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1.
Cochrane Database Syst Rev ; 6: CD009829, 2020 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-32572950

RESUMO

BACKGROUND: Around 1 in 1000 adolescents aged 12 to 17 years old display problematic or harmful sexual behaviour (HSB). Examples include behaviours occurring more frequently than would be considered developmentally appropriate; accompanied by coercion; involving children of different ages or stages of development; or associated with emotional distress. Some, but not all, young people engaging in HSB come to the attention of authorities for investigation, prosecution or treatment. Depending on policy context, young people with HSB are those whose behaviour has resulted in a formal reprimand or warning, conviction for a sexual offence, or civil measures. Cognitive-behavioural therapy (CBT) interventions are based on the idea that by changing the way a person thinks, and helping them to develop new coping skills, it is possible to change behaviour. OBJECTIVES: To evaluate the effects of CBT for young people aged 10 to 18 years who have exhibited HSB. SEARCH METHODS: In June 2019, we searched CENTRAL, MEDLINE, Embase, 12 other databases and three trials registers. We also examined relevant websites, checked reference lists and contacted authors of relevant articles. SELECTION CRITERIA: We included all relevant randomised controlled trials (RCTs) using parallel groups. We evaluated CBT treatments compared with no treatment, waiting list or standard care, irrespective of mode of delivery or setting, given to young people aged 10 to 18 years, who had been convicted of a sexual offence or who exhibited HSB. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: We found four eligible RCTs (115 participants). Participants in two studies were adolescent males aged 12 to 18 years old. In two studies participants were males simply described as "adolescents." Three studies took place in the USA and one in South Africa. The four studies were of short duration: one lasted two months; two lasted three months; and one lasted six months. No information was available on funding sources. Two studies compared group-based CBT respectively to no treatment (18 participants) or treatment as usual (21 participants). The third compared CBT with sexual education (16 participants). The fourth compared CBT (19 participants) with mode-deactivation therapy (21 participants) and social skills training (20 participants). Three interventions delivered treatment in a residential setting by someone working there, and one in a community setting by licensed therapist undertaking a PhD. CBT compared with no treatment or treatment as usual Primary outcomes No study in this comparison reported the impact of CBT on any measure of primary outcomes (recidivism, and adverse events such as self-harm or suicidal behaviour). Secondary outcomes There was little to no difference between CBT and treatment as usual on cognitive distortions in general (mean difference (MD) 1.56, 95% confidence interval (CI) -11.54 to 14.66, 1 study, 18 participants; very low-certainty evidence), assessed with Abel and Becker Cognition Scale (higher scores indicate more problematic distortions); and specific cognitive distortions about rape (MD 8.75, 95% CI 2.83 to 14.67, 1 study, 21 participants; very low-certainty evidence), measured with the Bumby Cardsort Rape Scale (higher scores indicate more justifications, minimisations, rationalisations and excuses for HSB). One study (18 participants) reported very low-certainty evidence that CBT may result in greater improvements in victim empathy (MD 5.56, 95% CI 0.94 to 10.18), measured with the Attitudes Towards Women Scale, compared with no treatment. One additional study also measured this, but provided no usable data. CBT compared with alternative interventions Primary outcomes One study (59 participants) found little to no difference between CBT and alternative treatments on post-treatment sexual aggression scores (MD 0.09, 95% CI -0.18 to 0.37, very low-certainty evidence), assessed using Daily Behaviour Reports and Behaviour Incidence Report Forms. No study in this comparison reported the impact of CBT on any measure of our remaining primary outcomes. Secondary outcomes One study (16 participants) provided very low-certainty evidence that, compared to sexual education, mean cognitive distortions pertaining to justification or taking responsibility for actions (MD 3.27, 95% CI -4.77 to -1.77) and apprehension confidence (MD 2.47 95% CI -3.85 to -1.09) may be lower in the CBT group. The same study indicated that mean cognitive distortions pertaining to social-sexual desirability may be lower in the CBT group, and there may be little to no difference between the groups for cognitive distortions pertaining to inappropriate sexual fantasies measured with the Multiphasic Sex Inventory. AUTHORS' CONCLUSIONS: It is uncertain whether CBT reduces HSB in male adolescents compared to other treatments. All studies had insufficient detail in what they reported to allow for full assessment of risk of bias. 'Risk of bias' judgements were predominantly rated as unclear or high. Sample sizes were very small, and the imprecision of results was significant. There is very low-certainty evidence that group-based CBT may improve victim empathy when compared to no treatment, and may improve cognitive distortions when compared to sexual education, but not treatment as usual. Further research is likely to change the estimate. More robust evaluations of both individual and group-based CBT are required, particularly outside North America, and which look at the effects of CBT on diverse participants.


