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Biomedical subjects

Anthony M A Smith

Publications and source records attributed to Anthony M A Smith.

At least 19 recordsLinked to original sources
PubMed2007

Associations between religiosity and sexuality in a representative sample of Australian adults.

Many studies have examined the influence on sexual attitudes and behavior of religious belief (i.e., religious denomination) or religiosity (e.g., attendance at services, subjective importance of religion). However, few studies have examined the combined effects of religion and religiosity on sexual attitudes and behavior. This study examined such effects in a representative sample of 19,307 Australians aged 16-59 years (response rate, 73.1%). The study compared members of four religious groups (Protestant, Catholic, Buddhist, Muslim) and two levels of frequency of attendance at religious service (less than monthly, at least monthly). Religious participants were compared to their non-religious peers in analyses adjusted for potential confounding by demographic variables. The outcomes were five sexual behaviors and five corresponding measures of sexual attitudes. The study revealed inconsistent patterns of association between religion/religiosity and a range of sexual behaviors and attitudes. In general, greater attendance at religious services was associated with more conservative patterns of behavior and attitudes. However, religious people who attended services infrequently were more similar to their non-religious peers than their more religious peers. The results of this study highlight the importance of considering not only religion or religiosity, but the intersection between these two variables.

Adolescent↗
PubMed2007

The impact of sexual coercion on psychological, physical, and sexual well-being in a representative sample of Australian women.

It is well established that, compared to other women, women who have been forced or frightened into unwanted sexual activity have poorer psychological, physical, and sexual health. However, it is not clear whether particular experiences of sexual coercion, such as younger age when coerced or number of times coerced, are more likely to lead to poorer health status. This study of a representative sample of Australian women aged 16-59 years was designed to examine such associations. Of the 9134 women recruited for the study, 885 (21%) had been sexually coerced, which was defined as being forced or frightened into unwanted sexual activity. This study showed that any experience of sexual coercion was associated with poorer psychological, physical, and sexual health. The data revealed no consistent associations between health status and particular characteristics of sexual coercion, such as the age when women were coerced, the number of times they had been coerced, or the time since being coerced. Two of the few significant findings were that women who had been coerced more than once reported significantly greater psychosocial distress, and that women first coerced when aged 13-16 reported poorer physical well-being than women first coerced at younger or older ages. There was no significant association between whether women had consulted a psychologist or other professional counselor and better health status. The absence of consistent associations between health status and particular characteristics of sexual coercion indicates a need for care and support services for all women who have been sexually coerced.

Adolescent↗
PubMed2006

Men who have sex with men (MSM): how much to assume and what to ask?

In Australia, about 150,000 men aged 16-59 years identify as gay or bisexual, while a similar number identify as heterosexual but have some history of same-sex sexual contact. Pitts, Couch and Smith advise that the clinical implications for these men include more than sexual health concerns. They suggest several consultation skills that can help doctors to recognise these men and better meet their needs.

Australia↗
PubMed2006

Two steps forward and one step back? Australian secondary students' sexual health knowledge and behaviors 1992-2002.

PURPOSE: To report on changes in the sexual health knowledge and sexual and risk behaviors of year 10 and 12 Australian school students between 1992 and 2002. METHODS: Surveys were administered at five yearly intervals to a total of 6781 students in 263 government secondary schools in all Australian states and territories. RESULTS: Analysis of data from the three survey administrations shows high levels of knowledge concerning human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), but a small but consistent decline since 1992. Knowledge about sexually transmitted infections and hepatitis remains poor. In 2002, there was an increase in the number of students reporting ever having had sexual intercourse, and this was most pronounced for year 10 students. The number of young men in year 10 who reported having three or more partners had doubled since 1997 to 33%. More year 10 young women also reported having intercourse with three or more partners. Consistency of condom use has improved over time; however, 39% still report condom use only sometimes. CONCLUSION: School-based sexual health education provides a critical basis for ensuring that young people begin to experience sex safely and with an appropriate knowledge base.

Adolescent↗
PubMed2006

Pregnancy and contraceptive use in a national representative sample of Australian secondary school students.

