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Young People And Their Experiences of Anal Sex

21 Aug, 14 | by shaworth

Readers of the Journal may have come across the recent study into teenage attitudes towards anal sex in heterosexual couples by the London School of Hygiene and Tropical Medicine, published last month via their Online First initiative already, but if you’ve not, it makes interesting reading for anyone working in young people’s sexual health.

Existing data suggests that anal sex between heterosexual couples is on the rise, and often increased access to pornographic materials in the digital age is cited as the reason behind this; although the evidence to suggest this is limited. Recent data, according to this study, suggests that 1 in 5 young people has tried anal sex.

The study took place in three centres in England, surveying 130 young people in total with various levels of interviews. Questions involved their perceptions of their own experiences, their partner’s experience and their reasons for trying anal intercourse. The answers seem to confirm some of the previous hypotheses, but with pornographic material being a small factor in why young people explored the idea of anal intercourse; although the belief that anal intercourse would be more pleasurable for the male partner due to a linked believe that “tightness” was integral to male sexual pleasure during penetrative intercourse, and encouragement from peers to try anal intercourse as part of a sexual conquest, were also prevalent attitudes amongst male interviewees.

Perhaps what’s most worrying is the evidence that some men felt that they had a right to coerce partners into trying anal intercourse, despite holding the belief that female partners would find anal sex painful. To those of us interested in the wider climate of sexual equality and sexual behaviour, this isn’t a shocking finding. The idea that some men feel entitled to sexual favours from women, and how this defines their behaviour and attitudes towards them, has been a centrepoint of modern feminist debate in recent years.

The study is of value to those working in sexual health, particularly with young people. It highlights that young people are unaware of the risks to their sexual health with regard to anal intercourse, and suggests that targeted interventions to improve condom use and safe anal intercourse is needed in this group. It also suggests that the worrying disparity between male and female experiences of anal intercourse needs to be addressed, perhaps through initiatives that empower young women to control their own sexual experience, and perhaps through initiatives that educate young men on how to achieve sexual pleasure for their partner as well as themselves.

Online First – August

24 Aug, 12 | by shellraine, e-Media Editor

The following papers have been published this month at http://jfprhc.bmj.com/content/early/recent

More than poverty: disruptive events among women having abortions in the USA (Jones)

We are all aware that poverty is associated with abortion but how many of us knew that bad (or disruptive) life events also play a major role? The research by Jones et al. demonstrates that more than half of the women seeking abortion had experienced a disruptive life event in the preceding 12 months. Women are making decisions about their abortion whilst in the midst of complex life events. The authors’ suggestions for changes in policy may not be directly relevant in the UK; however, the study findings are of wider significance. from Gillian RobinsonAssociate Editor

Psycho-social factors affect semen quality (Cao)

Semen quality appears to be declining and this cross-sectional study in China casts light upon some factors that may be associated with that decline. The research team analysed the semen of 1346 healthy 20-40-year-old Chinese men, capturing their psychological, social and behaviour profiles via questionnaire. It appears that stress, social class and underwear made from man-made fibres all play a significant part in declining semen quality. from Scott WilkesAssociate Editor

Young people and chlamydia – peer led strategies to increase the uptake of screening (Horner)

The major burden of Chlamydia trachomatis infection is borne in individuals under 25 years of age. Complications of untreated infection are manifold and encompass pelvic inflammatory disease, sub-fertility, epididymo-orchitis, urethritis, arthritis, conjunctivitis and proctitis. Despite high hopes, uptake of the English National Chlamydia Screening Programme has been lower than expected. As a result, the expected decline in chlamydia prevalence has not been observed. Paddy Horner’s group have investigated the use of a peer-led approach to increase screening and examine the feasibility and acceptability of this strategy in young people. Interestingly, although this is a relatively small proof of principle study, women peer-led screening was more successful than male in recruiting peers to participate in the programme. from Rachael JonesAssociate Editor

Inequity in family planning provision in urban Nigeria: a providers’ perspective (Herbert)

In Nigeria contraceptive use is low: used by only 10% of married women and with 20% of women estimated to have an unmet need. Provision needs to improve, and understanding the roles and perspective of the mixed economy of contraceptive providers is a key step in designing better services. A qualitative study from the Nigerian Urban Reproductive Health Initiative explores the experiences and challenges faced by a range of providers in two urban Nigerian areas. Using structured in-depth interviews and checklists, researchers identified need for further training and support for all providers to empower them to provide a wider range of contraception. Few providers engaged in meaningful promotional activities for their products or services. Vulnerable groups, likely to have high needs for contraceptive advice and provision, were routinely excluded from family planning services: adolescents, married women and those seeking post-abortion care. Understanding the underlying reasons for this inequitable provision, and developing appropriate marketing strategies and materials will indeed be key to developing more sensitive service provision. from Imogen Stephens,  Associate Editor

New female condom, the ‘Woman’s Condom’ – will the Chinese go for it? (Coffey)

The need for products that simultaneously protect against unwanted pregnancy and STIs, including HIV, has prompted interest in the development of Multipurpose Prevention Technologies (MPTs), including new variants of the female condom. In this issue, Coffey and colleagues describe their survey of initial reactions to the ‘Woman’s Condom’ (which obtained marketing approval in China in 2010) by potential user groups in Shanghai. Their study demonstrates the importance of assessing the potential acceptability of new products in a range of populations, with differing expectations, needs and culture-specific influences. Their findings are of particular value to programme/service providers, in order to identify most likely adopters of this new type of female condom. from Walli BoundsAssociate Editor

Online First and Emergency Contraception for Christmas

16 Dec, 11 | by shellraine, e-Media Editor

The latest article to be published at Online First is:

Questions about intimate partner violence should be part of contraceptive counselling: findings from a community-based longitudinal study in Nicaragua by Mariano Salazar, Eliette Valladares, Ulf Högberg.