Assuntos
Adaptação Psicológica , Terapia Cognitivo-Comportamental/métodos , Delitos Sexuais/prevenção & controle , Adolescente , Atitude , Criança , Transtornos Cognitivos/psicologia , Dessensibilização Psicológica , Fantasia , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Estupro/psicologia , Reincidência , Autoimagem , Educação Sexual , Delitos Sexuais/psicologia , Habilidades Sociais
2.
Rev Med Suisse ; 16(691): 765-768, 2020 Apr 22.
Artigo em Francês | MEDLINE | ID: mdl-32320150

RESUMO

Despite obvious needs, adolescent boys do not access information and care in the field of sexual and reproductive health as easily as adolescent girls. The primary care setting gives the opportunity to tackle sexuality topics with boys. It allows to defuse frequent causes of concern in this crucial developmental phase, in a proactive and open-minded way, while focusing on strengths rather than on risks. It also allows to discuss masculine norms and their impact on health, and to come up with essential prevention elements. It is -necessary to focus on boys' health to have them involved in a -changing process on behalf of their own health but also on behalf of girls' and young women's health.


Assuntos
Saúde do Homem , Atenção Primária à Saúde/métodos , Educação Sexual/métodos , Saúde Sexual/educação , Adolescente , Feminino , Humanos , Masculino , Saúde Reprodutiva/educação , Sexualidade , Saúde da Mulher
4.
Artigo em Inglês | MEDLINE | ID: mdl-32169418

RESUMO

Fertility awareness-based methods (FABMs) of family planning involve monitoring various signs and symptoms of fertility during the menstrual cycle to identify the "fertile window," or the days of the cycle when unprotected intercourse is most likely to result in pregnancy. Signs and symptoms include menstrual cycle length, basal body temperature, urinary hormone measurements, and/or cervical fluid and may be used alone or in combination. Fertility signs reflect both physiological changes during the menstrual cycle and the life cycle of the ovum and sperm. Women learn to observe or measure and interpret these signs according to the instructions of their chosen FABM and avoid unprotected intercourse on fertile days. FABMs are appropriate for those who choose to use them, are able and willing to observe one or more fertility signs, and are in relationships that support the use of a coitus-related method such as a condom or abstaining from intercourse on fertile days.


Assuntos
Serviços de Planejamento Familiar/métodos , Fertilidade/fisiologia , Conhecimentos, Atitudes e Prática em Saúde , Feminino , Humanos , Masculino , Ciclo Menstrual/fisiologia , Métodos Naturais de Planejamento Familiar , Gravidez , Educação Sexual , Espermatozoides
5.
Pediatrics ; 145(4)2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32184336

RESUMO

BACKGROUND: In the United States, transgender youth are at especially high risk for HIV infection. Literature regarding HIV prevention strategies for this vulnerable, often-hidden population is scant. Before effective, population-based HIV prevention strategies may be adequately developed, it is necessary to first enhance the contextual understanding of transgender youth HIV risk and experiences with HIV preventive services. METHODS: Two 3-day, online, asynchronous focus groups were conducted with transgender youth from across the United States to better understand participant HIV risk and experiences with HIV preventive services. Participants were recruited by using online advertisements posted via youth organizations. Qualitative data were analyzed by using content analysis. RESULTS: A total of 30 transgender youth participated. The average age was 18.6 years, and youth reported a wide range of gender identities (eg, 27% were transgender male, 17% were transgender female, and 27% used ≥1 term) and sexual orientations. Four themes emerged: (1) barriers to self-efficacy in sexual decision-making; (2) safety concerns, fear, and other challenges in forming romantic and/or sexual relationships; (3) need for support and education; and (4) desire for affirmative and culturally competent experiences and interactions (eg, home, school, and health care). CONCLUSIONS: Youth discussed experiences and perspectives related to their gender identities, sexual health education, and HIV preventive services. Findings should inform intervention development to improve support and/or services, including the following: (1) increasing provider knowledge and skills to provide gender-affirming care, (2) addressing barriers to services (eg, accessibility and affordability as well as stigma and discrimination), and (3) expanding sexual health education to be inclusive of all gender identities, sexual orientations, and definitions of sex and sexual activity.


