A link between binge drinking, negative sexual health outcomes, and sexual victimization among university populations is well established in the research literature (Messman-Moore et al., 2013; PHAC, 2016; Smith et al., 2009). Despite these known risks, young people often hold beliefs that alcohol consumption can enhance or facilitate their sexual experiences, however, less is known about the role of alcohol in young women’s consensual sexual experiences. In this qualitative study, I used a feminist perspective to explore young women’s perceptions and experiences of the role of alcohol in their sexual agency – the ability to communicate and fulfill their sexual desires and boundaries – and the social norms that influence this relationship. I collected data through interviews with 14 young university women between the ages of 19 and 25 who identified as heterosexual, lesbian, bisexual, or queer. Participants identified heteronormative sexuality norms that influence the role of alcohol in their sexual agency, namely the prioritization of women’s sexual inexperience, female sexual fidelity, and women’s attractiveness. Participants perceived that alcohol influenced their sexual agency at an individual and social level. In their individual experiences, participants discussed the dis-inhibitory effects of alcohol as a “tool” to alleviate feelings of shame associated with sexual expression and negative body image. At a social level, participants used alcohol as a means to deflect social stigma associated sexual expression as they could “blame the alcohol” as their motivation for engaging in sexual activity. These findings suggest that young women’s motivations for drinking may be linked to sexuality norms that discourage young women’s sexual agency, which could be relevant to consider in health promotion and harm reduction efforts. / Graduate / 0573 / 0453 / 0733 / 0758 / eecusack@gmail.com

Since June of 2013, Plan B and its generics have been available over-the-counter without age restriction nationwide. Even so, pharmacy-based economic, physical, and staff-associated barriers still exist, potentially leading adolescent customers to fail to obtain emergency contraception (EC) in a sufficiently timely manner to prevent pregnancy. This study explores these pharmacy-based barriers to EC in the state of Kentucky focusing on comparisons of urban and non-urban pharmacies and chain and private pharmacies. Using a secret-shopper survey technique, the researcher called 220 Kentucky pharmacies acting as a 15-year-old girl seeking information about EC. Among other findings, a logistic regression analysis revealed that private pharmacies were 97% less likely to carry EC compared to chain pharmacies (OR= .027; p

Bakgrund: Allt fler människor tillhör gruppen äldre. De går igenom både fysiologiska och psykiska förändringar under sin livstid som kan påverka den sexuella hälsan. Den sexuella hälsan är ett brett begrepp som inkluderar både kroppsliga och känslomässiga aspekter. Syfte: Att beskriva hur personer över 60 år upplever att åldrandet påverkar deras sexuella hälsa. Metod: En litteraturöversikt baserad på elva artiklar med kvalitativ design. Dataanalysen utgick från Fribergs femstegsmodell. Resultat: Följande teman presenteras: Ökade barriärer för den sexuella hälsan, Förändrat sexuellt uttryck och Ökad sexuell frihet. Äldre upplever både positiva och negativa förändringar av sin sexuella hälsa. Genom att förhålla sig till dessa förändringar kunde de äldre uppleva att deras sexuella hälsa var fortsatt god, i vissa fall bättre. De upplevde även att åldern kunde medföra en sexuell frihet fri från ungdomens förpliktelser. Slutsats: Sexuell hälsa förknippas starkt med en relation. De som inte har ett sexuellt samliv kan komma att lägga sina sexuella behov åt sidan och anse att den delen av livet är över. Vid ett nytt förhållande kan dock lusten återupplivas. Det finns ett behov att uppdatera synen på den äldre sexuella människan. / Background: An increasing number of people belong to the older age group. They have undergone both physiological and psychological changes during their lifetime which may affect the sexual health. Sexual health is a broad concept that includes both bodily and emotional aspects. Purpose: To describe how people over the age of 60 experience the effects of aging affect their sexual health. Method: A literature review based on eleven articles with qualitative design. The databases CINAHL, Medline and Ageline were used. Data analysis was based on Friberg's five-step model. Result: The following themes are presented: Increased Barriers to Sexual Health, Changed Sexual Expression and Increased Sexual Freedom. Older people experience both positive and negative changes in their sexual health. By addressing these changes, the elderly could experience that their sexual health was still good, in some cases better. They also felt that age could lead to sexual freedom, free of youth's obligations. Conclusion: Sexual health is strongly associated with a relationship. Those who do not have sexual partnership may lay their sexual desire aside and consider that part of life to be over. However, in a new relationship, the desire can be revived. There is a need to update the view of the older sexual person.

