The focus of this research was to: 1) study the perceptions of female students attending the university Student Health Center, concerning available services, 2) learn how they describe their decisions to obtain care, and 3) identify perceived barriers to reproductive health care and contraception. This exploratory study used a mixed-methods approach that included clinic public-space observations, interviews with health care providers and staff at Student Health Services (SHS), surveys distributed to clients of the campus clinic, and in-depth interviews to contextualize emergent themes. Topics addressed included sexual health behaviors and perceptions, influence of peers and partners, the propagation of health myths, and past experiences with SHS. Gathering practitioner perspectives on student barriers to care, goals of the clinic, and perceived health needs of the student community, allowed for measurement of incongruence between student and staff, thereby adding greater context to results. SHS sought recommendations in order to improve student's use of the Sexual Health and Gynecology clinic, increase accuracy of student's sexual health knowledge, and guide future clinic operations. SHS is now working with the College of Public Health to create improvement projects based on my results, including a peer education program. Research such as this can result in greater student awareness of available services, and more productive communication between patients and provide. Implications on the larger issues of gender and the search for health care, acceptance and knowledge of STI testing, and client comfort are addressed, and provide opportunity for future work in this area.

Young people are at risk of sexually transmitted infections (STI), and engage in sex and drug related risk behaviour. This thesis investigates novel methods to reach youth for research and health promotion. Mobile phone text messages (SMS) are convenient, low cost, fast, and popular among youth. SMS has been utilised in sexual health for clinical management, service delivery and health promotion, but few of these projects have been evaluated. Recognising this lack of research led to the design of a randomised controlled trial investigating the use of SMS and email in sexual health promotion. Recruitment of young people for this trial was piloted at Melbourne’s Big Day Out. 939 young people were recruited in several hours; 30% were classified as being at high risk of STI, and 46% had used illicit drugs in the month prior to the survey. Knowledge of STI was poor. Drug use was associated with both sexual risk behaviour and music preference. The study demonstrated that this festival is a valuable site for sex and drugs research and health promotion. The following year, young people were recruited at the music festival and randomised to an intervention group who received regular sexual health SMS and email, or a control group who received no messages. After 12 months, the intervention group had higher STI knowledge than the control group (OR 2.72, 95%CI 1.68, 4.41) and intervention group females were more likely to have had an STI test (OR 2.51, 95%CI 1.11, 5.69). Respondents’ opinions of the messages were favourable. This simple, low-cost, and novel method was shown to be effective in improving young people’s sexual health. At-risk young people are not well represented in sex and drug behavioural surveillance in Australia. As the pilot study identified that a music festival was a suitable site for sex and drug research, the survey was repeated each year. Between 2005 and 2008, the proportion of young people at risk of STI decreased from 34% to 29%, and recent illicit drug use decreased from 46% to 43%. A limitation of the studies described herein is reliance on self-report, which is subject to recall bias; this can be reduced using diaries to collect behavioural data. Participants completed weekly diaries of sexual behaviour and a retrospective questionnaire. Correlation between the diaries and questionnaire was substantial, adding confidence to the validity of results of other studies in this thesis. Diaries can be collected in different ways; SMS has not previously been used for this purpose. Participants were randomised to complete diaries through SMS, online or paper. Online diaries were superior to SMS in completeness and participant preference, but SMS diaries were more likely to be submitted on time. This thesis has tested several novel options for researching and promoting health to young people. Through music festivals, SMS, and email, young people can be reached through settings and media they are familiar with. Use of these novel methods has increased understanding of risk behaviour among youth and been effective in sexual health promotion.