Assuntos
Infecções por HIV/prevenção & controle , Serviços de Saúde para Pessoas Transgênero , Pessoas Transgênero/psicologia , Adolescente , Competência Cultural , Tomada de Decisões , Feminino , Grupos Focais , Identidade de Gênero , Infecções por HIV/transmissão , Humanos , Relações Interpessoais , Masculino , Pesquisa Qualitativa , Medição de Risco , Autoimagem , Autoeficácia , Educação Sexual , Apoio Social , Pessoas Transgênero/estatística & dados numéricos , Estados Unidos , Adulto Jovem
9.
J Pediatr Adolesc Gynecol ; 33(1): 72-82, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31561033

RESUMO

STUDY OBJECTIVE: In the present study we investigated the association between receiving information on sexual literacy topics and likelihood of experiencing adolescent pregnancy. DESIGN: Cross-sectional analysis. SETTING: Colombia. PARTICIPANTS: Female Adolescents, 13-19 years old (N = 8525). MAIN OUTCOME MEASURES: Our primary outcome of interest was adolescent pregnancy. RESULTS: We created a gradation of public health impact variable that ranged from grade 1 (least impactful) to grade 4 (most impactful) to determine which sexuality-related topics were most strongly associated with teenage pregnancy. We found that not receiving information on grade 4 topics had the strongest association with adolescent pregnancy. These topics were: changes related to puberty (prevalence ratio [PR], 2.15; 95% confidence interval [CI], 1.40-3.30), how sex organs work (PR, 1.90; 95% CI, 1.37-2.66), and sexual orientation (PR, 1.84; 95% CI, 1.38-2.44). In fact, teenagers who did not receive information on any sexuality-related topic were approximately 75% more likely (PR, 1.73; 95% CI, 1.09-2.74) to experience pregnancy during adolescence. CONCLUSION: The gradation levels of this study could guide sexual education programs in Colombia to prioritize sexuality-related themes, especially when resources are limited.


Assuntos
Letramento em Saúde/estatística & dados numéricos , Gravidez na Adolescência/estatística & dados numéricos , Saúde Reprodutiva/educação , Educação Sexual/estatística & dados numéricos , Adolescente , Colômbia/epidemiologia , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Gravidez , Gravidez na Adolescência/psicologia , Comportamento Sexual/estatística & dados numéricos
11.
Am J Public Health ; 110(2): 145-148, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31855482

RESUMO

Sex education in the United States is limited in both its content and the measures used to collect data on what is taught. The risk-reduction framework that guides the teaching of sex education in the United States focuses almost exclusively on avoiding unintended pregnancy and sexually transmitted diseases, overlooking other critical topics such as the information and skills needed to form healthy relationships and content related to sexual pleasure.Young people express frustration about the lack of information on sexuality and sexual behavior that is included in sex education programs; sexual and gender minority youths, in particular, feel overlooked by current approaches.International guidance provides a more robust framework for developing and measuring sex education and suggests a number of areas in which US sex education can improve to better meet the needs of youths.


Assuntos
Prazer , Educação Sexual , Comportamento Sexual , Adolescente , Bem-Estar da Criança/psicologia , Humanos , Comportamento de Redução do Risco , Doenças Sexualmente Transmissíveis/prevenção & controle , Estados Unidos
12.
Am J Public Health ; 110(2): 154-156, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31855489

RESUMO

In 2016, in response to concern about the impact of pornography on adolescents, the Boston Public Health Commission partnered with a university researcher to develop a nine-session media literacy curriculum on pornography for adolescents. The curriculum was pilot-tested with five small classes of adolescents between 2016 and 2019 (n = 31). Many adult teachers of sex education also expressed interest in being trained to use the curriculum, so our team has now trained 300 adults to use it.


