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      Condom Use and its Associated Factors Among Iranian Youth: Results From a Population-Based Study

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          Abstract

          Background: Given the young structure of Iran’s population and the fact that extramarital sexual relationships are both prohibited by legislation and shunned by society and religion, examining condom use practices among Iranian youth is highly important. The aim of this study was to explore condom use and its correlates among Iranian young adults.

          Methods: In a sample of 3,045 individuals aged 19-29 who were recruited from a nation-wide study, we analyzed data from 633 participants who reported a history of extramarital sex. Subjects were asked about their condom use practices during their last penetrative sex. Data were collected through a self-administered questionnaire where the respondents completed the survey on their own and passed it to trained gender-matched interviewers. Multivariable regression models were constructed to report adjusted odds ratios (AOR) along with 95% CI.

          Results: Of the 633 participants, 222 (35.1%) reported condom use at last sex. Men reported significantly higher condom use than women (38.5% vs. 25.7%). Having a stable job (AOR = 1.86, 95% CI: 1.01, 3.43), higher knowledge of condom use (AOR = 1.57, 95% CI: 1.03, 2.37) and sexual transmission of HIV (AOR = 1.83, 95% CI: 1.18, 2.85) were positively associated with condom use at last sex. Conversely, experience of sex under the influence of substances (AOR = 0.66, 95% CI: 0.45, 0.94) was significantly associated with reduced odds of condom use at last sex.

          Conclusion: This study shows that only one out of every three young adults reported using condoms at last sex. While educational programs are helpful, multi-sectoral approaches (eg, individual-, community-, and structural-level interventions) are required to change sexual behaviours towards safe sex practices and reinforce negotiating condom use among youth.

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          Adolescent cortical development: a critical period of vulnerability for addiction.

          Fulton Crews, Jun. He, Clyde W Hodge (2007)
          Cortical growth and remodeling continues from birth through youth and adolescence to stable adult levels changing slowly into senescence. There are critical periods of cortical development when specific experiences drive major synaptic rearrangements and learning that only occur during the critical period. For example, visual cortex is characterized by a critical period of plasticity involved in establishing visual acuity. Adolescence is defined by characteristic behaviors that include high levels of risk taking, exploration, novelty and sensation seeking, social interaction and play behaviors. In addition, adolescence is the final period of development of the adult during which talents, reasoning and complex adult behaviors mature. This maturation of behaviors corresponds with periods of marked changes in neurogenesis, cortical synaptic remodeling, neurotransmitter receptors and transporters, as well as major changes in hormones. Frontal cortical development is later in adolescence and likely contributes to refinement of reasoning, goal and priority setting, impulse control and evaluating long and short term rewards. Adolescent humans have high levels of binge drinking and experimentation with other drugs. This review presents findings supporting adolescence as a critical period of cortical development important for establishing life long adult characteristics that are disrupted by alcohol and drug use.
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            Socio-cultural challenges to sexual health education for female adolescents in Iran

            Robab Latifnejad Roudsari, Mojgan Javadnoori, Marzieh Hasanpour … (2013)
            Background: Despite clear reasons for necessity of sexual health education for adolescents, it is a contested issue and has faced challenges in most cultures. Providing sexual education for non-married adolescents is culturally unacceptable in most Muslim societies. Objective: This qualitative study addressed socio-cultural challenges to sexual health education for female adolescents in Iran. Materials and Methods: Qualitative data from female adolescents (14-18 yr), mothers, teachers, authorities in health and education organizations, health care providers and clergies were collected in two large cities of Iran including Mashhad and Ahvaz through focus group discussions and individual in-depth interviews. Data were analyzed using conventional qualitative content analysis with MAXqda software. Results: Our results revealed that the main socio-cultural challenges to sexual health education for adolescents in Iran are affected by taboos surrounding sexuality. The emergent categories were: denial of premarital sex, social concern about negative impacts of sexual education, perceived stigma and embarrassment, reluctance to discuss sexual issues in public, sexual discussion as a socio-cultural taboo, lack of advocacy and legal support, intergenerational gap, religious uncertainties, and imitating non-Islamic patterns of education. Conclusion: It seems that cultural resistances are more important than religious prohibitions, and affect more the nature and content of sexual health education. However, despite existence of salient socio-cultural doubtful issues about sexual health education for adolescents, the emerging challenges are manageable to some extent. It is hoped that the acceptability of sexual health education for adolescents could be promoted through overcoming the cultural taboos and barriers as major obstacles.
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              Gendered socioeconomic conditions and HIV risk behaviours among young people in South Africa.

              Kelly Hallman (2005)
              Recent evidence suggests that the burden of new HIV infections in sub-Saharan Africa is concentrated among young people, especially females. Even in a country such as South Africa where knowledge among young people of how to protect oneself from infection is rather high, such information may not always be usable in daily situations of economic and social disadvantage that characterise many of their lives. Despite this possibility, there are surprisingly few definitive studies that examine the effects of socioeconomic status on HIV risk and prevention behaviours among youth in South Africa. Using household survey data collected in 2001, this study investigates how socioeconomic disadvantage has influenced the sexual behaviour and experiences of 4 000 young women and men aged 14-24 years in KwaZulu-Natal province - an area characterised by high HIV prevalence and high rates of poverty and inequality. Socioeconomic disadvantage, measured here as low relative household wealth, is found to be associated with a variety of unsafe sexual behaviours and experiences, particularly for females. Among young women low wealth is associated with earlier sexual debut, having had multiple sexual partners in the year before the survey, and lower chances of condom use at last sex. It is also associated with increased chances that first female sexual experience is non-consensual and with higher odds of females having traded sex and having experienced physically forced sex. For females and males, low wealth reduces the chances of discussing safe-sex practices with the most recent sexual partner. Without sufficient attention, during the design and placement of HIV prevention programmes, to the gendered economic and social conditions in which individuals live - conditions that can make people more or less vulnerable to behaviours and experiences that may lead to infection - the potential effectiveness of the global response to HIV/AIDS is sacrificed.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Int J Health Policy Manag
                Journal ID (iso-abbrev): Int J Health Policy Manag
                Journal ID (publisher-id): Kerman University of Medical Sciences
                Journal ID (publisher-id): Int J Health Policy Manag
                Title: International Journal of Health Policy and Management
                Publisher: Kerman University of Medical Sciences
                ISSN (Electronic): 2322-5939
                Publication date Collection: November 2018
                Publication date (Electronic): 04 August 2018
                Volume: 7
                Issue: 11
                Pages: 1007-1014
                Affiliations
                1HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
                2The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.
                3School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
                4Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
                5Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada.
                Author notes
                [* ] Correspondence to: Samira Hosseini Hooshyar Email: s_hosseini2207@ 123456outlook.com
                Article
                DOI: 10.15171/ijhpm.2018.65
                PMC ID: 6326636
                PubMed ID: 30624874
                SO-VID: c69b6ccf-bb4e-4f64-928b-d7b492fe6feb
                Copyright © © 2018 The Author(s); Published by Kerman University of Medical Sciences
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 04 July 2017
                Date accepted : 11 July 2018
                Page count
                Tables: 2, References: 49, Pages: 8
                Categories
                Subject: Original Article

                Keywords: condom,sexual behaviour,educational programs,young adult,iran
                Data availability:
                Keywords: condom, sexual behaviour, educational programs, young adult, iran

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