Roger Ingham

‘We didn't cover that at school’: education against pleasure or education for pleasure?

This paper considers the common criteria by which school‐based sex and relationship programmes are evaluated, and argues that the domination of public health outcomes serves to make invisible other aspects of courses that warrant attention. In particular, the role of pleasure in sexual development and relations is normally not acknowledged. While it may be unacceptable in most cultures to suggest that teaching young people how to achieve sexual pleasure is valuable, there are increasing indications—from developing as well as developed countries—that public health outcomes may benefit from a greater acceptance of positive sexual experiences. It is suggested that greater comfort with ones own body will enable greater ability to communicate wishes to others, and to be less ‘pressured’ into unwanted sexual relationships.

Choice of surgery for early breast cancer: Psychosocial considerations

A prospective study was conducted with early breast cancer patients who had either been offered, or not been offered, a choice of surgery for treatment. The choice involved mastectomy or wide excision plus radiotherapy. Available evidence suggests that the medical outcome between these two options is similar; this study was designed to investigate selected psychosocial outcomes. It was found that whether or not patients were given a choice was of greater relevance to psychosocial outcomes that was the type of operation performed. Providing a choice led to improved reported adjustments with respect to the ability to undertake work, attitudes towards the future, beliefs about coping, and in physical and psychological functioning.

Masturbation among young women and associations with sexual health: an exploratory study.

Much research into young peoples developing sexuality is concerned with risk avoidance and the reduction of negative outcomes. Little research has been conducted into sexual self-exploration and, in particular, masturbation among young people, and this has generally been concerned merely with its prevalence. Little is known about the potential role of masturbation in relation to young peoples developing sexuality, especially among young women. This study aimed to explore, using a qualitative approach, how young women reported their experiences of masturbation and whether and how these related to other aspects of their sexual activity. Thematic analysis of interview transcripts was employed to identify the range of reported experiences across participants, as well as the relations between various aspects of sexual development and experiences within participants. The findings revealed a broad continuum of views and opinions on female masturbation, which had strong links with parent and partner communication and the young womens beliefs and values concerning their sexual selves. The article concludes by drawing attention to the apparent relation between positive early childhood communication, young womens positive views of their sexual self, and their subsequent sexual activity.

Psychosocial consequences of recurrent vertigo

Abstract Chronic vertigo is known to be associated with anxiety and depression in a significant proportion of patients, but there have been no systematic investigations into beliefs and behaviour related to recurrent vertigo. Twenty-three individuals with vertigo of various types were interviewed, generating over two thousand statements about vertigo and its psychosocial consequences. By means of progressive categorisation these were condensed into four tables of summary statements representing prevalent reactions to and effects of vertigo. Vertigo is viewed as intrinsically frightening and potentially stigmatising. In an attempt to avoid provoking attacks, particularly in public, subjects tended to impose restrictions on their activities and lifestyle which generated further feelings of helplessness and frustration. The statements obtained in this study provide an empirical basis for the development of a model that may be used to formulate predictions about the relationship between vertigo, handicap and ...

Oral Sex and Condom Use Among Young People In the United Kingdom

CONTEXT The development of UK national targets to reduce the transmission of HIV and other STDs has focused health promotion efforts on advocating the use of condoms during penetrative vaginal and anal sex. However, other behaviors that can facilitate STD transmission-such as oral sex and, in particular, fellatio-have received limited attention. METHODS Between 2003 and 2005, a sample of 1,373 full- and part-time students, primarily aged 16-18, completed questionnaires about their knowledge, attitudes and experiences related to sexual behavior and health. Chi-square tests were used to assess differences by sexual experience and gender. Supplementary data were obtained from sexual event diaries completed by 108 young people. RESULTS Fifty-six percent of survey respondents had experienced fellatio or cunnilingus, including 22% of those who had not yet engaged in penetrative intercourse. Of young people who had had vaginal intercourse, 70% had previously had oral sex. Among those who had experienced fellatio once, 17% had used a condom, but only 2% of respondents who had engaged in fellatio more than once reported consistent use. Reduced pleasure and lack of motivation, desire and forethought were reasons given for not using condoms during fellatio; hygiene, avoidance of the dilemma of whether to spit or swallow ejaculate, and taste were commonly cited as triggers for use. CONCLUSION Greater efforts are needed to publicize the risk of exposure to STDs that many young people face because of unprotected noncoital sexual activities before, as well as after, they enter into relationships involving intercourse.

