Sexual Health Flashcards
1
Q
Define ‘health’
A
a state of complete physical, mental, spiritual and social well-being and not merely the absence of disease or infirmity
2
Q
Define ‘Sexual health’ (WHO)
A
- a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity.
- Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence
3
Q
Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as…
A
the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence
4
Q
Why is “sexual health” preferable to “reproductive health”?
A
Sex is not just about reproduction (E.g same sex couples, postmenopausal women)
5
Q
20,037 respondents in Australian Study of Health & Relationships:
- Sexual identity and sexual … is important (idenity and … are not identical)
A
- Sexual identity and sexual experience is important (idenity and … are not identical)
- Majority - sexual identity is heterosexual
- BUT almost 10% say they have had sexual experiences with same gender and different gender, so experience does not match identity
6
Q
should we refer to STDs? or STIs? or RTIs? - why does it matter (Sexual health)
- much medical research focuses on … (HIV and other STIs) and sexual …
- (+ unplanned …)
- less attention is given to non-disease / dysfunction
- but it is important to consider sexual well-being in more broad terms
- sexual s..
- sexual d..
- sexual c…
- sexually transmitted …
A
- much medical research focuses on disease (HIV and other STIs) and sexual dysfunction
- (+ unplanned pregnancy)
- less attention is given to non-disease / dysfunction
- but it is important to consider sexual well-being in more broad terms
- sexual satisfaction
- sexual difficulties
- sexual coercion
- sexually transmitted infections
7
Q
Sexual satisfaction
- …% of men and …% of women agree that “An active sex life is important for your sense of well-being”
- (de Visser et al., 2014)
- overall … satisfaction is strongly related to sexual satisfaction
- In national surveys (USA and Australia) satisfaction with … aspects of … is significantly related to greater physical satisfaction and more frequent sex
A
-
87% of men and 79% of women agree that “An active sex life is important for your sense of well-being”
- (de Visser et al., 2014)
- overall relationship satisfaction is strongly related to sexual satisfaction
- in national surveys (USA and Australia) satisfaction with emotional aspects of relationships is significantly related to greater physical satisfaction and more frequent sex
8
Q
Frequency of Sex
- men have higher ideal frequency but large male/female overlap
- … frequency is similar for men and women, and … than ideal
- only 15% of men and 26% of women report a match between their ideal and actual frequency of sex
- most men and women want …
- mean frequency in relationships is … times per week
A
- men have higher ideal frequency but large male/female overlap
- actual frequency is similar for men and women, and lower than ideal
- only 15% of men and 26% of men report a match between their ideal and actual frequency of sex
- most men and women want more
- mean frequency in relationships is 1.5 times per week
9
Q
only …% of men and …% of women report a match between their ideal and actual frequency of sex
A
only 15% of men and 26% of women report a match between their ideal and actual frequency of sex
10
Q
Mean frequency of sex in relationships is … times per week
A
Mean frequency of sex in relationships is 1.5 times per week
11
Q
Sexual difficulties
A
12
Q
Lower Sexual function is also related to:
- … age *
- d…
- poor … health
- lower … satisfaction
- … to … about sex with partners
A
- greater age *
- depression
- poor physical health
- lower relationship satisfaction
- inability to talk about sex with partners
13
Q
Sexual Difficulties:
- lacked interest in sex ->…% of men & …% of women
A
lacked interest in sex ->25% of men & 55% of women
14
Q
Sexual Difficulties:
- orgasm too quickly …% of men & …% of women
A
orgasm too quickly 24% of men & 12% of women
15
Q
Sexual Difficulties:
- unable to orgasm …% of men and …% of women
A
unable to orgasm 6% of men and 29% of women
16
Q
Sexual Difficulties:
- anxious about ability to perform …% of men and …% of women
A
anxious about ability to perform 16% of men and 17% of women
17
Q
Sexual Difficulties:
- sex not pleasurable …% of men and …% of women
A
sex not pleasurable 6% of men and 27% of women
18
Q
Sexual Difficulties:
- pain during intercourse …% of men and …% of women
A
pain during intercourse 2% of men and 20% of women
19
Q
Sexual Difficulties:
- vaginal dryness in …% of women
A
vaginal dryness in 24% of women
20
Q
Sexual Difficulties:
- unable to keep erection …% of men
A
unable to keep erection 10% of men
21
Q
poor physical health has -ve effect on sexual … and …
A
poor physical health has -ve effect on sexual frequency and satisfaction
22
Q
poor … health has -ve effect on sexual frequency and satisfaction
A
poor physical health has -ve effect on sexual frequency and satisfaction
23
Q
- around …% of men and …% of women have ever been sexually coerced
- = forced or frightened into unwanted sexual activity
A
- around 5% of men and 20% of women have ever been sexually coerced
- = forced or frightened into unwanted sexual activity
24
Q
Define sexual coercion
A
= forced or frightened into unwanted sexual activity
25
_sexual coercion has potentially long lasting effects on:_
* psychological well-being
* e.g., higher prevalence of ... and ...
