An exploratory study of Muslim adolescents' views on sexuality: Implications for sex education and prevention

Hiding in plain sight: highlighting the research gap on access to HIV and other sexual health services for underrepresented gay men in developed Western countries - insights from a scoping review with a focus on Arab men

BACKGROUND

Strategies pertaining to HIV and sexual health for gay, bisexual, and other men who have sex with men (GBMSM) have shifted focus towards underrepresented subgroups within some developed Western countries. Although emerging research exists on some subgroups, limited attention has been given to the needs of Arab GBMSM in these contexts. Considering they are part of a large diaspora, understanding their access to services is crucial. This paper focuses on Arab GBMSM as a case study within a scoping review, highlighting their hidden status within the broader landscape of HIV and sexual health research for GBMSM in the West.

METHODS

A multi-method search strategy was employed, including searching four electronic databases using several terms within each of the following search topics: Arab, GBMSM, HIV and other sexual health services, and developed Western countries.

RESULTS

Of the 384 articles found, only one addressed the research question and met the inclusion criteria, revealing a stark scarcity of research on access to HIV and sexual health services for this population.

CONCLUSIONS

This review highlights a paucity of research on access to HIV and sexual health services for underrepresented GBMSM populations in developed Western countries. The literature indicates that, for Arab men, this may be due to a difficulty in participant recruitment and poor data collection efforts. By focusing on one hidden population, we aim to advocate for inclusive policies and interventions that promote equitable sexual health access for all. Addressing this research gap aligns with broader local and global HIV strategies to reduce disparities among underrepresented GBMSM populations.

Testing for sexually transmitted infection: who and where? A data linkage study using population and provider data in the Rotterdam area, the Netherlands

BACKGROUND

In the Netherlands, insight into sexually transmitted infection (STI) testing and characteristics of those tested by general practitioners (GPs) and sexual health centres (SHC) is limited. This is partly due to lacking registration of socio-demographics at GPs. We aimed to fill this gap by linking different registers.

METHODS

Individual STI testing data of GPs and SHC were linked to population register data (aged ≥15 years, Rotterdam area, 2015-2019). We reported population-specific STI positivity, proportion STI tested, and GP-SHC testing rate comparison using negative binomial generalised additive models. Factors associated with STI testing were determined by the provider using logistic regression analyses with generalised estimating equations.

RESULTS

The proportion of STI tested was 2.8% for all residents and up to 9.8% for younger and defined migrant groups. STI positivity differed greatly by subgroup and provider (3.0-35.3%). Overall, GPs performed 3 times more STI tests than the SHC. The smallest difference in GP-SHC testing rate was for 20-24-year-olds (SHC key group). Younger age, non-western migratory background, lower household income, living more urbanised, and closer to a testing site were associated with STI testing by either GP or SHC. GPs and SHC partly test different groups: GPs test women and lower-educated more often, the SHC men and middle/higher educated.

CONCLUSIONS

This study highlights GPs' important role in STI testing. The GPs' role in the prevention, diagnosis, and treatment of STIs needs continued support and strengthening. Inter-professional exchange and collaboration between GP and SHC is warranted to reach vulnerable groups.

Exploring Factors Influencing Cervical Cancer Prevention Behaviors: Unveiling Perspectives of Conservative Muslim American Women in Virginia

Understanding the complexities surrounding cervical cancer prevention methods and hesitancy among conservative Muslim American women is crucial in addressing health disparities. This qualitative study aimed to delve into the religious, behavioral, and socio-cultural factors influencing Muslim women's decisions regarding cervical cancer screening (CC-S) and HPV vaccination (HPV-V) in Virginia, USA. Through interviews with 10 Muslim women residing in Virginia, qualitative data were collected as part of a mixed-method cross-sectional study conducted between August and September 2021. Findings revealed that participants had limited knowledge about cervical cancer, CC-S, and HPV-V, with notable themes emerging, such as cultural influences, misconceptions, language barriers, and challenges posed by the intricate US healthcare system. Future research should focus on exploring these barriers to mitigate the impact of cervical cancer within the Muslim population.

The process of overcoming conflicts among teachers in the implementation of comprehensive sexuality education at ordinary public senior high schools in Mataram City, Indonesia: a qualitative study

BACKGROUND

Comprehensive sexuality education (CSE), which aims to help young people make responsible choices and acquire scientific knowledge and skills, has been promoted by UNESCO. Teachers experience conflicts in implementing CSE when teaching sexual topics in the local context, especially as the delivery of sexual knowledge and contraceptive methods is often prohibited by religious and traditional cultural norms. It was reported that there were multiple challenges in the implementation of sex education due to the religious and cultural background of societies and communities in Islamic countries. This study aimed to clarify the process of overcoming the conflicts, explore teachers' recognition and perception related to the implementation of CSE, and to suggest recommendations for promoting CSE in Islamic areas.

