Women with intellectual disabilities talk about their perceptions of sex.

BACKGROUND: Sexuality is learned through sexual socialisation that women with intellectual disabilities (IDs) understand and express. Rules of sexual engagement for these women can include barriers for their socialisation, intimate partner selection, and sexual expression. These rules can become more limiting when coupled with rules of femininity that encourage sexual restraint for women. METHODS: This ethnography explored how women with IDs perceived their sexuality and how sexuality functioned in their lives. Sources of data included 48 multiple and in-depth interviews and observations with 14 women. This article specifically describes how the women constructed 'sex' and how they described experiencing sex as two of their multiple expressions of sexuality in this study. RESULTS: Most of the women had very limited and exclusively heterosexual sexual experiences, and the majority of women reported practicing abstinence. Criteria they identified for sex included having protected sex, marital and monogamous sex for the purpose of procreation or parenting, and having feelings for a sexual partner. Most held negative perceptions of sex they attributed to fear of the first act, fear of experiencing negative consequences, physiological concerns about the act, and perceived or actual lack of pleasure. CONCLUSIONS: Although the women displayed some sense of self-determinism in their sexual behaviour, negative perceptions of sex resulted in self-imposed abstinence predicated by fear of intercourse, intimacy, or outcome. Central to their sexuality education then is increasing self-efficacy perceptions and performance of safer sex practices to prevent negative sexual consequence. Sexuality education from a positive perspective that enhances their sexual self-determinism and encourages sexual health is recommended.

Associations between number of lifetime partners and other health behaviors.

OBJECTIVE: To examine associations between health behaviors and lifetime sexual partners among college students. METHODS: Data from the 1995 National College Health Risk Behavior Survey were analyzed. RESULTS: After adjusting for age, sex, and race, having 2 or more lifetime sexual partners was associated with infrequently using seat belts, driving after drinking, having a physical fight, considering suicide, and using chewing tobacco and marijuana. Significant sex interactions occurred with cigarette smoking and fruit and vegetable consumption, and significant age interactions occurred with binge drinking. CONCLUSIONS: Having multiple lifetime sexual partners (> or = 2) was associated with several negative health behaviors.

Assessment of health knowledge after "a healthy adventure".

This study evaluated the general health education program for third graders at Hult Health Education Center (Hult HEC). A quasi-experimental, nonequivalent pretest-posttest control group design with four groups was employed to collect pretest and posttest data from 168 third graders. The four groups included a control group, a traditional classroom health education group, a group that visited Hult HEC, and a group that visited Hult HEC and incorporated center curricular materials in the classroom. Analysis of covariance (ANCOVA) was calculated to test for posttest differences among the four groups, while reducing the effects of initial group pretest score differences. A statistically significant difference occurred in posttest scores among the four groups (F = 120.62, df = 4, 163, p = .0001). Post hoc testing revealed the best results were obtained when combining curricular materials with a visit to the Hult HEC.

Sexual coercion content in 21 sexuality education curricula.

Sexual coercion, a topic of relevance to school health personnel, may be as common in high school populations as in university populations. Twenty-one sexuality education curricula were examined for information on the topics of date rape, stranger rape, pressure, incest, sexual harassment, unwanted/inappropriate touch, and exploitation/victimization. Curricula scoring highest in total coverage also were the most comprehensive with six of the seven sexual coercion topics covered. Overall, pressure and exploitation/victimization received the greatest attention, while sexual harassment was not covered in any of the curricula. Common themes occurring within the coercion topic areas included guilt, communication/assertiveness skills, blame, drug use, premeditation, fear, sources of help. Results suggest sexuality education curricula have not responded to the increased concern regarding sexual harassment in schools.

PIP: This study is an analysis of sexual coercion content in sexuality education curricula. Copies of 21 adolescent sexuality education curricula materials published from 1988 or later were obtained and the information therein reviewed for sexual coercion topics such as date/stranger rape, incest, sexual harassment or pressure, inappropriate touch, and exploitation/victimization. The results revealed that 3 of 21 curricula (Streetwise to Sex-wise, Values and Choices, and Life Planning Education-DC) addressed all the sexual coercion topics with the exception of sexual harassment. The topic covered by the greatest number of curricula was pressure. Date rape was addressed in 14 curricula, 12 covered the exploitation topic, inappropriate/unwanted touch was addressed by 11, stranger rape was addressed by 7, and incest was covered by 4 curricula. The curricula that covered the fewest number of topics also offered the least amount of depth as measured by the number of paragraphs. The most significant finding from the analysis was that none of the 21 curricula addressed sexual harassment. This article recommends that all facets of sexual coercion should be equally addressed in junior high/middle school and high school curricula. Even though the topic may seem sensitive or controversial, it should be covered because these adolescents deserve to have information and skills to prevent or effectively deal with sexual coercion.

