Introduction: Despite policy actions and strategic efforts for improving the reproductive and sexual health of adolescents by promoting the uptake of adolescent reproductive and sexual health (ARSH) services, the utilisation rate remains significantly low, especially in rural areas of India. This study aimed to assess the utilisation of these services by adolescents in rural West Bengal and its associated determinants. Methods: This mixed-method study was conducted from May to September 2021 in the Gosaba rural block of South 24 Parganas, West Bengal. Quantitative data were collected from 326 adolescents using a pre-tested structured questionnaire. Qualitative data were collected via four focus group discussions among 30 adolescents and key-informant interviews among six healthcare workers. Quantitative data were analysed using SPSS, while qualitative data were analysed thematically. Results: Ninety-six (29.4%) adolescents had utilised ARSH services at least once during adolescence. The factors associated with non-utilisation of ARSH services were younger age, female sex, increasing reproductive health stigma and decreasing parent–adolescent communication related to sexual health. Qualitative exploration revealed that unawareness regarding services, perceived lack of privacy and confidentiality at healthcare facilities and disruption of services post-emergence of the COVID-19 pandemic were some major barriers to ARSH service utilisation. Conclusion A multi-component strategy, including promotion of adolescent-friendly health clinics, community support interventions associated with motivation and counselling of parents regarding the importance of adolescent reproductive health, is needed to improve the utilisation of ARSH services. Necessary steps to correct the deficiencies at the facility level should also be prioritised.
Adolescent ; Reproductive Health Services ; Sexual Health ; Qualitative Research ; Rural Population

Objective: Despite the provision of local health policies promoting the utilization of sexual and reproductive health (SRH) services of adolescents, SRH services utilization remains very low and little information is known concerning the factors which may influence adolescents' use of these SRH services. This study aimed to determine the prevalence and determinants of school-based SRH services utilization among secondary school students.

Materials and Methods: This is a cross-sectional study that used a self-administered questionnaire to gather data among students in one public secondary school in the City of Dasmariñas. A total of 24 sections from Grades 8 to 12 were randomly selected using stratified cluster sampling. Both descriptive and inferential statistics were used to analyze the data using Epi Info version 7.3.2.1.

Results: Among 1,218 students who answered the questionnaire, 168 students (13.8%) utilized the SRH services in the Teen Health Kiosk (THK) during SY 2019-20. Students with favorable attitudes towards SRH issues (predisposing factor) were twice more likely to utilize the SRH services (Adjusted odds ratio, AOR 1.75, 95% CI 1.12-2.74) and those who have positive perceived accessibility on the SRH services (enabling factor) were 2.5 times more likely to utilize the SRH services (AOR 2.46, 95% CI 1.66 - 3.66).

Conclusion: Attitudes towards SRH issues and perceived accessibility to SRH services were found to be determinants of SRH services utilization in the THK of the selected public secondary school in the City of Dasmariñas. Even with the marked increase in the utilization of SRH services in the THK from 0.2% in SY 2018-19 to 13.8% in SY 2019-20, intensified efforts are still needed in order to target students' attitudes on SRH and accessibility of THK and the SRH services it offers to its clients. It is recommended that the existing THK Club be strengthened as this will play a significant role in changing the attitudes of students towards SRH issues, thus increasing the utilization of SRH services. Additionally, formulating an SRH policy at the school level targeting THK's accessibility will be helpful in increasing the utilization of school-based SRH services. For one, a policy mandating THK service providers to deliver services beyond school hours may be discussed such that it can also cater students who are attending the school during weekends (i.e. ALS students, Open High students). Likewise, policy makers in the City Schools Division Office including their top management and personnel from the Health and Nutrition Unit as well as school administrators must endeavor to provide a more conducive THK where privacy and confidentiality can be maintained at all times and clients can freely discuss SRH issues with the THK service provider. An initiative to provide a separately detached room for the THK is encouraged in order to provide a more suitable counselling area and to ensure privacy and confidentiality of student clients and their shared information.

PURPOSE: This study aimed to examine the association among sexual double standard, dating violence recognition, and sexual assertiveness among Korean university students. METHODS: Using a cross-sectional survey study in January 2018, Korean university students (N = 322, years; 54.3% female) completed structured questionnaires with the double standard scale, dating violence recognition index, and sexual assertiveness index. The relationship among the variables was analyzed with Pearson's correlations and multiple regression analyses. RESULTS: There were significant correlations among sexual double standard, dating violence recognition, and sexual assertiveness. Sexual double standard (β = .12, p = .043) was determined to influence dating violence recognition. In addition, gender (β = .63, p < .001) and sexual double standard (β = .11, p = .015) were determined to influence dating violence recognition; the explanatory power was 43%. CONCLUSION: These findings will serve as a basis for the development of education programs that help university students to establish appropriate sexual values and enjoy a healthy sex life.
Assertiveness ; Cross-Sectional Studies ; Education ; Humans ; Intimate Partner Violence ; Korea ; Reproductive Health ; Sexual Behavior ; Young Adult

