Intravaginal practices among a cohort of rural Malawian women

Sexual Health ◽  
2016 ◽  
Vol 13 (3) ◽  
pp. 275 ◽  
Author(s):  
Allahna Esber ◽  
Abigail Norris Turner ◽  
Gladson Mopiwa ◽  
Alison H. Norris

Background: Intravaginal practices (IVP) are highly prevalent and commonly performed in many countries for a variety of purposes related to genital health, hygiene and sexual pleasure. However, IVP may also have harmful side effects, including associations with bacterial vaginosis and HIV. Methods: The prevalence and motivations for IVP among 650 women participating in the baseline survey of a community-based cohort study on sexual and reproductive health in rural Lilongwe District, Malawi, were characterised. Key variables included the type and frequency of IVP, and motivations for engaging in IVP. Results: Most women (95%) had engaged in IVP in the past 30 days: 88% reported internal vaginal cleansing with water only, 87% reported cleansing with soap and water, and 84% reported inserting cotton, cloth or tissue. A majority (60%) reported at least three practices. Very frequent engagement in at least one type of IVP was also common; among those who inserted cotton, cloth or tissue, 43% did so more than once a day; among those who cleansed internally with soap and water, 51% did so more than once a day. Women reported many reasons for using IVP. The most commonly reported reasons were to remove odours (91%), to remove extra moisture (58%), to prevent disease (49%), to relieve symptoms of disease (41%) and to improve sex for a partner (40%). Conclusion: IVP are highly prevalent and frequently performed among these rural Malawian women. Future research should investigate the associations between IVP and sexually transmissible infection prevalence.

Sexual Health ◽  
2014 ◽  
Vol 11 (6) ◽  
pp. 592
Author(s):  
Christina A. Muzny ◽  
Richa Kapil ◽  
Erika L. Austin ◽  
Edward W. Hook ◽  
William M. Geisler

Background Sexually transmissible infection (STI) history, prevalence and seroprevalence among lifetime exclusive women who have sex with women (WSW) and an age-matched group of women who have sex with women and men (WSWM) was evaluated. Methods: Participants completed a study questionnaire and had genital specimens and sera collected for STI testing. Results: Twenty-one lifetime exclusive WSW and 42 WSWM were included. WSWM were more likely to report a history of prior STIs and be seropositive for chlamydia and HSV-2. Prevalent STIs were less common among WSW. Conclusions: While lifetime exclusive WSW are at risk of contracting STIs, WSWM are disproportionally affected. Healthcare providers should consider routine STI screening among WSW.


Sexual Health ◽  
2012 ◽  
Vol 9 (2) ◽  
pp. 120 ◽  
Author(s):  
Myles Balfe ◽  
Ruairi Brugha ◽  
Emer O'Connell ◽  
Deirdre Vaughan ◽  
Diarmuid O'Donovan

Objectives Chlamydia trachomatis is a sexually transmissible infection (STI) that affects significant numbers of men. Research on men’s perspectives on chlamydia screening (or testing) has been limited. We conducted a narrative review to examine: (1) what factors encourage or discourage men from attending health services for chlamydia screening, and/or from accepting screening once it has been offered to them, and (2) where men want chlamydia screening services to be located. Methods: A narrative review of the recent peer-reviewed literature (published between 1999 and 2009) on men’s attitudes towards chlamydia screening. To be included, articles had to explore men’s perspectives on screening (which could be ascertained through quantitative or qualitative studies, or from relevant discussion papers or reviews). Results: Forty-eight articles were included in all. Men’s attitudes towards chlamydia screening are influenced by their knowledge about the infection, their perceived vulnerability to the infection, the degree of embarrassment and shame that they associate with screening and the stigma that they associate with screening. Men prefer to be offered urine testing for chlamydia. Men want to be offered screening by non-judgemental professionals. Men’s attitudes towards screening for chlamydia in general practice, genito-urinary medicine clinics, home and outreach settings are also explored in this review. Conclusions: Several factors influence men’s attitudes towards screening. Two central themes underlie and influence many of these factors: men’s needs to make positive impressions on others, and men’s identification with particular ideals of masculinity. The review concludes with suggestions for future research on this topic.


