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1.
Tidsskr Nor Laegeforen ; 141(9)2021 06 08.
Artigo em Norueguês | MEDLINE | ID: mdl-34107653

RESUMO

BACKGROUND: Karl Evang's (1902-1981) efforts with regard to sex education in Norway are well documented, in particular his work in the interwar period, as an initiator and co-editor of Populært Tidsskrift for Seksuell Oplysning (Popular Journal for Sex Education) (1932-1935). This article takes Evang's work in the 1930s as its starting point, but emphasises his role in promoting sex education in schools after the war. MATERIAL AND METHOD: The main sources for the article are Evang's popular science texts on sex education as well as archive material that shows Evang's role in school policy. Searches have also been conducted in newspaper databases and in the journal. The text builds on research on Populært Tidsskrift and on the teaching of sex education in Norwegian schools undertaken by the author of this article. RESULTS AND INTERPRETATION: Karl Evang worked to promote sex education in Norway. His professional and ideological efforts in this regard in the interwar period are well documented, but he was also committed to this cause as Norway's director general of health in the post-war years. Evang regarded the teaching in schools as a particularly important tool for health-promoting knowledge about sexuality in the population, and he helped to place sex education in schools on the agenda after the war. Through his professional and political networks, he was perhaps the most important driver of sex education in Norway, in the decades before as well as after the war.


Assuntos
Educação Sexual , Comportamento Sexual , Humanos , Masculino , Noruega , Instituições Acadêmicas
2.
Reprod Health ; 18(1): 102, 2021 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-34022885

RESUMO

BACKGROUND: In settings where HIV prevalence is high, management of sexual and reproductive health is critical to reducing HIV transmission and maternal mortality. Integration of family planning with HIV services is appropriate for HIV therapy, HIV prevention, and care in a resource-limited country s like Ethiopia. The study aimed at examining the status of integration of family planning services with HIV treatment and factors associated with successful integration of family planning and HIV services for women of reproductive age in Oromia, Ethiopia for better health outcomes. METHODS: The research design of this study was a quantitative survey, non-experimental, explorative and descriptive. A questionnaire was used to collect data from women living with HIV attending ART clinics in the special zone of surrounding Finfinne, Oromia Region in five health centers. Simple random sampling was used to select 654 respondents. Data was analysed through the use of Statistical Package for Social Sciences version 23.0. Bivariate and multivariate logistic regressions were performed to identify factors associated integration of family planning with HIV services with the significant association at an adjusted odds ratio (AOR) with a 95% confidence interval (CI) to controlled effects of possible confounders from the final model. RESULT: The response rate of this study was 97.6% (654/670). The ages of those who responded to the administered questionnaires ranged between 18 and 49 years. The mean age of the respondents was 31.86 years with an SD of ± 6.0 years. Most of the respondents in the sample were in the age group 26-35 (n = 374, 57%), and only 96 (14.7%) were in the age group 18-25. This overall integration of FP-HIV services among reproductive-age women living with HIV in Oromia regional state of special zone health centers was found to be 55.8%. Almost all respondents (n = 635, 97.1%) preferred integrated family planning and HIV services from the same facility and the same providers. the study found that 622 (95%) were most satisfied with the utilization of integrated family planning/HIV services. CONCLUSION: This study established that in overall, the integration of family planning/HIV services was relatively moderate among women of reproductive age living HIV. The identified factors that affected the integration of family planning with HIV services were the level of education, occupational status, residence, discussion of family planning with healthcare providers, fertility desire and CD4 counts.