* - physical well-being
* e.g., lower ...-being, greater .../.../... use
* - sexual well-being
* e.g., more ..., more ... attitudes
* psychological well-being
* e.g., higher prevalence of **depression** and **anxiety**
* - physical well-being
* e.g., lower **well**-being, greater **cigarette/drug/alcohol** use
* - sexual well-being
* e.g., more **STIs**, more **negative** attitudes
26
any sexual ... has these detrimental effects (psychological weel-being, physical well-being, sexual well-being)
any sexual **coercion** has these detrimental effects (psychological weel-being, physical well-being, sexual well-being)
27
_Sexual health across the lifespan_
* **sexual health concerns vary over time**
* e.g. youth:
* avoiding unintended ...
* avoiding ...
* treating ... to protect ... health
* e.g. adulthood:
* optimising ... health
* optimising sexual ...
* e.g. older age:
* optimising sexual ...
* limiting impact of ... health on sexual health
* ? less lifespan variation in sexual health needs of homosexual people
* age and/or cohort effects -\> society more ...
* sexual health more ...
* **sexual health concerns vary over time**
* e.g. youth:
* avoiding unintended **pregancy**
* avoiding **STIS**
* treating **STIS** to protect **reproductive** health
* e.g. adulthood:
* optimising **reproductive** health
* optimising sexual **satisfaction**
* e.g. older age:
* optimising sexual **function**
* limiting impact of physical **health** on sexual health
* ? less lifespan variation in sexual health needs of homosexual people
* age and/or cohort effects society more **sexualised**
* sexual health more **valued**
28
_Sexual health across the lifespan:_
* age and/or cohort effects society more ...
* sexual health more ...
* age and/or cohort effects society more **sexualised**
* sexual health more **valued**
29
people are sexually active at younger ages = earlier potential ... exposure / ... ... risk + people are sexually active ... in life = longer potential ... exposure
* *(Rissel et al., 2003; Wellings et al., 2001)*
people are sexually active at younger ages = earlier potential **STI** exposure / **unplanned** **pregnancy** risk + people are sexually active **later** in life = longer potential **STI** exposure
30
What does being sexually active for longer (during your lifestime) mean for you?
