After safe sex, safe surgery?
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Accident Prevention↗
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After safe sex, safe surgery?
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Acquired Immunodeficiency Syndrome↗
Safe sex or safe love: competing discourses?
The way in which sex may be constructed as safe through its relationship with 'love' is the concern of this study. Interviews with 112 heterosexual women and men from discos and bars in Melbourne, Australia, catering to single adults revealed the pervasive construction of sex within the discourses of 'love' and 'romance'. The relationship of these discourses to unsafe practices is discussed and the article presents an analysis of the normative function of the sex-as-love/sex-as-desire opposition in terms of safe sex and HIV/AIDS prevention. We conclude that health messages which emphasize that 'sex is unsafe' may be counterproductive. We illustrate how women and some men construct casual sex as a strategy for obtaining the possibility of 'love'. For these women and men, 'safe sex' as 'unprotected sex' is viewed as a strategy for maximizing the possibility that the casual encounter will result in a longer term relationship. On the other hand, 'unsafe sex' as 'unprotected sex' is viewed as a strategy that is more likely to interrupt the construction of romance in the causal encounter thus risking the possibility of love as the desired outcome.
Adult↗
No sex or safe sex? Mothers' and adolescents' discussions about sexuality and AIDS/HIV.
The authors examined in this study whether mothers and adolescents discussed abstinence and safer sex, and how these discussions relate to demographic characteristics. Fifty mother-adolescent dyads (25 girls and 25 boys, aged 11-15) participated in videotaped conversations about two topics: (1) dating and sexuality, and (2) AIDS/HIV. These conversations were coded for specific topics. Both discussions of abstinence and safer sex occurred relatively infrequently during both conversations, although they were more common during AIDS than sexuality conversations and more for mothers than adolescents. The two topics were related--dyads who discussed one were more likely to discuss the other. Adolescents who discussed safer sex with their mothers tended to be older, less religious and have more educated mothers than those who did not. Using observational rather than self-report measures, this study revealed that the extent to which mothers and adolescents discuss abstinence and safer sex can depend on individual (age, gender, socioeconomic status and religious involvement) and contextual (conversational topic) factors.
Adolescent↗
Safe sex versus safe love? Relationship context and condom use among male adolescents in the favelas of Recife, Brazil.
This study examined the influence of the relationship context where adolescent sexual activity takes place on contraceptive decisions. The data were collected in a specially designed survey carried out in May 2000 on 1,438 adolescent males aged 13-19 residing in favelas (urban slum areas) of Recife, Brazil. A logistic regression analysis of condom use at last sexual intercourse and a multinomial logit analysis of contraceptive method choice were performed for 678 sexually active adolescents. Educational attainment, degree of knowledge of HIV transmission and prevention, and condom use at first sexual intercourse were found to be significantly associated with current condom use. Regarding the relationship context, the analysis revealed that adolescent males in steady relationships were less likely to use condoms, less likely to regard themselves at risk of HIV infection, and more concerned about pregnancy prevention than adolescents in casual relationships. Differentials in condom use by type of relationship, however, did not result from a higher rejection of contraception by steady partners but from their higher likelihood to rely on other contraceptive methods. Results suggest that prevention campaigns need to take into account the intimate context where adolescents assess potential health risks, and to address the divergent symbolic meanings condoms may have in different types of relationships. If an increase of condom use among stable sexual partners is pursued, public health campaigns might need to romanticize condom use as a sign of love and trust and place more emphasis on the benefits of dual protection.
Adolescent↗
Increase in safe sex among the young and non-monogamous: knowledge, attitudes and behavior regarding safe sex and condom use in The Netherlands from 1987 to 1993.
In 1987, the Dutch STD Foundation started several safe sex campaigns targeting the general population. These campaigns have been accompanied by surveys which were conducted every 6 months. Questions were asked about knowledge, attitudes and behavior. The number of people who regard condom use as being a safe sex practice increased over the years, as did the number of people who know that condoms protect against STDs and AIDs. Surprisingly, no accompanying changes in attitudes occurred. Nevertheless, the number of people saying they have done something to prevent HIV infection increased significantly among the young and non-monogamous. Also, specifically in these groups, both actual and intentional condom use increased remarkably. Although it is encouraging that those towards whom the campaigns were particularly directed, show the largest changes, there are also signs that these behavioral changes are levelling off.
