Search results for: sexual coercion
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 789

Search results for: sexual coercion

399 A Quality Improvement Approach for Reducing Stigma and Discrimination against Young Key Populations in the Delivery of Sexual Reproductive Health and Rights Services

Authors: Atucungwiire Rwebiita

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Introduction: In Uganda, provision of adolescent sexual reproductive health and rights (SRHR) services for key population is still hindered by negative attitudes, stigma and discrimination (S&D) at both the community and facility levels. To address this barrier, Integrated Community Based Initiatives (ICOBI) with support from SIDA is currently implementing a quality improvement (QI) innovative approach for strengthening the capacity of key population (KP) peer leaders and health workers to deliver friendly SRHR services without S&D. Methods: Our innovative approach involves continuous mentorship and coaching of 8 QI teams at 8 health facilities and their catchment areas. Each of the 8 teams (comprised of 5 health workers and 5 KP peer leaders) are facilitated twice a month by two QI Mentors in a 2-hour mentorship session over a period of 4 months. The QI mentors were provided a 2-weeks training on QI approaches for reducing S&D against young key populations in the delivery of SRHR Services. The mentorship sessions are guided by a manual where teams base to analyse root causes of S&D and develop key performance indicators (KPIs) in the 1st and 2nd second sessions respectively. The teams then develop action plans in the 3rd session and review implementation progress on KPIs at the end of subsequent sessions. The KPIs capture information on the attitude of health workers and peer leaders and the general service delivery setting as well as clients’ experience. A dashboard is developed to routinely track the KPIs for S&D across all the supported health facilities and catchment areas. After 4 months, QI teams share documented QI best practices and tested change packages on S&D in a learning and exchange session involving all the teams. Findings: The implementation of this approach is showing positive results. So far, QI teams have already identified the root causes of S&D against key populations including: poor information among health workers, fear of a perceived risk of infection, perceived links between HIV and disreputable behaviour. Others are perceptions that HIV & STIs are divine punishment, sex work and homosexuality are against religion and cultural values. They have also noted the perception that MSM are mentally sick and a danger to everyone. Eight QI teams have developed action plans to address the root causes of S&D. Conclusion: This approach is promising, offers a novel and scalable means to implement stigma-reduction interventions in facility and community settings.

Keywords: key populations, sexual reproductive health and rights, stigma and discrimination , quality improvement approach

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398 A Loop between Victimhood and Women with Choice: Case of Trafficked North Korean Women in China

Authors: Jinah Kwon

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Why are there North Korean women who prefer their life in China, living as an undocumented migrant, to legal residence in South Korea? What is the line between choice and coercion in trafficking and how does it relate to family, especially in Asian culture? Is family function as a haven in the unsecured world or a fetter against the better world? Are the current international mechanisms on trafficked victims fully reflecting the voices of the victims? This study is about the paradoxical conditions of North Korean women situated in China as the trafficked victim and as members of their Chinese family. In order to answer the questions above, this study explored the case of trafficked North Korean women in China. This mixed-methods study employed in-depth interviews of 18 trafficked women living in China and a survey of 98 North Korean origin women residing in South Korea. From the survey, 40 out of 98 women from the survey indicated an unexpected function of trafficking, which was used as a channel of supporting the subjectivity of women in the North Korean context. Such results supported the actual observation and narratives of North Korean women who experienced trafficking from the author’s two visits to the Northeastern area of China in 2012 and 2018, respectively. Based on the findings, the last part of the study makes policy implications on international trafficking mechanisms—theories by Gayatri Spivak and Herbert A. Simon was employed to approach the relatively less dealt aspect of trafficking.

Keywords: China, North Korean women, trafficking, victimhood

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397 Oral Sex Practice among Men Who Have Sex with Men: A Cross-Sectional Study in Indonesian Urban Settings

Authors: I Putu Yuda Hananta, Inke Kusumastuti

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The latest Indonesian Biology and Behavior Surveillance (IBBS) conducted by Indonesian Ministry of Health reported a large proportion of men who have sex with men (MSM) engaging in oral sex in their recent sexual history. While it is considered as a pleasuring and safe, oral sex might facilitate the transmission of various sexually transmitted infection (STI) pathogens. This study was aimed to investigate the oral sex practice among MSM in Indonesian urban settings to help delineate demographic and behavior determinants of such practice. In 2014, 501 MSM in 8 clinic-based and outreach STI services were recruited in Jakarta, Yogyakarta and Denpasar, Indonesia. Respondents completed a self-administered questionnaire inquiring about their demographics and sexual history. Median age (interquartile range) of the respondents was 27 (24-30) years; most completed senior high school (54.3%), worked in informal jobs (57.9%), and single (60.9%); and 32.3% reported receiving money in exchange for sex. Oral sex was practiced by most respondents: insertive only (10.0%), receptive only (6.0%), and both (82.4%). A separate multivariable analysis was performed using logistic regression to identify the determinants for receptive and insertive oral sex. Factors associated with receptive oral sex were having more than 10 sex partner(s) in the preceding 6 months vs 1 partner, adjusted odds ratio (aOR) [95% CI]=3.40 [1.22-9.42], p=0.03; and history of receptive-insertive anal sex vs no history, aOR=4.37 [1.76-10.82], p=0.01. Factors associated with insertive oral sex were receiving money for sex vs. not receiving, aOR=2.98 [1.10-8.04], p=0.02; and history of receptive-insertive anal sex vs. no history, aOR=2.10 [0.51-8.74], p<0.001. Only a few respondents reported consistent condom use (11.6% and 12.0% for receptive and insertive oral sex, respectively). Our findings demonstrated that while oral sex is a common practice among MSM, the consistency of condom use in oral sex is very low. In addition, certain sex behavior (number of sex partners, sex work and history of anal sex) were associated with oral sex, and this might need to be addressed during health promotion efforts on STI prevention through oral-genital contact.

Keywords: behavior, Indonesia, men who have sex with men, oral sex

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396 Challenging Heteronormativity and Mononormativity in Academia: Incorporating Consensual Non-Monogamy into Psychological Romantic Relationship Research

Authors: Jessica Wood, Serge Desmarais

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There has been recent resurgence in the popular and academic interest of consensual non-monogamous (CNM) relationships- an umbrella term that defines relationships in which each partner has openly agreed to engage in additional romantic and/or sexual relationships outside of their primary partnership. Despite an increase in the academic study of CNM, little psychological attention has been paid to the study of CNM, with the consideration of these relationships commonly occurring within related social science disciplines such as sociology or anthropology. As a discipline, psychology has a history of conducting research in the area of intimate relationships, and psychologists have amassed a wealth of theoretical knowledge in this field. However, historically individuals who engage in "alternative" sexual and romantic behaviours, such as non-heterosexual sex or sex with multiple partners have been pathologized within psychological research. Individuals in CNM relationships or individuals identifying as lesbian, gay, bisexual, trans or queer have often been excluded from research or “othered” in psychological interpretations of what healthy relationships entail. Thus, our current theoretical understandings of romantic relationships are limited to heterosexual, monogamous relationships. The goal of this presentation is to examine commonly cited components of relationship satisfaction (e.g., commitment, communication) and to critically assess how CNM experiences are presented in, or missing from, the psychological literature on romantic relationships. Additionally, the presentation will also consider how CNM relationships may add to our understanding or enhancement of traditional psychological theories and address issues related to heteronormativity and mononormativity within the discipline. Finally, we will close with a consideration of additional theoretical perspectives that may aid in our understanding of CNM relationships and suggest directions for future research.