Assuntos
Literatura Erótica , Conhecimentos, Atitudes e Prática em Saúde , Letramento em Saúde , Educação Sexual , Comportamento Sexual/psicologia , Adolescente , Comportamento do Adolescente/psicologia , Boston , Currículo , Feminino , Humanos , Relações Interpessoais , Masculino , Meios de Comunicação de Massa , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos
13.
BMC Public Health ; 19(1): 1614, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31791323

RESUMO

BACKGROUND: Disparities in sexually transmitted infections (STI) are an urgent problem among Native American youth and young adults which are not fully explained by different sexual or related behaviors. These sexual health disparities are more likely attributed to social environments and structural determinants such as a shortage of sexual healthcare providers, lower socioeconomic status, and access barriers to STI screening and treatment, including geographic isolation and confidentiality concerns. Innovative, non-clinic based alternatives to promote STI screening and treatment are essential for alleviating these disparities. Self-care, or the care taken by individuals towards their own health and well-being may be such a strategy. This study will assess the efficacy of a self-care intervention, called Protecting Our Future Generation, for increasing uptake of STI screening and impacting sexual risk and protective behaviors among Native American youth and young adults living in a reservation-based community in the Southwestern United States. METHODS: The proposed study is a randomized controlled trial to test the efficacy of a self-care intervention compared to a control condition. Participants will be Native Americans ages 14-26 years old who have had vaginal or anal sex at least once in their lifetime. Participants will be randomized to the intervention which includes: 1) a sexual health self-assessment with embedded clinical prediction tool predicting STI positivity, and 2) personalized messaging with key steps to lower risk for STIs, or the control condition which includes: 1) a self-assessment about water, soda and sugar sweetened beverage consumption, and 2) personalized messaging to meet recommended daily intake. All participants will be offered a self-administered STI test. Participants will complete assessments at baseline, 3- and 6-months follow-up. The primary outcome measure is completion of STI screening. DISCUSSION: Protecting Our Future Generation is among the first self-care interventions uniquely focused on sexual health among a Native American population, who endure significant sexual health disparities and are under-represented in research. If efficacious, the intervention will be a model of sexual health self-care for Native American youth and young adults adaptable for use in healthcare and community-based settings. TRIAL REGISTRATION: Clinical Trials: http://clinicaltrials.gov; NCT03895320; Registered 03/28/2019.


Assuntos
Terapia Comportamental/métodos , Índios Norte-Americanos/psicologia , Autocuidado/métodos , Educação Sexual/métodos , Saúde Sexual/etnologia , Adolescente , Adulto , Feminino , Comportamentos Relacionados com a Saúde , Disparidades nos Níveis de Saúde , Humanos , Masculino , Programas de Rastreamento/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Comportamento Sexual , Doenças Sexualmente Transmissíveis/prevenção & controle , Responsabilidade Social , Sudoeste dos Estados Unidos , Adulto Jovem
14.
Reprod Health ; 16(1): 178, 2019 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-31831034

