Bakgrund: Icke-heterosexuella ungdomar har ökad risk att drabbas av psykisk ohälsa. Forskning om icke-heterosexuella ungdomars psykiska hälsa i svensk kontext är dock begränsad. Syftet med denna studie var att undersöka sambandet mellan sexuell läggning och psykisk ohälsa respektive psykiskt välbefinnande bland ungdomar på Gotland.  Metod: Tvärsnittsstudiedesign med befolkningsenkäten Liv och Hälsa Ung i Region Gotland användes. Psykisk ohälsa mättes med Strenghts and Difficulties Questionnaire (SDQ). Psykiskt välbefinnande mättes med Mental Health Continuum Short Form (MHC-SF). Chi2-tester, t-tester och logistiska regressioner användes för att analysera data.  Resultat: Jämfört med heterosexuella ungdomar hade icke-heterosexuella ungdomar signifikant högre odds för både psykisk ohälsa och nedsatt psykiskt välbefinnande i ojusterade regressioner. Dessa samband var dock inte signifikanta i justerade regressioner. Däremot påvisades högre odds för psykisk ohälsa respektive nedsatt psykiskt välbefinnande bland tjejer, ungdomar med hög stressnivå, ungdomar som kände sig ensamma eller som inte hade någon att prata med. Risken för nedsatt psykiskt välbefinnande minskade även med bättre upplevd familjeekonomi och ökad social status i skolan.  Slutsats: De justerade resultaten påvisade inga signifikanta samband mellan sexuell läggning och psykisk ohälsa respektive psykiskt välbefinnande bland ungdomar på Gotland. Sexuell läggning kunde därmed inte direkt associeras med en ökad risk för psykisk ohälsa respektive nedsatt psykiskt välbefinnande. Signifikanta samband påvisades mellan stress, ensamhet och att inte ha någon att prata med och psykisk ohälsa samt nedsatt psykiskt välbefinnande. Inkluderingsinsatser och riktade stödjande insatser kan möjligen minska upplevelsen av stress, ensamhet och utanförskap. Studien visade också hög förekomst av nedsatt psykiskt välbefinnande i hela studiepopulationen. Breda åtgärder för att stärka ungdomars psykiska välbefinnande, såsom insatser i skolan, skulle kunna förbättra hälsan för många ungdomar, inklusive de med icke-heterosexuell läggning. / Background: Non-heterosexual adolescents are at higher risk of mental health problems than heterosexual adolescents. Research on the mental health among non-heterosexual adolescents in the Swedish context is limited. The purpose of this study was to investigate the relationship between sexual orientation and mental health problems and mental well-being in adolescents on Gotland.  Method: A cross-sectional design including the population survey Life and Health Youth in Region Gotland was utilized. The survey included the Strengths and Difficulties Questionnaire (SDQ) for assessing mental health problems, and the Mental Health Continuum Short Form (MHC-SF) for assessing mental well-being. Chi2 tests, t-tests and logistic regressions were used to analyze the data.  Results: In unadjusted regressions, non-heterosexual adolescents had significantly higher odds for both mental health problems and decreased mental well-being compared to heterosexual adolescents. These associations were no longer significant in adjusted regressions. Significantly higher odds for mental health problems and decreased mental well-being was demonstrated in girls, adolescents with high levels of stress, and adolescents who felt lonely or who had no one to talk to. The risk of decreased mental well-being was also reduced with better perceived family finances and increased social status at school.  Conclusion: Adjusted regressions showed no significant associations between sexual orientation and mental health problems or mental well-being among adolescents on Gotland. Therefore, sexual orientation could not be directly associated with an increased risk of mental health problems or decreased mental well-being. The results showed significant associations between stress, loneliness and not having anyone to talk to and mental health problems and decreased mental well-being. Inclusive interventions and targeted support efforts could possibly reduce the experience of stress, loneliness and exclusion. The study also showed a high prevalence of decreased mental well-being in the entire study population. Interventions to strengthen adolescents’ well-being, e.g. school-based interventions, could improve the health of adolescents, including those with a non-heterosexual orientation.

Unwanted and unintended pregnancies pose major reproductive health challenges to women throughout the world. Despite the availability of modern contraceptives, many women and men fail to use contraceptives effectively. This research focussed on reasons for not using contraceptives effectively in the Northern Tshwane area of the Gauteng Province of the Republic of South Africa (RSA). Structured interviews were conducted with 83 women and 71 men about their contraceptive practices. Age, religion, educational level and residential areas influenced clients' contraceptive practices. These results were categorised for adult males and females as well as for adolescent males and females. Adolescents encountered problems in accessing contraceptive services. Adult females knew most about traditional contraceptives, although men knew about some of these methods, and adolescents used some of them. All respondents could gain additional knowledge about modern contraceptives. The respondents' knowledge about · emergency contraceptives was extremely limited. Although most respondents knew about legalised choice on.termination of pregnancy (CTOP) services in the RSA, they did not know when nor how to access these services. Nurses working in contraceptive health services, revealed during a focus group discussion that a lack of resources (including shortages of malcondoms, contraceptive injections and oral contraceptives) hampered the quality of services that could be rendered. Of particular concern was the nonavailability of Norplant implants and female condoms. Nurses expressed a need for pecific national policy guidelines about supplying contraception to adolescents. Although most nurses knew about emergency contraceptives, they did not promote its use because they assumed that clients would misuse emergency contraceptives.instead of using contraceptives regularly. The nurses indicated that very few facilities offered CTOP services. The nurses regarded women who obtained repeated CTOPs to be misusing these services and suggested that limitations should be placed on the number-of times any woman could obtain such services. The negative attitudes of community members and of colleagues towards persons working in CTOP services caused hardships for them. Recommendations address ways in which contraceptive services could be improved. / Health Studies / D. Litt. et Phil. (Advanced Nursing Sciences)

Unwanted and unintended pregnancies pose major reproductive health challenges to women throughout the world. Despite the availability of modern contraceptives, many women and men fail to use contraceptives effectively. This research focussed on reasons for not using contraceptives effectively in the Northern Tshwane area of the Gauteng Province of the Republic of South Africa (RSA). Structured interviews were conducted with 83 women and 71 men about their contraceptive practices. Age, religion, educational level and residential areas influenced clients' contraceptive practices. These results were categorised for adult males and females as well as for adolescent males and females. Adolescents encountered problems in accessing contraceptive services. Adult females knew most about traditional contraceptives, although men knew about some of these methods, and adolescents used some of them. All respondents could gain additional knowledge about modern contraceptives. The respondents' knowledge about · emergency contraceptives was extremely limited. Although most respondents knew about legalised choice on.termination of pregnancy (CTOP) services in the RSA, they did not know when nor how to access these services. Nurses working in contraceptive health services, revealed during a focus group discussion that a lack of resources (including shortages of malcondoms, contraceptive injections and oral contraceptives) hampered the quality of services that could be rendered. Of particular concern was the nonavailability of Norplant implants and female condoms. Nurses expressed a need for pecific national policy guidelines about supplying contraception to adolescents. Although most nurses knew about emergency contraceptives, they did not promote its use because they assumed that clients would misuse emergency contraceptives.instead of using contraceptives regularly. The nurses indicated that very few facilities offered CTOP services. The nurses regarded women who obtained repeated CTOPs to be misusing these services and suggested that limitations should be placed on the number-of times any woman could obtain such services. The negative attitudes of community members and of colleagues towards persons working in CTOP services caused hardships for them. Recommendations address ways in which contraceptive services could be improved. / Health Studies / D. Litt. et Phil. (Advanced Nursing Sciences)