Bakgrund: Kvinnors sexuella hälsa kan påverkas negativt av behandlingar mot bröstcancer samt orsaka lidande. Medicinsk behandling mot bröstcancer orsakar bland annat klimakteriebesvär, trötthet och håravfall, medan kirurgisk behandling kan påverka kvinnornas självbild. Syfte: Att belysa kvinnors upplevelser av hur den sexuella hälsan har påverkats av behandling mot bröstcancer. Metod: En litteraturöversikt baserad på kvalitativa och kvantitativa forskningsresultat. Resultat: Tre kategorier identifierades i resultatet; nedsatt sexuell aktivitet, förändrad kroppsuppfattning och självbild samt relationens påverkan på den sexuella hälsan. De vanligaste biverkningarna som upplevdes var minskad sexuell lust och smärta vid samlag på grund av vaginal torrhet. Förlust av kvinnlighet till följd av mastektomi var en vanligt förekommande upplevelse hos kvinnorna. En stöttande och förstående partner belystes vara betydelsefullt och främjade deras sexuella hälsa. Konklusion: Kvinnors sexuella hälsa påverkas både mentalt och fysiskt av behandling mot bröstcancer vilket bör uppmärksammas av sjuksköterskor inom alla vårdinstanser. Det är viktigt att sjuksköterskor arbetar utifrån ett patientcentrerat förhållningssätt och anpassar information och stöd efter individuella önskemål och behov för att förebygga sexuell ohälsa. / Background: The sexual health might be negatively affected by breast cancer treatments and cause suffering for women. Medical treatments for breast cancer cause menopausal symptoms, fatigue and hair loss, while surgical treatments might affect women’s body image. Aim: To highlight women's experiences of how their sexual health has been affected by breast cancer treatments. Method: A literature review based on qualitative and quantitative research. Results: Three categories were identified in the result; reduced sexual activity, altered body image and the influence of relationships on the sexual health. The most common side effects that were experienced were reduced sexual desire and pain during sexual intercourse due to vaginal dryness. Loss of femininity as a result of mastectomy was a common experience among these women. It was found that a supportive and understanding partner is important to promote their sexual health. Conclusion: Women's sexual health is affected both mentally and physically by the breast cancer treatments, which should be observed by nurses in all health facilities. It is important that nurses are working from a patient centered approach and adjust information and support to individual requirements and needs to prevent sexual illness.

Bakgrund: Perineala bristningar är vanligt förekommande vid vaginal förlossning. Bristningar kan leda till bland annat smärta i underlivet som i sin tur kan påverka den sexuella hälsan negativt. Befintlig forskning visar att en förlossningsställning kan påverka både uppkomsten samt graden av bristning, dock framkommer inte förklaring om varför. Syfte: Undersöka barnmorskors uppfattning av förlossningsställningens betydelse för perineala bristningar under utdrivningsskedet. Metod: Studien baseras på en fenomenografisk forskningsmetod där tio intervjuer har genomförts med barnmorskor från sex olika förlossningsavdelningar i södra och mellersta Sverige. Resultat: Förlossningsställningen uppfattas av barnmorskor kunna avlasta trycket mot perineum, undvika ett utdraget utdrivningsskede, vara avgörande för kvinnors kroppskontroll samt bidra till ett långsamt framfödande, vilket uppfattas minska risken för uppkomst av perineala bristningar. Förlossningsställningen uppfattas även kunna öka belastningen mot perineum, minska kvinnors möjlighet att själv kontrollera sin kropp samt bidra till spänd muskulatur i bäckenbotten, vilket uppfattas öka risken för perineala bristningar. I denna studie belyser även barnmorskor värdet av kommunikation med de födande kvinnorna under utdrivningsskedet. Detta uppfattas vara en av de viktigaste faktorerna för att förebygga perineala bristningar. Konklusion: Barnmorskor uppfattar att förlossningsställningen har olika betydelser för perineala bristningar. De för också ett resonemang kring varför och hur bristningar kan uppkomma samt förebyggas relaterat till olika förlossningsställningar. / Background: Perineal tears are common in vaginal delivery. The injury can lead to vaginal pain, which in turn can affect the sexual health negatively. Existing research shows that a birth position can influence both the onset and the degree of rupture, but does not reveal the explanation of why. Aim: Investigate midwives perception of the birth positions significans to perineal tearing during the second stage of labor. Method: The study is based on a phenomenographical research where ten interviews were conducted with midwives from six maternity hospitals in southern and central Sweden. Result: Birth positions is perceived by midwives to relieve pressure on the perineum, avoid prolonged second stage of labor, be crucial to women's body control and contribute to a slow birth, which is perceived to reduce the risk of perineal tearing. The birth position perceived also to be able to increase the pressure against the perineum, reduce women's ability to control their body and contribute to tense muscles in the pelvic floor, which is perceived to increase the risk of perineal tearing. This study also highlights the value of midwives communication with women giving birth during the second stage of labor. This is perceived to be one of the most important factors for the prevention of perineal tearing. Conclusion: Midwives perceive that birth position has different meanings for perineal tearing. Midwives also reason why and how perineal tearing can occur and be prevented related to different birth positions.