Adolescent↗
Safe sex: does it exist?
Safe sex is alive and well. However, it is unsafe sex and the circumstances around it that clinicians need to identify. The difficulties in defining safe and unsafe sex will be described in an effort to highlight the great diversity and individuality that surrounds notions of safety and of sexual activity. It is emphasised that safe sex cannot be reduced to the use of a condom and that there are many complex personal, social, political, legislative and economic factors involved in an individual's decision to have safe sex and their ability to carry it out.
Female↗
Listening to female sex workers in Vietnam: influences on safe-sex practices with clients and partners.
BACKGROUND: This qualitative study assessed HIV/AIDS knowledge and frequency of and influences on condom use with clients and regular, non-client partners among female sex workers (FSWs) in Khanh Hoa, a tourist-oriented province of central Vietnam where sex work is common. METHODS: Data were collected via semi-structured interviews with indirect (n = 16) and direct (n = 9) FSWs. RESULTS: Although the majority of respondents were well informed about HIV/AIDS transmission, about one-third had inaccurate beliefs about HIV-positive people as well as the mechanisms by which HIV is transmitted from mother to child. Condom use was inconsistent. More direct than indirect FSWs reported using condoms most of the time with clients but none used condoms all the time. With regular partners, most respondents reported that they never used condoms. Around one-third of women hid their sex work from their regular partners, who made the decision to use or not to use condoms. The most frequently reported reasons for not using condoms with clients were because clients offered a higher price, clients insisted on condom-free sex, and possession of condoms as evidence of sex worker status. For regular partners, the reasons were familiarity, condom use being dependent on partner's decision, and condom use as evidence of sex worker status. There was no apparent relationship between HIV knowledge, time in sex work, and safe sex practices. CONCLUSION: Recommendations are made to improve the rate of condom use among FSWs.
Adolescent↗
Safe sex and student nurses in rural Australia: nurses' knowledge and practices (Part 2).
In this article, the second in a two-part series on a research study investigating student nurses' knowledge and attitudes to safe sex in a rural university in Australia, the results are revealed. The major findings discussed in this article are focused on sexual preference, the need for safe sex, safe sex practices, the need for educational material regarding safe sex, exploration of sex/sexuality and, the need for study of conflict resolution, negotiation skills, and self esteem building. The article concludes with deliberations on educational recommendations associated with the research.
Australia↗
Heterosexual relationship characteristics, condom use and safe sex practices.
It was examined whether sexual relationship characteristics were associated with condom use and safe sex practices against HIV. Characteristics investigated were: (1) age difference between sexual partners, (2) previous knowledge of partner, (3) type of relationship, (4) duration, and (5) exclusiveness. Safe sex practices (risky, non-safe, safe) were defined by condom use consistency, previous knowledge of partner and monogamy. Participants (N = 458, were Greek, sexually active and between 18-25 years old) responded to a questionnaire on sexual and condom use practices in their sexual relationships of the past 12 months, condom use negotiation and variables a-e. Only age difference between partners was found to differentiate consistent from inconsistent condom use. Inconsistent condom use was more frequent among partners whose age difference was over two years. Safe sex practices (risky, non-safe, safe) varied across different relationships of 36% and remained consistently non-safe or risky across those of 40%. Risky practices occurred more frequently in relationships where the man was older than the woman. When condoms had not been used, they had not been negotiated in 80% of the cases. These findings reconfirm the importance of negotiation in condom use, call attention to the neglected role of age differences between partners in safe sex and bring forward the issue of studying actual variation of safe sex practices across relationships as an indication of people's response to health campaign messages of risk reduction.
Adolescent↗
Sexual activity and knowledge of safe sex reported by HIV-infected persons receiving home care.
