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.

Public health is a concern of many important areas of society and it is therefore of great importance to examine and expand the goals of public health work within different sectors, e.g., school. Sexually transmitted diseases, sexual violence and mental health problems related to sexual orientation are some of the public health problems in society today. Throughout childhood and teenage years, norms and attitudes regarding sexuality and coexistence are formed, which means that school is an important arena when it comes to creating proficient conditions for    coexistence and sexual health. The quality of sex and coexistence education in Swedish schools differs in quality; for content and magnitude vary greatly among schools. It is, therefore, of interest to study how students experience sex and coexistence education, like prioritizations and desires. The purpose of this study is to describe how high school students experience sex and coexistence education in primary school, and which parts the students consider significant affecting coexistence and sexual health. A quantitative survey (n=113) was conducted at a high school in northeast Skåne. The survey consisted of ten standardized questions regarding experiences and magnitude of sex-and coexistence education in primary school. The results showed that 58,3 percent of the students were dissatisfied with the teaching, and the students prioritized aspects of sexuality and coexistence were included to a lesser extent than the content that was included in the sex- and coexistence education. The teachings in school focused primarily on biological aspects whilst the students prioritized aspects of coexistence. The participants did not consider the school as the main source of information about sex and coexistence. Instead, the students considered friends and family as the primary sources. To decrease the difference between the school and students approach to sex-and coexistence education, an collaboration with external resources should be established. A regional collaboration with affiliates that work with teaching sex and coexistence, like RFSU, could be established in order to gain a larger and abundant content that satisfies the needs of the students. / Folkhälsa berör många samhällsområden och därför är det av vikt att granska och vidareutveckla mål som kan förbättra folkhälsoarbete inom olika sektorer, bland annat skolan. Könssjukdomar, sexuellt våld och psykisk ohälsa relaterat till sexualitet är några av de folkhälsoproblem som finns i dagens samhälle. Under barn- och ungdomstiden utvecklas normer och attityder, kring bland annat sexualitet och samlevnad, vilket innebär att skolan utgör en viktig arena för att skapa goda förutsättningar för samlevnad samt sexuell hälsa. Sex- och samlevnadsundervisningen som bedrivs i de svenska skolorna är av skiftande kvalitet då innehåll och omfattning varierar från skola till skola. Det är därmed av intresse att undersöka hur eleverna upplever undervisningen, såsom aspekter av prioritering och önskningar. Syftet med studien är att beskriva gymnasieelevers upplevelser av sex- och samlevnadsundervisning i grundskolan samt vilka delar av undervisningen som ungdomarna anser är betydelsefulla för den sexuella och sociala hälsan. En kvantitativ enkätundersökning (n=113) genomfördes på en gymnasieskola i nordöstra Skåne. Enkäten innehöll tio standardiserade frågor med fokus på upplevelser och omfattning av sex- och samlevnadsundervisning i grundskolan. Resultatet visade att 58,3 procent av eleverna var missnöjda med undervisningen samt att elevernas prioriterade ämnesområden behandlades i mindre omfattning än de ämnesområden som berördes i sex- och samlevnadsundervisningen. Undervisningen i skolan fokuserade främst på biologiska aspekter medan majoriteten av eleverna prioriterade ämnesområden tillhörande samlevnad. Eleverna ansåg inte heller att skolan var den främsta informationsgivaren av sex och samlevnad, utan vänner och familj ansågs vara de främsta källorna. För att minska klyftan mellan skolans respektive elevernas förhållningssätt till sex- och samlevnadsundervisning borde skolan samarbeta med externa aktörer. Ett rikstäckande samarbete med aktörer inom sex- och samlevnadsupplysning, såsom RFSU, skulle kunna skapa ett bredare och rikare innehåll som tillfredsställer elevernas behov.