Keywords: heteronormativity, mononormativity, psychological research, diverse relationships, gender, sexuality, feminism, queer theory

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395 Effect of a Single Injection of hCG on Testosterone Concentration in Male Alpacas

Authors: A. ElZawam, D. McLean, A. Tibary

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In alpaca, age at puberty is variable and the factors regulating the pattern of puberty and sexual maturation are a subject of controversy. Plasma testosterone level is often used as an indicator of sexual maturity. Our hypothesis is that hCG treatment will cause an increase in testosterone level that is correlated with animal age. The specific aim was to investigate the testicular tissue response to a single hCG injection by monitoring the serum testosterone concentration. Eighty four (n=84) males ranging in age from 6 to 60 months were used. Alpacas were grouped based on their ages into 15 groups. Each group had three to five male animals. Blood samples were collected from the jugular vein before treatment with hCG and 2 hours after intravenous administration of 3000 IU of hCG (Chorulon®). The serum was harvested and stored at -20ºC until the analysis. The effect of age on basal testosterone level and response to hCG treatment was evaluated by Analysis of Variance. As a result, basal serum testosterone concentrations were very low (<0.1ng/ml) until 9 months of age. Although basal serum testosterone concentrations increased steadily with age there was a significant variation amongst males within the same age group. Administration of 3000 IU of hCG, resulted in an average increase of 50% (P<0.05) in serum testosterone concentration after 2 hours. The percentage increase in serum testosterone in response to hCG stimulation varied from 51 to 81%. There was no correlation between the degree of response and age. However, the response to hCG injection presented two modes of increase depending on the age of animals. The first mode occurred at ages 9 to 14 months and the second mode was observed between 22 and 36 months. In conclusion, our results suggest that testicular growth and sensitivity to LH stimulation may be bimodal in the male alpaca with a rapid increase in growth and sensitivity between 9 and 14 months of age and a second phase of increased responsiveness after 21 months of ages.

Keywords: alpaca, testosterone, hCG, animal science

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394 Isolating Refugees in Mountains: The Case of the Austrian Border Regime

Authors: Deike Janssen

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In the scenery of the Tyrolean mountains, at an altitude of 1300 meters, stands a building. Residents and activists call it a prison. However, it is not a prison -according to authorities, it is a 'Return Counseling Facility' where migrants and refugees should be "motivated" to return "voluntary" to their countries of origin. This paper argues that the geographical location of the camp functions as a site of exclusion, isolation, and coercion where no one can decide “voluntary” to return, but where people are brought to despair to leave Austria. Through a qualitative case study, this paper documents the heavy impact of offshore detention on the mental, physical and social state of the residents and a variety of human rights problems in the centre. Different developments at the Return Counselling Facility and the law that back up the centre uncover a worrying dynamic that deliberately accepts human rights problems in order to enforce borders, a policy that disregards humanitarian, legal, and ethical stands in order to deport people at all hazards. It, therefore, can be seen as a creative and ultimate exercise of state power, which uses isolated locations to control migration. While the analysis revises the micro and macro implications of the facility and, therefore, the legal and political facets, it also sheds light on the role of the civil society, which tries to increase through constant and collective efforts the human rights efforts of the government.

Keywords: deportation, human rights, migration, refugee detention, voluntary return

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393 Effects of Adding Sodium Nitroprusside in Semen Diluents on Motility, Viability and Lipid Peroxidation of Sperm of Holstein Bulls

Authors: Leila Karshenas, Hamid Reza Khodaei, Behnaz Mahdavi

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We know that nitric oxide (NO) plays an important role in all sexual activities of animals. It is made in body from NO synthase enzyme and L-arginin molecule. NO can bound with sulfur-iron complexes and because production of steroid sexual hormones is related to enzymes which have this complex, NO can change the activity of these enzymes. NO affects many cells including endothelial cells of veins, macrophages and mast cells. These cells are found in testis leydig cells and therefore are important source of NO in testis tissue. Minimizing damages to sperm at the time of sperm freezing and thawing is really important. The goal of this study was to determine the function of NO before freezing and its effects on quality and viability of sperms after thawing and incubation. 4 Holstein bulls were selected from the age of 4, and artificial insemination was done for 3 weeks (2 times a week). Treatments were 0, 10, 50 and 100 nm of sodium nitroprusside (SNP). Data analysis was performed by SAS98 program. Also, mean comparison was done using Duncan's multiple ranges test (P<0.05). Concentrations used was found to increase motility and viability of spermatozoa at 1, 2 and 3 hours after thawing significantly (P<0.05), but there was no significant difference at zero time. SNP levels reduced the amount of lipid peroxidation in sperm membrane, increased acrosome health and improved sample membranes especially in 50 and 100 nm treatments. According to results, adding SNP to semen diluents increases motility and viability of spermatozoa. Also, it reduces lipid peroxidation in sperm membrane and improves sperm function.

Keywords: sperm motility, nitric oxide, lipid peroxidation, spermatozoa

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392 Soft Power in International Politics: Defense and Continued Relevance

Authors: Shivani Yadav

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The paper will first elaborate on the concept of soft power as formulated by Joseph Nye, who argues that soft power is as important as hard power in international politics as it replaces coercion with non-coercive forms of co-optation and attraction. The central tenet of the paper is to extrapolate the continued relevance of soft power in international relations in the 21st century. It is argued that the relevance of soft power, in concurrence with hard power, is on the rise in the international system. This is found to be emanating out of two factors. First, the state-centric practice of international relations has expanded to allow other actors to participate in policymaking. This has led to the resources for power generation to become varied, largely move away from the control of governments, and to produce both hard and soft power attributes. Second, as the currency of coercive power seems to be devaluing in global politics, the role of intangible factors like soft power is getting more important in policymaking. The paper will then go on to elaborate on the critiques of the formulation of soft power from various perspectives, as well as the defenses to these critiques presented by soft power proponents. The paper will reflect on the continued relevance of soft power in international politics by giving the example of India, and how soft power has continued to serve its policy objectives over the years. It is observed that even as India is recognized as a rising superpower today, yet it has made a continuous effort in cultivating its soft power resources, which have proven to be its assets in furthering its foreign policy interests. In conclusion, the paper makes the point that soft power, in conjunction with hard power, will shape international politics in the coming times.