Introduction: Adolescence being a transition phase from a child to an adult, commonly associated with high-risk sexual behaviours, which put them at risks of sexually transmitted diseases (STD), HIV and unwanted pregnancy. All these risks can be prevented by having adequate knowledge on sexual and reproductive health (SRH). Hence, this study aimed to determine the sociodemographic determinants of good SRH knowledge among secondary school children in Kuala Kuantan, Pahang Malaysia. Methods: A cross-sectional study was conducted among 687 secondary school children in Kuala Kuantan, Kuantan, Pahang, using self-administered questionnaire. A multistage cluster sampling was employed to recruit the respondents. Three levels of analysis were conducted to describe the characteristics of the respondents and determining the determinants of good SRH knowledge. Data was analysed using Statistical Package of IBM SPSS Statistics Version 24 and the p value was set to be less than 0.05. Results: The proportion with good SRH knowledge was 58.4%. Upper secondary school age group (AOR 7.142, 95% CI: 4.830, 10.560) and smokers (AOR 2.597, 95% CI: 1.348, 5.004) were found to be significant determinants of good SRH knowledge. Conclusions: The percentage of respondents with good SRH knowledge was just slightly above average. As expected, older school children has the strongest likelihood of having good SRH knowledge. Whether the good SRH knowledge is contributed by the existing SRH curriculum is unclear and requires further exploration. In view of the alarming SRH issues involving younger school children, strategic plan are needed to instil the knowledge at earlier age.
Sexual and reproductive health

The purpose of this review study is to evaluate sexual function and its effective factors in menopause. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The key words of “menopause,” “postmenopause,” “postmenopausal,” “premenopause,” “pre-menopausal period,” “sexual function,” “sexual health,” “sexuality,” “sexual and gender disorders,” “sexual development,” “sexual dysfunction,” “sexual disorders,” “sexual behavior and “sexual activity” were used in combination with the Boolean operators OR and AND. After reviewing the selected articles, 27 papers were selected based on the criteria for entering the study and the goals set. The results of the reviewed articles showed that, in the physical domain, the factors affecting sexual function can be mentioned, age, hormonal changes, medical problems and reproductive history. Sexual disorders in menopause can be affected by some of the individual and social characteristics and psychological problems. Considering the fact that many psychological and social injuries occur in this period following sexual disorders; therefore, policies and programs for improving the quality of life of women in menopause should be aimed at eliminating sexual dysfunction, correcting attitudes and negative emotions and help to women for more comfortable in menopause.
Female ; Humans ; Menopause ; Quality of Life ; Reproductive Health ; Reproductive History ; Sexual Behavior ; Sociological Factors

Major improvements in health care have allowed people in the modern era to lead longer, healthier, and more active lives. The current generation of over-60s are more active than previous generations at the same age. In South Korea, the elderly population (65 years of age or older) has grown to more than 14% of the general population, meaning that we are already in the era of an ‘aged society’ and are transitioning into a super-aged society. Therefore, health issues in the elderly population cannot be ignored, and should be adequately addressed as soon as possible. Sexual health has become an important issue in the elderly that cannot be neglected, according to studies on sexual attitudes and behavior in older adults. As the quality of health improves in the elderly population, requests for proper sexual education and sexual health-related services have become more common. This pattern of increased sexual activity, partially driven by pharmacological advances in the treatment of sexual dysfunction and hormonal replacement products, has also led to increases in drug use and sexually transmitted infections (STIs). Responses to sexual health and education issues for the elderly currently remain ill-structured, as the significance of these issues is often ignored, largely due to incorrect assumptions about sexuality and sexual health among the elderly. Stronger requirements should be implemented for properly structured education and management systems regarding awareness, risk perception, and preventive strategies for safe sex among the elderly population in Korea.
Adult ; Aged ; Delivery of Health Care ; Education ; Family Characteristics ; Humans ; Korea ; Methods ; Reproductive Health ; Safe Sex ; Sexual Behavior ; Sexuality ; Sexually Transmitted Diseases

Sexually transmitted infections (STIs) in the elderly are a social problem that can no longer be ignored due to rapid population aging and the growing proportion of elderly people who continue to engage in sexual activity. An accurate assessment of the current status of STIs in the elderly, as well as their sexual behavior, is a prerequisite for public STI prevention and education campaigns and for future studies on the subject. Numerous studies have found a growing incidence of STIs among the elderly population. In South Korea, a recent analysis of the Health Insurance Review & Assessment Service database between 2010 and 2016 showed that the prevalence of STIs was not high and that it had remained stable in recent years, implying that STIs are not currently a significant public health issue in South Korea, unlike in other countries. The reported proportion of sexually active elderly individuals was higher than expected (40% to 60%, for both sexes). The rate of condom use is generally very low among the elderly, usually because they are past their reproductive age. In a South Korean survey-based study, approximately 42% of elderly South Koreans were sexually active, and the rate of condom use was also very low (under 15%). Although STIs are not currently a significant public health issue in South Korea, several sexual health behaviors found in numerous studies, such as the very low rate of condom use, together with rapid population aging, call for ongoing monitoring of STIs in the elderly population.
Aged ; Aging ; Condoms ; Education ; Humans ; Incidence ; Insurance, Health ; Korea ; Prevalence ; Public Health ; Reproductive Health ; Sexual Behavior ; Sexually Transmitted Diseases ; Social Problems

