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↗
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↗
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↗
Measurement of safe sex behavior in adolescents and young adults.
The aim of this project was to develop an instrument to measure use of safe sex practices among adolescents and to conduct initial evaluation of the psychometric properties of the instrument. The Safe Sex Behavior Questionnaire (SSBQ) was designed to measure the frequency of use of safe sex practices and was assessed for content validity, reliability, and construct validity through a series of tests. The content validity index computed for the SSBQ was 98%. Initial reliability computed for sums of items of the total scale was .82 among 89 college freshmen. Using a second sample of 531 subjects, the SSBQ was factor-analyzed separately for males and females and five similar factors emerged for each gender. Reliability coefficients for sums of salient items for each factor ranged from .52 to .85. Using a third sample of 174 subjects, construct validity was assessed by correlating the SSBQ with measures of general assertiveness and general risk-taking. The resulting correlations were appreciable and in the predicted directions, thus providing support for the construct validity of the instrument.
Acquired Immunodeficiency Syndrome↗
Sustaining safe sex: a longitudinal study of a sample of homosexual men.
OBJECTIVE: TO assess the maintenance of safe sexual practice. (We use the term 'safe' sex throughout the paper, since 'safe' is the term adopted by the Australian National Committee on AIDS). DESIGN: Maintenance was assessed by comparing sexual behaviour with both regular and casual partners reported in a 1986/1987 survey (time 1) with behaviour reported in a second survey in 1991 (time 2). METHOD: The 145 homosexually active participants were a non-clinical sample recruited in 1986/1987 by advertisement and followed-up in 1991. A structured questionnaire was administered at both times. Items included questions about the nature of the men's sexual relationships and their sexual practices. RESULTS: Our findings indicate that the majority of men had sustained safe sex practices. HIV prevention strategies adopted included condom use, avoidance of anal intercourse and negotiated safety (i.e., the negotiated practice of unprotected anal intercourse within regular partnerships of concordant serostatus). CONCLUSIONS: Negotiated safety is not the same as relapse.
AIDS Serodiagnosis↗
Understanding safe sex: gender narratives of HIV and pregnancy prevention by rural South African school-going youth.
In South Africa's HIV/AIDS epidemic, young people, especially women, are at high risk due to an apparent gap between awareness and practice. In repeated peer group discussions with girls aged 14-15 and boys aged 16-19, we explored influences on safe sex behaviour. Separate male and female safe sex paradigms emerged, with boys less likely to perceive themselves as 'at risk' and more likely to use condoms. Girls had not used condoms, would have preferred to delay sexual relationships and feared pregnancy as well as HIV/AIDS. Both sexes deemed it difficult for girls to initiate condom use, although both sexes viewed condoms favourably. Girls saw condoms as a sign of love and protection, whereas boys tended to use them with casual partners. A lack of decision-making autonomy within relationships further constrained girls' ability to practice safer sex. Involvement of peer participants in review of their own narrative data helped to ensure representation of participants' voices in the findings. Overall, these findings point to the need for programmes to address gender inequalities and emphasise behavioural skills in the years before sexual activity begins.
Adolescent↗