Good sexual and reproductive health is fundamental to the overall health status of Māori communities. In 2001, the Ministry of Health reported that New Zealand was facing a Chlamydia epidemic. This epidemic has not abated as rates of Chlamydia have increased significantly in the past five years, with disproportionately high rates in young Māori women compared to non-Māori women. Despite significant sexual health disparities, young Māori have had limited opportunities to participate in research focussed on sexual health and voice their opinions and concerns on sexual health issues. This qualitative descriptive study has used a Māori inquiry paradigm and approached the research from a Kaupapa Māori perspective. The primary research question asked what the knowledge, attitudes and reported behaviours of young urban Māori women were in regards to sexual health and in particular, the sexually transmitted infection Chlamydia. Secondary aims were to ascertain the sources of information used and accessibility of sexual health services, as well as identifying resilience factors associated with protection against Chlamydia infection. The data was collected from semi-structured interviews with 16 young Māori women living in the Auckland region. Data analysis involved the inductive approach of categorical content analysis to identify major categorical themes to answer the specific questions posed. The main conclusion was that there are a number of barriers to accessing quality sexual health information and services for young Māori women. Participants’ level of knowledge varied reflecting their personal experiences and many were unaware that Chlamydia is asymptomatic and that delayed diagnosis can lead to fertility problems. The main sources of sexual health information accessed were whānau, peers, school, and contact with health professionals. Racism was identified as one of the barriers to sexual healthcare services. The young women expressed a clear preference for sexual health services to be delivered by Māori. Most importantly, for sexual health interventions to be successful it is essential that Māori communities, including young people and their whānau, are an integral part of creating positive solutions. Resilience factors that may help protect young women from contracting chlamydia characteristic of this group were having a strong connection with a caring adult or friend and parents who viewed sexuality as a normal part of adolescent development. In addition, having a positive Māori cultural identity with an ability to understand bicultural differences was strongly associated with participants accessing sexual healthcare services despite identified barriers.

<p>Bakgrund: Sexualiteten är en viktig del av att vara människa men den är också sårbar vid sjukdom. Hälso- och sjukvården bör ha ett holistiskt synsätt på människan vilket även innefattar att ta hänsyn till den sexuella hälsan. Syftet med studien var att belysa sjuksköterskans respektive patientens perspektiv på kommunikationen om sexuella hälsa vid sjukdom. Resultatet baserades på 13 vetenskapliga artiklar publicerade mellan 2000–2010 och visade att patienterna var missnöjda samt hade ett större behov av kommunikation än vad som gavs. De ville att sjuksköterskan skulle ta initiativet till kommunikation om sexuell hälsa. Sjuksköterskan däremot upplevde en rad hinder för kommunikation och prioriterade patientens sexuella hälsa mycket lägre än patienten. Hindren var genans, attityd och resursbrist såsom tidsbrist och kunskapsbrist. Diskussion: Det är sjuksköterskans ansvar att ta initiativ till kommunikation om sexuell hälsa och bristen på kommunikation får konsekvensen att patientens omvårdnadsbehov inte tillgodoses. Genansen var den största orsaken till att sexuell hälsa inte adresserades av sjuksköterskan. Slutsatsen var att kommunikation om sexuell hälsa var viktigare för patienten än vad sjuksköterskan antog. För att utjämna detta förhållande och komma över genansen behövs utbildning av sjuksköterskan i kommunikation och sexuell hälsa samt att sjuksköterskan bör prioritera sexuell hälsa högre.</p> / <p>Background: Sexuality is an important part of being human, but it is also vulnerable to disease. Health services should have a holistic view of man which also includes taking account of the sexual health. The purpose of this study was to illuminate the patient's and nurse's perspective on communication about sexual health during sickness. The result were based on 13 peer reviewed articles published during 2000-2010 and showed that the patients were dissatisfied with the communication, and had a greater need for it than they where given. The patients wanted the nurse to initiate communication about sexual health. The nurse however experienced a number of barriers to communication and prioritised patient's sexual health much lower than the patient did. Barriers were embarrassment, attitude and lack of resources such as time constraints and lack of knowledge. Discussion: It is the nurse's responsibility to communicate about sexual health and the lack of commuication affects the patient's care needs which therefore are not met. Embarrassments were the major cause why not the nurse addressed the sexual health. The conclusion was that communication about sexual health was more important for the patient than the nurse supposed. To compensate such a relationship there is a need to educate the nurse in sexual health communication to overcome embarrassments and that the nurse should give higher priority to sexual health.</p>

This study examined the relationship between family functioning, as conceptualized by the FACES III instrument, and adolescents’ comfort and frequency communicating about sex, communicating and asserting personal boundaries, and sexual decision making. Quantitative data was collected from 154 Grade 9 students in the North Eastern Nova Scotia region. Gender, family structure, and sexual activity variables were explored. Findings showed that adolescents from balanced families scored higher on sexual decision making, were more comfortable communicating about sex, and communicated more frequently about sex to friends and parents. Females from more adaptive families scored higher on sexual decision making and sexually active adolescents were more comfortable talking about sex and their personal sexual boundaries but spent significantly less time thinking about the consequences of their choices, gathering information, and discussing it with others. Findings help understand adolescent sexual behaviour which is vital for promotion of positive sexual health across the life span. / Family Ecology and Practice

