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Trump’s gag rule hurts urban poor women

Health

Trump’s gag rule hurts urban poor women

2017-05-23

Tne urban poor woman is considered better off than her rural counterpart due to her proximity to health services. The reality is that she is still significantly excluded and marginalised.

Experts now say that the “urban advantage” does not exist for the urban poor woman, especially in accessing sexual and reproductive health services.

“Most of us deliver our babies assisted by traditional birth attendants and most of us still trust our friends for advice and we rarely go to the clinics to seek advice,” says Anastasia Wairimu who works at Mirera Flower Farms in Naivasha.

The recent reinstatement of the global gag rule by the Donald Trump administration will have far-reaching implications on the urban poor who still carry the heaviest load when it comes to maternal mortality.

“The rule means any organisation involved in providing sexual and reproductive health services that uses its own money to provide, or even discuss, abortion services will lose any US development funding it receives,” says Evelyn Samba, the Kenya Country Director, Deutsche Stiftung Weltbevoelkerung (DSW).

“That is, even if the activities for which it receives US funding have nothing to do with pregnancy, family planning or abortions,” she adds. The United Nations Population Fund (UNFPA), which provides family planning services in many developing countries including Kenya, is among the first casualties.

The United States has withdrawn its funding to UNFPA. “Access to sexual and reproductive health services, including family planning, helps in cutting maternal and child deaths, eases the burden of post-abortion care as well as new HIV and STI infections,” Samba expounds.

Wairimu knows all too well the dangers of not using family planning. “The woman who helped me deliver my second born told me that I could not get pregnant since I had just given birth, I stopped using family planning,” she says.

Seven months later while going about her duties at the flower farm, she fainted, only to be taken to the clinic and discover that she was three months pregnant. “It was a difficult pregnancy.

I ended up having a miscarriage and I have been anaemic ever since,” says the 28-year-old Wairimu. Her story is not unique. In fact hers would be considered to have had a happy ending bearing in mind that though at the national level government statistics show that about 362 women die in every 100,000 live births. Among the urban poor, the numbers are higher at over 700 deaths in every 100,000 live births.

“The urban poor woman will most likely deliver at home and be assisted by a traditional birth attendant. When complications arise, there is no way to get this woman to the hospital fast enough, especially because of lack of infrastructure in the slums,” says Dr Gikama Kinyanjui, a gynaecologist and obstetrician in Naivasha.

He says though these women will have attended at least one antenatal clinic visit, nearly half of them will not make it to the recommended four visits.

“This is why the government must focus on raising domestic funding to ensure family planning methods are available for the urban poor woman to avoid unplanned pregnancies,” Dr Gikama expounds.

Samba explains that in the light of dwindling external resources, “county governments need to increase investment in sexual and reproductive health service provision, especially family planning services.”

It is against this backdrop that the County government of Nakuru recently launched guidelines to particularly bring maternal health services closer to its people.

This has been done through the launch of the County Family Planning Costed Implementation Plan 2017-2021. Both national and county governments have expressed commitments to address the main challenges that affect the quality of sexual and reproductive health services that the urban poor woman receives.

This is being done by assessing the demand side and making efforts to remove obstacles that hinder these women from going to health facilities for services in the first place.

There are also initiatives that are working to improve the supply side. “This is where we improve the infrastructure around the health system,” says Dr Kinyanjui.

Other efforts include elimination of the urban exclusion whereby the urban poor have remained marginalised and vulnerable unable to access quality services.

“Continued access to sexual and reproductive health services will likely translate into a healthier, more economically productive population to power Kenya’s development aspirations,” Samba says.

Domestic mobilisation of resources will further ensure successes witnessed particularly in maternal health over the last decade do not go down the drain.

Maternal deaths have dropped from 488 in every 100,000 live births in 2008/09 to the current 362. Deliveries attended by skilled attendant have risen from 43 per cent in 2008/09 to 62 per cent. Within the same period pregnant women who received any antenatal care rose from 92 per cent to 96 per cent.