Neelima Deshapande (Associate editor) writes:

Effect of domestic violence on contraceptive choice

Sadly, domestic violence against women continues in many countries. This study from Nicaragua looks at the impact of intimate partner violence (IPV) on the choices that women make about their contraception. It appears that women who are abused tend to use more reversible contraception than women who are not and that women actually make conscious choices about delaying pregnancies far more often when their partner is violent than if they are in a non-violent relationship This study quantifies the high proportion of women suffering from IPV and adds strength to the argument that enquiry about domestic violence should be included in contraceptive choices consultations and steps taken to identify and refer appropriately.

Emergency Contraception in Advance:
The BPAS christmas campaign (at www.santacomes.org) to offer free EHC through the post caused the usual mixed tranche of reactions in the media – all of which will hopefully succeed in raising awareness, as described in Marge Berer’s wonderful blog on 12th December. The FSRH have issued a Faculty statement on the subject saying that at a time of limited access advance provision will be in the best interests of many women.

FPA/Brook have issued a response to the Systematic Review of Induced Abortion and Women’s Mental Health discussed last week.

FPA have, today, issued a reaction to the Health Survey for England 2010, published yesterday, which shows that 1 in 4 women claim to have lost their virginity before their 16th birthday. Like the BPAS EHC campaign, above, the Survey has brought out the worst of our tabloid and conservative press with predictable, extreme headlines. However, as reported in The Independent, the authors noted that surveys of sexual behaviour are hard to interpret as responses are subject to both exaggeration and concealment. In addition (but less reported) it showed 26% of women and 32% of men aged 16 to 24 say they have never had sex and across all age groups, men have typically had 9.3 female sexual partners in their lifetime, while women have slept with an average of 4.7 men and almost a quarter of all women (24%) have only ever had one sexual partner, compared to 17% of men. With regards to methods of contraception it showed that equal numbers of women (22%) were using condoms or pills compared with 7% using LARC.

RCOG – Abortion Guidelines & Honorary Fellowships

25 Nov, 11 | by shellraine, e-Media Editor

The Royal College of Obstetricians and Gynaecologists (RCOG) has, this week, published its revised guidelines on the care of women requesting induced abortion. The recommendations cover commissioning and organising services, possible side effects and complications, pre-abortion management, abortion procedures and follow up care.  A summary of new and improved recommendations and link to Q&A’s are in the RCOG press release.

Medical Students for Choice (MSFC) – based in the US, is a non-profit organisation recognising the need to create abortion providers for tomorrow:  www.medicalstudentsforchoice.org. They aim to try and correct the drastically falling numbers of providers in the US and Canada – 57% of current providers are over 50. This along with targeted violence, restrictive legislation and medical schools not addressing the issue means doctors are qualifying with little knowledge of abortion.

RCOG Honorary Fellowship

Toni Belfield

Our friend and colleague, Toni Belfield, has, today, been awarded an RCOG honorary fellowship in recognition of her long service in the field of contraception and sexual health and passionate dedication to providing accessible, evidence-based information for men and women. Included in the citation Professor Janice Rymer noted responses from colleagues who said Toni is “One of the most knowledgeable people in women’s health” and “Her contribution is always very sound”.  Her many friends in the field know, love and respect her as an ardent advocate for service users (never patients or clients!) and as someone who always keeps us on our toes when it comes to accurate use of terminology – we always fit IUDs never coils! Congratulations Toni.

Take Action! Respond to the PSHE Review – Deadline 30th November

The Department for Education is running a Review of PSHE including Sex & Relationships Education with a view to improving its delivery in state funded schools. You can read the review and respond online by following the link. The British Humanist Association has succintly summarised the situation and the fears of many in its statement to accompany its own response.


Risk of VTE with combined oral contraceptives

4 Nov, 11 | by shellraine, e-Media Editor

Readers are signposted to the Rapid Responses at BMJ Online following last week’s publication of an extended analysis of the Danish Cohort Study on VTE risk with combined oral contraceptives with different progestogens and oestrogen doses.

Volunteers required for CEU guidance
The CEU are looking for volunteers to be involved in the development of the next 3 guidance documents:
Contraceptive choices for women with cardiac disease; Intrauterine contraception; Progestogen-only implants. Details available via the Faculty website.

Young men and contraception  [Brown, published Online First 1 November 2011]
It is rare to see a study looking at young men and their contraceptive views. This pilot study indicates that engaging with young men may be a challenging task. Getting them to talk about contraception and responsibility will be even more so. The young men who participated in the pilot were willing to consider shared responsibility for contraception when talking with the researcher about their contraceptive choices. How these young men view women who take charge of their sexual health reveals a lot about the dynamics of relationship forming and the confusion around contraceptive responsibility felt by young people.
Neelima Deshpande (Associate Editor, JFPRHC)

Brook and FPA launch UK Sexual Health Awards to reward innovation and creativity in sexual health work. There are 6 categories for nominations which close on 31 December. Open to professionals, writers, young people or projects the first awards ceremony is to be held in March 2012, hosted by Davina McCall. Click on the image for more information.

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