BAKGRUND: Ungdomar med psykisk ohälsa är en utsatt grupp i samhället med större risk för ohälsa.SYFTE: Syftet med litteraturstudien var att ta reda på hur psykisk ohälsa påverkar ungdomars sexuella riskbeteenden.METOD: Litteratursökning genomfördes i databaserna PubMed, Cinahl och Cochrane för att hitta studier som undersökte påverkan av psykisk ohälsa hos ungdomar och deras utsatthet för sexuella riskbeteenden.  RESULTAT: Psykisk ohälsa hos ungdomar bidrar till en tidigare sexualdebut, fler sexuella partners, oskyddade sexuella kontakter och en ökad risk för könssjukdomar. Det kan även bidra till att ungdomar använder sex som självmedicinering och kombinerar det med alkohol och droger. SLUTSATS: En ökad kunskap kring hur psykisk ohälsa hos ungdomar påverkar deras sexuella riskbeteenden kan öka förståelsen för deras mående och bidra till att vårdpersonal som möter dessa ungdomar kan hjälpa till att fånga upp ungdomar med ökad risk. Att ge mer utbildning och stöd till ungdomar med psykisk ohälsa kan vara ett sätt att minska riskbeteenden. / BACKGROUND: Adolescents with mental health issues are part of a vulnerable group in society with a higher risk of health complications.AIM: The aim of this review was to see how mental health affects adolescents and their sexual risk behaviors.METHODS: A search in the databases PubMed, Cinahl and Cochrane were executed to find relevant articles that studied mental health in adolescents and their sexual risk behaviors. RESULTS: Mental health issues in adolescents can lead to an early sexual debut, a higher number of sexual partners, unprotected sex and a higher risk of contracting a sexually transmitted infection. It can also lead to adolescents using sex as a form of self medication and that they combine it with alcohol or drugs.CONCLUSIONS: Expanded knowledge about how mental health in adolescents affects their sexual risk behaviors can raise the comprehension of their health and help the medical professionals who care for these young people to identify those with a higher risk. More education and support for the adolescents with mental health issues could be a way to decrease their sexual risk behaviors.

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The objective of this thesis is to examine which socio-economic, structural and cultural factors may influence Indian women’s propensity to contract HIV and later their ability to access the relevant healthcare services for their condition. The research draws on two theoretical frameworks, the first being Barnett and Whiteside’s (2002) concept of social structural factors of disease transmission. Second, Anderson and Aday’s (1981) model of access examines how a variety of structural and resource-based factors, e.g. area of residence, can influence usage of healthcare facilities. Two stages of data analysis were undertaken, the first being secondary statistical analysis of the National Family Health Survey III. The survey provided state level estimates on the HIV sero-status of the general population in India and data on demographic and socio-economic determinants for family planning, nutrition, utilization of healthcare and emerging health issues. The second stage of analysis consisted of a set of qualitative interviews conducted in Andhra Pradesh, India. Thirty-three interviews were conducted with female sero-positive patients and ten with HIV-infected women who were providing social services to others with the same condition. Statistical results on social structural determinants of HIV transmission illustrated that Indian women who were formerly married (OR=5.27, CI=3.07-9.04), lived in higher prevalence states (OR=3.48, CI=2.19-5.54), had a low level of education (OR=2.27, CI=1.40-3.68) and were employed (OR=1.45, CI=0.96-2.18) had significantly (<.05) higher odds of being HIV-positive in comparison to those who were not. Findings in the qualitative phase of analysis were similar but participants’ narratives illustrated that their risk of contracting HIV begun before they even had the opportunity to seek a match as they seemed to live in communities with a high level of HIV prevalence. Many of the participants commented that there were factors outside of their sphere of control, e.g. lack of education, which resulted in them having a narrow choice of potential partners. Additionally, statistical results on female participants’ access to healthcare services indicated the vast majority of HIV-positive respondents were almost certainly not aware of their sero-status as they had not undertaken an HIV test prior to the survey. As the sample of female HIV infected respondents was relatively small, it was difficult to ascertain which social factors had an impact on these participants utilisation of HIV testing services. On the other hand, respondents’ narratives from the qualitative stage of research highlighted on social structural factors which could potentially influence WLHA’s continual utilisation of HIV-related healthcare services. It was found that participants experienced the most barriers to accessing healthcare facilities in the initial phases of their treatment. These barriers were mediated by the structure of healthcare services, culturally sanctioned medical practices (e.g. physicians refusal to inform the patient of their sero-status) and quality of services.

