| 1. |
- Deogan, Charlotte, et al.
(författare)
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Are Men Who Buy Sex Different from Men Who Do Not? : Exploring Sex Life Characteristics Based on a Randomized Population Survey in Sweden
- 2021
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Ingår i: Archives of Sexual Behavior. - : Springer Nature. - 0004-0002 .- 1573-2800. ; 50:5, s. 2049-2055
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Tidskriftsartikel (refereegranskat)abstract
- The buying and selling of sex is a topic of frequent discussion and a relevant public health issue. Studies of sex workers are available, while studies addressing the demand side of sex are scarce, especially based on robust population data. The current study provides national estimates of the prevalence of and factors associated with having paid for sex among men in Sweden. We used a randomized population-based survey on sexual and reproductive health and rights among ages 16-84 years, linked to nationwide registers. The sample consisted of 6048 men. With a logistic regression, we analyzed what sex life factors were associated with ever having paid for or given other types of compensation for sex. A total of 9.5% of male respondents reported ever having paid for sex. An increased probability of having paid for sex was identified in men who were dissatisfied with their sex life (aOR: 1.72; 95% CI: 1.34-2.22), men reporting having had less sex than they would have liked to (aOR: 2.78; 95% CI: 2.12-3.66), men who had ever looked for or met sex partners online (aOR: 5.07; 95% CI: 3.97-6.46), as well as frequent pornography users (aOR: 3.02; 95% CI: 2.28-3.98) Associations remained statistically significant after adjustment for age, income, and educational attainment. Sex life characteristics such as poor sex life satisfaction, high online sex activity, and frequent pornography use are strongly associated with sex purchase. These findings can help guide and support counselling and prevention activities targeting sex buyers.
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| 2. |
- Deogan, Charlotte, et al.
(författare)
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Having a child without wanting to? : Estimates and contributing factors from a population-based survey in Sweden
- 2022
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 50:2, s. 215-222
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aims of the current study were to identify the prevalence of unwanted childbirth (UC), to explore the association with sociodemographic factors and to identify possible contributing factors such as psychosomatic health, contraceptive use, experiences of induced abortion and sexual violence. Methods: We used Swedish data from the randomised population-based study SRHR2017 on sexual and reproductive health and rights (SRHR), based on self-administered surveys, linked to nationwide registers. The national sample consisted of 14,537 women and men aged between 16 and 84 years. With logistic regression, we examined differences in self-reported experience of UC, stratified by sex, in relation to socio-economic factors, as well as several possible contributing factors. Results: Despite advances in SRHR and fertility control, 6% of women and men in Sweden reported UC. This experience tends to be unevenly distributed in the population according to age, country of birth and, to some extent, income and educational attainment. Previous experience of induced abortion, sexual violence and threat from a partner were significantly associated with UC, whereas self-reported good health was protective. Conclusions: Mechanisms behind unintended, unplanned, unwanted or mistimed pregnancies are complex. Current results focus on the role of individual factors and personal experiences. In addition, in line with previous understanding, there is a need for adopting a broader socio-ecological perspective on fertility intentions.
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| 3. |
- Deogan, Charlotte, et al.
(författare)
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Meeting sexual partners online and associations with sexual risk behaviors in the Swedish population
- 2020
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Ingår i: Journal of Sexual Medicine. - : Oxford University Press (OUP). - 1743-6095 .- 1743-6109. ; 17:11, s. 2141-2147
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Tidskriftsartikel (refereegranskat)abstract
- Background: Online arenas may facilitate sexual encounters. However, to what extent finding sexual partners online is associated with sexual risk behavior and sexual health outcomes is still not fully explored. Methods: A stratified randomized population based study on sexual and reproductive health and rights of 50,000 Swedes was conducted in 2017. The final sample consisted of 14,537 women and men aged 16-84 years. We identified sexual health factors associated with finding sexual partners online and estimated prevalences thereof. Results: Having used the internet to meet sexual partners was reported by 11% (95% confidence interval: 10.1-12.3) of men and 7% (95% confidence interval: 6.0-7.4) of women and was most common among men aged 30-44 years (13.7%). After adjustment, those reporting a non-heterosexual identity were most likely to meet sexual partners online. Meeting sexual partners online was also associated with reporting several sexual risk behaviors: condomless sex with temporary partner during the past 12 months, adjusted odds ratio (AOR): 5.1 (3.8-6.8) for women and AOR: 6.0 (4.5-7.9) for men, and having had a test for sexually transmitted infections (STIs) generated a 4-fold AOR for both sexes, STI diagnosis showed a 2-fold AOR, ever having paid or given other compensation for sex AOR: 4.8 (2.7-8.8) for women and AOR: 4.2 (2.9-6.1) for men as well as ever having received money or other compensation for sex AOR: 4.0 (1.3-11.9) for women and AOR: 6.0 (2.4-15.1) for men. Clinical translation: Meeting sexual partners online was associated with sexual risk behaviors, which is of importance in tailoring sexual health interventions and STI/HIV-control activities. Strengths and limitations: Few studies of online sexual behaviors are based on population-based surveys of the general population with results stratified by sexual identity. However, the use of lifetime prevalence of ever having used the internet, smartphone, or app to meet sexual partners has limitations. Conclusion: Meeting sexual partners online was associated with sexual risk behaviors in a randomized sample of the Swedish population, which is of importance to tailoring sexual health interventions. Copyright (C) 2020, The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.
