Health service providers’ perspectives on the influence of modern health systems on adolescents’ sexual health practices in Umguza and Mberengwa districts of Zimbabwe

Background Health service providers play a significant role in crafting and implementing health policies and programs that manage adolescent sexual health-related issues at different health system levels. These influence adolescent sexual behaviours and practices. Aim This study explored the roles of health service providers in managing adolescent sexual issues and how this impacts their sexual behaviours and practices. The study further probed the health service providers on how the indigenous health system could be integrated into the modern health system for effective management of adolescent sexual health related issues. Methods A qualitative cross-sectional survey was conducted on purposively selected health service providers in health facilities in Mberengwa and Umguza districts. Data was collected using unstructured interviews that were recorded, transcribed verbatim, and thematically analysed. Findings were presented as clearly defined as superordinate and subordinate themes. Results A total of five superordinate themes and 19 subordinate themes emerged from the interrogated data. The superordinate themes were: overview of adolescent sexual health issues, role of modern health system in adolescent sexual health issues, challenges encountered, indigenous health system factors that could be factored into modern health systems, and strategies to foster the integration of indigenous health system and modern health system. The subordinate themes explored in-depth the findings of the key stakeholders under the five superordinate themes. Conclusions From the findings, it can be concluded that health service providers play an essential role in shaping and providing adolescent sexual health services that adolescents utilise despite challenges that have reduced demand for these services. Therefore, there is a need to point out that there is a window of opportunity to foster collaborations between the indigenous health system and the modern health system as they strive to serve the adolescents to the best of their ability though in different contextual settings.

FACTORS ASSOCIATED TO UNHEALTHY SEXUAL BEHAVIOURS AMONG PORTUGUESE ADOLESCENTS: 2018 HBSC STUDY

Practicing sexual intercourse (SI) under the influence of alcohol or drugs has been identified as an unhealthy sexual behaviour. The sample consisted of 5695 adolescents, of which 46.1% were males, with a mean age of 15 years old. The measures consisted of asking the adolescent if he or she had ever had SI, age of 1st SI, condom use at last SI, SI under the influence of alcohol or drugs and HIV testing. Most adolescents reported having never had SI (77.0%). Among those who responded affirmatively, they referred having had their 1st SI at 15 years old. A significant minority reported not having used condom at last SI (34.1%) and having had SI under the influence of alcohol or drugs (14.5%). It was noticeable that males, adolescents with high SES, those who reported not having used condom at last SI, those not having been HIV tested, those who consider themselves fat, smoke daily, and scored lower in emotional sensitivity and quality of life were those who were more likely to have reported having had SI under the influence of alcohol or drugs. Adolescents who reported having had SI under the influence of alcohol or drugs have multiple risk behaviours. These results may account for important changes in educational and health policies, directed towards the development of personal and social skills, the importance of adolescents’ quality of life and the activation of all the support structures where adolescents are involved and that are somewhat responsible for promoting a healthy lifestyle. Keywords: unhealthy sexual behaviour, sexual intercourse, substance use, Portuguese adolescents

Psychosocial Factors Underlying Sexual Deviance Among Adolescents in ASEAN: a Systematic Review

Background: Risky sexual behaviours amongst adolescents are associated with detrimental impact on their personal growth, influenced by psychosocial factors including subjective cultural norms. This systematic review aimed to examine the evidence on ASEAN countries’ adolescents risky sexual behaviour defined as sexual deviance with its associated psychosocial factors.Methods: A systematic literature review was guided by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) for a search through four electronic databases for articles published within the time frame of 2010 and 2020 resulting in 20 articles that meet the inclusion criteria. Results: Adolescent sexual deviance in ASEAN is associated with salient psychosocial factors such as cultural norm, self-esteem, parental support/monitoring, substance abuse (alcohol/drugs/smoking), spirituality and religion. Intention, attitude and motivation of sexual transgression appear to be recurrent factors as well. Most studies are cross-sectional and quantitatively designed. The diverse and nuanced psychosocial factors of sexually deviant behaviour affirm the sexual dimension and values of absolutism, hedonism and relativism.Conclusions: Strategies for reducing risky sexual behaviours among ASEAN adolescents should take regard of subjective culture norms and psychosocial needs to achieve the goal of progress as per the ASEAN Youth Development Index. More qualitative and longitudinal approaches in future research are also recommended for more in-depth insights for appropriate intervention or rehabilitative measures.

