Double-standards in reporting of risk and responsibility for sexual health: a qualitative content analysis of negatively toned UK newsprint articles

Background: The need to challenge messages that reinforce harmful negative discourses around sexual risk and responsibility is a priority in improving sexual health. The mass media are an important source of information regularly alerting, updating and influencing public opinions and the way in which sexual health issues are framed may play a crucial role in shaping expectations of who is responsible for sexual health risks and healthy sexual practices. Methods: We conducted an in-depth, qualitative analysis of 85 negatively toned newspaper articles reporting on sexual health topics to examine how risk and responsibility have been framed within these in relation to gender. Articles published in 2010 in seven UK and three Scottish national newspapers were included. A latent content analysis approach was taken, focusing on interpreting the underlying meaning of text. Results: A key theme in the articles was men being framed as a risk to women's sexual health, whilst it was part of a women's role to "resist" men's advances. Such discourses tended to portray a power imbalance in sexual relationships between women and men. A number of articles argued that it was women who needed to take more responsibility for sexual health. Articles repeatedly suggested that women and teenage girls in particular, lacked the skills and confidence to negotiate safer sex and sex education programmes were often presented as having failed. Men were frequently portrayed as being more promiscuous and engaging in more risky sexual health behaviours than women, yet just one article drew attention to the lack of focus on male responsibility for sexual health. Gay men were used as a bench mark against which rates were measured and framed as being a risk and at risk Conclusions: The framing of men as a risk to women, whilst women are presented at the same time as responsible for patrolling sexual encounters, organising contraception and preventing sexual ill health reinforces gender stereotypes and undermines efforts to promote a collective responsibility for sexual health. This has implications for sexual ill health prevention and could continue to reinforce a negative culture around sex, relationships and sexual health in the UK

Barriers to sexual health services for young people in Nepal

Although sexual and reproductive health education and services are provided to young people, current rates of HIV infection and pregnancy are increasing in Nepal, indicating that young people do not always use sexual health services. Health facilities have apparently failed to provide young people with specialized sexual health education and services. This study explored the barriers to using sexual health services, including condom-use among young people in Nepal. Participants from 10 focus groups and 31 in-depth interviews, carried out by a same-sex researcher, reported many socioeconomic, cultural and physical norms that impose barriers to accessing information on sexual health and relevant services. It is concluded that the establishment of youth-friendly service centres in convenient places might help encourage young people to use sexual health services

Mental health of victims of sexual violence in eastern Congo: associations with daily stressors, stigma, and labeling

Background: The conflict-ridden context of eastern Congo has set the scene for grueling human rights violations, with sexual violence as one of the 'weapons of war'. Currently, sexual violence continues, with a considerable increase in civilian perpetrators. However, little is known regarding the particular impact of different experiences of sexual violence on adolescents' mental health. This study therefore investigates the impact of sexual violence on eastern Congolese adolescents' mental health and its differing associations with daily stressors, stigma, and the labeling of sexual violence (as 'rape' or 'non-consensual sexual experience'). Methods: A cross-sectional, population-based survey design was implemented in 22 secondary schools, randomly selected from a stratified sample, in Bunia, eastern Congo, a region extensively affected by war. A total of 1,305 school-going adolescent girls aged 11 to 23 participated. Self-report measures of mental health symptoms, war-related traumatic events, experiences of sexual violence, daily stressors, and stigmatization were administered. Differences in sociodemographic characteristics, traumatic experiences and daily and social stressors between types of sexual violence (rape, non-consensual sexual violence, no sexual violence) were explored through statistical analysis. ANCOVA analyses investigated associations between those risk factors and adolescents' mental health. Results: More than one third of eastern Congolese adolescent girls reported experiences of sexual violence. Elevated levels of daily stressors, experiences of stigmatization, and stressful war-related events were found amongst girl victims of sexual violence, with the highest levels for girls who labeled the sexual violence as rape. Daily stressors, stigmatization, and war-related events showed a large impact on the girls' mental health. Last, girls who labeled the sexual violence as non-consensual sexual experiences reported more post-traumatic hyper-arousal and intrusion symptoms compared to those labeling the sexual violence as rape. Conclusions: These findings point to the important association between how war-affected adolescent girls label sexual violence (rape or non-consensual sexual experiences) and their mental health. This study also documents the large impact of sexual violence on other stressors (daily stressors, stigmatization, and stressful war events) and the impact of these stressors on girl victims' mental health. It discusses important implications for addressing sexual violence and its consequences in war-affected contexts

An exploratory study of the sexual health knowledge and attitudes of Asian male student sojourners in New Zealand

This study looked into the sexual and general health attitudes of Asian male student sojourners in New Zealand. The following issues on sexual and general health were probed: level of awareness, views and perceptions, levels of knowledge, main sources of information, and cultural factors in seeking health information. An Internet-mediated survey was employed to gather data on this sensitive topic. Sixty-six participants from Waikato, Massey, Canterbury, and Otago Universities answered the questionnaire. In addition, key-informant interviews with health providers were conducted to provide additional data. Data from the survey indicated a high level of health awareness concerning both general and sexual health maintenance, but there was cultural reluctance to discuss health issues, especially sexual health. General and sexual health matters were regarded as highly personal and sensitive, which they discussed with close associates. Findings from the study suggest the need for culturally appropriate approaches to improve Asian male students' access to health services

Lesbian and bisexual women's human rights, sexual rights and sexual citizenship: negotiating sexual health in England.