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| 4. |
- Deogan, Charlotte, et al.
(författare)
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Socioeconomic inequalities in sexual victimisation in a nationally representative sample of the Swedish population
- 2023
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 51:4, s. 552-560
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Sexual victimisation is a key public health concern because of its physical, psychological and social consequences. Nationally representative studies exploring sexual victimisation and re-victimisation are still scarce. The aim of the current study was to explore associations of sexual victimisation with sociodemographic factors including sexual orientation in Sweden.Methods: We used Swedish data from a national population survey linked to nationwide registers. The sample consisted of 3349 individuals aged 30-44 years, (2021 women and 1328 men). With a latent class analysis we identified groups of individuals with distinctly different experiences of sexual victimisation. Multinomial logistic regression was used to explore how common characteristics could explain latent class membership classes.Results: Experiences of sexual victimisation were common: 48% of women and 13% of men had experienced sexual harassment, 47% of women and 12% of women sexual assault, 11% of women and 1% of men attempted intercourse and 8% of women and 1% of men rape. Among women four groups were identified who had distinctly different experiences of exposure to sexual victimisation such as low victimisation, sexually harassed and assaulted several times, highly sexually victimised with low re-victimisation and finally high victimisation. Both women and men who were highly sexually victimised had to a higher extent a non-heterosexual sexual identity.Conclusions: Non-heterosexual orientation is a robust indicator of a high level of sexual victimisation as well as re-victimisation among both male and female adults.
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| 5. |
- Areskoug Josefsson, Kristina, 1973-, et al.
(författare)
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Education for sexual and reproductive health and rights (SRHR) : a mapping of SRHR-related content in higher education in health care, police, law and social work in Sweden
- 2019
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Ingår i: Sex Education. - : Taylor & Francis. - 1468-1811 .- 1472-0825. ; 19:6, s. 720-729
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Tidskriftsartikel (refereegranskat)abstract
- Knowledge of sexual and reproductive health and rights (SRHR) by health care, police, legal and social work professionals has been shown to be insufficient. This lack of competence is likely to affect the quality of services. The aim of this study was to describe SRHR indicators in educational programmes in health care, police, legal and social work higher education in Sweden. A text-based analysis was conducted of written material from all educational programmes in law, midwifery, nursing, occupational therapy, physiotherapy, police work, psychology, social work and undergraduate medicine (93 educational programmes at 27 universities and university colleges). Representation of different SRHR indicators varied, but most were poorly covered in the educational programmes. Existing educational programmes lack comprehensiveness in their coverage of SRHR and are unequal both within and between the professions and universities. This situation creates the risk of inequalities in SRHR competence and suggests that needs within this field may be unmet. There is an urgent need therefore to enhance the presence of SRHR in health care, social work and law enforcement education in Sweden.
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| 6. |
- Deogan, Charlotte, et al.
