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Introdução: A gravidez e o puerpério são períodos de mudanças físicas, psicológicas e socioculturais que podem alterar a sexualidade e levar a disfunções sexuais. A sexologia tem adotado instrumentos de avaliação da função sexual (FS) para auxiliar no diagnóstico das disfunções, como o Índice da Função Sexual Feminina (IFSF). Apesar disso, o comportamento e os fatores associados a FS das mulheres durante a gestação e o pós-parto não estão bem estabelecidos na literatura. Objetivo: Analisar a FS das mulheres desde a gestação até 6 meses após o parto. Método: Coorte prospectiva com 500 mulheres desde o primeiro trimestre da gestação até 6 meses após o parto, realizada em um serviço do setor suplementar de saúde em Guarulhos, SP. Foram incluídas na amostra todas as mulheres que iniciaram o pré-natal e atenderam aos critérios de inclusão do estudo no período ininterrupto de 21 de novembro de 2012 a 17 de setembro de 2013. Foram considerados como exposição a idade gestacional (IG) e os dias de pós-parto; e como desfecho, a FS. As mulheres foram acompanhadas em seis etapas: Etapa 1, com IG < 13 semanas (n = 500); Etapa 2, com IG de 20 a 27 semanas (n = 226); Etapa 3, com IG de 31 a 38 semanas (n = 187); Etapa 4, de 39 a 66 dias após o parto (n=89); Etapa 5, de 76 a 135 dias (n = 64); Etapa 6, com 168 a 208 dias (n = 30). A FS foi avaliada pelo IFSF. Foi realizada análise descritiva, inferencial e múltipla. Resultados: Na gestação, 84,6%, 88,9% e 70,6% das mulheres tiveram atividade sexual no primeiro, segundo e terceiro trimestres, respectivamente. Após o parto, essa proporção foi de 53,9%, 90,6% e 86,7%, nas etapas 4, 5 e 6, respectivamente. A média do escore do IFSF nas 6 etapas foi: 27,7 (dp = 4,9); 27,1 (dp = 4,7); 26,0 (dp = 5,5); 24,8 (dp = 6,1); 26,3 (dp = 6,1) e 26,5 (dp = 5,2), respectivamente. Houve diferença estatística nos escores do IFSF na gestação (p = 0,001) e entre a gestação e após o parto (p = 0,022). As variáveis que, em conjunto, explicam a variação na média do IFSF são: trimestre gestacional e dias de pós-parto, incontinência urinária (IU) e força dos músculos do assoalho pélvico (FMAP). Na etapa 3, o escore do IFSF foi 1,8 (95%IC -2,94 a -0,71) menor que na etapa 1; na etapa 4, foi 2,2 (95%IC -3,65 a -0,77) menor que na etapa 1; na etapa 5, foi 1,4 (95%IC -2,67 a -0,03) menor que na etapa 1. Mulheres com IU tiveram 2,1 (95%IC -3,26 a -0,85) pontos a menos no escore do IFSF do que mulheres sem IU. Na etapa 4, mulheres com IU tiveram 11,3 (95% IC -20,94 a -1,66) pontos a menos no escore do IFSF do que mulheres sem IU na etapa 1. Na etapa 5, esse escore foi 13,3 (-21,60 a -5,09) pontos a menos em relação à etapa 1. A cada 1,0 cmH20 a mais na medição da FMAP, as mulheres tiveram 0,04 pontos a mais no escore IFSF. Na análise de subgrupo após o parto, em mulheres com IU, o escore do IFSF foi 10,5 (95%IC -20,16 a -0,89) pontos menor que em mulheres sem IU. A cada 1,0 cmH20 a mais na medição da FMAP após o parto, as mulheres tiveram 0,08 pontos a mais no escore do IFSF. Conclusões: A FS diminui gradativamente no decorrer da gestação e nos dois primeiros meses após o parto. Do terceiro ao sexto mês após o parto, as mulheres recuperam parcialmente a FS. A IU contribui para a diminuição do escore do IFSF na gestação e após o parto, com maior impacto nos primeiros 4 a 5 meses pós-parto. O impacto clínico da FMAP no escore do IFSF é desprezível. / Introduction: Pregnancy and postpartum are periods of physical, psychological and socio-cultural changes that can affect the sexuality and cause sexual dysfunction. Sexology has adopted assessment tools to measure sexual function (SF) to help on the diagnosis of disorders such as the Female Sexual Function Index (FSFI). Nevertheless, the behaviour and the associated factors with women SF during pregnancy and postpartum are not well established in the literature. Objective: To analyze the women SF from pregnancy to 6 months after delivery. Methods: Prospective cohort study with 500 women from the first trimester of pregnancy until six months after birth, held in a insurance health care facility in Guarulhos, SP. The sample was all women who start prenatal care and met the study inclusion criteria in an uninterrupted period of November, 21th 2012 to September, 17th 2013. The gestational age (GA) and days after birth were considered as exposure; and as an outcome, SF. The women were followed in six steps: Step 1, with GA < 13 weeks (n = 500); Step 2, with GA from 20 to 27 weeks (n = 226); Step 3, with GA from 31 to 38 weeks (n = 187); Step 4, from 39 to 66 days after birth (n = 89); Step 5, from 76 to 135 days (n = 64); Step 6, from 168 to 208 days (n = 30). The SF was assessed by FSFI. Descriptive, inferential and multivariate analysis was performed. Results: During pregnancy, 84.6%, 88.9% and 70.6% of women had sexual activity in the