(This item is among the 5-10 highlights posted for ISHN members each week from the ISHN Member information service. Click on the web link to join this service and to support ISHN)
A research review in the July 2016 issue of the Journal of Adolescent Health reports that "youth lacked knowledge about sexually transmitted infections STIs and services. In addition, youth experienced barriers related to service availability and a lack of integration of services. The most reported barriers were related to acceptability of services. Youth reported avoiding services or having confidentiality concerns based on provider demographics and some behaviors. Finally, experiences of shame and stigma were common barriers to seeking care.Improving uptake may require efforts to address clinic systems and provider attitudes, including confidentiality issues. Moreover, addressing barriers to STI services may require addressing cultural norms related to adolescent sexuality. Read more>>
(This item is among the 5-10 highlights posted for ISHN members each week from the ISHN Member information service. Click on the web link to join this service and to support ISHN)
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(An item from the ISHN Member information service) Several news stories and commentaries were noted this week about the need to review mandatory sex education and health education curricula. In the US, several former surgeon-generals have called for a renewal of sex education, the lack of attention from school districts is noted, a reduced teen pregnancy rate is reported, the US Congress considers making health education part of the core curriculum and Hawaii has dropped its abstinence only approach to sex ed. In the UK, an all party committee has recommended mandatory health education and sex education and a response is expected from the new government by the end of June 2015. Read more>>
(An item from the ISHN Member information service) Renewed interest in sexuality education is noted in several items this week. Two articles in Issue #2, 2015 of American Journal of Sexuality Education are part of this trend, with reports on the contents of ten leading programs being used in the USA and the nature of public policies in Germany and the Netherlands. The US analysis "indicate that the majority of programs provide education on sexually transmitted diseases and unplanned pregnancy, abstinence, and contraceptive use. Far fewer address components related to healthy dating relationships, including interpersonal violence and an understanding of gender roles. No programs address nonheterosexual orientations." The european analysis suggests that a more integrative, life span approach is emerging. Read more>>
(From the ISHN Member information service) An article in Issue #3, 2015 of the Journal of Sex research reports on a study in the Netherlands that examined the impact of parent-teen communications on sexual health behaviours. The researchers found that more frequent communications affected some but not all adolescent behaviours. "A nationally representative sample of parent–adolescent dyads (N = 2,965; mean adolescent age = 13.8 years) in the Netherlands was employed to examine the frequency of parent–adolescent sexual communication and its association with adolescent sexual behaviors (defined as sexual initiation, condom use, and contraceptive pill use). Nine communication topics in the areas of anatomy, relationships and rights, and protection and contraception were examined. In all, 75%of parents reported having discussed at least one topic multiple times with their adolescents. Romantic relationships were discussed most frequently. Hierarchical logistic regression analyses indicated that parent–adolescent sexual communication on protection and contraception was positively associated with adolescent sexual initiation and contraceptive pill use but not condom use. This may reflect that adolescents, when they become sexually active, are more likely to discuss sexuality with their parents. Findings are interpreted within the context of Dutch culture, which is generally accepting of adolescent sexuality and characterized by open sexual communication." Read more>>
(From the ISHN Member information service) A systematic review and meta-analyses of parent-based adolescent sexual health interventions reports that they have an effect on communication outcomes. The article appears in Issue #1, 2015 of Perspectives on Sexual and Reproductive Health. "A systematic search of databases for the period 1998–2013 identified 28 published trials of U.S. parent-based interventions to examine theory use, setting, reach, delivery mode, dose and effects on parent–child communication. Established coding schemes were used to assess use of theory and describe methods employed to achieve behavioral change; intervention effects were explored in meta-analyses. Most interventions were conducted with minority parents in group sessions or via self-paced activities; interventions averaged seven hours, and most used theory extensively. Meta-analyses found improvements in sexual health communication: Analysis of 11 controlled trials indicated a medium effect on increasing communication (Cohen's d, 0.5), and analysis of nine trials found a large effect on increasing parental comfort with communication (0.7); effects were positive regardless of delivery mode or intervention dose. Intervention participants were 68% more likely than controls to report increased communication and 75% more likely to report increased comfort. These findings point to gaps in the range of programs examined in published trials—for example, interventions for parents of sexual minority youth, programs for custodial grandparents and faith-based services. Yet they provide support for the effectiveness of parent-based interventions in improving communication. Innovative delivery approaches could extend programs’ reach, and further research on sexual health outcomes would facilitate the meta-analysis of intervention effectiveness in improving adolescent sexual health behaviors." Read more>>