RESUMO

BACKGROUND: We examine the association between the quality of family planning (FP) counseling received in past 24 months, and current modern contraceptive use, initiation, and continuation, among a sample of women in rural Uttar Pradesh, India. METHODS: This study included data from a longitudinal study with two rounds of representative household survey (2014 and 2016), with currently married women of age 15-49 years; the analysis excluded women who were already using a permanent method of contraceptive during the first round of survey and who reported discontinuation because they wanted to be pregnant (N = 1398). We measured quality of FP counseling using four items on whether women were informed of advantages and disadvantages of different methods, were told of method(s) that are appropriate for them, whether their questions were answered, and whether they perceived the counseling to be helpful. Positive responses to every item was categorized as higher quality counseling, vs lower quality counseling for positive response to less than four items. Outcome variables included modern contraceptive use during the second round of survey, and a variable categorizing women based on their contraceptive use behavior during the two rounds: continued-users, new-users, discontinued-users, and non-users. RESULTS: Around 22% had received any FP counseling; only 4% received higher-quality counseling. Those who received lower-quality FP counseling had 2.42x the odds of reporting current use of any modern contraceptive method (95% CI: 1.56-3.76), and those who received higher quality FP counseling at 4.14x the odds of reporting modern contraceptive use (95% CI: 1.72-9.99), as compared to women reporting no FP counseling. Women receiving higher-quality counseling also had higher likelihood of continued use (ARRR 5.93; 95% CI: 1.97-17.83), as well as new use or initiation (ARRR: 4.2; 95% CI: 1.44-12.35) of modern contraceptives. Receipt of lower-quality counseling also showed statistically significant associations with continued and new use of modern contraceptives, but the effect sizes were smaller than those for higher-quality counseling. CONCLUSIONS: Findings suggest the value of FP counseling. With a patient-centered approach to counseling, continued use of modern contraceptives can be supported among married women of reproductive age. Unfortunately, FP counseling, particularly higher-quality FP counseling remains rare.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepção/estatística & dados numéricos , Anticoncepcionais Femininos/administração & dosagem , Aconselhamento/estatística & dados numéricos , Serviços de Planejamento Familiar/estatística & dados numéricos , Adolescente , Adulto , Aconselhamento/métodos , Feminino , Humanos , Índia , Estudos Longitudinais , Casamento , Pessoa de Meia-Idade , Gravidez , População Rural , Educação Sexual , Adulto Jovem
15.
Artigo em Inglês | MEDLINE | ID: mdl-31861114

RESUMO

Background and objectives: Sex education is a necessity and a right of young people in Angola. However, this education is deficient or even absent in various subsystems and, therefore, the impact of an educational intervention on human biology and sexuality was addressed. Materials and methods: This quasi-experimental study employed a non-equivalent control group, pre-test post-test design. It was conducted with students from three secondary schools (6th to 12th grade, two public and one private) in Huambo (Angola), between June and December 2017. First, a questionnaire was distributed to assess the students' knowledge on aspects related to sexual maturation, psychological development, gynecological organs' anatomy, human fertilization, contraception, and risks of unprotected sexuality. Then, an educational program was developed by the principal investigator along with the school's moral and civic education and biology teachers selected for a group of students (experimental group, EG); the others constituted the control group (CG). Classes were held on non-working days, on Saturday mornings (8:00 to 10:00 a.m.), so as not to interfere with the school calendar. The initial questionnaire was redistributed two months later to assess the impact of the intervention. Results: Of the 589 individuals included (mean age of 16.8 ± 2.5 years), 56.7% were males. EG (n = 241) consisted of students from the public school and CG (n = 348) by students from public and private schools. The last part of the questionnaire consisted of 30 questions to assess students' knowledge, and in 23 of these questions, both groups showed no differences at baseline. After the intervention, the EG showed significant improvements (p < 0.05), while the CG revealed only slight improvements. Conclusions: Students from Huambo province have a significant lack of knowledge on human biology and sexuality. Rigorous development and evaluation of interventions addressing multiple individual and environmental level factors is needed, notably for effective education in human biology and sexuality.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Educação Sexual/organização & administração , Adolescente , Adulto , Angola , Anticoncepção , Feminino , Humanos , Masculino , Instituições Acadêmicas , Comportamento Sexual , Estudantes , Adulto Jovem
16.
Reprod Health ; 16(1): 180, 2019 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-31852538