first, second and third trimesters respectively. After birth, this ratio was 53.9%, 90.6% and 86.7% in steps 4, 5 and 6, respectively. The mean score of FSFI in the 6 steps was: 27.7 (sd = 4.9); 27.1 (sd = 4.7); 26.0 (sd = 5.5); 24.8 (sd = 6.1); 26.3 (sd = 6.1) and 26.5 (sd = 5.2), respectively. There was a statistical difference in the FSFI scores during pregnancy (p = 0.001) and between the pregnancy and postpartum (p = 0.022). The variables that together explain the variation in the IFSF score are: trimester and days after birth, urinary incontinence (UI) and pelvic floor muscles strength (PFMS). In step 3, the IFSF score was 1.8 (95% CI -2.94 to -0.71) lower than in step 1; in step 4, was 2.2 (95% CI -3.65 to -0.77) lower than in step 1; in step 5, was 1.4 (95% CI -2.67 to -0.03) lower than in step 1. Women with UI had 2.1 (95% CI -3.26 to -0.85) points less in the FSFI score than women without UI. In step 4, women with UI had 11.3 (95% CI -20.94 to -1.66) points less in IFSF score than women without UI in step 1. In step 5, this score was 13.3 (-21.60 to -5.09) points less in relation to the step 1. Every 1.0 cmH2O in the PFMS increase 0.04 points the FSFI score. In a subgroup analysis after birth, women with UI had FSFI score 10.5 (95% CI -20.16 to -0.89) points less than women without UI. Every 1.0 cmH2O in the PFMS after birth, women had more 0.08 points at FSFI score. Conclusions: SF gradually decreases during the pregnancy and in the first 2 months after delivery. From 3 t 6 month after delivery, women partially recover the SF. The UI contributes to reduce the FSFI score during pregnancy and after birth, with an important impact in the first 4-5 months after birth. The clinical impact of the PFMS in the FSFI score is negligible.

An association between persistent Human papillomavirus (HPV) infection in women and cervical cancer has been established. Young women are particularly at risk of acquiring sexually transmitted infections such as HPV because of risky sexual activity and physiological immaturity. While at risk though, young women have been shown to be amenable to health promoting initiatives. There are a small number of international studies concerning adolescent HPV infection and the risk factors associated with infection, but there is currently no evidence on the prevalence and risk factors for HPV in an Australian, sexually active female adolescent population. This study aimed to provide evidence of the prevalence of HPV, risk factors associated with infection and the patterns of sexual activity in a female sexually active, senior high school population in the Australian Capital Territory. Participants in this study were a convenience sample of 161 sexually active 16-19 year old females who had an HPV test who were attending a senior high school in the Australian Capital Territory. Nurses and doctors using a clinical record collected information about sexual and other risk behaviours. Self-obtained vaginal swabs were tested for HPV DNA using the polymerase chain reaction method and genotyping was undertaken. The HPV prevalence in this cohort of young women was 1 1.2%. High-risk genotypes were found in 55.5% and multiple genotypes were found in 38.8%. There was a significant association found between HPV infection and having had more than one male partner with whom vaginal intercourse had occurred in the previous six months. No statistically significant association was found between HPV and the age of coitarche, length of time young women had been sexually active, condom use, and smoking or alcohol intake. A young age at coitarche was common for this group. Smoking and alcohol use was seen in large proportions in this group. This is the first Australian study that has examined the prevalence and risk factors for genital HPV in this demographic group. The HPV prevalence is lower than in international studies in comparable groups, in similar age groups and much lower than in older women both in Australia and overseas. With the comparatively low prevalence comes an opportunity for important public health interventions for this group including routine Pap smears, vaccination against the high-risk types of HPV when this becomes available and strategies for young women to reduce their number of male sexual partners. A substantial amount of young women in this study were sexually active aged under 16 years. Whilst this was not identified as being a risk factor in this study, it is both a health and personal safety issue for these young women. There is a demonstrated need for health promotion strategies for this cohort about the consumption of safe levels of alcohol and for smoking cessation. Further research is recommended that includes a repetition of this study with a larger sample, the use of a prospective study design to identify trends in infection and examination of HPV prevalence and risk factors for a variety of populations.