Bodies in Balance: Does Exercise Affect Sex?

blog, blog-home, Sexual Health

Bodies in Balance: Does Exercise Affect Sex?

So, the really big question: Does exercise affect sex?

It depends on who you ask. Recently, a study came out that warned guys of the risk to their sex drive if they do too much physical activity. The study found that men who exercise strenuously may have a lower libido than those whose workouts are lighter.

The key words here are may and strenuous. Complications arose when men were exposed to higher levels of chronic intense and greater durations of endurance training on a regular basis. But the majority of people do not consistently exercise at this level, right? So it’s important to read the study and understand if what they analyzed describes you.

Because for most fitness enthusiasts, continuing to exercise on a regular basis does help with intimate relationships and contribute to a healthy sex life. “Exercise is extremely beneficial to sexual desire, performance, and satisfaction, says Lawrence Siegel, MA, CSE, AASECT, a Clinical Sexologist.

“Since sexual function involves more physiological, psychological, and emotional processes than most other human experiences, the closer to optimum levels we are in each state, the greater our sexual experiences,” he says. And since exercise is one of the few things that can help in ALL areas, it is an essential element to achieving those optimum levels of performance and satisfaction (or at least helping one get a bit closer).

What does exercise have to do with sex?

Siegel says exercise, in general, can significantly help achieve better sleep and reduced stress, both of which are important to emotional well being. And if you happen to be one of the millions of people taking an anti-depressant medication, “engaging in exercise is often recommended as a way of overcoming or reducing the negative sexual side effects of these medications, especially in women,” he explains. In fact, research from the University of Texas at Austin found that exercise increases genital arousal in healthy women, likely due to increasing sympathetic nervous system (SNS) activity.

In addition to engaging in daily exercise such as strength training and cardiovascular activities, Siegel also recommends yoga. “Yoga has been shown to provide significant improvement in sexual arousal in women with metabolic syndrome (often a precursor diagnosis to cardiovascular disease and diabetes; related to obesity, lack of activity, and pre-diabetes) and post-menopausal women,” he explains. And for men, “yoga has also been shown to help with erectile dysfunction and rapid (premature) ejaculation, especially when it involves strengthening and opening one’s core and pelvic region,” Siegel adds.

And don’t think you’re going to get through an article on sex without talking about Kegels. Yup, that’s right—those dreaded exercises women are told to practice while waiting at a stop light, sitting in their chair at work, or basically anywhere they can, actually do help with sexual performance—and they are not just beneficial to women. Siegel says by strengthening the pelvic floor muscles, particularly the pubococcygeus or PC muscle, both men and women have reported increases in frequency and intensity of orgasms and the feeling that they have more control. “Women have long reported increased vaginal sensation and sensitivity but there is preliminary evidence to show that Kegel exercises may be very helpful in treating erectile dysfunction, or ED and rapid ejaculation in men,” he adds.

And just in case you need one more reason to be active, both sexually and via exercise, Siegel says that in addition to centuries of anecdotal evidence, there is growing empirical data to support the connection between exercise and well being. “Numerous studies have established strong correlations between moderate exercise and help in relieving depression and anxiety, in addition to improvements in sexual arousal and enjoyment.”

What about nutrition?

We can’t talk about a body being in balance without mentioning food. And according to Siegel, there are a number of nutritional changes people can make to improve sexual desire and arousal. He believes that overall, it’s less about finding specific foods that will increase libido, usually referred to as “aphrodisiacs,” than it is to develop good nutritional strategies.

Siegel says a pro-sexual diet should be based on eating lots of legumes, whole-grain products and other complex carbohydrates, as well as a good amount of nuts, fruits and vegetables. “In particular, cruciferous vegetables like brussels sprouts, cauliflower and broccoli, as well as green leafy vegetables are best, but carrots, beets, garlic, ginger, and avocado are also list toppers, he explains.