Factors associated with female students’ past year experience of sexual violence in South African public higher education settings: A cross-sectional study

Background Intimate partner sexual violence and non-partner rape experiences are widely reported by female students in South African higher education institutions, as they are globally. However, limited research has focused on investigating vulnerability factors, which is vital for informing interventions. Objective To describe the factors and inter-relationships associated with female students’ increased vulnerability to past year experience of partner sexual violence and non-partner rape in South African higher education settings. Methods We interviewed 1293 female students, i.e., 519 students in six Technical Vocational Education and Training (TVET) college campuses and 774 students at three university campuses. Participants were volunteers aged 18–30. The measured vulnerability factors included childhood sexual abuse, other trauma, mental ill-health, risky sexual behaviours, food insecurity, partner violence, and controlling behaviours. We used bivariate analysis, logistic regression, and structural equation modelling methods. Results Twenty percent of participants experienced past-year sexual violence (17% partner sexual violence and 7.5% non-partner rape). Childhood sexual abuse had direct effects on experiencing past year sexual violence and physical, emotional partner violence or controlling behaviours. Risky sexual behaviours mediated the relationships of childhood sexual abuse or harmful alcohol use and past-year sexual violence experience. Mental ill-health mediated the relationships between childhood sexual abuse, other traumatic exposures, food insecurity, physical, emotional partner violence or controlling behaviours, and past-year partner sexual violence or non-partner rape experience. Conclusions Risky sexual behaviours, gender inequitable relationship dynamics, mental ill-health, and food insecurity are related and amenable vulnerability factors associated with female students’ sexual violence experiences. Therefore, addressing these through comprehensive campus interventions, which are implemented when students first enrol in higher education and are most vulnerable to sexual violence, is critical. Society-wide sexual violence prevention is also imperative.

Understanding Risky Sexual Behaviour Among Undergraduates

Background: Exploring sexual activities that may make individuals vulnerable to sexually transmitted infections and unplanned pregnancies is being considered following observation and increased reports of unplanned pregnancies and its attendant consequences among students in tertiary institutions. Objective: Determine the undergraduates’ awareness and attitude towards risky sexual behaviour. Methods: A descriptive Cross-sectional survey was conducted, among year one and year two Medical and Nursing undergraduate students at two tertiary institutions in Rivers State of Nigeria, using a questionnaire adapted from World Health Organisation survey instrument to obtain data on knowledge of and attitude towards risky sexual behaviours. Two hundred and eighty participants were randomly selected. Descriptive analysis was carried out using Statistical Package for Social Sciences version 21.0. Results: About 92.9% of the respondents are aware that unprotected (oral, anal, vaginal) sexual intercourse is a risky sexual behaviour. Assessing respondents’ attitudes to risky sexual behaviour revealed that 9.3% agree that condom should only be used during sexual intercourse with commercial sex workers. Conclusions: Most Undergraduates are aware of sexual activities that constitute risky sexual behaviours but there is need to cascade this awareness to reflect on general sexual habits and reduce public health emergencies among undergraduates.

Sexual Behaviours and Sexual Health Among Middle-Aged and Older Adults in Britain: A Latent Class Analysis of The Natsal-3

Objectives: Population-representative studies of the sexual health of middle-aged and older adults are lacking in aging societies. This study aimed to identify latent patterns of sexual behaviours and health of people aged 45-74. Methods: We conducted a latent class analysis of the National Attitudes and Sexual Lifestyles Survey (Natsal-3), a nationally representative survey conducted in Britain in 2011. Results: Of the 5260 respondents aged 45-74, 49% of men and 45% of women belonged to the Content Caseys class who reported good sexual health. The Infrequent Indigos (31% of men, 44% of women) were characterized by a lack of sexual activity, reported some dissatisfaction, and were more likely to have a disability. The Low-Functioning Lees (12% of men, 8% of women) reported some more disability and had issues with sexual functioning and higher levels of distress. The Multiple-Partnered Morgans (9% of men, 2% of women) were characterized by a greater number of sexual partners and several risk behaviours. Conclusions: The use of these four classes can aid in improved targeting of tailored sexual health services to improve sexual function, sexual satisfaction, reduce distress and risky behaviours among middle-aged and older adults. These services should be inclusive of the disabled community.

