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1.
Pan Afr Med J ; 38: 121, 2021.
Artículo en Francés | MEDLINE | ID: mdl-33912291

RESUMEN

Introduction: the purpose of this study was to assess adolescents and teachers´ knowledge, attitude and practices towards family planning (FP). Methods: in 2018, a qualitative study was conducted among seven teachers and 62 teenagers aged 15-19 years based on the Theory of Reasoned Action published by Fishbein and Ajzen in 2011. Data were collected from six focus group (FG) with adolescents and seven semi-structured interviews of teachers. They were analyzed using Atlas Ti software on the basis of a deductive approach. Results: periodic abstinence, male condoms and pills were the only contraceptive methods reported. Adolescents and teachers were apprehensive about using artificial contraceptive methods other than irregularly used male condom. Girls prefer natural methods fearing side effects. The majority of adolescents wanted to be informed about FP in school; however, they felt that the content of the Life Education Course (EVIE) was insufficient and that teachers lacked of openness. Peers, brothers, sisters and internet were the main sources of information. Mothers were an important source of information especially for girls, unlike fathers who were generally less appreciated. Conclusion: knowledge about FP is weak. Misconceptions about contraception lead to the use of ineffective practices to prevent unintended pregnancies. Training programs to improve teachers´ knowledge should be developed and the content of the EVIE course should be formalized and regulated.


Asunto(s)
Anticoncepción/psicología , Anticonceptivos/uso terapéutico , Conocimientos, Actitudes y Práctica en Salud , Maestros/estadística & datos numéricos , Adolescente , República Democrática del Congo , Servicios de Planificación Familiar , Femenino , Grupos Focales , Humanos , Entrevistas como Asunto , Masculino , Embarazo , Embarazo en Adolescencia/prevención & control , Educación Sexual/métodos , Adulto Joven
2.
Artículo en Inglés | MEDLINE | ID: mdl-33806507

RESUMEN

Adolescence, a period of physical, social, cognitive and emotional development, represents a target population for sexual health promotion and education when it comes to achieving the 2030 Agenda goals for sustainable and equitable societies. The aim of this study is to provide an overview of what is known about the dissemination and effectiveness of sex education programs and thereby to inform better public policy making in this area. Methodology: We carried out a systematic review based on international scientific literature, in which only peer-reviewed papers were included. To identify reviews, we carried out an electronic search of the Cochrane Database Reviews, ERIC, Web of Science, PubMed, Medline, Scopus and PsycINFO. This paper provides a narrative review of reviews of the literature from 2015 to 2020. Results: 20 reviews met the inclusion criteria (10 in school settings, 9 using digital platforms and 1 blended learning program): they focused mainly on reducing risk behaviors (e.g., VIH/STIs and unwanted pregnancies), whilst obviating themes such as desire and pleasure, which were not included in outcome evaluations. The reviews with the lowest risk of bias are those carried out in school settings and are the ones that most question the effectiveness of sex education programs. Whilst the reviews of digital platforms and blended learning show greater effectiveness in terms of promoting sexual and reproductive health in adolescents (ASRH), they nevertheless also include greater risks of bias. Conclusion: A more rigorous assessment of the effectiveness of sexual education programs is necessary, especially regarding the opportunities offered by new technologies, which may lead to more cost-effective interventions than with in-person programs. Moreover, blended learning programs offer a promising way forward, as they combine the best of face-to-face and digital interventions, and may provide an excellent tool in the new context of the COVID-19 pandemic.


Asunto(s)
Educación Sexual , Adolescente , Femenino , Humanos , Aprendizaje , Pandemias , Embarazo
3.
Artículo en Inglés | MEDLINE | ID: mdl-33672240

RESUMEN

BACKGROUND: Within the context of the widespread use of technologies by adolescents, the objectives of this study were to identify the perpetrators of intimate partner cyberstalking (IPCS) in adolescents; to analyze the relationship between IPCS and gender, age, sexting behaviors, pornography consumption, and ambivalent sexism; and to investigate the influence of the study variables as predictors of IPCS and determine their moderating role. METHODS: Participants were 993 Spanish students of Secondary Education, 535 girls and 458 boys with mean age 15.75 (SD = 1.47). Of the total sample, 70.3% (n = 696) had or had had a partner. RESULTS: Boys perform more sexting, consume more pornographic content, and have more hostile and benevolent sexist attitudes than girls. However, girls perpetrate more IPCS than boys. The results of the hierarchical multiple regression indicate that hostile sexism is a predictor of IPCS, as well as the combined effect of Gender × Pornography and Benevolent Sexism × Sexting. CONCLUSIONS: it is essential to implement sexual affective education programs in schools in which Information and Communication Technologies (ICT) are incorporated so that boys and girls can experience their relationships, both offline and online, in an egalitarian and violence-free way.


