Recovering Sexuality after Childbirth. What Strategies Do Women Adopt? A Qualitative Study

This study aimed to determine the strategies used by women to adapt to the changes that affect the first sexual relations after childbirth. A qualitative study with a phenomenological approach used three data collection techniques (in-depth interviews, discussion groups, and online forums). Thirty-six women in the first six months postpartum participated in the study, from physiotherapy centers with maternal child specialties in several locations in Spain. Women with different types of delivery, presence or absence of perineal trauma during delivery, previous deliveries, and different types of breastfeeding were included. Among the strategies, closeness support and understanding were the ones that women used to adjust to the new situation, in order to improve the couple’s relationship, intimacy, and cope with the significant changes that appear in the first six months postpartum. Changes and adaptations in sexual practices become a tool for coping with a new sexuality, especially if it is affected by the presence of pain or discomfort associated with physical changes. Personal time facilitates emotional management and improvement of emotional changes related to the demands of motherhood. Accepting the changes that motherhood brings is critical to dealing with the new situation. Strategies used by postpartum women focus on acceptance, self-care, partner, couple time, personal time, and adapting encounters. The findings of this study are of interest to health professionals as they provide insight into how women cope with the changes that appear in the first six months postpartum. In this way, the findings will be able to transmit to couples the alternatives they can adopt before the resumption of sexual relations to improve satisfaction both as a couple and in terms of sexuality after childbirth.

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

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.

Sexual practices of women who have sex with women and condom use

Objective: to analyze the sexual practice of women who have sex with women and its association with condom use. Methods: correlational study involving 231 women who have sex with women, recruited through electronic application (Instagram and WhatsApp). A questionnaire was applied through Google Forms, containing sociodemographic data, sexual history, and the types of sexual practices. Results: most women performed oral sex (86.4%) and manual sex (86.9%) without using condoms. A large proportion (84.8%) reported the use of fomites in sexual practices without condoms. The inexistence of a fixed partnership (p=0.000) and the performance of sex with vaginal contact (p=0.013) were associated with sexual intercourse without condoms. Conclusion: the sexual practice of women who have sex with women points to greater vulnerability to sexually transmitted infections, by practicing oral and vaginal sex with manual practices without the use of barrier methods.

A prevenção das infecções sexualmente transmissíveis entre jovens e a importância da educação em saúde

Objective: To analyze sexual practices and the adoption of prevention practices for sexually transmitted infections among university students.Method: A descriptive, cross-sectional and quantitative study, carried out in a public higher education institution, located in the city of Rio de Janeiro. A sample of 173 students from the Nutrition, Medicine, Nursing and Biological Sciences courses was selected from the matrix research database.Results: There was predominance of young women (76.88%), aged between 18 and 23 years old (84.39%), sexually active (78.03%), who did not use condoms continuously with stable (47.22%) and casual (30.36%) partners; the majority negotiated condom use (37.78%); never performed a test to detect HIV (56.07%) and denied previous occurrence of STIs (91.33%).Conclusion: The low adherence of young people to condoms with stable and casual partners is a risky sexual behavior that can contribute to acquiring STIs. Expansion of the provision of timely testing and intensification of educational activities in the university environment are necessary practices to reduce the group's vulnerability to STIs. Objetivo: Analizar las prácticas sexuales y la adopción de prácticas de prevención de infecciones de transmisión sexual entre estudiantes universitarios.Método: Investigación descriptiva, transversal, cuantitativa, realizada en una institución pública de educación superior, ubicada en la ciudad de Río de Janeiro. Se seleccionaron 173 estudiantes de las carreras de nutrición, medicina, enfermería y ciencias biológicas como muestra en la base de datos matricial de investigación.Resultados: Hubo predominio de mujeres jóvenes (76,88%), de 18 a 23 años (84,39%), sexualmente activas (78,03%), que no usaban preservativo de forma continuada con parejas estables (47,22%) y casuales (30,36%); la mayoría negoció el uso del condón (37,78%); nunca realizó una prueba para detectar el VIH (56,07%) y negó la ocurrencia previa de ITS (91,33%).Conclusión: La baja adherencia de los jóvenes al condón con parejas estables y casuales son conductas sexuales de riesgo que pueden contribuir a contraer ITS. La ampliación de la oferta de pruebas oportunas y la intensificación de las actividades educativas en el ámbito universitario son prácticas necesarias para reducir la vulnerabilidad del grupo a las ITS. Objetivo: Analisar as práticas sexuais e a adoção de práticas de prevenção de infecções sexualmente transmissíveis entre estudantes universitários. Método: Pesquisa descritiva, transversal, quantitativa, realizada em instituição pública de ensino superior, localizada no município do Rio de Janeiro. Foram selecionados como amostra 173 estudantes dos cursos de nutrição, medicina, enfermagem e ciências biológicas, no banco de dados da pesquisa-matriz. Resultados: Houve predomínio de jovens do sexo feminino (76,88%), faixa etária 18 a 23 anos (84,39%), sexualmente ativos (78,03%); não faziam uso contínuo do preservativo com parceiros fixos (47,22%) e casuais (30,36%); a maioria negociava o uso do preservativo (37,78%); nunca realizaram teste para detectar o HIV (56,07%) e negaram ocorrência prévia de Infecções Sexualmente Transmissíveis (IST) (91,33%). Conclusão: A baixa adesão dos jovens ao preservativo com parceiros fixos e casuais são comportamentos sexuais de risco que podem contribuir para adquirir IST. A ampliação da oferta de testagem oportuna e a intensificação de ações educativas no ambiente universitário são práticas necessárias para reduzir a vulnerabilidade do grupo às IST.