RESUMO

BACKGROUND: Early marriage and early childbearing are highly prevalent in Niger with 75% of girls married before age 18 years and 42% of girls giving birth between ages 15 and 18 years. In 2012, only 7% of all 15-19-year-old married adolescents (male and female) reported use of a modern contraceptive method with barriers including misinformation, and social norms unsupportive of contraception. To meet the needs of married adolescents and their husbands in Niger, the Reaching Married Adolescents (RMA) program was developed with the goal of improving modern contraceptive method uptake in the Dosso region of Niger. METHODS: Using a four-arm cluster randomized control design, the RMA study seeks to assess whether household visits only (Arm 1), small group discussions only (Arm 2), or a combination of both (Arm 3), as compared to controls (no intervention - Arm 4), improve modern contraceptive method use among married adolescent girls and young women (AGYW), age 13-19 years-old, in three districts of the Dosso region. Intervention conditions were randomly assigned across the three districts, Dosso, Doutchi, and Loga. Within each district, eligible villages were assigned to either that intervention condition or to the control condition (12 intervention and 4 control per district). Across the three intervention conditions, community dialogues regarding modern contraceptive use were also implemented. Data for the study was collected at baseline (April - June 2016), at 24 months post-intervention (April - June 2018), and a final round of data collection will occur at 40 months post-intervention (October - December 2019). DISCUSSION: The RMA intervention is a gender-synchronized and community-based program implemented among married adolescent girls and their husbands in the context of rural Niger. The intervention is designed to provide education about modern contraception and to promote gender equity in order to increase uptake of modern contraceptive methods. Results from this cluster randomized control study will contribute to the knowledge base regarding the utility of male engagement as a strategy within community-level approaches to promote modern contraceptive method use in the high need context of West Africa. TRIAL REGISTRATION: Registered October 2017 - ClinicalTrials.gov NCT03226730.


Assuntos
Comportamento Contraceptivo/psicologia , Anticoncepção/psicologia , Características da Família , Conhecimentos, Atitudes e Prática em Saúde , Casamento , Comportamento Reprodutivo/psicologia , Educação Sexual/métodos , Adolescente , Adulto , Anticoncepção/estatística & dados numéricos , Comportamento Contraceptivo/estatística & dados numéricos , Serviços de Planejamento Familiar/estatística & dados numéricos , Feminino , Humanos , Masculino , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
17.
Rev Chilena Infectol ; 36(3): 318-330, 2019 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-31859751

RESUMO

BACKGROUND: Since the incorporation of antiretroviral therapy (ART) HIV has become a chronic condition, improving survival and allowing children with the virus to come in better conditions to adolescence, where they are faced with a series of changes, among them, to sexual awakening. AIM: To explore the main beliefs, perceptions and experiences in sexuality of a group of adolescents with HIV infection acquired through vertical transmission. METHODS: A qualitative research was carried out with exploratory and descriptive scope. Semi-structured interviews were applied to 28 adolescents, under control in hospitals in Santiago and Valparaíso, with HIV infection. The analysis was carried out according to the Grounded Theory. RESULTS: There was a lack of sexual education and a vision that focuses on risks, such as sexually transmissible infections or teenage pregnancy. There are fears about the possibility of rejection by others and of transmitting the virus to the couple or the children and they are invaded by feelings of shame and anger. CONCLUSION: It is important to train health professionals who work with this group, because they are identified as a reliable source of information and education.


Assuntos
Comportamento do Adolescente/psicologia , Infecções por HIV/transmissão , Conhecimentos, Atitudes e Prática em Saúde , Transmissão Vertical de Doença Infecciosa , Comportamento Sexual/psicologia , Adolescente , Adulto , Criança , Cultura , Feminino , Infecções por HIV/psicologia , Humanos , Acontecimentos que Mudam a Vida , Masculino , Percepção , Educação Sexual , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
18.
Afr J Reprod Health ; 23(3): 134-148, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31782638

RESUMO

Teenage pregnancy and the prevalence of HIV among school girls are very high in South Africa, despite the introduction of sexuality education in schools since 2002. A qualitative approach of inquiry was used to investigate challenges faced by schools offering sexuality education in Mahikeng, South Africa. Four school principals, seven teachers and 39 learners were interviewed. The curriculum on sexuality education indicates that sexual matters are introduced to learners only when they reach Grade 8, whereas pregnancy is already common among girls as early as Grade 3. Participants from all groups represented in the study revealed that Life Orientation was not taken seriously in schools compared to other subjects. Although learners are very much interested in the subject matter, there were no qualified teachers and the content of the curriculum is very shallow. In addition, schools paid very little attention to this subject since it is not considered for admission into tertiary institutions. There is need, therefore, for the South African government to revise the curriculum content and presentation of Life Orientation to ensure the improvement of sexuality education in schools. The appropriate age-specific topics on sexual matters for learners should also be revised and the qualification of teachers considered.