OBJECTIVE: To determine rate of pregnancy and use of contraception in a nationally representative sample of school students. METHODS: Year 10 and 12 students from a representative random sample of schools throughout Australia completed a survey concerning health and sexual behaviour. RESULTS: Thirty-five per cent of students had experienced sexual intercourse. Of these, 6.1% (males 4.1%, females 7.8%) reported they had experienced sex that resulted in pregnancy, and a further 7.5% were unsure. Most sexually active students reported using a condom (65%), and a further 36.8% reported using the pill for contraception the last time they had sex. Relatively few students (17.2%) used a dual contraceptive (female method and condom). CONCLUSIONS: Rates of reported pregnancy among Year 10 and 12 students are relatively high. Although the majority of students used some form of contraception when they had sex, a significant minority practised unprotected and unsafe sex. IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: Sex education concerning pregnancy and sexually transmitted infection risks must be delivered early enough to influence first and early sexual activity.

Adolescent↗
PubMed2006

Travel undertaken by women accessing private Victorian pregnancy termination services.

OBJECTIVE: To investigate the extent and cost of travel undertaken by women accessing Victorian termination of pregnancy services. DESIGN, SETTING AND PARTICIPANTS: This was a multi-centre, cross-sectional observational study of women receiving privately funded pregnancy termination services, conducted between November 2002 and June 2003 at eight major pregnancy termination service providers in Victoria. MAIN OUTCOME MEASURES: Distance travelled, money and time expended undertaking travel, and reasons women chose particular clinics. RESULTS: Of the 1,244 Australian resident respondents who resided in Victoria, 9.3% travelled more than 100 km to access services. Teenagers were 2.5 times more likely than other respondents to travel further than 100 kilometres (km) (18.2% compared with 7.8%, OR = 2.5, 95% CI 1.5-4.2, p < 0.001). Women originated from all Australian States and Territories except South Australia and 13.7% were from Statistical Divisions other than Melbourne. More than one-third of respondents (41.3%) chose their clinic because they were referred by a doctor or general practitioner. CONCLUSION: Many pregnancy termination patients face substantial and immediate costs beyond the service fee, as well as the difficulties associated with poor continuity of care and significant time away from home. Patients and service providers should be consulted further to determine appropriate clinical services, support services and subsidy schemes for the sizeable proportion of patients who undertake long-distance travel to access pregnancy termination services.

Abortion Applicants↗
PubMed2006

Sociodemographic correlates of selected health risk behaviors in a representative sample of Australian young people.

To facilitate the development of interventions to reduce health risk behavior among young people, we designed this study to compare risk behavior among young people and older people, to compare risk behavior profiles between young men and women, and to identify sociodemographic correlates of risk behavior among young people. Computer-assisted telephone interviews with a representative sample of 19,307 Australian men and women (response rate 73.1%) assessed alcohol consumption, cigarette smoking, injection drug use, and unprotected intercourse. Respondents aged 16 to 24 reported less healthy behavior than older people. Although men and women aged 16 to 24 had similar profiles of health risk behavior, correlates of these behaviors differed for men and women. There were few consistent sociodemographic correlates of different risk behaviors. The results suggest that young women are now as important a priority as young men for interventions. Young people remain an important target group for health promotion, with nonheterosexual young people a particular high-risk group.

Adolescent↗
PubMed2006

Interpersonal and social network influences on gay men's communication about unprotected sex.

This study documents gay men's communication patterns about unprotected sex. Gay men (n = 206) completed a structured interview about their social networks. The 167 men who had had unprotected sex identified 1390 social relations; 32.6% had involved discussing an episode of unprotected sex. Discussions about unprotected sex were associated with the nature of the relationship, whether the other party was gay or lesbian, how often the parties spent time together, whether the relationship had been sexual, and the density of the other parties' social network. Social networks provide an important context for the maintenance of safe sex cultures.

Adult↗
PubMed2006

Circumcision in Australia: prevalence and effects on sexual health.

The results from a telephone survey in 2001-02 of a probability sample of Australian households including 10,173 men aged 16-59 (response rate 69.4%) are used to assess the prevalence of circumcision across social groups in Australia and examine lifetime history of sexually transmissible infection (STI), sexual difficulties in the last year, sexual practices including masturbation, and sexual attitudes. More than half (59%) of the men were circumcised. Circumcision was less common among younger men (32% aged <20) and more common among the Australian born (69%). After correction for age, circumcision was unrelated to reporting STI, but appeared to protect against penile candidiasis. Circumcision was unrelated to most sexual difficulties, but circumcised men were less likely to report physical pain during intercourse or trouble keeping an erection; reasons for this are unknown. There were no significant differences in practices at last sexual encounter with a female partner or in masturbation alone. Circumcised men had somewhat more liberal sexual attitudes. Neonatal circumcision was routine in Australia until the 1970s. It appears not to be associated with significant protective or harmful sexual health outcomes. This study provides no evidence about the effects on sexual sensitivity.