(författare)
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Cost-Effectiveness of School-Based Prevention of Cannabis Use
- 2015
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Ingår i: Applied Health Economics and Health Policy. - : Springer Science and Business Media LLC. - 1175-5652 .- 1179-1896. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cannabis is the most frequently used illicit drug globally. Despite increasing evidence that cannabis use is associated with adverse health effects, the knowledge on preventative strategies is still limited. This study stemmed from a systematic review of effective prevention in which school-based programmes were identified as promising. The primary objective was to evaluate the cost effectiveness of Project ALERT (Adolescent, Learning, Experiences, Resistance, and Training), compared with ordinary ATOD (Alcohol, Tobacco, and Other Drug) education, among Swedish students in the eighth grade of compulsory school.Methods: The cost-effectiveness analysis was performed from the societal perspective with quality-adjusted lifeyears (QALYs) as an outcome (willingness-to-pay threshold €50,000) and follow-up periods from 1 year to a lifetime, considering a discounting rate of 3 %, and with costs inflated to 2013 levels. A Markov model was constructed on the basis of the ‘states’ of single use, regular use, daily use and use of other illicit drugs, which were associated with ‘complications’ of psychosis, schizophrenia, traffic accidents, depression and amotivational syndrome. Health and cost consequences were linked to both states and complications.Results: The programme was cost saving on the basis of evidence from the USA (ratio 1:1.1), and was cost effective (incremental cost-effectiveness ratio €22,384 per QALY) after reasonable adjustment for the Swedish context and with 20 years of follow-up. When the target group was restricted to boys who were neither studying nor working/doing work experience, the programme was cost effective after 9 years and cost saving (ratio 1:3.2) after 20 years.Conclusion: School-based prevention such as Project ALERT has the potential to be cost effective and to be cost saving if implemented in deprived areas. In the light of the shifting landscape regarding legalization of cannabis, it seems rational to continue the health economic analysis of prevention initiated here.
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| 7. |
- Deogan, Charlotte L., et al.
(författare)
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A cost-effectiveness analysis of the Chlamydia Monday A community-based intervention to decrease the prevalence of chlamydia in Sweden
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : SAGE PUBLICATIONS LTD. - 1403-4948 .- 1651-1905. ; 38:2, s. 141-150
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The study was undertaken to assess the cost-effectiveness of the Chlamydia Monday, 2007. This is a community-based intervention aimed at reducing the prevalence of chlamydia by information and increased availability of testing, treatment and contact tracing in Stockholm. The aim was to analyze the cost-effectiveness by estimating costs, savings and effects on health associated with the intervention, and to determine if cost-effectiveness varies between men and women. Methods: A societal perspective was adopted, meaning all significant costs and consequences were taken into consideration, regardless of who experienced them. A cost-effectiveness model was constructed including costs of the intervention, savings due to avoiding potential costs associated with medical sequels of chlamydia infection, and health gains measured as quality adjusted life years (QALY). Sensitivity analyses were done to explore model and result uncertainty. Results: Total costs were calculated to be (sic)66,787.21; total savings to (sic)30,370.14; and total health gains to 9.852324 QALYs (undiscounted figures). The discounted cost per QALY was (sic)8,346.05 ((sic)10,810.77/QALY for women and (sic)6,085.35/QALY for men). Sensitivity analyses included changes in effectiveness, variation of prevalence, reduced risk of sequel progression, inclusion of prevented future production loss and shortened duration for chronic conditions. The cost per QALY was consistently less than (sic)50,000, which is often regarded as cost-effective in a Swedish context. Conclusions: The Chlamydia Monday has been demonstrated by this study to be a cost-effective intervention and should be considered a wise use of society's resources.
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| 8. |
- Deogan, Charlotte
(författare)
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Public health economics of chlamydia and other STIs : aspects of risk, prevention and resources
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to increase the knowledge of the public health economic aspects of chlamydia and other STIs, in terms of risk, prevention and resources. In Study I, we examined the association between demographic, socioeconomic and lifestyle factors and the risk of self-reported chlamydial infection among young adults in the Stockholm public health cohort. We found that the risk of self-reported chlamydia infection among young adults in Sweden was associated with lower age, high alcohol consumption, lower educational level and being employed or unemployed, on sick leave or pre-retired compared to being a student. In Study II, we identified potential key factors for successful regional prevention of chlamydia and other STIs by a case study including seven Swedish counties. We found that potential key factors include adequate programme- and county council investments, suitable organizational structure, strong leadership, management of regional networks, research connection, multiple local collaborations, high testing coverage and a strategic risk approach. In Study III, we analyzed the cost-effectiveness of the intervention Chlamydia Monday by estimating costs, savings and health gains generated by the intervention and analyzed whether the cost-effectiveness varied between men and women. We found that this testing intervention of a self-selected sample of individuals was cost-effective for both sexes with a discounted average cost of €8,346 per QALY. Sensitivity analyses showed consistent results for changes in parameters, and all scenarios except exclusion of contact tracing for males, generated a cost per QALY below the established threshold. In Study IV, we estimated the additional resources required to scale up adolescent- friendly health services to universal coverage in 74 low-and middle-income countries. We found that the financial costs for scaling up key adolescent-friendly health services was US$ 15.4 billion through 2015. The cost for STI management was approximately US$ 226.97 million of which approximately 20% constituted management of chlamydia. The estimated required resources illustrate a substantial investment gap in relation to current expenditure. In conclusion, the thesis illustrates a public health economic approach to studying STI- prevention. The findings show that chlamydia in young adults in Stockholm is associated with social and lifestyle factors, that greater consideration should be taken to the structural factors of prevention, that one of the common testing interventions implemented in many parts of Sweden is cost-effective and finally that considerable investment is required to improve quality and expand reproductive health care services to universal coverage for adolescents in the least developed countries in the world.