Lesbian and bisexual women's sexual health is neglected in much Government policy and practice in England and Wales. This paper examines lesbian and bisexual women's negotiation of sexual health, drawing on findings from a small research project. Themes explored include invisibility and lack of information, influences on decision-making and sexual activities and experiences of services and barriers to sexual healthcare. Key issues of importance in this respect are homophobic and heterosexist social contexts. Drawing on understandings of lesbian, gay and bisexual human rights, sexual rights and sexual citizenship, it is argued that these are useful lenses through which to examine and address lesbian and bisexual women's sexual health and related inequalities

ABC of adolescence: sexual health, contraception, and teenage pregnancy

Sexual health becomes a new health priority in early adolescence. The sexual health of young people is a matter of intense public concern. The adverse consequences of unsafe sexual behaviour-such as pregnancy and sexually transmitted infections (STIs), including HIV infection-affect adolescents as well as adults. "Risk taking" behaviours are common when adolescents start being sexually intimate and are often linked with other health risk behaviours, such as substance misuse

Are older people at risk of sexually transmitted infections? A new look at the evidence

Two policy documents were published by the UK Department of Health in 2001 which established the service development agendas for their respective areas over the coming years. The National Service Framework (NSF) for Older People sets out national standards for ‘better, fairer and more integrated health and social care services for older people’ and ‘addresses conditions significant to older ages’ to promote ‘active and healthy aging’. The National Sexual Health Strategy identifies ways to ensure that that the sexual health of the UK population is maximized, predicated on the grounds that ‘our sexual health affects our physical and psychological well-being and is central to some of the most important and lasting relationships in our lives’. What is striking, if perhaps ultimately unsurprising, is that there is no overlap between the documents. The NSF for Older People makes no reference to sexuality or sexual health issues, and the National Sexual Health Strategy makes no reference to older people and, indeed, explicitly focuses on younger people, particularly through linking the prevention of sexually transmitted infections (STIs) with the reduction in teenage pregnancies

Barriers to Utilisation of Sexual Health Services by Female Sex Workers in Nepal

Sexual health services are relatively rare in Nepal. Female sex workers (FSWs) do not use health services as much as would be desirable. A study was conducted to identify barriers to access of sexual health services by FSWs in Nepal. A mixed-method approach consisting of a 425 questionnaire-based survey and 15 in-depth interviews were conducted in 2007. One fifth of the FSWs had never visited health facilities. FSWs turned to private clinics followed by clinics belonging to non-governmental organisations and pharmacies for treatment. A combination of personal and service-related factors acted as critical barriers in accessing health services. Lack of confidentiality, discrimination and negative attitudes held by health care providers, poor communication between service providers and fear of exposure to the public as a sex worker were the major barriers to seeking sexual health services. These barriers should be taken into account while planning for sexual health services

Sexual health education for behavior change: How much is enough?

Purpose: Successful implementation of sexual health curricula in school settings is often compromised by competing academic priorities. This study explores the association between exposure to sexual health lessons (time-on-task in hours and lesson content topics) and delayed sexual initiation of middle school students at long term follow-up. Methods: Post hoc data analysis was conducted from a RCT (n=15 middle schools) in the south-central U.S. in which grade 7 students demonstrated delayed sexual initiation (adjusted odds ratio [AOR]: 1.54, 95% CI: 1.20 to 1.99) by grade 9 follow-up after using It’s Your Game (IYG), a 24 lesson sexual health curriculum. Logistic regression was conducted on a sub-sample of 314 grade 7 and 8 students who received IYG and who were sexually inexperienced at baseline, adjusting for covariates of age, gender, and race/ethnicity to address the impact of lesson exposure variables (time-on-task in hours and type of sexual health content) on initiation of any sex by grade 9. Results: The greatest impact of exposure on delayed sexual initiation was a duration of 13 or more lesson hours (OR = 8.40; p\u3c0.05) and exposure to lesson content on HIV/STI and pregnancy consequences (OR = 4.93; p\u3c0.05). Conclusions: Results support previous exposure studies and provide guidance on how effective sexual health curricula can meet the challenges of delivery in a reduced and competitive academic environment