Search results for: sexual and reproductive health rights

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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Authors: Alexandra M. Kriofske Mainella

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This paper will examine the need for more aggressive public policies around bodily, reproductive and sexual health education for young people with disabilities in the United States. This paper will consider the policies around sexuality education for students in the United States and the recommendation for national standards around sexuality education. We will investigate the intersection of these policies and recommendations for students with disabilities and the Individuals with Disabilities Education Act (IDEA): what this means for students with disabilities’ access to comprehensive sexuality education and how it affects their behaviors and outcomes.

Keywords: disability, sexuality, education, policy

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Authors: Rocio Murad, Marcela Sanchez, Mariana Calderon Jaramillo, Danny Rivera, Angela Cifuentes, Daniela Roldán, Juan Carlos Rivillas

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Women and girls have specific health needs, but during health pandemics such as COVID19 they are less likely to have access to quality essential health information, commodities and services, or insurance coverage for routine and catastrophic health expenses, especially in rural and marginalized communities. This is compounded by multiple or intersecting inequalities, such as ethnicity, socioeconomic status, disability, age, geographic location, and sexual orientation, among others. Despite concerted collective action, there is a lack of information on the situation of women, adolescents and youth, including gender inequalities exacerbated by the pandemic. Much more needs to be done to amplify the lived realities of women and adolescents in global and national advocacy and policy responses. The COVID 19 pandemic reflects the need for systematic advocacy policies based on the lived experiences of women and adolescents, underpinned by human rights. This research is part of the initiative of Profamilia Association (Solidarity Study), and its objective is twofold: i) to analyze the behavioral changes and immediate expectations of Colombians during the stage of relaxation of the confinement measures decreed by the national government; and ii) to identify the needs, experiences and resilient practices of adolescents and young women during the COVID-19 crisis in Colombia. Descriptive analysis of data collected by Profamilia through the Solidaridad study, an exploratory cross-sectional descriptive study that used subnational level data from a nonprobabilistic sample survey conducted to 1735 adults, between September 01 and 11, 2020. Interviews were conducted with key stakeholders about their experiences during COVID19, under three key axes: i) main challenges for adolescents and young women; ii) examples of what has worked well in responding to the challenge; and iii) how/what services are/should be provided during COVID-19 (and beyond) to address the challenge. Interviewees were selected based on prior mapping of social groups of interest. In total, 23 adolescents and young women participated in the interviews. The results show that people adopted behavioral changes such as wearing masks, avoiding people with symptoms, and reducing mobility, but there was also a doubling of concerns for many reasons, from effects on mental health, sexual health, and unattended reproductive health to the burden of care and working at home. The favorable perception that people had at the beginning of the quarantine about the response and actions of the national and local government to control Covid-19 decreased over the course of the quarantine. The challenges and needs of adolescents and young women were highlighted during the most restrictive measures to contain the COVID-19 pandemic, which resulted in disruptions to daily activities, education and work, as well as restrictions to mobility and social interaction. Concerns raised by participants included: impact on mental health and wellbeing due to disruption of daily life; limitations in access to formal and informal education; food insecurity; migration; loss of livelihoods; lack of access to health information and services; limitations to sexual and reproductive health and rights; insecurity problems; and problems in communication and treatment among household members.

Keywords: COVID-19, changes in behavior, adolescents, women

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Authors: Daniel Y. Fiaveh, Chimaraoke O. Izugbara

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Based on the narratives of 20 women and 16 men, the paper explores how knowing more about the factors that trigger sex positions decisions advance knowledge of male and female sexuality, and how these translate into higher levels of female sexual negotiations in Ghana. Findings demonstrated that the willingness to perform sex positions or not were gendered and derive, at least in part, from differences in demographic profiles (such as age, gender, and marriage), beliefs associated with sexual practices (such as anal sex), the desire to maximize sexual pleasure, and sexual myths and misconceptions e.g. fear of infecundity. The women were not passive to sex positions decisions and engaged in a dialogical sexual encounter with men including threats of sexual refusal in negotiating sex.

Keywords: sexual positions, sexual pleasure, masculinity, femininity, Ghana

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Authors: Eliza F. Dunn

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Scripts are a hypothetical outline or roadmap to life as defined by culture. Sexual scripts are similarly a roadmap for what to expect in dating and sexual experiences. The articles for this review were found by searching three databases and refining 621 articles to 13 that are used in the results section. Some ways deaf sexual scripts vary from Traditional Sexual Scripts (TSS) are in the areas of gendered roles and sexual themes, which were both absent in deaf sexual scripts. Theories for why these differences exist are explored: the presence or absence of sexual education or the effects of intimate partner violence due to being a part of a disabled community. Finally, unique sexual flourishing for people who are d/Deaf found in studies was discussed, suggesting the needed perspective of resilience to be a focus of future research to fully understand deaf sexual scripts. Future research is discussed, noting the need for defining aspects of deaf sexual scripts in detail and studying the differences between these scripts and the TSS.