Bakgrund: Sexualiteten är en viktig del av att vara människa men den är också sårbar vid sjukdom. Hälso- och sjukvården bör ha ett holistiskt synsätt på människan vilket även innefattar att ta hänsyn till den sexuella hälsan. Syftet med studien var att belysa sjuksköterskans respektive patientens perspektiv på kommunikationen om sexuella hälsa vid sjukdom. Resultatet baserades på 13 vetenskapliga artiklar publicerade mellan 2000–2010 och visade att patienterna var missnöjda samt hade ett större behov av kommunikation än vad som gavs. De ville att sjuksköterskan skulle ta initiativet till kommunikation om sexuell hälsa. Sjuksköterskan däremot upplevde en rad hinder för kommunikation och prioriterade patientens sexuella hälsa mycket lägre än patienten. Hindren var genans, attityd och resursbrist såsom tidsbrist och kunskapsbrist. Diskussion: Det är sjuksköterskans ansvar att ta initiativ till kommunikation om sexuell hälsa och bristen på kommunikation får konsekvensen att patientens omvårdnadsbehov inte tillgodoses. Genansen var den största orsaken till att sexuell hälsa inte adresserades av sjuksköterskan. Slutsatsen var att kommunikation om sexuell hälsa var viktigare för patienten än vad sjuksköterskan antog. För att utjämna detta förhållande och komma över genansen behövs utbildning av sjuksköterskan i kommunikation och sexuell hälsa samt att sjuksköterskan bör prioritera sexuell hälsa högre. / Background: Sexuality is an important part of being human, but it is also vulnerable to disease. Health services should have a holistic view of man which also includes taking account of the sexual health. The purpose of this study was to illuminate the patient's and nurse's perspective on communication about sexual health during sickness. The result were based on 13 peer reviewed articles published during 2000-2010 and showed that the patients were dissatisfied with the communication, and had a greater need for it than they where given. The patients wanted the nurse to initiate communication about sexual health. The nurse however experienced a number of barriers to communication and prioritised patient's sexual health much lower than the patient did. Barriers were embarrassment, attitude and lack of resources such as time constraints and lack of knowledge. Discussion: It is the nurse's responsibility to communicate about sexual health and the lack of commuication affects the patient's care needs which therefore are not met. Embarrassments were the major cause why not the nurse addressed the sexual health. The conclusion was that communication about sexual health was more important for the patient than the nurse supposed. To compensate such a relationship there is a need to educate the nurse in sexual health communication to overcome embarrassments and that the nurse should give higher priority to sexual health.

<p>Since the early 1980&rsquo / s when the first case of HIV was diagnosed, AIDS remains a serious and threatening health crisis in the world. Sub-Saharan Africa is the region most affected by the HIV/AIDS pandemic having 67 % of the 33 million people infected with HIV globally in 2007. Young people aged 15-24&nbsp / account for an estimated 45% of all new HIV infections worldwide. The study aimed to assess the knowledge and attitudes on HIV/AIDS and sexual&nbsp / behavior among 15-19 year olds in Kenya. A descriptive, cross-sectional survey was conducted among 96 students randomly selected from five public&nbsp / schools in Ngong sub-district. Descriptive and bivariate analysis was conducted using Epi Info 3.3 and SPSS. The main findings indicate that a third&nbsp / (31/96) of respondents were sexually experienced. Knowledge level was however found to be inadequate (below 60 %) indicating a poorly informed sample on knowledge about HIV transmission and prevention. The study showed poor attitudes towards the risk to HIV as only 40 % of both males and females supported the use of condoms even when the sexual partners know each other well. Inaddition, risky sexual behaviors were reported by sexually&nbsp / &nbsp / experienced respondents where condom use in last sexual intercourse was (57 %) among males and (20 %) among females.</p>

