A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Medicine in Bioethics and Health Law Johannesburg, 2015 / Generally, consensual adolescent sexual intercourse is fraught with a number of negative outcomes such as socio-economically, where unplanned pregnancies occur, and medically with the spread of sexually transmitted diseases that require treatment. The Sexual Offences and Related Matters Amendment Act 32 of 2007, hereunder referred to as the Sexual Offences Act (“SOA”), criminalised consensual sexual intercourse between adolescents aged from 12 to less than16 years. Since the inception of the SOA in 2007, there seemed to have been relatively little evaluation of the practical effect of sections 15 and 16 of the SOA on society. This changed in 2011 when two non-profit organisations, The Teddy Bear Clinic for Abused Children and RAPCAN (Resources Aimed at the Prevention of Child Abuse and Neglect) who were the first and second applicants respectively, challenged the constitutionality of certain sections of the SOA. These sections are: - section 15 – entitled “Acts of consensual sexual penetration with certain children (statutory rape)”; - section 16 – entitled “Acts of consensual sexual violation with certain children (statutory sexual assault); and - section 56(2) – which deals with defences in respect of sections 15 and 16. In October 2013, the Constitutional Court declared sections 15 and 16 inconsistent with the Constitution. That declaration was suspended for a period of 18 months to enable Parliament to correct the defects in the statute. It is widely known that adolescents still engage in consensual sex with each other regardless of the law. The issues invite an evaluation of the current legislation in the context of the health and social issues that surround them. In addition, the impact of the current applicable legislation on the present realism needs to be scrutinised. It is essential for alternative interventions to be established which will aid in reducing the negative impact of consensual adolescent sexual intercourse. This research report looks at interventions that could be introduced to prevent adolescent sexual intercourse and alleviate the negativity of outcomes. Furthermore, the report aims to suggest an ethical, structured approach to reduce the current negative outcomes of adolescent sexual intercourse. In order to accomplish this I first describe the legislation that applies to consensual adolescent sexual intercourse of children between the ages of 12 and 16 years old. This brought to the fore the health practitioner’s practical experiences of problems associated with this legislation. In addition, I identify and discuss some ethical problems that health practitioners are confronted with in relation to consensual adolescent intercourse, in terms of having to balance their professional legal and ethical obligations. Finally, I propose some recommendations that will inform educational organisations on the relevant information to be included in sexual and reproductive health education campaigns. Furthermore, recommendations are made to relevant national policy-making departments to make strategic decisions regarding health and social interventions for adolescent sexual and reproductive health services. / MT2016

Thesis (M.Sc. (Forensic Science))--Mahidol University, 1982.

