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Sexual abstinence and the Sexual Abstinence Behavior Scale.

INTRODUCTION: Nurses may choose to promote sexual abstinence, particularly when they are working with young adolescents. However, it is difficult to know how to intervene because sexual abstinence has not been well defined in the literature. The purpose of this study was to evaluate the psychometrics of a four-item measure of sexual abstinence behavior (the SABS) that both registered nurses and advanced practice nurses may find useful in their practice. METHOD: African American, middle school students (n = 113) completed a self-administered questionnaire during their health education class. The questionnaire contained the SABS along with items assessing demographics, sexual behavior, and psychosocial variables related to sexual behavior. RESULTS: Psychometric analysis supported SABS reliability (alpha =.73) and validity. For example, SABS scores correlated with perceived negative consequences of teen sex (r = 0.38) and sexual abstinence self-efficacy (r = 0.48). DISCUSSION: Although the SABS is still in a preliminary stage of development, it is useful for assessment purposes and for directing registered nurses and advanced practice nurses toward specific behaviors they may want to promote when teaching sexual abstinence to their young adolescent patients.

Adolescent↗

Promotion of sexual abstinence: reducing adolescent sexual activity and pregnancies.

The prevention of unplanned pregnancies has become a national public health priority. To assure that every newborn child in America is planned and wanted, three strategies are to be implemented: expansion of school-based sex education, expansion of free condom distribution, and expansion of the role of school-based health clinics. Studies show that these strategies may not prevent unplanned pregnancies; furthermore, their implementation may be associated with public health risks. Sexual abstinence is not associated with public health risks and needs to be presented and promoted as the most effective primary prevention for unplanned pregnancies.

Adolescent↗

A relative risk-based, disease-specific definition of sexual abstinence failure rates.

Sexual abstinence programs have the potential to reduce the incidence of unplanned pregnancies and sexually transmitted diseases (STDs) among adolescents. Effectiveness measures are needed to help researchers assess the impact of sexual abstinence promotion programs on STD and pregnancy rates and to enable comparisons of abstinence effectiveness with other contraception and STD prevention methods. Abstinence "failure rates" have been proposed as one measure of program effectiveness. However, the concept of abstinence failure rates has not been adequately operationalized. The present study examines a novel mathematical framework for estimating abstinence failure rates, both theoretically and empirically. Examples are provided, and the advantages and disadvantages associated with the mathematical model-based approach are discussed.

Adolescent↗

Decreasing postpartum sexual abstinence time.

Postpartum sexual abstinence time can be safely shortened for most patients when episiotomy repair is done meticulously with fine PGA suture on small needles. The time preferred by patients for resumption of intercourse seems to be between the second and third postpartum week. We have seen no ill effects from this, and we feel that sexual intercourse at these early dates does not influence the healing of the episiotomy in any way.

Episiotomy↗

Sexually abstinent African American adolescent females' descriptions of abstinence.

PURPOSE: To describe sexual abstinence from the perspective of abstinent African American female adolescents. DESIGN: Descriptive qualitative. METHODS: Data were collected from 14 sexually abstinent, African American adolescent girls during two semi-structured interviews. Data were collected using the life history method and were analyzed in the style of narrative analysis. FINDINGS: This analysis indicated four themes in descriptions of abstinence: limited information, categorization of sexual behaviors, activities that lead to intercourse, and abstinence as a self-determined choice. For most participants, "having sex" referred to heterosexual vaginal intercourse and being abstinent meant that one chose to refrain from intercourse. CONCLUSIONS: The participants' limited definition of abstinence might lead them to unknowingly put themselves at risk by engaging in other forms of genital sexual activities. They may think that they are protected because they believe that they are practicing abstinence.

Adolescent↗

Correlates of sexual abstinence among adolescent virgins dating steady boyfriends in Taiwan.

PURPOSES: (a) To examine the relations among processes of change, decisional balance, self-efficacy, perceptions of personal power, and relationship power to stage of change (SOC) for sexual abstinence behavior, and (b) to identify the important explanatory factors of SOC for sexual abstinence among adolescent virgins who were dating steady boyfriends. DESIGN: A cross-sectional survey. Female adolescents (N=500) who were dating steady boyfriends and had not had sexual experience in the past were selected. METHODS: An anonymous, self-administered questionnaire was used with parts concerning: age, processes of change for sexual abstinence, decisional balance for sexual abstinence, self-efficacy for sexual abstinence, perceptions of personal power, perceptions of relationship power, and SOC for sexual abstinence. FINDINGS: Processes of change, decisional balance, self-efficacy, perceptions of personal power, and relationship power differed across the SOC for sexual abstinence. Stepwise logistic regression showed higher self-efficacy for sexual abstinence, higher decisional balance for sexual abstinence, and lower age increased the probability of being in the definite group (preparation and action stage). In the final regression model 77.3 % of the participants were correctly classified. CONCLUSIONS: This information about SOC for sexual abstinence can be used by health professionals for intervention strategies for adolescent girls who were dating steady boyfriends.

