Malin Lindroth

Unequal sexual health – Differences between detained youth and their same aged peers

Purpose: To describe sexual health risks in an understudied group, youth in detention, and compare these to sexual health risks among non-detained youth. In addition, variables predicting adverse sexual health outcomes are sought and compared. Methods: In 2009, a self-administered questionnaire on sexuality was conducted amongst youth in Sweden. In 2010, the same Internet-based questionnaire was applied in a study at Swedish detention centres. In this article, sexually active youth aged 15–20 years in the two groups are compared and bivariate logistic regression analyses are conducted in order to find predictors of adverse sexual health outcomes, among detainees and non-detainees respectively. Results: Major differences between the detained and the non-detained concerning a majority of risk-taking variables exist. Conclusions: Although detained youth display several risky sexual behaviors, no specific risk factors are found in a logistic regression analysis. However, this is a vulnerable group. The mere fact that an adolescent is placed at a detention centre should be an imperative for professionals to address the subject of sexual health and safer sex. Furthermore, the results will be used in a forthcoming sex education curriculum tailored especially at detained youth. This is one, but by far not the only way to minimize the health inequalities that are presented in this study.

Sex education and young people in group homes: balancing risks, rights and resilience in sexual health promotion

This paper presents findings from focus group interviews conducted in Swedish government group homes for young people with a history of psychosocial problems, substance misuse and criminal behaviour. Participants were asked to reflect on a newly developed sex education curriculum located within a harm-reduction paradigm prior to its implementation. In addition to appreciating the proposed 10 sessions, young people positively evaluated the proposed dialogical and norm critical teaching style as likely to facilitate productive discussion about sexuality. Findings will contribute to future implementation of the sex education curriculum across a range of institutional settings. Results also highlight the democratic aspects of involving vulnerable young people in matters that directly concern them, and underline the importance of properly contextualised forms of sex education.

Sexual chance taking: a qualitative study on sexuality among detained youths.

Abstract Background Many, although not all, juvenile detainees are known to be sexual risk-takers but little attention has been paid to why they engage in early sexual intercourse, have more partners, often have sex under the influence of drugs or alcohol, and without protection. Objective To understand the rationale behind sexual risk-taking among detained adolescents. Method Qualitative study of interviews with nine girls and 11 boys, aged 15 to 20 years, at detention centres in southern Sweden. Results Two major categories surface in the analysis of the interviews: contradictions and vulnerability. A core category, chance outdoes risk that describes the adolescents’ pragmatic view on sexual risk-taking as being a chance of something good rather than a risk of something bad, captures the connection between these categories and the individual. Conclusion Among our interviewees, sexual chance taking appears rewarding. Recognising this rationality is valuable for all professionals promoting sexual health within similar groups of youths.

Sexual health among transgender people in Sweden

ABSTRACT Introduction: Transgender people´s general health and sexual function has previously been studied. However, holistic sexual health—physical, emotional, and relational well-being in relation to sexuality—as both a determinant for and a part of general health is an understudied field in research concerning health among transgender people. There is no research addressing holistic sexual health and sexual health determinants combining quantitative and qualitative data. Aim: To explore and describe holistic sexual health and sexual health determinants among transgender people in Sweden. Methods: For the purpose of this paper, descriptive statistics from a previous web-based survey with 796 respondents and quotes from a previous qualitative interview study with 20 transgender people were combined. Results: Physical, emotional, and relational well-being are all vital aspects for experiencing holistic sexual health; that is, they are all important sexual health determinants, although of different importance to different individuals at different times. Satisfaction with sex life, having an ongoing sexual relationship and having been exposed to disrespectful or discriminatory care are examples of physical, emotional, and relational sexual health determinants that are connected to factors such as condom use, access to respectful STI/HIV-testing and having received reimbursement for sex. Experiences of disrespect and discrimination were reported in both the qualitative and the quantitative data, and in the qualitative data a wish for equity in access to sexual health care is evident. Conclusion: The results provide a broad and extensive insight into transgender people´s sexual health in Sweden. Furthermore it underlines that access to nondiscriminatory health care services is vital, including access to gender-confirming care and different sexual-health-promoting and preventive services such as testing facilities.

Sexual and reproductive health and rights (SRHR) education with homeless people in Sweden

Abstract This paper describes the implementation of an educational intervention to enhance sexual health among homeless people by including sexual and reproductive health and rights (SRHR) as a part of social work provision with this group. Adult service users in different forms of temporary accommodation were provided with the opportunity to participate in three group sessions. Seventeen sessions, six with women and eleven with men, took place at six different housing facilities in Gothenburg. The intervention implementation process (which involved preparation, creation, realisation and evaluation) is described, and factors of importance are identified. Service users appreciated the opportunity to receive information and discuss sexual health, rights and norms. The success of the work may be related to the fact that the project was anchored both in social services and among service users, constantly adjusted, and delivered using a respectful approach. Social work organisations and professionals have an important role to play in acknowledging and promoting service users’ sexual health and rights, especially among disadvantaged and socially excluded groups including homeless people.

Sexual health interventions for young people in state care: a systematic review:

Objectives: To describe evaluated sexual health interventions for young people in state care and provide an assessment of the quality of and evidence for these interventions. Methods: A systematic review of sexual health interventions for young people in state care was conducted. Randomised controlled trials and quasi-experimental designs were eligible, 2051 records were screened, 412 full-text studies retrieved, and 12 publications with low-to-moderate risk of bias included. Results: Due to substantial heterogeneity in study populations, settings, intervention approaches, outcomes and measures, standard summary measures for intervention outcomes was not used. Instead, data were synthesised across studies and presented narratively. Conclusion: Without making recommendations, the result suggests that group-based educational interventions in general increase knowledge, attitudes and behaviour compared with standard care. However, these findings need to be further investigated, with a special emphasis on cultural context and the involvement of young people.