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Sexual Health

Sexual Health

Volume 13 Number 1 2016

Sexual and reproductive health are global health, development and human rights priorities, essential to the wellbeing of individuals, couples and families. Despite widespread recognition of this, young people, including those from culturally diverse backgrounds in wealthy nations such as Australia, remain largely hidden to, and underserved by, sexual and reproductive healthcare services. A scoping review was undertaken to describe the range of research on sexual and reproductive health among culturally diverse young people in Australia, in order to identify gaps in the literature. Two gaps were identified: (1) the perspectives of culturally diverse young people regarding sexual and reproductive health and health care; and (2) the engagement of culturally diverse young people with sexual and reproductive health services. New directions for a research agenda on sexual and reproductive health care for culturally diverse young people in Australia are proposed.

Previous studies have suggested that human papillomavirus (HPV) can be transmitted in ways other than penetrative sex. We systematically reviewed articles that suggest evidence of non-sexual or non-penetrative sexual transmission HPV. HPV DNA was detected in the genital tract of female virgins with a prevalence up to 51.1%.

SH15080Identifying types of sex conversations in adolescent health maintenance visits

Stewart C. Alexander, Sharon L. Christ, J. Dennis Fortenberry, Kathryn I. Pollak, Truls Østbye, Terrill Bravender and Cleveland G. Shields
pp. 22-28

Using latent class analysis, we identified four types of physician–adolescent sexuality discussions that differed in terms of emphasis, topics addressed as part of the sexual history and risk assessment, and topics addressed in anticipatory guidance. The presence of sexuality conversations in the majority of these visits suggests that physicians consider sexuality to be an important issue and part of their responsibility in caring for their adolescent patients. However, the substantial variability in the types of sexuality conversations, particularly the notable omissions of many key topics, supports the importance of teaching sexual health interview skills in medical school and residency, and as part of continuing medical education and quality improvement.

The rate of ever having a sexually transmissible infection in Korean adolescents with experience of sexual intercourse was 10.0%. Ever having a sexually transmissible infection was significantly and independently associated with sexual debut at elementary school and contraceptive methods other than condoms. Additionally, ever having a sexually transmissible infection was significantly and independently associated with depressive mood, suicidal ideation and suicide attempts.

SH15119Sexual health among female Aboriginal university students in the Maritime Provinces of Canada: risk behaviours and health services use

Kevin Wilson, Audrey Steenbeek, Mark Asbridge, Amber Cragg and Donald B. Langille
pp. 35-42

This study examined associations of being Aboriginal and sexual risk behaviours as well as use of health services in female Canadian university students. Aboriginal students were more likely not to not have used a condom or effective contraception at last intercourse than non-Aboriginal students, and they had a higher lifetime prevalence of ever having had a pregnancy or STI test. Health services providers should be aware of this greater level of risk-taking among university students of Aboriginal ethnicity.

Mycoplasma genitalium was almost as commonly diagnosed as Chlamydia trachomatis in women attending a sexual health service. C. trachomatis was the only infection that was significantly associated with a diagnosis of pelvic inflammatory disease (PID). The cost-effectiveness of routine screening for M. genitalium in women with PID in our population remains unclear.

SH14218Potential impact of the human papillomavirus vaccine on the incidence proportion of genital warts in French women (EFFICAE study): a multicentric prospective observational study

Philippe Judlin, Anne-Carole Jacquard, Xavier Carcopino, François Aubin, André Dahlab, Frédéric Mistretta, Didier Not, Pierre-Yves Boelle, Olivier Aynaud and Benoît Soubeyrand
pp. 49-54

A study among 15- to 26-year-old women found a trend for a not significant decreased incidence proportion of genital warts among women younger than 20 years who are more frequently vaccinated against human papillomavirus (HPV).

SH15160Costs of pleasure and the benefits of pain: self-perceived genital sensation, anatomy and sexual dysfunction

Nina Callens, Guy Bronselaer, Petra De Sutter, Griet De Cuypere, Guy T'Sjoen, Piet Hoebeke and Martine Cools
pp. 63-72

Women with self-described female sexual dysfunction (FSD) reported significantly decreased genital sensation (pain and pleasure) at most genital sites when compared to a group of age-matched control women displaying normal levels of sexual function. For the clitoral site, sensitivity was more decreased with partner stimulation than with self-stimulation, in contrast to findings in women without FSD. Furthermore, perceived or expected discomfort in the vaginal area was a significant risk factor of concomitant FSD. These results combined suggest that a disturbed or otherwise suboptimal subject–partner (sexual) interaction may be a main determinant of sexual difficulties in women, underlining the need for further research on the interpersonal effects of genital pain and pleasure.