Keywords: foreign policy, India’s soft power, international politics, smart power, soft power

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391 Access to Sexual Reproductive Health (SRH) Education and Services to Deaf Adolescents in Wakiso, Uganda - The Ugandan Perspective

Authors: Racheal Ayanga, Nancy Katumba Muwangala, Jane Babirye, Harriet Kivumbi

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Background: Deaf adolescents are vulnerable. Deafness limits their access to resources that are accessed by their hearing peers. There is minimal attention placed on the SRH needs of persons with disabilities, especially in developing countries. We sought to assess barriers to access of SRH education and services for deaf adolescents in Uganda. Methods: We performed a cross sectional study using a questionnaire on knowledge of and access to SRH education and services from a selected sample of deaf adolescents aged 13-19 years at Wakiso Secondary school for the deaf. A consecutive sample of eligible participants was asked to join the study after obtaining informed consent until the target sample size was reached. Results: From 01 Jul 2022 to 30 Jan 2023, 70 quantitative interviews were conducted. Participants’ mean age was 17 years, and 66% were female. 89% had heard about several components of SRH. 99% reported a need for education and services but had challenges with access 85% of the time. 54% reported receipt of education and services from government or private facilities, and the rest from friends, parents, siblings, teachers and the internet. Conclusion: Government needs to look into availing tailored, sustainable SRH education/services to deaf adolescents at health facilities and teach health workers sign language. SRH education to parents, teachers and communities of deaf adolescents improves access in hard-to-reach areas. Integration of services into routine health care is key in creating and improving models of access to wider communities of persons with disabilities to improve their mental health.

Keywords: sexual and reproductive health, deaf, adolescents, education, services, disabilities, mental health, hard-to-reach areas

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390 Through the Lens of Forced Displacement: Refugee Women's Rights as Human Rights

Authors: Pearl K. Atuhaire, Sylvia Kaye

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While the need for equal access to civil, political as well as economic, social and cultural rights is clear under the international law, the adoption of the Convention on the Elimination of all forms of Discrimination against women in 1979 made this even clearer. Despite this positive progress, the abuse of refugee women's rights is one of the basic underlying root causes of their marginalisation and violence in their countries of asylum. This paper presents a critical review on the development of refugee women's rights at the international levels and national levels. It provides an array of scholarly literature on this issue and examines the measures taken by the international community to curb the problem of violence against women in their various provisions through the instruments set. It is cognizant of the fact that even if conflict affects both refugee women and men, the effects on women refugees are deep-reaching, due to the cultural strongholds they face. An important aspect of this paper is that it is conceptualised against the fact that refugee women face the problem of sexual and gender based first as refugees and second as women, yet, their rights are stumbled upon. Often times they have been rendered "worthless victims" who are only in need of humanitarian assistance than active participants committed to change their plight through their participation in political, economic and social participation in their societies. Scholars have taken notice of the fact that women's rights in refugee settings have been marginalized and call for a need to incorporate their perspectives in the planning and management of refugee settings in which they live. Underpinning this discussion is feminism theory which gives a clear understanding of the root cause of refugee women's problems. Finally, this paper suggests that these policies should be translated into action at local, national international and regional levels to ensure sustainable peace.

Keywords: feminism theory, human rights, refugee women, sexual and gender based violence

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389 Coping with Incompatible Identities in Russia: Case of Orthodox Gays

Authors: Siuzan Uorner

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The era of late modernity is characterized, on the one hand, by social disintegration, values of personal freedom, tolerance, and self-expression. Boundaries between the accessible and the elitist, normal and abnormal are blurring. On the other hand, traditional social institutions, such as religion (especially Russian Orthodox Church), exist, criticizing lifestyle and worldview other than conventionally structured canons. Despite the declared values and opportunities in late modern society, people's freedom is ambivalent. Personal identity and its aspects are becoming a subject of choice. Hence, combinations of identity aspects can be incompatible. Our theoretical framework is based on P. Ricoeur's concept of narrative identity and hermeneutics, E. Goffman’s theory of social stigma, self-presentation, discrepant roles and W. James lectures about varieties of religious experience. This paper aims to reconstruct ways of coping with incompatible identities of Orthodox gays (an extreme sampling of a combination of sexual orientation and religious identity in a heteronormative society). This study focuses on the discourse of Orthodox gay parishioners and ROC gay priests in Russia (sampling ‘hard to reach’ populations because of the secrecy of gay community in ROC and sensitivity of the topic itself). We conducted a qualitative research design, using in-depth personal semi-structured online-interviews. Recruiting of informants took place in 'Nuntiare et Recreare' (Russian movement of religious LGBT) page in VKontakte through the post with an invitation to participate in the research. In this work, we analyzed interview transcripts using axial coding. We chose the Grounded Theory methodology to construct a theory from empirical data and contribute to the growing body of knowledge in ways of harmonizing incompatible identities in late modern societies. The research has found that there are two types of conflicts Orthodox gays meet with: canonic contradictions (postulates of Scripture and its interpretations) and problems in social interaction, mainly with ROC priests and Orthodox parishioners. We have revealed semantic meanings of most commonly used words that appear in the narratives (words such as ‘love’, ‘sin’, ‘religion’ etc.). Finally, we have reconstructed biographical patterns of LGBT social movements’ involvement. This paper argues that all incompatibilities are harmonizing in the narrative itself. As Ricoeur has suggested, the narrative configuration allows the speaker to gather facts and events together and to compose causal relationships between them. Sexual orientation and religious identity are getting along and harmonizing in the narrative.

Keywords: gay priests, incompatible identities, narrative identity, Orthodox gays, religious identity, ROC, sexual orientation

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388 Frankie Adams’s Sexuality in the Member of the Wedding: Focusing on Musical References

Authors: Saori Iwatsuka

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In The Member of the Wedding, Carson McCullers starts with the words, “It happened,” without telling the reader what happens to a twelve-year-old protagonist, Frankie Adams. The reader feels confused and incomprehensible. However, he or she later realizes that the confusing phrase is connected to the scene where Frankie feels “the thing happened” after listening to the melodic lines of jazz and blues. Yet, the reader cannot really comprehend what happens to Frankie and feels puzzled till the end. And the story ends with Frankie’s words, “I am simply mad about . . .” Implying her queer desire for her new friend Mary Littlejohn, McCullers never tells the reader whom Frankie is mad about. Despite McCullers’s ambiguous way of depicting Frankie’s sexuality, recent critics and reviewers have come to discuss her sexuality as anti-heterosexual because Frankie expresses her hatred for Barney, whom she has had some type of sexual encounter, and feels wrong with her brother Jarvis’s wedding. After giving up her sexual desire for Jarvis’s bride, Janice, Frankie changes her name to Frances, becomes engrossed with Michelangelo, and enjoys reading Tennyson’s poetry with Mary. Michelangelo and Tennyson are well-known homosexual artists, which suggests that Frankie has an anti-heterosexual orientation. As McCullers does not precisely describe Frankie’s sexuality, the reader can only assume it by connecting fragmentary descriptions. However, this discussion is more clarified to show Frankie’s sexuality because analyzing the musical references of jazz and blues and interpreting them from a musicological viewpoint will illuminate it. In her works, McCullers frequently uses musical references and descriptions, which have a significant and psychological impact on the protagonists and portrays their bodily reactions to the impact to reveal what the reader cannot see on the surface. Thus, in this story, too, Frankie’s bodily reaction to music is portrayed to cue her feelings. After seeing the chimney swifts, known as monogamous birds, Frankie feels “a jazz sadness,” quivers her nerves and stiffens her heart. After listening to Berenice’s “dark jazz voice,” Frankie feels dizzy and throws a knife because Berenice’s voice jazzes (excites) her heart that beats in her head. Calming herself, she fantasizes that Jarvis, Jarvis’s bride, Janice, and herself are members of “the we of me.” Then in the evening, listening to the blues and jazz being played by a black horn player somewhere in her neighborhood, Frankie realizes “the thing happened” and discovers “a new feeling.” Following the musical references “jazz” and “blues” and examining them from the viewpoint of musicology and terminology leads the reader to explore what “it” is in “it happened” and what her “new feeling” is when “the thing happened” with the blues tune breaking off. Those discussions will illuminate Frankie’s sexuality. As McCullers does not clearly name her sexuality, this paper uses the word queer to express Frankie’s anti-sexual orientation.