<p>The overall aim of this thesis was to inestigate Swedish adolescents' perceptions and behaviours regarding sexual risk taking. Specific objectives were to explore teenagers' perceptions of contraceptive use, unintended pregnancy, and abortion; teenage girls' experiences of decision making process and support connected to abortion; and male adolescents' perceptions of sexual risk taking and barriers to practicing safe sex. Another objective was to evaluate the effect of advance provision of emergency contraceptive pills to teenage girls. The methodologies included focus group discussions, in-depth interviews, and a randomized controlled trial. </p><p>Among the adolescents in our studies, teenage parenthood was generally viewed as a "catastrophe", and the majority expressed supportive attitudes towards abortion (studies I-IV). Occasions of failure to use contraceptives were common, especially when sex was unplanned (studies I-V). Pregnancy prevention was perceived as the woman's responsibility. However, many girls were reluctant about using homonal contraceptives due to worries about negative side effects (I, III). Initiating condom use was difficult for girls, as well as for boys, for a number of reasons (I-IV): fear of ruining an intimate situation, associations with disease, distrust, pleasure reduction, and (for the boys) the fear of loosing one's erection. Males generally perceived personal and partner-related risks connected to unprotected intercourse as low. Few males were worried that an unintended pregnancy would be carried to term, and the majority would urge the girl towards abortion if she seemed ambivalent (II, IV). Girls viewed the abortion decision as a natural, yet difficult choice, strongly influenced by attitudes of partners, parents, peers and societal norms (III). Teenage girls provided with emergency contraceptive pills in advance used it more frequently and sooner after unprotected intercourse compared with controls, without jeopardising regular contraceptive use (V).</p>

Les hommes ayant des rapports sexuels avec des hommes (HSH) sont les plus touchés par le VIH. La prévention du VIH dans cette population doit aujourd'hui se diversifier grâce à divers outils visant à réduire le risque : traitement des personnes séropositives, traitement préventif chez les personnes séronégatives, et comportements de réduction des risques sexuels. Le dépistage du VIH est alors un enjeu crucial de la prévention.La diversification de l'offre de dépistage en France, notamment grâce au dépistage rapide et communautaire, est un résultat majeur de cette thèse. D'autres problématiques sont également investiguées : le recours au dépistage du VIH chez les HSH vivant au Cameroun et l'intérêt pour la recherche en prévention chez les HSH en France.Tous ces résultats sont confrontés les uns aux autres et sont mis en perspective, en termes de recherches à mener mais aussi en termes de recommandations pour les politiques de prévention à destination des HSH. / Men who have sex with men (MSM) are the most affected by HIV. In this population, HIV prevention must be diversified, using several tools aiming to reduce risks: treatment of HIV positive persons, preventive treatment among HIV negative persons and, sexual risk reduction behaviours. HIV testing thus becomes the cornerstone of HIV prevention.Diversifying HIV testing is one of the most important results of this thesis. Other questions are also addressed: access to HIV testing among MSM living in Cameroon and interest in prevention research among MSM in France.The discussion of all these results leads to several perspectives in terms of researches that should be conducted, but also in terms of recommendations for prevention policies towards MSM.

Mother-to-infant vertical transmission of HIV usually occurs during pregnancy, labor, delivery or breastfeeding. It is the third leading cause of transmission of HIV after sexual intercourse and blood transfusions. In 2008, 12 million women aged 15 years and above were anticipated to be living with HIV in countries within Sub-Saharan Africa. In this study, the association between parental HIV knowledge, attitudes and risk reduction practices, and HIV vertical transmission in Kenya were explored. The health belief model was used to help understand and interpret the findings. For this quantitative study, data were collected via surveys from 212 participants in 3 HIV clinics in Kenya. Data were analyzed using descriptive and inferential statistics. Around 45% of respondents lacked knowledge on key aspects of Prevention of Mother to Child Transmission (PMTCT) of HIV particularly on expressing and heat treating milk from HIV positive mothers to make it safe for their babies. About 65% of Participants had awareness towards Mother to Child Transmission (MTCT) of HIV. Logistic regression showed no association between socioeconomic factors and parental knowledge on MTCT of HIV. Logistic modeling found that there was association between attitude and MTCT, revealing that attitude increased the likelihood to influence MTCT. Being married was associated with reduced risk of MTCT of HIV. The overall results indicated gaps in knowledge and information packaging. The potential positive social change implication of this study is that factors related to HIV vertical transmission identified in this study might be utilized to develop and implement HIV prevention strategies to reduce HIV vertical transmission and decrease associated morbidity and mortality among this vulnerable population.

