Health beliefs and teenage condom use: a prospective study

The authors investigated the extent to which Health Belief Model (HBM) measures can be used to predict subsequent sexual activity and consistency of condom use among teenagers, especially those who report having new sex partners. Results from a longitudinal survey of sex behavior and HIV-relevant cognitions among 258 sexually active 16 and 18 year olds in Dundee, Scotland, are reported. Participants responded to a confidential postal questionnaire on their demographic characteristics, previous sexual experience, prior condom use, beliefs specified by the HBM, peer norms regarding condom use, and condom use intentions. Measures of sexual behavior and condom use consistency were then included in a follow-up questionnaire 1 year later. Demographic and HBM measures, as determined through discriminant analysis, did not account for significant proportions of variance in the consistency of condom use or mediate the effects of prior sexual experience or demographic measures. The respondents who reported more frequent sexual intercourse were less likely to use condoms consistently while those who had used condoms previously reported more consistent use. Female respondents were less likely than the young men to follow through upon their intentions to consistently use condoms.     

Mediators of Posttraumatic Mental Health in Sexual Assault Survivors

The development of posttraumatic growth (PTG) and the relationship between PTG and distress outcomes in sexual assault is an important area of investigation. Recent research suggests that some forms of cognitive processing might be critical in the development, maintenance, and resolution of posttraumatic mental health among sexual assault survivors. The objective of this study was to examine factors associated with posttraumatic mental health among sexual assault survivors. Seventy-three participants who experienced sexual assault completed measures of trauma symptoms, PTG, changes in outlook, cognitive processing, and support and coping. Results revealed that significant levels of posttraumatic symptomatology and low levels of PTG were reported 3 years following sexual assault. A weak relationship was found between symptoms of distress and growth. Contrary to predictions, only ratings of hope and brooding rumination were mediators of the relationship between posttraumatic symptoms and PTG. Reflective rumination was not related to the development of PTG.     

Women's Sexual Health: The Need for Feminist Analyses in Public Health in the Decade of Behavior

Women's sexual health is directly affected by women's low status in society. This low status, and subsequent lack of sexual autonomy, not only increases risk for sexual health problems, it also decreases ability to obtain treatment and support when a sexual health concern arises. This has clearly been demonstrated in the HIV epidemic within the U.S.. Earlier in the epidemic, women were simply ignored by public health research and practice. Once they could no longer be ignored, they were blamed and viewed as vectors. Current seroprevalence rates among men reveal that women are not significant vectors. In contrast, rates among women indicate that infection from men is the primary mechanism by which women are contracting HIV, and male-controlled sexual decision-making, male partner violence against women, and histories of sexual assault all contribute to increased HIV risk for women. Once infected, women are not given the support and resources they need as mothers and caretakers of HIV-positive partners and/or children. These findings are especially true for marginalized women such as women of color, poor women, women addicted to alcohol or drugs, and women who exchange sex for drugs or money. Findings from this review demonstrate the need for feminist approaches in understanding and addressing this issue in the Decade of Behavior. Such approaches must include an understanding of the needs of diverse women. An empowerment approach is needed to better contend with the sexual health needs of women; this must include the goal of ensuring women's control of their own bodies.     

Mental Health, Social Environment and Sexual Risk Behaviors of Adolescent Service Users: A Gender Comparison

We examined individual mental health problems (depression, conduct disorder, and substance abuse) and social environment (family, peer, and neighborhood) factors associated with the sexual risk behaviors of male and female adolescents. Interviews with 778 adolescents, aged 14 to 18, showed that both mental health problems and social environment were related to adolescents' involvement in sexual risk behaviors. Conduct disorder symptoms, substance abuse or dependence symptoms, and the interaction between peer misbehavior and neighborhood problems were significantly associated with risky sexual behaviors. Peer misbehavior was a particularly strong factor related to sexual risk behaviors for youths who lived in neighborhoods with multiple problems. The only gender differences were found in age, with older males more likely to report engaging in high risk sexual behaviors. This study suggests the utility of multidimensional intervention strategies to deal with various adolescent problem behaviors, including risky sexual behaviors, within the context of their social environment.     

An Examination of Disclosure,Mental Health Treatment use,and Posttraumatic Growth Among College Women Who Experienced Sexual Victimization

Few investigations have sought to identify factors associated with posttraumatic growth among survivors of sexual victimization. The present study examined the relationship between posttraumatic growth, disclosure, and mental health treatment use following sexual assault. Undergraduate female psychology students (N = 85), who reported a prior history of sexual victimization, completed measures assessing trauma exposure, posttraumatic growth, disclosure, and mental health treatment use. Results revealed that degree of disclosure of the assault to support sources and mental health treatment use following sexual assault was related to increased posttraumatic growth. Findings have valuable implications for treatment interventions for survivors of sexual trauma.     

