Roslyn Kane

Gender double standards in young people attending sexual health services in Northern Thailand

Concern about the sexual and reproductive health of young people has been mounting recently in Thailand. Unequal gender relations have a considerable influence on the lives of young people, especially young women, yet few studies have explored the ways in which they have impacted on provision of sexual health care. Drawing upon data from a qualitative study in Northern Thailand, this paper explores the views and experiences of young people in seeking health care, highlighting the kinds of gender double standards and power imbalances that may pose obstacles to their use of sexual and reproductive health services. Findings reveal the vulnerability of sexually active young women in seeking support and care from partners, parents, and service providers. Those who experience adverse outcomes of sexual activity, such as unwanted pregnancy or infection, report facing indifference, victim blaming, or the threat of abandonment by their partners. Because of their fear of disclosure to their parents and communities, of their sexual activity, they opt for clandestine and unsafe abortion and seek the counsel of peers and drugstores rather than parents and providers. At the service provider level, young women report facing threatening and judgemental attitudes, indifferent counselling, and possible violation of confidentiality. This is in marked contrast to the treatment of young men, who generally meet with a more sympathetic and accepting response.

Trends in Teenage Pregnancy in England and Wales: How can we Explain Them?

Teenage pregnancy is associated with adverse social and physical outcomes for both mother and child. We drew on various sources—birth and abortion statistics from the Office for National Statistics, data from the National Survey of Sexual Attitudes and Lifestyles, and routinely collected data from family planning clinics—to identify trends in England and Wales and their possible determinants. The rate of teenage sexual activity has increased steadily and consistently over the past four decades, whilst the rate of teenage fertility has shown greater variation. When the teenage fertility rate is calculated against the denominator of sexually active women, rather than the total sample of teenage women, the underlying trend in teenage fertility over the past four decades has been downwards, though not consistently so. Fluctuations in the teenage fertility rate seem to track intervention-related factors such as access to, and use of, contraceptive services and the general climate surrounding the sexual health of young people.

Integrated sexual health services: The views of medical professionals

This paper describes the findings of the in-depth semi-structured interview of medical professionals on their views on integrated sexual health services. Health professionals working in genitourinary medicine, family planning, and generic sexual health services in UK were selected to represent the views of the clinical staffs in different residential areas and levels of integration. Findings showed that many sexual health professionals had strong positive views of integrating family planning, and genitourinary medicine services. They reported that integration was seen as benefiting clients as well as the staffs in terms of increased opportunities for career development. However, there were reservations expressed concerning the issues relating to professional status, career development, and adequacy of expertise; for example, as in the two specialties of family planning and genitourinary medicine, wherein family planning tends to be preventive and community-based, while the latter is more curative and hospital-based. Negative views are important in signaling perceived obstacles to integration, which should not be construed. Rather, it would allow the move towards integrated services to be guided by and to take account of all the factors likely to influence effectiveness.

Uses of routine data sets in the evaluation of health promotion interventions: opportunities and limitations

Practitioners are under constant pressure to evaluate their work. In the current environment, health professionals frequently have limited time and financial resources, and opportunities for using existing data sets must be exploited. Routinely collected data provide a potentially useful resource for use in this context. The aim of this paper is to discuss the potential uses of routinely collected data in the evaluation of health promotion interventions. Opportunities for and limitations of routine data are discussed, drawing on examples primarily from the field of sexual health, to demonstrate principles which are also relevant in other areas of health care.

Providing information for young people in sexual health clinics: getting it right

Background The need to improve the quality and availability of information on sexual health is identified as a key element in achieving the aims set out in the National Strategy for Sexual Health and HIV. Providing information about sexual health to young people poses particular challenges because of the sensitive nature of the issues and because of the difficulties that young people may face in sourcing information and asking questions of professionals. Objective To explore the views of young people attending sexual health services on several aspects of service delivery, including provision of information. Method Twenty-five in-depth qualitative interviews were conducted with a purposive sample of young people attending a range of different outlets for sexual health care. Results This research revealed important information about the ways in which the type, format, tone and design of health promotion materials and the methods used to impart information to young people has a strong impact on client satisfaction during visits to sexual health services. Conclusions Young people vary greatly in their needs for sexual health information in terms of level, extent and manner of provision. Passive acceptance of information should not be taken to indicate tacit satisfaction with level and complexity. Written information needs to be used in conjunction with face-to-face discussion. Effective provision of sexual health information impacts notably on client satisfaction. Pitched at the right level, sexual health information has considerable potential to enhance sexual health status.

Screening for chlamydia among adolescents in the UK: a review of policy and practice

The contribution of the Expert Working Group to combating increasing incidence rates of chlamydia among young people in the UK has been important and timely. The pilot projects, which are currently being evaluated, will shed some light on the feasibility and acceptability of a national screening programme. In the current climate, with increasing prevalence of both symptomatic and asymptomatic infections and low levels of awareness amongst adolescents, detection and treatment of existing infections must be a public health priority.