Background: Sexuality and sexual health are affected by many factors in a person’s life. A persons’ sexual health matters for their health in general. Nurses has an important role in giving a holistic care to patients, but nurses rarely ask about patients’ sexual health. Aim: The aim was to describe barriers and enabling factors for nurses talking to patients about sexuality and sexual health. Method: A literature review of 20 articles was performed. Results: The analysis resulted in barriers and enabling factors that where both of personal and organizational character. The main findings were that barriers to talking about sexuality and sexual health with the patient were feelings of discomfort, taboo, patients’ age, gender, cultural background and sexual orientation and also lack of time, education/knowledge and routines. Enabling factors for the discussion of sexuality were a good patient-nurse-relation, education, talking about sexuality in relation to the illness/treatment or using humor to bring up the topic. Conclusion: More education is needed about how to address sexuality with older people, HBTQ people and people from different cultures and religions. / Bakgrund: Sexualitet och sexuell hälsa påverkas av många olika faktorer i en människas liv. Den sexuella hälsan är viktig för människans totala upplevelse av hälsa. Sjuksköterskan har en viktig roll i att ge en holistisk omvårdnad, men sjuksköterskor frågar sällan patienter om deras sexuella hälsa.  Syfte: Syftet var att beskriva barriärer och möjliggörande faktorer för samtal mellan sjuksköterska och patient om sexualitet och sexuell hälsa.  Metod: En allmän litteraturstudie över 20 artiklar har genomförts.  Resultat: Analysen resulterade i barriärer och möjliggörande faktorer som var av både personliga och organisatoriska karaktärer. Huvud fynden var att barriärer för att prata om sexualitet och sexuell hälsa var känslor av obekvämhet, tabu, faktorer hos patienten såsom ålder, kön, kulturell bakgrund och sexuell läggning samt tidsbrist, otillräcklig utbildning/kunskapsluckor och otillräckliga rutiner. Möjliggörande faktorer var en god vårdrelation, utbildning, att prata om sexualitet i relation till sjukdom/behandling eller att använda humor för att tala om ämnet.  Slutsats: Resultatet visade att personliga värderingar och attityder ofta var anledning till att inte prata om sexualitet. Mer utbildning behövs för hur sexualitet kan adresseras hos äldre personer, HBTQ-personer och personer med olika kulturell och religiös bakgrund. / <p>Röda Korsets sjuksköterskeförening stipendium 2019</p><p></p>

According to public health research, bisexual men are at elevated risk for contracting STIs and HIV relative to other sexual minority groups (e.g., gay men, lesbian women) as well as heterosexual people; yet, no studies to date have examined contextual factors that may contribute to this sexual health trend. Using a minority stress theory framework, the present study tested the direct and indirect associations of anti-bisexual discrimination with risky sexual behaviors in a sample of 508 self-identified bisexual men (age range = 18 - 76), with internalized biphobia, bisexual identity concealment, and substance use mediating this relation. Bisexual identity centrality’s direct relations with internalized biphobia, bisexual identity concealment, and risky sexual behavior were also tested. A path analysis was used to analyze the data. Results indicated that anti-bisexual discrimination yielded significant direct positive associations with internalized biphobia, bisexual identity concealment, and risky sexual behavior. Internalized biphobia, but not bisexual identity concealment, yielded a significant direct association with substance use, which yielded a significant direct positive link with risky sexual behavior. Bisexual identity centrality yielded significant direct negative associations with both internalized biphobia and bisexual identity concealment, but it yielded a nonsignificant association with risky sexual behavior. Internalized biphobia also yielded a total indirect link with risky sexual behavior through the mediating role of substance use. Implications of these findings for clinical practice and future research with bisexual men are discussed.

