A systematic review of factors influencing condom use among female sex workers

A systematic review of research published in English was conducted across seven electronic databases in public health, social and psychological sciences. The aim was to ascertain the factors that influence condom use among female sex workers in the commercial sex industry globally. The perspectives and experiences of 29,112 female sex workers (FSWs) and 1,792 male clients of FSWs with regards to condom use are represented across the 47 studies included in this review. Key themes comprised of Perceived self-efficacy, Relationship Types, Condom use and Attitudes, Violence and Abuse, Location and Support, Knowledge and Perceived Risk, Perception and Perspectives of Male Clients, Drug and Alcohol use, Criminalisation and Price and Payment. Female sex workers are defined as a high-risk population for HIV/AIDS. Condoms were used less frequently in situations where structural and cultural determinants heavily impacted the experiences and decisions of FSWs. Cultural contextual factors also heavily impacted on the perspectives and perceptions of male clients and their attitudes towards condom use. Criminalization and anti-sex work legislation in many of the countries where these studies were conducted meant that FSWs were a socially marginalised and ostracized population. Recommendations are explored for theory, practice and education and future research

A systematic review on LGBTIQ intimate partner violence from a Western perspective

Intimate Partner Violence (IPV) as experienced by minority populations is poorly understood. Within the Western world, the Lesbian, Gay, Bisexual, Transgender, Intersex, and Queer or Questioning LGBTIQ population is one such group which suffers from misrepresentations and misunderstandings. In Western nations, IPV is primarily constructed as perpetrated by men and experienced by women. However, for the LGBTIQ population, this dichotomous view of IPV is inaccurate and invalidating. A systematic review was conducted to investigate the level of LGBTIQ inclusivity within IPV discourses in the Western world as discussed in peer-reviewed literature. In particular, the review sought to understand how media, advocacy, policy, and legislation shape LGBTIQ IPV experiences and resulting discourses. The literature search was conducted between June 2018 and January 2019. The search included five electronic databases in psychology, health, and social sciences. Of the 206 articles identified by the search, 21 were reviewed. The review analyzed literature using a thematic approach. Eight key themes emerged, indicating media, legislation, policy, and advocacy are not entirely inclusive concerning LGBTIQ IPV. The review found that pervasive attitudes like heterosexism, cissexism, homophobia, transphobia, and biphobia reinforce institutional barriers and limited LGBTIQ IPV reporting. In addition, the review found low service and provider competency levels, and more broadly, the research was limited. It is likely that heteronormative frameworks and discourses mean many aspects of LGBTIQ IPV are still under-researched. Without a more robust inclusion of diversity in discourses on IPV, services and supports for LGBTIQ people will continue to be limited and based on heteronormative frameworks of victimhood

The social determinants of otitis media in Aboriginal children in Australia : are we addressing the primary causes? : a systematic content review

Background: Aboriginal and Torres Strait Islander children experience some of the highest rates of otitis media in the world. Key risk factors for otitis media in Aboriginal children in Australia are largely social and environmental factors such as overcrowded housing, poverty and limited access to services. Despite this, little is known about how to address these risk factors. A scoping content review was performed to determine the relationship between social determinants of health and otitis media in Aboriginal and Torres Strait Islander children as described by peer-reviewed and grey literature. Method: Search terms were established for location, population and health condition. The search terms were used to conduct a literature search using six health research databases. Following the exclusion process, articles were scoped, analysed and categorised using scoping parameters and a social determinants of health framework. Results: Housing-related issues were the most frequently reported determinants for otitis media (56%). Two articles (4%) directly investigated the impact of social determinants of health on rates of otitis media within Aboriginal and Torres Strait Islander children. The majority of the literature (68%) highlights social determinants as playing a key role in the high rates of otitis media seen in Aboriginal populations in Australia. There were no intervention studies targeting social determinants as a means to reduce otitis media rates among Aboriginal and Torres Strait Islander children. Conclusions: This review identifies a disconnect between otitis media drivers and the focus of public health interventions within Aboriginal and Torres Strait Islander populations. Despite consensus that social determinants play a key role in the high rates of otitis media in Aboriginal and Torres Strait Islander children, the majority of intervention studies within the literature are focussed on biomedical approaches such as research on vaccines and antibiotics. This review highlights the need for otitis media intervention studies to shift away from a purely biomedical model and toward investigating the underlying social determinants of health. By shifting interventions upstream, otitis media rates may decrease within Aboriginal and Torres Strait Islander children, as focus is shifted away from a treatment-focussed model and toward a more preventative model

