<p>Klamydia har ökat de sex senaste åren, vilket kan inverka negativt på flickor förutsättningar för att bli fertila senare i livet. Inriktningen på uppsatsen är ungdomars kunskaper och inställning till kondomanvändning och klamydia. Föresatsen var att även få en överblick av det förebyggande arbete som redan pågår i samhället. Sammantaget var avsikten att undersöka om ungdomarnas kunskaper är tillräckliga, varifrån kommer deras kunskaper och även inställning till kondomanvändning samt vilka faktorer påverkar att kondomen används.</p><p>En kvantitativ studie har genomförts på två olika ungdomsmottagningar. Resultaten visar att ungdomar har kunskaper om kondomanvändning och klamydia och att det är många olika faktorer som påverkar att kondomen inte används. Faktorer som har olika betydelse och tyngd för olika individer där bland annat självkänsla och förmågan att kommunicera är en väsentlig del. Även andra faktorer har betydelse såsom intag av alkohol, fast partner, osäker på användning eller annat graviditetsskydd.</p>

<p><strong>Aim </strong>The aim of this study was to investigate the attitudes of midwives and gynaecologists at youth health clinics about their own thoughts of risks with unprotected oral sex and testing of orally contagious sexually transmitted infections (STI). The aim was also to investigate the level of knowledge of oral STIs. One further aim was to examine what they thought about the level of knowledge about oral STIs among adolescents and how common unprotected oral sex is within this group and if oral STIs/oral sex is brought up in the form of information or questions during STI-testing.</p><p><strong>Method </strong>Seventy-five youth health clinics all over Sweden were randomly chosen. A questionnaire was sent by mail to the clinics. It included questions about attitudes, knowledge about STIs and information exchange. A midwife or a gynaecologist was asked to fill out the questionnaire. The answers were analysed in the statistical programme SPSS.</p><p><strong>Results </strong>The percentage of answers was 76 % (57/75).  One third of the clinics had guidelines for oral STI-testing. Those clinics were more often testing for oral STIs, informing and asking adolescents about oral STIs. Seventy-nine percent responded that they always or sometimes informed adolescents who were tested for STIs about risks with unprotected oral sex. Almost everyone thought that the knowledge about oral STIs was insufficient among health care staff.  Staff working at clinics with guidelines more often thought that they had sufficient knowledge about oral STIs than those without guidelines. All respondents thought unprotected oral sex was common among adolescents. Eight out of ten were in favor of oral STI-testing being performed more often. The overall attitude was that adolescents should be given more information of the risks of STIs when practising unprotected oral sex. <strong></strong></p><p><strong>Conclusions </strong>Practise of unprotected oral sex involves a risk of transmission of oral STIs. Youth health clinics need to be more actively informing adolescents about it. There is a lack of national guidelines for testing of STIs in Sweden. The majority of youth health clinics did not have any local guidelines for oral STI-testing. Guidelines on oral STI-testing are needed for achieving a more evidence-based care in testing and informing about oral STIs.</p><p><strong>Keywords; </strong>Oral sex, STI, testing, midwives, attitudes.</p>

Aim The aim of this study was to investigate the attitudes of midwives and gynaecologists at youth health clinics about their own thoughts of risks with unprotected oral sex and testing of orally contagious sexually transmitted infections (STI). The aim was also to investigate the level of knowledge of oral STIs. One further aim was to examine what they thought about the level of knowledge about oral STIs among adolescents and how common unprotected oral sex is within this group and if oral STIs/oral sex is brought up in the form of information or questions during STI-testing. Method Seventy-five youth health clinics all over Sweden were randomly chosen. A questionnaire was sent by mail to the clinics. It included questions about attitudes, knowledge about STIs and information exchange. A midwife or a gynaecologist was asked to fill out the questionnaire. The answers were analysed in the statistical programme SPSS. Results The percentage of answers was 76 % (57/75).  One third of the clinics had guidelines for oral STI-testing. Those clinics were more often testing for oral STIs, informing and asking adolescents about oral STIs. Seventy-nine percent responded that they always or sometimes informed adolescents who were tested for STIs about risks with unprotected oral sex. Almost everyone thought that the knowledge about oral STIs was insufficient among health care staff.  Staff working at clinics with guidelines more often thought that they had sufficient knowledge about oral STIs than those without guidelines. All respondents thought unprotected oral sex was common among adolescents. Eight out of ten were in favor of oral STI-testing being performed more often. The overall attitude was that adolescents should be given more information of the risks of STIs when practising unprotected oral sex. Conclusions Practise of unprotected oral sex involves a risk of transmission of oral STIs. Youth health clinics need to be more actively informing adolescents about it. There is a lack of national guidelines for testing of STIs in Sweden. The majority of youth health clinics did not have any local guidelines for oral STI-testing. Guidelines on oral STI-testing are needed for achieving a more evidence-based care in testing and informing about oral STIs. Keywords; Oral sex, STI, testing, midwives, attitudes.