Perceived impact of COVID-19 on sexual health and access to sexual health services among university students in Canada

We examined the perceived impact of the COVID-19 pandemic on sexual health, sexual behaviour, well-being, and access to sexual health services among university students in Canada. Between December 2020 and January 2021, 1504 university students across Canada completed an online survey focused on overall sexual health, well-being, solitary sexual behaviours, partnered sexual interactions, and access to sexual health services. The survey was designed by the Sex Information & Education Council of Canada and administered by the Leger polling company. Reported levels of overall sexual health were high. Cisgender women reported significantly greater scores of COVID-19—related stress compared to cisgender men; LGBQ+ students had higher levels of stress compared to heterosexual participants. Overall, solitary sexual behaviours (i.e., masturbation, porn use, vibrator use) remained unchanged or were perceived to increase compared to the time before the pandemic. Cisgender men reported higher scores (i.e., greater perceived increases) on masturbation and porn use than cisgender women. Frequency of sex with casual partners was perceived as similar or lower than what was usual before the pandemic, and most participants did not engage in sex where the close personal contact put them or their partner at risk for COVID-19. Declines in access were reported for all sexual health care services surveyed, with cisgender women and students of colour more likely to report decreased access to services. Results highlight the need for targeted public health messaging regarding sexual behaviour, investment in sexual health services, and supports tailored to the needs of women, LGBTQ+ individuals, and people of colour.

Testing the Assumption of Behavioural Consistency in a New Zealand Sample of Serial Rapists

<p>One of the assumptions that underlies the profiling process is that criminals are behaviourally consistent from one offence to another. To date, however, this is an assumption that has not been scientifically validated. The present study therefore tested the assumption of behavioural consistency in serial rape offences. The author collected dichotomous data on 30 behavioural variables for a total of 439 offences committed by 121 serial rapists in New Zealand. There were two main research aims of the study. The first aim was to test the behavioural consistency of a range of individual behaviours. It was hypothesised that higher consistency would be found for behaviours that reflected a degree of planning or that prioritised control of the victim and the offence environment, because these behaviours might be less affected by environmental factors. In contrast, many sexual behaviours arise directly out of offender-victim interactions and therefore are most affected by environmental factors such as victim resistance. It was therefore also hypothesised that sexual behaviours would display lower consistency. A consistency measure was used that compared behaviour in consecutive offences. Consistency for each behaviour was defined as present-present or absent-absent matches of that behaviour in consecutive offences. The degree of consistency for any behaviour will be reflected in the consistency score received by that variable based on the number of matches for that behaviour across the offence series. The consistency analysis found moderate to high levels of consistency for the majority of individual behaviours. As predicted, higher consistency was exhibited for behaviours that prioritised control of the victim and the offence environment, and lower consistency was exhibited for the sexual behaviours. The second research aim was that if behavioural consistency was found in the results of the consistency analysis, to explore whether there were any underlying patterns to the consistency of offending behaviour. A factor analysis of the consistency scores established that there are clear patterns to the behavioural consistency of offenders consistent with previous analysis of offence characteristics. The factor analysis resulted in three themes or domains to behaviour: hostility, involvement and control. These findings have theoretical implications for the assumption of behavioural consistency in serial rapists, for the concepts of modus operandi and signature in offence behaviour, and for the theoretical understanding of the profiling process. The findings also have practical implications for the practice of profiling and case linkage in New Zealand, and raise possibilities for future directions in research.</p>