Factors associated with sexual practices and positions performed by pregnant women: a cross-sectional study

ABSTRACT Objectives: to identify factors associated with the sexual practices and positions performed by pregnant women. Methods: a cross-sectional, quantitative study conducted with 354 pregnant women, in the interior of Ceará, Brazil, in 2016. For data collection, a form and a Pregnancy Sexuality Questionnaire were used. Results: there was a reduction in the sexual initiative of the woman, sexual disposition of the couple, sexual practices and most of the sexual positions, while the maintenance of preliminary sexual activities and initiative to perform them was verified. Sexual practices and positions decreased (p<0.0001): preliminary sexual activities, sexual disposition, lubrication, orgasm, pain or discomfort, sexual positions, sexual practices, and sexual satisfaction. Sexual practices and positions increased (p<0.0001) as a function of: education, number of deliveries, sexual life, desire and arousal, and sexual disposition of the pregnant woman, frequency of orgasm and of sexual practices (p<0.0001). Conclusions: sexual practices and positions of pregnant women were affected by domains of sexual function, sexual, reproductive, physical, and psychological aspects.

Bad Queers: LGBTQ People and the Carceral State in Modern America

The war on sex offenders was an American campaign against sex crime that began in the 1930s and is still ongoing. In this review essay, I argue that the architects and opponents of that war engaged in political struggles that—especially during the pivotal era of the long 1970s—produced, criminalized, and hierarchized multiple new categories of “good” and “bad” LGBTQ legal subjects. In making this argument, my aim is to bring the field of LGBTQ political and legal history—especially the work of George Chauncey ([1994] 2019) and Margot Canaday (2009)—into closer conversation with scholarship by queer theorists who are not historians—especially Gayle Rubin ([1984] 2011a) and Michael Warner (1999)—about the stigmatization of non-normative gender and sexual practices. While historians have examined the policing of multiple queer behaviors in the early twentieth century, their examinations of the post-1945 period have been concerned primarily with the consolidation of a starker social and legal binary between homo- and heterosexuality. As their narratives get closer to the present, the most stigmatized “bad” queers become more and more tangential. At least in part, this has been because historians have been under the same pressure as LGBTQ activists to distance LGBTQ identity from the stigma of sexual “deviance”—especially sex that violated age-of-consent statutes—in order to promote the political project of LGBTQ rights. Placing bad queers at the center of LGBTQ political and legal history diversifies who counts as a subject of this history and reveals an even bigger carceral state that governed them.