Asunto(s)
Literatura Erótica , Violencia de Pareja , Adolescente , Femenino , Humanos , Masculino , Educación Sexual , Sexismo , Conducta Sexual , Parejas Sexuales
4.
Artículo en Inglés | MEDLINE | ID: mdl-33672323

RESUMEN

BACKGROUND: The prevailing sex education (SE) model falls within a neoliberal prevention- and risk-oriented paradigm. This model ignores the identity dimension of sexuality, is based on the cis-heteronormative and ethnocentric matrix and stigmatizes sexual and cultural diversity; this has significant consequences for sexually and culturally diverse adolescents and youth. In this study, we explored the potential of the identity dimension of SE to prevent violence toward sexual and cultural diversity. Specifically, our objective was to identify the influence of heteronormative and ethnocentric variables on violence exerted against trans* and gender-diverse people and people from minority ethnic groups. METHODS: A total of 623 Spanish adolescents with a mean age of 14.73 years and an age range of 13 to 18 years participated in the study. Students completed a questionnaire that included measures regarding violence toward sexual and cultural diversity, gender stereotypes, sexist attitudes and rejection of sexual and cultural diversity. We performed two hierarchical linear regression models. RESULTS: Students who exerted the highest amount of violence toward trans* and gender-diverse people were those who showed the lowest endorsement of expressive traits and the highest endorsement of instrumental traits as well as the highest level of hostile sexist, heteronormative and hostile racist attitudes (the five predictor variables explained 29.1% of the variance of gender-bashing). These same variables-except expressiveness-and benevolent sexism explained 46.1% of the variance of rejection of minority ethnic groups. CONCLUSIONS: There is a need for a comprehensive, intercultural, critical and queer SE aimed at transforming the classroom into a space that promotes social transformation through an educational practice that is transgressive and critical of cis-heteronormativity and normative ethnocentrism.


Asunto(s)
Diversidad Cultural , Minorías Sexuales y de Género , Adolescente , Identidad de Género , Humanos , Educación Sexual , Violencia/prevención & control
5.
Reprod Health ; 18(1): 26, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33618726

RESUMEN

BACKGROUND: A coherent sexuality education program for adolescents is part of their sexual and reproductive rights and can help them have a healthier future. Therefore, the aim of this study was to explore the perspectives and intervention preferences of Iranian stakeholders regarding comprehensive sexuality education (CSE) in male adolescents based on the IMB model (information, motivation, behavioral skills). METHODS: This study was a qualitative study that was analyzed through a directed content analysis approach. Individual interviews and focused group discussions (FGDs) were used for data collection. The data were collected through in-depth semi-structured interviews with stakeholders in two schools and the Education Department in Sari and the Ministry of Health and Ministry of Education in Tehran from March 2019 to August 2019. Data saturation was achieved after 28 interviews and 1 FGDs with 9 participants. Finally, two sets of data were coded and analyzed using directed content analysis. RESULTS: In this study, five themes emerged as (1) role of institutions; (2) role of organizations; (3) need for stakeholder's partnership; (4) need for adolescent sexuality socialization management; and (5) need for enhancing the teachers' professional competence, which seemed to influence the implementation of CSE in male adolescents. Participants also expressed a number of intervention preferences for CSE. The most important of these was the change in macro policies, helping to create a culture against all forms of violence and breaking the taboo of sexuality education for children and adolescents. CONCLUSIONS: The results of this study revealed the need for a CSE program for adolescents' sexuality socialization. The finding showed that teachers required training to enhance their professional competence about sexuality issues. Therefore, it is necessary to design and implement culture-appropriate skill based programs to enhance the teachers' professional competence regarding the adolescents' sexual health.


Asunto(s)
Actitud Frente a la Salud , Percepción , Salud Reproductiva/educación , Educación Sexual , Salud Sexual/educación , Adolescente , Conducta del Adolescente/fisiología , Conducta del Adolescente/psicología , Niño , Grupos Focales , Conocimientos, Actitudes y Práctica en Salud , Humanos , Entrevistas como Asunto , Irán , Masculino , Motivación/fisiología , Investigación Cualitativa , Servicios de Salud Escolar , Educación Sexual/métodos , Conducta Sexual/psicología , Participación de los Interesados , Adulto Joven
6.
Reprod Health ; 18(1): 48, 2021 Feb 23.
Artículo en Inglés | MEDLINE | ID: mdl-33622358

