A review of family-planning literature reveals that researchers adopt narrow definitions of sexual behavior and focus almost exclusively on risks of pregnancy and diseases. Little concern is shown in these articles about promoting the idea of more communicative, pleasurable, and egalitarian sexual relations among teenagers, because the focus is on avoiding behaviors that are defined as "high risk." In the United States, there is little evidence that these contraceptive-based sex education programs have resulted in reduced sexual activity, diminished teenage-pregnancy rates, or increased effective contraceptive use. In Canada the clinical evidence is that existing prevention strategies are not working. In Sweden the increasing rates of STDs and teenage pregnancies in the late 1980s worried authorities. The figures were brought down in the 1990s by extensive efforts both in schools and at publicly funded adolescent health clinics and family-planning units. It has been shown that girls with good self-esteem and a sense of responsibility avoided pregnancies and STDs in follow-up studies. Girls with a high degree of risk-prone behavior or attitudes and girls with a problematic life situation and without adequate family support were those who became unintentionally pregnant and/or acquired an STD. Countries where sex education has been accepted, combined with widely spread family-planning services and abortion on demand, have the lowest pregnancy and abortion rates in the world. But even they could do better by putting sex education in its proper place in society and by using both old and new methods.
Seven out of ten of the adolescents included in the study had experienced unsafe sex with a new partner. Afterwards, 48% worried about STD and 31% worried about pregnancy. Teenagers calculate the risk of contracting STD from the looks and the reputation of a new partner. Young women and men agree, that both share responsibility for the use of condoms, but more often the young women initiate the use of condoms. Many participants found it more embarrassing to buy condoms than to use them. The participants hoped for improved education in schools and less expensive condoms. The adolescents possessed good knowledge concerning how to protect themselves, but changes in attitudes are needed. School and youth clinics play important roles in this process.
A local centre for information to adolescents on sexual behaviour and use of contraceptives was opened in 1990 in the Stovner district of Oslo. At the end of 1993, the centre had recorded 975 visits. 248 of the 271 girls who had consulted the centre's doctor, had already had intercourse. No use or unsatisfactory use of contraceptives was reported by 40%. The two main reasons for contacting the centre were a need for contraceptives (58%) and fear of sexually transmitted diseases (21%). The findings indicate a need for this kind of centre for health information.
An evaluation of the interaction of place and community-based participatory research as a research methodology in the implementation of a sexually transmitted infection intervention for Greenlandic youth.
Newly emerging research suggests that the actual physical location of a study and the geographic context in which a study is implemented influences the types of research methods most appropriate to use in a study as well as the study's research outcomes. This article presents a reflection on the extent to which place influenced the use of community-based participatory research (CBPR) as a research methodology in the implementation of an intervention to address sexually transmitted infections in Greenland. An evaluation of the interaction between place and CBPR suggests that the physicality of place influenced the intervention's successes and challenges. Future research that uses CBPR as a research methodology in sexual and reproductive health research in the Arctic warrants situating the research design, implementation and outcomes within the context of place.
Notes
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