Adolescent↗
PubMed2005

Random digit dialing and directory-based samples in telephone surveys of HIV risk: a comparison from the Australian Study of Health and Relationships.

PURPOSE: To compare the estimates of HIV-related risk derived from a sample drawn through random digit dialing and that component of the sample drawn from households listed in a telephone directory. METHODS: The prevalence of key outcomes, and their 95% confidence intervals, was estimated for the total sample and for that component of the sample drawn from households listed in a telephone directory. RESULTS: On all outcome measures the sample derived from listed households was more conservative. With few exceptions, the estimates derived from the overall sample and from listed households were not significantly different. CONCLUSION: A continued reliance on random digit dialing seems unwarranted.

Adolescent↗
PubMed2005

In from the outer generational differences in coming out and gay identity formation.

This paper explores generational differences among gay men in their experience of, and narratives relating the process of, coming out. The interview data for 32 gay men living in Melbourne, Australia, is drawn from the Community, Attachment, Structures and the epidemic (CASE) Study. Narratives of coming out for three generational groups: pre-AIDS, peri-AIDS, and post-AIDS, are examined in terms of the experiences of disclosure to family and friends. A shift from narratives organised around crisis and disjunction to those organised around consolidation is matched by differences in the degree to which peer networks are maintained post-coming out.

Adult↗
PubMed2004

Who pays for sex and why? An analysis of social and motivational factors associated with male clients of sex workers.

A total of 1,225 men and women attending a commercial event in the state of Victoria, Australia were surveyed as to whether they had ever paid for sex. Of 612 men surveyed, 143 (23.4%) had paid for sex at least once. Men who had ever paid for sex were compared with male nonclients on 13 demographic and sexual history measures; only four significantly differentiated clients from nonclients. Clients were significantly older, less likely to have been educated beyond high school, less likely to report having a regular partner in the past 6 months, and more likely to report that their most recent sexual encounter was with a casual partner. Clients of sex workers reported the major reason for paying for sex was to satisfy their sexual needs (43.8%), followed by the belief that paying for sex was less trouble (36.4%), and that it would be entertaining (35.5%). A factor analysis of reasons for visiting sex workers identified three factors labelled Ease, Engagement, and Arousal. Together, these factors accounted for 55% of the variance associated with the factor solution of motivations for paying for sex. In a setting where commercial sex is legally available from brothels, it would appear that clients are unremarkable in their social characteristics and are motivated mainly by the ease of the commercial sex encounter, the need for engagement with another, and because they feel in need of sexual "relief."

Adult↗
PubMed2004

Intention to claim a Medicare rebate among women receiving private Victorian pregnancy termination services.

OBJECTIVES: To determine the proportion of women who have pregnancy terminations as private patients in Victoria who do not intend to claim a procedure fee rebate from Medicare, to compare characteristics of women who intend to submit a Medicare claim with those who do not and to compare the findings to the results from a similar study conducted in NSW in 1992. DESIGN, SETTING AND PARTICIPANTS: This was a cross-sectional observational study over a 12-week period. Women having a pregnancy termination service in eight large Victorian private clinics were invited to complete a brief written questionnaire. OUTCOME MEASURE: The proportion of women who did not have a Medicare card or who had a Medicare card but did not intend to use it to claim from Medicare. RESULTS: Of the 1,329 women who responded, 13.1% either did not have a Medicare card or did not intend to use their card to claim a Medicare rebate. A further 20.7% of respondents were not sure about whether they would submit a claim. Women who intended to claim a Medicare rebate were different from women who did not according to age, language spoken at home, residency, citizenship and distance travelled to the service. These results are very similar to the findings from the 1992 NSW study. CONCLUSION: Between 13.1% and 33.8% of private Victorian pregnancy terminations were estimated to not be recorded at the Health Insurance Commission. Health Insurance Commission records of Medicare rebate claims for pregnancy terminations are an incomplete and somewhat biased record of the services that are provided and are likely to have been so for some time.

Abortion, Induced↗
PubMed2003

Sex in Australia: a guide for readers.