RESUMEN

BACKGROUND: Contraceptive use among adolescent girls is low in many sub-Saharan African countries including Kenya. Attitude and perspectives about contraception of community members including adolescent girls themselves may be likely to limit contraceptive use among adolescent girls. This study was conducted to explore and compare adults'/parents' and adolescent girls' narratives and perspectives about contraception in Narok and Homa Bay counties, Kenya. METHODS: Qualitative data from 45 in-depth-interviews conducted with purposively selected consenting adolescent girls aged 15-19 was used. Additionally, twelve focus group discussions were held with 86 consenting adults conveniently recruited from the two counties. All discussions were conducted in the local language and audio recorded following consent of the study participants. Female moderators were engaged throughout the study making it appropriate for the study to solicit feedback from the targeted respondents. RESULTS: Findings highlighted adults' perceptions on adolescents' sexuality and the presence of stringent conceptions about the side-effects of contraception in the study communities. Some participants underscored the need for open contraceptive talk between parents and their adolescent girls. Four main themes emerged from the discussions; (i) Perceptions about adolescents' sexuality and risk prevention, (ii) Conceptions about contraception among nulligravida adolescents: fear of infertility, malformation and sexual libertinism, (iii) Post-pregnancy contraceptive considerations and (iv) Thinking differently: divergent views regarding contraceptives and parent/adolescent discussion. CONCLUSIONS: Our findings suggest the need for increased attention towards adolescents and their caregivers particularly in demystifying contraceptive misconceptions. Programmatic responses and models which include the provision of comprehensive sexuality education and increased access to and utilization of SRH information, products and services through a well-informed approach need to be well executed. Programmatic efforts like SRH community education should further seek to enhance the capacity of parents to discuss sexuality with their adolescents.


Asunto(s)
Conducta Anticonceptiva , Matrimonio , Relaciones Padres-Hijo , Percepción , Psicología del Adolescente , Adolescente , Conducta del Adolescente/fisiología , Adulto , Anticoncepción/métodos , Anticoncepción/psicología , Anticoncepción/estadística & datos numéricos , Conducta Anticonceptiva/psicología , Conducta Anticonceptiva/estadística & datos numéricos , Anticonceptivos/uso terapéutico , Femenino , Grupos Focales , Conocimientos, Actitudes y Práctica en Salud/etnología , Humanos , Kenia/epidemiología , Matrimonio/psicología , Matrimonio/estadística & datos numéricos , Relaciones Padres-Hijo/etnología , Embarazo , Embarazo en Adolescencia/prevención & control , Embarazo en Adolescencia/psicología , Embarazo en Adolescencia/estadística & datos numéricos , Investigación Cualitativa , Educación Sexual/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Adulto Joven
7.
Artículo en Inglés | MEDLINE | ID: mdl-33557441

RESUMEN

Evidence indicates that school-based sexuality education empowers children and adolescents with the skills, values, and attitudes that will enable them to appreciate their health and well-being, nourish respectful social and sexual relationships, understand their rights, and to make informed choices. Owing to organized community resistance and prevalent misconceptions, promoting sexual and reproductive health has been challenging, especially in conservative settings like Pakistan. This study aimed at systematically exploring communities' perceptions regarding implementing school-based comprehensive sexuality education by conducting a cross-sectional community readiness assessment in Islamabad, Pakistan. A total of 35 semi-structured interviews were conducted with community key informants. Following the guidelines of the community readiness handbook, the interviews were transcribed and scored by two independent raters. The results indicate that, overall, the Islamabad community is at stage two of community readiness, the denial/resistance stage. Individual dimension scores indicate that knowledge of efforts, resources for efforts, knowledge about the issue, and leadership dimensions are at the denial/resistance stage. Only community climate was rated at stage three of community readiness, the vague awareness stage. This indicates that, for promoting sexuality education in the Pakistani context, it is essential to tackle resistance by sensitizing the community and the stakeholders through awareness campaigns.


Asunto(s)
Instituciones Académicas , Educación Sexual , Adolescente , Niño , Estudios Transversales , Humanos , Pakistán , Sexualidad
8.
Arch Sex Behav ; 50(2): 629-646, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33398696

RESUMEN

We analyzed cross-sectional data collected from a U.S. nationally representative survey of individuals ages 14-24 years old on what sources of information from the past year they considered to be the most helpful about how to have sex (n = 600 adolescents ages 14-17 years old, and n = 666 young adults ages 18-24 years old). Among the 324 adolescents who indicated that they had been helped by at least one source of information, helpful information was most likely to have come from parents (31.0%) and friends (21.6%). Only 8.4% of adolescents said pornography was helpful. However, for those in the 18-24-year-old age group, pornography was the most commonly endorsed helpful source (24.5%), as compared to other possible options such as sexual partners, friends, media, and health care professionals. Multivariable regression analyses revealed that indicating that pornography was the most helpful source of information about how to have sex, compared to the other sources, was inversely associated with being female (OR = 0.32, p = .001), inversely associated with identifying as bisexual compared to heterosexual (OR = 0.15, p = .038), positively associated with being Black compared to being white non-Hispanic (OR = 4.26, p = .021), inversely associated with reporting a household income of either $25 K to $49,999 (OR = 0.31, p = .010) or $50 K to $74,999 (OR = 0.36, p = .019) compared to more than $75 K, and positively associated with having masturbated (OR = 13.20, p = .005). Subsequent research should investigate the role of pornography in both adolescent and adult sexual development, including why one-quarter of U.S. young adults say that pornography is a helpful source of information about how to have sex and what they think that they are learning from it.