Sexual Health ◽  
2005 ◽  
Vol 2 (2) ◽  
pp. 63 ◽  
Author(s):  
Danielle C. Newton ◽  
Marita P. McCabe

This paper provides a discussion of the utility of stigma theory as a conceptual framework for the interpretation and analysis of the psychological impact of contracting a sexually transmissible infection (STI). Most particularly, it focuses on those viral infections that cannot be medically cured, such as genital herpes and genital human papilloma virus. Recent research in the area of STIs suggests that the stigma associated with these conditions can hinder psychosocial and sexual adjustment post-diagnosis, and provides support for the use of stigma theory as a conceptual framework with which to analyse these experiences. This paper defines the concept of stigma and presents a theoretical overview of the process of stigmatisation. Three dimensions of stigma relevant to the experience of having a STI are then presented: the degree of concealability of the condition including the social consequences of concealing a condition; the origin of the condition; and the degree of peril presented by the condition. An overview of the way in which the presence of a stigmatising condition such as a STI may affect a person’s feelings of self and his/her intimate relationships is then presented. Finally, the implications of stigma theory as a conceptual framework for guiding future research in the area of personal and interpersonal reactions to STIs is discussed.


Sexual Health ◽  
2012 ◽  
Vol 9 (3) ◽  
pp. 205 ◽  
Author(s):  
Rebecca Guy ◽  
James S. Ward ◽  
Kirsty S. Smith ◽  
Jiunn-Yih Su ◽  
Rae-Lin Huang ◽  
...  

Objective To systematically review evaluations of the impact of sexually transmissible infection (STI) programs delivered by primary health care services in remote Aboriginal communities. Methods: PubMed, Google Scholar, InfoNet, Cochrane Controlled Trials Register, Australian New Zealand Clinical Trial Registry, conference proceedings and bulletins were searched to April 2011 using variations of the terms ‘Aboriginal’, ‘programs’ and ‘STI’. The primary outcome of interest in the review was the change in bacterial STI infection prevalence in the target age group assessed through cross-sectional screening studies over a 5-year period or more. The characteristics of the primary health care service, STI programs and other clinical service outcomes were also described. Results: Twelve reports described four distinct STI programs in remote communities and their impact on STI prevalence. In the Anangu Pitjantjatjara Yankunytjatjara (APY) lands of northern South Australia, there was a reduction in the age-adjusted chlamydia and gonorrhoea prevalence by 58% and 67%, respectively (1996–2003). In the Tiwi Islands of Northern Territory (NT), chlamydia and gonorrhoea positivity decreased by 94% and 34%, respectively (2002–2005). In the Ngaanyatjarra Lands of Western Australia, crude chlamydia and gonorrhoea prevalence decreased by 36% and 48%, respectively (2001–2005), and in the central Australian region of NT, there was no sustained decline in crude prevalence (2001–2005). Conclusion: In three of the four programs, there was some evidence that clinical best practice and well coordinated sexual health programs can reduce STI prevalence in remote Aboriginal communities.


Sexual Health ◽  
2015 ◽  
Vol 12 (6) ◽  
pp. 472 ◽  
Author(s):  
Melissa A. Habel ◽  
Roberta Scheinmann ◽  
Elizabeth Verdesoto ◽  
Charlotte Gaydos ◽  
Maggie Bertisch ◽  
...  