These vegetables contain phytonutrients and other substances, such as antioxidants, polyphenols and vitamins, that reduce inflammation and improve metabolic function. “For men, these nutrients have been shown to help prevent BPH, or enlarged prostate, a condition often related to erectile dysfunction and ejaculatory problems,” says Siegel. Other nutrients like vitamin E, nitrates, lycopene, folate, and riboflavin are all helpful at improving sexual health.

“With regard to fruits, it’s hard to go wrong,” says Seigel. Of particular interest are watermelon, papaya, and citrus (go vitamin C!). Lemon should also be on your list because of its ability to decrease acidity in the body. To keep it simple, Siegel says “for the most part, if it’s good for your heart, it’s good for sex!”

Sara Lindberg is a freelance writer specializing in health, fitness and wellness.

Sex Education Programmes in Kenyan Schools Are Failing Students

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Sex Education Programmes in Kenyan Schools Are Failing Students

2017-05-09

ANALYSISBy Estelle Monique Sidze, Guttmacher Institute and Melissa Stillman

Imagine giving Kenyan students something that has been proven to help them make healthy informed choices about their sexual and reproductive lives.

The solution already exists: comprehensive sexuality education.

To be comprehensive, sexuality education needs to be scientifically accurate, age-appropriate, nonjudgmental and gender-sensitive. The lessons should extend to prevention of HIV and other sexually transmitted infections (STIs), as well as contraception and unintended pregnancy. The students should also learn about values and interpersonal skills, gender, and sexual and reproductive rights. Programmes that cover all of these topics can have a positive impact on adolescents’ sexual and reproductive health.

Previous research shows that nationally more than a third of Kenyan teens between the ages of 15 and 19 have already had sex. About one-fifth are currently sexually active. And while only four in ten sexually active unmarried teenage girls use any modern method of contraception, the vast majority of them want to avoid pregnancy. About one-fifth of them are already mothers, and more than half of these births were unplanned.

Early childbearing may limit girls’ ability to stay enrolled in school and to develop the skills needed to successfully transition to adulthood. Knowledge about HIV infection also remains a concern: around half of adolescents in Kenya do not have comprehensive knowledge of HIV/AIDS.

At a time when a new national school curriculum is starting its pilot phase, our recently released study provides critical evidence of the gaps in the content and delivery of existing sexuality education programmes and an opportunity for strengthening them.

The study, conducted in 2015 in 78 public and private schools, found that three out of four surveyed teachers are reportedly teaching all the topics that constitute a comprehensive sexuality education programme. Yet only 2% of the 2,484 sampled students said they learned about all the topics.

Worse still, incomplete and sometimes inaccurate information is being taught. A majority of surveyed teachers reported emphasising in their classes that abstinence is the best or only method to prevent pregnancy and STIs. Yet numerous studies have shown that abstinence-only programmes do not work.

Only 20% of students in our study had learned about types of contraceptive methods. And even fewer had learned how to use and where to access methods. The majority of teachers also reported very strongly emphasising that having sex is dangerous or immoral for young people. Furthermore, almost six in 10 teachers who teach about condoms incorrectly tell their students that condoms alone are not effective for pregnancy prevention. Something is wrong with this picture

The reality is that at the time of being surveyed for our study, a quarter of the students – who were mostly aged between 15 and 17 – had already had sex. Students want and need information about how to prevent unintended pregnancies, HIV and other STIs.

Slow implementation

Kenya already has the policy infrastructure for a comprehensive programme. Its National School Health Policy was developed by the Ministry of Education and the Ministry of Public Health and Sanitation and their partners in 2009. The policy underscores the need to ensure that students receive quality health education, including sexuality education.

Kenya has also been a signatory since 2013 of a joint health and education ministerial commitment to provide comprehensive and rights-based sex education starting in primary school. Twenty-one other countries of East and Southern Africa are also part of this initiative.

However, implementation has been slow and uneven. Nairobi City county has acknowledged this gap and is working to increase coverage of sexuality education. Recently the county launched a plan of action to strengthen school health programming to increase the number of schools that offer comprehensive sexuality education.

Sexuality education is primarily taught under the subject Life Skills, which is compulsory but not examinable. Teachers face pressure to focus on examinable subjects, such as Mathematics and English. Even in schools that teach a wider range of sexuality education topics, many teachers lack the training to teach them effectively.