Keywords: jazz and blues, musical references, queer sexuality, “we of me”

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387 A Vaccination Program to Control an Outbreak of Acute Hepatitis A among MSM in Taiwan, 2016

Authors: Ying-Jung Hsieh, Angela S. Huang, Chu-Ming Chiu, Yu-Min Chou, Chin-Hui Yang

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Background and Objectives: Hepatitis A is primarily acquired by the fecal-oral route through person-to-person contact or ingestion of contaminated food or water. During 2010 to 2014, an average of 83 cases of locally-acquired disease was reported to Taiwan’s notifiable disease system. Taiwan Centers for Disease Control (TCDC) identified an outbreak of acute hepatitis A which began in June 2015. Of the 126 cases reported in 2015, 103 (82%) cases were reported during June–December and 95 cases (92%) of them were male. The average age of all male cases was 31 years (median, 29 years; range, 15–76 years). Among the 95 male cases, 49 (52%) were also infected with HIV, and all reported to have had sex with other men. To control this outbreak, TCDC launched a free hepatitis A vaccination program in January 2016 for close contacts of confirmed hepatitis A cases, including family members, sexual partners, and household contacts. Effect of the vaccination program was evaluated. Methods: All cases of hepatitis A reported to the National Notifiable Disease Surveillance System were included. A case of hepatitis A was defined as a locally-acquired disease in a person who had acute clinical symptoms include fever, malaise, loss of appetite, nausea or abdominal discomfort compatible with hepatitis, and tested positive for anti-HAV IgM during June 2015 to June 2016 in Taiwan. The rate of case accumulation was calculated using a simple regression model. Results: During January–June 2016, there were 466 cases of hepatitis A reported; of the 243 (52%) who were also infected with HIV, 232 (95%) had a history of having sex with men. Of the 346 cases that were followed up, 259 (75%) provided information on contacts but only 14 (5%) of them provided the name of their sexual partners. Among the 602 contacts reported, 349 (58%) were family members, 14 (2%) were sexual partners, and 239 (40%) were other household contacts. Among the 602 contacts eligible for free hepatitis A vaccination, 440 (73%) received the vaccine. There were 87 (25%) cases that refused to disclose their close contacts. The average case accumulation rate during January–June 2016 was 21.7 cases per month, which was 6.8 times compared to the average case accumulation rate during June–December 2015 of 3.2 cases per month. Conclusions: Despite vaccination program aimed to provide free hepatitis A vaccine to close contacts of hepatitis A patients, the outbreak continued and even gained momentum in transmission. Refusal by hepatitis A patients to provide names of their close contacts and rejection of contacts to take the hepatitis A vaccine may have contributed to the poor effect of the program. Targeted vaccination efforts of all MSM may be needed to control the outbreak among this population in the short term. In the long term, universal vaccination program is needed to prevent the infection of hepatitis A.

Keywords: hepatitis A, HIV, men who have sex with men, vaccination

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386 Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda

Authors: Humphrey Atwijukiire, Gladys Nakidde, Anne Tweheyo Otwine, Jane Kabami

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Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda Introduction: Disclosure of HIV status is key in HIV management. Despite many studies on serostatus disclosure, there is a gap in experiences regarding HIV status disclosure among discordant couples. This study explored the lived experiences of serostatus disclosure among discordant couples in Mbarara City, South Western Uganda. Methods: We conducted 12 in-depth interviews using translated interview guide, and audio recorders. Participants were purposively enrolled in the study. The study was conducted at three public health facilities in Mbarara City. Data was analyzed using thematic content analysis. Approval for this research was obtained from Mbarara University Research Ethics Committee and administrative clearance from city clerk of Mbarara City. Results: The mean age of participants was 38 years. An equal number of males (six) and females participated. Most of them had at least secondary level education, only three had primary education. Experienced benefits of HIV serostatus disclosure included: social support and care; decisions regarding health, fertility, and child bearing; sharing information on HIV prevention and protection; positive living; and, ease of HIV disclosure. The challenges included: misunderstandings in the families. Conclusion: Socially, psychologically and financially PLWHIV have benefited from their negative partners. Health wise, they have been supported, and cared for, but some have faced challenges, such as family misunderstandings. Couple HIV counseling and testing by a trained health worker is beneficial in HIV care and could mitigate the challenges related HIV serostatus disclosure.

Keywords: discordant couples, disclosure, experiences, HIV

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385 Pre-Cancerigene Injuries Related to Human Papillomavirus: Importance of Cervicography as a Complementary Diagnosis Method

Authors: Denise De Fátima Fernandes Barbosa, Tyane Mayara Ferreira Oliveira, Diego Jorge Maia Lima, Paula Renata Amorim Lessa, Ana Karina Bezerra Pinheiro, Cintia Gondim Pereira Calou, Glauberto Da Silva Quirino, Hellen Lívia Oliveira Catunda, Tatiana Gomes Guedes, Nicolau Da Costa

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The aim of this study is to evaluate the use of Digital Cervicography (DC) in the diagnosis of precancerous lesions related to Human Papillomavirus (HPV). Cross-sectional study with a quantitative approach, of evaluative type, held in a health unit linked to the Pro Dean of Extension of the Federal University of Ceará, in the period of July to August 2015 with a sample of 33 women. Data collecting was conducted through interviews with enforcement tool. Franco (2005) standardized the technique used for DC. Polymerase Chain Reaction (PCR) was performed to identify high-risk HPV genotypes. DC were evaluated and classified by 3 judges. The results of DC and PCR were classified as positive, negative or inconclusive. The data of the collecting instruments were compiled and analyzed by the software Statistical Package for Social Sciences (SPSS) with descriptive statistics and cross-references. Sociodemographic, sexual and reproductive variables were analyzed through absolute frequencies (N) and their respective percentage (%). Kappa coefficient (κ) was applied to determine the existence of agreement between the DC of reports among evaluators with PCR and also among the judges about the DC results. The Pearson's chi-square test was used for analysis of sociodemographic, sexual and reproductive variables with the PCR reports. It was considered statistically significant (p<0.05). Ethical aspects of research involving human beings were respected, according to 466/2012 Resolution. Regarding the socio-demographic profile, the most prevalent ages and equally were those belonging to the groups 21-30 and 41-50 years old (24.2%). The brown color was reported in excess (84.8%) and 96.9% out of them had completed primary and secondary school or studying. 51.5% were married, 72.7% Catholic, 54.5% employed and 48.5% with income between one and two minimum wages. As for the sexual and reproductive characteristics, prevailed heterosexual (93.9%) who did not use condoms during sexual intercourse (72.7%). 51.5% had a previous history of Sexually Transmitted Infection (STI), and HPV the most prevalent STI (76.5%). 57.6% did not use contraception, 78.8% underwent examination Cancer Prevention Uterus (PCCU) with shorter time interval or equal to one year, 72.7% had no cases of Cervical Cancer in the family, 63.6% were multiparous and 97% were not vaccinated against HPV. DC identified good level of agreement between raters (κ=0.542), had a specificity of 77.8% and sensitivity of 25% when compared their results with PCR. Only the variable race showed a statistically significant association with CRP (p=0.042). DC had 100% acceptance amongst women in the sample, revealing the possibility of other experiments in using this method so that it proves as a viable technique. The DC positivity criteria were developed by nurses and these professionals also perform PCCU in Brazil, which means that DC can be an important complementary diagnostic method for the appreciation of these professional’s quality of examinations.