earlier STI exposure and unplanned pregnancy (younger) and longer STI exposure (older)
31
_prevalence of sexual difficulties varies with age - but not simply more problems with age_
* sexual function not simply physical
* = also related to relationship satisfaction, and ability to talk about sex with partners
* (de Visser et al., 2017; Mitchell et al., 2013)
32
_Promoting preventive behaviour_
* major focus in sexual health is prevention
* absence of ..., ... or ... treatment increases importance of behaviour
* high and increasing rates of ..., particularly among young people
* major focus in sexual health is prevention
* absence of **vaccines, cures or effective treatment** increases importance of behaviour
* high and increasing rates of **STIs**, particularly among young people
33
_Condom use_
* ...% of men and women have ever used condoms
* but only ...% used one last time they had vaginal sex
* and ...% said the condom was put on late
* **90**% of men and women have ever used condoms
* but only **23**% used one last time they had vaginal sex
* and **15**% said the condom was put on late
34
...% of men and women have ever used condoms
**90**% of men and women have ever used condoms
35
90% of men and women have ever used condoms but only ...% used one last time they had vaginal sex
90% of men and women have ever used condoms but only **23**% used one last time they had vaginal sex
36
* 90% of men and women have ever used condoms but only ...% used one last time they had vaginal sex and ...% said the condom was put on late
* need to promote condom use and correct condom use
* 90% of men and women have ever used condoms but only **23**% used one last time they had vaginal sex and **15**% said the condom was put on late
* need to promote condom use and correct condom use
37
Sexual Difficulties
* no clear association between sexual difficulties and whether people seek treatment
* issue with seeking treatment - degree of problem is more likely than duration of problem.
* Everyone should know they can seek treatment for common problems
38
There is a need to promote ... use and ... ... use
There is a need to promote **condom** use and **correct condom** use
39
_What affects condom use? - The IMB Model - the key to effective safe sexual promotion_
40
The ... Model is the key to effective safe sexual promotion
The **IMB** Model is the key to effective safe sexual promotion
41
The IMB Model is the key to effective safe ... promotion
The IMB Model is the key to effective safe **sexual** promotion
42
What model is this?
IMB model - information, motivation, behaviour
43
_Weighted average correlations with condom use (Albarracín et al., 2001; ; Sheeran et al., 1999)_
* ... regarding condom use has the strongest influence on condom use behaviour - knowledge and susceptibility not so much
* **Communication** regarding condom use has the strongest influence on condom use behaviour - knowledge and susceptibility not so much
44
* Sexual health - \> scare campaigns may be ineffective if:
* people do not have the necessary ...
* and ...
* can be ...-...
* Sexual health - \> scare campaigns may be ineffective if
* people do not have the necessary **skills**
* and **confidence**
* can be **counter-productive**
45
_Sexual Health - Interventions_
* interventions that include a .... component are the most effective (Carey et al. 2000)
* but few ... promotion materials focus on ... (Abraham et al., 2001)
* heterosexual condom use is influenced more by concerns about ... than ...
* dual use is ... (de Visser, 2007; Ott et al., 2002)
* access to contraception and post-coital contraception
* (... after pill) may mean greater STI risk
* is it responsible to prescribe the pill without also giving condoms to protect against STIs?
* interventions that include a **skills** component are the most effective (Carey et al. 2000)
* but few **condom** promotion materials focus on **skills** (Abraham et al., 2001)
* heterosexual condom use is influenced more by concerns about **pregnancy** than **STIs**
* dual use is **uncommon** (de Visser, 2007; Ott et al., 2002)
* access to contraception and post-coital contraception
* (**morning** after pill) may mean greater STI risk
* is it responsible to prescribe the pill without also giving condoms to protect against STIs?
46
Sexual health interventions that include a ... component are the most effective (Carey et al. 2000)
Sexual health interventions that include a **skills** component are the most effective (Carey et al. 2000)
47
heterosexual condom use is influenced more by concerns about ... than ...
heterosexual condom use is influenced more by concerns about **pregnancy** than **STIs**
48
* heterosexual condom use is influenced more by concerns about pregnancy than STIs
* ... dual use is ... (de Visser, 2007; Ott et al., 2002)
* heterosexual condom use is influenced more by concerns about pregnancy than STIs
* ... dual use is **uncommon** (de Visser, 2007; Ott et al., 2002)
49
access to contraception and post-coital contraception (morning after pill) may mean greater ... risk
* access to contraception and post-coital contraception (morning after pill) may mean greater **STI** risk
50
_PEP and PrEP_
* Anti-... therapy drugs can be used to prevent sexual transmission of HIV through
* ...-exposure ... (PEP) immediately after high-risk events
* ...-exposure ... (PrEP)
* (Krakower et al., 2015; Traeger et al., 2018)
* ... but is it responsible to prescribe PrEP without condoms for other STIs?