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| 9. |
- Johansson, Klara, et al.
(författare)
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Factors associated with condom use and HIV testing among young men who have sex with men : a cross-sectional survey in a random online sample in Sweden
- 2018
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Ingår i: Sexually Transmitted Infections. - : BMJ Publishing Group Ltd. - 1368-4973 .- 1472-3263. ; 94:6, s. 427-433
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The objectives are to analyse social determinants of sexual health behaviour (condom use and HIV testing) among young, internet-active, cis men who have sex with men (MSM) in a high-income country. The aspects of sexual health behaviour analysed here are condomless anal intercourse with one or more new or casual partner(s), condomless anal intercourse during the most recent sex with a man and HIV testing.METHODS: A randomised sample of men active on Sweden's main online community for Lesbian, Gay, Bisexual and Trans people responded to an online survey (response rate 19%). A subsample of young people, aged 15-29, was analysed (effective sample 597-669) using multivariable logistic regression with respect to factors associated with condomless anal intercourse with one or more new or casual partner(s), condomless anal intercourse at most recent sex and not having had a test for HIV.RESULTS: Low education, being single and living in a metropolitan area were found to be independently associated with condomless anal intercourse with new or casual partner(s). Sex with a steady partner was associated with condomless anal intercourse during the most recent sex. Knowledge of where to get tested, high education, being born outside Sweden and condomless anal intercourse with new or casual sex partner(s) were independently associated with having been tested for HIV.CONCLUSIONS: The factors associated with sexual health behaviour among young MSM are complex, and preventive messages need to be tailored accordingly.
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| 10. |
- Linander, Ida, 1987-, et al.
(författare)
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Ett spektrum av sexuella samtycken : En intervjustudie om samtycke hos sexuellt aktiva vuxna
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Studien undersöker hur sexuellt samtycke förstås, praktiseras och upplevs: Samtycke anses ofta vara en typ av avtal för sexuell aktivitet, men definitionen av sexuellt samtycke är komplex. Tidigare forskning har till stor del fokuserat på amerikanska collegestudenter, och det har saknats svenska empiriska studier som undersöker sexuellt samtycke i befolkningen.Syftet med den här studien är därför att undersöka hur sexuellt samtycke förstås, praktiseras och upplevs i sexuella relationer bland vuxna i Sverige idag.Studien är en kvalitativ intervjustudie med 31 sexuellt aktiva personer 23–61 år. Deltagarna rekryterades via annonser i lokaltidningar, breda Facebook-grupper och på stora arbetsplatser. Intervjuerna var semi-strukturerade och berörde sexuell kommunikation, sexuella relationer och erfarenheter av sexuellt samtycke. Intervjumaterialet analyserades med hjälp av tematisk analys.Samtycke kan placeras in på ett spektrum: Analysen av intervjuerna resulterade i ett huvudtema: Ett spektrum av samtycken: kontextuellaoch kontinuerliga sexuella praktiker. Huvudtemat beskriver hur samtycke är mångfacetterat och uttrycks olika beroende av situation,relation och föreställningar om kvinnlig och manlig sexualitet och sexuell praktik. Det beskriver också hur samtycke i sig och hur samtycke kommuniceras är föränderligt och pågående, bådeöver tid och i den sexuella situationen. Huvudtemat beskriver vidare hur deltagarnas förståelse, praktik och upplevelser av samtycke och brist på samtycke kan placeras in på ett spektrummellan fullkomligt samförstånd och avsaknad av samtycke, det vill säga i form av övergrepp och sexuellt våld. Däremellan kan