Asunto(s)
Literatura Erótica/psicología , Conducta Exploratoria , Conducta Sexual/psicología , Parejas Sexuales/psicología , Adolescente , Medios de Comunicación , Estudios Transversales , Femenino , Heterosexualidad/psicología , Humanos , Masculino , Prevalencia , Educación Sexual/métodos , Conducta Sexual/estadística & datos numéricos , Estados Unidos , Adulto Joven
9.
Artículo en Inglés | MEDLINE | ID: mdl-33435342

RESUMEN

Background: Developmentally appropriate evidence-based sexual health education should be included as part of a comprehensive school health education program and be accessible to all students. The registered school nurse is a valuable resource to parents and educators in this area and supports the implementation of evidence-based sexual health education programs that promote healthy sexual development for adolescents. Methods: The research group consisted of 438 adolescents aged 12 to 15 years in a selected region in Slovakia, 186 boys and 252 girls. Average age of the girls was 13.2 and the boys 13.3 years. A nurse-a specialist in community nursing-collected the data using a self-designed questionnaire. The questions evaluated by the five-point Likert scale focused on finding out the knowledge and attitudes of adolescents to the role of school nurses regarding sexuality and reproductive health. Results were analyzed using parametric comparison tests with significance value 0.05: Student t-test for independent samples. Results: The girls and the boys most often drew information on sexuality and reproductive health from their parents and friends. The evaluation of the adolescents' views on who should be a competent professional in the field of sexual education at schools found statistically significant differences between the boys and girls. For the boys and girls, a sexologist received the most significant assessment of competence. The interest in a school nurse in a school environment would be statistically significantly more appreciated by the girls compared to the boys, not just for solving problems related to healthy lifestyle, but also regarding sexuality, parenting and marriage. The adolescents consider the education for marriage and parenthood as the least discussed issue at present. In evaluating topics the adolescents would discuss, there were statistically significant differences between the boys and girls. Conclusions: A community or school nurse would also be able to successfully perform sexual education at schools. In Slovakia, this applied nursing discipline is lacking.


Asunto(s)
Educación Sexual , Conducta Sexual , Adolescente , Actitud , Niño , Femenino , Educación en Salud , Humanos , Masculino , Eslovaquia
10.
PLoS One ; 16(1): e0243854, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33439888

RESUMEN

BACKGROUND: Family planning is a key means to achieving many of the Sustainable Development Goals. Around the world, governments and partners have prioritized investments to increase access to and uptake of family planning methods. In Uttar Pradesh, India, the government and its partners have made significant efforts to increase awareness, supply, and access to modern contraceptives. Despite progress, uptake remains stubbornly low. This calls for systematic research into understanding the 'why'-why people are or aren't using modern methods, what drives their decisions, and who influences them. METHODS: We use a mixed-methods approach, analyzing three existing quantitative data sets to identify trends and geographic variation, gaps and contextual factors associated with family planning uptake and collecting new qualitative data through in-depth immersion interviews, journey mapping, and decision games to understand systemic and individual-level barriers to family planning use, household decision making patterns and community level barriers. RESULTS: We find that reasons for adoption of family planning are complex-while access and awareness are critical, they are not sufficient for increasing uptake of modern methods. Although awareness is necessary for uptake, we found a steep drop-off (59%) between high awareness of modern contraceptive methods and its intention to use, and an additional but smaller drop-off from intention to actual use (9%). While perceived access, age, education and other demographic variables partially predict modern contraceptive intention to use, the qualitative data shows that other behavioral drivers including household decision making dynamics, shame to obtain modern contraceptives, and high-risk perception around side-effects also contribute to low intention to use modern contraceptives. The data also reveals that strong norms and financial considerations by couples are the driving force behind the decision to use and when to use family planning methods. CONCLUSION: The finding stresses the need to shift focus towards building intention, in addition to ensuring access of trained staff, and commodities drugs and equipment, and building capacities of health care providers.