Gay Identification and Psychological Health in HIV-Positive and HIV-Negative Gay Men1

This paper reports a study of HIV-positive and HIV-negative gay men focusing on comparisons between the HIV-positive and HIV-negative on gay identification, the interrelationships among gay identification variables, and the psychological correlates of gay identification. We hypothesized that better psychological health would be related to gay self-acceptance, participating in gay organizations and groups, socializing with other gay men, and parental disclosure and acceptance of being gay. The sample was composed of 169 gay men, including 98 asymptomatic HIV-positive and 71 HIV-negative men. The findings are largely consistent with our hypotheses. A strong and consistent relationship of the gay identification measures with psychological variables was observed, explaining up to one fifth of the variance in current level of mood and self-esteem. Among the HIV-positive subjects, participating in gay organizations and groups and having parents who accepted their sexual orientation were important correlates of psychological adaptation. Despite this, 36% of subjects had parents who disapproved of their sexual orientation, and 69% of HIV-positive subjects were not in any gay organizations or groups. Among the HIV-negative subjects, gay self-acceptance and disclosing their sexual orientation to parents were associated with better psychological adjustment. These results suggest that the psychological health and outlook of gay men may be influenced by gay self-acceptance, participation in gay groups, and parental disclosure and acceptance of their children's sexual orientation.     

GPS: A Randomized Controlled Trial of Sexual Health Counseling for Gay and Bisexual Men Living With HIV

Gay, bisexual, and other men who have sex with men (GBM) continue to have high rates of HIV and sexually transmitted infections, including syphilis. GBM have therefore been identified by public health agencies as a high-priority population to reach with prevention initiatives. Despite the importance of mental health in preventing HIV and related infections, there is a shortage of credentialed mental health professionals to deliver behavioral Counseling interventions. The current study evaluated the efficacy of GPS, a community-based and peer-delivered sexual health promotion motivational interviewing–based intervention for HIV-positive GBM who engaged in condomless anal sex (CAS) in the past 2 months. GPS prevention counseling demonstrated a 43% relative reduction at 3-month follow-up in CAS with serodiscordant partners and significant reductions in sexual compulsivity. The study demonstrated that community-based counselors can administer an efficacious motivational interviewing program, and suggests a continued benefit of counseling methods to promote the sexual health of higher risk populations.     

Sexual Minority Stress,Coping, and Physical Health Indicators

Sexual minorities experience higher rates of several physical health problems compared to their heterosexual counterparts. The present study uses Meyer's Minority Stress Model (Psychological Bulletin, 129(5): 674-697, 2003) to examine physical health indicators among 250 adults who identified as sexual minorities. Study hypotheses include that sexual minority stress is predictive of two physical health indicators (i.e., engagement in a health-promoting lifestyle and number of physical health problems) and that planning (i.e., problem-focused) and social support coping will partially mediate the relationship between sexual minority stress and each physical health indicator. Results showed that as level of sexual minority stress increased, engagement in a health-promoting lifestyle decreased and the number of physical health problems increased. Planning and social support coping did not mediate these relationships; however, as levels of coping increased, engagement in a health-promoting lifestyle increased. These findings have implications for researchers and healthcare professionals in their efforts to promote the physical health of sexual minorities.     

The Impact of Depressive Symptoms and Health on Sexual Satisfaction for Older Couples: Implications for Clinicians

This study of 535 older married couples examined the relationship between depression and health and sexual satisfaction directly and when mediated by communication. The sample included 535 older couples who completed a survey questionnaire known as Project Couple Retire. Among the items in the questionnaire were measures of depression, health, perception of sexual intimacy, communication and other demographic information. Results from Structural Equation Modeling indicated that for women, health was a significant predictor of sexual satisfaction. For both genders, the results suggest that depression, when mediated by communication, is a predictor of sexual satisfaction among older couples. Implications for clinicians are discussed.     