METHODS

This qualitative study combined the methods of focus group discussions (FGDs) and in-depth interviews (IDIs) to explore the conflict among teachers. Ten ordinary public senior high schools in Mataram City, Indonesia, agreed to participate, and in total, 59 participants were involved in this study. FGDs were conducted with teachers (n = 49), and IDIs were focused on school principals (n = 10) in each school. The collected interview data were analyzed using a deductive thematic analysis and the findings triangulated for both the FGDs and IDIs.

RESULTS

Overall, the teachers experienced conflicts in relation to religion, cultural background, and gender inequality in implementing CSE. The present study revealed the mutual recognition among teachers and acceptance of diverse backgrounds in the implementation of CSE at ordinary public senior high schools in Mataram City. Despite teachers reporting multiple conflicts, they made efforts to overcome these conflicts through mutual recognition and provided comprehensive guidance. The present findings indicated that teachers adapted CSE to follow multiple religions and cultural backgrounds.

CONCLUSIONS

The teachers accepted diverse backgrounds and provided CSE by collaborating with related educational subjects and external institutions to overcome conflicts. To provide more specialized education, it would be necessary to advocate a formal policy that might be accepted by diverse societies. Further research is necessary to apply the findings and recommendations for CSE implementation globally in the contexts of different countries.

Knowledge Mapping of Articles on Application of the Quran and Hadiths in Health Care: VOSviewer Visualization Techniques

This study sought to conduct a knowledge mapping of articles to shed light on the application of the Quran and Hadiths in health care. The study is applied in terms of purpose and scientometrics in terms of type, which has been carried out using retrospective bibliometric analysis methods and visualization through knowledge mapping. In order to do so, the PubMed database with related keywords was thoroughly searched. Then, 302 relevant articles were reviewed in terms of the author, the year of publication, the journal, and the subject. In addition, VOSviewer software was employed to analyze and visualize keywords and maps of the articles. The findings showed that 302 articles were published between 1972 and 2021 in 190 journals, among which the Journal of Religion and Health was ranked first with 43 articles. Word co-occurrence map of scientific products of the Quran and Hadith in health care were categorized into six clusters, namely: "complementary and alternative medicine," "ethics," "the effectiveness of spirituality on the treatment and control of mental illness," "women's rights and status," "family planning, infertility treatment and abortion," and "the views of the Quran and Hadiths on sexual issues." Adopting a holistic approach toward the application of various aspects of the Quran and Hadiths on health care, the present study can be considered as a pioneering research whose results can account for determining relevant applied research projects.

Determinants of Adolescent Reproductive Health in West Java Indonesia: A Cross-Sectional Study

The problem of adolescent reproductive health (ARH) in Indonesia is worrying, especially regarding the Triad Adolescent Reproductive Health (Triad ARH) behavior. Many factors influence ARH behavior. This cross-sectional study explores the association factors between demographic factors, knowledge, and attitudes toward ARH behavior. Six hundred and sixty-eight junior high school and senior high school students were randomly selected from five public schools in Bandung Regency, West Java, Indonesia. The questionnaire used in this study consisted of four parts, namely: (1) demographic data of respondents; (2) knowledge including 20 questions used multiple choice questions; (3) attitude with 12 questions measured using the Likert scale; and (4) behaviors with seven questions measured using Likert scale. Results showed that gender (p = 0.006), age (p = 0.031), and level of education (p = 0.006) were associated with behavior toward ARH behavior, but knowledge (p = 0.582), religion (p = 0.628), ethnic (p = 0.276), and attitude (p = 0.094) were not associated with ARH behavior. Multivariate analysis showed that only gender (p < 0.010) significantly contributed to ARH behavior. Multivariate analysis showed that gender (OR: 2.168, 95% (CI: 1.204-3.904)) significantly contributed to ARH behavior. Based on the results, it can be concluded that the gender factor influences adolescent reproductive health behavior. This study provides further evidence that to promote positive ARH behavior's among youth in West Java, Indonesia, gender should be put in place and be sustainable, using the media and the Internet and involving the collaboration of parents, teachers, and peers to improve adolescent reproductive health.

Web-based and machine learning approaches for identification of patient-reported outcomes in inflammatory bowel disease

BACKGROUND

Messages from an Internet forum are raw material that emerges in a natural setting (i.e., non-induced by a research situation).