Factors and processes in heterosexual competence and risk: An integrated review of the evidence

Abstract Separate bodies of literature exist on factors influencing negative or positive outcomes in terms of sexual health. These research traditions have shown that sexual conduct is complex social behaviour. Both heterosexual pleasure and risk are influenced by a multitude of factors and cannot be reduced to separate causes. In this article we combine these separate areas of research by putting together the evidence on the use of contraceptives in general. condoms in particular, and on sexual aggression. The evidence on factors influencing either positive or negative outcomes regarding these risks is reviewed. and common factors are identified. An integrated conceptual view of heterosexual risks is presented. in which interactional competence is taken to be a crucial concept. The competence of both heterosexual partners is considered to be related to factors in childhood and adolescence, the wider socio-cultural and interpersonal context, the specific meanings and functions of sexuality for the individ...

Spatial variation in teenage conceptions in south and west England

Multilevel Poisson models are used to identify factors influencing variation in census ward level teenage conception rates. Multilevel logistic models are also employed to examine the outcome of these conceptions. Demographic and socioeconomic characteristics are accounted for as well as access to family planning services. The paper emphasizes the importance of customized deprivation indices that are specific to the health outcome in urban and rural areas.

How, not just if, condoms are used: the timing of condom application and removal during vaginal sex among young people in England.

Objective: To assess the prevalence of, and factors associated with, vaginal penetration before condom application and following condom removal among young people in education in England. Method: A large cross sectional survey (n = 1373) was conducted in educational establishments in England and sexual event diaries were completed by a subsample of young people over a 6 month period. Results: Of the 375 survey respondents who reported having used a condom on the most recent occasion of vaginal sex, 6% had applied the condom after penetration and 6% had continued penetration after condom removal. Of the 74 diary respondents, 31% applied a condom late and 9% removed a condom early at least once over a 6 month period. The odds of “imperfect” condom use were found to decrease with overall consistency of condom use, confidence in correct condom use, positive reported relationship with mother, non-use of other contraception, and desire to use a condom. Conclusion: Given that late application and early removal of condoms fail to maximise their effectiveness as a method of STI prevention, it is important to address “imperfect” condom use and the factors associated with such use in public health policies and programmes. It is essential that young people understand the importance of using condoms consistently and correctly, and are also equipped with the skills and knowledge to do so.

‘Where do babies come from?’ Barriers to early sexuality communication between parents and young children

‘Where do babies come from?’ ‘Why do boys have willies?’ ‘What does gay mean?’ Probably all parents have faced such ‘innocent’ questions from young children, and many have found them challenging to answer. Access to sexuality education at an early age is frequently considered controversial; however, there are strong indications that early and open communication can impact positively in terms of sexual safety and outcomes. Using focus group discussions with parents of 3–7 year olds in the UK, this study explores some of the challenges parents report in dealing with early sexual socialisation as well as the reasons they cite for restricting young childrens sexual awareness and access to knowledge. Thematic analysis reveals a number of barriers to communication: the need to protect childhood ‘innocence’, suitable timing and age appropriateness of explanations, personal discomfort, and fear of criticism and judgement.

Who presents more than once? Repeat abortion among women in Britain

Background and methodology Around one in three sexually active women in Britain will have an abortion during their lifetime and a third of those women will experience more than one. Using data collected during the second National Survey of Sexual Attitudes and Lifestyles the characteristics of women who have presented for a second or subsequent abortion are compared to those women who have obtained only one. Results Results indicate that increased age and parity are key characteristics distinguishing between women who have experienced only one abortion and those women who have had more. Findings also reveal that those who have sought abortion on more than one occasion are more likely (than those who have had one abortion) to be Black, have left school at an earlier age, be living in rented accommodation, report an earlier age at first sexual experience, be less likely to have used a reliable method of contraception at sexual debut and report a greater number of sexual partners. Discussion and conclusions It is well recognised that attendance at abortion services presents an important opportunity for the provision of individually tailored information regarding contraception to assist women avoid the need for subsequent procedures. However, differential use of abortion services may also indicate variations in knowledge levels, attitudes to risk, attitudes towards abortion, partner communication, gender power and differential access to services. Further research is required to clarify these potential relationships so that suitable health promotion activities can be developed.