国内外残疾青少年性与生殖健康研究进展

和普通青少年一样,残疾青少年也面临着各种性与生殖健康问题。残疾青少年性与生殖健康知识十分有限,性行为的发生率与普通青少年相比并无差异,在不安全的性行为特别是性侵犯方面有明显的易感性。他们面临着非意愿妊娠、性传播疾病(包括艾滋病)等不良生殖健康结局的威胁,虽然相关的数据报道较少,但已有证据证明残疾青少年在面临这些生殖健康结局时有多重的危险因素,这些不良结局给他们的身心健康带来了沉重的负担,并且残疾青少年对性与生殖健康教育及服务的需求往往得不到满足。残疾青少年性与生殖健康亟需国内外学者的关注和进一步研究。     

Concordance between sexual behavior and sexual identity in street outreach samples of four racial/ethnic groups

BACKGROUND: There is a discrepancy between self-reported sexual identity and sexual behavior. The magnitude of this discrepancy is unclear, as is its variation across race/ethnicity and gender. GOAL: The goal of the study was to assess the range of discrepancy in self-reported sexual identity and sexual behavior in men and women of four racial/ethnic groups. STUDY DESIGN: Self-reported data on sexual identity (homosexual, bisexual, heterosexual) and sexual behavior in the past 3 months were collected from 1494 African American, Hispanic, Asian, and white men and women in public congregation places in Houston, Texas. RESULTS: Data indicated that concordance rates between self-reported sexual identity and sexual behavior varied widely across racial/ethnic groups, with the highest rates of concordance in Asian males and females and the lowest in African American females and white males. The largest discordant category was in those self-described heterosexuals who reported partners of both genders. Breakdown of data to exclude those who reported sex trade work or illegal sources of income improved the concordance rates for African American and Hispanic subsamples. CONCLUSION: Data indicate the importance of designing and targeting HIV risk interventions and clinical screening, based on behavior and not reported sexual identity.     

Sexually transmitted disease in young people: the importance of health education

In most cultures sexually transmitted diseases (STD) and unwanted pregnancy are major health problems for sexually active youths aged 15-24. Since the early 1970s contraceptive use has increased in developed countries, but as few as 4-6% of young people in developing countries have access to reliable, modern contraceptives. In most countries the age-specific rates for STD are highest in the younger age groups. One of the few methods available to limit the extent of these problems, and particularly the problem of infection with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), is health education directed toward behavioral change. The content, timing, and characteristics of the source presenting the information are all important. This article reviews international data on the problems of STD and AIDS in young people and the experience of various countries in preventive efforts through health education.     

Where young people with multiple sexual partners seek medical care: implications for screening for chlamydial infection

OBJECTIVE: To investigate among young people the relation between the number of sexual partners and use of medical services in order to guide planning of sexually transmitted disease screening. DESIGN: Cross sectional study within a birth cohort using a questionnaire presented by computer. SETTING: Dunedin, New Zealand in 1993-4. SUBJECTS: 477 men and 458 women aged 21 enrolled in the Dunedin Multidisciplinary Health and Development Study, comprising 91.7% of survivors of the cohort. RESULTS: Men with multiple sexual partners in the previous year were less likely to have a general practitioner than men with one or no partners (76.2% v 88.5%, p < 0.01). Among the women the respective proportions (83.1% and 88.4%) were not significantly different. Significantly more women than men (75.8% v 50.7%, p = 0.03) with five or more partners in the previous year had visited their own general practitioner over that period. Among the sexually experienced, more women than men attended any setting appropriate for sexually transmitted disease screening (93.6% v 71.6%, p < 0.001). CONCLUSIONS: In New Zealand a screening programme for sexually transmitted diseases among young adults reliant on invitation by their own general practitioner would be biased towards those at less risk. Opportunistic screening in general practice would potentially include only about half the most sexually active men and three quarters of such women over a 12 month period. The extension of opportunistic screening to other settings considered appropriate for discussion of sexual health issues could potentially engage the vast majority of women, but not men, at most risk. Any screening programme should incorporate an effective method of finding and treating the sexual partners of infected women.     

The 374 clinic: an outreach sexual health clinic for young men

OBJECTIVES: To describe the establishment of a community based walk-in outreach genitourinary medicine clinic, the "374 clinic," in south London to target young men under 25 in an area with high rates of sexually transmitted infections (STIs). METHODS: The outreach clinic was set up within a Brook advisory centre, which already had gained the trust of local young people. Epidemiological, clinical, and laboratory data were obtained retrospectively for the first 24 weeks of the service. RESULTS: 134 attendances were recorded, including 94 new and 10 rebook events. The age range of the young men seen was 12-27 years (mean 18.2 years), the patients were mainly from black and ethnic minority groups, and all but one were heterosexual. Most men had heard about the clinic by "word of mouth," recommendation by Brook staff or through clinic promotional material. Condoms were used more frequently with non-regular sexual partners than with regular partners. The uptake of screening for gonococcal and chlamydial infections, mostly by urine based molecular techniques, was 98%. The uptake for HIV testing in men aged 16 or more was 72%. An overall STI prevalence rate of 26% was detected in the clinic population, which consisted almost equally of asymptomatic and symptomatic patients. The most prevalent STI was chlamydial infection (12%). CONCLUSIONS: The young men who attended the outreach clinic were happy to undergo both non-invasive urine based testing for gonorrhoea and chlamydia as well as phlebotomy to test for HIV and syphilis. The 374 clinic approach may prove to be a useful model for further outreach services to combat poor sexual health of young men in inner city areas.     