Queering Marriage: The Homoradical and Anti-Normativity

This article explores ‘bad’ sex in an age of same-sex marriage, through an analysis of the ‘homoradical’ as a rejection of both hetero and homo-normativities. Drawing on qualitative data from 29 LGBTQ interviewees, the article considers resistance to the discursive privileging of same-sex marriage in the context of Gayle Rubin’s theories of respectability and sexual hierarchies. These hierarchies constitute a ‘charmed circle’ of accepted sexual practices which are traditionally justified by marriage, procreation and/or love. It examines non-normative sexuality through the example of the lived experiences of non-normative, anti-assimilationist identities, particularly non-monogamy, public sex, and kink sex, showing how the ‘homoradical’ deviates from the normative practices that same-sex marriage reinforces.

Health System Strategies and Adolescent Sexual Health: A Systematic Review of the Literature using Rodgers Concept Analysis Framework

Background: Health Systems Strategies play a key role in determining Adolescent Sexual Health outcomes. This study aims to review the literature on the relationship between Health Systems Strategies and Adolescent Sexual Health issues guided by Rodger's evolutionary concept analysis framework. The study further develops a Conceptual Framework that would guide a study that seeks to “Develop strategies to facilitate safe sexual practices in adolescents through Integrated Health Systems in selected Districts in Zimbabwe.” Methods: Adolescents, Health Systems, Sexual Health, and Strategies were used to search for published literature (in English) on Google Scholar, PUBMED, EBSCO, Cochran Library, and Science Direct. A total of 142 Articles and 11 reports were obtained, and the content was screened for relevance. This led to 42 articles and 03 reports being found suitable and relevant, and thus, the content was reviewed. Thematic analysis was done to identify attributes, antecedents, and consequences of Health Systems Strategies on Adolescent Sexual Health. These findings were then used to inform the development of the Conceptual Framework. Results: Key attributes, antecedents and consequences of Health System Strategies on Adolescent Sexual Health were identified. Strategies to Improve Adolescent Sexual Health outcomes were also identified. Conclusions: Different contextual factors influence policy changes and the consequences are mixed, with both positive and negative outcomes.

Vaginal microbiota of American Indian women and associations with measures of psychosocial stress

Molecular-bacterial vaginosis (BV) is characterized by low levels of vaginal Lactobacillus species and is associated with higher risk of sexually transmitted infections (STI). Perceived psychosocial stress is associated with increased severity and persistence of infections, including STIs. American Indians have the highest rates of stress and high rates of STIs. The prevalence of molecular-BV among American Indian women is unknown. We sought to evaluate measures of psychosocial stress, such as historic loss (a multigenerational factor involving slavery, forced removal from one’s land, legally ratified race-based segregation, and contemporary discrimination) and their association with the vaginal microbiota and specific metabolites associated with BV, in 70 Northwestern Plains American Indian women. Demographics, perceived psychosocial stressors, sexual practices, and known BV risk factors were assessed using a modified version of the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project survey. Self-collected mid-vaginal swabs were profiled for bacterial composition by 16S rRNA gene amplicon sequencing and metabolites quantified by targeted liquid-chromatography mass spectrometry. Sixty-six percent of the participants were classified as having molecular-BV, with the rest being either dominated by L. crispatus (10%) or L. iners (24%). High levels of lifetime trauma were associated with higher odds of having molecular-BV (adjusted Odds Ratio (aOR): 2.5, 95% Credible Interval (CrI): 1.1–5.3). Measures of psychosocial stress, including historic loss and historic loss associated symptoms, were significantly associated with lifestyle and behavioral practices. Higher scores of lifetime trauma were associated with increased concentrations of spermine (aFC: 3.3, 95% CrI: 1.2–9.2). Historic loss associated symptoms and biogenic amines were the major correlates of molecular-BV. Historical loss associated symptoms and lifetime trauma are potentially important underlying factors associated with BV.