Assuntos
Prestação Integrada de Cuidados de Saúde/organização & administração , Serviços de Planejamento Familiar/estatística & dados numéricos , Infecções por HIV/tratamento farmacológico , Adulto , Estudos Transversais , Etiópia/epidemiologia , Serviços de Planejamento Familiar/provisão & distribuição , Feminino , Infecções por HIV/epidemiologia , Humanos , Educação Sexual , Adulto Jovem
3.
BMC Public Health ; 21(1): 839, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33933064

RESUMO

BACKGROUND: Young Thai women are growing up amidst conflicting influences of globalization and traditional Thai culture. They experience confusion about which aspects of their sexuality they can express and must hide. This study examined forms of sexual control and sexual negotiation among young Thai women in secondary and vocational schools. METHODS: Semi-structured interviews and focus group discussions were conducted among 13-to 18-year-old female students attending secondary and vocational schools in six regions of Thailand. Additional semi-structured interviews were conducted with instructors of sex education, school administrators, and parents of students. NVIVO 10 was used to manage, code and assist with data analysis. RESULTS: Socio-cultural control on young women's sexualities was found from members of their families, schools, communities, and other students. Young women expressing their sexualities openly through verbal expressions, clothing, and behaviors were deemed negatively and stigmatized as dekkaedaet or "kids pretending to be grownups" as it is believed that they are too young and too immature to be responsible for their own decisions on their bodies and sexuality. This dominant discourse subsequently stigmatize and embarrass sexually active women. However, some young women try to negotiate and create options, by utilizing strategies that ensure secrecy. CONCLUSION: Comprehensive sexuality education is needed and should be based on the respect for human dignity and sexual and reproductive rights.


Assuntos
Negociação , Comportamento Sexual , Adolescente , Feminino , Humanos , Educação Sexual , Estudantes , Tailândia
4.
Pan Afr Med J ; 38: 121, 2021.
Artigo em Francês | MEDLINE | ID: mdl-33912291

RESUMO

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.


Assuntos
Anticoncepção/psicologia , Anticoncepcionais/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Professores Escolares/estatística & dados numéricos , Adolescente , República Democrática do Congo , Serviços de Planejamento Familiar , Feminino , Grupos Focais , Humanos , Entrevistas como Assunto , Masculino , Gravidez , Gravidez na Adolescência/prevenção & controle , Educação Sexual/métodos , Adulto Jovem
5.
BMJ Open ; 11(4): e044060, 2021 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-33837100

RESUMO

OBJECTIVE: This study was aimed to assess the magnitude and associated factors of unmet need for family planning among rural women in Ethiopia. DESIGN: Cross-sectional study. SETTING: Ethiopia. PARTICIPANTS: Reproductive age group women. PRIMARY OUTCOME: Unmet need for family planning. METHODS: This study drew data from Ethiopian Demographic and Health Survey, which was conducted from 18 January to 27 June 2016. A total of 8327 rural reproductive-aged (15-49 years) women were included. A two-level multivariable logistic regression model was carried out to identify individual and community-level factors associated with unmet need for family planning. Adjusted OR (AOR) with a 95% CI was used to assess the strength of association between independent and dependent variables. RESULTS: The overall unmet need for family planning among rural women was 24.08% (95% CI 23.17 to 25.01), of which 14.79% was for spacing and 9.29% for limiting. Number of children (AOR=1.15; 95% CI 1.07 to 1.24) and working status of women (AOR=1.18; 95% CI 1.02 to 1.37) were significantly associated with a higher odds of unmet need for family planning. However, women with primary education (AOR=0.87; 95% CI 0.74 to 0.94), women married at age 18 or later (AOR=0.82; 95% CI 0.70 to 0.96), women from households with high wealth index (AOR=0.77; 95% CI 0.64 to 0.94), women who deem distance to a health facility as not a big problem (AOR=0.85; 95% CI 0.73 to 0.99), women from communities with a high percentage of educated women (AOR=0.73; 95% CI 0.59 to 0.89) and women who live in communities with high media exposure (AOR=0.81, 95% CI 0.68 to 0.98) were significantly associated with a lower odds of unmet needs for family planning. CONCLUSION: Unmet need for family planning among reproductive-aged women in rural Ethiopia was high. Number of children, working status of women, women's education, age at first marriage, household wealth, distance to a health facility, community women's education and community media exposure were significantly associated with unmet needs for family planning. Therefore, to reduce unmet need for family planning, public health policymakers should consider both individual and community-level factors when designing FP programmes and emphasis should be given to high-risk populations.