kommunikationen vara bättre eller sämre, och förväntningar på kvinnlig och manlig sexualitet kan spela in i vad som upplevs eller förstås som samtycke. Gråzoner för vad som upplevs som självklart och lustfyllt, eller obekvämt eller tveksamt är en del av samtyckets spektrum. Huvudtemat byggs upp av fem underteman:1. Kommunikation – så tydligt, så svårt belyser deltagarnas syn på tydlig och lyhördkommunikation som en nyckel till ett fungerande sexuellt samtycke och samspel. Samtidigt upplever deltagarna att det är svårt att kommunicera om sex och samtycke, och att de därför kan behöva träna på det och finna forum för att förbättra dessa färdigheter. Vidare beskriver deltagarna att typen av kommunikation skiljer sig åt mellan olika slags sexuella situationer och praktiker. Det som upplevs som tabubelagt kan också försvåra en god kommunikation.2. Sex och samspel i samförstånd belyser hur sexuellt samtycke när det fungerar bra förstås som självklart och ömsesidigt. Det beskriver hur samtycken kan förändras och fungera olika beroende på situation och utifrån individuella och relationella faktorer. Samtycket är någonting pågående som sker här och nu.3. Samtyckets gråzoner beskriver upplevelser där deltagarna varit osäkra på sitt eget eller andras samtycke, och erfarenheter av att bristande lust har omvandlats till samtycke efter hand.4. Avsaknad av samtycke handlar om att samtycke inte uppnås utan på olika sätt överträds, exempelvis i form av sexuellt våld. Temat handlar också om konsekvenserna av att bära med sig dessa erfarenheter. 5. Att navigera och utmana föreställningar och praktiker för sexualitet belyser hur olika föreställningar om och förväntningar på sexuellt beteende utifrån kön påverkar hur deltagarna förstår, kommunicerar och praktiserar sexuellt samtycke. I temat ingår inslag av att utmana förväntningar på romantisk och tvåsam kärlek. Viktiga insikter för arbetet för sexuell hälsa och motsexuellt våld: Kunskapen från studien kan öka förståelsen för hur sexuellt aktiva vuxna kommunicerar, praktiserar och upplever sexuellt samtycke. Detta har både vetenskaplig och samhälleligbetydelse. Insikterna kan bidra till att utveckla det hälsofrämjande arbetet för sexuell hälsa samtutveckla interventionerna i det förebyggande arbetet och de behandlande insatserna vid sexuellatrakasserier och sexuellt våld.
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| 11. |
- Lindroth, Malin, 1968-, et al.
(författare)
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Rätten till hälsa : Hur normer och strukturer inverkar på transpersoners upplevelser av sexuell hälsa
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna rapport handlar om transpersoners upplevelser och beskrivningar av sexuell hälsa och baseras på en kvalitativ intervjustudie. Utgångspunkten för studien är Folkhälsomyndighetens arbete med nationella strategin mot hiv och aids och vissa andra smittsamma sjukdomar (proposition 2005/06:60) samt uppföljningen av hälsan bland trans-personer inom regeringens strategi för lika möjligheter och rättigheter oavsett sexuell läggning, könsidentitet eller könsuttryck.Resultatet innehåller transpersoners egna beskrivningar och utsagor kring möjligheter och hinder till sexuell hälsa samt berör sexuellt risktagande och erfarenheter av möten med personal inom hälso- och sjukvården. Resultaten visar att respekt är centralt för upplevelsen av sexuell hälsa– respekt för sig själv, sin kropp och sina känslor samt respekt från andra i intima relationer och relationer med personal inom hälso- och sjukvården.Rapporten riktar sig till främst till personal inom hälso- och sjukvården, kommuner landsting, relevanta myndigheter och ideella organisationer inom området. Förhoppningen är att rapporten kan bidra med insikt och kunskap om transpersoners livssituation i relation till sexualitet, sexuell hälsa och sexuellt risktagande samt ge underlag avseende hälsofrämjande och sjukdomsförebyggande arbete.
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| 12. |
- Lindroth, Malin, et al.