AIMS

The FLARE-IBD project aimed at using an innovative approach consisting of collecting messages posted by patients in an Internet forum and conducting a machine-learning study (data analysis/language processing) for developing a patient-reported outcome measuring flare in inflammatory bowel disease meeting international requirements.

METHODS

We used web-based and machine learning approaches, in the following steps. 1) Web-scraping to collect all available posts in an Internet forum (23 656 messages) and extracting metadata from the forum. 2) Twenty patients were randomly assigned 50 extracted messages; participants indicated whether the message corresponded or not to the flare phenomenon (labeling). If yes, participants were asked to identify excerpts from the text they considered significant flare markers (annotation). 3) The set of annotated messages underwent a vocabulary analysis.

RESULTS

The phenomenon of flare was circumscribed with the identification of 20 surrogate flare markers classified into five dimensions with their frequency within extracted labeled data: impact on life, symptoms, extra-intestinal manifestations, drugs and environmental factors. Web-based and machine-learning approaches met international recommendations to inform the content and structure for the development of patient-reported outcomes.

"My Existence is not Haram": Intersectional Lives in LGBTQ Muslims Living in Canada

Little is known about the lived experiences of Lesbian, Gay, Bisexual, Transgendered and Queer (LGBTQ) Muslims living in Canada. Using an intersectional theoretical perspective and a qualitative methodology, this paper examines key themes emerging in the stories of six LGBTQ Muslim women and men living in Canada. The key themes emerging in this research were the tension between perceived family obligations and religious values, the ambiguous relationship with Islam, and coping with mental health issues. The research points to the importance of understanding such experiences as occurring in a matrix of identities and processes, as postulated by intersectionality theory.

Development of the First Health-Related Quality of Life Questionnaires in Arabic for Women with Polycystic Ovary Syndrome (Part I): The Creation and Reliability Analysis of PCOSQoL-47 and PCOSQoL-42 Questionnaires

Background and objective

We lack a reliable and validated health-related quality of life (HRQoL) questionnaire to measure the negative impact of polycystic ovary syndrome (PCOS) on the various aspects of the lives of Arabic women, which addresses sexuality in married women only. Hence, we aimed to develop two separate, simple, reliable, validated, and easily interpretable HRQoL questionnaires in Arabic for married and unmarried women with PCOS for effective QoL evaluation.

Materials and methods

The development and reliability analysis of the Polycystic Ovary Syndrome Quality of Life (PCOSQoL)-47 and PCOSQoL-42 involved two quantitative and qualitative phases. Phase 1 included retrieval of 158 items from 584 PubMed articles, item reduction, Arabic translation, content and face validity testing, creation of a five-domain draft (53 items for married and 45 items for unmarried women), with no sexuality domain for unmarried women. Phase 2 involved test-retest reliability, which involved using the Spearman's correlation, Wilcoxon nonparametric signed-rank, and internal consistency using Cronbach's-alpha, inter-item, and intraclass correlation (ICC) coefficients, as well as creating a second draft (47 items for married and 42 items for unmarried women).

Results

The content validity indices testing by 26 healthcare experts decreased the item pool to 57 items for married and 45 items for unmarried women. Face validity by another 30 experts and 30 women from each group resulted in a further reduction to 53 items for married and 45 items for unmarried women, to be tested in a pilot study, which included another 30 women from each group. Test-retest reliability analysis by 195 married and 173 unmarried women revealed significantly excellent redundancy, reliability, and stability of items (highly significant Cronbach's alpha and ICC by internal consistency testing), and reduced the item pool to 47 items for married and 42 items for unmarried women.

Conclusions

Both questionnaires were found to be highly reliable for the HRQoL evaluation among both married and unmarried Arabic women with different phenotypes of PCOS.

Culture clash of female Somali adolescents and sexual and reproductive health services in Oslo, Norway

OBJECTIVE

Culture influences an individual's perception of health needs. The influence of culture also applies to Somali individuals' perception of their sexual and reproductive health (SRH) and uptake of related services. An understanding of female Somali adolescents' SRH needs is vital to achieve inclusive health coverage. No research has, however, been conducted to explore the SRH needs of this population group in Oslo; hence, the aim of this qualitative study was to minimise the knowledge gap.

METHODS

Fourteen young women aged 16-20 years were recruited using the snowball technique with purposive sampling. In-depth interviews using a semi-structured interview guide were used to collect data, and thematic analysis was applied.

RESULTS

Participants perceived SRH as a very private matter and open discussion of SRH was extremely limited owing to certain Somali cultural beliefs and values. As the participants intend to practise chastity before marriage, they believed that existing SRH services were largely irrelevant and inappropriate. Where they felt the need to access SRH services, participants wished to do so in a way they considered culturally appropriate.