Adolescent↗

Perceptions of sexual abstinence among high-risk early and middle adolescents.

PURPOSE: Sexual abstinence has become the primary response to adolescent pregnancy and sexually transmitted infection (STI) prevention. However, most abstinence programs are based on adult ideas of abstinence, and little is known about how adolescents themselves conceptualize sexual abstinence. METHODS: In this qualitative study, we conducted semi-structured exploratory interviews with 42 adolescents aged 11-17 years recruited from primary care clinics. RESULTS: We observed marked confusion over the term "abstinence." However, the concept of abstinence, or choosing not to have sex, was clear and relevant. Participants viewed sexual abstinence as part of a normal developmental continuum. All adolescents were abstinent for a period of time, and then transitioned to sexual activity when they were ready. Readiness was determined by (1) individual factors, such as age, life events, physical maturity and social maturity, (2) relationship factors such as being with the "right" person, or having a committed relationship, (3) moral and religious beliefs, and (4) the balance of health, social, and family risks and benefits. Sex was considered something powerful, and the transition to first sex a rite of passage in which adolescents took on what they perceived to be adult roles. We observed differences by age, gender, and sexual experience in how adolescents determined readiness. CONCLUSIONS: Adolescents conceptualize sexual abstinence differently than adults, with differences by age, gender and sexual experience. Rather than a simple behavioral decision, our participants viewed abstinence as a broader part of normal development and viewed the transition to sex as an important rite of passage to adulthood.

Adolescent↗

Relationship between the duration of sexual abstinence and semen quality: analysis of 9,489 semen samples.

OBJECTIVE: To evaluate the relationship between duration of sexual abstinence and various characteristics of normal and subnormal semen. DESIGN: A retrospective study based on computerized data. SETTING: Fertility and IVF unit at a university medical center. PATIENT(S): Nine thousand, four hundred eighty-nine semen samples from 6,008 patients were analyzed according to the World Health Organization (WHO) manual and grouped according to sperm concentration (10(6)/mL) into severe (0.2-4 x 10(6)), moderate (>4-10 x 10(6)), and mild (>10-19.99 x 10(6)) oligozoospermia, and normozoospermia (> or =20-250 x 10(6)) groups. MAIN OUTCOME MEASURE(S): In each group mean values of semen volume, sperm concentration, percentage of motile sperm and of normal morphology (according to WHO or Kruger criteria), total sperm count, and total motile sperm count per ejaculate were related to duration of abstinence. RESULT(S): Among the 3,506 oligozoospermic samples, the peak mean sperm motility of 30.3% was observed after 1 day of abstinence. Similarly, the mean percentage of normal morphology among mild-moderate oligozoospermic samples (n = 2,260) reached peak values of 7.4%-8.6% between 0-2 days of abstinence. The 5,983 normozoospermic samples showed a significant decrease in the percentage of sperm motility and normal morphology to mean values of 33.1% and 7.0%, respectively, on days 11-14 of sexual abstinence. CONCLUSION(S): Our data challenge the role of abstinence in male infertility treatments and suggest that to present the best possible semen samples, patients with male factor infertility should collect the semen after just 1 day of sexual abstinence. Patients presenting normal sperm analysis or sperm donors for cryopreservation purposes should be advised not to exceed 10 days of sexual abstinence.

Adult↗

Endocrine response to masturbation-induced orgasm in healthy men following a 3-week sexual abstinence.

This current study examined the effect of a 3-week period of sexual abstinence on the neuroendocrine response to masturbation-induced orgasm. Hormonal and cardiovascular parameters were examined in ten healthy adult men during sexual arousal and masturbation-induced orgasm. Blood was drawn continuously and cardiovascular parameters were constantly monitored. This procedure was conducted for each participant twice, both before and after a 3-week period of sexual abstinence. Plasma was subsequently analysed for concentrations of adrenaline, noradrenaline, cortisol, prolactin, luteinizing hormone and testosterone concentrations. Orgasm increased blood pressure, heart rate, plasma catecholamines and prolactin. These effects were observed both before and after sexual abstinence. In contrast, although plasma testosterone was unaltered by orgasm, higher testosterone concentrations were observed following the period of abstinence. These data demonstrate that acute abstinence does not change the neuroendocrine response to orgasm but does produce elevated levels of testosterone in males.