Asunto(s)
Conducta Anticonceptiva , Servicios de Planificación Familiar , Educación Sexual/estadística & datos numéricos , Adolescente , Adulto , Anticoncepción , Conducta Anticonceptiva/psicología , Conducta Anticonceptiva/estadística & datos numéricos , Anticonceptivos , Servicios de Planificación Familiar/métodos , Servicios de Planificación Familiar/organización & administración , Servicios de Planificación Familiar/tendencias , Femenino , Humanos , India , Intención , Masculino , Persona de Mediana Edad , Población Rural , Conducta Sexual , Adulto Joven
11.
AIDS Behav ; 25(6): 1901-1912, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33483899

RESUMEN

To improve women's access to pre-exposure prophylaxis (PrEP) in family planning (FP) clinics, we examined readiness to provide PrEP, and barriers and facilitators at the clinic level to integrate PrEP services into Title X-funded FP clinics across the Southern US. Title X-funded FP clinics across DHHS regions III (Mid-Atlantic), IV (Southeast), and VI (Southwest), comprising the Southern US. From February to June, 2018, we conducted a web-based, geographically targeted survey of medical staff, providers and administrators of Title X-funded FP clinics in DHHS regions III (Mid-Atlantic), IV (Southeast), and VI (Southwest). Survey items were developed using the Consolidated Framework for Implementation Research to assess constructs relevant to PrEP implementation. One-fifth of 283 unique Title X clinics across the South provided PrEP. Readiness for PrEP implementation was positively associated with a climate supportive of HIV prevention, leadership engagement, and availability of resources, and negatively associated with providers holding negative attitudes about PrEP's suitability for FP. The Title X FP network is a vital source of sexual health care for millions of individuals across the US. Clinic-level barriers to providing PrEP must be addressed to expand onsite PrEP delivery in Title X FP clinics in the Southern US.


Asunto(s)
Fármacos Anti-VIH , Infecciones por VIH , Profilaxis Pre-Exposición , Instituciones de Atención Ambulatoria , Fármacos Anti-VIH/uso terapéutico , Servicios de Planificación Familiar , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , Humanos , Educación Sexual , Estados Unidos
12.
Nursing (Säo Paulo) ; 23(269): 4741-4750, out.2020.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1145406

RESUMEN

Objetivo: Analisar os dados de vitimização de homens, com idade entre 20 e 59 anos, pelas distintas formas de violência física e sexual, registrados no Sistema de Vigilância de Violências e Acidentes/SIVVA da cidade de São Paulo (SP). Método: Trata-se de um estudo transversal, de abordagem quantitativa, descritivo, retrospectivo. Realizado por meio das notificações do Sistema de Informação para a Vigilância de Violência e Acidentes (SIVVA) da Secretaria Municipal de Saúde da cidade de São Paulo, no período de janeiro a dezembro de 2014 na cidade de São Paulo, sendo composto por 6658 homens na faixa etária entre 20 a 59 anos. Resultados: O número de casos de violência física foram 6.624 casos e violência sexual 34 casos contra homens com idade entre 20 e 59 anos. O vínculo do agressor em relação a vítima era familiar ou conhecido da vítima; 61,8% violência sexual e 42,8% violência física. Conclusão: O estudo evidenciou que as vítimas eram predominantemente adultos jovens. A violência na maioria dos estudos é vista como um grande problema social que atinge toda a sociedade, sendo responsável pelo adoecimento e mortes causadas por ações realizadas por indivíduos ou, provocando danos físicos, emocionais as vítimas; além de gerar despesas para os serviços público.(AU)


Objective: the analyze the victimization data of men, aged between 20 and 59 years, by the different forms of physical and sexual violence, registered in the Violence and Accident Surveillance System / SIVVA in the city of São Paulo (SP). Method: This is a cross-sectional study, with a quantitative, descriptive, retrospective approach. Carried out through the notifications of the Information System for the Surveillance of Violence and Accidents (SIVVA) of the Municipal Health Department of the city of São Paulo, in the period from January to December 2014 in the city of São Paulo, consisting of 6658 men aged between 20 and 59 years. Results: The number of cases of physical violence was 6,624 cases and sexual violence 34 cases against men aged between 20 and 59 years. The aggressor's relationship with the victim was familiar or known to the victim; 61.8% of sexual violence and 42.8% of physical violence. Conclusion: The study showed that the victims were predominantly young adults. Violence in most studies is seen as a major social problem that affects the whole of society, being responsible for illness and deaths caused by actions performed by individuals or, causing physical harm, emotional victims; in addition to generating expenditure for public services.(AU)