Keywords: gynecological examination, human papillomavirus, nursing, papillomavirus infections, uterine lasmsneop

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384 Parent-Child Communication: Community Based HIV/AIDS Response Strategy among Young Persons

Authors: Vicent Lwanga

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Issue: Communication between parent and child is important and necessary. Poor parenting and lack of openness and communication between parents and their children contribute to the increasing rate of HIV infection among young persons between the ages of 10-25. The young person, when left on their own are at the risk of misinformation from peers and from other sources. Description: Parent-Child Communication (PCC) was designed as a key component of a community-based HIV and AIDS intervention focused on young persons by Elderly Widows Orphans Family Support Organisation. Findings from the preliminary community-level process indicated that the lack of parent-child communication militates against young persons adopting and maintaining healthier sexual behaviors. An integrated youth strategy consisting of youth Peer Education/Facilitation and PCC was used to bridge this gap. The process involved an interactive parent-child forum, which allowed parents and children to meet and have open and frank discussions on the needs of young persons and the role of parents. This forum addressed all emerging issues from all parties and created better cordiality amongst them. Lessons Learnt: When young people feel unconnected to their parents, family, or home, they may become involved in activities that put their health at risk. Equally, when parents affirm the value of their children through open interaction, children are more likely to develop positive and healthy attitudes about themselves. Creating the opportunity for this interactive forum is paramount in any intervention program focused on young persons. Conclusion: HIV and AIDS-related programmes, especially those focusing on youth, should have PCC as an integral, essential component. Parents should be vehicles for information dissemination and need to be equipped with the capacity and skills to take on the onerous task of talking sexual reproductive health and sexuality with their children and wards.

Keywords: aids, communication, HIV, youth

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383 Engaging With Sex, Gender and Sexuality Diversity at Higher Education Institutions

Authors: Shakila Singh

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Dominant discourses constitute heterosexuality as natural, normal and the only legitimate sexuality, and diverse sexual subjectivities as abnormal, unnatural and socially taboo. Similarly, the cisgender subject is reified. There are ongoing debates about the inclusion and suitability of sexuality education in the school curriculum and research show that teachers are not adequately prepared to teach about such issues in the classroom. Not surprising then, that many young people enter these institutions having had limited previous exposure to, or education about, sex, gender and sexuality diversity. This paper discusses the presence of heterosexism and cissexism at multiple layers in higher education institutions, impacting students and staff. Increasing knowledge and awareness of sex, gender and sexuality diversities is also crucial to challenging existing perceptions of sex, gender and sexuality diversities that marginalise and subordinate a large proportion of students and staff. There is a persistent disjuncture between dominant discourses that generally position higher education institutions as socially progressive, open environments and the discourses that legitimate the ascendency of heterosexual and cisgender identities. This paper argues that such disjuncture must be addressed by providing inclusive physical and emotional spaces if universities are to affirm every individual and produce graduates across all disciplines with the cultural capability to engage with increasingly diverse communities. Given the key role of language in shaping cultural and social attitudes, using gender-inclusive language is a powerful way to promote gender equality and eradicate gender bias. This means speaking and writing in a way that does not discriminate against a particular sex, gender or sexual identity and does not perpetuate gender stereotypes. Individuals must be allowed to present themselves and identify in ways they choose and be addressed by their chosen pronouns.

Keywords: heteronormativity, inclusivity, gender, universities

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382 Erectile Function and Heart Rate Variability in Men under 40 Years Old

Authors: Rui Miguel Costa, Jose Pestana, David Costa, Paula Mangia, Catarina Correia, Mafalda Pinto Coelho

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There is lack of studies examining the relation of different heart rate variability (HRV) parameters with the risk of erectile dysfunction (ED) in younger men. Thus, the present study aimed at examining, in a nonclinical sample of men aged 19-39 years old (mean age = 23.98 years, SD = 4.90), the relations of risk of ED with the standard deviation of the heart rate (SD of HR), high and low frequency power of HRV, and low-to-high frequency HRV ratio. Eighty-three heterosexual Portuguese men completed the 5-item version of the International Index of Erectile Function (IIEF-5) and HRV parameters were calculated from a 5-minute resting period. Risk of ED was determined by IIEF-5 scores of 21 or less. Fifteen men (18.1%) reported symptoms of ED (14 with mild and one with mild to moderate symptoms). Univariate analyses of variance revealed that risk of ED was related to lesser SD of HR and lesser low-frequency power, the two HRV parameters that express a coupling of higher vagal and sympathetic tone. Risk of ED was unrelated to high-frequency power and low-to-high frequency HRV ratio. Further, in a logistic regression, the risk of ED was independently predicted by older age and lower SD of HR, but not by low-frequency power, having a regular sexual partner, and cohabiting. The results provide preliminary evidence that, in younger men, a coupling of higher vagal and sympathetic tone, as indexed by the SD of HR, is important for erections. Greater resting SD of HR might reflect better vascular and interpersonal function via vagal tone coupled with greater motor mobilization to pursue sexual intercourse via sympathetic tone. Many interventions can elevate HRV; future research is warranted on how they can be tailored to treat ED in younger men.

Keywords: erectile dysfunction, heart rate variability, standard deviation of the heart rate, younger men

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381 Intracommunity Attitudes Toward the Gatekeeping of Asexuality in the LGBTQ+ Community on Tumblr

Authors: A.D. Fredline, Beverly Stiles

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This is a qualitative investigation that examines the social media site, Tumblr, for the goal of analyzing the controversy regarding the inclusion of asexuality in the LGBTQ+ community. As platforms such as Tumblr permit the development of communities for marginalized groups, social media serves as a core component to exclusionary practices and boundary negotiations for community membership. This research is important because there is a paucity of research on the topic and a significant gap in the literature with regards to intracommunity gatekeeping. However, discourse on the topic is blatantly apparent on social media platforms. The objectives are to begin to bridge the gap in the literature by examining attitudes towards the inclusion of asexuality within the LGBTQ+ community. In order to analyze the attitudes developed towards the inclusion of asexuality in the LGBTQ+ community, eight publicly available blogs on Tumblr.com were selected from both the “inclusionist” and “exclusionist” perspectives. Blogs selected were found through a basic search for “inclusionist” and “exclusionist” on the Tumblr website. Out of the first twenty blogs listed for each set of results, those centrally focused on asexuality discourse were selected. For each blog, the fifty most recent postings were collected. Analysis of the collected postings exposed three central themes from the exclusionist perspective as well as for the inclusionist perspective. Findings indicate that from the inclusionist perspective, asexuality belongs to the LGBTQ+ community. One primary argument from this perspective is that asexual individuals face opposition for their identity just as do other identities included in the community. This opposition is said to take a variety of forms, such as verbal shaming, assumption of illness and corrective rape. Another argument is that the LGBTQ+ community and asexuals face a common opponent in cisheterosexism as asexuals struggle with the assumed and expected sexualization. A final central theme is that denying asexual inclusion leads to the assumption of heteronormativity. Findings also indicate that from the exclusionist perspective, asexuality does not belong to the LGBTQ+ community. One central theme from this perspective is the equivalization of cisgender heteroromantic asexuals with cisgender heterosexuals. As straight individuals are not allowed in the community, exclusionists argue that asexuals engaged in opposite gender partnerships should not be included. Another debate is that including asexuality in the community sexualizes all other identities by assuming sexual orientation is inherently sexual rather than romantic. Finally, exclusionists also argue that asexuality encourages childhood labeling and forces sexual identities on children, something not promoted by the LGBTQ+ community. Conclusions drawn from analyzing both perspectives is that integration may be a possibility, but complexities add another layer of discourse. For example, both inclusionists and exclusionists agree that privileged identities do not belong to the LGBTQ+ community. The focus of discourse is whether or not asexuals are privileged. Clearly, both sides of the debate have the same vision of what binds the community together. The question that remains is who belongs to that community.