Klamydia har ökat de sex senaste åren, vilket kan inverka negativt på flickor förutsättningar för att bli fertila senare i livet. Inriktningen på uppsatsen är ungdomars kunskaper och inställning till kondomanvändning och klamydia. Föresatsen var att även få en överblick av det förebyggande arbete som redan pågår i samhället. Sammantaget var avsikten att undersöka om ungdomarnas kunskaper är tillräckliga, varifrån kommer deras kunskaper och även inställning till kondomanvändning samt vilka faktorer påverkar att kondomen används. En kvantitativ studie har genomförts på två olika ungdomsmottagningar. Resultaten visar att ungdomar har kunskaper om kondomanvändning och klamydia och att det är många olika faktorer som påverkar att kondomen inte används. Faktorer som har olika betydelse och tyngd för olika individer där bland annat självkänsla och förmågan att kommunicera är en väsentlig del. Även andra faktorer har betydelse såsom intag av alkohol, fast partner, osäker på användning eller annat graviditetsskydd.

Objective: To compare individual risk behaviors in African American, Whites, and Hispanic women as found in the literature and support those findings by analyzing date available through NHANES in order to find out if the higher rate of HIV infection in African American women is a direct result of higher risk behaviors. Those risk behaviors include lower rates of condom use, higher rates of drug use including those taken intravenously, higher rates of risky sex habits, higher number of sexual partners over their lifetime, and a more extensive history of sexually transmitted infection. This study also aims to draw attention to larger factors that may foster the conditions for increased HIV rates in African American women. Results: The perception that higher rate of HIV infection is the result of increased risk factors among African American women is not supported either in the literature or in the analysis of NHANES data. For instance, results from data analysis found that African American women had fewer average sexual partners (P ≤ 0.05), lower overall rate of drug use (P ≤ 0.01), lower rates of risky sexual practices (P ≤ 0.01), but more likely to report a history of STIs (P ≤ 0.01) than Whites. The literature also confirmed that current HIV testing recommendations do not cover a large enough portion of the population to make significant impact on HIV incidence. In addition, socioeconomic situations further exacerbate the condition favorable to transmitting the disease. Conclusion: Methods that rely on individual risk behaviors alone may not be enough to reduce HIV rates in African American women, though those methods may be work in MSM. Socioeconomic programs that address disparities and testing recommendations that cover more people are needed in order to drive down HIV infection rates in African American women.

Objective: To compare known individual risk behaviors in African American, Whites, and Hispanic women as found in the literature and support those findings by analyzing data available through NHANES in order to find out if the higher rate of HIV infection in African American women is a direct result of higher risk behaviors. Those risk behaviors include lower rates of condom use, higher rates of drug use including those taken intravenously, higher rates of risky sex habits, higher number of sexual partners over their lifetime, and a more extensive history of sexually transmitted infections. This study also aims to draw attention to larger factors that may foster the conditions for increased HIV rates in African American women. Results: The perception that higher rate of HIV infection is the result of increased risk factors among African American women is not supported either in the literature or in the analysis of NHANES data. For instance, results from data analysis found that African American women had fewer average number of sexual partners (P ≤ 0.05), lower overall rate of drug use (P ≤ 0.01), lower rates of risky sexual practices (P ≤ 0.01), but more likely to report a history of STIs (P ≤ 0.01) than Whites. The literature also confirmed that current HIV testing recommendations do not cover a large enough portion of the population to make a significant impact on HIV incidence. In addition, socioeconomic situations further exacerbate the conditions favorable to the transmission of the disease in African American women. Conclusion: Prevention programs that rely on individual risk behaviors alone may not be enough to reduce HIV rates in African American women, though those same programs may be working in MSM. Programs that address socioeconomic disparities and testing recommendations that cover more people are needed in order to drive down HIV infection rates in African American women.

I århundraden har användandet av kondom varit ett sätt att skydda sig från oönskade graviditeter, och på senare år, även könssjukdomar. Trots att kondom är det bästa skyddet vid en tillfällig sexuell kontakt, används den i för liten utsträckning. För att kunna motivera till ett ökat kondomanvändande måste faktorer och upplevelser som påverkar kondomanvändandet identifieras. Syftet med föreliggande studie var att belysa studenters erfarenheter av kondomanvändning vid en tillfällig sexuell kontakt. Fyra kvinnliga och fyra manliga studenter på ett svenskt universitet har deltagit och berättat om sina erfarenheter och tankar. Vad är det som gör att de använder eller inte använder kondom vid en tillfällig sexuell kontakt, och vilka upplevelser kan kopplas till lidande och välbefinnande? Intervjuerna har analyserats med en kvalitativ innehållsanalys. Viktiga fynd i resultatet är att kondomanvändning inte bara upplevs som negativt. Både att använda och inte använda kondom upplevs komplext genom att både välbefinnande och lidande kan erfaras. Dessa upplevelser kan vara t.ex. ökad fysisk njutning då man inte använder kondom eller att slippa ångest och oro för könssjukdomar och graviditeter då man använder. En annan viktig aspekt är att valet om att använda inte bara hänger på individens upplevelser eller värderingar utan även, och nästan mer, på praktiska faktorer som tillgänglighet och högt pris.