Assuntos
Comportamento Contraceptivo , Serviços de Planejamento Familiar , Adolescente , Adulto , Criança , Estudos Transversais , Etiópia , Feminino , Humanos , Análise Multinível , Educação Sexual
6.
BMC Pregnancy Childbirth ; 21(1): 334, 2021 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-33902468

RESUMO

BACKGROUND: Some women avoid sexual intercourse during pregnancy due to the physiological changes they undergo during this period as well as their fear of causing harm to the fetus and to themselves, which can lead to problems in sexual health. The aim of the present study was to investigate the effects of a sexual health education package on the dimensions of sexual health in pregnant women. METHODS: This randomized, longitudinal, clinical trial was carried out in 2018-2019 on 154 pregnant women in early to late pregnancy who presented to comprehensive health centers in Rasht, Iran, and were divided into three groups: Group A or the training group (50 participants), Group B or the self-training group (53 participants), and Group C or the control group (51 participants). The study tools included the Pregnancy Sexual Response Inventory (PSRI), the Sexual Quality of Life-Female (SQOL-F) and the Sexual Violence Questionnaire. The dimensions of sexual health were examined before beginning each intervention in each trimester of pregnancy and then at the end of pregnancy using these questionnaires. The collected data were analyzed using statistical tests, namely the Chi-square test, one-way ANOVA, Cochrane's test, and the repeated measures ANOVA at a significance level of P < 0.05. RESULTS: There was no statistically significant difference in the mean total scores of SQOL-F and PSRI in the three groups at baseline. As for the intergroup results, there was a statistically significant difference in the mean score of SQOL-F and PSRI at the end of pregnancy. The mean scores of PSRI and SQOL-F in the training group (Group A) increased from the beginning to the end of pregnancy compared to the control and self-training groups. As for the intergroup comparisons, there was no statistically significant difference in the mean total scores of sexual violence among the pregnant women in the different groups in the third trimester of pregnancy and at the end of the third trimester. Although sexual violence was not statistically significant, the number of sexually-violated women in the training group decreased during the training period compared to the self-training and control groups. CONCLUSION: The results obtained in the intervention group compared to the control group revealed the effectiveness of the sexual health education package in terms of improvement in the dimensions of sexual health. According to the results, in order to maintain and promote the sexual health of pregnant women, health care providers are recommended to offer sexual health training during pregnancy along with other health care services. TRIAL REGISTRATION: IRCT20190427043398N1 ; the trial was registered on June 2, 2019. (retrospective registration).


Assuntos
Educação em Saúde , Gestantes , Qualidade de Vida , Educação Sexual , Delitos Sexuais/prevenção & controle , Comportamento Sexual , Adulto , Feminino , Educação em Saúde/métodos , Educação em Saúde/normas , Humanos , Irã (Geográfico) , Determinação de Necessidades de Cuidados de Saúde , Gravidez , Gestantes/educação , Gestantes/psicologia , Educação Sexual/métodos , Educação Sexual/normas , Delitos Sexuais/psicologia , Comportamento Sexual/fisiologia , Comportamento Sexual/psicologia , Ensino
7.
Artigo em Inglês | MEDLINE | ID: mdl-33806507

RESUMO

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.


Assuntos
COVID-19 , Educação Sexual , Adolescente , Feminino , Humanos , Aprendizagem , Pandemias , Gravidez , SARS-CoV-2
8.
Soc Sci Med ; 276: 113817, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33743208

RESUMO

The 21st century has seen the proliferation of technologies and sources of information on issues of all kinds, including sexuality. Amid debates about the role of social media and the internet in mediating sexuality, questions about credible, reliable and objective sources of information have also arisen, particularly in relation to young people's knowledge-seeking. Drawing on theorisations of sexual citizenship, Foucault's notion of the 'episteme', and the work of science and technology studies scholar John Law, this article examines a 'collateral reality' produced by contemporary demands on young people to source, assess and act on sexual health information. Using interviews with 37 young people living in Australia, the analysis identifies a range of approaches to sexual health-seeking practices, key dynamics in the construction of reliability and fact, and the extent and nature of the accommodations young people report making to navigate incomplete and unreliable information. With the contemporary self increasingly framed through the ability to discern truth from falsehood, reality from fake news, these demands and choices have significant implications for qualification as the proper modern citizen. Accommodating information weaknesses and gaps in sexual health information, we argue, produces what we call contemporary 'epistemic citizens'; young people explicitly aware of the limits of official knowledges about sex and sexualities, and of the expectation that individual citizens must either content themselves with officially constituted sexual selves or else seek and enact marginal or unofficial alternatives using sources generally denigrated as unreliable. As we will conclude, current forms of sexual health information and related calls for youth literacy operate as a mechanism for generating a specific modern form of epistemic citizenship. Future sexuality education might consider ways to support even more literate, sophisticated epistemic citizens relieved of the responsibility to piece the truth together on their own, and who in turn feel more included.