CONCLUSION

Somali culture markedly influences individuals' perceptions of SRH services. It is recommended to modify existing SRH services by increasing confidentiality and anonymity in order to take into account the cultural requirements of female Somali adolescents.

Masturbatory Guilt Leading to Severe Depression

Masturbation is a common sexual behavior in humans. However, it is viewed negatively across cultures and is prohibited by almost all religions. These views lead to certain cultural beliefs that affect the sexual behavior of people and have implications on the mental health of the individual. There is limited literature linking masturbatory guilt with psychopathology. Here, we present a case in which masturbatory guilt contributed to the development of a depressive illness in a young male. The patient presented with typical symptoms of severe major depressive disorder with resulting impairment of academic and social performance. Our approach to treatment included utilizing a combination of psychotherapy, antidepressant and antipsychotic medications and vitamin supplementation with notable clinical improvement. The article highlights the importance of incorporating various cultural beliefs into an individualized treatment plan, particularly in unique cases where behaviors that may be stigmatized - perhaps wrongfully so - are involved.

Stakeholders' perspectives of comprehensive sexuality education in Iranian male adolescences

Background

A coherent sexuality education program for adolescents is part of their sexual and reproductive rights and can help them have a healthier future. Therefore, the aim of this study was to explore the perspectives and intervention preferences of Iranian stakeholders regarding comprehensive sexuality education (CSE) in male adolescents based on the IMB model (information, motivation, behavioral skills).

Methods

This study was a qualitative study that was analyzed through a directed content analysis approach. Individual interviews and focused group discussions (FGDs) were used for data collection. The data were collected through in-depth semi-structured interviews with stakeholders in two schools and the Education Department in Sari and the Ministry of Health and Ministry of Education in Tehran from March 2019 to August 2019. Data saturation was achieved after 28 interviews and 1 FGDs with 9 participants. Finally, two sets of data were coded and analyzed using directed content analysis.

Results

In this study, five themes emerged as (1) role of institutions; (2) role of organizations; (3) need for stakeholder’s partnership; (4) need for adolescent sexuality socialization management; and (5) need for enhancing the teachers’ professional competence, which seemed to influence the implementation of CSE in male adolescents. Participants also expressed a number of intervention preferences for CSE. The most important of these was the change in macro policies, helping to create a culture against all forms of violence and breaking the taboo of sexuality education for children and adolescents.

Conclusions

The results of this study revealed the need for a CSE program for adolescents' sexuality socialization. The finding showed that teachers required training to enhance their professional competence about sexuality issues. Therefore, it is necessary to design and implement culture-appropriate skill based programs to enhance the teachers’ professional competence regarding the adolescents’ sexual health.

Sex education and Afghan migrant adolescent women

INTRODUCTION

Successful sex is one of the greatest behavioral needs of couples, especially those who marry at an early age. The best way to access information is education and learning. Face to face training is one of the most common methods, with the advancement of technology, multimedia training can be a good alternative method to sex education. This study was designed to comparison between two educational method Multimedia and Face to face on sexual function of Afghan Migrant Adolescent Women.

METHODS

The study was a quasi-experimental educational intervention conducted in selected charity centers in Mashhad. The selected centers were randomly chosen as face to face intervention (n = 36), multimedia intervention (n = 36) and control (n = 36) groups. Our method of sampling was convenient at each center. Intervention groups received four one-hour sessions of sex education using various face to face and multimedia methods. Sexual function were measured using female sexual function index (FSFI) before, immediately and 8 weeks after the intervention. Data were analyzed with SPSS version 16.

RESULTS

The level of sexual function did not show a significant difference in groups before the intervention, but these increased significantly immediately (P = 0.005) and 8 weeks later (P < 0.001).

CONCLUSION

Because of the taboo of sexual issues and the lack of difference between the two methods in improving sexual function, multimedia method is a good alternative educational method.

Sexuality in Muslim Women With Gynecological Cancer

BACKGROUND

Sexuality is a multidimensional subject that can be negatively affected after a diagnosis of gynecological cancer.

OBJECTIVE

The aim of this study was to reveal what sexuality difficulties Muslim women with gynecological cancers experience and how they overcome them.

INTERVENTIONS/METHODS

A qualitative approach was used. Data were gathered through semistructured interviews and analyzed by using a content analysis method. Eighteen Muslim women with gynecological cancers participated in the study.

RESULTS

The study findings were grouped into 3 major categories: situations that make sexual life difficult, impact of cancer on sexual life, and coping.