A novel condom policy for young attenders at a sexual health clinic

OBJECTIVES: To review the uptake of a new service for condom provision in the under 16s. METHODS: A retrospective case note review of attenders at an inner London sexual health clinic. RESULTS: The service was audited over a 3 month period in the spring of 2000. There were 97 individual attendances, 94% (92) male and 6% (5) female. 89% (87) had never attended a sexual health service before. When asked how they had heard of the clinic 88% (86) said a friend had told them about the clinic. 66% (64) claimed not to be sexually active. CONCLUSIONS: A novel policy of condom distribution to groups of boys has been successfully piloted at an inner London sexual health clinic. This policy appears to be overcoming the reluctance of teenage boys to access sexual health services.     

听障生性健康教育模式研究

听障生作为一个特殊的群体,他们有着强烈的求知欲,也会对异性的身体与行为产生幻想与冲动,多方位探究听障生性健康教育模式,正确引导听障生的思想和行为,促进其顺利地度过青春期,具有非常重要的意义.心理健康研究课题组设计出四种性教育模式,通过社会、学校、家庭三位一体相互配合,来达到对听障生性教育的示范与引导的作用,以促进特教事业的发展.     

试述古代文献中男女两性房事养生原则的异同

房事是正常成年人的生活必需,但男女的交合应有一定的原则,否则容易引起早衰甚至导致一系列疾病的发生。由于男女生理、心理不同以及社会因素等原因,古代医家关于男女两性房事养生原则的论述既有相同之处,又有所侧重。男女两性房事养生原则的相同点是都以乐而有节为基本原则,包括欲不可早、欲不可绝、欲不可纵、欲有所忌四个方面;不同点是古代文献对于男性房事养生重点强调了欲不可纵,对于女性则主要强调了欲不可绝,而欲有所忌中的避会三期对女性尤有重要意义。     

STI-prevalence and differences in social background and sexual behavior among urban and rural young women in Uganda

BackgroundAdolescents in Uganda carry a heavy burden of reproductive health problems. Different environment creates different problems.ObjectivesTo study the prevalence of STI and to compare social and behavioral risk factors for Neisseria gonorrhoea (NG) and Chlamydia trachomatis (CT) among sexually experienced young women in one urban and one rural area in Uganda.MethodsConsenting, sexually experienced women, below 20 years, visiting two different youth clinics were asked about social background, genital symptoms and sexual experiences. Vaginal samples were taken for NG and CT and analyzed by PCR.ResultsThe prevalence of NG and/or CT was 20 (6.8%) in the urban and 23 (7.8%) in the rural study site, a non-significant difference. The rural women were often in marital union, 25.3% compared to 12.2% of the urban women (OR 2.4, 95% CI 1.6-3.8) and had experienced more pregnancies and had more children. Their partners were often more than 10 years older. More urban women (42.2%) knew their HIV status compared to rural women (16.2%), OR 2.1 (1.6–2.7), reported more condom use and more sexual partners.ConclusionsMarital status and few sexual partners does not appear to protect young rural women from sexually transmitted infections (STIs), implying that male sexual behavior may have an important impact on women’s risk to be infected.     

法国人性行为的变化

1993年3月,法国出版了一部题为<性行为在法国>的书,这部书是一个多学科小组工作三年多的成果.这个小组于1991年9月至1992年2月进行了题为"法国性行为分析"(以下简称ACSF)的调查,随机抽样调查了20,055名男性和女性,被调查者年龄18岁至69岁.书中指出了自<西蒙报告>发表后21年来,尤其是自80年代艾滋病泛滥以来,生活在法国的人(包括外国人)的性行为变化,其结果表明,自<西蒙报告>以来,法国人的性行为没有根本性的变化.     

健康的性自由与合理的性控制——对性文明和性健康的理解

我们提倡性文明和性健康。我们“以史为镜”,研究中国五千年的性文化史,其目的也是为了汲取历史的经验和教训,以促进现代社会的性文明和性健康。那么什么是性文明和性健康,即性的理想境界呢?它的内容可以用两句话来表达,即:健康的自由,合理的控制。人是追求自由的,“不自由,毋宁死”,“生命诚可贵,爱情价更高,若为自由故,两者皆可抛”,都说明了     

Accessing sexual and reproductive health care and information: Perspectives and recommendations from young Asian American women

ObjectivesUnderstanding the influence of culture on how sexual and reproductive health is perceived and addressed in Asian American communities is important for the effective provision of care and health information. This study aimed to explore how and when sexual and reproductive health information is shared within Asian American families and communities, barriers and facilitators to accessing sexual and reproductive health care and information for young Asian American women, and their recommendations to improve access.MethodsQualitative data were collected through six focus groups conducted with a total of 33 young Asian American women.ResultsThe majority of participants reported that stigma created a barrier to discussing these topics within their families and communities, and discussed ways in which they confidentially seek out care and information. Responses varied with respect to participants' preferred means of increasing access to care and information; some recommended strategies that would increase communication about these issues in their families and communities, while others expressed a desire to maintain confidentiality.ConclusionsThese findings suggest that diversified strategies are needed to connect Asian American women with sexual and reproductive health care and information in order to meet their varied preferences, including strategies that are community-driven and culturally appropriate.