Bakgrund: Gynekologisk cancer är ett utbrett spektrum av cancersjukdomar bland kvinnor och behandlingarna har betydelse för upplevelsen av den sexuella hälsan. Den sexuella hälsan är viktig för människans totala upplevelse av hälsa. Om den sexuella hälsan upplevs otillfredsställande kan ett lidande uppstå. Syfte: Syftet är att beskriva kvinnors upplevelse av sexuell hälsa vid gynekologisk cancer. Metod: En litteraturöversikt över tolv kvalitativa artiklar har genomförts. Resultat: Resultatet visade upplevda barriärer för sexuell hälsa vid gynekologisk cancer. Barriärerna presenteras i tre huvudkategorier: Den sexuella kroppen, Sexuella hinder och Sexuella relationer. Slutsats: Kvinnor med gynekologisk cancer upplever huvudsakligen flera barriärer för sexuell hälsa. Upplevelsen av dessa sexuella barriärer kan leda till en otillfredsställande sexuell hälsa vilket vidare kan orsaka ett lidande. Genom kunskap om upplevelsen av sexuell hälsa vid gynekologisk cancer kan sjukvården erbjuda vård som omfattar flera aspekter av sjukdomen och därmed minska risken för lidande. Klinisk betydelse: Denna litteraturstudie kan bidra med kunskap om kvinnors upplevda sexuella hälsa vid gynekologisk cancer. Sjukvården har en viktig roll att uppfylla med hänsyn till kvinnors upplevelse av bristande information. Utbildning och diskussion kring sexuell hälsa på sjuksköterskeutbildningen skapar förutsättningar för att samtal om sexuella hälsa ska bli ett självklart inslag i vården. / Background: Gynecological cancer is an expanded spectrum of cancer diseases among women and the treatments have importance for the experience of sexual health. Sexual health is important for the total experience of health. If the sexual health is perceived unsatisfactory, a suffering can arise. Aim: The aim is to describe women’s experience of sexual health within gynecological cancer. Method: A literature review of twelve qualitative articles was performed. Results: The analysis resulted in experienced barriers for sexual health within gynecological cancer. The barriers are presented in three main categories: The sexual body, Sexual obstacles and Sexual relations. Conclusion: Women with gynecological cancer mainly experience several barriers for sexual health. The barriers can lead to an unsatisfied sexual health which can cause a suffering. By knowledge about the experience of sexual health within gynecological cancer, the health care can provide care including several aspects of the disease and thereby decrease the risk for suffering. Clinical significance: This study can contribute knowledge about women’s perceived sexual health within gynecological cancer. Health care providers have an important role to fulfill regarding women’s experience of lack of information. Education and discussion about sexual health in the nursing education creates conditions for conversations about sexual health to become an obvious part of the health care. / <p>Röda Korsets sjuksköterskeförening stipendium juni 2015</p>

Background HIV/AIDS has always been a concern since it first came up in 1981 in the field of medicine and public health. The trend of overall HIV epidemic has slow down through over 30 years fighting against the disease. Yet, being the largest population nowadays, young people still face high risk of HIV/AID. Sexual transmitted diseases, similar with HIV infection, are also a serious concern in young people. Peer education is widely used in the sexual education in young people. No review focused on the school-based peer education while most young people received their sexual education in schools. This systematic review aims to evaluate the effectiveness of school-based peer education on HIV/STD prevention and evaluate the factors that are likely to influence the effect of school-based peer education. Method Searching through PubMed and Cochrane Library, a literature review was carried out on the relevant articles about the evaluation of school-based peer education in developing and developed countries around the world from 2000-01-01 to 2014-05-31. Findings 10 experimental studies were chosen in this review, including 3 randomized controlled trials. Among 10 studies, 8 found significant improved about the general knowledge of HIV/STD and all studies showed positive change in attitude and risk perception in the peer-led education. However, no studies found significant effect of peer education on the behavioral change regarding condom use, postponing sexual intercourses and the reduction of sexual partners, etc. The interaction of peer education and the quality of peer-educators plus other demographical factors such as socioeconomic status and religions may influence the effect of school-based peer-led education. Conclusion School-based peer education was demonstrated to be effective on the prevention of HIV/STD in knowledge and attitude improvement, similar with other kinds of peer education. Peer educators and interactions between educators and educatees play important roles in the peer education. Yet, the effect of school-based education still requires long-term assessment. / published_or_final_version / Public Health / Master / Master of Public Health

In my thesis, I focus on the role that sexual health messages play in the lives of African newcomer teen girls and young women living in Winnipeg. The research question I ask is: How have sexual health discourses shaped my interlocutors’ experiences and perceptions of sex and sexuality upon settling in Canada? My work seeks to address the complexities of sexual health discourses through a feminist-poststructuralist framework that reveals the taken-for-granted and emphasizes how looking at the heterogeneity of these young women’s experiences of sex and sexuality can challenge universalizing public health discourses. Specifically, I utilize the concepts of risk, bio-pedagogy, and biological citizenship to better understand how health has become bound up with idea of being a “bio-citizen.” I conducted 13 ethnographic interviews with ten participants and utilized participant observation in the field. My research will allow us to question not only the importance placed on being “sexually healthy,” but also how these narrowly defined discourses effectively obfuscate other ways of thinking about sexual health. / October 2015