Paradox of Parental Involvement in Sexual Health and Induced Abortions Among In-school Female Adolescents in Southwest Nigeria

Prevalent early sexual initiation and unprotected sex involvement with various partners create dilemmas for adolescents and their parents. This article explores parents' involvement in their adolescents’ sexual and reproductive health, particularly with respect to terminating unintended pregnancies. This was done to gain an understanding of the dynamics of parental involvement in resolving anxieties concerning unintended pregnancy and the reasons for seeking induced abortions. The study used a mixed method approach, and 460 female students aged 13–20 years completed the self-administered questionnaire. Thirty-three parents who had an adolescent daughter in school and 31 female adolescents participated in eight different focus group discussion sessions, respectively. A quarter of the respondents had been pregnant at least once. All the females who had ever become pregnant had tried to terminate the pregnancy. Few (9 %) had used contraception at their last sexual intercourse. Twenty nine percent of the respondents had discussed sexual matters with their parents and 82 % preferred discussing such matters with their mothers. In the qualitative findings, some of the parents reported not having been involved in or supportive of terminating their daughter's pregnancy, but confirmed that some mothers had reasons to support induced abortions. Major reasons for mothers' involvement in their daughters' induced abortions were to avoid the social stigma, disruption of schooling and financial stress associated with unintended pregnancy. Resolving conflicting parental interests and values concerning adolescent sexuality and induced abortions is essential for promoting adolescent sexual health in Nigeria.     

青春期性心理健康的初步研究

在文献综述、开放式问卷调查和个别访谈的基础上,提出了青春期性心理健康的理论构想,自编了“青春期性心理健康量表”。约1,600名青少年学生接受了测试。研究表明,该量表具有良好的信度和效度,青春期性心理健康体现在性认知(生理知识、性知识)、性价值观(性观念、性态度)和性适应(社会适应、性控制力、自身适应)等三个方面。     

Sexual Health Counselor Preferences of African American and European American Women: A Brief Report

African American women (n = 42) and European American women (n = 46) were queried regarding their comfort level discussing various sexual health topics with hypothetical counselors who were varied by race (African American vs. European American) or counseling value (culturally sensitive vs. knowledgeable). Contrary to hypotheses, European American participants were more comfortable with the knowledgeable African American counselor and the culturally sensitive European American counselor, while African American women showed no preference. Implications are discussed for improving sexual health counseling services for African American and European American women with consideration of client sexual attitude and race of counselor in order to reduce disparities in sexual health.     

Entertainment Media and Sexual Health: A Content Analysis of Sexual Talk, Behavior, and Risks in a Popular Television Series

Recent landmark content analyses of sexual content on television (e.g., Kunkel, Biely, Eyal, Cope-Farrar, Donnerstein, & Fandrich, 2003) provide a baseline for interpreting depictions of sex on individual programs. The present study was designed to investigate the nature and extent of sexual content on HBO’s popular television series Sex and the City. Compared to television in general, Sex and the City is more likely to depict sexual content (including sexual talk and behavior), intercourse between established partners (rather than between partners who had just met), and sexual risks and responsibilities (including sexual patience, precaution, and risks/negative consequences). Sex and the City does not differ from television in general in terms of pairing alcohol or drugs with sexual intercourse. The results suggest that Sex and the City is more likely than television in general to depict “healthy” sex.     

Abortion and Mental Health

Abstract

Unwanted pregnancy and abortion are common life events, and therapists are likely to work with clients who experience them. Legal abortion currently entails little physical or mental health risk; most women currently cope effectively with these life events without need of clinical intervention. But current abortion politics include efforts to make abortion a more threatening, stressful, and stigmatized experience and to create a “postabortion syndrome.” Using a stress and coping framework, we examine how antiabortion activists spread myths and misinformation aimed at women's appraisal processes, and discuss approaches therapists can use to enhance women's strategies for coping with abortion. We also discuss specific issues and useful techniques for counseling about abortion concerns, including cultural sensitivity and strategies for promoting positive sexual health.     

Condoms,Sex, and Sexually Transmitted Diseases: Exploring Sexual Health Issues Among Asian-Indian College Students

Sexually transmitted infections (STIs) continue to pose a serious risk to college students in the US. According to the Centers for Disease Control, the highest rates of STIs are among college students and adolescents. Specifically regarding Asian-Indian students, more research is needed to thoroughly understand the knowledge, attitudes and sexual behaviors of this population. A comprehensive review of the literature found a paucity of studies involving Asian-Indian involvement in sexual activity. Therefore, the present study was undertaken to fill gaps in the research. The present study examined Asian-Indian college students’ involvement in sexual behaviors, overall STI knowledge, condom use rate, perceived benefits and barriers to condom use, and history of STIs and STI testing. A five page survey was completed by 122 Asian-Indian college students. Results indicated that overall STI knowledge was low. Females, students who perceived fewer barriers to condom use and students who had lived in the US for at least 3 years held significantly higher STI knowledge levels than their counterparts. Such findings could be used by community and university-based health educators to more effectively serve the needs of Asian-Indian students.     

