needs of international students, who  migrate from traditional sexual cultures to Australia, where sexual norms are more liberal.

What proportion of sexually transmissible infections and HIV are diagnosed in New South Wales’ public sexual health services compared with other services?

Sexual Health ◽  
2013 ◽  
Vol 10 (2) ◽  
pp. 119 ◽  
Author(s):  
Chris Bourne ◽  
Debbie Allen ◽  
Katherine Brown ◽  
Stephen C. Davies ◽  
Anna McNulty ◽  
...  
Keyword(s):  
Health Services ◽  
Sexual Health ◽  
New South ◽  
New South Wales ◽  
Large Contribution ◽  
Geographical Variations ◽  
South Wales ◽  
Sexually Transmissible Infections ◽  
Geographical Regions ◽  
High Risk Populations

Background: In New South Wales (NSW), publicly funded sexual health services (PFSHSs) target the populations at greatest risk for important sexually transmissible infections (STIs) and so may make a large contribution to the diagnosis of notifiable STIs. We aimed to determine the proportions of STIs diagnosed in PFSHSs and notified to the NSW Ministry of Health in 2009, and describe geographical variations. Methods: The number of notifiable STIs (infectious syphilis, gonorrhoea, HIV and chlamydia) diagnosed in 2009 was obtained for each Area Health Service (AHS) and each PFSHS. The proportion of diagnoses made by PFSHSs was calculated at the state and AHS level according to five geographical regions: inner and outer metropolitan, regional, rural and remote. Results: The overall proportions of diagnoses made by NSW PFSHSs were syphilis, 25%; gonorrhoea, 25%; HIV, 21%; and chlamydia, 14%. Within each zone, the proportions of these STIs were (respectively): (i) inner metropolitan: 32%, 26%, 21% and 13%; (ii) outer metropolitan: 41%, 24%, 43% and 9%; (iii) regional: 62%, 15%, 23% and 10%; (iv) rural: 8%, 29%, <5% and 20%; and (v) remote: <5%, 43%, <5% and 29%. There was considerable variation in proportions of STIs between and within AHSs (<5–100%). Conclusions: NSW PFSHSs contribute a large proportion of diagnoses for syphilis, gonorrhoea and HIV, but less so for chlamydia. Across AHSs and zones, there was considerable variation in the proportions. These data support the role of PFSHS in identifying and managing important STIs in high-risk populations.

Sexual behaviour and HIV prevention needs of men attending a suburban Sex on Premises Venue

Sexual Health ◽  
2015 ◽  
Vol 12 (5) ◽  
pp. 383 ◽  
Author(s):  
Anthony J. Santella ◽  
Timothy E. Schlub ◽  
Catriona Ooi ◽  
Rick Varma ◽  
Martin Holt ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Health Services ◽  
Sexual Health ◽  
General Practitioners ◽  
Sexual Behaviour ◽  
Consistent Condom ◽  
Health Clinic ◽  
Anal Sex ◽  
Condom Usage ◽  
Health Services Needs

Background Sexual behaviour and HIV prevention needs of men who have sex with men (MSM) attending suburban Sex on Premises Venues (SOPVs) are understudied. Methods: A cross-sectional survey examining sexual activity, health services utilisation, sexual health services needs and STI knowledge was conducted among MSM over 18 years old attending a SOPV in Western Sydney between June and July 2013. Results: A total of 213 MSM were sampled; approximately half of the respondents (51%) reported that they only had sex with other men, and 46% had sex with both men and women. Condom use varied considerably, with ~50% of responders not using condoms consistently during anal sex. Consistent condom usage was not associated with having regular, casual or a mix of regular and casual partners during anal sex (P = 0.09). The majority (59.5%) obtained sexual health screening services from general practitioners; only 15.0% sought services from a local sexual health clinic. Over half of respondents (57.7%) believed that SOPVs should offer on-site and free testing services. Those with the highest level of previous STI diagnoses were gay men (41%), those who only had casual partners (38%) and those who did not complete high school (65%). Conclusions: Sexual health services and non-government organisations should consider targeting bisexual men with rapid HIV testing and condom usage campaigns. Low cost or free on-site HIV and STI testing at SOPVs and stronger partnerships between general practitioners and sexual health services are needed.

Analysis of diagnostic data for sexually transmissible infections in South Australian Aboriginal Community Controlled Health Services (2008–16)

Sexual Health ◽  
2019 ◽  
Vol 16 (6) ◽  
pp. 566
Author(s):  
Salenna R. Elliott ◽  
Sarah Betts ◽  
Katie Hobbs ◽  
Handan Wand ◽  
Alice R. Rumbold ◽  
...  
Keyword(s):  
Health Services ◽  
Sexual Health ◽  
Health Program ◽  
Aboriginal Communities ◽  
Aboriginal Community ◽  
Diagnostic Data ◽  
Australian Aboriginal ◽  
Sti Testing ◽  
Sexually Transmissible Infections ◽  
Sexual Health Program