Background: Throughout life, sexuality is a central aspect of being human and to experience a full and healthy. Several diseases and treatments can cause problems related to sexuality and sexual health. Despite this, research has shown that nurses, for various reasons choose not to take up the subject with their patients. Aim: The aim of this literature-based study was to illuminate nurses' experiences of talking with patients about sexuality and sexual health. Method: A literature-based study where both qualitative and quantitative studies, have been used. Results: Four categories were formed: Professional liability and competence, nurse perceptions of patient, organization and work environment and culture and religion. The main results showed that the majority of nurses believe that it is their responsibility to talk about sexuality and sexual health of the patient. The obstacles that were identified could be linked to nurse private beliefs about the patient and their religion and culture, and lack of knowledge, experience and organization and work environment. Conclusions: More research is needed in the area in order to find out the underlying causes of the barriers experienced by nurses. / Bakgrund: Under hela livet är sexualitet en central aspekt av att vara mänsklig och för att kunna uppleva en fullständig och god hälsa. Flertalet sjukdomar och behandlingar kan ge upphov till problem relaterade till sexualitet och den sexuella hälsan. Trots detta har forskning visat att sjuksköterskor av olika anledningar väljer att inte ta upp ämnet med sina patienter. Syfte: Syftet med denna litteraturbaserade studie var att belysa sjuksköterskors uppfattningar om att samtala med patienter om sexualitet och sexuell hälsa. Metod: Litteraturbaserad studie där både kvalitativa och kvantitativa studier har använts. Resultat: Fyra kategorier bildades; Yrkesansvar och kompetens, Sjuksköterskans föreställningar om patienten, Organisation och arbetsmiljö och Kultur och religion. Huvudresultatet visade att majoriteten av sjuksköterskorna anser att det ligger på deras ansvar att samtala om sexualitet och sexuell hälsa med patienten. De hinder som kunde identifieras kunde kopplas till sjuksköterskans privata föreställningar om patienten och dennes religion och kultur, samt brist på kunskap, erfarenhet och organisation och arbetsmiljö. Konklusion: Mer forskning behövs inom området med syfte att ta reda på bakomliggande orsaker till de hinder som upplevs av sjuksköterskorna.

Bakgrund: Det är känt att erektil dysfunktion, eller impotens, orsakas av förstorad prostata, depression och diabetes. Den typ av erektil dysfunktion som orsakas av diabetes har en mer komplicerad utveckling än övriga orsaker.Syfte: Syftet med denna litteraturöversikt var att belysa sexuellt aktiva mäns erfarenheter av erektil dysfunktion till följd av diabetes mellitus typ 2. Metod: Metoden som valdes var en litteraturöversikt med kvalitativa och kvantitativa artiklar. Datamaterialet bestod av tio kvantitativa och två kvalitativa artiklar. Resultat: Två kategorier identifierades såsom Livet påverkas samt Förståelse för situationen med underkategorier. Konklusion: Det råder kunskapsbrist i fråga om varför män drabbas av erektil dysfunktion. Många män anser inte att det finns någon fungerande behandling. Om kontroll av den erektila funktionen ingick i årskontrollen av diabetes tillsammans med en välgrundad information samt adekvat behandling skulle de drabbade männen och deras partner få bättre insikt och medvetande om problemet. Detta skulle leda till mindre oro, bättre sexuell och mental hälsa samt en bättre relation. / Background: It is commonly known that erectile dysfunction, popularly known as impotence, is caused by several factors including enlarged prostate, depression and diabetes. The erectile dysfunction caused by diabetes has a more difficult progress than other causes.Aim: The aim of this study was to illustrate sexually active men’s experiences of erectile dysfunction caused by diabetes mellitus type 2. Method: The chosen method was a literature review based of qualitative and quantitative articles. Ten quantitative and two qualitative articles were analysed. Results: Two categories were identified, Affects on life and Understanding the situation with subcategories. Conclusions: There is lack of knowledge about why men suffer from erectile dysfunction. Several of the men do not believe there is a treatment for their problem. If erection status was a part of the annual diabetes check-ups as well as valid information and adequate treatment the men and their partner would have better knowledge and awareness about the condition. This would also result in less anxiety, better sexual and mental health and a better relation.

Since 1999, youth have experienced an increase in HIV incidence. Gay male youth, in particular, are a priority sub-population because they accounted for the highest exposure category in 2008 among youth. Due to the lack of studies on gay male youth who are susceptible to HIV, and the reality that most previous research on stigma may no longer reflect the contemporary context, nursing based research was undertaken. Utilizing critical theory, stigma within the therapeutic relationship was investigated through eight semi-structured interviews with gay male youth who were recruited through a gay men’s sexual health clinic in Ottawa, Canada. The results of this research showed that while stigma, whether perceived stigma or the fear of stigmatization, was still felt by these participants in some interactions, overall, these youth had positive experiences with the health care system, particularly within the context of the gay men’s sexual health clinic.