Assuntos
Saúde Sexual , Adolescente , Austrália , Humanos , Reprodutibilidade dos Testes , Educação Sexual , Comportamento Sexual
9.
Nursing (Säo Paulo) ; 24(274): 5357-5366, mar.2021.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1222811

RESUMO

Objetivo: identificar a expectativa dos adolescentes sobre educação sexual; caracterizar o perfil socioeconômico e cultural dos adolescentes de uma escola da rede privada do município de São Gonçalo/RJ. Metodologia: trata-se de estudo descritivo, exploratório de natureza qualitativa, estudo de caso com coleta de dados, realizada entrevista individual a fim de obter dados socioeconômicos e culturais dos entrevistados; técnica de grupo focal que utilizou roteiro orientado por algumas perguntas norteadoras para apreensão das concepções sobre as expectativas da educação sexual. O estudo foi aprovado pelo Comitê de Ética do Hospital Universitário Antônio Pedro, sob o CAAE: 0265.0.258.000-10. Resultados: emergiram duas categorias: Papo sério: conversando com adolescentes sobre educação sexual no âmbito escolar e sociedade reafirmando tabus na questão da sexualidade. Conclusão: os adolescentes entendem que a escola e a família devem trabalhar em conjunto desempenhando papel importante na educação para sexualidade ligada à vida, à saúde, ao prazer e ao bem-estar.(AU)


Objective: to identify adolescents' expectations about sex education; characterize the socioeconomic and cultural profile of adolescents from a private school in the city of São Gonçalo / RJ. Methodology: this is a descriptive, exploratory study of a qualitative nature, a case study with data collection, an individual interview was conducted in order to obtain socioeconomic and cultural data from the interviewees; focus group technique that used a script guided by some guiding questions to apprehend the conceptions about the expectations of sex education. The study was approved by the Ethics Committee of Hospital Universitário Antônio Pedro, under CAAE: 0265.0.258.000-10. Results: two categories emerged: Serious conversation: talking to teenagers about sex education in the school and society reaffirming taboos on the issue of sexuality. Conclusion: the adolescents understand that the school and the family must work together playing an important role in education for sexuality linked to life, health, pleasure and well-being.(AU)


Objetivo: identificar las expectativas de los adolescentes sobre la educación sexual; caracterizar el perfil socioeconómico y cultural de los adolescentes de una escuela privada en la ciudad de São Gonçalo / RJ. Metodología: este es un estudio descriptivo, exploratorio de naturaleza cualitativa, un estudio de caso con recolección de datos, se realizó una entrevista individual para obtener datos socioeconómicos y culturales de los entrevistados; técnica de grupo focal que utilizaba un guión guiado por algunas preguntas orientadoras para comprender las concepciones sobre las expectativas de la educación sexual. El estudio fue aprobado por el Comité de Ética del Hospital Universitario Antônio Pedro, bajo el CAAE: 0265.0.258.000-10. Resultados: surgieron dos categorías: conversación seria: hablar con los adolescentes sobre la educación sexual en la escuela y la sociedad, reafirmando tabúes sobre el tema de la sexualidad. Conclusión: los adolescentes entienden que la escuela y la familia deben trabajar juntas, desempeñando un papel importante en la educación para la sexualidad vinculada a la vida, la salud, el placer y el bienestar.(AU)


Assuntos
Humanos , Adolescente , Educação Sexual , Sexualidade , Saúde do Adolescente , Fatores Socioeconômicos
10.
Artigo em Inglês | MEDLINE | ID: mdl-33672240

RESUMO

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.