Qualitative studies investigating the sexual activity of people with low back pain found a substantial reduction in the frequency of coitus and have shown that pain during coitus due to mechanical factors (i.e., movements and postures) are the primary reason for this decreased frequency. However, a biomechanical analysis of coitus has never been done. The main objective of this study was to describe male and female lumbar spine and hip motion and muscle activation patterns during coitus and compare these motions and muscle activity across five common coital positions. Specifically, lumbar spine and hip motion in the sagittal plane and electromyography signal amplitudes of selected trunk, hip, and thigh muscles were described and compared. A secondary objective was to determine if simulated coitus could be used in place of real coitus for future coitus biomechanics research. Ten healthy males (29.3 ± 6.9 years, 176.5 ± 8.6 centimeters, 84.9 ± 14.5 kilograms) and ten healthy females (29.8 ± 8.0 years, 164.9 ± 3.0 centimeters, 64.2 ± 7.2 kilograms) were included for analysis in this study. These couples had approximately 4.7 ± 3.9 years of sexual experience with each other. This study was a repeated-measures design, where the independent variables, coital position and condition, were varied five (i.e., QUADRUPED1, QUADRUPED2, MISSIONARY1, MISSIONARY2, and SIDELYING) and two (i.e., real and simulated) times, respectively. Recruited participants engaged in coitus in five pre-selected positions (presented in random order) for 20 seconds per position first in a simulated condition, and again in a real condition. Three-dimensional (3D) lumbar spine and hip kinematic data were continuously collected for the duration of each trial by optoelectronic and electromagnetic motion capture systems. Electromyography (EMG) signals were also continuously collected for the duration of each trial. The kinematic data and EMG signals were collected simultaneously for both participants. Five sexual positions were chosen for this study based on the findings of previous literature and a biomechanical rationale. QUADRUPED – rear-entry, female quadruped, male kneeling behind – had two variations; in QUADRUPED1 the female was supporting her upper body with her elbows and in QUADRUPED2 the female was supporting her upper body with her hands. MISSIONARY – front-entry, female supine, male prone on top – also had two variations; in MISSIONARY1 the female was not flexing her hips or knees and the male was supporting his upper body with his hands, but in MISSIONARY2, the female was flexing her hips and knees and the male was supporting his upper body with his elbows. SIDELYING – rear-entry, female side-lying on her left side, male side-lying behind – did not have any variations. To determine if each coital position had distinct spine and hip kinematic and muscle activation profiles, separate univariate general linear models (GLM) (factor: coital position = five levels, α=0.05) followed by Tukey’s honestly significant difference (HSD) post hoc analysis were used. To determine if simulated coitus was representative of real coitus across all spine and hip kinematic and muscle activation outcome variables, paired-sample t-tests (α=0.05) were performed on all outcome variables for the real condition and their respective simulated values. In general, the coital positions studied showed that, for both males and females, coitus is mainly a flexion-extension movement of the lumbar spine and hips. Males used a greater range of their spine and hip motion in comparison to females. As expected, differences were found between coital positions for males and females and simulated coitus was not representative of real coitus, in particular the spine and hip kinematic profiles. The results found in this biomechanical analysis of common coital positions may be useful in a clinical context. It is recommended that during the acute stage of a low back injury resulting in flexion-, extension-, or motion-intolerance that coitus be avoided. If the LBP is a more chronic issue, particular common coital positions should be avoided. For the flexion-intolerant male patient, avoid SIDELYING and MISSIONARY2 as they were shown to require the most flexion. Both variations of QUADRUPED are the more spine-sparing of coital positions followed by, MISSIONARY1. Coaching the male patient on proper hip-hinging technique while thrusting – an easy technique to incorporate in both variations of QUADRUPED – will likely decrease spine movement and increase the spine-sparing quality of QUADRUPED. For the flexion-intolerant female patient, avoid both variations of MISSIONARY, especially with hip and knee flexion, as they were shown to elicit the most spine flexion. QUADRUPED2 and SIDELYING are the more spine-sparing coital positions, followed by QUADRUPED1. Subtle posture changes for a coital position should not be considered lightly; seemingly subtle differences in posture can change the spine kinematic profile significantly, resulting in a coital position that was considered spine-sparing becoming a position that should be avoided. Thus, spine-sparing coitus appears to be possible for the flexion-, extension-, and motion-intolerant patient. Health care practitioners may recommend appropriate coital positions and coach coital movement patterns, such as speed control and hip-hinging. With respect to future research in the area of sex biomechanics, using simulated coitus in replace of real coitus is not justifiable according to the data of this study. However, including a simulated condition did prove beneficial for increasing the comfort level of the couples and allowing time to practice the experimental protocol. Future directions may address female-centric positions (e.g., ‘reverse missionary’ with male supine and female seated on top), and back-pained patients with and without an intervention (e.g., movement pattern coaching or aides, such as a lumbar support).