Keywords: asexuality, exclusionists, inclusionists, Tumblr

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380 Legal Provisions on Child Pornography in Bangladesh: A Comparative Study on South Asian Landscape

Authors: Monira Nazmi Jahan, Nusrat Jahan Nishat

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'Child Pornography' is a sex crime that portrays illegal images and videos of a minor over the Internet and now has become a social concern with the increase of commission of this crime. The major objective of this paper is to identify and examine the laws relating to child pornography in Bangladesh and to compare this with other South Asian countries. In Bangladesh to prosecute under child pornography, provisions have been made in ‘Digital Security Act, 2018’ where it has been defined as involving child in areas of child sexuality or in sexuality and whoever commits the crime will be punished for 10 years imprisonment or 10 lac taka fine. In India, the crime is dealt with ‘The Protection of Children from Sexual Offences Act, 2012’ (POSCO) where the offenders for commission of this crime has been divided separately and has provision for punishments starting from three years to rigorous life imprisonment and shall also be liable to fine. In the Maldives, there is ‘Special Provisions Act to Deal with Child Sex Abuse Offenders, Act number 12/2009’. In this act it has been provided that a person is guilty of such an act if intentionally runs child prostitution, involves child in the creation of pornography or displays child’s sexual organ in pornography then shall be punished between 20 to 25 years of imprisonment. Nepal prosecutes this crime through ‘Act Relating to Children, 2018’ and the conviction of using child in prostitution or sexual services is imprisonment up to fifteen years and fine up to one hundred fifty thousand rupees. In Pakistan, child pornography is prosecuted with ‘Pakistan Penal Code Child Abuse Amendment Act, 2016’. This provides that one is guilty of this offence if he involves child with or without consent in such activities. It provides punishment for two to seven years of imprisonment or fine from two hundred thousand to seven hundred thousand rupees. In Bhutan child pornography is not explicitly addressed under the municipal laws. The Penal Code of Bhutan penalizes all kinds of pornography including child pornography under the provisions of computer pornography and the offence shall be a misdemeanor. Child Pornography is also prohibited under the ‘Child Care and Protection Act’. In Sri Lanka, ‘The Penal Code’ de facto criminalizes child prohibition and has a penalty of two to ten years and may also be liable to fine. The most shocking scenario exists in Afghanistan. There is no specific law for the protection of children from pornography, whereas this serious crime is present there. This paper will be conducted through a qualitative research method that is, the primary sources will be laws, and secondary sources will be journal articles and newspapers. The conclusion that can be drawn is except Afghanistan all other South Asian countries have laws for controlling this crime but still have loopholes. India has the most amended provisions. Nepal has no provision for fine, and Bhutan does not mention any specific punishment. Bangladesh compared to these countries, has a good piece of law; however, it also has space to broaden the laws for controlling child pornography.

Keywords: child abuse, child pornography, life imprisonment, penal code, South Asian countries

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379 Embracing Complex Femininity: A Comparative Analysis of the Representation of Female Sexuality in John Webster and William Faulkner

Authors: Elisabeth Pedersen

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Representations and interpretations of womanhood and female sexualities bring forth various questions regarding gender norms, and the implications of these norms, which are permeating and repetitive within various societies. Literature is one form of media which provides the space to represent and interpret women, their bodies, and sexualities, and also reveals the power of language as an affective and affected force. As literature allows an opportunity to explore history and the representations of gender, power dynamics, and sexuality through historical contexts, this paper uses engaged theory through a comparative analysis of two work of literature, The Duchess of Malfi by John Wester, and The Sound and the Fury by William Faulkner. These novels span across space and time, which lends to the theory that repetitive tropes of womanhood and female sexuality in literature are influenced by and have an influence on the hegemonic social order throughout history. It analyzes how the representation of the dichotomy of male chivalry and honor, and female purity are disputed and questioned when a woman is portrayed as sexually emancipated, and explores the historical context in which these works were written to examine how socioeconomic events challenged the hegemonic social order. The analysis looks at how stereotypical ideals of womanhood and manhood have damaging implications on women, as the structure of society provides more privilege and power to men than to women, thus creating a double standard for men and women in regards to sexuality, sexual expression, and rights to sexual desire. This comparative analysis reveals how strict gender norms are permeating and have negative consequences. However, re-reading stories through a critical lens can provide an opportunity to challenge the repetitive tropes of female sexuality, and thus lead to the embrace of the complexity of female sexuality and expression.

Keywords: femininity, literature, representation, sexuality

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378 Domestic Violence Against Women (With Special Reference to India): A Human Rights Issue

Authors: N. B. Chandrakala

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Domestic violence is one of the most under-reported crimes. Problem with domestic violence is that it is not even considered as abuse in many parts of the world especially certain parts of Asia, Africa and Middle East. It is viewed as “doing the needful”. Domestic violence could be in form of emotional harassment, physical injury or psychological abuse perpetrated by one of the family members to another. It is a worldwide phenomenon mainly targeting women. The acts of violence have terrible negative impact on women. It is also an infringement of women’s rights and can be safely termed as human rights abuse. In cases pertaining to domestic violence, male adults often misuses his authority and power to control another using physical or psychological means. Violence and other forms of abuse are common in domestic violence. Sexual assaults, molestation and battering are common in these cases. Domestic violence is a human rights issue and a serious deterrent to development. Domestic violence could also take place in subtle forms like making the person feel worthless or not giving the victims any personal space or freedom. The problematic aspect is cases of domestic violence are very rarely reported. The majority of the victims are women but children are also made to suffer silently. They are abused and neglected. Their innocent minds are adversely affected with the incidents of domestic violence. According to a report by World Health Organization (WHO), sexual trafficking, female feticide, dowry death, public humiliation and physical torture are some of the most common forms of domestic violence against Indian women. Such acts belie our growth and claim as an economic superpower. It is ironic that we claim to be one of the most rapidly advancing countries in the world and yet we have done hardly anything of note against social hazards like domestic violence. Laws are not that stringent when it comes to reporting acts of domestic violence. Even if the report is filed it turns out to be a long drawn process and not every victim has that much resource to fight till the end. It is also a social taboo to make your family matters public. The big challenge in front now is to enforce it in true sense. Steps that are actually needed; tough laws against domestic violence, speedy execution and change in the mindset of society only then we can expect to have some improvement in such inhuman cases. An effective response to violence must be multi-sectoral; addressing the immediate practical needs of women experiencing abuse; providing long-term follow up and assistance; and focusing on changing those cultural norms, attitudes and legal provisions that promote the acceptance of and even encourage violence against women, and undermine women's enjoyment of their full human rights and freedoms. Hence the responses to the problem must be based on integrated approach. The effectiveness of measures and initiatives will depend on coherence and coordination associated with their design and implementation.