Maternal health service utilisation of adolescent women in sub-Saharan Africa : a systematic scoping review

Introduction: Sub-Saharan Africa has the highest rate of adolescent pregnancy in the world. While pregnancy during adolescence poses higher risks for the mother and the baby, the utilisation of maternity care to mitigate the effects is low. This review aimed to synthesise evidence on adolescent mothers’ utilisation of maternity care in Sub-Saharan Africa and identify the key determinant factors that influence adolescent mothers’ engagement with maternity care. Method: A systematic review of scholarly literature involving seven databases: ProQuest, PubMed, EMBASE/Elsevier, SCOPUS, PsycINFO, CINAHL and Infomit was conducted. Studies published in English between 1990 and 2017 that examined Sub-Saharan adolescent mothers’ experiences of utilising biomedical maternity care during pregnancy, delivery and the post-partum period were included. Results: From 296 relevant articles 27 were identified that represent the experience of adolescent mothers’ maternal health service utilisation in Sub-Saharan Africa. The review indicates that maternal health service utilisation in the majority of Sub-Saharan African countries is still low. There is also a wide discrepancy in the use of maternity care services by adolescent mothers across countries in Sub-Saharan Africa. Conclusions: The review reveals that a significant number of adolescents in Sub-Saharan Africa do not access and use maternity services during pregnancy. Several factors from individual to systemic levels contributed to low access and utilisation. This implies that interventions targeting the women, their partners, healthcare professionals, communities and the organisations (local to national) are necessary to improve adolescent mother’s engagement with maternity care in Sub-Saharan Africa

Out of the closet, not yet out of the house : gay men’s experiences of homonegativity and internalized homonegativity

This paper explores how Australian gay men experience gender and sexuality in relation to heteronormative gender norms, specifically masculinity. A sample of 32 gay men 22–72 years of age participated in an online interview, using a videoconferencing software, on masculinity and homosexuality. Thematic analyses revealed that gay men experience gender and sexuality-related strain across all levels of their socioecological environment through social regulation, homophobic discrimination/harassment, and anti-effeminacy prejudice. The gay men expressed feelings of self-loathing, shame, internalized homonegativity, and isolation as a result. In examining interactions at each level of the socioecological environment, future research and practice may gain understanding in the social phenomena and how to ameliorate such strain

It's a man's world : a qualitative study of gender and sexuality amongst Australian gay men

Currently, research explicitly examining masculinity and internalized homonegativity is sparse, and even sparser studies are those using qualitative methods. To address this, this study aims to explore: how gender norms are constructed and experienced amongst gay men; and how gender and sexual identity are experienced in relation to masculine norms amongst gay men. A sample of 32 self-identified gay men aged 22–72 years (M = 34.34, SD = 12.94) participated in an online semi-structured interview on masculinity and homosexuality. The study used Zoom to facilitate the online interviews as it offered privacy, accessibility, ease of use, and voice recording, among other benefits. Thematic analyses revealed gay men’s understandings of masculinity, femininity, and sources of pressure to conform. Furthermore, gay men emphasize the conflict experienced between heteronormative gender and sexuality norms, which highlights the term homosexual male as an oxymoron

The relationship between masculinity and internalized homophobia amongst Australian gay men

Due to the heterosexist ideals associated with gender norms, gay men often experience negative attitudes towards their own sexuality—internalized homophobia. As a result, gay men often feel compelled to compensate for their perceived lack of masculinity. The study aimed to investigate the relationship and predictive power of masculinity on gay men’s experiences of internalized homophobia. A sample of 489 self-identified Australian gay men 18–72 years old participated in an online survey on masculinity and homosexuality. Descriptive statistics, bivariate correlations, and sequential multiple regressions were used to test the study’s aims. Sequential multiple regressions revealed that conformity to masculine norms and threats to masculinity contingency were stronger predictors of internalized homophobia over and above demographic and other factors. Given the already known psychological risks associated with social isolation, internalized homophobia, and the poor mental health outcomes associated with sexual minority groups, it is suggested that gay men who are experiencing high degrees of internalized homophobia should not be distancing themselves from other gay men but, conversely, seek a strong relationship with the LGBTI community

LGBTIQ CALD people's experiences of intimate partner violence : a systematic literature review