Assuntos
Literatura Erótica , Violência por Parceiro Íntimo , Adolescente , Feminino , Humanos , Masculino , Educação Sexual , Sexismo , Comportamento Sexual , Parceiros Sexuais
11.
Artigo em Inglês | MEDLINE | ID: mdl-33672323

RESUMO

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.


Assuntos
Diversidade Cultural , Minorias Sexuais e de Gênero , Adolescente , Identidade de Gênero , Humanos , Educação Sexual , Violência/prevenção & controle
12.
Artigo em Inglês | MEDLINE | ID: mdl-33557441

RESUMO

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.


Assuntos
Instituições Acadêmicas , Educação Sexual , Adolescente , Criança , Estudos Transversais , Humanos , Paquistão , Sexualidade
13.
Reprod Health ; 18(1): 26, 2021 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-33618726

RESUMO

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.


Assuntos
Atitude Frente a Saúde , Percepção , Saúde Reprodutiva/educação , Educação Sexual , Saúde Sexual/educação , Adolescente , Comportamento do Adolescente/fisiologia , Comportamento do Adolescente/psicologia , Criança , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Entrevistas como Assunto , Irã (Geográfico) , Masculino , Motivação/fisiologia , Pesquisa Qualitativa , Serviços de Saúde Escolar , Educação Sexual/métodos , Comportamento Sexual/psicologia , Participação dos Interessados , Adulto Jovem
14.
Reprod Health ; 18(1): 48, 2021 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-33622358

RESUMO

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.


Assuntos
Comportamento Contraceptivo , Casamento , Relações Pais-Filho , Percepção , Psicologia do Adolescente , Adolescente , Comportamento do Adolescente/fisiologia , Adulto , Anticoncepção/métodos , Anticoncepção/psicologia , Anticoncepção/estatística & dados numéricos , Comportamento Contraceptivo/psicologia , Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepcionais/uso terapêutico , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Quênia/epidemiologia , Casamento/psicologia , Casamento/estatística & dados numéricos , Relações Pais-Filho/etnologia , Gravidez , Gravidez na Adolescência/prevenção & controle , Gravidez na Adolescência/psicologia , Gravidez na Adolescência/estatística & dados numéricos , Pesquisa Qualitativa , Educação Sexual/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Adulto Jovem
15.
Reprod Health ; 18(1): 19, 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33482843

RESUMO

BACKGROUND: While the Kenya government is mobilizing high-level strategies to end adolescent pregnancy by 2030, a clear understanding of drivers of early unintended pregnancy in the country is a necessary precursor. In this study, we determine the prevalence, associated factors, and reasons for unintended pregnancy among sexually active adolescent girls (aged 15-19 in two Kenya counties with the highest rate of teenage pregnancy. METHODS: We used the "In Their Hands" (ITH) program's baseline evaluation data. The study adopted a mixed-methods design with 1110 sexually active adolescent girls in the quantitative component and 19 girls who were either pregnant or nursing a child in the qualitative. We used adjusted and unadjusted logistic regression to model factors associated with unintended pregnancy among respondents. We used a thematic analysis of qualitative data to examine girls' reasons for having unintended pregnancy. RESULTS: Overall, 42% of respondents have had an unintended pregnancy; however, higher proportions were observed among girls who were 19 years (49.4%), double orphans (53.6%), never used contraceptive (49.9%), out-of-school (53.8%), and married (55.6%). After adjusting for relevant covariates, the odds of unintended pregnancy were higher among girls who resided in rural areas (AOR 1.64, 95% CI 1.22-2.20), had primary or no formal education (AOR 1.50 95% CI 1.11-2.02), and had never used contraceptive (AOR 1.69 95% CI 1.25-2.29) compared with their counterparts. Current school attendance was associated with a 66% reduction in the probability of having an unintended pregnancy. Participants of the qualitative study stated that the desire to maintain a relationship, poor contraceptive knowledge, misinformation about contraceptive side effects, and lack of trusted mentors were the main reasons for their unintended pregnancies. CONCLUSION: A massive burden of unintended pregnancy exists among sexually active adolescent girls in the study setting. Adolescent boys and girls need better access to sexuality education and contraceptives in the study setting to reduce early unintended pregnancy.