Adult↗

[Is sexual abstinence a factor in the etiology of chromosome abnormalities?].

Some epidemiological and experimental data in mouse have suggested that there could exist a relationship between sexual abstinence duration and occurrence of chromosomal disorders. In order to determine whether sexual abstinence exerts an effect on the incidence of chromosomal abnormalities in Human, sperm chromosome complements of 4 men were analyzed after fusion with golden hamster eggs. The period of abstinence ranged from 2 days to 15 days. Seven hundred and seventy five karyotypes were obtained. The overall frequency of abnormalities was 9.4% that is not different from controls. There was no correlation between the length of the sexual abstinence and each type of chromosomal abnormality but an indirect effect of paternal aging cannot be excluded.

Adult↗

Postpartum sexual abstinence in the era of AIDS in Ghana: prospects for change.

Postpartum sexual abstinence for females has been identified as one of the socio-cultural factors with the potential for creating conditions for the sexual spread of HIV in areas where it is practised. In general, women are expected to abstain from sex after childbirth in order to ensure the survival of the mother and child. Men are not similarly expected to abstain and that has been used to rationalize polygyny. With changes in socio-economic conditions making it more difficult now than before to maintain two or more wives, particularly in urban areas, some men will abstain like their wives for fear of HIV infection; but such men may press their wives to resume sex early. Some women, on the other hand, may give in to the demands of their husbands by reducing the prescribed duration of postpartum abstinence. If this happens without the use of effective modern contraception, fertility may be affected. Some may also enter short or long-term relationship outside marriage, hoping that they will be safe from sexually transmitted infection. Using data from the Ghana segment of the Social Dimensions of AIDS Infection Survey, the study examines the responses of women who reported postpartum sexual abstinence and that of their partners. Both men and women reported abstaining, but some women were aware that their partners did not abstain as they did. Some of the women knew the sexual partners of their partners. Mostly it was men who made the first move to resume sex. For any behavioural change to occur, attitudes towards socially-constructed practices such as postpartum sexual abstinence will need to be changed by intensive education of both men and women and also through community support.

Adolescent↗

Relationship between sexual abstinence of men and chromosomally abnormal spermatozoa.

Epidemiological and mouse cytogenetic studies have suggested the existence of a positive relationship between the frequency of chromosomal abnormalities and the duration of male sexual abstinence. A cytogenetic analysis of human spermatozoa was performed with 4 men after periods of sexual abstinence ranging from 2 to 15 days. Using hamster eggs for penetration, 934 sperm chromosome complements were obtained. The overall frequency of sperm chromosomal abnormalities was 9.4%. There was no correlation between the length of sexual abstinence and each type of chromosomal abnormality. Our results do not support the hypothesis of an increased risk of aberration with duration of abstinence.

Adult↗

Understanding sexual abstinence in African American teens.

PURPOSE: To explore the perspectives of teenage girls on how life contexts influenced sexuality and sexual abstinence. STUDY DESIGN AND METHODS: A qualitative descriptive study with a convenience sample of 14 sexually abstinent African American adolescent females who were interviewed to obtain their life histories. Narrative analysis was used to identify unique and common experiences and to develop themes. RESULTS: For these participants, being abstinent was a way to demonstrate their emerging identities as adult women. They described themselves as faithful, unique persons who defied negative stereotypes, avoided risky situations, wanted to be strong women like their mothers and grandmothers, and were selective about their friends. The primary challenge to abstinence was their degree of vulnerability to sexual harassment, romantic partner pressure, and female peer pressure. CLINICAL IMPLICATIONS: Abstinence is a complex state of being that is influenced by a variety of contexts, develops over time, and is consciously chosen. Maintaining abstinence requires effort and a variety of skills. While these young women were cognitively familiar with reasons why they should refrain from sex, nurses may still assist youth with being abstinent by providing ongoing teaching and specific dialogue on how to refrain from sex.

Adolescent↗

Semen analysis in fertile patients undergoing vasectomy: reference values and variations according to age, length of sexual abstinence, seasonality, smoking habits and caffeine intake.