Sexual activity and knowledge of safe sex were assessed for 57 human immunodeficiency virus (HIV)-infected persons on admission to home care. More than one third of the individuals providing information were sexually active; 72% of the sexually active persons reported that they practiced safe sex. Definitions of safe sex were inconsistent, particularly regarding safety of oral sex. Needs for counseling on safe sex of HIV-infected persons receiving home care practices were clearly evident.
Adult↗
Teaching safe sex in school.
OBJECTIVE: To teach safe sex practices to adolescents in school, before they start to become sexually active, using peer group education. METHOD: To send young medical students back to their old schools to do the teaching, and to get them to make videos suitable for showing to teenage audiences that can be widely circulated to all schools. RESULTS: The program has been running in Australia since 1992, and has proved highly popular with school teachers, school children, and particularly with medical students. We are now working with medical schools in Beijing and Shanghai, at the invitation of the Chinese Ministry of Health, to see if we can adapt our program to a very different cultural setting. CONCLUSION: Educating children about Safe Sex is one of the most effective ways of postponing their onset of sexual activity. It is also the best investment that we can make to ensure people's future reproductive health; if they start right, there is every hope that they will stay right.
Acquired Immunodeficiency Syndrome↗
Factors predicting safe-sex talk and condom use in early sexual relationships.
This study explored some of the antecedents and consequences of young adults' beliefs about safe-sex communication in their early couple relationships. The sample consisted of 237 unmarried, heterosexual Australian university students, 16 to 19 years of age, approximately evenly divided between virgins and those with sexual experience. Drawing on a model of couple sexual communication as the product of prior experiences with communication, assertion, and conflict resolution in the family of origin, we examined links between these variables and respondents' attitudes and practices of safe-sex discussion and condom use with their dating partners. The results showed that women and nonvirgin men had more positive attitudes toward safe-sex communication than male virgins had. Difficulties with self-assertion outside of the sexual context and mothers' and fathers' use of avoidance as a conflict resolution strategy were negatively correlated with willingness to discuss safe sex, whereas mothers' more frequent safe-sex education was a positive predictor. The results of a hierarchical multiple regression analysis indicated that assertion, paternal conflict avoidance, and male gender were independent predictors of reluctance to negotiate for safer sex. At a behavioral level, positive attitudes to safe-sex discussion predicted having talked about AIDS and condoms with a dating partner as well as actual condom use by the subsample of daters who had experienced sexual intercourse. Implications for improving family and couple communication and for sex education were considered.
Adolescent↗
The determinants of safe sex behaviors of junior college students with sexual experience.
The purpose of this study was to explore the safe sex behavior and related factors of junior college students with sexual experience in southern Taiwan. This study used a cross-sectional design, in which data from a sample of 187 junior college students with sexual experience were collected by an anonymous and self-administered questionnaire. For a conceptual framework, the study used constructs from the PRECEDE (Predisposing, Reinforcing, and Enabling Causes in Educational Diagnosis and Evaluation) model. Two predisposing factors (AIDS-prevention self-efficacy, AIDS related knowledge), one enabling factor (school resources in AIDS prevention), one reinforcing factor (perception of peers' AIDS prevention behavior), demographic characteristics (gender, parents' educational level), substance use (cigarette and alcohol use) and sexual history (age of first sexual intercourse, number of sexual partners) were examined for their ability to influence safe sex behavior of junior college students with sexual experience. The results showed that gender, fathers' educational level, age of first sexual intercourse, number of sexual partners, cigarette use and alcohol use were significant factors for difference in safe sex behavior. AIDS prevention self-efficacy, AIDS-related knowledge, and perception of peers' AIDS prevention behavior were all positively related to safe sex behavior. AIDS prevention self-efficacy, fathers' educational level accounted for 49.8% of the variance in safe sex behavior.
Acquired Immunodeficiency Syndrome↗
"When you carry condoms all the boys think you want it": negotiating competing discourses about safe sex.