Keywords: domestic violence, human rights, sexual assaults, World Health Organization

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377 Male Sex Workers’ Constructions of Selling Sex in South Africa

Authors: Tara Panday, Despina Learmonth

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Sex work is often constructed as being an interaction between male clients and female sex workers. As a result, street-based male sex workers are continuously overlooked in the South African literature. This qualitative study explored male sex workers’ subjective experiences and constructions of their male clients’ identities and the client-sex worker relationship. This research was conducted from a social-constructionist perspective, which allowed for a deeper understanding of the reasons and context driving the choices and actions of male sex workers. Semi-structured face-to-face interviews were conducted with 10 South African men working as sex workers in Cape Town. Data was analysed through thematic analysis. The findings of the study construct the client-sex worker relationship in terms of a professional relationship, constrained choice, sexual identity and need, as well as companionship for pay, potentially highlighting underlying reasons for supply and demand. The data which emerged around the client-sex worker relationship and the clients’ identities also served to illuminate the power-dynamics in the client-sex worker relationship. This data increases insight into the exploitation and disempowerment experienced by male sex workers through verbal abuse, physical and sexual violence, and unfairly enforced laws and regulations. The findings of this study suggest that, in the context of South Africa, male sex workers' experiences of the client-sex worker relationship cannot be completely understood without considering the intersectionality of the triple stigmatisation of: the criminality of sex work, race, and the lack of economic power, which systematically maintains marginalization. Motivating for the Law Reform Commission to continue to review all emerging research may assist with guiding related policy and thereby, the provision of equal human rights and adequate health and social interventions for all sex workers in South Africa.

Keywords: human rights, prostitution, power relations, sex work

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376 Health Ramifications of Workplace Bullying: Gender, Race and Sexual Orientation as Risk Factors

Authors: Kathleen Canul

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Bullying is on the rise according to several recent studies. Workplace bullying has garnered less attention than other forms yet incidence rates range from 35-45%. The consequences of being bullied at work are broad, ranging from physiological to psychological to occupational. As the bullying progresses, employees begin to exhibit physical and psychological symptoms. Blood pressure rises, along with other cardiac related concerns. For men, covert coping with job unfairness was associated with a four-fold risk of heart attack and death. Gastrointestinal distress, headaches, muscle tension, sleep disorders and exhaustion are also common. Workplace bullying appears to contribute to the risk of subsequent psychotropic medication, as well. Emotionally, anxiety and depression increase along with lowered self-esteem and problems concentrating on the duties of the job. In an attempt to cope, individuals may succumb to unhealthy practices involving food, alcohol and other drugs. Patterns of bullying vary by gender, race, and ethnicity, as well as sexual orientation, with women, ethnic minorities and LGBTQ employees reporting higher rates of bullying in the workplace. Not only is this an issue of inequity on the job, but also a problem of health disparities as there are few mental health professionals confident and competent in dealing with workplace bullying issues, and the lack of culturally competent clinicians exacerbates this inequality in receiving adequate care. Alone, the topic of workplace bullying is not unique; however, the diverse experiences of underrepresented groups who disproportionately are affected on the job and suffer untreated, health related concerns represent a significant and emerging problem requiring attention. Conference participants who have experienced, witnessed or help those bullied on the job would benefit most from this review of the literature on the consequences of bullying experienced by diverse and underrepresented groups in the workplace.

Keywords: bullying, ethnic minorities, health disparities, workplace conflict

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375 A Survey on Erotic Literature, Woman, and Its Sociological Aspect

Authors: Sulmaz Mozaffari, Zahra Mozaffari, Saman Mozaffari

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Erotic literature is a branch in modern literature which has the key terms of woman and her sexual desire. It has so many supporters and it is growing to be more important everyday and in such a way that it is criticized on social medias. To create their work in that part of literature, the authors take the woman into consideration to explore the cultural, social, and political theories. In this research, the author gives an analysis of the erotic literature in Asia and the role of woman as the main element in it.

Keywords: erotic literature, social media, woman, attract addressee

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374 Global Analysis of Modern Economic Sanctions

Authors: I. L. Yakushev

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Economic sanctions are an integral part of the foreign policy repertoire of States. Increasingly, States and international organizations are resorting to sanctions to address a variety of issues -from fighting corruption to preventing the use of nuclear weapons. Over time, the ways in which economic sanctions have been used have changed, especially over the past two decades. In the late 1990s, the recognition of the humanitarian harm of economic sanctions and the "War on Terrorism" after the events of September 11, 2001, led to serious changes in the structure and mechanisms of their application. Questions about how these coercive tools work, when they are applied, what consequences they have, and when they are successful are still being determined by research conducted in the second half of the 20th century. The conclusions drawn from past cases of sanctions may not be fully applicable to the current sanctions policy. In the second half of the 20th century, most cases of sanctions were related to the United States, and it covered restrictions on international trade. However, over the past two decades, the European Union, the United Nations, and China have also been the main initiators of sanctions. Modern sanctions include targeted and financial restrictions and are applied against individuals, organizations, and companies. Changing the senders, targets, stakeholders, and economic instruments used in the sanctions policy has serious implications for effectiveness and results. The regulatory and bureaucratic infrastructure necessary to implement and comply with modern economic sanctions has become more reliable. This evolution of sanctions has provided the scientific community with an opportunity to study new issues of coercion and return to the old ones. The economic sanctions research program should be developed to be relevant for understanding the application of modern sanctions and their consequences.

Keywords: global analysis, economic sanctions, targeted sanctions, foreign policy, domestic policy, United Nations, European Union, USA, economic pressure

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373 Structure Modification of Leonurine to Improve Its Potency as Aphrodisiac