SH15134The impact of a chlamydia education program on practice nurse’s knowledge and attitudes in relation to chlamydia testing: a cross-sectional survey

Rebecca Lorch, Rebecca Guy, Meredith Temple-Smith, Alaina Vaisey, Anna Wood, Belinda Ford, Carolyn Murray, Chris Bourne, Jane Tomnay, Jane Hocking and on behalf of the ACCEPt Consortium
pp. 73-80

A cross-sectional survey was conducted at baseline and following delivery of a chlamydia education program with practice nurses (PNs) participating in the Australian Chlamydia Control Effectiveness Pilot. The education program led to improved knowledge and attitudes to chlamydia, and could be made available to PNs working in general practice. Future analyses will determine if the education program plus other initiatives can increase testing rates.

SH14220Frequent condom use with casual partners varies by sexual position among younger gay and bisexual men in New Zealand: national behavioural surveillance 2006–2011

Nathan J. Lachowsky, Peter J. W. Saxton, Anthony J. Hughes, Nigel P. Dickson, Robin R. Milhausen, Cate E. Dewey and Alastair J. S. Summerlee
pp. 81-86

National HIV behavioural surveillance data were analysed to examine condom use with casual partners among younger gay, bisexual and other men who have sex with men (YMSM) in New Zealand. Three-quarters of YMSM reported frequent condom use during insertive (76.0%) and receptive (73.8%) anal intercourse, which varied by demographic, behavioural and relational factors. These findings demonstrate that condom norms can be actively established and maintained among YMSM. Condom promotion efforts must increase YMSM’s capacity, agency and skills to negotiate condom use, especially for the receptive partner.

SH15141Prescription rates of the contraceptive implant in Australia 2008–2012: impact of patient age and area of residence

Amie L. Bingham, Cameryn C. Garrett, Anne M. Kavanagh, Louise A. Keogh, Rebecca J. Bentley and Jane S. Hocking
pp. 87-90

Uptake of the sub-dermal contraceptive implant (SDI) in Australia is thought to be low, despite it being a highly effective form of contraception. Comprehensive data regarding use of the device in Australia and factors that affect this are scarce. This paper reports on an analysis of prescriptions of the SDI made through the Pharmaceutical Benefits Scheme between 2008 and 2012, finding that uptake is significantly associated with younger age and residence in a regional area.

Favourable attitudes toward serosorting were assessed among a clinical sample of young Black MSM (YBMSM) residing in the United States. Findings suggest that YBMSM having favourable attitudes toward serosorting may be more likely to report condomless sex than their counterparts without favourable attitudes. Those with more favourable attitudes were no less likely to report having sex with multiple partners compared to those without such favourable attitudes.

SH15163Measuring exposure to sexually explicit media among young men who have sex with men: a pilot study

Kimberly M. Nelson, Matthew R. Golden and Sara Nelson Glick
pp. 93-95

The prevalence and frequency of sexually explicit media (SEM) consumption as well as associations with contextual and sexual risk characteristics among 61 young men who have sex with men (YMSM) were estimated. Results indicate that SEM use among YMSM is extremely common. Future research should clarify potential relations between SEM and sexual risk-taking with larger samples of YMSM and specific measures, including SEM content and amount.

SH15115As good as it gets? Retention in care of people newly diagnosed with HIV at the Sydney Sexual Health Centre

Dominic Rowley, Amel Ahmed, Anna McNulty, Lynne Wray and Vickie Knight
pp. 96-98

The spectrum of engagement in HIV care, known as the HIV care cascade, is a relatively new concept in HIV medicine. Retention in care (RIC) is an important component of the cascade as it aims to reduce HIV viral load at both an individual and population level. This study aimed to determine retention in care rates in HIV-positive patients attending a large Australian urban sexual health clinic. At 6 months post-diagnosis, 63 (66%) patients were RIC while 33 (34%) were not retained in care. Within those not retained in care, 17 (18%) were lost to follow-up and 16 (17%) were known to have been referred to other services. Overall the clinic performed well compared to international standards but the efforts to improve the lost to follow up rate can be improved upon.

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