Assuntos
Currículo , Conhecimentos, Atitudes e Prática em Saúde , Gravidez na Adolescência/prevenção & controle , Educação Sexual , Adolescente , Feminino , Humanos , Masculino , Gravidez , Instituições Acadêmicas , África do Sul , Estudantes , Inquéritos e Questionários
19.
Pan Afr Med J ; 33: 224, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692753

RESUMO

Introduction: Despite increasing efforts to address the reproductive health needs of persons living with Human Immuno-Deficiency Virus (HIV), a high unmet need for contraception exists among HIV+ women in sub-Saharan Africa. Currently, Ethiopia promotes integration of family planning (FP) services in to HIV chronic care. Yet the contraceptive prevalence rate among clients remains low. The objective of the study was to assess the role of socio-cultural factors on modern family planning use among HIV+ clients attending Anti-Retroviral Therapy clinics in Addis Ababa sub-cities. Methods: The study involved a facility based cross sectional survey. The ten sub cities were initially categorized/stratified into 5 based on direction (East, West, South, North and Central) and from each category one sub city was randomly selected. The total sample size was proportionally allocated to the selected health facilities according to previous monthly average client load per health center. Participants were selected using simple random sampling technique during their routine visit at the health centers. Data were collected through a semi-structured interviewer administered questionnaire. Both descriptive and inferential statistics were generated and results considered significant at 95% confidence level using STATA version 14.0. Results: Six hundred and thirty-six clients participated in the study. Majority of them were age between 30-39 years. Though majority, 607 (95.4%) participants approved the use of modern FP method, current use rate stood at 39%. Condom was the most (14.5%) commonly used single method. The odds of FP use by participants who disclosed their HIV status were almost twice that of their counterparts (AOR= 1.84; 95% CI: 1.14, 2.95). Participants who held discussion with their spouse/partners concerning FP, irrespective of the frequency had an odd of more than four when using FP than their counterparts (AO= 4.35; 95% CI: 2.69, 7.04). Conclusion: This study revealed that 6 out of every 10 HIV+ clients are not currently using FP methods. Disclosure of HIV status as well as open discussion with spouse/partner were positively associated with family planning use. These study findings call for comprehensive and client focus FP education and counseling in line with disclosure of HIV status and dialogue with spouse/partner in order to increase uptake and utilization of FP among clients. Partners have a great influence on the use and choice of FP methods, so their views are paramount.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Serviços de Planejamento Familiar/estatística & dados numéricos , Infecções por HIV/epidemiologia , Educação Sexual/estatística & dados numéricos , Síndrome de Imunodeficiência Adquirida/epidemiologia , Adulto , Preservativos/estatística & dados numéricos , Anticoncepção/métodos , Anticoncepção/estatística & dados numéricos , Estudos Transversais , Revelação/estatística & dados numéricos , Etiópia , Serviços de Planejamento Familiar/organização & administração , Feminino , Humanos , Masculino , Saúde Reprodutiva , Parceiros Sexuais/psicologia , Inquéritos e Questionários , Adulto Jovem
20.
Cult Med Psychiatry ; 43(4): 686-709, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31729691

RESUMO

Drawing on a historical ethnography conducted in Southern Brazil, this article explores how public health programs for adolescent reproductive and mental health have emerged in Brazil and begun to intersect with the growing field of "global mental health" (GMH). The story I recount begins not in the 2010s with the rapid rise of expert interest in adolescent health within GMH, but in the 1990s, the decade when young teens in Brazil were first coming into contact with practices and approaches in research, schools and clinics that have both underpinned and critiqued the production of an adolescent mental and reproductive health sub-field. In parsing what young women's encounters with the then newly-emerging questionnaires, measurement tools, school-based programs and clinical practices came to mean to them, I use a genealogical approach to consider how histories of education reform, population control, psychoanalysis, social medicine, the transition to democracy, feminism and grass-roots politics all entered the fold, shaping the way adolescent sex-and-psyche materialized as a contested object of expertise. I end by exploring what this case can teach global mental health advocates and social theorists about practices of critique.


Assuntos
Comportamento do Adolescente/etnologia , Serviços de Saúde do Adolescente , Saúde Global , Serviços de Saúde Mental , Saúde Mental , Educação Sexual , Comportamento Sexual/etnologia , Adolescente , Brasil , Feminino , Humanos
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