We owe it to young people

That’s why the ministries of Health and Education should honour their prior commitments. An immediate priority should be fostering partnerships between schools and community health care providers. Health care providers may be better placed to provide some particularly sensitive sexuality education content, such as where to access and how to use contraceptive methods.

As a longer term priority, the ministries should invest in improved pre-service and in-service teacher training in how to teach sexuality education effectively. They should also ensure that teachers have sufficient time to cover the full range of topics in their classes.

Increased focus on pregnancy and STI prevention strategies should cover a broad range of contraceptive methods and negotiation skills within relationships. This is necessary to ensure that all Kenyan youth have the knowledge to make informed decisions about their sexual and reproductive health. We owe it to young people to do much better.

Disclosure statement

The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond the academic appointment above.

http://allafrica.com/stories/201705080106.html

Read the original article on The Conversation Africa.

Sending the wrong message on sex and reproductive health

blog, Reproductive Health

Sending the wrong message on sex and reproductive health

By FIONA MACGREGOR | FRONTIER

DON’T DO that! No, I mean it. Really. A video called “Don’t do that”, which has been circulating recently on Myanmar social media attempts to shame and frighten young women with misinformation about unplanned pregnancies and abortions, is extremely damaging.

The short film, sponsored by a popular domestic soft drinks company and produced by Myanmar Media 7 news, follows the story of a young woman. It shows her dancing at a nightclub and then having dates with various men before she becomes pregnant.

If it is meant to be educational, it fails miserably.

The cause of her unplanned pregnancy is merely hinted at. Did it happen when she was seductively sipping juice in the swimming pool? Was it the moment she travelled through Yangon at night with her head protruding from a car’s sunroof? Or was it – as is strongly implied – simply the consequence of being a young woman failing to follow restrictive societal conventions.

But if the “slut-shaming” message of the video is abhorrent in itself (the men in it are not subject to the same judgements), its depiction of the abortion becomes a horror show. Confusing the differences between a medical termination (by taking a pill) and one involving surgery, it ends with the young woman in agony – physical and mental – after being forced to look at the aborted foetus.

Tragically, the reality for women in countries such as Myanmar where abortion is illegal is that those who terminate a pregnancy too often suffer unnecessary, and sometimes fatal, physical and mental trauma that could have been avoided had proper medical services been available to them.

If the moral debate around abortion remains divisive in many parts of the world, the right of women to receive accurate, impartial information and access to family planning and reproductive health services is something that should always be protected.

Yet, early this month the United States government announced that it was halting funding for the United Nations Population Fund (UNFPA), which has been instrumental in providing family planning and maternal health services to women throughout the world and preventing maternal mortality. In other words, UNFPA’s work directly focuses on saving the lives of women and babies.

The cut came after President Donald Trump earlier this year reinstated a ban on US funding for any international organisation that provided any kind of abortion service or advice.

The US is not the only country failing to support women’s reproductive health services at previous levels. Last year Denmark also announced a significant reduction in funding to UNFPA. As donors throughout the world increasingly focus attention on the global refugee crisis, it is feared vital women’s services will lose out – an irony being that displaced women are in particular need of such support.

Myanmar’s 2014 census found that 282 women die for every 100,000 births, or about eight deaths every day. That is double the regional average and more than ten times the mortality ratio of 20 deaths for every 100,000 births in neighbouring Thailand. The need for better family planning and reproductive health services is more than evident.

If anything positive emerged from the “Don’t do that” video, it was the number of Facebook responses from women who objected to its sexism and erroneous information.

“Instead of this story, why don’t you do a story about birth control choices for women and men. Also educate about STDs [sexually transmitted diseases]. This is not convincing me about staying against abortion at all,” wrote one woman.