Keywords: deaf, deafness, sexual scripts, lift scripts, sexual flourishing

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Authors: Bridget J. Kenny, Elizabeth Hoban, Jo Williams

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Adolescent pregnancy presents a significant public health challenge for Cambodia. Despite declines in the overall fertility rate, the adolescent fertility rate is increasing. Adolescent pregnancy is particularly problematic in the Northeast provinces of Ratanak Kiri and Mondul Kiri where 34 percent of girls aged between 15 and 19 have begun childbearing; this is almost three times Cambodia’s national average of 12 percent. Language, cultural and geographic barriers have restricted qualitative exploration of the sexual and reproductive health (SRH) challenges that face indigenous adolescents in Northeast Cambodia. The current study sought to address this gap by exploring the SRH practices of adolescent mothers from indigenous populations in Ratanak Kiri Province. Twenty-two adolescent mothers, aged between 15 and 19, were recruited from seven indigenous villages in Ratanak Kiri Province and asked to participate in a combined body mapping exercise and semi-structured interview. Participants were given a large piece of paper (59.4 x 84.1 cm) with the outline of a female body and asked to draw the female reproductive organs onto the ‘body map’. Participants were encouraged to explain what they had drawn with the purpose of evoking conversation about their reproductive bodies. Adolescent mothers were then invited to participate in a semi-structured interview to further expand on topics of SRH. The qualitative approach offered an excellent avenue to explore the unique SRH challenges that face indigenous adolescents in rural Cambodia. In particular, the use of visual data collection methods reduced the language and cultural barriers that have previously restricted or prevented qualitative exploration of this population group. Thematic analysis yielded six major themes: (1) understanding of the female reproductive body, (2) contraceptive knowledge, (3) contraceptive use, (4) barriers to contraceptive use, (5) sexual practices, (6) contact with healthcare facilities. Participants could name several modern contraceptive methods and knew where they could access family planning services. However, adolescent mothers explained that they gained this knowledge during antenatal care visits and consequently participants had limited SRH knowledge, including contraceptive awareness, at the time of sexual initiation. Fear of the perceived side effects of modern contraception, including infertility, provided an additional barrier to contraceptive use for indigenous adolescents. Participants did not cite cost or geographic isolation as barriers to accessing SRH services. Child marriage and early sexual initiation were also identified as important factors contributing to the high prevalence of adolescent pregnancy in this population group. The findings support the Ministry of Education, Youth and Sports' (MoEYS) recent introduction of SRH education into the primary and secondary school curriculum but suggest indigenous girls in rural Cambodia require additional sources of SRH information. Results indicate adolescent girls’ first point of contact with healthcare facilities occurs after they become pregnant. Promotion of an effective continuum of care by increasing access to healthcare services during the pre-pregnancy period is suggested as a means of providing adolescents girls with an additional avenue to acquire SRH information.

Keywords: adolescent pregnancy, contraceptive use, family planning, sexual and reproductive health

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Authors: Adeshina Francis Akindutre, Adebolarin Adekanle

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Sexual assault is often considered as the most extreme form of violence that degrades and humiliates women in society. It is a widespread public health and psychological problem in Nigeria. Criminologically, sexual assaults have been considered as one of the several violent crimes targeted specifically at women and perpetrated by men. This paper attempts to examine the types of sexual assaults in Nigeria, the strategies used by the offenders, the causes, the psychological effects on the victims and the possible solutions of sexual assaults. This work also, examines the law prohibiting sexual assault in Nigeria. The authors made use of three theories: the victim precipitation approach, the feminist approach, and the psychological approach which explain why sexual assault takes place in society. Finally, it takes the Stockholm Syndrome into consideration (the treatment of victims).

Keywords: feminist, victims, offenders, psychological, sexual assault, Stockholm Syndrome

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Authors: Chinyama Lukama, Million Phiri, Namuunda Mutombo

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Background: Improving access and utilization to high-quality sexual and reproductive health (SRH) information and services, including family planning (FP) commodities, is central to the global developmental agenda of sub-Saharan Africa (SSA). Despite the importance of family planning use in enhancing maternal health outcomes and fertility reduction, the prevalence of adolescents and young women using modern contraception is generally low in SSA. Zambia is one of the countries in Southern Africa with a high prevalence of teenage pregnancies and fertility rates. Despite many initiatives that have been implemented to improve access and demand for family planning commodities, utilization of FP, especially among adolescents and young women, has generally been low. The objective of this research agenda was to better understand the determinants of modern contraceptive use in adolescents and young women in Zambia. This analysis produced findings that will be critical for informing the strengthening of sexual and reproductive health policy strategies aimed at bolstering the provision and use of maternal health services in order to further improve maternal health outcomes in the country. Method: The study used the recent data from the Demographic and Health Survey of 2018. A sample of 3,513 adolescents and young women (ADYW) were included in the analysis. Multilevel logistic regression models were employed to examine the association of individual and contextual factors with modern contraceptive use among adolescents and young women. Results: The prevalence of modern contraception among sexually active ADYW in Zambia was 38.1% [95% CI, 35.9, 40.4]. ADYW who had secondary or higher level education [aOR = 2.16, 95% CI=1.35–3.47], those with exposure to listening to the radio or watching television [aOR = 1.26, 95% CI=1.01–1.57], and those who had decision-making power at household level [aOR = 2.18, 95% CI=1.71–2.77] were more likely to use modern contraceptives. Conversely, strong neighborhood desire for large family size among ADYW [aOR = 0.65 95% CI = 0.47–0.88] was associated with less likelihood to use modern contraceptives. Community access to family planning information through community health worker visits increased the likelihood [aOR = 1.48, 95% CI=1.16–1.91] of using modern contraception among ADYW. Conclusion: The study found that both individual and community factors were key in influencing modern contraceptive use among adolescents and young women in Zambia. Therefore, when designing family planning interventions, the Government of Zambia, through its policymakers and sexual reproductive health program implementers at the Ministry of Health, in collaboration with stakeholders, should consider the community context. There should also be deliberate actions to encourage family planning education through the media.