With the advent of HIV, sexual health campaigns and formal sex education in schools have worked to instil the concept of safe sex into the collective minds of Australia's youth. However the concept in its present guise is a fairly limited one. We argue in this paper that the predominant emphasis in education programmes on safe sex as condom use may be counter-productive for some young heterosexuals for two reasons. First, this strategy is male-focused and may not extrapolate well to young women who face special risks around pregnancy and rigid societal gender norms which govern sexual behaviour. Second, health promotion strategies aimed at young heterosexuals are based on an assumption of rational decision-making in sexual encounters and obscure the non-rational nature of arousal and desire, and the unequal power relations that exist between young men and women engaging in sex. Five hundred and twelve senior rural students participated in the study which included group discussions about sexuality and survey items which focused on the meanings of safe sex and the accessibility and use of condoms. The results showed that though most students identified condoms with safe sex, many were ambivalent about using them. Reasons given related to problems of negotiation, difficulties of access, and the risks which condoms gave no protection from, such as a sullied reputation. Perhaps, partly because of this, some students were looking to less secure methods of protection such as informal history-taking and monogamy. It is argued that successful sexual health promotion strategies must address the broad spectrum of concerns facing young men and women when they become sexually active and that consideration be given to the social context in which young people conduct their sexual lives.
Adolescent↗
HIV-seropositive individuals' optimistic beliefs about prognosis and relation to medication and safe sex adherence.
OBJECTIVE: The study objective was to characterize respondents' prognostic perceptions of HIV infection and to explore how perceptions might affect medication and safe sex nonadherence. METHODS: Surveys were mailed to 295 clients of an HIV-specific case management organization. Participants were asked to describe experience with HIV/AIDS right after serostatus knowledge and currently, using provided word lists, after which they were asked to assess current life expectancy. Self-reported information on antiretroviral medication and safe sex nonadherence was obtained. RESULTS: A total of 220 (75%) clients (66% nonwhite, 73% male, 63% gay/bisexual, 50% educated >12 years, and 53% with incomes <$10,000/year) returned surveys. Negative descriptors from word lists were significantly less common and positive descriptors significantly more common now compared to right after serostatus knowledge. Current perceptions about life expectancy indicated that most respondents thought they would live many years, many believing they would live well into old age. Whites (odds ratio [OR], 0.34; P =.01) were less likely and those with >12 years education (OR, 2.76; P =.02) and with CD4 cell counts >200 (OR, 2.70; P =.01) were more likely to have optimistic prognostic beliefs. The optimistic subgroup, when compared with the pessimistic subgroup, was more likely to report medication (26% vs 13%, P =.04) and safe sex (57% vs 29%, P =.004) nonadherence. CONCLUSIONS: Seropositive individuals, including persons of color (adjusted) as well as women and drug users (unadjusted), self-reported optimistic beliefs about their prognosis. Those with more optimism about their prognosis were significantly more likely to report medication and safe sex nonadherence. A better understanding of seropositive patients' prognostic beliefs and the factors determining them is warranted.
Adult↗
Safe sex after post-exposure prophylaxis for HIV: intentions, challenges and ambivalences in narratives of gay men.
This paper draws on findings from an on-going prospective cohort study, with a quantitative and a qualitative arm, to monitor the implementation of non-occupational post-exposure prophylaxis (PEP) in Australia. The aim of the qualitative arm was to explore in-depth details of exposures to HIV and participants' understanding of 'risk'. Of the 328 patients who were enrolled in the study from March 1999 to July 2001, 88 (27%) participated in the qualitative arm. Interviews were conducted in a semi-structured style and explored the event that precipitated the request for PEP, participants' understanding of safe sex, their physical and psychological experience of the treatment and the impact that the availability of PEP may have on their sexual practices in the future. One theme running through the interviews was a determination to either maintain existing high levels of safe sex or to increase safe sex practices in those men who perceived PEP as 'a wake up call'. This determination was motivated by the experience of taking combination therapies and reflection on a potentially HIV-positive future. However, there were also tensions and ambivalences in the narratives. PEP was promoted as an adjunct to safe sex, not as an alternative. This is how PEP was understood by the men in this study.
Adolescent↗