Browsing by Author "De Meyer, Sara"

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A cross-sectional study on attitudes toward gender equality, sexual behavior, positive sexual experiences, and communication about sex among sexually active and non-sexually active adolescents in Bolivia and Ecuador
(2014) De Meyer, Sara; Jaruseviciene, Lina; Zaborskis, Apolinaras; Decat, Peter; Vega Crespo, Bernardo José; Pozo Córdova, Kathya; Temmerman, Marleen; Degomme, Olivier; Michielsen, Kristien
Background: It is widely agreed upon that gender is a key aspect of sexuality however, questions remain on how gender exactly influences adolescents’ sexual health. Objective: The aim of this research was to study correlations between gender equality attitudes and sexual behavior, sexual experiences and communication about sex among sexually active and non-sexually active adolescents in 2 Latin American countries. Design: In 2011, a cross-sectional study was carried out among 5,913 adolescents aged 14 18 in 20 secondary schools in Cochabamba (Bolivia) and 6 secondary schools in Cuenca (Ecuador). Models were built using logistic regressions to assess the predictive value of attitudes toward gender equality on adolescents’ sexual behavior, on experiences and on communication. Results: The analysis shows that sexually active adolescents who consider gender equality as important report higher current use of contraceptives within the couple. They are more likely to describe their last sexual intercourse as a positive experience and consider it easier to talk with their partner about sexuality than sexually experienced adolescents who are less positively inclined toward gender equality. These correlations remained consistent whether the respondent was a boy or a girl. Non-sexually active adolescents, who consider gender equality to be important, are more likely to think that sexual intercourse is a positive experience. They consider it less necessary to have sexual intercourse to maintain a relationship and find it easier to communicate with their girlfriend or boyfriend than sexually non-active adolescents who consider gender equality to be less important. Comparable results were found for boys and girls. Conclusions: Our results suggest that gender equality attitudes have a positive impact on adolescents’ sexual and reproductive health (SRH) and wellbeing. Further research is necessary to better understand the relationship between gender attitudes and specific SRH outcomes such as unwanted teenage pregnancies and sexual pleasure among adolescents worldwide.
Boys should have the courage to ask a girl out: gender norms in early adolescent romantic relationships
(2017) De Meyer, Sara; Kagesten, Anna; Mmari, Kristin; Mceachran, Juliet; Chilet Rosell, Elisa; Kabiru , Caroline W.; Maina, Beatrice; Jerves Hermida, Elena Monserrath; Currie, Candace; Michielsen, Kristien
Purpose: The purpose of the study is to explore how gender norms emerge in romantic relationships among early adolescents (EAs) living in five poor urban areas. Methods: Data were collected as part of the Global Early Adolescent Study. The current research analyzed data from interviews with 30 EAs (aged 11e13 years) living in five poor urban sites: Baltimore, Cuenca, Edinburgh, Ghent, and Nairobi. All interviews were recorded, transcribed, and analyzed in English using Atlas.ti, focusing on how EAs experience and perceive gender norms in romantic relationships. Results: Across the five sites, only a few respondents described having been in love, the majority of whom were boys. Findings indicate that stereotypical gender norms about romantic relationships prevail across these cultural settings, depicting boys as romantically/sexually active and dominant, and girls as innocent with less (romantic) agency. In spite of the similarities, Nairobi was unique in that respondents referred to how sexual behavior and violence can occur within EA relationships. In all countries, heterosexuality was perceived to be the norm. Nevertheless, there were examples of EAs accepting homosexuality and expressing supportive attitudes toward equality between the sexes. Conclusions: While EAs across five different cultural settings seem to endorse stereotypical gender norms in romantic relationships, a few stories also illustrate more gender-equal attitudes. Asstereotypical gender norms have a demonstrated negative effect on adolescent sexual and reproductive health and well-being, additional research is needed to understand which factorsdat the interpersonal and structural leveldcontribute to the construction of these norms among EAs.