Bakgrund: År 2017 drabbades 2850 kvinnor av gynekologisk cancer. Det finns flertalet behandlingsstrategier där den vanligaste är kirurgi. Efter behandlingen kan många kvinnor befinna sig i ett lidande där den sexuella hälsan påverkas. Syfte: Att undersöka kvinnans upplevelse av sexuell hälsa efter behandling av gynekologisk cancer. Metod: Studien har genomförts som en litteraturöversikt baserad på kvalitativa artiklar där materialet grundades på kvinnors upplevelse av sexuell hälsa efter behandling av gynekologisk cancer. Artiklarna hittades på databaserna CINAHL och MEDLINE. Resultat: Resultatet visar på olikheter gällande kvinnors upplevelser av den sexuella hälsan efter behandling av gynekologisk cancer. De vanligaste förekommande förändringarna till följd av behandlingen var torra slemhinnor och förminskad vagina som ledde till smärta vid samlag och bidrog till minskad sexlust. Självkänslan påverkades hos många kvinnor och konsekvenserna av behandlingen inverkade på deras relationer. Deltagarna upplevde otillräcklig information om behandlingens effekter på den sexuella hälsan från vården. Konklusion: Behandlingen resulterade i förändringar på den sexuella hälsan som drabbade kvinnan både psykiskt och fysiskt. Många kvinnor önskade mer information och ett större stöd från sjukvården under sjukdomsförloppet. Sjuksköterskan har ett ansvar att bryta tystnaden och möta patientens känslor kring den förändrade sexualiteten. En ökad kunskap krävs för att förebygga ohälsa hos dessa patienter. / Background: 2850 women suffered from gynecological cancer year 2017. There are several treatment options and the most common one is surgery. After treatment many women suffer from issues regarding their sexual health. Aim: To explore women’s experiences of sexual health after treatment of gynecological cancer. Method: The study was made as a literature review based on qualitative articles where the women expressed their experience of sexual health after treatment of gynecological cancer. The articles were found on the two databases CINAHL and MEDLINE. Result: The result shows that the women had different experiences of how gynecological cancer and the treatment affected their sexual health. The most common effects of the treatment was dry mucous membrane and shortened vagina that made intercourse painful which decreased their libido. For many of the women their self esteem was affected and the majority expressed that the consequences of the treatment had an impact on their relationship. The women of the study experienced a lack of information about the treatments effects on their sexual health from health care providers. Conclusion: The treatment resulted in a change in the womens’ sexual health that affected them both physically and mentally. The women would have appreciated more information and a greater support from healthcare providers during the time of the disease. Nurses have a responsibility to break the silence and meet the patients’ needs when it comes to the change in sexuality. More knowledge is necessary to prevent illness when it comes to these patients.