* **Anti-retroviral therapy** drugs can be used to prevent sexual transmission of HIV through
* **post**-exposure **prophylaxis** (PEP) immediately after high-risk events
* **pre**-exposure **prophylaxis** (PrEP)
* (Krakower et al., 2015; Traeger et al., 2018)
* ... but is it responsible to prescribe PrEP without condoms for other STIs?
51
What is PEP and PrEP?
* Anti-retroviral therapy drugs can be used to prevent sexual transmission of HIV through
* post-exposure prophylaxis (PEP) immediately after high-risk events
* pre-exposure prophylaxis (PrEP)
52
_Promoting screening and testing_
* diagnoses are not decreasing for many STIs - artefact?
* more ... tests
* more ... getting ...
* real increase
* more ... people sexually active
* ... condom use
* lack of ... about HIV affects STI concern
* belief that STIs are not ...
* diagnoses are not decreasing for many STIs - artefact?
* more **sensitive** tests
* more **people** getting **tested**
* real increase
* more **young** people sexually active
* **inconsistent** condom use
* lack of **concern** about HIV affects STI concern
* belief that STIs are not **serious**
53
diagnoses are not decreasing for many ...
diagnoses are not decreasing for many **STIs**
54
_National Chlamydia Screening Programme (NCSP)_
* opportunistic Chlamydia screening - under ...s
* i.e. testing at places other than GUM clinics
* all people aged under ... attending healthcare facilities not providing specialist sexual health services
* + outreach (e.g. “pee in a pot”)
* testing via urine sample (all men, ...% of women)
* or self-collected vulvo-vaginal swabs (...% of women)
* how many people had undiagnosed chlamydia? ...%
* opportunistic Chlamydia screening - under **25s**
* i.e. testing at places other than GUM clinics
* all people aged under **25** attending healthcare facilities not providing specialist sexual health services
* + outreach (e.g. “pee in a pot”)
* testing via urine sample (all men, **70**% of women)
* or self-collected vulvo-vaginal swabs (**30**% of women)
* how many people had undiagnosed chlamydia? - **~10% of men and women aged 16-24 not seeking STI testing tested positive for chlamydia**
55
In opportunistic Chlamydia screening - under 25s - what % of men and women aged 16-24 not seeking STI testing tested positive for chlamydia?
**~10%** of men and women aged 16-24 not seeking STI testing tested positive for chlamydia
56
_Purpose of National Chlamydia Screening Programme (NCSP) (opportunistic screening)_
* collect ...
* raise ...
* ... people
* ... partners
* collect **data**
* raise **awareness**
* **treat** people
* **notify** partners
57
* prevalence of Human Papilloma Virus was ...-...% of 20-24yo women
* ... so, introduction of HPV vaccination
* ...% of eligible women have had 2-dose vaccination
* prevalence of HPV16 and HPV18 in 18-20yo women is now ...%
* (PHE, 2020; Sonnenberg et al., 2014)
* prevalence of Human Papilloma Virus was **20-40**% of 20-24yo women
* ... so, introduction of HPV vaccination
* **84**% of eligible women have had 2-dose vaccination
* prevalence of HPV16 and HPV18 in 18-20yo women is now **6**%
* (PHE, 2020; Sonnenberg et al., 2014)
58
* ...% of eligible women have had 2-dose vaccination (HPV) and prevalence of HPV16 and HPV18 in 18-20yo women is now ...%
* (PHE, 2020; Sonnenberg et al., 2014)
* **84**% of eligible women have had 2-dose vaccination (HPV) and prevalence of HPV16 and HPV18 in 18-20yo women is now **6**%
* (PHE, 2020; Sonnenberg et al., 2014)
59
How are older people protected? (Sexual health)
some catch up vaccination of over 13 but older - hope there is no mixing with age too much and if HPV goes down in general population risk is decreased overall