CONCLUSIONS

Women with gynecological cancers experience sexual reluctance, orgasmic incapacity, lack of enjoyment of sexual intercourse, and decreased frequency of sexual intercourse. In individuals with cancer, social support is important to facilitate coping; however, some women do not receive sufficient support. Women who consider sexuality to be a taboo topic and feel shame about asking sexuality-related questions are not likely to seek or receive relevant information from health professionals.

IMPLICATIONS FOR PRACTICE

Health professionals should provide information to women diagnosed with gynecological cancers about changes that they are likely to experience in their bodies and possible difficulties in sexuality. These women should be encouraged to talk about their sexual problems, and religious and cultural differences should be reflected in their cancer care.

The effect of educational intervention based on dramatic literature on parents of elementary schoolchildren skills in sex education

BACKGROUND

Today, one of the biggest concerns of parents is protecting their children and properly educating them about sex. The aim of this study was to determine the effect of educational intervention on parental skills in sex education on their children in elementary schools in the northwest of Tehran-Iran in 2019 based on literature.

MATERIALS AND METHODS

This quasi-experimental study was conducted on 125 parents of elementary schoolchildren in the northwestern of Tehran. The data were collected by valid and reliable questionnaire. Before the intervention, two intervention and control groups filled up the pretest questionnaire; the data were collected by valid and reliable questionnaire. Before the intervention, two intervention and control groups filled the pretest questionnaire, and then the parents participated in the educational program based on dramatic literature. Two months later, the same questionnaire was completed by the control and intervention groups. Finally, the data were analyzed by regression and one-way ANOVA test.

RESULTS

The results showed that there was a statistically significant difference between the mean scores of knowledge in the experimental and control groups in the posttest (P < 0.01). There was also a statistically significant difference between the mean scores of attitude in the experimental and control groups at the posttest stage (P < 0.01). There was also a statistically significant difference between the mean scores of performance based on group membership (experimental group and control group) in the posttest phase (P < 0.01).

CONCLUSIONS

The findings of the study showed that educational intervention on parental skills in sex education based on the dramatic literature to their children has significant effect on parental knowledge, attitude, and performance.

"Resumption of Sexuality and Health Education in Postpartum Period: From Jordanian Health Care Professionals' Perspectives"

Objective: to explore Jordanian health care professionals' perspectives about sexual education after giving birth. Methods: a descriptive qualitative approach was used to address the study aim. A purposive sampling method was used to recruit seven midwives, 13 nurses and two obstetricians from three Primary Health Centres. The inclusion criteria were: midwives, nurses or obstetricians with at least two years' experience and currently working at a maternity health centre. Focus group discussions were used to collect data. A manual Thematic Content Analysis Tool was used to analyse the data. Results: five major themes emerged. Silence; resumption of sexuality after giving birth/area of conflict; men's authority in resumption of sexuality; the importance of sexual education (what, when and whom) and suggestions for sexual education approaches. Conclusions: Healthcare professionals were hesitant to open sexuality topic with the women during antenatal and postnatal visits due to cultural limitations and lack of knowledge. Therefore, in a time of global migration, the healthcare professionals have the need to understand cultural differences in attitude towards health care issues involving sexuality.

Pornography consumption and psychosomatic and depressive symptoms among Swedish adolescents: a longitudinal study

BACKGROUND

The aims of this longitudinal study were to identify predictors for continued pornography consumption and to investigate pornography consumption in relation to psychosomatic and depressive symptoms among a group of adolescents in Sweden.

METHODS AND MATERIALS

A longitudinal study in classroom environment in 53 randomly selected senior high school classes in mid-Sweden in years 2011 and 2013. Out of 477 participating boys and 400 girls in 2011, 224 boys (47%) and 238 girls (60%) participated in 2013.

RESULTS

Higher pornography consumption at baseline and being born outside Sweden predicted continued pornography consumption at follow-up (adjusted R2 = 0.689). Psychosomatic symptoms at follow-up were predicted by higher pornography consumption at baseline (adjusted R2 = 0.254), being a girl, living with separated parents, and attending a vocational high school program. By contrast, depressive symptoms at follow-up were predicted by less pornography consumption at baseline (adjusted R2 = 0.122) and being a girl.

CONCLUSIONS

Pornography consumption may, for some individuals, be associated to mental health issues. Differences between teenage boys and girls and between adolescents with diverse ethnic backgrounds imply that counseling and discussion about pornography need to be adjusted and individualized.