Coerced First Sexual Intercourse Among Women in Ghana: Evidence from the Demographic and Health Survey

Using the 2008 Demographic and Health Survey, and applying logit and log-normal hazard models, this study examined the determinants and timing of coerced first sexual intercourse among women aged 15–49 years in Ghana. Results indicate statistically significant relationships between demographic and sociocultural variables on the likelihood and timing of coerced first sexual intercourse among Ghanaian women. Married women were significantly less likely to report coercion at first sex, but had a faster timing to coerced first sex compared to the never married. Older women were significantly less likely to report coerced first sex, compared to younger women. Similarly, women who had their sexual debut at younger ages were more likely to say they were forced, compared to those who experiencing theirs at older ages. While Ewe and Ga Adangbe women were more likely to report coerced first sex, compared to Akans, traditionalists were less likely to do so, compared to Christians. This study highlights the need for critical appraisal of the cultural interpretation of violence and for future studies to explore the causes of this phenomenon.     

Gender differences in victimized homeless adolescents

Most of what we know about sexual abuse comes from efforts to examine female children victimized by men. Although some researchers have identified similarities between male and female victims of sexual abuse, few studies have examined gender-specific factors associated with sexual health practices among homeless adolescents. The aim of this study was to explore how gender and history of sexual abuse influence cognitive-perceptual and behavioral factors associated with sexual health practices of homeless adolescents. This study was a secondary analysis of data collected for a cross-sectional study of the sexual health practices of homeless adolescents. The sample consisted of 414 youths (104 males who reported sexual abuse and 124 who did not; and 95 females who reported sexual abuse and 75 who did not; 16 did not provide these data). Homeless adolescent females with a history of sexual abuse scored higher (indicating a shorter perspective) on a measure of future time perspective than females with no sexual abuse. Males who reported no sexual abuse scored higher than abused females on perceived health status and higher than abused males on assertive communication. With respect to perceived health status, males who reported no sexual abuse scored significantly higher than females who reported sexual abuse (p = .04). Males with no sexual abuse had significantly higher assertive communication scores than did males who had experienced sexual abuse (p = .015). We found that male and female abuse victims differ in terms of their cognitive-perceptual and behavioral factors associated with sexual health practices. Early identification of those who have been abused is critical so that interventions can be developed. Effective short-term interventions are needed for the adolescent victims of Child Sexual Abuse (CSA), particularly those who are homeless and prone to further sexual victimization.     

Family Violence and Health Among Elderly in Croatia

This article presents the research carried out on a sample of 303 elderly men and women. In the last year they reported experiencing violence in the family as follows: psychological abuse (24.1%), financial exploitation (6.4%), physical abuse (4.4%), and sexual abuse (2.1%). The abusers were most often husbands (30.15%), sons (16.64%), daughters (14.01%), and wives (9.21%). In the partner relationship, 44%?of the women and 35%?of the men had experienced at least some form of violence. The results showed that elderly men and women who were victims of family abuse had poorer psychological health than those without such experiences. Elderly who had experienced partner violence consumed alcohol more often than those who had experienced violence by other household members.     

The Use of Mental Health Services Among Victims of Partner Violence on College Campuses

The present study investigated the relationship between past victimization of different types of intimate partner violence (IPV; physical, psychological, and sexual) and the likelihood of using mental health services. Results indicate 86% of participants reported experiencing some form of IPV, but only 16% of those victims used mental health services to address emotional problems. The participants reported embarrassment, expense, ineffectiveness, and social stigma as the most prominent barriers to seeking help from a mental health professional. The study also found that participants who experienced physical and psychological IPV, but not sexual IPV, reported using mental health services. Sexual IPV may elicit different barriers in help-seeking behaviors. Implications for college IPV prevention programs and mental health services are discussed.     

Religion in Sexual Health: A Staff Perspective

This paper reports data on the complexities of delivering religious/spiritual care in sexual health from a staff perspective. A learning needs analysis, in survey format, was conducted with the nursing staff of a leading London, sexual health clinic. Recruitment took place in May 2011 over a period of 2 weeks. The sample consisted of 25 members of staff which included service support workers and registered nurses. The 25 question survey was conducted and reviewed using Survey Monkey?. The survey was divided into three sections, being population demographics, clinical experience and understanding and education. This article will explore the second section of being clinical experience and understanding. This section used six open-ended questions to investigate participant’s experience of common clinical episodes where religion was an influential part of the patient experience and decision-making. A range of contemporary sexual health and religious issues were extrapolated from the survey findings ranging from homosexuality to termination of pregnancy. Four main areas of complexity identified from participants responses were sexual dysfunction, treatment issues, sexual health knowledge and high-risk behaviour. Findings from the study highlight the diversity of influence of religion has on the sexual health of patients.