Background Australian Aboriginal communities experience a high burden of sexually transmissible infections (STIs). Since 2009, a comprehensive sexual health program has been implemented at nine Aboriginal Community Controlled Health Services in South Australia. This study assessed trends in STI testing and positivity using deidentified diagnostic data from this period (2008–16). Methods: Testing data for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) from one urban, three regional and five remote Aboriginal health services were analysed using logistic regression. Results: From 2008 to 2016, testing increased for CT (twofold), NG (threefold) and TV (sixfold). On average, 30% of testing occurred during an annual 6-week screen. Fewer males were tested (range 27–38% annually). Mean annual STI testing coverage was 28% for 16- to 30-year-old clients attending regional or remote services (2013–16). Positivity at first testing episode for all three infections declined during the study period. From 2013 to 2016, when testing was stable and changes in positivity were more likely to indicate changes in prevalence, there were significant reductions in CT positivity (adjusted odds ratio (aOR) 0.4; 95% confidence interval (CI) 0.2–0.5) and TV positivity (aOR 0.6, 95% CI 0.4–0.9), although declines were statistically significant for females only. There was no significant decrease in NG positivity (aOR 0.9; 95% CI 0.5–1.5). Conclusions: Since the sexual health program began, STI testing increased and STI positivity declined, but significant reductions observed in CT and TV positivity were confined to females. These findings suggest evidence of benefit from sustained, comprehensive sexual health programs in Aboriginal communities with a high STI prevalence, but highlight the need to increase STI testing among men in these communities.

Corrigendum to: What proportion of sexually transmissible infections and HIV are diagnosed in New South Wales’ public sexual health services compared with other services?

Sexual Health ◽  
2013 ◽  
Vol 10 (3) ◽  
pp. 290
Author(s):  
Chris Bourne ◽  
Debbie Allen ◽  
Katherine Brown ◽  
Stephen C. Davies ◽  
Anna McNulty ◽  
...  
Keyword(s):  
Health Services ◽  
Sexual Health ◽  
New South ◽  
New South Wales ◽  
Large Contribution ◽  
Geographical Variations ◽  
South Wales ◽  
Sexually Transmissible Infections ◽  
Geographical Regions ◽  
High Risk Populations

Background: In New South Wales (NSW), publicly funded sexual health services (PFSHSs) target the populations at greatest risk for important sexually transmissible infections (STIs) and so may make a large contribution to the diagnosis of notifiable STIs. We aimed to determine the proportions of STIs diagnosed in PFSHSs and notified to the NSW Ministry of Health in 2009, and describe geographical variations. Methods: The number of notifiable STIs (infectious syphilis, gonorrhoea, HIV and chlamydia) diagnosed in 2009 was obtained for each Area Health Service (AHS) and each PFSHS. The proportion of diagnoses made by PFSHSs was calculated at the state and AHS level according to five geographical regions: inner and outer metropolitan, regional, rural and remote. Results: The overall proportions of diagnoses made by NSW PFSHSs were syphilis, 25%; gonorrhoea, 25%; HIV, 21%; and chlamydia, 14%. Within each zone, the proportions of these STIs were (respectively): (i) inner metropolitan: 32%, 26%, 21% and 13%; (ii) outer metropolitan: 41%, 24%, 43% and 9%; (iii) regional: 62%, 15%, 23% and 10%; (iv) rural: 8%, 29%, Conclusions: NSW PFSHSs contribute a large proportion of diagnoses for syphilis, gonorrhoea and HIV, but less so for chlamydia. Across AHSs and zones, there was considerable variation in the proportions. These data support the role of PFSHS in identifying and managing important STIs in high-risk populations.

scholarly journals Under one roof? A population-based survey of patient use and preference for sexual health services

2009 ◽  
Vol 10 (03) ◽  
pp. 223 ◽  
Author(s):  
Debra Gray ◽  
Catherine H. Mercer ◽  
Anna Graham ◽  
Rebecca S. French ◽  
Chris Salisbury ◽  
...  
Keyword(s):  
Health Services ◽  
Sexual Health ◽  
Population Based ◽  
Patient Use ◽  
Population Based Survey

Sexual practices of female sex workers in Melbourne, Australia: an anonymous cross-sectional questionnaire study in 2017–18

Sexual Health ◽  
2020 ◽  
Vol 17 (1) ◽  
pp. 53 ◽  
Author(s):  
Annalisa Zappulla ◽  
Christopher K. Fairley ◽  
Basil Donovan ◽  
Rebecca Guy ◽  
Catriona S. Bradshaw ◽  
...  
Keyword(s):  
Sexual Health ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Sexual Practices ◽  
Consistent Condom ◽  
Anal Sex ◽  
Consistent Condom Use ◽  
Cross Sectional ◽  
Male Clients ◽  
Vaginal Sex