The Australian Study of Health and Relationships (ASHR), a survey of 19,307 people aged 16-59 years which had a broad focus across many aspects of sexual and reproductive health. Our primary goal in presenting these data is to describe the overall prevalence of key outcomes and the ways in which they are patterned with respect to a range of sociodemographic factors. The socio-demographic factors used include age, gender, language spoken at home, highest level of education completed, region of residence, household income and occupational category. Where appropriate we also include stated sexual identity. Our choice of these factors reflects the fact that they are major elements in the structure of the Australian population and Australian society. For the purpose of reporting the initial results, we have grouped these outcomes into 18 papers. They are bracketed by an introductory methods paper which provides a detailed account of the design and execution of the study, and a concluding paper reflecting on the key themes emerging from the findings, the strengths and limitations of our approach and recommendations for future research.

Adolescent↗
PubMed2003

Sex in Australia: the rationale and methods of the Australian Study of Health and Relationships.

OBJECTIVE: To describe the methods and process of the Australian Study of Health and Relationships. METHODS: A computer-assisted telephone interview was developed and applied to a stratified sample of the Australian population. After initially weighting to reflect the study design, the sample was further weighted to reflect the location, age and sex distribution of the 2001 Census. RESULTS: Interviews were completed with 10,173 men and 9,134 women aged 16-59 years from all states and Territories. The overall response rate was 73.1% (69.4% among men and 77.6% among women). After accounting for the survey design and weighting to the 2001 Census, the sample appears broadly representative of the Australian population. CONCLUSION: The combination of methods and design in the Australian Study of Health and Relationships, coupled with the high response rate, strongly suggests that the results of the study are robust and broadly representative of the Australian population.

Adolescent↗
PubMed2003

Sex in Australia: attitudes towards sex in a representative sample of adults.

OBJECTIVE: To describe social attitudes towards sex of Australian adults and correlates of a scale of sexual liberalism. METHODS: Computer-assisted telephone interviews were completed by a representative sample of 10,173 men and 9,134 women aged 16-59 years. The overall response rate was 73.1% (69.4% men, 77.6% women). Respondents were asked about their agreement with nine attitude statements. Factor analysis and examination of internal consistency resulted in a six-item scale of liberalism. Correlates of attitude statements and the liberalism scale were examined. RESULTS: Most people agreed that premarital sex was acceptable, that oral sex was considered 'sex', that sex was important for a sense of well-being and that extramarital sex was unacceptable. Men were more likely (36.9%) to disapprove of sex between two men than women were to disapprove of sex between two women (25.1%). Higher levels of education were associated with increased liberalism for men and women, as was speaking English at home, identifying as homosexual or bisexual, vaginal intercourse before age 16, having had more than one sexual partner in the year before interview, having had heterosexual anal intercourse, having no religion or faith, smoking tobacco, and drinking more alcohol. CONCLUSION: Sexual attitudes of Australians largely support a heterosexual paradigm with no sex outside the relationship. High levels of approval of premarital sex are consistent with decreasing age of first intercourse in Australia. Higher levels of liberalism were associated with greater sexual adventurism and health risk taking.

Adolescent↗
PubMed2003

Sex in Australia: selected characteristics of regular sexual relationships.

OBJECTIVE: To describe selected characteristics of Australian adults' regular or ongoing sexual relationships. METHOD: Computer-assisted telephone interviews were completed by a representative sample of 10,173 men and 9,134 women aged 16-59 years. The overall response rate was 73.1% (69.4% men, 77.6% women). Respondents indicated how often they had sex in the past four weeks, contraceptive use, their own and their partners' expectations about having sex with other people during their relationship, whether they had discussed these expectations with their partners and whether they had an explicit agreement about sex with other people. RESULTS: 85.3% of men and 89.5% of women were in a regular heterosexual relationship, among whom 81.4% of men and 89.3% of women reported contraceptive use. Men and women who had a regular partner for the past 12 months had had sex with their partners an average of 1.84 times per week in the four weeks before interview; younger people had sex more often. Most respondents expected themselves and their partners to not have sex with other people, although men were less likely than women to have discussed these expectations with their partner. Bisexually identified men and women were significantly less likely than heterosexually identified men and women to support having sex only with their regular partner. Only 4.9% of men and 2.9% of women in regular heterosexual relationships had concurrent sexual partners in the past 12 months. CONCLUSION: Australians' attitudes to not having sex with people while in a regular relationship are highly consistent with their behaviour.

Adolescent↗