Keywords: adolescents, young women, modern contraception use, fertility, family planning

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Authors: Azza Gaber Farag, Yasser Atta Shehata, Sara Elsayed Elghazouly, Mustafa Elsayed Elshaib, Nesreen Gamal Elden Elhelbawy

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Background: Androgen receptor (AR) polymorphism in cytosine adenineguanine (CAG) repeat has an effect on the functional capacity of AR in males. However, little researches in this field are available regarding female sexual function. Aim: To investigate the possible link between polymorphism in the CAG repeat of AR gene and female sexual function in a sample of the Egyptian population. Materials and methods: 500 Egyptian married females completed a questionnaire regarding sociodemographic, reproductive, and sexual data. AR CAG repeat length was analyzed for those having female sexual dysfunctions (FSD) using real-time PCR. Results: The most sensitive domain to AR CAG repeat length was the orgasm domain that showed significant positive correlations with short allele (p=0.001), long allele (p=.015), biallellic mean (p=.000), and X weighted biallelic mean (p=.000). The satisfaction domain had significant positive correlations with the biallelic mean (p=.035), and the X weighted biallelic mean (p=. 032). However, the pain domain was of significant negative correlations with AR polymorphism of short allele (p=.002), biallelic mean (p=.013), and X weighted biallelic mean (p = . 011). Conclusions: AR polymorphism could represent a non-negligible aspect in female sexual function. The lower AR CAG repeat polymorphism was of significant impact on FSD, affecting mainly female orgasm followed by pain disorders that finally reflected On her sexual satisfaction.

Keywords: female sexual dysfunction, androgen receptor, CAG repeat polymorphism, androgen

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Authors: Daphney Nozizwe Conco, Jonathan Levin, Boitumelo Komane, Sharon Fonn

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Background: South Africa is globally renowned for its reproductive rights framework. Despite the progressive abortion legislation, evidence points to limited access to safe abortion due to stigma, provider opposition, and lack of trained providers. Consequently, women resort to informal abortion providers and later present with incomplete abortion (ICA) at public hospitals. 20 years after the passing of the Choice for Termination of Pregnancy Act (CTOPA), we hypothesized that the incidence of ICA and abortion-related morbidity would change, influenced by access to safe abortion care and the availability of medication abortion. The aim was to generate data that could be compared with the results of similar studies conducted in 1994 and 2000. Objectives: The research objectives were to determine the number of women who presented with ICA to public hospitals, to describe their characteristics, to categorize medical complications according to severity, and to describe treatment provided to them at South African public hospitals. Methods: This is a cross-sectional retrospective medical record review study. A stratified random sample of public hospitals was selected. Data was extracted from the medical records of women who presented with incomplete abortions to sampled public hospitals in 2018. Data was captured directly into a REDCap database. To estimate the national prevalence of incomplete abortions, we used population estimates for 2018 comprising 17,199,227 women aged 12-49 years and 1,200,436 live births. Results: We found 913 medical records of women who presented with ICA to the 52 sampled hospitals. The women’s mean age of 27 years, and most had a previous pregnancy. These results were similar in the three studies (2018, 2000, and 1994). A greater proportion of women admitted with a gestation between 0-12 weeks seem to be on the increase, 60.5% in 1994, 67.1% in 2000, and 73.9% in 2024. We found an ICA incidence of 362 (269-455) per 100 000 women aged 12­49 years, which was the same as the 2000 incidence of 362 (282­441) but lower than the incidence of 375 (299­451) in 1994. Signs of infection decreased over time: 79.5% in 1994, 90.1% in 2000, and 92.5% in 2018 had no signs of infection. Similarly, 95.6% in 1994, 97.1% in 2000 and 99.1% in 2018 recorded no organ failure. Conclusion: A trend of lower infection rates was observed, suggesting that women are getting safer abortions, possibly from informal providers. However, the lack of change in ICA incidence indicates that the implementation of CTOPA has failed. It is safe to conclude that the legislation has made no significant impact on women’s health and rights. The implications of such failure are profound, as South Africa has not effectively implemented the act, which has important consequences for women’s health and rights.

Keywords: incomplete abortion, abortion-related morbidity, safe-abortion, South Africa public health, sexual and reproductive health rights, women’s health

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Authors: Kerols Seif Said Botros

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The relationship between development and human rights has been debated for a long time. Various principles, from the right to development to development-based human rights, are applied to understand the dynamics between these two concepts. Despite the measures calculated, the connection between enhancement and human rights remains vague. Despite, the connection between these two opinions and the need to strengthen human rights have increased in recent years. It will then be examined whether the right to sustainable development is acceptable or not. In various human rights instruments and this is a good vibe to the request cited above. The book then cites domestic and international human rights treaties, as well as jurisprudence and regulations defining human rights institutions, to support this view.

Keywords: sustainable development, human rights, the right to development, the human rights-based approach to development, environmental rights, economic development, social sustainability human rights protection, human rights violations, workers’ rights, justice, security.