On the (In)compatibility of Islamic Religiosity and Citizenship in Western Democracies: The Role of Religion for Muslims’ Civic and Political Engagement

Questioning the compatibility of Islam with liberal democratic principles has become a common argument in the public rhetoric across the socio-political spectrum. This article examines this claimed irreconcilability through the prism of a constitutive dimension of healthy democracies: active citizenship. Drawing on a systematic synthesis of recent studies, the article argues that, while it is impossible to ultimately decide whether Islam as a faith is compatible with liberal democratic norms, the lived religiosity of most Muslims is generally not an obstacle to civic engagement in non-Muslim majority countries; active involvement in mosques rather tends to enhance their active citizenship. Data from an explorative study on Muslims’ engagement in Australia and Germany allow new insights into the different ways civically active Muslims refer to their faith as a driver for their citizenship. Some describe it as a religious duty, while for others ‘serving humanity’ constitutes a fundamental aspect of lived religiosity.

Effects of interactive teaching on university students' knowledge and attitude toward reproductive health: a pilot study in Jordan

Background

Youths in Jordan lack knowledge related to reproductive health (RH). Interactive teaching methods showed positive results in enhancing health awareness and adopting healthy practices among students.

Objectives

The objective of this study was to examine the usefulness of interactive teaching in promoting health awareness of RH among nonmedical university students in Jordan.

Methods

We employed a quasi-experimental one group pretest and posttest design for a purposive sample of 210 students (18-24 years). Knowledge and attitudes regarding RH issues were assessed using a questionnaire developed by the researchers.

Results

A significant improvement in students' knowledge and attitudes toward RH was evident. Female students had higher scores on knowledge than male students in the pretest; this difference was smaller in the posttest. Also, female students had significantly more positive attitudes toward RH in pretest than males, although this difference vanished in the posttest. Study results indicated that students benefit from study intervention regardless their gender.

Conclusion

Integrating RH into university's curriculum coupled with interactive learning approach is a powerful way to promote RH awareness among youths.

A qualitative study of sexual health education among Iranian engaged couples

BACKGROUND

Sexual health education for Iranian engaged couples is always ignored in the premarital education program.

OBJECTIVES

The aim of this study was to explore the necessity of sexual health education for Iranian engaged couples.

MATERIALS AND METHODS

This qualitative study was conducted in Rasht, Iran. The studied sample consisted of 38 engaged men and women; and also 9 health experts and policymakers. We used interview guides to collect data. The data was analyzed through content analysis method.

RESULTS

Analyzing participants' perspectives revealed six themes including: (1) socio-cultural changes, (2) emerging social pathologies, (3) inadequate sexual knowledge; (4) challenges in providing sexual health services, (5) individual consequences and (6) social consequences.

CONCLUSION

Most participants emphasized the necessity of sexual health education not only because of medical concerns, but also from the perspective of social issues. Providing these services should be considered a priority.

Culture Clash? Investigating constructions of sexual and reproductive health from the perspective of 1.5 generation migrants in Australia using Q methodology

BACKGROUND

In Australia, those who migrate as children or adolescents (1.5 generation migrants) may have entered a new cultural environment at a crucial time in their psychosexual development. These migrants may have to contend with constructions of sexual and reproductive health from at least two cultures which may be at conflict on the matter. This study was designed to investigate the role of culture in constructions of sexual and reproductive health and health care seeking behaviour from the perspective of 1.5 generation migrants.

METHODS

Forty-two adults from various ethno-cultural backgrounds took part in this Q methodological study. Online, participants rank-ordered forty-two statements about constructions of sexual and reproductive health and health seeking behaviours based on the level to which they agreed or disagreed with them. Participants then answered a series of questions about the extent to which their ethnic/cultural affiliations influenced their identity. A by-person factor analysis was then conducted, with factors extracted using the centroid technique and a varimax rotation.

RESULTS

A seven-factor solution provided the best conceptual fit for constructions of sexual and reproductive health and help-seeking. Factor A compared progressive and traditional sexual and reproductive health values. Factor B highlighted migrants' experiences through two cultural lenses. Factor C explored migrant understandings of sexual and reproductive health in the context of culture. Factor D explained the role of culture in migrants' intimate relationships, beliefs about migrant sexual and reproductive health and engagement of health care services. Factor E described the impact of culture on sexual and reproductive health related behaviour. Factor F presented the messages migrant youth are given about sexual and reproductive health. Lastly, Factor G compared constructions of sexual and reproductive health across cultures.

CONCLUSIONS

This study has demonstrated that when the cultural norms of migrants' country of origin are maintained it has a significant influence on how 1.5 generation migrants construct, experience and understand various aspects of sexual and reproductive health. Policy makers, health care professionals and resettlement service providers are advised to engage with migrant parents and youth in exploring, discussing, reframing and reconstructing SRH in an Australian context.