Community embedded reproductive health interventions for adolescents in Latin America: development and evaluation of a complex multi-centre intervention
(2013) Decat, Peter; Nelson, Erica; De Meyer, Sara; Jaruseviciene, Lina; Orozco, Miguel Angel; Segura, Zoyla Esmerada; Gorter, Anna Cornelia; Vega Crespo, Bernardo José; Córdova, Kathya; Maes, Lea; Temmerman,, Marleen; Leye,, Els; Degomme, Olivier
Background: Adolescents in Latin America are at high risk for unwanted and unplanned pregnancies, which often result in unsafe abortions or poor maternal health outcomes. Both young men and women in the region face an increased risk of sexually transmitted infections due to inadequate sexual and reproductive health information, services and counselling. To date, many adolescent health programmes have targeted a single determinant of sexual and reproductive health. However, recent evidence suggests that the complexity of sexual and reproductive health issues demands an equally multi-layered and comprehensive approach. Methods. This article describes the development, implementation and evaluation design of the community-embedded reproductive health care for adolescents (CERCA) study in three Latin American cities: Cochabamba (Bolivia), Cuenca (Ecuador) and Managua (Nicaragua). Project CERCA's research methodology builds on existing methodological frameworks, namely: action research, community based participatory research and intervention-mapping.The interventions in each country address distinct target groups (adolescents, parents, local authorities and health providers) and seek improvement of the following sexual health behaviours: communication about sexuality, sexual and reproductive health information-seeking, access to sexual and reproductive health care and safe sexual relationships.In Managua, we implemented a randomised controlled study, and in Cochabamba and Cuenca we adopted a non-randomised controlled study to evaluate the effectiveness of Project CERCA interventions, in addition to a process evaluation. Discussion. This research will result in a methodological framework that will contribute to the improved design and implementation of future adolescent sexual and reproductive health interventions. Trial registration. ClinicalTrials.gov (NCT01722084). © 2013 Decat et al; licensee BioMed Central Ltd.
Mejora de la salud sexual y reproductiva del adolescente en América Latina: reflexiones de un Congreso Internacional
(2015) Pozo Córdova, Kathya; Venkatraman, Chandra Mouli; Decat, Peter; Nelson, Erica; De Meyer, Sara; Jaruseviciene, Lina; Vega Crespo, Bernardo José; Segura, Zoyla Esmeralda; Auquilla Díaz, Nancy Eulalia; Hagens, Arnold; Braeckel, Dirk Van; Michielsen, Kristien
En febrero de 2014, un congreso internacional sobre la promoción de la Salud Sexual y Reproductiva de los adolescentes (SSRA) tuvo lugar en Cuenca, Ecuador. Su objetivo era compartir evidencia sobre proyectos y programas de intervención eficaz en SSRA en América Latina, y vincular esta evidencia a la política de SSRA y al desarrollo de programas. Más de 800 personas participaron en un evento de tres días con sesenta y seis presentaciones. Este documento resume los puntos clave del congreso y del proyecto CERCA (Cuidado de la Salud sexual y Reproductiva para Adolescentes enmarcada en la comunidad). Su objetivo es orientar la investigación futura y la política de SSRA en América Latina. 1. El contexto es importante. Los comportamientos individuales están fuertemente influenciados por el contexto social en el que se producen a través de factores determinantes a nivel individual, relacional, familiar, comunitario y social. Las normas de género, actitudes y facilidad de comunicación son dos factores determinantes. 2. Acción innovadora. Hay evidencia limitada e irregular de los enfoques eficaces para llegar a los adolescentes con intervenciones que necesitan llevarse a escala. Sin embargo, existen varios ejemplos que fueron presentados en el congreso y que se ven prometedores e innovadores porque proporcionan una educación integral de la sexualidad a través de los métodos convencionales y el uso de nuevos medios de comunicación, la mejora del acceso a servicios de salud, y uso de intervenciones comunitarias para llegar a los adolescentes, familias y su comunidad. 3. Mejor medición. Los diseños de evaluación y los indicadores elegidos para medir el efecto e impacto de las intervenciones no siempre son sensibles a los cambios sutiles y graduales. Esto puede crear una brecha entre la eficacia de medidas y el impacto percibido por las poblaciones beneficiarias. Por lo tanto, una conclusión es que necesitamos más pruebas para determinar mejor los factores que obstaculizan el progreso en la SSRA de América Latina, para innovar y responder con flexibilidad a los cambios en la dinámica social y las prácticas culturales, y para medir mejor el impacto de las estrategias de intervención existentes. No obstante, este congreso proporcionó un punto de partida para construir un esfuerzo común entre las multi agencias y multi-país que genere evidencia específica sobre SSRA con el objetivo de orientar la toma de decisiones políticas y programas. En una región que aún tiene barreras de acceso a la educación y los servicios de SSRA y se encuentran las tasas de embarazo adolescente más altas del mundo, los participantes coincidieron en que no hay tiempo que perder.