Another responded, “So much misinformation here! Not all club-going, rich, social girls end up getting knocked-up. (In fact, it’s the poor, uneducated girls who mostly suffer from unwanted pregnancies.) ALSO, taking abortion pills is different from yanking a foetus out. ALSO, since it’s supposed to be ‘educational’, do inform the public about many options such as use of contraceptives, taking morning-after pills, etc, to prevent unwanted pregnancy.”

It is extremely encouraging to see young women standing up for themselves and others and, even though the issue is controversial and potentially emotive, defending their right to receive accurate information free from gender-based discrimination and prejudice.

Yet even among these strong and enlightened young women there were clear gaps in their knowledge of reproductive health options.

One respondent, who made it clear she was aware of emergency contraception and how it works, nevertheless “doubt[ed] you can also abort a baby simply with a pill”.

Another highlighted the discrimination and challenges young women face when it comes to discussing sexuality, and said she believed the reputation of the actress in the video had been ruined by playing the role.

“I am a virgin but I know everyone is using a condom for one night stands. Also, the way you presented [the video] completely destroyed the girl’s career,” she wrote.

The tendency to oppress women’s self expression and freedoms rather than deal with deeper societal problems, permeates much of society in Myanmar.

It was evident when Yangon Region Chief Minister U Phyo Min Thein announced a crackdown on alcohol consumption near Thingyan pandals this year.

“We are ending the situation whereby parents are horrified to see their daughters on the pandals,” he said.

His comments may well reflect traditional cultural values that prioritise the sensibilities of parents over those of their children, but they also exhibit an inherent sexism.

By ignoring the common reports of groping and sexual assaults by male revelers during the festival, and focusing instead on the behaviour of young women whose only “offence” is to be seen enjoying themselves in public, it promotes the idea that “saving face” is more important than defending women’s rights.

This is the kind of attitude that leads to women keeping domestic abuse secret, to sexual assaults going unreported, and to the practice in some communities of women who have been raped being forced to marry their rapist to “protect their family’s honour”.

In previous years, Yangon authorities have demanded that shops clear their shelves of condoms during Thingyan in an ill-advised attempt to control “morality” by depriving people of contraceptives.

The responses to the “Don’t do that” video show that young women want access to the information and services that will allow them to protect themselves and make their own decisions about contraception and how they live their lives.

Politics, religion and policing in this country, as in much of the world, are overwhelmingly dominated by older men, most of whom appear to show little inclination to take the concerns and demands of young women seriously.

All the more important then that funding continues for organisations, international and national, that can provide women with accurate and impartial family planning information and reproductive health services.

Those who support women’s rights everywhere must work to ensure the needs and demands of young women are met and to end the situation in which decisions about women’s health are made by roomfuls of men, whether in Washington or Nay Pyi Taw.

Does Your Sex Life Affect How Often You Masturbate?

blog, blog-home, Sexual Health

Does Your Sex Life Affect How Often You Masturbate?

2017-04-26

Can the sex you’re having with your girlfriend determine how often you take matters into your own hands—erm, hand? The answer might be more complicated than you think, a new study from University of Texas at Austin and Brigham Young University suggests.

Researchers looked at survey data from 7,600 men between the ages of 18 and 60 who were asked whether or not they had masturbated in the past two weeks, how often they had sex during that time, and if they were happy with the action they were getting.

It’s not exactly shocking that 61 percent of guys admitted to masturbating within the past two weeks. (Here’s how common masturbation really is.) As it turns out, how often you get laid isn’t really linked to how often you have solo sex. People who did and didn’t get off on their own had similar amounts of sex, the researchers found.

That changed slightly when they took sexual satisfaction into account: Men who reported being happy with their sex lives were just as likely to masturbate, regardless of how often they got laid or not. But guys who were less satisfied with their sex lives had the highest masturbation rates.

Translation: Your tendency to masturbate may rely more on whether you actually like the sex you’re having, rather than how often you actually do it.

But either way, you shouldn’t hesitate to give yourself a little love every now and then, says Moushumi Ghose, a licensed sex and marriage therapist who is not affiliated with the study. If you’re having regular sex—and loving every minute of it—masturbation has the ability to complement what you’re doing in bed, the study authors say.