The increase in life expectancy has caused attention to be focused on quality of life in the elderly. Sexual health is an important part of physical health and quality of life, and poor health is associated with both a decline in sexual activity with age and sexual dysfunction. Herein, we review the topics of sexual function, sexual activity, the prevalence rate of sexual dysfunction and its risk factors, changes in sexuality-related attitudes, the relationship between sexual health and physical health, and the effects of sexual health on quality of life in the elderly. Sexual activity is associated with physical health, and is also an important component of enjoying life. Sexual activities include sexual intercourse and physical intimacy, which are indicators of sexual health in the elderly. Good physical health, stable sexual partners, and regular sexual activity are important for maintaining sexual health in old age Therefore, sexual health needs to be considered as part of the management of geriatric patients.
Aged ; Coitus ; Humans ; Life Expectancy ; Prevalence ; Quality of Life ; Reproductive Health ; Risk Factors ; Sexual Behavior ; Sexual Partners

PURPOSE: To compare reproductive health promoting behaviors (RHPBs) of infertile women with those of normal women and identify effects of RHPB on infertility. METHODS: A total of 148 females (73 infertile women and 75 normal women) were enrolled in this study. Measurements included their general characteristics and RHPB using self-report questionnaires. Data were analyzed with descriptive statistics, χ2 test, ANCOVA, and hierarchical logistic regression using SPSS. RESULTS: There were significant difference in incomes, number of family, number of term deliveries, and number of abortions according to infertility diagnosis. Mean duration of infertility was 32.16 months. Only 12.32% women had known cause of infertility. The most common cause of infertility was unknown. Mean RHPB score was 3.98 for infertile women and 4.41 for normal women. In logistic regression, total RHPB (odds ratio [OR], 0.21) and safe sex of RHPB (OR, 0.66) were significant factors influencing infertility. Infertile women's total RHPB and subcategories of RHPB (safe sex behavior and sexual transmitted disease [STD] prevention) were lower than those of normal women. CONCLUSION: For infertility women, RHPB-related intervention programs are needed, especially information about safe sex behavior and STD prevention.
Diagnosis ; Female ; Health Promotion ; Humans ; Infertility ; Infertility, Female ; Logistic Models ; Reproductive Health ; Safe Sex ; Sexual Behavior

OBJECTIVE: To assess the burden of cervical neoplasia in mid-western rural, Nepal using cytology, visual inspection with acetic acid (VIA) and visual inspection with Lugol's iodine (VILI). METHOD: A cross-sectional, population-based study was conducted. Total of 2,279 married, non-pregnant women aged 20–65 years participated in a screening clinic from May 2016 to January 2017. All eligible women completed self-report of socio-demographic and reproductive health data followed by screening tests. Biopsies were obtained from areas on the cervix assessed by VIA and or VILI to be abnormal. Final disease was confirmed by biopsy report. RESULTS: A total of 96.09% (n=2,190) women were eligible for this study with mean age 32.78±9.33 years. The overall rate of positive cytology, VIA, and VILI were 3.69%, 12.45%, and 16.89%, respectively. Sixty-two cases were biopsy proven cervical neoplasia. Altogether 78 (3.69%) cases were cytologically abnormal: 25 (1.18%) were atypical squamous cells of undetermined significance, 33 (1.56%) were low-grade squamous intraepithelial lesion, 11 (0.52%) were high-grade squamous intraepithelial lesion, and 9 (0.42%) were squamous cell carcinoma. Illiterate women appeared to be at higher risk for cervical neoplasia (p < 0.001). Similarly, age ≥ 46 years (p < 0.013), participant's multiple marriages or sexual partners (p < 0.005), and positive human immunodeficiency virus status (p < 0.001) were significantly associated with abnormal cytology. CONCLUSION: Based on cytology report, there is 3.69% prevalence of cervical neoplasia among women in a rural region of mid-western, Nepal. A “screen and treat” approach would be more attractive in low resource settings.
Acetic Acid ; Atypical Squamous Cells of the Cervix ; Biopsy ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Female ; HIV ; Humans ; Iodine ; Marriage ; Mass Screening ; Methods ; Nepal* ; Prevalence ; Reproductive Health ; Sexual Partners ; Squamous Intraepithelial Lesions of the Cervix