Objetivo: Analizar los datos de victimización de hombres, de entre 20 y 59 años, debido a las diferentes formas de violencia física y sexual, inscritas en el Sistema de Vigilancia de La Violencia y Accidentes/SIVVA de la ciudad de Sao Paulo (SP). Método: Se trata de un estudio transversal, con un enfoque cuantitativo, descriptivo y retrospectivo. Realizado a través de las notificaciones del Sistema de Información para la Vigilancia de la Violencia y accidentes (SIVVA) del Departamento Municipal de Salud de la ciudad de Sao Paulo, en el período de enero a diciembre de 2014 en la ciudad de Sao Paulo, con una crianza de 6658 hombres de entre 20 y 59 años. Resultados: El número de casos de violencia física fue de 6.624 casos y violencia sexual 34 casos contra hombres de entre 20 y 59 años. El vínculo del agresor con la víctima era familiar o conocido por la víctima; 61,8% de violencia sexual y 42,8% de violencia física. Conclusión: El estudio mostró que las víctimas eran predominantemente adultos jóvenes. La violencia en la mayoría de los estudios es vista como un problema social importante que afecta a toda la sociedad, siendo responsable de enfermedades y muertes causadas por acciones realizadas por individuos o, causando daño físico, víctimas emocionales; además de generar gastos para los servicios públicos.(AU)


Asunto(s)
Humanos , Masculino , Educación Sexual , Delitos Sexuales , Violencia , Abuso Físico , Factores de Riesgo , Salud del Hombre
13.
Obstet Gynecol ; 136(4): 868-869, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32976376

RESUMEN

The primary goal of the initial reproductive health visit is to provide preventive health care services, educational information, and guidance, in addition to problem-focused care. The initial reproductive health visit should take place between the ages of 13 and 15 years. The scope of the initial visit will depend on the patient's concerns, medical history, physical and emotional development, and the level of care the patient is receiving from other health care professionals. All adolescents should have the opportunity to discuss health issues with a health care professional one-on-one, because they may feel uncomfortable talking about these issues in the presence of a parent or guardian, sibling, or intimate partner. Addressing confidentiality concerns is imperative because adolescents in need of health care services are more likely to forego care if there are concerns about confidentiality. Laws regarding confidentiality of care to minors vary by state, and health care professionals should be knowledgeable about current laws for their practice. Taking care to establish secure lines of communication can build trust with the patient and guardian, support continuity of care, ensure adherence to legal statutes, and decrease barriers to services. Obstetrician-gynecologists have the opportunity to serve as educators of parents and guardians about reproductive health issues. Preparing the office environment to include adolescent-friendly and age-appropriate reading materials, intake forms, and educational visual aids can make the general office space more inclusive and accessible. Resources should be provided for both the adolescent patient and the parent or guardian, if possible, at the conclusion of the visit. This Committee Opinion has been updated to include gender neutral terminology throughout the document, counseling topics with direct links to helpful resources, screening tools with direct links, addition of gender and sexuality discussion, and inclusion of trauma-informed care.


Asunto(s)
Servicios de Salud del Adolescente , Ginecología/métodos , Obstetricia/métodos , Servicios Preventivos de Salud , Salud Reproductiva , Adolescente , Conducta del Adolescente , Salud del Adolescente , Servicios de Salud del Adolescente/ética , Servicios de Salud del Adolescente/organización & administración , Femenino , Humanos , Servicios Preventivos de Salud/ética , Servicios Preventivos de Salud/métodos , Salud Reproductiva/educación , Salud Reproductiva/ética , Educación Sexual/métodos , Conducta Sexual , Estados Unidos
14.
Obstet Gynecol ; 136(4): e70-e80, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32976378

RESUMEN

The primary goal of the initial reproductive health visit is to provide preventive health care services, educational information, and guidance, in addition to problem-focused care. The initial reproductive health visit should take place between the ages of 13 and 15 years. The scope of the initial visit will depend on the patient's concerns, medical history, physical and emotional development, and the level of care the patient is receiving from other health care professionals. All adolescents should have the opportunity to discuss health issues with a health care professional one-on-one, because they may feel uncomfortable talking about these issues in the presence of a parent or guardian, sibling, or intimate partner. Addressing confidentiality concerns is imperative because adolescents in need of health care services are more likely to forego care if there are concerns about confidentiality. Laws regarding confidentiality of care to minors vary by state, and health care professionals should be knowledgeable about current laws for their practice. Taking care to establish secure lines of communication can build trust with the patient and guardian, support continuity of care, ensure adherence to legal statutes, and decrease barriers to services. Obstetrician-gynecologists have the opportunity to serve as educators of parents and guardians about reproductive health issues. Preparing the office environment to include adolescent-friendly and age-appropriate reading materials, intake forms, and educational visual aids can make the general office space more inclusive and accessible. Resources should be provided for both the adolescent patient and the parent or guardian, if possible, at the conclusion of the visit. This Committee Opinion has been updated to include gender neutral terminology throughout the document, counseling topics with direct links to helpful resources, screening tools with direct links, addition of gender and sexuality discussion, and inclusion of trauma-informed care.