CONTEXT AND OBJECTIVE: Recent studies have shown regional and population differences in semen characteristics. The objective was to establish reference values for semen analysis and to verify the effect that age, length of sexual abstinence, seasonality, smoking habits and coffee consumption have on fertile individuals' semen characteristics. DESIGN AND SETTING: Prospective study in the Urology Division, Hospital das Clínicas, Universidade de São Paulo. METHODS: Between September 1999 and August 2002, 500 fertile men requesting a vasectomy for sterilization purposes were asked to provide a semen sample before the vasectomy. We evaluated the effects of age, sexual abstinence, seasonality, smoking and coffee consumption on semen characteristics. RESULTS: Compared with World Health Organization values, 87.2% of the patients presented sperm morphology below the normal level. A significant decline in semen volume, sperm motility and sperm morphology in patients over 45 years of age was observed. In patients with 5 days or more of abstinence, there was reduced sperm motility. The lowest values for sperm concentration, motility and morphology were observed in summer and the highest in winter. No differences in semen parameters relating to smoking were detected. Patients who drank six or more cups of coffee per day presented higher sperm motility. CONCLUSIONS: Our sample had a very low percentage of normal sperm morphology. Only sperm morphology showed a high abnormality rate. Differences in semen parameters with regard to age, length of sexual abstinence, seasonality and coffee consumption were identified. No differences relating to smoking were detected.

Adult↗

The changing pattern of post-partum sexual abstinence in a Nigerian rural community.

With a structured interview schedule, this study surveyed the pattern of post-partum sexual abstinence in a Nigerian rural community where facilities for active contraception were absent. It was found that the younger generation observed significantly shorter abstinence period (P less than 0.01). Without contraception, the resultant increased period of sexual contact among couples may considerably raise the fertility of the population. The need for family planning services is therefore indicated, preferably integrated into primary health care programmes designed to reach rural communities.

Adolescent↗

Relationship between sexual abstinence duration and the acrosome index in teratozoospermic semen: analysis of 1800 semen samples.

A high acrosome index (percentage of sperm with normal acrosome morphology--cutoff value > or =10%) is known to be associated with an improved fertilization rate in conventional IVF. A retrospective evaluation of the relationship between duration of sexual abstinence and acrosome index among oligozoospermic and normozoospermic semen samples with teratozoospermia was undertaken. A significant (P = 0.001) decrease in the acrosome index was observed among the normozoospermic samples (n = 1264) between the peak value of 10.2 +/- 3.6% on day 2 and 8.5 +/- 4.0% on day 5 of abstinence, while for the oligozoospermic samples (n = 536) the peak value of 8.7 +/- 3.5% was observed on day 1 and the lowest values of 6.8 +/- 3.7% (P = 0.04) on day 5 of abstinence. The results suggest that an optimal acrosome index will be obtained following a short sexual abstinence.

Acrosome↗

Effect of sexual abstinence on the proportion of X-bearing sperm as assessed by multicolor fluorescent in situ hybridization.

OBJECTIVE: To document the relation between sexual abstinence and the proportion of X-bearing sperm in the ejaculate. DESIGN: Prospective cohort study. SETTING: Medical college. PATIENT(S): Ten normospermic men, aged 30 to 40 years, provided two semen samples: the first sample was obtained 1.0 to 1.5 days after ejaculation; the second, 7 to 10 days after ejaculation. INTERVENTION(S): Abstinence. MAIN OUTCOME MEASURE(S): Proportion of X- and Y-bearing sperm in two ejaculates. RESULT(S): Multicolor fluorescent in situ hybridization using directly labeled alpha-satellite probes specific for chromosomes 18, X and Y were used to analyze 40,273 sperm. After 1.0 to 1.5 days of abstinence, there were 47.6% +/- 1.7% (mean +/- SD) X-bearing sperm, and after 7 to 10 days of abstinence, there were 49.6% +/- 2.1% X-bearing sperm. The X:Y ratio increased marginally from 0.905 to 0.981. CONCLUSION(S): Sexual abstinence marginally increases the proportion of X-bearing sperm in the ejaculate as assessed by multicolor fluorescent in situ hybridization. This change of borderline statistical significance probably has little impact on the secondary sex ratio.

Adult↗

The determinants of the duration of postpartum sexual abstinence in West Africa: a multilevel analysis.

The question of how postpartum sexual abstinence responds to social change in West Africa is important because declines in the practice could increase fertility levels and worsen child and maternal health. This study uses data from the late 1970s in Cote d'Ivoire, Ghana, and Cameroon to examine effects of modernization and women's status on the length of abstinence. The results show that modernization and female status should be associated with declines in abstinence, which could lead to an increase in fertility and deterioration in maternal and child health.

Adolescent↗