Reorienting adolescent sexual and reproductive health research: Reflections from an international conference
(2016) Chandra Mouli, Venkatraman; Michielsen, Kristien; De Meyer, Sara; Olena, Ivanova; Vega Crespo, Bernardo José
On December 4th 2014, the International Centre for Reproductive Health (ICRH) at Ghent University organized an international conference on adolescent sexual and reproductive health (ASRH) and well-being. This viewpoint highlights two key messages of the conference - 1) ASRH promotion is broadening on different levels and 2) this broadening has important implications for research and interventions – that can guide this research field into the next decade. Adolescent sexuality has long been equated with risk and danger. However, throughout the presentations, it became clear that ASRH and related promotion efforts are broadening on different levels: from risk to well-being, from targeted and individual to comprehensive and structural, from knowledge transfer to innovative tools. However, indicators to measure adolescent sexuality that should accompany this broadening trend, are lacking. While public health related indicators (HIV/STIs, pregnancies) and their behavioral proxies (e.g. condom use, number of partners) are well developed and documented, there is a lack of consensus on indicators for the broader construct of adolescent sexuality, including sexual well-being and aspects of positive sexuality. Furthermore, the debate during the conference clearly indicated that experimental designs may not be the only appropriate study design to measure effectiveness of comprehensive, context-specific and long-term ASRH programmes, and that alternatives need to be identified and applied. Presenters at the conference clearly expressed the need to develop validated tools to measure different sub-constructs of adolescent sexuality and environmental factors. There was a plea to combine (quasi-)experimental effectiveness studies with evaluations of the development and implementation of ASRH promotion initiatives.
Sexual onset and contraceptive use among adolescents from poor neighbourhoods in Managua, Nicaragua
(2015) Decat, Peter; De Meyer, Sara; Jaruseviciene, Lina; Orozco Valladares, Miguel Angel; Ibarra, Marcia; Segura, Zoyla Esmeralda; Medina, Joel; Vega Crespo, Bernardo José; Michielsen, Kristien; Temmerman, Marleen; Degomme, Olivier
Background and objectives The prevalence of teenage pregnancies in Nicaragua is the highest in Latin-America. This study aimed to gain insight into factors which determine the sexual behaviours concerned. Methods From July until August 2011, a door-to-door survey was conducted among adolescents living in randomly selected poor neighbourhoods of Managua. Logistic regression was used to analyse factors related to sexual onset and contraceptive use. Results Data from 2803 adolescents were analysed. Of the 475 and 299 sexually active boys and girls, 43% and 54%, respectively, reported contraceptive use. Sexual onset was positively related to increasing age, male sex, alcohol consumption and not living with the parents. Catholic boys and boys never feeling peer pressure to have sexual intercourse were more likely to report consistent condom use. Having a partner and feeling comfortable talking about sexuality with the partner were associated with hormonal contraception. Conclusions Our data identifi ed associates of adolescents ’sexual behaviour related to personal characteristics (sex and alcohol use), to the interaction with signifi cant others (parents, partners, peers) and to the environment (housing condition, religion). We interpreted those associates within the context of the rapidly changing society and the recently implemented health system reform in Nicaragua.
Which factors contribute to sexual well-being? A comparative study among 17 to 20 year old boys and girls in Belgium and Ecuador
(2021) De Meyer, Sara
Despite recognition that sexual well-being is an important part of adolescent sexual and reproductive health, a clear description of adolescent sexual well-being does not yet exist. Through six in-depth interviews and four focus group discussions with 56 young people in two distinct contexts (Belgium and Ecuador), we used the social-ecological framework to identify factors influencing adolescent sexual well-being. According to respondents, the main factors that influence adolescent sexual well-being are not only situated at the individual (having knowledge and skills and being physically, sexually and mental mature and healthy) and interpersonal levels (positive attraction towards others and communication about sexuality), but at a broader societal level, including social acceptance of sex, gender and sexual diversity and its (legal) translation into comprehensive sexuality education and the ready availability of contraceptives. Our results go well beyond two existing definitions of (adolescent) sexual well-being to contribute to understanding and measurement from the perspective of young people themselves, adding substantively to ongoing discussion about the definition of the concept.