(författare)
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Sexual health among transgender people in Sweden
- 2017
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Ingår i: International Journal of Transgenderism. - : Taylor & Francis. - 1553-2739 .- 1434-4599. ; 18:3, s. 318-327
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Transgender people´s general health and sexual function has previously been studied. However, holistic sexual health—physical, emotional, and relational well-being in relation to sexuality—as both a determinant for and a part of general health is an understudied field in research concerning health among transgender people. There is no research addressing holistic sexual health and sexual health determinants combining quantitative and qualitative data.Aim: To explore and describe holistic sexual health and sexual health determinants among transgender people in Sweden.Methods: For the purpose of this paper, descriptive statistics from a previous web-based survey with 796 respondents and quotes from a previous qualitative interview study with 20 transgender people were combined.Results: Physical, emotional, and relational well-being are all vital aspects for experiencing holistic sexual health; that is, they are all important sexual health determinants, although of different importance to different individuals at different times. Satisfaction with sex life, having an ongoing sexual relationship and having been exposed to disrespectful or discriminatory care are examples of physical, emotional, and relational sexual health determinants that are connected to factors such as condom use, access to respectful STI/HIV-testing and having received reimbursement for sex. Experiences of disrespect and discrimination were reported in both the qualitative and the quantitative data, and in the qualitative data a wish for equity in access to sexual health care is evident.Conclusion: The results provide a broad and extensive insight into transgender people´s sexual health in Sweden. Furthermore it underlines that access to nondiscriminatory health care services is vital, including access to gender-confirming care and different sexual-health-promoting and preventive services such as testing facilities.
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| 13. |
- Nkulu-Kalengayi, Faustine Kyungu, et al.
(författare)
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Evidence and gaps in the literature on HIV/STI prevention interventions targeting migrants in receiving countries : a scoping review
- 2021
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Ingår i: Global Health Action. - : Taylor & Francis Group. - 1654-9716 .- 1654-9880. ; 14:1
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Evidence suggests that migration increases vulnerability to human immunodeficiency virus (HIV) and other sexually transmitted infections (STI). However, there is limited knowledge about what has been done or needs to be done to address migrants' vulnerability in receiving countries.OBJECTIVES: A scoping review was carried out to map the existing literature in this field, describe its characteristics, identify gaps in knowledge and determine whether a Sexual and Reproductive Health and Rights (SRHR)-perspective was applied.METHODS: We used the Arksey and O'Malley framework and the Joanna Briggs Institute guidelines for scoping reviews and subsequent enhancements proposed by other authors. We searched three databases and grey literature to identify relevant publications.RESULTS: A total of 1,147 records were found across the three electronic databases and compiled. Of these, only 29 papers that met the inclusion criteria were included. The review shows that research in this field is dominated by studies from the USA that mostly include behavioural interventions for HIV and HBV prevention among migrants from Latin America and Asian countries, respectively. None of the interventions integrated an SRHR perspective. The intervention effects varied across studies and measured outcomes. The observed effects on knowledge, attitudes, perceptions, behavioural intentions and skills were largely positive, but reported effects on testing and sexual risk behaviours were inconsistent.CONCLUSIONS: There is a need for good quality research, particularly in parts of the world other than the USA that will address all STIs and specifically target the most vulnerable subgroups of migrants. Further research requires greater scope and depth, including the need to apply an SRHR perspective and incorporate biomedical and structural interventions to address the interacting causes of migrants' vulnerability to HIV/STIs.
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| 14. |
- Stenström, Nils, et al.
(författare)
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Cannabisprevention i skolor – kostnadseffektivt?
- 2015
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Ingår i: BestPractice. ; :15, s. 19-21
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Tidskriftsartikel (refereegranskat)abstract
- Cannabisanvändning kan få negativa konsekvenser för ungdomars hälsa och mentala förmåga samt medföra ekonomiska kostnader för samhället.I denna studie exemplifieras kostnader för en typ av förebyggande insats, för besparingar inom olika samhällssektorer samt för hälsorelaterade risker i form schizofreni, psykos, depression, trafikolyckor och amotivationssyndrom. Med hjälp av hälsoekonomisk modellering skattas kostnadseffektivitet i form av kostnader (i EUR) per enhet vunnen hälsa mätt i kvalitetsjusterade levnadsår (QALY) av skolbaserad cannabisprevention i relation till traditionell ANDT-undervisning (alkohol, narkotika, dopning och tobak).Resultaten visar att det amerikanska programmet Project ALERT skulle kunna vara en kostnadseffektiv strategi för cannabisprevention efter rimlig anpassning till svenska förhållanden (cirka 22 000 EUR/ QALY), och kostnadsbesparande om det riktas mot pojkar 14–15 år från socioekonomiskt svaga områden (relationen kostnad:besparing cirka 1:3). Utifrån bland annat den diskussion om legalisering av cannabis som pågår på många håll i världen rekommenderar vi fortsatt arbete med det hälsoekonomiska perspektivet för utvärdering av preventiva strategier.
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