Assuntos
Comportamento Contraceptivo , Conhecimentos, Atitudes e Prática em Saúde , Gravidez na Adolescência/estatística & dados numéricos , Gravidez não Planejada , Adolescente , Adulto , Feminino , Humanos , Quênia/epidemiologia , Masculino , Gravidez , Prevalência , Educação Sexual , Comportamento Sexual , Adulto Jovem
16.
BMC Public Health ; 21(1): 197, 2021 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-33482802

RESUMO

BACKGROUND: Hong Kong lacks comprehensive school-based sexuality education. Recent public health concerns have brought the inadequacies of sex education in Hong Kong to the forefront. The aim of the proposed study is to develop and evaluate the effectiveness of a comprehensive school-based sexuality education program in Hong Kong. METHODS: The proposed study is a prospective longitudinal study implemented in six secondary schools in Hong Kong over two academic years. The study adopts an ecological approach providing informational workshops for students, teachers and school management, social workers and guidance counsellors and parents. Study outcomes will be evaluated through pre- and post-tests. RESULTS: Key outcomes of interest among students include sexual health knowledge, awareness of values motivating healthy sexual decisions, understanding and efficacy of sexual communication and intention to use contraception. Among school employees and parents key outcomes include self-efficacy to engage in sexual health discussions with students/children, sexual health knowledge and awareness of Hong Kong community sexual health resources. CONCLUSIONS: The proposed study will result in the development of a tested school-based culturally relevant comprehensive sexual health education program. Ultimately, this program aims to not only empower adolescents and their trusted adults in building a supportive environment for sexual health promotion but also construct a learning network to generate longitudinal evidence for the effectiveness of comprehensive sexuality education in improving sexual health outcomes. The program has the potential for expansion through widespread adoption in Hong Kong schools to benefit more adolescents and reduce the medical and societal burdens related to crisis pregnancy, sexually transmitted infections and sexual abuse.


Assuntos
Educação Sexual , Comportamento Sexual , Adolescente , Adulto , Criança , Feminino , Hong Kong , Humanos , Estudos Longitudinais , Avaliação de Resultados em Cuidados de Saúde , Gravidez , Estudos Prospectivos , Sexualidade
17.
AIDS Behav ; 25(6): 1901-1912, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33483899

RESUMO

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.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Profilaxia Pré-Exposição , Instituições de Assistência Ambulatorial , Fármacos Anti-HIV/uso terapêutico , Serviços de Planejamento Familiar , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/prevenção & controle , Humanos , Educação Sexual , Estados Unidos
18.
Arch Sex Behav ; 50(2): 629-646, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33398696

RESUMO

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.


Assuntos
Literatura Erótica/psicologia , Comportamento Exploratório , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Adolescente , Meios de Comunicação , Estudos Transversais , Feminino , Heterossexualidade/psicologia , Humanos , Masculino , Prevalência , Educação Sexual/métodos , Comportamento Sexual/estatística & dados numéricos , Estados Unidos , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: mdl-33435342

RESUMO

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.


Assuntos
Educação Sexual , Comportamento Sexual , Adolescente , Atitude , Criança , Feminino , Educação em Saúde , Humanos , Masculino , Eslováquia
20.
PLoS One ; 16(1): e0243854, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33439888

RESUMO

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.


Assuntos
Comportamento Contraceptivo , Serviços de Planejamento Familiar , Educação Sexual/estatística & dados numéricos , Adolescente , Adulto , Anticoncepção , Comportamento Contraceptivo/psicologia , Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepcionais , Serviços de Planejamento Familiar/métodos , Serviços de Planejamento Familiar/organização & administração , Serviços de Planejamento Familiar/tendências , Feminino , Humanos , Índia , Intenção , Masculino , Pessoa de Meia-Idade , População Rural , Comportamento Sexual , Adulto Jovem
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