Background This study assessed the feasibility and acceptability of pharmacy and home-based sexually transmissible infection (STI) screening as alternate testing venues among emergency contraception (EC) users. Methods: The study included two phases in February 2011–July 2012. In Phase I, customers purchasing EC from eight pharmacies in Manhattan received vouchers for free STI testing at onsite medical clinics. In Phase II, three Facebook ads targeted EC users to connect them with free home-based STI test kits ordered online. Participants completed a self-administered survey. Results: Only 38 participants enrolled in Phase I: 90% female, ≤29 years (74%), 45% White non-Hispanic and 75% college graduates; 71% were not tested for STIs in the past year and 68% reported a new partner in the past 3 months. None tested positive for STIs. In Phase II, ads led to >45000 click-throughs, 382 completed the survey and 290 requested kits; 28% were returned. Phase II participants were younger and less educated than Phase I participants; six tested positive for STIs. Challenges included recruitment, pharmacy staff participation, advertising with discretion and cost. Conclusions: This study found low uptake of pharmacy and home-based testing among EC users; however, STI testing in these settings is feasible and the acceptability findings indicate an appeal among younger women for testing in non-traditional settings. Collaborating with and training pharmacy and medical staff are key elements of service provision. Future research should explore how different permutations of expanding screening in non-traditional settings could improve testing uptake and detect additional STI cases.


Sexual Health ◽  
2013 ◽  
Vol 10 (2) ◽  
pp. 183
Author(s):  
Lynne Martin ◽  
Sione Crawford ◽  
Vickie Knight ◽  
Nicky Bath ◽  
Anna McNulty

Sydney Sexual Health Centre (SSHC) and the NSW Users and AIDS Association (NUAA), the NSW peer-based drug user organisation, pilot tested an outreach sexually transmissible infection (STI) testing station using self-collected urine and swabs in NUAA’s needle and syringe program (NSP) space. The model was based on SSHC’s established Xpress clinic. A needs assessment among NUAA clients was undertaken prior to commencement in order to ascertain potential uptake. A computer-assisted self interview was developed with data securely transferred to SSHC daily. During the 6 months from January to July 2011, almost 3000 occasions of service were recorded in the NSP from an estimated 375 clients. Four clients took advantage of NUAA Xpress during this time. Despite initial client interest, promotional efforts and the success of this methodology elsewhere, this outreach model did not have a successful uptake and was discontinued. This project provides value in considering the methodology and implementation of future outreach STI testing projects for people who inject drugs.


Sexual Health ◽  
2016 ◽  
Vol 13 (4) ◽  
pp. 353 ◽  
Author(s):  
Cherie Bennett ◽  
Vickie Knight ◽  
Douglas Knox ◽  
James Gray ◽  
Gemma Hartmann ◽  
...  

Background Sydney Sexual Health Centre (SSHC) partnered with a large sex-on-premises venue, South Eastern Sydney Local Health District HIV and Related Programs Unit and AIDS Council of NSW (ACON) to develop and implement a community-based sexually transmissible infection (STI) screening model co-located in a sex-on-premises venue. This paper describes the process, the outcomes and examines the cost of this model. Methods: A retrospective cross-sectional study of gay and bisexual men (GBM) attending a STI testing service co-located in a sex-on-premises venue in Sydney city between the 1 November 2012 and 31 May 2014. Results: A total of 402 patrons had 499 testing episodes in the study period. Testing patrons were a median of 39.5 years of age, 221 (55%) were born overseas, 85 (21%) spoke a language other than English at home and 54 (13%) had a STI at first testing. A total of 105 (26%) testing patrons had never tested for a STI before. Of the 297 (74%) who had been tested before, 83 (21%) had not been tested within the last 12 months. A total of 77 STIs were detected in 63 people over 499 testing episodes, giving a STI positivity rate of 15% in the testing episodes. The prevalence of rectal chlamydia was the highest at 8% followed by pharyngeal gonorrhoea at 3%. A total of 97% of testing patrons were successfully relayed their results via their preferred methods within a median of 7.5 days. Conclusion: This paper highlights that offering STI screening in a community-based setting was an effective and low-cost alternative to traditional testing services.