Qualitative studies investigating the sexual activity of people with low back pain found a substantial reduction in the frequency of coitus and have shown that pain during coitus due to mechanical factors (i.e., movements and postures) are the primary reason for this decreased frequency. However, a biomechanical analysis of coitus has never been done. The main objective of this study was to describe male and female lumbar spine and hip motion and muscle activation patterns during coitus and compare these motions and muscle activity across five common coital positions. Specifically, lumbar spine and hip motion in the sagittal plane and electromyography signal amplitudes of selected trunk, hip, and thigh muscles were described and compared. A secondary objective was to determine if simulated coitus could be used in place of real coitus for future coitus biomechanics research. Ten healthy males (29.3 ± 6.9 years, 176.5 ± 8.6 centimeters, 84.9 ± 14.5 kilograms) and ten healthy females (29.8 ± 8.0 years, 164.9 ± 3.0 centimeters, 64.2 ± 7.2 kilograms) were included for analysis in this study. These couples had approximately 4.7 ± 3.9 years of sexual experience with each other. This study was a repeated-measures design, where the independent variables, coital position and condition, were varied five (i.e., QUADRUPED1, QUADRUPED2, MISSIONARY1, MISSIONARY2, and SIDELYING) and two (i.e., real and simulated) times, respectively. Recruited participants engaged in coitus in five pre-selected positions (presented in random order) for 20 seconds per position first in a simulated condition, and again in a real condition. Three-dimensional (3D) lumbar spine and hip kinematic data were continuously collected for the duration of each trial by optoelectronic and electromagnetic motion capture systems. Electromyography (EMG) signals were also continuously collected for the duration of each trial. The kinematic data and EMG signals were collected simultaneously for both participants. Five sexual positions were chosen for this study based on the findings of previous literature and a biomechanical rationale. QUADRUPED – rear-entry, female quadruped, male kneeling behind – had two variations; in QUADRUPED1 the female was supporting her upper body with her elbows and in QUADRUPED2 the female was supporting her upper body with her hands. MISSIONARY – front-entry, female supine, male prone on top – also had two variations; in MISSIONARY1 the female was not flexing her hips or knees and the male was supporting his upper body with his hands, but in MISSIONARY2, the female was flexing her hips and knees and the male was supporting his upper body with his elbows. SIDELYING – rear-entry, female side-lying on her left side, male side-lying behind – did not have any variations. To determine if each coital position had distinct spine and hip kinematic and muscle activation profiles, separate univariate general linear models (GLM) (factor: coital position = five levels, α=0.05) followed by Tukey’s honestly significant difference (HSD) post hoc analysis were used. To determine if simulated coitus was representative of real coitus across all spine and hip kinematic and muscle activation outcome variables, paired-sample t-tests (α=0.05) were performed on all outcome variables for the real condition and their respective simulated values. In general, the coital positions studied showed that, for both males and females, coitus is mainly a flexion-extension movement of the lumbar spine and hips. Males used a greater range of their spine and hip motion in comparison to females. As expected, differences were found between coital positions for males and females and simulated coitus was not representative of real coitus, in particular the spine and hip kinematic profiles. The results found in this biomechanical analysis of common coital positions may be useful in a clinical context. It is recommended that during the acute stage of a low back injury resulting in flexion-, extension-, or motion-intolerance that coitus be avoided. If the LBP is a more chronic issue, particular common coital positions should be avoided. For the flexion-intolerant male patient, avoid SIDELYING and MISSIONARY2 as they were shown to require the most flexion. Both variations of QUADRUPED are the more spine-sparing of coital positions followed by, MISSIONARY1. Coaching the male patient on proper hip-hinging technique while thrusting – an easy technique to incorporate in both variations of QUADRUPED – will likely decrease spine movement and increase the spine-sparing quality of QUADRUPED. For the flexion-intolerant female patient, avoid both variations of MISSIONARY, especially with hip and knee flexion, as they were shown to elicit the most spine flexion. QUADRUPED2 and SIDELYING are the more spine-sparing coital positions, followed by QUADRUPED1. Subtle posture changes for a coital position should not be considered lightly; seemingly subtle differences in posture can change the spine kinematic profile significantly, resulting in a coital position that was considered spine-sparing becoming a position that should be avoided. Thus, spine-sparing coitus appears to be possible for the flexion-, extension-, and motion-intolerant patient. Health care practitioners may recommend appropriate coital positions and coach coital movement patterns, such as speed control and hip-hinging. With respect to future research in the area of sex biomechanics, using simulated coitus in replace of real coitus is not justifiable according to the data of this study. However, including a simulated condition did prove beneficial for increasing the comfort level of the couples and allowing time to practice the experimental protocol. Future directions may address female-centric positions (e.g., ‘reverse missionary’ with male supine and female seated on top), and back-pained patients with and without an intervention (e.g., movement pattern coaching or aides, such as a lumbar support).