The overall aim of this thesis was to inestigate Swedish adolescents' perceptions and behaviours regarding sexual risk taking. Specific objectives were to explore teenagers' perceptions of contraceptive use, unintended pregnancy, and abortion; teenage girls' experiences of decision making process and support connected to abortion; and male adolescents' perceptions of sexual risk taking and barriers to practicing safe sex. Another objective was to evaluate the effect of advance provision of emergency contraceptive pills to teenage girls. The methodologies included focus group discussions, in-depth interviews, and a randomized controlled trial. Among the adolescents in our studies, teenage parenthood was generally viewed as a "catastrophe", and the majority expressed supportive attitudes towards abortion (studies I-IV). Occasions of failure to use contraceptives were common, especially when sex was unplanned (studies I-V). Pregnancy prevention was perceived as the woman's responsibility. However, many girls were reluctant about using homonal contraceptives due to worries about negative side effects (I, III). Initiating condom use was difficult for girls, as well as for boys, for a number of reasons (I-IV): fear of ruining an intimate situation, associations with disease, distrust, pleasure reduction, and (for the boys) the fear of loosing one's erection. Males generally perceived personal and partner-related risks connected to unprotected intercourse as low. Few males were worried that an unintended pregnancy would be carried to term, and the majority would urge the girl towards abortion if she seemed ambivalent (II, IV). Girls viewed the abortion decision as a natural, yet difficult choice, strongly influenced by attitudes of partners, parents, peers and societal norms (III). Teenage girls provided with emergency contraceptive pills in advance used it more frequently and sooner after unprotected intercourse compared with controls, without jeopardising regular contraceptive use (V).

This thesis aims to explore a topic of attachment and its influence on adolescents' risk behaviour. First, the theoretical part provides an overview of important milestones of the developmental period of middle adolescence. Afterwards, it introduces the concept of attachment and finally, it deals with risk behaviour with great emphasis on researches addressing the substance abuse, antisocial behaviour and sexual risk behaviour in the Czech Republic. The practical part focuses on correlation between attachment styles (secure, preoccupied, dismissive avoidant and fearful avoidant) and risk behaviour using a questionnaire survey. In addition, it deals with the prevalence of above-mentioned types of risk behaviour and their relationship. Survey dealing with the prevalence of risk behaviour showed that respondents of this research were more likely to engage in risk behaviour in comparison to participants of other studies. It was also confirmed that there was a close association between different types of risk behaviour, so it could be beneficial to perceive them as a unitary syndrome. As far as the main aim of this thesis is concerned, adolescents with the preoccupied attachment style were proved to be at highest risk of development of risk behaviour. These individuals were more likely to use drugs,...

This quantitative descriptive cross sectional study explored factors influencing sexual risk behaviours among youths in senior secondary schools in Ethiopia. Data were collected using structured questionnaires. Religious attachment, living with friends, living alone, parental control, level of parental education, peer pressure and number of friends who had experienced sex were some of the factors noted to influence youths to engage in sexual risk behaviours. The findings of this study have implications for both practice and policy development. They will enable healthcare workers to identify youths at risk of engaging in sexual risk behaviours and subsequently motivate them using health promotion strategies to engage in safe sexual practices. Adopting such an approach will prevent or at least minimise risk of youths being infected with sexually transmitted diseases, such as HIV/AIDS. / Health Studies / M.A. (Health Studies)

Today, 1.2 billion adolescents stand at the challenging crossroads between childhood and the adulthood. Driven by a combination of biological, psychological and social forces, adolescence is a period of “stress and storm” for many adolescents predisposing them to risky behaviours with long term consequences. Adolescence is not only a time of vulnerability; it is also an age of opportunity for investment in sustained health and wellbeing through education and preventive efforts to help them navigate risks and vulnerabilities. Evidence-based sexuality education programmes are a cornerstone in reducing adolescent sexual risk behaviours and promoting sexual health. A qualitative, grounded theory study was undertaken to explore and describe experiences of adolescents, teachers and perceptions of parents of school-based sexuality education (SBSE). An indepth literature review through concept analysis on the phenomenon was conducted to assist the researcher with theoretical sensitivity and theoretical saturation. In-depth Individual interviews and focus group interviews were conducted to generate data. Interviews were audio-taped and transcribed by the researcher verbatim. The direct quotes of participants were coded and arranged into meaning units for analysis. A constant comparison method of data analysis was applied by following a Strauss and Corbin (1998) analysis process of open, axial and selective coding to analyse textual qualitative data until themes, categories and sub-categories were identified and developed. Data analysis revealed that adolescents benefitted from SBSE but the implementation of programme was undermined by challenges at national, institutional, community, family and individual levels enshrined in the physical. There were also challenging contextual factors at various levels that influenced the benefits of the SBSE. It is recommended that there is need to review the teaching and learning resources and to fully integrate sexuality education into the formal curriculum. The ministry of education in Uganda should take a leadership role in fostering engagement and participation of major stakeholders, particularly teachers, parents and other community groups in delivering school-based sexuality education that addresses the needs of the schoolgoing children / Health Studies / D. Litt. et Phil. (Health Studies)