Abstract: Background: Experience of surviving intimate partner violence (IPV) is well documented in research, policing practices, newspapers, and awareness campaigns domestically and internationally. Arguably, those who have survived IPV and have their experiences reflected within society undergo a transformative experience of empowerment. As society recognises and validates their experience has occurred, and responds to it, accordingly, as some survivors have targeted services and interventions to assist in this transformation. However, for LGBTIQ-identifying peoples, experiences of IPV are poorly understood in contemporary society, which is further exacerbated for LGBTIQ-identifying CALD people as they continue to remain hidden. Aim and objective: The systematic literature review aims to explore the experiences of this group in their development of resilience following an abusive and violent relationship. Methods: Of the potential 230 identified studies, 5 studies met the eligibility criteria. In line with the eligibility criteria, these studies were first reviewed by title, then by abstract and then by full text. Of those studies which the research team deemed relevant for inclusion, their reference lists where also reviewed to determine if any further relevant studies could be identified using this strategy. As a result of the above process, five (5) studies met the eligibility criteria and were included in the study. Results: From data extraction, three major themes emerged: Intimate Partner Violence as Experienced by LGBTIQ survivors, Marginalised Identity and Types of Survivorship. While refined, these themes capture a more robust set of sub-themes that identify the diverse ways in which LGBTIQ survivors experience responses to their victimised status as experienced in IPV situations. Conclusions: Overall, the review found that resilient outcomes for LGBTIQ CALD survivors remain misunderstood and missing within the literature. There is a propensity to focus on negative coping strategies and an exclusive focus on LGBTIQ CALD vulnerabilities. Future research requires investigation into strategies and support that move beyond coping to include resilient outcomes and support systems that allow manifestations of resilience

Postnatal care service utilisation in Ethiopia : reflecting on 20 years of demographic and health survey data

Background: Most maternal deaths in the world occur during the postpartum period, especially within the first two days following delivery. This makes postnatal care (PNC) critical to improving the chances of maternal and child survival. Over the past 20 years, the proportion of women receiving antenatal care (ANC) in Ethiopia has increased while the proportion of those receiving PNC has remained low. This study aimed to understand the trends, determinants and urban–rural variations of PNC service utilisation. Methods: This study draws on the Ethiopian Demographic and Health Survey (EDHS) data for the years 2000 (n = 4552), 2005 (n = 4467), 2011 (n = 4445) and 2016 (n = 4275) to estimate the trends and determinants of PNC service utilisation. Multivariate logistic regression models with adjustment for clustering and sampling weights were used to investigate the association between the independent factors, the study factors and PNC service utilisation. Results: Over the twenty-year period of the EDHS, the proportion of Ethiopian women who received PNC services increased from 5.6% (95% CI: 4.6–6.9%) in 2000 to 18.5% (95% CI: 16.4–20.7%) in 2016. Similarly, women who received PNC services in urban areas increased from 15.2% (95% CI: 23.6–30.7%) in 2000 to 47% (95% CI: 60.4–67.3%) in 2016. Women who were in the wealthy quintile, had ANC visits, delivered in a health facility, and delivered by caesarean section were most likely to have PNC. The present study also showed that whilst birth spacing was a significant factor among urban women, wealth index, ANC visits, and perception of health facility distance were significant factors among rural women. Conclusions: The study suggests low levels of utilisation of PNC among Ethiopian women from rural districts. Geographically targeted interventions with a focus on low-socioeconomic rural women, and those with no previous contacts with the health system during pregnancy, are needed to improve PNC in Ethiopi

Critiquing the Health Belief Model and sexual risk behaviours among adolescents : a narrative review of familial and peer influence

Research into the rising rates of sexually transmitted infections and unwanted pregnancies among adolescents has highlighted the challenge in developing sexual education campaigns that affect behavioural change. Frequent attempts to apply the otherwise robust Health Belief Model to the challenge of high-risk sexual behaviours have yielded confounding results from sexually active teens who discount the seriousness of consequences or their susceptibility to them. Social dynamics involving familial and peer relationships may strongly influence teen sexual risk-taking; the growing population of sexual risk-takers is strongly associated with disengaged family environments and a shift in alliance from family to peer community. This shift in identification to peer groups, in the absence of supportive parental relationships, is correlated with permissive and coercive sexual behaviour and a future of substance abuse, depression, sexually transmitted infections and unwanted pregnancy. This paper seeks to explore the correlation between peer interaction and parental relationships and availability, while assessing the predictive value of the Health Belief Model in relation to adolescent high risk sexual behaviour. Doing so can inform research to further clarify the nature of these associations and investigate new insights into adolescent sexual dynamics and new policy and programming approaches to sexual health promotion