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Authors: Rudraksh Kesharwani, Ritika Agarkar

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Sexually transmitted diseases are a major public health concern affecting both the mortality and the morbidity of a population. It is among the most serious causes of the diseases affecting the quality of life of a individual leading to a significant decrease in their health. In India, STIs have been a significant public health concern due to various reasons, including a large population, limited access to healthcare in certain areas, stigma around discussing sexual health, and insufficient sex education. Some common STIs in India include HIV/AIDS, syphilis, gonorrhea, chlamydia, and herpes. This research report aims to determine the percentage of people infected with sexually transmitted infections (STI) worrying about it’s impact on their day to day activity, specifically focusing on it’s impact on the mentaland sexual health of the patient infected along with his/her partner.

Keywords: sexual health, mental health, sexually transmitted disease, sexual taboos

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Authors: Olalekan Olaluwoye, Joanne Williams, Elizabeth Hoban, Sonia Brockington

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Cases of sexual violence against men have been reported in at least twenty-five conflict situations in history. However, there is a paucity of academic literature and minimal media, policy and legal discussions on sexual violence against men. Most studies and discussions remain locked in the ‘male perpetrators, female victims’ paradigm. Male victims continue to suffer the consequences of sexual violence in conflict and post-conflict settings in silence. A rigorous narrative systematic review of the literature revealed few studies on the subject and those that exist have a narrow focus on rape as the only form of sexual violence despite the existence of other forms of sexual violence that have equally devastating effects. This paper argues that while research and discussions on sexual violence against women should continue, it is time to conduct rigorous mixed methods research to understand the experiences of men and boys survivors of sexual violence. There is a need to study sexual violence more broadly, without limiting it to rape, and to understand the determinants and health implications of sexual violence perpetrated on men. The paper concludes by proposing a research approach that gives voice to the experiences of male survivors of sexual violence in conflict and post-conflict settings.

Keywords: conflict, male survivors, post-conflict settings, sexual violence

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Authors: Michelle J. Miller

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Millions of girls are forcibly married during the transitional period between puberty and adulthood. At a stage of vulnerability; cultural practices, religious rights, and social standards place girls in a position where they are catapult into womanhood. An advocate against forced child marriage could argue that child rights, cultural rights, religious rights, right to marry, right to life, right to health, right to education, right to be free from slavery, right to be free from torture, right to consent to marriage are all violated by the practice of child marriage. This paper will present how some of these rights are violated and how they establish the need for change.

Keywords: child marriage, forced child marriage, children's rights, religious rights, cultural rights

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Authors: Elizabeth Carthy

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There is growing recognition that sexual exploitation and abuse (SEA) perpetrated by humanitarian workers is widespread, most recently affirmed by allegations of high-ranking Oxfam officials paying women for sex in post-earthquake Haiti. SEA covers a range of gendered abuses, including rape, sexual assault, and ‘transactional’ or ‘survival’ sex. Holding individuals legally accountable for such behaviors is difficult in all contexts even more so in fragile and conflict-affected settings. Transactional sex, for the purposes of this paper, refers to situations where humanitarian workers exchange aid or assistance for sexual services. This paper explores existing organizational accountability measures relating to transactional sex engaged in by international humanitarian workers through a descriptive and interpretive case study approach-examining the situation in Haiti. It comparatively analyses steps the United Nations has taken to combat this problem. Then it examines the possibility of domestic legal accountability for such conduct in Haiti. Finally, the paper argues that international human rights law can fill in potential gaps in domestic legal frameworks to ensure states hold humanitarian workers and potentially organizations accountable for engaging in and/or perpetuating this gendered abuse of power.

Keywords: gender-based violence, humanitarian action, international human rights law, sexual exploitation

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Authors: Glauberto S. Quirino, Emanuelly V. Pereira, Amana S. Figueiredo, Antonia T. F. Santos, Paulo R. A. Firmino, Denise F. F. Barbosa, Caroline B. Q. Aquino, Eveliny S. Martins, Cinthia G. P. Calou, Ana K. B. Pinheiro

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Introduction: During pregnancy there are adjustments in the physical, emotional, existential and sexual areas, which may contribute to changes in sexual behavior. The objective was to analyze the sexual behavior of pregnant women. Methods: Quantitative, exploratory-descriptive study, approved by the Ethics and Research Committee of the Regional University of Cariri. For data collection, it was used the Sexuality Questionnaire in Gestation and Sexual Quotient - Female Version. It was carried out in public institutions in the urban and rural areas of three municipalities of the Metropolitan Region of Cariri, south of Ceará, Brazil from February to September 2016. The sampling was proportional stratified by convenience. A total of 815 pregnant women who were literate and aged 20 years or over were broached. 461 pregnant women were excluded because of high risk, adolescence, saturation of the extract, incomplete filling of the instrument, mental and physical handicap, without sexual partner, and the sample was 354 pregnant. The data were grouped, organized and analyzed in the statistical program R Studio (version 386 3.2.4). Descriptive frequency statistics and non-parametric tests were used to analyze the variables, and the results were shown in graphs and tables. Results: The women presented a minimum age of 20, maximum 35 and average of 26.9 years, predominantly urban area residents, with a monthly income of up to one minimum wage (US$ 275,00), high school, catholic, with fixed partner, heterosexuals, multiparous, multiple sexual partners throughout life and with the beginning of sexual life in adolescence (median age 17 years). There was a reduction in sexual practices (67%) and when they were performed, they were more frequent in the first trimester (79.7%) and less frequent in the third trimester (30.5%). Preliminary sexual practices did not change and were more frequent in the second trimester (46.6%). Throughout the gestational trimesters, the partner was referred as the main responsible for the sexual initiative. The women performed vaginal sex (97.7%) and provided greater pleasure (42.8%) compared to non-penetrative sex (53.9%) (oral sex and masturbation). There was also a reduction in the sexual disposition of pregnant women (90.7%) and partner (72.9%), mainly in the first trimester (78.8%), and sexual positions. Sexual performance ranged from regular to good (49.7%). Level of schooling, marital status, sexual orientation of the pregnant woman and the partner, sexual practices and positions, preliminaries, frequency of sexual practices and importance attributed to them were variables that influenced negatively sexual performance and satisfaction. It is concluded that pregnancy negatively changes the sexual behavior of the women and it is suggested to further investigations and approach of the partner, in order to clarify the influence of these variables on the sexual function and subsidize intervention strategies, with a view to the integrality of sexual and reproductive health.