Thesis (Ph. D.)--University of Washington, 2006. / Vita. Includes bibliographical references (leaves 83-91).

O coito interrompido à um mÃtodo de anticoncepÃÃo usado desde a antiguidade, por homens de todas as idades, credos e raÃas, perpetuando-se aos dias atuais. Apesar disto, dÃvida quanto à presenÃa de espermatozoides no lÃquido prÃ-ejaculatÃrio, em quantidade e qualidade viÃveis à fecundaÃÃo, permanece como lacuna do conhecimento. Neste contexto, estabeleceu-se a tese: ausÃncia de espermatozoides no lÃquido prÃ-ejaculatÃrio de homens com espermograma normal contribui para eficÃcia do coito interrompido. Para sua defesa, realizou-se pesquisa transversal, laboratorial, com objetivo de analisar o mÃtodo anticoncepcional coito interrompido nas perspectivas de prevalÃncia do uso, percepÃÃes masculinas e prova laboratorial do lÃquido prÃ-ejaculatÃrio. Foi realizado no Hospital Geral de Fortaleza (Hospital do ExÃrcito), CearÃ, Brasil, com 43 homens, quantitativo mÃximo atingido no perÃodo delimitado para coleta de dados, junho a novembro de 2012. Os critÃrios de inclusÃo foram: idade mÃnima de 18 anos e laudo do espermograma normal. Realizou-se entrevista seguindo formulÃrio prÃ-estabelecido. ApÃs responderem à entrevista, os participantes eram exaustivamente orientados e preparados pela autora para coleta do lÃquido prÃ-ejaculatÃrio e do sÃmen. Os dados foram processados pelo Statistical Package for the Social Sciences versÃo 18.0 e analisados por meio de estatÃstica descritiva e para comparaÃÃo de mÃdias foram utilizados os testes t de Student e de Mann-Whitney. As proporÃÃes entre a presenÃa ou nÃo de espermatozoides foram comparadas por meio do teste z para proporÃÃes. Para todas as anÃlises, fixou-se como estatisticamente significante p<0,05. Falas de participantes foram tomadas para ilustrar pontos relevantes da discussÃo. A idade dos homens foi em mÃdia de 33,2Â8,6; mÃdia de anos de estudo foi de 10,6Â1,74 anos; 39 (90,7%) relataram companheira fixa; a renda mensal teve mÃdia de R$ 1789,50Â1300,00; 31(72,1%) homens nÃo tinham filhos; 37 (86,0%) nÃo utilizavam mÃtodos anticoncepcionais e 2 (4,7%) homens afirmaram uso do CI como mÃtodo; 29 (67,4%) haviam praticado CI alguma vez; interromper o coito para ejacular fora da vagina foi o principal obstÃculo apresentado pelos homens; predominou a crenÃa da baixa eficÃcia do CI. Dos 43 (100%) participantes, 37 (86,0%) conseguiram coletar o sÃmen e destes, todos tiveram o laudo do espermograma normal; 33 (89,1%) conseguiram coletar o lÃquido prÃ-ejaculatÃrio e destes, apenas dois (6,0%) apresentaram raros espermatozoides no lÃquido prÃ-ejaculatÃrio, sendo o tempo mÃdio entre a Ãltima ejaculaÃÃo e a coleta de espÃcimes de 4,24Â3,07 dias. Aplicando-se o teste z de proporÃÃo e comparando a proporÃÃo dos que nÃo apresentaram espermatozoides no lÃquido prÃ-ejaculatÃrio (0,94) com os que apresentaram (0,06), pode-se afirmar que a presenÃa de espermatozoides no lÃquido prÃ-ejaculatÃrio, na amostra estudada, foi devido ao acaso (p<0,0001). Homens com espermograma normal nÃo apresentam espermatozoides no lÃquido prÃ-ejaculatÃrio. Mediante o exposto, confirma-se a tese de que a ausÃncia de espermatozoides no lÃquido prÃ-ejaculatÃrio de homens com espermograma normal contribui para eficÃcia do coito interrompido.