Ghose agrees: “I like to

think of masturbation as the gateway to a healthy sexuality,” she says. “It’s the one way to discover our inner passions and desires, by tapping into what turns us on.”

And if you’ve hit a dry spell, keeping yourself satisfied on your own is typically perfectly healthy, even though masturbation can be a taboo topic, she explains. (Here’s how you can tell if you’ve been masturbating too much.)

Bottom line: Some sexual alone time can benefit you beyond the bedroom. As if you needed any convincing, here are five reasons you should masturbate tonight.

What You Need To Know About The Disturbing Sexual Assault Trend Called ‘Stealthing’

blog, blog-home, Sexual Health

What You Need To Know About The Disturbing Sexual Assault Trend Called ‘Stealthing’

When it comes to safe sex, a condom seems like a no-brainer. When used properly, it is the most effective way to prevent sexually-transmitted infections, and of course, it also prevents pregnancy. Yet a paper published in the Columbia Journal of Gender and Law examines a disturbing new sex trend called “stealthing,” the act of intentionally and secretly removing a condom during intercourse without consent.

In the paper, author Alexandra Brodsky spoke to victims about the emotional and physical consequences of stealthing. The most obvious: unwanted pregnancy and STIs. But one victim named Rebecca told Brodsky, “None of it worried him. It didn’t perturb him. My potential pregnancy, my potential STI, that was my burden.”

On an emotional level, Brodsky reveals that the men and women who are victims of stealthing also experience a “deeply felt feeling of violation.” Another victim Brodsky interviewed for the study said, “The harm mostly had to do with trust. He saw the risk as zero for himself and took no interest in what it might be for me and from a friend and sexual partner. That hurt.” Another victim quoted in the study even referred to the act of stealthing as “rape-adjacent.”

And this isn’t something that has only happened to a few people. In her paper, Brodsky examines an online community devoted to sharing information and stories about “stealthing.” She looked, in particular, at a website that offers tips to users on how to do this to their own partners. While the website she looked at describes itself as a place for gay men, Brodsky found many comments that talked about heterosexual sex, too.

Based on the content of the site and comments from visitors, Brodsky describes this online community as males who “root their actions in misogyny and investment in male sexual supremacy.” Their communication focuses on a man’s “right” to “spread seed,” even when referring to stealthing in same-sex encounters. Brodsky argues in her study that consenting to sex with the use of a condom is not equivalent to consenting to sex without one at any point in the encounter.

In response, victims are expressing their frustration and seeking help on Reddit, with some threads amassing more than 70 comments.

According to The Guardian, a man was convicted of rape in Switzerland in January for removing his condom during sex without her consent in a landmark case. But Brodsky says she was unable to find a single legal case around this issue in the U.S.

Brodsky, for her part, concludes her paper by calling this behavior a form of “sexual violence,” and urges for a change to the law to recognize this as a punishable offense. “At its best, such a law would clearly respond to and affirm the harm victims report by making clear that ‘stealthing’ doesn’t just ‘feel violent’—it is,” she writes.

7 causes of lower sperm count and male infertility

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7 causes of lower sperm count and male infertility

2017-04-11

The production of sperms is definitely a complex process, and infertility is highly related to sperm count and sperm production. Treatment for infertility is the need of the hour because more and more couples are turning out to be victims of infertility. While several gynaecological disorders in women are causes of infertility, men too are reasons of the cause. So, like women, men too needs to be treated for infertility and should be taken into consideration when a couple is trying to enter parenthood.

Here are seven reasons that cause infertility in men by lowering sperm count or damaging sperm quality:

1. Smoking: Men who smoke consistently have a lower sperm count. Smoking not only decreases sperm count, but also lowers sperm motility.

2. Tight underwear: Wearing this inner garment increases temperature in the scrotal sac. A rise in temperature in the scrotal sac leads to a fall in sperm count.

3. Excessive alcohol intake: Like smoking, binge drinking is also a vital cause of reduced sperm count and increased cases of infertility. Alcohol intake lowers testosterone level significantly and hence the damage to sexual health is caused.