2021 ◽  
pp. 088626052110283
Author(s):  
Cara Herbitter ◽  
Alyssa L. Norris ◽  
Kimberly M. Nelson ◽  
Lindsay M. Orchowski

Previous research indicates that teen dating violence (TDV) is more common among sexual minority than heterosexual adolescents, with approximately half of female sexual minority adolescents (SMA) endorsing TDV victimization in the last year. In samples of adolescents without regard to sexual orientation, exposure to violent pornography is associated with TDV, but this relationship has not been assessed in female SMA. The current study sample consisted of 10th-grade high school students aged 14–17 who identified as cisgender females ( N = 1,276). Data were collected from a baseline survey prior to the delivery of a sexual assault prevention intervention. Female SMA had 2.54 times the odds (95%CI [1.75, 3.69]) of being exposed to violent pornography and 2.53 times the odds (95%CI [1.72, 3.70)]) of TDV exposure compared to heterosexual girls. Exposure to violent pornography was not associated with involvement in TDV among female SMA, controlling for episodic heavy drinking ( aOR = 2.25, 95%CI [0.88,6.22]). Given the relatively higher rates of violent pornography and TDV exposure among female SMA compared to heterosexual girls, it is critical that sex education curricula address these experiences and meet the needs of adolescents of all sexual orientations. Future research can assess how these TDV interventions might be tailored for female SMA. Although we did not find that exposure to violent pornography was associated with TDV among female SMA, these investigations should be replicated with larger data sets, given that the association between exposure to violent pornography and engagement in TDV was in the expected direction.


Author(s):  
Sachiko Ogawa ◽  
Yoshinori Takahashi ◽  
Misako Miyazaki

Background: Although interprofessional education (IPE) has come to be considered essential in health and social care education programs, most IPE programs in Japan focus on clinical settings. However, following the 2011 Great East Japan Earthquake, IPE programs are considered essential for community development, especially in disaster-affected areas. To identify key issues for the development of IPE, we aimed to clarify the current status of IPE programs and problems in their implementation using an original questionnaire. Methods and Findings: The targets were 865 undergraduate courses that qualify students to take national registered health/social care examinations. Effective responses were received from 284 targets. Of these 284 respondents, 103 respondents had already implemented an IPE program and 181 respondents had not. Among the 103 respondents who had already implemented an IPE program, we found a tendency to collaborate with partners in clinical settings or in social settings. Furthermore, respondents who had implemented or were planning to implement an IPE program had difficulty with ‘interdisciplinary and/or extramural collaboration’ and ‘educational factors’. Conclusions: These difficulties could be considered barriers to developing effective IPE programs for community-based collaboration between health and social care professionals. Future research should investigate more specific solutions to these problems.


Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 273 ◽  
Author(s):  
Sara K. Head ◽  
Richard A. Crosby ◽  
Lydia A. Shrier ◽  
Gregory R. Moore

Background: This exploratory study investigated young women’s perceptions of sexually transmissible infection (STI) testing received during gynaecological care. Correlates of the incorrect perception that STI testing occurred were assessed. Methods: Cross-sectional study of sexually active young women, age 18–24 years, attending a university healthcare setting for gynaecological care (n = 109). Two hundred and four women were approached and 87 were ineligible; of the remaining 117, 93.2% chose to enrol. Results: Of the women enrolled, 25.7% falsely perceived that they were STI tested (labelled ‘clean and clear’). Only approximately one in seven (14.7%) accurately understood the STI for which they were tested. In multivariate analyses, controlling for race, STI symptoms, depression, number of lifetime visits to the gynaecologist, and suspicion of current STI, three variables were significant: minority race (adjusted odds ratio (AOR) = 4.84, confidence interval (CI) = 1.38–16.96, P = 0.01), earlier age at sexual debut (AOR = 4.67, CI = 1.73–12.57, P = 0.002), and previous STI diagnosis (AOR = 3.38, CI = 1.07–10.66, P = 0.04). Comment: The findings suggest that many young women may have an inaccurate understanding of the STI testing they undergo during gynaecological care and may operate under the misperception they are ‘clean and clear’ of STI. Women with said misperception were more likely to be of minority race and report relatively earlier age of sexual debut and previous STI diagnosis. Further investigation is warranted to determine whether the ‘clean and clear’ misperception influences young women’s sexual risk behaviour.


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