Sex, drugs and the honour roll: the perennial challenges of addressing moral purity issues in schools

The Global Adolescent Fertility Decline is Counteracted by Increasing Teen Births in Sub-Saharan Africa

There is a lack of understanding of the persistence of elevated teen fertility rates in certain regions and countries, in contrast to the significant decline observed in other regions globally. This report considers fertility trends among 15- to 19-year olds in the period 1950-2020 and explores potential driving factors behind the significant shifts that occurred over this period. The countries where teen fertility remains high are those with fast-growing populations, primarily located in sub-Saharan Africa. Countries with higher teen fertility are typically characterized by limited use of modern contraception, lower education levels, and early marriage. Sub-Saharan Africa has emerged as the world region with the most teen births, increasing its proportion of global teen births from 12 percent in 1950 to 47 percent in 2020, a time during which this region's share of the global adolescent (15-19) population grew from 7.5 percent to 19 percent. By 2035, 67 percent of all teen births globally are projected to occur in this region. Consequently, the future number of births to teenage mothers will to a large extent depend on the development in sub-Saharan Africa over the coming decades.

Social marketing and mass media interventions to increase sexually transmissible infections (STIs) testing among young people: social marketing and visual design component analysis

INTRODUCTION

Globally, sexually transmissible infections (STIs) continue to disproportionately affect young people. Regular STI testing is an important public health strategy but remains low among this age group. Raising awareness of testing is an essential step and requires effective interventions designed for young people. To inform the development of effective interventions that promote STI testing among young people, we conducted a systematic literature review to describe the social marketing and visual design components commonly found in STI testing interventions and explore associations of these components with intervention effectiveness.

METHODS

We used a systemic review methodology to identify peer-reviewed articles that met pre-defined inclusion criteria. Social marketing and visual component analyses were conducted using structured data extraction tools and coding schemes, based on the eight key social marketing principles and 28 descriptive dimensions for visual analysis.

RESULTS

18 studies focusing on 13 separate interventions met the inclusion criteria. Most interventions used photograph-based images, using conventionally attractive actors, positioned centrally and making direct eye contact to engage the viewer. The majority of interventions featured text sparingly and drew on a range of tones (e.g. serious, humorous, positive, reassuring, empowering and informative) and three interventions used sexualised content. Four articles explicitly stated that the interventions was informed by social marketing principles, with two explicitly referencing all eight principles. Around half of the articles reported using a formal theoretical framework, but most were considered to have theoretical constructs implicit in interventions materials. Four articles provided detailed information regarding developmental consumer research or pre-testing. All articles suggested segmentation and development of materials specifically for young people. Explicit consideration of motivation and competition was lacking across all articles. This study found that there were some design elements common to interventions which were considered more effective. High social marketing complexity (where interventions met at least seven of the 11 criteria for complexity) seemed to be associated with more effective interventions.

CONCLUSIONS

Our findings suggest that the incorporation of social marketing principles, could be more important for intervention effectiveness than specific elements of visual design. Effective and systematic use of social marketing principles may help to inform future evidence-informed and theoretically based interventions and should be employed within sexual health improvement efforts.

Embarrassment, Shame, and Reassurance: Emotion and Young People's Access to Online Sexual Health Information

INTRODUCTION

Research suggests that embarrassment and shame are significant barriers to young people's access to sexual health information. In this article, we analyse the relationship between emotion and young people's engagement with online sexual health information.

METHODS

Drawing on the work of Ahmed on the performativity of emotion and Probyn's theorisation of shame, we analyse interviews conducted in 2020 with 37 young people in Australia on sources of sexual health information.

RESULTS

Based on themes emerging from the data, our analysis considers the role of embarrassment and shame in shaping young people's access to sexual health information, the sources they seek, and the forms of information provision they prefer. Overall, we find that shame, embarrassment, and judgement shape our participants' access to sexual health information in four key ways: (1) by enacting suitable sources of information; (2) by propelling curiosity in different directions; (3) by constituting 'normal' bodies, sexuality, and sexual health; and (4) by constituting desired forms of communication.

CONCLUSIONS

As part of these dynamics, our participants use a range of strategies to avoid potential embarrassment or judgement when seeking sexual health information. The article concludes by exploring the implications of these practices and dynamics.

POLICY IMPLICATIONS

Our analysis suggests the need for research, policy, and public health initiatives that are open to the multiple effects of emotion, including those traditionally thought of as negative, and their role in materialising encounters with sexual health information.

A public health based vision for the management and regulation of opioids

Prohibition of the possession of opioids for non-medical purposes and medical/pharmaceutical commercialization of opioids are important contributors to the current opioid overdose epidemic. A new model of regulation is urgently required. Within the context of a public health framework, we explore supply control, demand reduction, health promotion, and harm reduction and describe an alternative regulatory model that includes access for medical and non-medical purposes. Oversight of this proposed new system would include a control structure with an explicit public health mandate to minimize harms and maximize benefits of opioids. Medical access would be achieved through multi-disciplinary teams who would prescribe a range of opioids for 1) pain, 2) treatment for patients who develop opioid use disorder, and 3) other medical indications. Non-medical access could be achieved through models that would allow adults to purchase and use opioids for either supervised or take-home use. We describe three possible models to support jurisdiction specific discussions around the world. The first includes education and training that could result in certification with a basic or advanced license or a purchase authorization card. The second includes mandatory training that allows general access to opioids, but excludes people with problematic opioid use. The third model has optional training and excludes people with problematic opioid use. Allowing for inclusion of people dependent on the current illegal market during transition is highlighted. With any of these models, this approach, while attending to illegal market drivers, would result in a greatly reduced illegal opioid market and its attendant toxic products, reduced violence and corruption, and at the same time, provide a sharper focus for medical use with more appropriate prescribing and indications.