Understanding the sexuality and sexual health of Muslim young people in Canada and other Western countries: A scoping review of research literature

Muslim communities comprise one of the fastest growing populations in Canada and other Western countries. Healthcare providers and educators point to the lack of relevant and inclusive sexual health information as a major barrier in promoting Muslim young people's sexual health. Since evidence-based knowledge is critical to the development of relevant sexual health resources, we undertook a scoping review of primary and secondary research literature on sexuality and sexual health of Muslim young people. For the purpose of identifying relevant literature, we include studies of youth and young adults aged 12 to 30. We searched nine electronic databases encompassing multiple disciplines to identify recent peer-reviewed journal articles and grey literature published in English between 2005 and 2015. The search yielded 1187 articles; 306 duplicated articles were removed; 859 did not meet the inclusion criteria of Muslim young people and sexuality or sexual health; and a total of 22 articles were included in this review. This paper reports on the major themes identified through the review: (1) sexual health knowledge and perspectives on sex education; (2) socialization and conflicting values about sexuality; (3) gender, risks and sexual practices; and (4) sexual health information and service needs. We conclude that the lack of research on sexuality and sexual health of Muslim young people poses a challenge for policy-makers, service providers, sex educators and other stakeholders to gain sufficient understanding to guide the development of effective and inclusive sexual health programming for Muslim young people in Canada and other Western countries.

Recommendations for Developing Contextually Relevant HIV/AIDS Prevention Strategies Targeting African-Born Immigrants and Refugees in the United States

African-born immigrants and refugees have HIV infection rates six times higher than any other minority groups in the United States. Despite the increase in the population size and diversity of Somali immigrants and refugees in the United States, Somalis are one of the medically underserved population subgroups in this region. The lack of aggregate HIV infection rates among African-born immigrants, for example, Somali refugees, is a cause for alarm and calls for more research to be conducted in this subgroup. The purpose of this article was to examine contextually relevant HIV prevention strategies that will enhance HIV prevention among Somali immigrant/refugee young adults in the United States. Using the grounded theory approach, a convenience sample of 27 immigrant/refugee young adults was recruited in central Ohio. Recommendations for potential HIV prevention strategies emerged under two main categories: (1) internal community resources and (2) external platforms. Study findings support a collaborative approach involving community leaders (parents, elders, religious leaders) and educational (schools), media, and healthcare settings to tailor HIV prevention strategies that meet the needs of the priority group.

Gaming for Safer Sex: Young German and Turkish People Report No Specific Culture-Related Preferences Toward Educational Games Promoting Safer Sex

OBJECTIVE

Comprehensive sex education programs specifically designed for adolescents and young adults that take into account gender norms and cultural background have shown promise as a means of countering the high sexually transmitted infection rate in young people. Recently, digital gaming interventions delivered on computers or mobile devices have emerged as another way to promote safer sex behavior in a young population. Tailoring these computer-based interventions to their target population has been recognized to increase positive behavior outcomes. In this qualitative study, we investigated whether young female and male adults from two different cultural backgrounds (all living in Germany) would have different preferences and needs in relation to an educational game promoting safer sex.

MATERIALS AND METHODS

We conducted four semistructured focus group interviews comprising open-ended questions with male and female participants who had either a German or a Turkish background. In total, 20 individuals, aged between 18 and 22 years, from two socially diverse and ethnically mixed vocational schools in Germany participated.

RESULTS

Independent of cultural background and gender, participants preferred a real-world design with a first-person visual perspective over a fantasy-like third-person perspective. Furthermore, they preferred highly customizable avatars. All participants mentioned the importance of including an alcohol-intoxicated avatar and most participants wanted there to be additional information available about various safer sex approaches and about the use of different barrier protection methods. Males and females reported similar preferences for the design of an educational game promoting safer sex, with the only difference being exactly how the topic of having sexual intercourse should be addressed in the game. Males preferred a direct approach, whereas females had a preference for treating this subject more sympathetically.

CONCLUSION

Educational games offer anonymity and can provide young people across different cultural backgrounds with gender-tailored opportunities to experiment with specific safer sex precautions in a nonthreatening virtual environment, free from unwanted parental control and peer monitoring.