Keywords: obstetric nursing, pregnant women, sexual behavior, women's health

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Authors: Nasrin Nejatbakhsh, Anita Kaiser, Sander Hitzig, Colleen McGillivray

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Following spinal cord injury (SCI), many individuals experience anxiety in adjusting to their lives, and its impacts on their sexuality. Research has demonstrated that regaining sexual function is a very high priority for individuals with SCI. Despite this, sexual health is one of the least likely areas of focus in rehabilitating individuals with SCI. There is currently a considerable gap in appropriate education and resources that address sexual health concerns and needs of people with spinal cord injury. Furthermore, the determinants of sexual health in individuals with SCI are poorly understood and thus poorly addressed. The purpose of this study was to improve current practices by informing a service delivery model that rehabilitation centers can adopt for appropriate delivery of their services. Methodology: We utilized qualitative methods in the form of a semi-structured interview containing open-ended questions to assess 1) sexual health concerns, 2) helpful strategies in current resources, 3) unhelpful strategies in current resources, and 4) Barriers to obtaining sexual health information. In addition to the interviews, participants completed surveys to identify socio-demographic factors. Data gathered was coded and evaluated for emerging themes and subthemes through a ‘code-recode’ technique. Results: We have identified several robust themes that are important for SCI sexual health resource development. Through analysis of these themes and their subthemes, several important concepts have emerged that could provide agencies with helpful strategies for providing sexual health resources. Some of the important considerations are that services be; anonymous, accessible, frequent, affordable, mandatory, casual and supported by peers. Implications: By incorporating the perspectives of individuals with SCI, the finding from this study can be used to develop appropriate sexual health services and improve access to information through tailored needs based program development.

Keywords: spinal cord injury, sexual health, determinants of health, resource development

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Authors: Diana K. Kwok

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Despite the fact that Hong Kong government aims to develop an inclusive society, sexual minority students continue to encounter sexual prejudice without legal protection. They also have difficulties accessing relevant services from mental health and educational professionals, who do not receive systematic training to work with sexual minority students. Informed by the literature on sexual prejudice, heterosexual hegemony, genderism, as well as code of practice for frontline practitioners, the authors explored self-perceived knowledge of teachers and sexual minorities on sexuality and sexual prejudice, and how they perceive prejudice towards sexual minorities in Chinese cultural context. Semi-structure qualitative interviews were carried out with 31 school personnel informants (school teachers and counseling team members) and 25 sexual minority informants on their understanding of sexuality knowledge, their perception of sexual prejudice within school context in Hong Kong, as well as their suggested themes on teachers training on sexual prejudice reduction. This presentation specifically focuses on transcripts from sexual minority informants. Data analysis was carried out through NVivo, and followed the procedures spelt out in the qualitative research literature. Trustworthiness of the study was addressed through various strategies. Preliminary themes emerged from transcript content analysis: 1) A gap of knowledge between sexual minority informants and teachers; 2) Perception on sexual prejudice within cultural context; 3) Heterosexual hegemony and genderism within school system; 4) Needs for mandatory training: contents and strategies. The sexual minority informants found that teachers they encountered were predominantly adopted concepts of binary sex and dichotomous gender. Informants also indicated that the teachings of Confucianism cultural values, religiosity in Hong Kong might well be important cultural forces contributing to sexual prejudice manifested in school context. Although human rights and social justice concepts were embedded in professional code of practice of teachers and school helping professionals, informants found that teachers they encountered may face a dilemma when supporting sexual minority students navigating heterosexual hegemony and genderism in, as a consequence of their personal, institutional, cultural and religious backgrounds. Acknowledgments: The sexual prejudice project was funded by the Hong Kong Research Grant Council (ECS28401614), 2015 to 2017.

Keywords: sexual prejudice, Chinese teachers, Chinese sexual minorities, teacher training

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Authors: Razieh Rezaeekalantari

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Objective: The purpose of this study was to investigate the prediction of parenting orientations in terms of the components of couples' sexual review. Methods: This was a descriptive correlational research method. The population consisted of 500 couples referring to Sari Health Center. Two hundred and fifteen (215) people were selected randomly by using Krejcie-Morgan-sample-size-table. For data collection, the childbearing orientations scale and the Multidimensional Sexual Self-Concept Questionnaire were used. Result: For data analysis, the mean and standard deviation were used and to analyze the research hypothesis regression correlation and inferential statistics were used. Conclusion: The findings indicate that there is not a significant relationship between the tendency to childbearing and the predictive value of sexual review (r = 0.84) with significant level (sig = 219.19) (P < 0.05). So, with 95% confidence, we conclude that there is not a meaningful relationship between sexual orientation and tendency to child-rearing.