The primary objective of this study was to investigate whether adolescents make use of an ethical decision–making framework when they make choices in relation to sexual activities and the elements that make up this ethical decision–making framework. The adolescent stage of development is characterized by physical and cognitive changes, of which the development of sexual characteristics and morality are only parts. Both these developments are discussed at length within the context of adolescent sexual activity, and cognitive and moral development. Different influences on the morality of adolescents were identified, of which the faith community of adolescents were one. These elements also influence the ethical decision–making framework of adolescents on sexual activity. The influence of the religious community on the ethical decision–making framework of adolescents was also investigated on the basis of the faith community's message about sexual activities and the perceptual influence of the religious community on the morality of adolescents. The sexual activity of adolescents, adolescents? perceptions about these sexual activities as well as the messages and sources of information that are available to adolescents with regard to sex was identified by making use of Participant Observation Research. A small group of participants and observers used the PIRASH program to identify the above–mentioned information. The participants also identified the obstacles that adolescents must overcome to establish a healthy sexual life, and what their definition of a healthy sexual life is. Participants in this study agreed that their faith community did not provide enough information to adolescents about sex and sexual activities. Participants indicated this lack of information as their reason for using other sources of information about sexual activities. These messages conveyed by other sources, including those of the media, friends and parents vary from those the faith community has about sex. Adolescents have easier access to these other sources; therefore there is a difference between the faith community's view on sexual activity and that of the adolescents who form part of the faith community. It is concluded that it is necessary, almost urgently, for faith communities to establish the actual view of adolescents who form part of the community, on sexual activity, and to have a stronger influence on the ethical decision–making framework of adolescents. The ethical decision–making framework of adolescents can only be influenced if the faith communities speak more comfortably and more extensively with their adolescents about sex and sexual activities. Postmodern adolescents have access to a variety of sources with a variety of messages about sex and the importance of moral messages from the faith community cannot be underestimated. A secondary outcome of this study was to explore the possibility of Participant Observation Research as research methodology within Theological Ethics. / Thesis (M.A. (Ethics))--North-West University, Potchefstroom Campus, 2011.

The primary objective of this study was to investigate whether adolescents make use of an ethical decision–making framework when they make choices in relation to sexual activities and the elements that make up this ethical decision–making framework. The adolescent stage of development is characterized by physical and cognitive changes, of which the development of sexual characteristics and morality are only parts. Both these developments are discussed at length within the context of adolescent sexual activity, and cognitive and moral development. Different influences on the morality of adolescents were identified, of which the faith community of adolescents were one. These elements also influence the ethical decision–making framework of adolescents on sexual activity. The influence of the religious community on the ethical decision–making framework of adolescents was also investigated on the basis of the faith community's message about sexual activities and the perceptual influence of the religious community on the morality of adolescents. The sexual activity of adolescents, adolescents? perceptions about these sexual activities as well as the messages and sources of information that are available to adolescents with regard to sex was identified by making use of Participant Observation Research. A small group of participants and observers used the PIRASH program to identify the above–mentioned information. The participants also identified the obstacles that adolescents must overcome to establish a healthy sexual life, and what their definition of a healthy sexual life is. Participants in this study agreed that their faith community did not provide enough information to adolescents about sex and sexual activities. Participants indicated this lack of information as their reason for using other sources of information about sexual activities. These messages conveyed by other sources, including those of the media, friends and parents vary from those the faith community has about sex. Adolescents have easier access to these other sources; therefore there is a difference between the faith community's view on sexual activity and that of the adolescents who form part of the faith community. It is concluded that it is necessary, almost urgently, for faith communities to establish the actual view of adolescents who form part of the community, on sexual activity, and to have a stronger influence on the ethical decision–making framework of adolescents. The ethical decision–making framework of adolescents can only be influenced if the faith communities speak more comfortably and more extensively with their adolescents about sex and sexual activities. Postmodern adolescents have access to a variety of sources with a variety of messages about sex and the importance of moral messages from the faith community cannot be underestimated. A secondary outcome of this study was to explore the possibility of Participant Observation Research as research methodology within Theological Ethics. / Thesis (M.A. (Ethics))--North-West University, Potchefstroom Campus, 2011.