The aim of this study was to examine sexual behavior, contraceptive use, self-rated health, lifestyle factors and the prevalence of HPV vaccination among last year high school students. The study was a quantitative cross-sectional study which was a substudy of the longitudinal study " Pornography, Youth and Health". Results showed that the majority of students had had sexual intercourse (75 %, n=524) and both performed (67 %, n=479) and received oralsex (70 %, n=498). Forty percent (n=282) of the students had had one night stand, a quarter (n=159) anal sex and 29 (n=202) percent sex with a friend. The contraceptive use increased from the first to the last intercourse while the use of condoms decreased. Five percent (n=38) of the students reported a sexually transmitted disease, more women than men. Significant difference in sexual experience was shown between students in vocational versus theoretical study programs, between students with low and high self-rated health as well as between students with low versus high risk behavior regarding lifestyle factors. Two thirds of the female students were vaccinated against HPV. No significant difference regarding condom use was shown between the female students who were vaccinated against HPV compared with non-vaccinated. The knowledge of existing differences between gender, between students at different high school programs and attention to risk factors can improve sex education and contraceptive counseling in which the midwife has an important role. / Syftet med föreliggande studie var att undersöka sexualvanor, preventivmedelsanvändning, egen upplevd hälsa, livsstilsfaktorer och förekomsten av HPV-vaccination bland elever som gick sista året på gymnasiet. Studien var en kvantitativ tvärsnittsstudie som var en del av den longitudinella studien "Pornografi, ungdomar och hälsa". Resultat visade att majoriteten av eleverna hade haft samlag (75 %, n=524) samt både givit (67 %, n=479) och fått oralsex (70 %, n=498). Fyrtio procent (n=282) av eleverna hade haft one night stand, en fjärdedel (n=159) analsex och 29 procent (n=202) sex med en kompis. Preventivmedelsanvändningen ökade från första samlaget till det senaste medan kondomanvändningen minskade. Fem procent (n=38) av eleverna hade haft en könssjukdom, fler kvinnor än män. Signifikanta skillnader avseende sexuella erfarenheter fanns mellan elever på yrkesförberedande- respektive studieförberedande gymnasieprogram, mellan elever med låg- och hög självskattad hälsa samt mellan elever med lågt- och högt riskbeteende beträffande livsstilsfaktorer. Två tredjedelar av de kvinnliga eleverna var vaccinerade mot HPV. Ingen signifikant skillnad med avseende på kondomanvändning fanns mellan de kvinnliga eleverna som var vaccinerade respektive ej vaccinerade mot HPV. Kunskap om dessa skillnader mellan kön och mellan elever på olika studieprogram samt att riskfaktorer uppmärksammas kan förbättra sexualundervisning och preventivmedelsrådgivning i vilka barnmorskan har en viktig roll.

Even though it may not seem like it at first glance, the phenomenon of rape conceals in fact much more than anyone who has ever faced this problem we are dealing with could say about it. Worse, it is these people, the vast majority of them men, where the tendency is to downplay this crime and, under the influence of ignorance and myths associated with rape or even religion and ideology, often see it as made up by the victims or as completely removed from the intentions of the offender. And because the aim of this work is not only to provide a view of rape in terms of criminal law, but also from a criminological, i.e. view of a number of other scientific disciplines, that this is indeed the case, that rape cannot be seen in this manner, this is also - and no less important - the task of this work. The fundamental part of this work, as a work looking at the issue addressed especially in terms of criminal law, and its main investigative contribution provide not only an analysis of the various elements of the crime of rape, but primarily an attempt within it to completely categorize all hitherto considered and neglected forms of sexual behavior within individual - prescribed by law - forms of sexual intercourse. The same is true then and the main investigative contribution of this work can be...

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.

Thesis (D.P.H.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed June 23, 2008). Includes bibliographical references.