Development and Refinement of a Targeted Sexual Risk Reduction Intervention for Women With a History of Childhood Sexual Abuse

Childhood sexual abuse (CSA) is associated with sexual risk behavior in adulthood. Traditional sexual risk reduction interventions do not meet the unique needs of women who have been sexually abused. In the current paper, we describe the four-stage process we followed to develop and refine a targeted sexual risk reduction intervention for this population. First, initial quantitative work revealed that the intervention should address how maladaptive thoughts related to traumatic sexualization, trust, powerlessness, and guilt/shame (traumagenic dynamics constructs) influence current sexual behavior. Second, qualitative interviews with 10 women who reported a history of CSA (M age = 34 years; 90% African American) as well as current sexual risk behavior provided support for targeting maladaptive thoughts associated with these traumagenic dynamics constructs. Third, based on the qualitative and quantitative results, we developed a 5-session, group-delivered intervention to address the maladaptive thoughts that occurred as a result of CSA, as well as the cognitive-behavioral determinants of sexual risk behavior. This intervention drew heavily on cognitive behavioral techniques to address cognitions associated with CSA and the links between these cognitions and current sexual risk behavior. Techniques from trauma-based therapies, as well as motivational techniques, were also incorporated into the intervention. Finally, we refined the intervention with 24 women (M age = 33 years; 79% African American), and assessed feasibility and acceptability. These women reported high levels of satisfaction with the intervention. The resultant intervention is currently being evaluated in a small, randomized controlled trial.     

性传播疾病过度医疗的思考

在性传播疾病 (Sexually Transmitted Disease,STD)的诊治过程中,过度医疗的现象司空见惯,现状堪忧,原因是多方面的:STD患者是一个特殊群体,缺乏科学的就医观;医疗机构利益驱动;媒体缺乏正确的宣传等。这必将导致增加患者的身心负担,破坏医患关系,浪费医疗卫生资源。只有重视这一特殊群体,加强监管,取缔非法诊所,避免利益驱动,更新观念,坚持个体化综合治疗才能使STD的诊治走上健康发展的道路。     

盆腔炎性疾病与不孕不育

腔炎性疾病（pelvic inflammatory disease,PID）是常见的妇科疾病,且迁延难愈。同时,盆腔炎（PID）发病率增高与性传播疾病（STD）发病人数增多相平行。这些可以引起一系列临床症状,统称为盆腔炎性疾病后遗症（sequelae of PID）。除了长期慢性疼痛、月经不调、盆腔炎性疾病反复发作外,严重的还会影响女性的生育功能,导致不孕症或异位妊娠。此外,盆腔炎对于IVF—ET的成功率也存在一定的影响。     

Impact of Abuse History on Adolescent African American Women's Current HIV/STD-Associated Behaviors and Psychosocial Mediators of HIV/STD Risk

This study examined if relationship power, sex refusal self-efficacy, or fear of condom negotiation mediated the relationship between abuse history and consistent condom use (CCU) among African American female adolescents (N?=?593). Participants with an abuse history (58%) were less likely to report CCU. Women with an abuse history reported less relationship power and self-efficacy for refusing sex and more fear of condom negotiation, none of which independently or jointly mediated the association between abuse and CCU. Notably, history of abuse was associated with CCU across mediator models despite inclusion of psychosocial mediators. This study demonstrates the importance of understanding adolescents' condom use behaviors within the context of their life experiences, especially past abuse history.     

Double Depression in Men: Does It Exist?

Differences between male veterans diagnosed with major depression alone and male veterans diagnosed with both major depression and dysthymia (double depression) were investigated. Assessment instruments included the Structured Clinical Interview for DSM-III-R, the Beck Depression Inventory (BDI), and the Symptom Checklist-90-R (SCL-90-R). Consistent with prior literature, it was hypothesized that male veterans diagnosed with both major depression and dysthymia display more severe depressive symptomatology and other forms of psychopathology than male veterans diagnosed with major depression alone. Results did not corroborate these hypotheses. Patients with double depression (n = 17) yielded BDI and SCL-90-R scores which did not differ significantly from those of patients with major depression alone (n = 14). Our results call into question the existence of double depression among men, a disorder whose existence has been demonstrated primarily among women.     

‘Sluts’ or ‘Sleazy Little Animals’?: Young People's Difficulties with Carrying and Using Condoms

Qualitative data from a Western Australian study of sexual behaviour in young people were used to describe difficulties experienced in carrying and using condoms. Both men and women were concerned for their sexual reputation if they carried condoms, although this was more of a problem for the women than the men. However, these fears were not matched by the attitudes of the opposite gender: in general, there was less negativity about condom-carrying than was feared. Many of those who described using condoms had experienced condom failure and other difficulties, and it appeared that they were unfamiliar with the correct way to use condoms. It is suggested that many of these barriers to condom use can be removed with appropriate education and information strategies.     

盆腔炎性疾病的预防

盆腔炎性疾病（pelvic inflammatory disease,PID）是影响妇女健康的常见病,针对其发病的诱因,预防PID可以从以下几个方面进行：（1）加强性教育,减少性传播疾病;（2）积极做好妇女的卫生保健指导工作;（3）重视筛查、早期诊断及一次性根治下生殖道感染;（4）提高医务人员的理论水平和技术,避免医源性感染;（5）持续正确选择避孕措施;（6）避免阴道冲洗。此外,长期放置宫内节育器不会增加PID的风险;口服避孕药对PID无明显预防作用,而仅仅与减轻其严重症状有关。