Introdução: A gravidez e o puerpério são períodos de mudanças físicas, psicológicas e socioculturais que podem alterar a sexualidade e levar a disfunções sexuais. A sexologia tem adotado instrumentos de avaliação da função sexual (FS) para auxiliar no diagnóstico das disfunções, como o Índice da Função Sexual Feminina (IFSF). Apesar disso, o comportamento e os fatores associados a FS das mulheres durante a gestação e o pós-parto não estão bem estabelecidos na literatura. Objetivo: Analisar a FS das mulheres desde a gestação até 6 meses após o parto. Método: Coorte prospectiva com 500 mulheres desde o primeiro trimestre da gestação até 6 meses após o parto, realizada em um serviço do setor suplementar de saúde em Guarulhos, SP. Foram incluídas na amostra todas as mulheres que iniciaram o pré-natal e atenderam aos critérios de inclusão do estudo no período ininterrupto de 21 de novembro de 2012 a 17 de setembro de 2013. Foram considerados como exposição a idade gestacional (IG) e os dias de pós-parto; e como desfecho, a FS. As mulheres foram acompanhadas em seis etapas: Etapa 1, com IG < 13 semanas (n = 500); Etapa 2, com IG de 20 a 27 semanas (n = 226); Etapa 3, com IG de 31 a 38 semanas (n = 187); Etapa 4, de 39 a 66 dias após o parto (n=89); Etapa 5, de 76 a 135 dias (n = 64); Etapa 6, com 168 a 208 dias (n = 30). A FS foi avaliada pelo IFSF. Foi realizada análise descritiva, inferencial e múltipla. Resultados: Na gestação, 84,6%, 88,9% e 70,6% das mulheres tiveram atividade sexual no primeiro, segundo e terceiro trimestres, respectivamente. Após o parto, essa proporção foi de 53,9%, 90,6% e 86,7%, nas etapas 4, 5 e 6, respectivamente. A média do escore do IFSF nas 6 etapas foi: 27,7 (dp = 4,9); 27,1 (dp = 4,7); 26,0 (dp = 5,5); 24,8 (dp = 6,1); 26,3 (dp = 6,1) e 26,5 (dp = 5,2), respectivamente. Houve diferença estatística nos escores do IFSF na gestação (p = 0,001) e entre a gestação e após o parto (p = 0,022). As variáveis que, em conjunto, explicam a variação na média do IFSF são: trimestre gestacional e dias de pós-parto, incontinência urinária (IU) e força dos músculos do assoalho pélvico (FMAP). Na etapa 3, o escore do IFSF foi 1,8 (95%IC -2,94 a -0,71) menor que na etapa 1; na etapa 4, foi 2,2 (95%IC -3,65 a -0,77) menor que na etapa 1; na etapa 5, foi 1,4 (95%IC -2,67 a -0,03) menor que na etapa 1. Mulheres com IU tiveram 2,1 (95%IC -3,26 a -0,85) pontos a menos no escore do IFSF do que mulheres sem IU. Na etapa 4, mulheres com IU tiveram 11,3 (95% IC -20,94 a -1,66) pontos a menos no escore do IFSF do que mulheres sem IU na etapa 1. Na etapa 5, esse escore foi 13,3 (-21,60 a -5,09) pontos a menos em relação à etapa 1. A cada 1,0 cmH20 a mais na medição da FMAP, as mulheres tiveram 0,04 pontos a mais no escore IFSF. Na análise de subgrupo após o parto, em mulheres com IU, o escore do IFSF foi 10,5 (95%IC -20,16 a -0,89) pontos menor que em mulheres sem IU. A cada 1,0 cmH20 a mais na medição da FMAP após o parto, as mulheres tiveram 0,08 pontos a mais no escore do IFSF. Conclusões: A FS diminui gradativamente no decorrer da gestação e nos dois primeiros meses após o parto. Do terceiro ao sexto mês após o parto, as mulheres recuperam parcialmente a FS. A IU contribui para a diminuição do escore do IFSF na gestação e após o parto, com maior impacto nos