The purpose of this study was to use the Theory of Planned Behavior (TPB) to predict university students’ intention to use emergency contraception (EC). The study explored the utility of the TPB model constructs (attitude [A], subjective norm [SN], perceived behavioral control [PBC]) as well as recent past behavior (RPB) to predict students’ intention to utilize EC. The study also investigated the significance of demographic and personal characteristics—age and gender in particular—as they relate to the TPB components and RPB. A web-based survey, developed from three structured focus groups, was pretested and emailed to 2,000 university students. An overall usable response rate of 21.0 percent was obtained. In general, university students intended to use EC should the need occur, held favorable attitudes toward the use of EC, were somewhat influenced by social norms regarding EC use, and perceived themselves to have some control over EC utilization. For direct measures (TPB), A, SN, and PBC were significant predictors of intention to use EC. The direct model explained 49.2 percent of the variance in intention. Using indirect measures, A and SN were significant predictors of intention, but PBC was not; the indirect model accounted for 41.3 percent of the variance in intention to take EC. Attitude was the strongest TPB predictor for both models, followed by SN and PBC. The RPB variable did not significantly improve the TPB model. While hypothesized age differences were not significant, gender differences showed female students having a more favorable A and SN as well as a stronger PBC (direct measures) toward the use of EC. In addition, several statistically significant relationships occurred between demographic/personal characteristics and the TPB constructs. In summary, this study identified several key factors that partially explain why university students either intend or do not intend to use EC if needed. The TPB has utility in predicting utilization of EC in university students. Focusing particular attention on A, as well as SN and PBC, will allow researchers, educators, healthcare professionals, and legislators to develop strategies and educational programs to enable men and women to use EC responsibly. / text

Background: Adolescents and young adults aged 15 to 24 acquire nearly half of all new STDs in the United States, yet they represent only 25% of the sexually active population. Young men and women in this age group have the highest rates of chlamydia, gonorrhea, and syphilis, especially in the African American population. Adolescent risk factors include having a history of pregnancy or STDs, being arrested or incarcerated, substance abuse, early sexual debut and having 4 or more lifetime sexual partners. Protective behaviors such as parental involvement, school enrollment, and consistent condom use have been associated with decreased incidence of STDs. The purpose of this study is to observe changes in adolescent behaviors and experiences that are known risk factors for acquiring sexually transmitted diseases. The aim is to identify the time at which STD prevention interventions may be administered most effectively. In addition, the study aims to identify relevant themes and content that may be useful in creating interventions targeted to different age groups and genders. Methods: This study utilizes primary data collected between 1999 and 2003 by Dr. Rothenberg and colleagues for a community-based network study of low-income African American adolescents living in a working class neighborhood in Southwest Atlanta. Two descriptive analyses were conducted: a period analysis in which all participants ages 15 to 18 who completed any or all of three interviews were included; and a cohort analysis, which included only participants who completed three interviews and who were 15, 16, 17 or 18 years of age at the time of the first interview. Univariate analysis was used to describe each variable and the resulting frequencies and percentages were reported. Results: In both period and cohort analyses, higher proportions of older adolescents (ages 17 and 18) reported engaging in risky behaviors including drinking alcohol, using marijuana, having sex and having multiple sexual partners, compared to younger adolescents (ages 15 and 16). Males reported higher proportions of engaging in risky behaviors than females, but also higher proportions of condom use. The proportion of participants diagnosed with one or more STDs decreased at each interview. In the cohort analysis, the proportion of participants who perceived their STD risk as “medium” or “high” increased over time. Conclusions: The findings suggest that as adolescents mature they engage in a greater variety of risky behaviors known to have a positive association to STD diagnosis. Period analyses, which have usually been done to study the sexual behaviors of adolescents, may give aberrant results that are clearer when the population is studied as a cohort. Future studies are needed to more precisely identify the period during which adolescents experience rapid changes in their risk behaviors.

This study explores eight young people’s perception of the gender roles in Zambia, Lusaka. In this study I have asked the informants to define the genders and the result were that the genders are defined based on the biological sexes. The genders therefore become homogenous based on the male and female sex. The regulations of the genders were traditionally also based on assumed ‘biologically natural characteristics’. As I argue in this study that gender roles are social constructed I also present the socialization processes in the Zambian culture regarding initiation ceremonies and premarital ceremonies, which visualizes the regulations of the gender roles and the importance of marriages as it implies social status and identity. The young informants’ perception of the gender roles was based on a complex intermixture between the cultural norms, the Western influences and their own life experiences. This means that Zambian society is changing in response to external as well as internal influences and that globalization both facilitates change and may create problems, as different values and norms collide. The informants recognized a need of change in the perception of the gender roles due to the issues that the gender hierarchy contributes to. This study also discusses the fact that cultural norms causes lack of knowledge about sexual issues, which have devastating consequences. The informants argued that the cultural perception of a man as superior and the woman as inferior caused gender based violence, domestic violence and the HIV-epidemic to continue. Based on the informants awareness that many of the social challenges exist because of the patriarchal norms in society I argue that this awareness indicates that a change is in progress.

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