Religiosity for promotion of behaviors likely to reduce new HIV infections in Uganda: a study among Muslim youth in Wakiso District

The study was done to determine the association between religiosity and behaviors likely to reduce new HIV infections among 1,224 Muslim youth. Respondents with Sujda, the hyperpigmented spot on the forehead due to prostration during prayers, were more likely to abstain from sex, be faithful in marriage, and avoid alcohol and narcotics. Males wearing a Muslim cap were more likely to abstain from sex and avoid alcohol and narcotics. Females wearing the long dress (Hijab) were also more likely to avoid alcohol. This data should be used by stakeholders in promoting behaviors likely to reduce new HIV infections among Muslims.

Online health information seeking among Jewish and Arab adolescents in Israel: results from a national school survey

This study examined patterns and determinants of seeking online health information among a nationally representative sample of 7,028 Jewish and Arab 7th- through 12th-grade students in 158 schools in Israel. Nearly all respondents (98.7%) reported Internet access, and 52.1% reported having sought online health information in the past year. Arab students (63%) were more likely than Jewish students (48%) to seek online health information. Population-group and sex differences in health topics sought online were identified, although fitness/exercise was most common across groups. Multivariate regression models revealed that having sought health information from other sources was the strongest independent correlate of online health information-seeking among Jews (adjusted odds ratio = 8.93, 95% CI [7.70, 10.36]) and Arabs (adjusted odds ratio = 9.77, 95% CI [7.27, 13.13]). Other factors associated with seeking online health information common to both groups were level of trust in online health information, Internet skill level, having discussed health/medical issues with a health care provider in the past year, and school performance. The most common reasons for not seeking online health information were a preference to receive information from a health professional and lack of interest in health/medical issues. The closing of the digital divide between Jews and Arabs represents a move toward equality. Identifying and addressing factors underpinning online health information-seeking behaviors is essential to improve the health status of Israeli youth and reduce health disparities.

Socio-cultural challenges to sexual health education for female adolescents in Iran

BACKGROUND

Despite clear reasons for necessity of sexual health education for adolescents, it is a contested issue and has faced challenges in most cultures. Providing sexual education for non-married adolescents is culturally unacceptable in most Muslim societies.

OBJECTIVE

This qualitative study addressed socio-cultural challenges to sexual health education for female adolescents in Iran.

MATERIALS AND METHODS

Qualitative data from female adolescents (14-18 yr), mothers, teachers, authorities in health and education organizations, health care providers and clergies were collected in two large cities of Iran including Mashhad and Ahvaz through focus group discussions and individual in-depth interviews. Data were analyzed using conventional qualitative content analysis with MAXqda software.

RESULTS

Our results revealed that the main socio-cultural challenges to sexual health education for adolescents in Iran are affected by taboos surrounding sexuality. The emergent categories were: denial of premarital sex, social concern about negative impacts of sexual education, perceived stigma and embarrassment, reluctance to discuss sexual issues in public, sexual discussion as a socio-cultural taboo, lack of advocacy and legal support, intergenerational gap, religious uncertainties, and imitating non-Islamic patterns of education.

CONCLUSION

It seems that cultural resistances are more important than religious prohibitions, and affect more the nature and content of sexual health education. However, despite existence of salient socio-cultural doubtful issues about sexual health education for adolescents, the emerging challenges are manageable to some extent. It is hoped that the acceptability of sexual health education for adolescents could be promoted through overcoming the cultural taboos and barriers as major obstacles.

Female adolescents' experiences and perceptions regarding sexual health education in Iranian schools: A qualitative content analysis

BACKGROUND

Despite so many unmet sexual health education (SHE) needs of adolescents, socio-cultural challenges have caused this issue to be ignored in different scoieties. This study investigated Iranian female adolescents' experiences and perceptions with respect to SHE that they received at schools, and what they really needed, expected, and preferred.

MATERIALS AND METHODS

In this qualitative study, seven focus group discussions (44 adolescents) and 13 individual in-depth interviews were conducted among female adolescents aged 14-18 in Mashhad and Ahvaz, Iran, to explore adolescents' experiences and perceptions towards SHE in Iranian schools. Data were analyzed using qualitative content analysis.

RESULTS

Analyzing adolescents' perspectives and experiences revealed their great dissatisfaction with SHE in schools. Emerged categories included: lack of obligation and priority for SHE, sexual reticence and evading, making adolescents frightened of sexual issues, inconsistency of SHE with adolescents' needs, unqualified educators, and lack of appropriate educational materials.

CONCLUSION

This study found some similarities between expectations of Iranian adolescents and those of adolescents from other cultures about an SHE program. Adolescents showed great abilities to appraise health services delivered for them, and so any program for sexual health promotion in adolescents ought to address adolescents' needs, demands, and aspirations. Their contribution can provide insights for tailoring SHE programs for adolescents.