This thesis explores incidence rates of sexually transmitted infections (STIs) among minority group teenagers in the United States and among adults aged 20-34 in the U.S. and in China. The focus is on trends and patterns in the United States compared to those in China. Research questions include whether or not the early onset of sexual activity is directly related to the incidence of STI transmission among Americans. The Chinese analysis enables addressing the question of whether or not a hidden epidemic exists in China with regard to STI transmission rates. The thesis involves three separate analyses including a comparative study of teens (age 15-19) and adults (age 20-44) in the United States, a comparative study of adults aged 20-44 in the United States and China, and a comparative analysis of urine-based results versus self-reported responses among the Chinese adults. The use of logistic regression is employed in order to model the odds of the risk of transmission among the different groups. The results from this thesis indicate that early onset of sexual activity is indeed a risk factor for young minority group members in the United States in terms of the bacterial infections. The analysis of American adults revealed that women who have college educations and who are not minority group members are at risk of contracting viral infections with more frequency. Finally, a hidden epidemic among Chinese women was detected with respect to the bacterial infections. It is important to study these trends within the U.S. and abroad in China for many reasons. First and foremost, young adults are the most heavily impacted in the United States. This population should be focused on as many of the infections discussed may lead to lifelong difficulties (including infertility) if left untreated. Also, with respect to China, a large proportion of those who are infected do not know they are. Again, these infections may lead to many complications and Chinese women are at an increased risk because many are infected unknowingly due to the behavior of their partner/spouse. Finally, sexually transmitted infections amplify the transmission rates of HIV/AIDS and should be studied specifically for this reason if none other.

<p>I århundraden har användandet av kondom varit ett sätt att skydda sig från oönskade graviditeter, och på senare år, även könssjukdomar. Trots att kondom är det bästa skyddet vid en tillfällig sexuell kontakt, används den i för liten utsträckning. För att kunna motivera till ett ökat kondomanvändande måste faktorer och upplevelser som påverkar kondomanvändandet identifieras.</p><p>Syftet med föreliggande studie var att belysa studenters erfarenheter av kondomanvändning vid en tillfällig sexuell kontakt. Fyra kvinnliga och fyra manliga studenter på ett svenskt universitet har deltagit och berättat om sina erfarenheter och tankar. Vad är det som gör att de använder eller inte använder kondom vid en tillfällig sexuell kontakt, och vilka upplevelser kan kopplas till lidande och välbefinnande? Intervjuerna har analyserats med en kvalitativ innehållsanalys.</p><p>Viktiga fynd i resultatet är att kondomanvändning inte bara upplevs som negativt. Både att använda och inte använda kondom upplevs komplext genom att både välbefinnande och lidande kan erfaras. Dessa upplevelser kan vara t.ex. ökad fysisk njutning då man inte</p><p>använder kondom eller att slippa ångest och oro för könssjukdomar och graviditeter då man använder. En annan viktig aspekt är att valet om att använda inte bara hänger på individens upplevelser eller värderingar utan även, och nästan mer, på praktiska faktorer som tillgänglighet och högt pris.</p>

abstract: The value of safe sex may be discounted based on contextual factors associated with an opportunity for sex. College students (n = 75) in a within-subjects study selected hypothetical sexual partners from a set of pictures and classified them based on attractiveness and estimated chance of having an STI. In the sexual delay discounting (SDD) task, participants rated their likelihood (0 – 100%) of waiting for some period of time (e.g., 3 hours) to have protected sex with their selected partners, when they could have immediate sex without protection. In the sexual probability discounting (SPD) task, participants rated their likelihood of having protected sex if the opportunity was uncertain (e.g., 50%), when they could have unprotected sex for sure (100%). All participants included in the final analyses were aware of and had a positive attitude towards protection against STIs as they indicated preference for immediate (or certain) protected sex. Results show that participants’ willingness to have safe sex systematically decreased as the delay to and odds against having safe sex increased. However, these discounting patterns were observed only in some partner conditions but not others, showing that preference for delayed (or uncertain) safe sex was altered by perceived attractiveness and STI risk of sexual partners. Moreover, the hyperbolic discounting model provided good to acceptable fit to the delay and probability discounting data in most-wanted and least-STI conditions. Gender differences in devaluation of safe sex were also found. / Dissertation/Thesis / Masters Thesis Psychology 2016