Introdução: Entre os aspectos das ações desenvolvidas no campo da Saúde Pública voltadas aos adolescentes, no que tange àquelas voltadas à esfera da saúde sexual e reprodutiva, além das questões de vulnerabilidade mais habitualmente abordadas como as DST/ AIDS e gravidez na adolescência, devem ser destacadas as ações que propiciem o desenvolvimento sexual saudável. A adolescência é um conceito histórica e socialmente construído envolvendo indivíduos que vivenciam transformações bio-psico-sociais, nas quais a questão da sexualidade implica uma importante dimensão. O acesso às informações e conhecimentos por adolescentes sobre aspectos sexuais, biológicos, entre outros, pode favorecer a melhor compreensão de seu desenvolvimento, viabilizando maior autonomia nas suas atitudes e decisões. Objetivos: Identificar e caracterizar temas de perguntas que adolescentes do Ensino Médio têm sobre sexualidade em dois momentos históricos distintos; identificar as fontes de informação que adolescentes utilizam e/ou gostariam de utilizar para responder às suas perguntas; e comparar as dúvidas de estudantes do 2º grau de uma mesma escola em dois momentos históricos (1996, 2008). Métodos: Pesquisa transversal, quali-quantitativa, mediante utilização de questionário auto-preenchido aplicado após aprovação do Comitê de Ética em Pesquisa da FSP/USP e consentimento esclarecido da diretoria da escola e dos responsáveis dos adolescentes menores de 18 anos. Compõem o grupo dos sujeitos de pesquisa, adolescentes estudantes do Ensino Médio de uma escola estadual da cidade de São Paulo. Análise: Os dados da pesquisa foram transcritos para um banco de dados do programa Microsoft Access e a análise foi realizada a partir do referencial teórico da Análise de Conteúdo. Resultados: foram sujeitos deste estudo 1178 adolescentes no ano de 1996 e 657 em 2008. A partir dos dados coletados foram criadas 22 categorias de perguntas e percebeu-se que as 11 mais freqüentes se repetiram nos dois anos pesquisados, entretanto essas categorias se manifestaram de forma diferente em relação ao gênero, sendo que as questões relativas aos agravos à saúde como DST/AIDS foram mais freqüentes entre os meninos e as referentes à temática da gravidez entre as meninas. Em relação às fontes que os adolescentes procuram informação sobre sexualidade, a internet foi a mais mencionada e quanto às fontes que os adolescentes gostariam de encontrar a informação, a escola aparece em primeiro lugar. Conclusão: apesar do distanciamento de mais de uma década do material de pesquisa analisado as temáticas sobre sexualidade demonstram um caráter atemporal deste campo do conhecimento, indicando temas centrais que permeiam a vivencia da sexualidade na adolescência ainda que com diferentes ênfases em cada época; quanto às fontes de informação, enquanto o cenário virtual aparece de forma marcante no cotidiano dos adolescentes indicando uma possível instrumentalização melhor para lidar com a sexualidade, a escola aparece como espaço de socialização e de demanda, configurando-se como lócus a ser melhor aproveitado pelas políticas públicas / Introduction: Among the aspects of the developed activities in Public Health area focused on teenagers, related to the sexual and reproductive health, beyond the vulnerability issues most frequently discussed as STD / AIDS and teenager\'s pregnancy, the activities that provide the healthy sexual development should be highlighted. The adolescence is a historical and socially built concept involving individuals who had experienced biological, psychological and social transformations, in which the sexuality issue implicates an important dimension. The access t However o information and knowledge by teenagers about sexual and biological features (among others) may promote a better comprehension of their development making more autonomy practical in their attitudes and decisions. Goals: Identify and characterize questions themes that High School teenagers have about sexuality in two distinct historical moments; identify the sources of information that teenagers use and/or would like to use to answer their questions; and compare the doubts of High School students from the same school in two historical moments (1996, 2008). However Methods: Transversal research, qualitative and quantitative, through using a questioner filled by the teenagers, applied after the approval of the Ethics Committee in Research of FSP/USP and declared consent of the school Directors and the people responsible for the teenagers under 18. The group is composed by research\'s subjects, High School teenager students from a public school in Sao Paulo. Analysis: The research\'s data were transcribed to a database of the software Microsoft Access and the analysis was done from the theoretical reference of Content Analysis. Results: 1178 teenagers were submitted to this study in 1996 and 657, in 2008. From the data collected were created 22 questions categories and it was perceived that the 11 most frequent were repeated in both researches. However those categories were expressed in different ways related to gender: the issues related to the health aggravation like STD/AIDS were more frequent among boys and those referred to the pregnancy thematic among girls. According to this research the internet was the most mentioned source of information about sexuality among teenagers. And among the sources teenagers would like to find information, school is the first one. Conclusion: Despite the distance of more than a decade of the analyzed research material, the thematics about sexuality demonstrate an atemporal characteristic in this knowledge area, indicating central themes that permeates the sexuality experience in adolescence even though with different emphasis in each age; about the informations sources while the virtual scenery appears in a striking way in the teenager\'s quotidian indicating the possibility of having better tools to deal with sexuality, the school appears as an space of socialization and demand, set as location to be better enjoyed by the public politics