Asunto(s)
Servicios de Salud del Adolescente , Ginecología/métodos , Obstetricia/métodos , Servicios Preventivos de Salud , Salud Reproductiva , Adolescente , Conducta del Adolescente , Salud del Adolescente , Servicios de Salud del Adolescente/ética , Servicios de Salud del Adolescente/organización & administración , Confidencialidad/normas , Femenino , Humanos , Planificación de Atención al Paciente , Servicios Preventivos de Salud/ética , Servicios Preventivos de Salud/métodos , Salud Reproductiva/educación , Salud Reproductiva/ética , Educación Sexual/métodos , Conducta Sexual , Estados Unidos
15.
PLoS One ; 15(9): e0239376, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32966322

RESUMEN

BACKGROUND AND OBJECTIVE: India contributes a major share of global unintended births. It is established that contraception plays a significant role in preventing unintended pregnancies, maternal mortality and induced abortion. In this study, to analyze the effectiveness of our family welfare program, we tried to give district-level estimates of number of births averted due to contraception. DATA AND METHODS: Data for this study came from the cross-sectional, population-based data from the fourth round of National Family Health Survey (NFHS-4) conducted in 2015-16. Here, we discussed two methods based on robust regression for computing number of births averted at district level. Further, we analyzed the percentage increase in births (PIB) that would be experienced by each district in the absence of contraception. RESULTS: Findings of this study clearly showed that there was a huge variation in the estimates of number of births averted among different districts as well as states of India. Out of 640 districts, 315 districts achieved below-replacement fertility and 365 districts have contraceptive prevalence rate (CPR) more than 50 percent. Method 1 found around 22 percent districts showed less than 15 percent reduction in births while Method 2 suggested nearly 14 percent districts predominantly located in Uttar Pradesh, Bihar, Jharkhand, Arunachal Pradesh, Meghalaya and Manipur exhibited less than 30 percent reduction of births due to use of all forms of contraception. At all India level, an average estimate obtained by two methods, nearly 63 million births would have been averted by the use of contraception or 40 percent more than the number of births occurred during that period. CONCLUSION: The study successfully identified the districts that were not performing well at the front of utilization of various family planning methods for birth control. To achieve objectives of National Population Policy (2000), poor-performing districts must be monitored like the government keeps monitoring of Aspirational districts.


Asunto(s)
Anticoncepción/estadística & datos numéricos , Parto , Adulto , Femenino , Humanos , India , Embarazo , Educación Sexual , Encuestas y Cuestionarios
16.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(4): 452-458, 2020 Aug 30.
Artículo en Chino | MEDLINE | ID: mdl-32895096

RESUMEN

Objective To understand the family sex education for young children in rural areas of Sichuan province and analyze the influencing factors. Methods A multi-stage random sampling method was used to select 2246 parents of kindergarten children from rural areas in Sichuan province for a questionnaire-based survey.The Chi-square test and Logistic regression model were used for data analysis. Results It was found 1132(52.33%)parents had implemented family sex education for young children and 1031(47.67%)had not.Young children having asked sex-related questions(OR=1.536,95%CI=1.257-1.878),parents thinking that early childhood sex education is necessary(OR=3.691,95%CI=2.029-6.717),and parents having the intention to know early childhood sex education(OR=1.700,95%CI=1.274-2.269),and kindergarten having implemented early childhood sex education(OR=3.316,95%CI=2.515-4.372)were promoting factors for parents to conduct early childhood sex education,whereas a total annual household income at the middle level(OR=0.664,95%CI=0.456-0.968)was a hindering factor for parents to conduct early childhood sex education. Conclusions Parents of young children in rural areas of Sichuan province have poor awareness of sex education,and the proportion of parents who have never conducted sex education for children is high.The total annual income of the family,whether the children have asked about sex-related questions,parents' attitude towards early childhood sex education,and whether the kindergarten has conducted the early childhood sex education are important factors that influence the level of children's family sex education.