4. Long driving hours: Driving leads to sitting in the same position for a long time. Long driving hours or regualar driving raises temperature in the testicles, which in turn prevents good sperm production.

5. Keeping laptops on laps: Laptops cause heat damage to sperm. When a laptop is placed on the lap, the heat generated in the gadget passes from it to men’s lower body part, and causing damage to sperms.

6. Emotional stress: Chronic stress or prolonged mental illness adversely affects male fertility. Stress interferes with testosterone produced in the testes, a hormone necessary for sperm production.

7. Television watching: Sitting and watching television for extended hours is negatively linked to sperm count and quality. Prolonged sitting overheats the testicle, which in turn results in lower sperm production. Men who wish to enter parenthood should reduce hours of TV watching and indulge themselves in regular exercise.

Like women, men should also take care of reproductive health. After all, entering parenthood is a mutual decision!

Confidentiality concerns may deter teens from sexual, reproductive health care services

blog, Psycological Health

Confidentiality concerns may deter teens from sexual, reproductive health care services

2017-04-06

According to a national survey, 12.7% of sexually-active teenagers and young adults who were on their parent’s insurance plan would not use sexual and reproductive health services due to concerns that their parents would learn about it.

“Changes in the U.S. health care system have permitted dependent children to remain on a parent’s health insurance plan until the child’s 26th birthday and required coverage of certain preventive services,” Jami S. Leichliter, PhD, from the Division of Sexually Transmitted Disease Prevention, the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC, and colleagues wrote. “Although these provisions likely facilitate access to the health care system, adolescents and young adults might not seek care or might delay seeking care for certain services because of concerns about confidentiality, including fears that their parents might find out.”

To ascertain the prevalence of confidentiality concerns among teenagers and young adults, the researchers examined data from sexually-experienced individuals aged between 15 and 25 years (n = 10,205) included in the 2013-2015 National Survey of Family Growth. In addition to information on marriage, divorce, family life, having and raising children and medical care, the National Survey of Family Growth also measures reproductive health status and examines the efficacy or need of health education programs.

The survey included questions concerning confidentiality that addressed whether those aged 15 to 17 would “ever not go for sexual or reproductive health care because their parents might find out,” whether they had “time alone with a provider in the past 12 months without a parent, relative or guardian in the room” and the status of their current health insurance.

Respondents who received STD services were defined as those who had a sexual risk assessment or other clinical services in the past year. A risk assessment included a doctor or health care provider questioning about sexual orientation or the sex of their partners, number of partners, condom use and type of sex (vaginal, oral or anal). Other services include chlamydia testing for girls in the last 12 months or receiving treatment for an STD in the past year for both boys and girls.

Among sexually-experienced youth aged 15 to 17 years, 22.6% responded that they would not seek services with concerns that their parents would know. Girls who were concerned about confidentiality were less likely to report receipt of chlamydia testing (17.1%) compared with girls who did not have concerns about confidentiality (38.7%).

When both male and female youth received more time alone with their health care providers, researchers noted that

they were more likely to report receipt of risk assessment (71.1%); however, when parents were present, reporting dropped to 36.6%. Girls who spent more time alone with their health care provider reported a  higher rate of chlamydia testing (34.0%) than those who had a parent present (14.9%).

“Several medical organizations have emphasized the need for confidentiality for youths seeking care such as STD services,” Leichliter and colleagues wrote. “Previous research has found that females might have more general and sexual and reproductive health-specific confidentiality concerns than do males.” – by Katherine Bortz

Disclosure: The researchers report no relevant financial disclosures.

New vaccine programme for gay men is introduced in Wales

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New vaccine programme for gay men is introduced in Wales

HPV infections which persist can lead to some forms of cancers or cause genital warts

A new vaccination programme for men who have sex with other men has been rolled out across Wales.

The human papillomavirus (HPV) vaccine is now being offered to all gay men up to 45 years old who attend sexual health clinics.