Homens e mulheres têm iniciado sua vida sexual, em grande parte, na adolescência e de formas um tanto diferenciadas. As práticas sexuais, nessa fase, têm sido descritas como dinâmicas e em constantes transformações, sendo que seus perfis podem acarretar impacto importante na vida reprodutiva dos adolescentes. Com o intuito de analisar o início da vida sexual de adolescentes, foram realizadas entrevistas domiciliárias com 383 homens e mulheres, não unidos, de 15 a 19 anos de idade, matriculados em uma unidade básica de saúde da família da zona leste do município de São Paulo, correspondendo a uma amostra representativa dos indivíduos deste grupo etário. A análise de regressão logística múltipla identificou como variáveis associadas ao início da vida sexual de adolescentes do sexo masculino a idade, a situação de estudo, a idade materna no primeiro filho, a concordância materna de que adolescentes tenham vida sexual, o fato de que o pai gostaria que seu filho iniciasse a vida sexual independentemente do casamento, o namoro anterior e o namoro atual. Por sua vez, as variáveis associadas ao início da vida sexual entre adolescentes do sexo feminino foram a idade, o tipo de domicílio, o namoro anterior, o namoro atual e a presença de irmão(ã) que tenha vivenciado uma gestação previamente à união. Entre os 164 adolescentes com experiência sexual, foi observada uma convergência na idade em que homens e mulheres tiveram a primeira relação sexual (mediana de 15 anos). No entanto, mesmo que a primeira relação sexual tenha ocorrido em idades similares e igualmente sem planejamento prévio, aspectos importantes do comportamento sexual diferiram entre os adolescentes e deveriam ser lembrados na assistência e promoção de sua saúde reprodutiva e sexual. Assim, as mulheres relataram ter iniciado a vida sexual, principalmente, porque estavam apaixonadas pelo parceiro, que foi, com maior freqüência, seu namorado. Por outro lado, os homens iniciaram sua vida sexual em relacionamentos ocasionais e justificaram como motivação a atração física. A prática contraceptiva foi deixada de lado por 41,5% dos homens e 31,7% das mulheres. Desta forma, os resultados indicaram que os diferenciais de gênero estiveram presentes em todo o processo de iniciação sexual e, ainda, os fatores individuais, tais como o namoro e a idade, e os fatores familiares, tais como os valores e atitudes dos pais e mães acerca da sexualidade, foram marcantes na iniciação sexual dos adolescentes. / Women and men initiate their sexual life in different ways mainly during adolescence. Sexual practices in youth have been described as dynamic and in constant transformation, though its profile should be considered as having an impact in reproductive health. This study aimed to analyse associated factors to the onset of sexual life and to describe the first sexual relationship. Therefore, 383 fifteen to nineteen year-old single males and females enrolled in a family health unit from the east area of the city of São Paulo were interviewed at home. From multiple logistic regression analysis, data showed that associated variables to the onset of sexual life in males were age, schooling insertion, maternal age at first delivery, maternal acceptance that adolescents engage in sexual practices, paternal opinion that son should have the first intercourse independently from a marriage, previous and current dating. On the other hand, associated variables among females were age, house affording, previous and current dating and the presence of a single sibling who had already faced a pregnancy. Among the 164 adolescents who had sexual experience, a convergence in the age males and females initiated their sexual life (median at 15) was observed. Even though the first intercourse occurred at the same age and without planning, important aspects of the sexual behaviour differed between males and females and ought to be taken into consideration in their reproductive and sexual health promotion. Girls said they had the first intercourse because they were in love and it thus occurred majority with a boyfriend. Boys had their first intercourse mainly in occasional relationships and because of physical attraction. Contraceptive practice was observed in 58,5% of the boys and 68,3% of the girls. The results indicated that gender differences were present at the whole sexual initiation process and that individual factors, such as dating and age, and familial factors, such as parents attitudes towards sexuality, were determinants for the sexual initiation of these adolescents.