Background Sexually transmissible infections (STIs) are rising among female sex workers (FSW) in Australia. The rise might be explained by changes in sexual practices; however, there is limited behavioural data available. This study aimed to explore the current sexual practices among FSW in Melbourne. Methods: This cross-sectional study was conducted among FSW at Melbourne Sexual Health Centre between September 2017 and March 2018. Participants were asked about current sexual practices with male clients in an average working week. The frequency and proportion of each sexual practice was calculated. Results: There were 180 questionnaires included in the analysis. The median age of the FSW was 28 years (interquartile range [IQR]: 25–34). Most FSW (80.6%) worked in brothels. In an average working week, FSW had a median of 10 (IQR: 7–20) male clients. The most common sexual practices included: vaginal sex (98.3%), fellatio (97.2%), cunnilingus (92.2%) and tongue-kissing (83.7%). FSW had a median number of 10 (IQR: 6–18) vaginal, 10 (IQR: 5–18) fellatio, 7 (IQR: 2–10) cunnilingus and 6 (IQR: 2–10) tongue-kissing clients. Consistent condom use with all clients was highest for vaginal sex (97.1%), followed by anal sex (92.3%), then fellatio (78.9%). Only 3.1% used dental dams consistently for cunnilingus. Conclusion: Consistent condom use with all clients was high among FSWs, especially for vaginal and anal sex. However, one-fifth of FSW had condomless fellatio during an average working week. Tongue-kissing was more common than previously published. Peer-led sexual health education on safe sex practice for FSW is of high importance.

Providing competent, comprehensive and inclusive sexual health services for men who have sex with men in low- and middle-income countries: a scoping review

Sexual Health ◽  
2019 ◽  
Vol 16 (4) ◽  
pp. 320 ◽  
Author(s):  
Cedric H. Bien-Gund ◽  
Peipei Zhao ◽  
Bolin Cao ◽  
Weiming Tang ◽  
Jason J. Ong ◽  
...  
Keyword(s):  
Health Services ◽  
Sexual Health ◽  
Scoping Review ◽  
Healthcare Delivery ◽  
Middle Income ◽  
Behavioural Interventions ◽  
Middle Income Countries ◽  
Sexually Transmissible Infections ◽  
Sex With Men ◽  
Low And Middle Income

Although men who have sex with men (MSM) are disproportionately affected by HIV and other sexually transmissible infections, sexual health services for MSM in low- and middle-income countries (LMIC) remain under-resourced and are poorly understood. A scoping review of literature on MSM sexual health in LMIC was conducted in order to identify key clinical services and gaps in knowledge. Three databases were searched, in addition to hand-reviewing key journals and bulletins, to identify literature with a focus on MSM sexual health. Key services related to providing care to MSM in LMIC that emerged from our review are described. These services include creation of safe and confidential clinic environments, HIV testing services, behavioural interventions, HIV pre-exposure prophylaxis (PrEP), rapid antiretroviral therapy (ART) initiation and STI services. Compared with high-income settings, major differences in LMIC include lack of diagnostic technology, unfavourable legal environments and lack of funding for MSM health. Innovative approaches to healthcare delivery, such as harnessing mobile technology, self-testing and crowdsourcing interventions, can improve health services among MSM in LMIC. There are gaps in the evidence about how best to provide sexual health services for MSM in LMIC settings. Implementation research and scale-up of existing biomedical and behavioural interventions, such as HIV/STI testing services, PrEP and early antiretroviral initiation are urgently needed in LMIC.

scholarly journals How perceived Australian sexual norms shape sexual practices of East Asian and sub-Saharan African international students in Sydney

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sylvester R. Okeke
Keyword(s):  
International Students ◽  
Sexual Health ◽  
Home Country ◽  
Sexual Communication ◽  
East Asian ◽  
Sexual Practices ◽  
African Countries ◽  
Sexual Norms ◽  
Face To Face ◽  
Sub Saharan

Abstract Introduction Sexual norms, real or perceived, shape young people’s sexual behaviour and may constitute one of the greatest challenges in HIV/STIs prevention among this population. This study used sexual script theory to explore how international students in Sydney, Australia – from traditional cultures of East Asian and sub-Saharan African countries – construct home backgrounds and Australian sexual norms and how this may shape their sexual practices during their studies in Australia. Methods The study involved face-to-face and telephone semi-structured in-depth interviews. Data were provided by 20 international students who are enrolled in various universities in Sydney. Interviews were audio-recorded, transcribed, coded into NVivo and analysed using reflexive thematic analysis. Results Identified patterns in the data showed three themes through which participants perceive sexual norms in Australia as distinctly different from their home country norms. First, participants stated that unlike their home country norms, sexual norms in Australia are permissive. Second, participants hold the view that compared to their home country norms, sex in Australia is largely casual as it is not always attached to love. Some participants revealed that this could shape their own sexual practices during their studies in Australia. Finally, participants noted that compared to their home countries’ norm of sex talk taboo, Australia has an open sexual communication norm; which they believe, enables young people in western societies to easily acquire sexual health information. Conclusions Findings provide evidence to support a need for contextualized and effective sexual health services for international students that take account of perceptions around sexual norms and how they can be modified to ensure that sexual practices which these students may engage in, will be managed in a safe and responsible manner.

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