Gender representation in illustrations, text, and topic areas in sexuality education curricula.

A content analysis instrument was developed to examine differences in gender representation in sexuality education curricula. Fourteen middle school and high school curricula, published between 1985 and 1995, were examined. Variables included illustrations, noun/pronoun usage, and specific topics within the two categories of biological function and mutual interest. The study examined differences in gender representation in illustrations, photographs, cartoons, drawings, and text. Omission of sexuality topics related to gender also was examined. Little difference occurred within the text of the curricula in noun and pronoun usage. Illustrations were few in number, but showed greater female representation. Greater male representation occurred in topics related to drug use, sexual exploitation, sexual desire, and homosexuality. Topics with greater female representation included body image, diseases of the reproductive organs, and hygiene.

An assessment of 23 selected school-based sexuality education curricula.

While quality sexuality education curricula are available, those responsible for selecting a curriculum may not feel confident to choose one to meet the needs of their students and community. This paper presents a method to guide in selecting sexuality education curricula as well as results from an evaluation of 23 school-based sexuality education curricula. School administrators, curriculum specialists, health educators, school nurses, teachers, and parents involved in curriculum adoption or development can use the process described to select or develop a sexuality education curriculum to meet the needs of their school and community.

Norplant: what health educators need to know.

PIP: The US Food and Drug Administration approved the contraceptive implant Norplant in December 1990. Many US physicians and nurse practitioners have received training in inserting the implant, but few health educators know enough about Norplant and potential users to provide adequate education and counseling. The 6-capsule system steadily releases 50-80 mg levonorgestrel into the bloodstream for five years for a contraceptive effectiveness rate greater than 99%. Levonorgestrel keeps the pituitary gland from releasing two hormones needed for ovulation, thickens the cervical mucus, and suppresses endometrial development. Irregular bleeding is the most common side effect. Contraindications for Norplant include liver tumors, active liver disease, breast cancer, active thrombophlebitis, unexplained uterine bleeding, pregnancy, blood clots in the eyes or lungs, diabetes, hypertension, and cigarette smoking. Advantages are its 5-year effectiveness period, that it is easy and convenient to use, does not require compliance, and is reversible. Disadvantages are that it offers no protection against sexually transmitted diseases, especially HIV/AIDS; it requires a surgical procedure; and its cost ($500-$750/patient). Few studies present a profile of US women using Norplant. Potential users are adolescents, vulnerable women, low income women with children, and women who do not want to become pregnant for a long time but do not consider the pill or sterilization viable options. Extensive research indicates that Norplant is safe in the short and intermediate term. More research is needed to identify the demographic profile of a typical user, why she chooses Norplant, how well she understands it, or whether she was well informed about it; to learn about satisfaction with Norplant; and to find out who discontinues Norplant before the end of 5 years. This information would help health educators in their counseling and education strategies.^ieng

The 1993 ASHA membership survey: members speak up.

Professional organizations, to better serve their members, must strive to communicate regularly with the membership at large and to learn about members' needs, interests, and personal and professional status. The membership survey of the American School Health Association was sent to a stratified random sample of 500 members. A 68% response rate was achieved after a presurvey announcement and two follow-up mailings. Collected data was subjected to descriptive analysis and the chi-square test of significance. Survey findings indicated most ASHA members are satisfied with the overall operation and services of the Association. Data revealed satisfaction with overall quality, format, content, and appearance of the Journal of School Health. The ASHA national school health conference, The PULSE, and other ASHA publications also received strong approval. One-half the respondents reported they are required to earn continuing education credit. More than two-thirds of respondents had never attended a national conference. Overall ratings of various ASHA functions were statistically related to age, gender, income level, educational background, and primary discipline.

Sexual coercion experience and help-seeking behavior of college women.

In a study of 656 college women enrolled in elective health education classes at three midwestern universities, results showed that 42% of the women had been victims of sexual coercion in dating situations while in college. Seventy percent of those who had experienced sexual coercion had intercourse when they did not want to as a result of overwhelming arguments and pressure. Only 28% of the sexual coercion victims sought any type of help. Of those who sought help, 75% sought help from a friend. Because the experience of victimization can disrupt various aspects of women's lives, it is important that victims seek help in their attempts to cope successfully after the sexually coercive event. If campus help providers--administrators, educators, residence hall staff, and health center personnel--are more aware of the incidence and dynamics of sexual coercion, they can be more effective in encouraging college student victims to seek the help they need.