primeiros 4 a 5 meses pós-parto. O impacto clínico da FMAP no escore do IFSF é desprezível. / Introduction: Pregnancy and postpartum are periods of physical, psychological and socio-cultural changes that can affect the sexuality and cause sexual dysfunction. Sexology has adopted assessment tools to measure sexual function (SF) to help on the diagnosis of disorders such as the Female Sexual Function Index (FSFI). Nevertheless, the behaviour and the associated factors with women SF during pregnancy and postpartum are not well established in the literature. Objective: To analyze the women SF from pregnancy to 6 months after delivery. Methods: Prospective cohort study with 500 women from the first trimester of pregnancy until six months after birth, held in a insurance health care facility in Guarulhos, SP. The sample was all women who start prenatal care and met the study inclusion criteria in an uninterrupted period of November, 21th 2012 to September, 17th 2013. The gestational age (GA) and days after birth were considered as exposure; and as an outcome, SF. The women were followed in six steps: Step 1, with GA < 13 weeks (n = 500); Step 2, with GA from 20 to 27 weeks (n = 226); Step 3, with GA from 31 to 38 weeks (n = 187); Step 4, from 39 to 66 days after birth (n = 89); Step 5, from 76 to 135 days (n = 64); Step 6, from 168 to 208 days (n = 30). The SF was assessed by FSFI. Descriptive, inferential and multivariate analysis was performed. Results: During pregnancy, 84.6%, 88.9% and 70.6% of women had sexual activity in the first, second and third trimesters respectively. After birth, this ratio was 53.9%, 90.6% and 86.7% in steps 4, 5 and 6, respectively. The mean score of FSFI in the 6 steps was: 27.7 (sd = 4.9); 27.1 (sd = 4.7); 26.0 (sd = 5.5); 24.8 (sd = 6.1); 26.3 (sd = 6.1) and 26.5 (sd = 5.2), respectively. There was a statistical difference in the FSFI scores during pregnancy (p = 0.001) and between the pregnancy and postpartum (p = 0.022). The variables that together explain the variation in the IFSF score are: trimester and days after birth, urinary incontinence (UI) and pelvic floor muscles strength (PFMS). In step 3, the IFSF score was 1.8 (95% CI -2.94 to -0.71) lower than in step 1; in step 4, was 2.2 (95% CI -3.65 to -0.77) lower than in step 1; in step 5, was 1.4 (95% CI -2.67 to -0.03) lower than in step 1. Women with UI had 2.1 (95% CI -3.26 to -0.85) points less in the FSFI score than women without UI. In step 4, women with UI had 11.3 (95% CI -20.94 to -1.66) points less in IFSF score than women without UI in step 1. In step 5, this score was 13.3 (-21.60 to -5.09) points less in relation to the step 1. Every 1.0 cmH2O in the PFMS increase 0.04 points the FSFI score. In a subgroup analysis after birth, women with UI had FSFI score 10.5 (95% CI -20.16 to -0.89) points less than women without UI. Every 1.0 cmH2O in the PFMS after birth, women had more 0.08 points at FSFI score. Conclusions: SF gradually decreases during the pregnancy and in the first 2 months after delivery. From 3 t 6 month after delivery, women partially recover the SF. The UI contributes to reduce the FSFI score during pregnancy and after birth, with an important impact in the first 4-5 months after birth. The clinical impact of the PFMS in the FSFI score is negligible.

