Sexual health (de Visser) Flashcards
(16 cards)
What is the difference between ‘health’ and ‘sexual health’?
health - a state of complete physical, mental, spiritual and social well-being and not merely the absence of disease or infirmity
sexual H - a state of physical, emotional, mental and social well-being in relation to sexuality
- not merely the absence of disease, dysfunction or infirmity
- requires a positive and respectful approach to sexuality and sexual relationships
- the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence
Why is ‘sexual health’ preferred to ‘reproductive health’?
- SEX is not just about reproduction
- Doesnt include various sexual experiences
- Excludes sexual identities (LGBTQ)
- Women of post-menopausal status
Should we refer to STDs, STIs or RTIs?
- RTIs may not only manifest themselves in the reproductive tracks e.g. syphilis in eyes
- We want to prevent the spread of infection not neccessarily the disease. If we only focus on disease we may neglect prevention
Why is sexual satisfaction important
80% of men and women say “An active sex life is important for your sense of wellbeing”
- Relationship satisfaction is strongly associated to sexual satisfaction (frequent, physically satisfying)
How does desired and actual frequency of sexual activity compare?
Men have higher frequency of sex BUT large overlap for men and women
- ACTUAL frequency is similar
Desired frequency is higher than actual frequency. 15% men and 26% women report a match in demand
Mean frequency is 1.5x/week
- Poor physical health has negative effect on sexual frequency and satisfaction
Consider the sexual difficulties.
Women are more likely to experience these. Give 3 examples
Men report…
Both genders report…
Low sexual fucntion is also related to….
- Lacked interest in sex, unable to orgasm, sex not pleasurable, pain during intercourse, vaginal dryness
- Orgasm too quickly, unable to keep erection
- Anxiety about ability to perform
- Greater age, depressio, poor physical health, lower relationship satisfaction, inability to talk about sex with partners.
Consider sexual coercion
Definition?
How prevalent is it?
Long term sequelae?
Forced or frightened into unwanted sexual activity
- 5% men, 20% women
- Psychological well-being (depression and anxiety)
- Physical well being (cigarette, drug, alcohol use)
- Sexual well being (more STIs, more negative attitudes)
What is included in a biopsychosocial definition of “sexual health”?
- Feeling good in relationships
- Feeling that in society your sexual practices dont lead to discrimination
- Not only about disease absence but broader psychological wellbeing
Sexual health concerns vary over time
How?
How does this vary in homosexual people?
Young people want to avoid unintended pregnancy, STIs and get STI treatment to protect reproductive health
Adults want to optimise reproductive health and sexual satisfaction
Older people want to optimise sexual function and limit physical impediments tp sex.
Less middle variation as no need for increased reproductive function.
How does age/cohort impact sexual health across the lifespan?
Society is more sexualised (–> people now sexually active at younger ages, potential exposure to STIs/pregnancy). On the flip side, some people are starting sexual activity laater in life so exposure to STIs/unplanned pregnancy is longer (due to lifespan) and later
and sexual health more valued
How do sexual problems amongst men and women vary by age?
In men, anxiety doesnt have simple linear relationship. 16-19 year olds are most anxious. Causes: media expectations of sex, first experiences etc
- Erectile problems increase with age (40+)
In women, vaginal dryness increases with age (hormones, physiological responses to stimulation). Pain during sex decreases with age (unable to talk to partner about slowing down, increasing lubrication)
How does the fact that some STD’s have no cure effect individual sexual responsibility?
Discuss the prevalence of condom use
What factors affecr condom use?
Absence of vaccines, cures or effective treatment increases importance of behaviour
90% of people say theyve used a condom but only 23% used one durign their last sexual encounter
- Much more is needed to promote correct condom use
Knowledge, susceptibility, severity, condom attitudes, subjective norms, self efficacy, intentions to use
What is good/ bad about condom promotion campaigns
- interventions that include a skills component in addition to knowledge/ attitudes are the most effective
- few condom promotion materials focus on the skills that most strongly influence condom use
Pill users and condoms
is it responsible to prescribe the pill without
also giving condoms to protect against STIs?
condom use is influenced more by concerns about pregnancy than STIs
… dual use is uncommon
STI diagnoses are increasing.
Why?
- Artefact
- more sensitive tests, more people getting tested - Real increase
- increased sexual activity in young people
- inconsistent condom use
- lack of concern about HIV affects
- belief that STIs are not serious
What has the National Chlamydia Screening programme (NCSP) highlighted?
- Screening U25 in GUM clinics, other healthcare facilities + outreach
- 10% of 16-24yo not seeking testing had chlamydia
- Purpose of screening is to collect data, raise awareness, treat people and notify partners
- 20-40% of 20-24yo women had HPV