Authors: Ruslin, R. E. Kartasasmita, M. S. Wibowo, S. Ibrahim

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An aphrodisiac is a substance contained in food or drug that can arouse sexual instinct and increase pleasure while working, these substances derived from plants, animals, and minerals. When consuming substances that have aphrodisiac activity and duration can improve the sexual instinct. The natural aphrodisiac effect can be obtained through plants, animals, and minerals. Leonurine compound has aphrodisiac activity, these compounds can be isolated from plants of Leonurus Sp, Sundanese people is known as deundereman, this plant is empirical has aphrodisiac activity and based on the isolation of active compounds from plants known to contain compounds leonurine, so that the compound is expected to have activity aphrodisiac. Leonurine compound can be isolated from plants or synthesized chemically with material dasa siringat acid. Leonurine compound can be obtained commercial and derivatives of these compounds can be synthesized in an effort to increase its activity. This study aims to obtain derivatives leonurine better aphrodisiac activity compared with the parent compound, modified the structure of the compounds in the form leonurin guanidino butyl ester group with butyl amin and bromoetanol. ArgusLab program version 4.0.1 is used to determine the binding energy, hydrogen bonds and amino acids involved in the interaction of the compound PDE5 receptor. The in vivo test leonurine compounds and derivatives as an aphrodisiac ingredients and hormone testosterone levels using 27 male rats Wistar strain and 9 female mice of the same species, ages ranged from 12 weeks rats weighing + 200 g / tail. The test animal is divided into 9 groups according to the type of compounds and the dose given. Each treatment group was orally administered 2 ml per day for 5 days. On the sixth day was observed male rat sexual behavior and taking blood from the heart to measure testosterone levels using ELISA technique. Statistical analysis was performed in this study is the ANOVA test Least Square Differences (LSD) using the program Statistical Product and Service Solutions (SPSS). Aphrodisiac efficacy of the leonurine compound and its derivatives have proven in silico and in vivo test, the in silico testing leonurine derivatives have smaller binding energy derivatives leonurine so that activity better than leonurine compounds. Testing in vivo using rats of wistar strain that better leonurine derivative of this compound shows leonurine that in silico studies in parallel with in vivo tests. Modification of the structure in the form of guanidine butyl ester group with butyl amin and bromoethanol increase compared leonurine compound for aphrodisiac activity, testosterone derivatives of compounds leonurine experienced a significant improvement especial is 1RD compounds especially at doses of 100 and 150 mg/bb. The results showed that the compound leonurine and its compounds contain aphrodisiac activity and increase the amount of testosterone in the blood. The compound test used in this study acts as a steroid precursor resulting in increased testosterone.

Keywords: aphrodisiac dysfunction erectile leonurine 1-RD 2-RD, dysfunction, erectile leonurine, 1-RD 2-RD

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372 Unveiling the Truth of Female Reproductive Health: The Tied Shackles of Authoritative Knowledge and Domestic Violence: An Ethnographic Study on an Urban Slum of Dhaka City

Authors: Saba Nuzhat

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The present ethnographic study examines how domestic violence and authoritative knowledge affect the reproductive health of females; in terms of contraceptive behavior and induced abortion. This qualitative study has been conducted by collecting in depth informal interviews and case studies of 12 female respondents living in an urban slum of Keraniganj, located Dhaka city. The study depicts how multivariable factors are linked to a woman’s ability to contracept and make abortion decisions in a cultural context where being a wife infers to submission, limited mobility, sexual availability, and restricted autonomy on her own reproduction health. This study shows how violence is being normalized and socially acceptable, every time women do not adhere to go through expected gender roles. The study primarily explores the subjective experiences and perceptions of the females about contraceptive behavior as well as abortions from a medical anthropological perspective. A number of salient examples are highlighted into this paper where women who go through abortion or adopt various measures of contraceptives get highly influenced by authoritative knowledge or under the pressure of male dominance. The lack of female autonomy or prevalence of domestic violence challenges the gender equality of Bangladeshi society and female sovereignty in accessing sexual or reproductive rights. This paper remarks the significance of medical anthropological research that helps to understand the intricate interrelationship between authoritative knowledge and male dominance with female reproductive health in order to reduce women’s risk of experiencing domestic violence and to promote reproductive health autonomy for themselves for espousing contraceptive behaviors and abortion decisions.

Keywords: abortion, authoritative knowledge, contraception, domestic violence, reproductive health

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371 A Scoping Review of Psychosocial Interventions for the Survivors and/or Victims of Intimate Partner Violence in Low- and Middle-Income Countries

Authors: Mukondi Nethavhakone

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The high prevalence of violence against women is a global public health problem. Our societies have become dangerous places for women. Women during their child-bearing ages are at a higher risk of experiencing emotional, physical, and sexual violence. What makes it more concerning is that these violent acts are perpetrated by family members or partners, or ex-partners. Intimate Partner Violence (IPV) is associated with long-lasting physical, reproductive, sexual, mental, and maternal health implications. Expectedly women’s mental health would dimmish as a result of experiencing IPV. The burden of violence against women is seen to be heavier in low- and middle-income countries (LMICs) compared to the rest of the world. Countries have committed to eliminating all forms of violence against women through the sustainable development goal, aiming to see changes by the year 2030. As such, various countries have implemented psychosocial interventions of different levels of impact. However, little is known, especially in low- and middle-income countries, with regard to the potential of psychosocial interventions for IPV to improve the mental health outcomes for the survivors and/or victims of IPV. Analysing the risk for IPV through a social-ecological theoretical approach, low- and middle-income countries still readdressing gender inequality which is the cause of intimate partner violence. That is why it is taking time for these countries to shift psychosocial interventions to focus more on the improvement of the mental health of the survivors. It is, therefore, against this backdrop that the researcher intends to undertake a scoping review to understand the nature and characteristics of psychosocial interventions that have been implemented in low- and middle-income countries. With the findings from the scoping review, the researcher aims to develop a conceptual framework that may be a useful resource for healthcare practitioners and researchers in low- and middle-income countries. As this area of research has not been thoroughly reviewed, the results from this scoping will determine whether a systematic review will be justifiable. Additionally, the researcher will identify gaps and opportunities for future research in this area.

Keywords: mental health improvement, psychosocial interventions, intimate partner violence, LMICs

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370 Psychosocial Effect of Body-Contouring Surgery on Patients after Weight Loss

Authors: Abdullah Kattan, Khalid Alzahrani, Saud Alsaleh, Loui Ezzat, Khalid Murad, Bader Alghamdi

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Background and Significance: Patients are often bothered by the excess skin laxity and redundancy that they are left with after losing weight. Body-contouring surgery offers a solution to this problem; however, there is scarce literature on the psychological and social effects of these surgeries. This study was conducted to assess the psychosocial impact of body-contouring surgery on patients after weight loss. Methodology: In this cross-sectional study, a specifically designed questionnaire was administered to forty three patients whom have undergone body-contouring surgery. All included patients had lost no less than 20 Kg before body-contouring surgery, and were interviewed at least 6 months after surgery. The twenty-question interviewer based questionnaire was used to assess the psychosocial status of the patients before and after undergoing body-contouring surgery. The questionnaire assessed the quality of life (social life, job performance and sexual activity), presence of symptoms of depression and overall satisfaction. Data was analyzed as paired variables in SPSS using McNemar’s test. Results: Among the 43 participants, 19 (44.2%) have undergone mammoplasty, 12 (27.9%) have undergone abdominoplasty and the remainder of the patients have undergone other various procedures including brachioplasty, thigh lifts and nick liposuction. The mean age of patients was 34 +/- 10, the sample included 24 (55.8%) females and 19 (44.2%) males. The patients’ quality of life significantly improved in the following areas; social life (P<0.001), job performance (P<0.002) and sexual activity (P<0.001). Moreover, 17 (39.5%) patients suffered symptoms of depression before body-contouring surgery; however, only 1 (2.3%) patient suffered symptoms of depression after surgery. Overall satisfaction rate was found to be 62.8%; with mammoplasty being the highest satisfaction rate procedure (66.6 %). Conclusion: Body-contouring surgery after weight loss has shown to improve the psychological and social aspects in patients. These findings have been found to be consistent with the majority of relevant published studies, further increasing reliability of our study.

Keywords: abdominoplasty, body-contouring, mammoplasty, psychosocial

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