Bakgrund: Hjärtinfarkt är en av de vanligaste sjukdomarna i Sverige. Efter en genomgången hjärtinfarkt kan den sexuella hälsan, som definieras som ett psykiskt, socialt och mentalt välbefinnande, påverkas på flera sätt. Syfte: Att beskriva hur patienter erfar sin sexuella hälsa efter en genomgången hjärtinfarkt. Metod: En litteraturöversikt som innefattar 11 vetenskapliga artiklar. Resultat: Ur analysen identifierades fyra teman;bristande sexuell rådgivning, osäkerhet över kroppens förmåga, förändrad sexuell aktivitet och förändrad harmoni i kärleksrelationen. Slutsats: För att öka eller bibehålla den sexuella hälsan hos patienten efter en hjärtinfarkt är det viktigt att sjuksköterskan ska kunna samtala och ge råd om den sexuella hälsan till patienterna, vilket är ett av sjuksköterskans ansvarsområden. / Background: Myocardial infarction is one of the most common diseases in Sweden. After arecent heart attack, sexual health, which is defined as mental, social and mental well-being, can be affected in several ways. Aim: To describe how patients experience their sexual health after arecent heart attack. Method: A literature review that includes 11 scientific articles. Results:From the analysis four themes were identified; lack of sexual counseling, uncertainty about the body's ability, altered sexual activity and altered harmony in the love relationship. Conclusion: In order to increase or maintain the sexual health of the patient after a heart attack, it is important that the nurse should be able to talk and advise about the sexual health to the patients, which is one of the nurse's areas of responsibility.

The topic of this thesis is the effect of pornography consumption on the partner sexual activity. The content of the theoretical part is the definition of pornography, history of pornography and psychological view on pornography. Furthermore, the work deals with the current psychological research concerning the influence on individual areas of sexual activity. The empirical part aims to discover the connection between the pornography consumption and sexual activity in relationships, such as frequency of sexual activities, sexual satisfaction, sexual communication and openness or repertoire and frequency of using partner sexual practices. The research was carried out using an anonymous online questionnaire, in which respondents were selected by the method of self-selection. The outcomes of the thesis could be used in relationship and sexuology counseling as a tool for deeper understanding of sexuality in relationships and for more accurate targeting of help in this area of problems. Keywords pornography consumption, relationship, sexual activity, sexual satisfaction, sexual communication

Sexual function in men with Spinal Cord Injury (SCI) is usually affected to a greater or lesser extent, depending on the type of injury and physiological prerequisites. Social contexts and psychological factors are other aspects that affect sexual function. Sexual dysfunction can lead to an impaired quality of life, depression and other illnesses. Aim: To study reported experiences of sexual function in men with SCI who have participated in The Nordic Spinal Injury Registry (NSCIR) five years follow-up. Design: Quantitative method consisting of a register study based on secondary data. Setting: Information collected from units at Linköping and Umeå, which are two of Sweden's six units of the County Councils' Centers for Spinal Cord Injuries. Sample: Eighty-two men with SCI between ages 19-81 years (mean age: 48 years). Method: A Study of NSCIR´s five years follow-ups regarding the questionnaires for Sexual function and Socio-demographic. Results: Fifty-nine percent (34/58) reported that sexual function was unsatisfactory in relation to intercourse. Almost 80% (55/69) reported experiencing sexual desire after injury. Fifty-four percent (38/70) reported engaging in sexual activity. Conclusions: The results are useful in the aim of developing Spinal Cord Injury care to optimize sexual rehabilitation for men with SCI and to provide a basis for confident and satisfactory sexuality and a better quality of life.

This study described sexual behaviours among adolescents living with the Human Immunodeficiency Virus (HIV) in Zimbabwe. This study utilised a quantitative descriptive design. Data was collected using structured questionnaires from 341 adolescents living with HIV. Findings revealed that some adolescents were sexually active and had early onset of sexual activity (before their sixteenth birthday). A good proportion of sexually active adolescents were noted not to practise safer sex and the main reason was condom inaccessibility and some had multiple sex partners. Factors independently associated with being sexually active included exposure to erotic content on television programmes, having a psychiatric diagnosis, discussions of sexuality with health worker and older age. Adolescents` behaviours living with HIV and the issue of availability of condoms may play a part in the spread of HIV. More discussions and research on sexuality of adolescents are recommended / Health Studies / M.A. (Public Health)