Keywords: couples referring, health center, sexual review component, parenting orientations

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Authors: Ya-Ching Wang, Yi-Maun Subeq

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Background: There is a lack of evidence to understand differences in risk for developing breast cancer between sexual minority women and heterosexual women in Taiwan. The purpose of this study is to compare differences in risk for developing breast cancer between the two groups of Taiwanese women. Methods: An online cross-sectional survey was used to collect data. A total of 238 Taiwanese women (mean age 30.69 years old, SD=8.231, range 20-60) were recruited between December 2016 and February 2017, including 115 heterosexual women and 123 sexual minority women. Results: There were no significant differences between heterosexual women and sexual minority women in body mass index, history of non-malignant breast disease, age at menarche and menopause, use of hormone replacement therapy, use of hormone replacement therapy, nor the prevalence of breast cancer. The sexual minority women had higher rates of current drinking, smoking and using breast-bindings and also reported exercise more a week; the heterosexual women had higher rates of pregnancy, children, breastfeed, miscarriages, abortion and use of birth control pills. Discussion/Conclusion: There were significant differences between heterosexual women and sexual minority women in reproductive factors and behavioral risk factors for the development of breast cancer. In particular, the finding that the sexual minority women had higher rate of using breast-bindings (56.6%) than the heterosexual women (4.7%) should be further explore, in order to understand whether long-term breast compression is associated with the development of breast cancer.

Keywords: breast cancer, risk, sexual orientation, Taiwan

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Authors: Muthukuda Arachchige Dona Shiroma Jeeva Shirajanie Niriella

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The necessity of protection of the rights of victims of crime is a matter of concerns today. In the criminal justice system, child victims who are subjected to sexual abuse/violence are more vulnerable than the other crime victims. When they go to the police to lodge the complaint and until the end of the court proceedings, these victims are re-victimized in the criminal justice system. The rights of the suspects, accused and convicts are recognized and guaranteed by the constitution under fair trial norm, contemporary penal laws where crime is viewed as an offence against the State and existing criminal justice system in many jurisdictions including Sri Lanka. In this backdrop, a reasonable question arises as to whether the existing criminal justice system, especially which follow the adversarial mode of judicial trial protect the fair trial norm in the criminal justice process. Therefore, this paper intends to discuss the rights of the sexually abused child victims in the criminal justice system in order to restore imbalance between the rights of the wrongdoer and victim and suggest legal reforms to strengthen their rights in the criminal justice system which is essential to end secondary victimization. The paper considers Sri Lanka as a sample to discuss this issue. The paper looks at how the child victims are marginalized in the traditional adversarial model of the justice process, whether the contemporary penal laws adequately protect the right of these victims and whether the current laws set out the provisions to provide sufficient assistance and protection to them. The study further deals with the important principles adopted in international human rights law relating to the protection of the rights of the child victims in sexual offences cases. In this research paper, rights of the child victims in the investigation, trial and post-trial stages in the criminal justice process will be assessed. This research contains an extensive scrutiny of relevant international standards and local statutory provisions. Case law, books, journal articles, government publications such as commissions’ reports under this topic are rigorously reviewed as secondary resources. Further, randomly selected 25 child victims of sexual offences from the decided cases in last two years, police officers from 5 police divisions where the highest numbers of sexual offences were reported in last two years and the judicial officers both Magistrates and High Court Judges from the same judicial zones are interviewed. These data will be analyzed in order to find out the reasons for this specific sexual victimization, needs of these victims in various stages of the criminal justice system, relationship between victimization and offending and the difficulties and problems that these victims come across in criminal justice system. The author argues that the child victims are considerably neglected and their rights are not adequately protected in the adversarial model of the criminal justice process.

Keywords: child victims of sexual violence, criminal justice system, international standards, rights of child victims, Sri Lanka

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Authors: Hossein Shareh, Farhad Seifi

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The present study was to examine the role of attachment styles, gender schemas, sexual-self schemas, and body image during sexual activity in sexual function, marital satisfaction, and sexual self-esteem. The sampling method was among married women who were living in Mashhad; a snowball selected 765 people. Questionnaires and measures of adult attachment style (AAS), Bem Sex Role Inventory (BSRI), sexual self-schema (SSS), body exposure during sexual activity questionnaire (BESAQ), sexual function female inventory (FSFI), a short form of sexual self-esteem (SSEI-W-SF) and marital satisfaction (Enrich) were completed by participants. Data analysis using Pearson correlation and hierarchical regression and case analysis was performed by SPSS-19 software. The results showed that there is a significant correlation (P <0.05) between attachment and sexual function (r=0.342), marital satisfaction (r=0.351) and sexual self-esteem (r =0.292). A correlation (P <0.05) was observed between sexual schema (r=0.342) and sexual esteem (r=0.31). A meaningful correlation (P <0.05) exists between gender stereotypes and sexual function (r=0.352). There was a significant inverse correlation (P <0.05) between body image and their performance during sexual activity (r=0.41). There is no significant relationship between gender schemas, sexual schemas, body image, and marital satisfaction, and no relation was found between gender schemas, body image, and sexual self-esteem. Also, the result of the regression showed that attachment styles, gender schemas, sexual self- schemas, and body exposures during sexual activity are predictable in sexual function, and marital satisfaction can be predicted by attachment style and gender schema. Somewhat, sexual self-esteem can be expected by attachment style and gender schemas.