(From the ISHN Member information service) An article in the March 2015 issue of Journal of Adolescent Health reports that school-based health centresd can effectively promote sexual health among their clients. The researchers report that "Reproductive health indicators among students at four urban high schools in a single building with an SHC in 2009 were compared with students in a school without an SHC, using a quasi-experimental research design (N = 2,076 students, 1,365 from SHC and 711 from comparison school). The SHC provided comprehensive reproductive health education and services, including on-site provision of hormonal contraception. Students in the SHC were more likely to report receipt of health care provider counseling and classroom education about reproductive health and a willingness to use an SHC for reproductive health services. Use of hormonal contraception measured at various time points (first sex, last sex, and ever used) was greater among students in the SHC. Most 10th–12th graders using contraception in the SHC reported receiving contraception through the SHC. Comparing students in the nonintervention school to SHC nonusers to SHC users, we found stepwise increases in receipt of education and provider counseling, willingness to use the SHC, and contraceptive use. Read More>>
(From the ISHN Member information service) One of the themes being discussed in the ISHN International Discussion Group on Integration of Health/Social Programs Within School Systems focuses on the political, normative and practical constraints on schools in doing this work. A special issue of Health Education (#1, 2015) illustrates these constraints as several articles discuss the nature and delivery of sexual education in several countries. The editorial introducing this special issue makes note of these powerful differences imposed by the national, state or local contexts. "The papers highlight contrasts, tensions, potentials and barriers embedded in the ways sexuality education is delivered to children and young people internationally. Examples are drawn from Russia, Wales, China and the USA; they identify historical and structural issues related to the implementation of comprehensive progressive approaches. Topics discussed include the importance of appropriate content, theoretical/conceptual frameworks, modes of delivery, timing, attitudes from key stakeholders and the need for comprehensive evaluation of innovative approaches to the delivery of sexual education." . These constraints are especially true for sex education but other, less sensitive issues can also be contentious. These include compulsory vaccinations, the use of alcohol, gender equity, child abuse and neglect, and more. Even actions taken to promote huealthier school lunches can be politicized (eg the recent debates in the US) or cause controversy when letters are sent to parents asking them to prepare healthier lunches or that their child is overweight.
(From the ISHN Member information service) An analysis of three school-based initiatives in AIDS/HIV education based on a rights-based approach suggests that we are left with some unfinished business. The article prompting this discussion appears in Issue #1, 2015 of Sex Education: Sexuality, Society and Learning. The authors suggest that "Over the past 25 years, there has been growing investment in concepts of rights in the areas of HIV prevention, care and treatment, including HIV- and AIDS-related education delivered in schools. Despite this increasing commitment to the notion of rights, few efforts appear to have been made to understand the varying conceptions of rights that underpin different kinds of initiatives. Engaging with a multi-disciplinary body of literature on the issue of rights, and through a focus on three rights-informed HIV- and AIDS-related initiatives, this paper seeks to address this gap in the current literature. In so doing, it also examines a central tension within human rights discourse, namely between the construal of rights as shared and universally applicable to all human beings, while being created in and limited by the location in which they were elaborated, as well as by the language used to formulate them. More explicit engagement with the diversity of approaches made possible through a commitment to human rights may facilitate forms of HIV- and AIDS-related education that are more meaningful to young people." Or, in our view, a rights-based approach may create political and social barriers to the expansion and improvement of sex education in schools where the understandings about human rights differ from those articulated by experts and UN agencies. Read more>>
(From the ISHN Member information service) Several articles in Supplement Issue #1, 2014 of Journal of Adolescent Health report on an international conference on sexual and reproductive healthhealth, One article reviews emerging trends in evidence & practice in sexuality education. "Drawing from these documents, reviews and meta-analyses of program evaluations, and situation analyses, this article summarizes the elements, effectiveness, quality, and country-level coverage of CSE. Throughout, it highlights the matter of a gender and rights perspective in CSE. It presents the policy and evidence-based rationales for emphasizing gender, power, and rights within programs—including citing an analysis finding that such an approach has a greater likelihood of reducing rates of sexually transmitted infections and unintended pregnancy—and notes a recent shift toward this approach. It discusses the logic of an “empowerment approach to CSE” that seeks to empower young people—especially girls and other marginalized young people—to see themselves and others as equal members in their relationships, able to protect their own health, and as individuals capable of engaging as active participants in society." Read more>>
(An item from the ISHN Member information service) An article in Issue #8, 2013 of the Journal of Sex Research reports on a small study of the perceptions of college students of hooking up. "A random sample (N = 1,468) of undergraduates (56.4% female) completed a Web-based survey composed of measures of drinking and sexual behavior. Open-ended definitions of hooking up were content-coded and analyzed using a mixture model to explore discrete definitions of hooking up among college students. Findings indicated three clusters of student definitions of hooking up: Cluster 1 had the broadest definition, referring to sex in general, not specific sexual acts, and to making out. Cluster 2 placed an emphasis on interpersonal and social aspects. Cluster 3 defined hooking up as sex with notable references to specific sexual acts. Results further indicated that hooking up behavior and normative perceptions differentiated these three groups of definitions. Clinical implications regarding the inconsistency of student definitions of hooking up and how they may impact negative consequences associated with hooking up are discussed. Read more>>
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