The rollout comes after the Joint Committee on Vaccination and Immunisation (JCVI), which provides independent advice to governments across the UK, recommended the introduction of a targeted programme of this type.

HPV infections which persist can lead to some forms of cancers or cause genital warts. Experts claim the HPV vaccine is very effective in reducing these risks.

Public Health Minister Rebecca Evans said: “A HPV vaccine programme for adolescent girls has been in place since 2008.

“Vaccinating the majority of girls in the UK means that their future male partners get some protection too. However boys who become men who have sex with men will get far less of this protection.

“I am pleased that a new targeted HPV vaccination programme for gay men up to the age of 45 has been introduced across Wales.

“Gay men attending clinics for sexual health services will now be offered the vaccine.”

Rhian Edwards, director of research and support at Tenovus Cancer Care, said the Welsh Government hadn’t gone far enough.

She said: “We know that four in 10 cancers are preventable and HPV cancers make up 5% of all cancers worldwide, so this is a very important step in the right direction.

“However it is vital that the Welsh Government make the HPV vaccination free for both boys and girls of school age so that they are protected against the virus before they become sexually active.

“We encourage parents to consider vaccinating their sons at the same time as girls receive the vaccination in school, although at present they would need to pay for this privately.

“This reinforces the inequalities that already exist between the most affluent and most deprived communities in Wales and must be addressed.”

 

Health needs of men who have sex with men neglected in SA

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Health needs of men who have sex with men neglected in SA

In South Africa, men who have sex with men (MSM) are at higher risk of contracting HIV as they are ‘stigmatised and discriminated against’ in health facilities.

Men who have sex with men (MSM) in Africa are twice as likely as the general population to be HIV positive – partly because their health needs are not being met.

Although, South Africa has made great strides in the provision of HIV-related healthcare services, the health needs of MSM are often misunderstood by healthcare practitioners and neglected in HIV service programmes, according to the Anova Health Institute.

Sensitising health facilities

Gordon Khoza, Anova’s outreach ambassador, said that the MSM community is stigmatised and discriminated against in health facilities.

“The MSM community is stigmatised in a way that they cannot access the health services fully like other populations, but we have started sensitising the health facilities so they can be MSM friendly,” Khoza told an MSM forum in Johannesburg attended by representatives from southern and eastern African countries.

Nine years ago, Anova established a model called Health4Men (H4M) to lead South Africa’s response to HIV among gay, bisexual and other men who have sex with men (MSM).

This model provides direct health care services at two centres of excellence in MSM sexual health care, and also by building support networks of MSM competent sites.

H4M’s David Motsoagae said that they are training public health facilities to become MSM friendly and provide services that ensure people’s dignity. “We are actually a bridge between H4M and the public health facilities,” said Motsoagae.

Not very competent

Anova’s Dr Kevin Rebe said that even when clinics were friendly towards MSM they were usually not asked about anal sex, and, as a result, they were not screened for their health care needs.

“You find that the clinic can be very friendly to the MSM but it is not very competent to meet their health care needs,” said Rebe.

In contrast, the H4M centres offered health interventions aimed at protecting men who have sex with men, such as offering antiretroviral drugs as pre-exposure prophylaxis (PreP).

“It is absolutely clear from multiple clinical trials that PreP will prevent HIV in MSM if used correctly even if they have high risks of sexual exposure  to the virus,” said Rebe.

PrEP, for HIV prevention, involves the use of ARVs by HIV-negative people to reduce the risk of becoming infected. Daily TDF/FTC (a combination ARV marketed as Truvada) has been approved for use in populations at high risk of HIV by a number of national regulatory agencies. In late-2015, the World Health Organization recommended PrEP as an additional prevention option for HIV- negative people at substantial risk of HIV. According to a previous Health24 article, PrEP should not be viewed as the first line of defence against HIV, but in conjunction with other preventative measures, and should be taken daily.

According to Rebe H4M currently has two sites that are providing PreP for MSM, one in Cape Town and one in Johannesburg. He added that the Department of Health will also be increasing access of PreP to MSM as they will be opening new sites starting from April 2017.