Keywords: attachment styles, gender and sexual schemas, body image, sexual function, marital satisfaction, sexual self-esteem

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Authors: Nqobizwe Mvelo Ngema

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This paper argues that the custom of virginity testing has been revived in order to combat against social ills such as unwanted pregnancies, immorality, promiscuity and the spread of HIV/AIDS. However, virginity testing is not free from challenges such as the belief that having sexual intercourse with a virgin can cure men from AIDS, virginity testing is not accurate because there is scientific evidence supporting the fact that there many ways of losing virginity other than sexual intercourse, for example, the usage of tampons and participation in physical activities may tear the hymen. South African parliament took some positive steps in combatting against harm associated with virginity testing by regulating it in the Children’s Act. It is argued, in this paper, that the abolition of virginity testing may lead to paper law and it would be premature to abolish virginity testing in South Africa.

Keywords: equality rights, virginity testing, human rights, interdisciplinary law and legal studies

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Authors: Tara Hunter, Kristine Concepcion, Wendy Cheng, Brianna Pike, Jane Estoesta, Anne Stuart

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In 2015, Family Planning NSW was contracted by the NSW Ministry of Health to design and deliver Sexual Safety Policy training (SSPT) to mental health professionals across NSW. The training was based on their current guidelines and developed in consultation with an expert reference group. From October 2015 to April 2017 it was delivered to over 2,400 mental health professionals with a view to supporting implementation of consistent prevention and intervention related to sexual safety in the mental health setting. An evaluation was undertaken to determine the knowledge and confidence of participants related to sexual safety before and after the training, and whether any improvements were translated into changes in practice. Participants were invited to complete a survey prior to the training, upon completion and three to six months thereafter. Telephone interviews were conducted among service managers and mental health champions six months post-training. Prior to training, the majority of mental health professionals reported being slightly to moderately confident in identifying a sexual safety incident. When asked on their understanding of sexual safety, gender sensitive practice and trauma informed care, they reported no confidence, slight confidence and moderate confidence. Immediately after the training, 54.5% reported being very confident and 10.9% extremely confident in identifying a sexual safety incident. More than half felt very confident or extremely confident in their understanding of sexual safety principles. The impact survey (six months later) found that the majority of participants (91%) were highly confident in identifying a sexual safety incident. Telephone interviewees reported a change in workplace culture and increased awareness after the training. Mental health professionals experienced increased knowledge and confidence about sexual safety principles following the training and were able to implement positive changes and concrete actions to better address sexual safety issues in their workplace.

Keywords: sexual safety, mental health professionals, trauma informed care, policy training

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Authors: J. J. Lloyd, J. S. Phillips

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Background: HIV/AIDS has made a huge impact on human development and sexual reproductive habits in this century in the world and especially in sub-Saharan Africa. It has only recently been acknowledged that HIV/AIDS has an equal if not greater effect on or threat to people with disabilities. Survivors of traumatic spinal cord injury (SCI) with resultant disability are incorrectly believed to be sexually inactive, unlikely to use drugs or alcohol and at less risk of violence or rape than their non-disabled peers. This group can thus be described as economically, educationally and socially disadvantaged, which in itself, suggest that they are a high-risk group for HIV infection. Objectives: Thus, the overall objective of this study was to assess the factors that exacerbate the risk and vulnerability of individuals with spinal cord injuries to HIV infection in order to develop a more effective HIV intervention. Methodology: This paper reports on the cross-sectional data gathered from individuals with a traumatic spinal cord injury in 4 conveniently selected provinces in South Africa. Data was collected by means of self-administered questionnaires. The questionnaire consisted of various sections requesting for information on Demographics; HIV-Knowledge (HIV- KQ-18); Sexual behaviours; sexual communication, and negotiation skills and Self-efficacy to refuse sex. Results: The majority of the study sample was males (72.7%) with a mean age of 34.6 years. The majority reported lifetime sexual intercourse (92.4%) but only 31.8% reported condom use with last sexual intercourse. Low level of HIV knowledge, and being male were the strongest predictor of risky sexual behaviours in this sample. Conclusion: Significant numbers of individuals with spinal cord injuries are thus engaging in risky sexual behaviours pointing to a need to strengthen comprehensive sexual health education to increase access to HIV testing, promote safe sex and condom use among this group.

Keywords: Human Immunodeficiency Virus (HIV), individuals with spinal cord injuries, risky sexual behaviours, HIV risk factors, sub-saharan Africa

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Authors: Sangita Bharati

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Violence against women is now well recognised as a public health problem and human rights violation of worldwide significance. It is an important risk factor for women's ill health, with far reaching consequences for both their physical and mental health. Gender based violence takes many forms and results in physical, sexual and psychological harm to the women throughout their lives. Gender based violence often manifests unequal power relation between men and women in society and the secondary status of the women because of which women have to suffer a range of health problems in silence. This paper will aim at describing a few problems related to women’s health which are directly linked to their experience as victims of gender based violence.