Asunto(s)
Educación Sexual , Niño , China , Humanos , Modelos Logísticos , Padres , Encuestas y Cuestionarios
17.
PLoS One ; 15(9): e0236712, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32915798

RESUMEN

INTRODUCTION: The Reproductive Life Plan (RLP) is a clinical tool to help clients find strategies to achieve their reproductive goals. Despite much research on the RLP from high-income countries, it has never been studied in low- or middle income countries. Together with health workers called Mentor Mothers (MMs), we used a context-adapted RLP in disadvantaged areas in Eswatini. Our aim was to evaluate the implementation of the RLP in this setting. METHODOLOGY: MMs participated in focus group discussions (FGDs, n = 3 MMs n = 29) in January 2018 and at follow-up in May 2018 (n = 4, MMs n = 24). FGDs covered challenges in using the RLP, how to adapt it, and later experiences from using it. We used a deductive qualitative thematic analysis with the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, creating themes guided by its four constructs: facilitation, innovation, recipients and context. The MMs also answered a questionnaire to assess the implementation process inspired by normalization process theory. RESULTS: The RLP intervention was feasible and acceptable among MMs and fit well with existing practices. The RLP questions were perceived as advantageous since they opened up discussions with clients and enabled reflection. All except one MM (n = 23) agreed or strongly agreed that they valued the effect the RLP has had on their work. Using the RLP, the MMs observed progress in pregnancy planning among their clients and thought it improved the quality of contraceptive counselling. The clients' ability to form and achieve their reproductive goals was hampered by contextual factors such as intimate partner violence and women's limited reproductive health and rights. DISCUSSION: The RLP was easily implemented in these disadvantaged communities and the MMs were key persons in this intervention. The RLP should be further evaluated among clients and suitable approaches to include partners are required.


Asunto(s)
Implementación de Plan de Salud/normas , Evaluación de Programas y Proyectos de Salud , Educación Sexual/métodos , Adulto , Esuatini , Femenino , Implementación de Plan de Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Conducta Reproductiva/psicología , Conducta Reproductiva/estadística & datos numéricos , Educación Sexual/normas , Encuestas y Cuestionarios , Poblaciones Vulnerables
18.
PLoS One ; 15(9): e0238501, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32915838

RESUMEN

Digital technologies are increasingly intertwined into people's sexual lives, with growing scholarly interest in the intersection of sex and technology (sex-tech). However, much of the literature is limited by its over emphasis on negative outcomes and the predominance of work by and about North Americans, creating the impression that sex-tech is largely a Western phenomenon. Based on responses from 130,885 women in 191 countries, we assessed how women around the world interact with mobile technology for sex-related purposes, and whether in areas of greater gender inequality, technological accessibility may be empowering women with knowledge about sexuality. We investigated women's use of technology to find sexual partners, learn about sex and improve their sexual relationships, and track their own sexual health. About one-fifth reported using mobile apps to find sexual partners. This use varied by region: about one-third in Oceania, one-fourth in Europe and the Americas, and one-fifth in Asia and Africa. Staying connected when apart was the most commonly selected reason for app use with a sexual partner. About one-third had used an app to track their own sexual activity. Very few reported that the app they used to improve their sexual relationships was detrimental (0.2%) or not useful (0.6%). Women in countries with greater gender inequality were less likely to have used mobile apps to find a sexual partner, but nearly four times more likely to have engaged in sending and receiving sexts. To our knowledge, this study provides the most comprehensive global data on sex-tech use thus far, demonstrates significant regional variations in sex-tech use, and is the first to examine women's engagement in sex-related mobile technology in locations with greater gender disparities. These findings may inform large-scale targeted studies, interventions, and sex education to improve the lives of women around the world.


Asunto(s)
Derechos Humanos/tendencias , Aplicaciones Móviles/tendencias , Conducta Sexual/psicología , Adulto , África , Américas , Asia , Actitud , Europa (Continente) , Femenino , Humanos , Persona de Mediana Edad , Educación Sexual/tendencias , Parejas Sexuales/psicología , Sexualidad/psicología , Tecnología/tendencias
20.
Lancet Child Adolesc Health ; 4(9): 699-708, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32827491

RESUMEN

Sexual and reproductive health is an important aspect of human development, but discussions with adolescents and young adults on this topic are often challenging for health-care providers. As a result, many adolescents and young adults do not receive appropriate, comprehensive sexual education, despite recognition from WHO and the UN that access to this education is a human right. Adolescents and young adults with mild to moderate intellectual or developmental disability, or both, are just as likely to be sexually active as are their peers without disability; however, these individuals are less likely to receive comprehensive sexual education. To ensure adequate comprehensive sexual education for adolescents and young adults with intellectual and developmental disabilities, sexual health educators should facilitate conversations about sexual and reproductive health that are non-judgmental and sexually inclusive. Such initiatives should use an educational framework grounded in universal design for learning, including use of multiple media types with clear, concise language and images.


Asunto(s)
Educación Sexual/métodos , Conducta Sexual , Salud Sexual/educación , Adolescente , Discapacidades del Desarrollo/psicología , Discapacidades del Desarrollo/terapia , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Discapacidad Intelectual/psicología , Discapacidad Intelectual/terapia , Masculino , Medición de Riesgo , Adulto Joven
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