Keywords: violence, health, women, society

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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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Authors: Anna Pudlo

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The EU law encompasses many supranational legal systems (EU law, ECHR, international public law and constitutional traditions common to the Member States) which guarantee the protection of fundamental rights, with partly overlapping scopes of applicability, various principles of interpretation of legal norms and a different hierarchy. In EU law, the prohibition of discrimination on grounds of sexual orientation originates from both the primary and secondary EU legislation. At present, the prohibition is considered to be a fundamental right in pursuance of Article 21 of the Charter, but the Court has not yet determined whether it is a right or a principle within the meaning of the Charter. Similarly, the Court has not deemed this criterion to be a general principle of EU law. The personal and materials scope of the prohibition of discrimination on grounds of sexual orientation based on Article 21 of the Charter requires each time to be specified in another legal act of the EU in accordance with Article 51 of the Charter. The effect of the prohibition of discrimination on grounds of sexual orientation understood as above will be two-fold, for the States and for the Union. On the one hand, one may refer to the legal instruments of review of EU law enforcement by a Member State laid down in the Treaties. On the other hand, EU law does not provide for the right to individual petition. Therefore, it is the duty of the domestic courts to protect the right of a person not to be discriminated on grounds of sexual orientation in line with the national procedural rules, within the limits and in accordance with the principles set out in EU law, in particular in Directive 2000/78. The development of the principle of non-discrimination in the Court’s case-law gives rise to certain doubts as to its applicability, namely whether the principle as the general principle of EU law may be granted an autonomous character, with respect to the applicability to matters not included in the personal or material scope of the Directives, although within the EU’s competence. Moreover, both the doctrine and the opinions of the Advocates-General have called for the general competence of CJEU with regard to fundamental rights which, however, might lead to a violation of the principle of separation of competence. The aim of this paper is to answer the question what is the nature of the prohibition of discrimination on grounds of sexual orientation in EU law (a general principle in EU law, or a principle or right under the Charter’s terminology). Therefore, the paper focuses on the nature of Article 21 of the Charter (a right or a principle) and the scope (personal and material) of the prohibition of discrimination based on sexual orientation in EU law as well as its effect (vertical or horizontal). The study has included the provisions of EU law together with the relevant CJEU case-law.

Keywords: EU law, EU principles, non-discrimination in EU law, Charter of the Fundamental Rights

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Authors: Terri A. Croteau, Todd G. Morrison

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Despite increased scholarly attention paid to minority stress and sexual satisfaction among sexual minorities, to the authors’ knowledge, no researchers, to date, have attempted to synthesize this literature. To address this omission, the authors conducted a meta-analytic review of the association between sexual minority stress (i.e., sexual identity stigma, internalized sexual identity stigma, and sexual identity concealment) and sexual satisfaction. Twenty-seven articles containing 58 effect sizes were analyzed (N = 183,582). Findings indicated a small, inverse relationship between these constructs, indicating that minority stress may lead to diminished sexual satisfaction among gay/lesbian and bisexual individuals. Further, the overall effect size varied as a function of minority stress type, such that the effect for internalized stigma was significantly larger than the effects for stigma or concealment. Age also moderated the relationship between minority stress and sexual satisfaction; specifically, older age was associated with a smaller effect, suggesting that older adults may be better at coping with minority stress than younger adults. Limitations, implications, and directions for future research are discussed.

Keywords: minority stress, stigma, sexual satisfaction, sexual minorities

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Authors: Soheila Rabiepoor, Elham Sadeghi

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Introduction: Divorce is both a personal and a social issue. Nowadays, due to various factors such as rapid social, economical, and cultural changes, the family structure has undergone many rough changes, out of 3 marriages 2 of them lead to divorce. One of the factors affecting the incidence of divorce and relationship problems between couples is the sexual and marital behaviors. There are several different reasons to suspect that pornography might affect divorce in either a positive or a negative way. Therefore this study evaluated the sexual health of divorce-asking in Urmia, Iran. Methods: This was a cross-sectional descriptive study and was conducted on 71 married women of Urmia, Iran in 2016. Participants were applicants of divorce (referred to divorce center) who were selected by using convenient sampling method. Data gathering tool included the scales for measuring demographic, sexual health (sexual satisfaction and function), and researcher made pornography questions. Data were analyzed based on the SPSS 16 software. P-values less than 0.05 were considered significant. Results: Investigation of demographic features showed that age average of studied samples was 28.98 ± 7.44, with a marriage duration average 8.12 ± 6.53 years (min 1 year/ max 28 years). Most of their education was at diploma (45.1%). 69 % of the women declared their income and expenditure as equal. Nearly 42% of women and 59% of their partner had watched sexual pornography clips. 45.5% of participants reported that they compared own sexual relationship with sexual pornography clips. In the other hand, sexual satisfaction total score was 51.50 ± 17.92. The mean total sexual function score was 16.62 ± 10.58. According to these findings, most of women were experienced sexual dissatisfaction and dysfunction. Conclusions: The results of the study indicated that who had low sexual satisfaction score, had higher rate of watching pornography clips. Based on current study, paying attention to family education and counseling programs especially in the sexual field will be more fruitful.

Keywords: divorce-asking, pornography, sexual satisfaction, sexual function, women

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