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Harmful sexual behaviour (HSB) carried out by children and young people can include sexual abuse of younger children or adults, or sexual assault in dating or peer relationships. The aim of this paper is to capture the "practice wisdom" of practitioners and applied researchers about clusters of risk factors associated with HSB onset, as well as possibilities for earlier intervention. Participants included practitioners and applied researchers in the HSB field. Data was collected in 2020 through individual interviews with eight key expert informants, and two group interviews – the first with two applied researchers and the second with three practitioners. Data analysis revealed risk factor clusterings around five key childhood experiences: being sexually curious; having a sexual interest in children; living with childhood trauma; living with contextual violence; and using pornography. These clusters are discussed in relation to early intervention. PRACTICE IMPACT STATEMENT Harmful sexual behaviour (HSB) is preventable but the early intervention agenda is underdeveloped. In this paper, five risk clusters are identified: being sexually curious; having a sexual interest in children; living with childhood trauma; living with contextual violence; and using pornography. The identification of these risk clusters present opportunities for early intervention that could enhance the prevention agenda to address HSB in Australia and internationally. [ABSTRACT FROM AUTHOR]

Secondary prevention efforts, which target risk and protective factors associated with harmful sexual behaviour (HSB) and seek to intervene early in the trajectory of HSB, are underdeveloped in Australia. This study explored design considerations for an online early intervention service for children and young people worried about their sexual thoughts and behaviours. A trauma-informed child right's framework underpinned the study, which involved 10 individual interviews with international experts in HSB, and one group interview (n = 3) with Australian practitioners. Analysis was carried out using thematic analysis. Results reflect design considerations in relation to: theoretical approaches; practice frameworks; service delivery components; and helpseeking challenges. Key tensions emerging from the results are discussed, including the need to move beyond binary constructions of victims and perpetrators. PRACTICE IMPACT STATEMENT: This paper has significant potential to influence practice in the field of harmful sexual behaviour prevention and response. The paper sets out the components of an early intervention online service for children and young people worried about their sexual thoughts and behaviours. The online service could be built and trialed for impact and efficacy in supporting children and young people not to sexually harm. It would be the first service of its kind in Australia and fill a gap in the current service delivery landscape. [ABSTRACT FROM AUTHOR]

This paper develops and applies the emergent concept of institutional transphobia to explore the barriers to transgender research in early years education. It argues that institutional processes embed and disguise the logic of transphobia by drawing on dominant, taken-for-granted claims of the inappropriateness or irrelevance of gender-focused education interventions that challenge cis-normativity and heteronormativity. Drawing on the barriers and difficulties experienced through a PhD journey, the paper explores how institutional transphobia was evident in the seemingly neutral reasons for denying site access and ethics approvals, divergent institutional ethics requirements, the tensions between individual support and institutional processes, and the expectations on research higher degree students. The paper concludes that current processes and priorities must be challenged and replaced with an institutional mandate that explicitly values and welcomes transgender research as a priority. [ABSTRACT FROM AUTHOR]

Female genital fashioning practices, a term encompassing a range of temporary and permanent options for cosmetic genital alteration, are becoming an increasingly prominent part of contemporary beauty regimes. Drawing on a series of 11 small focus groups and 10 interviews with 34 Australian women aged 18–30, this paper explores the ways that cisgender young women negotiate a combination of social pressures, pleasures and influences in their decisions to engage with genital fashioning. These pressures are described by women to emanate from broad social norms, sexual partners, family members, and peer groups. The women in this study demonstrate a nuanced and critical awareness of the cultural context which they inhabit but deploy postfeminist narratives of self-care and enjoyment to make sense of genital fashioning practices. The paper contributes to scholarship on postfeminism by demonstrating the ways that women creatively use the discursive tools available to enable critical reflection on notions of choice. At the same time, the findings in this study constitute an empirical contribution to critiques of postfeminism to reveal the limitations of postfeminist reasoning which ultimately works to curtail or impede the identification of structural problems and constraints. [ABSTRACT FROM AUTHOR]

Barriers and facilitators affecting the social activities of people with congenital physical and communication disabilities are well documented. However, little is known of their experiences of developing sexual and intimate relationships. This study conducted a systematic review of the literature to address this gap in knowledge. Ten online databases were searched for relevant papers between 1990 and 2014. In addition, hand searches of Augmentative and Alternative Communication Journal and the Sexuality and Disability Journal were conducted. Fifteen papers were identified and appraised. The thematic coding approach identified six principal themes. However, the content analysis revealed that the majority of the literature focused on the social needs of people with physical and communication disabilities. Despite evidence that people with disabilities are sexually active, there is little focus on the experiences of people with disabilities developing intimacy and expressing sexuality. The few references to sexuality in the relevant literature focused on protection from abuse, though some researchers called for improved counseling on sexuality and relationships, and improved access to sexual health services. Further research is required to focus on practical and theoretical outcomes to enhance social relationships and sexuality, and offer lovers who use AAC real advice in their search for intimacy. [ABSTRACT FROM AUTHOR]

Previous research has indicated that healthcare support for sexuality after spinal cord injury appears to be neglected or inadequately provided. The perspectives of people living with spinal cord injuries regarding what is lacking and what support they would like to be provided, and why, has yet to be explored. This paper uses critical theory to explore how societal constructs of sexuality and disability shape how sexuality is supported after a spinal cord injury. To do this, we conducted in-depth semi-structured interviews with 11 people with a spinal cord injury from Australia, the United Kingdom, and the United States. We drew from the works of various critical disability theorists to analyze what discourses underpinned the experiences people with spinal cord injuries had when receiving sexuality support. Analysis suggested that the following discourses were apparent: (1) broken bodies require repair, (2) sex is penetration, ejaculation then reproduction, and (3) sexual autonomy is required. Findings indicated healthcare professionals need to recognize people with spinal cord injuries as sexual beings with a diverse range of desires, lives, relations, and bodies. Provision of individualized comprehensive high-quality sexuality support is therefore warranted. To achieve this, healthcare professionals should aim to be aware of, and mitigate, ableist and normative assumptions. [ABSTRACT FROM AUTHOR]

Background: It is unclear what factors are associated with sexually transmissible infections (STI) and HIV testing and diagnosis among justice-involved adolescents, and if these differ for Aboriginal or Torres Strait Islander peoples. Methods: A cross-sectional survey of 465 justice-involved adolescents (aged 14–17 years) from Australia was conducted between 2016 and 2018. Participants were asked about sexual behaviours, STI/HIV knowledge, and prior STI diagnoses and testing. Results: Approximately 38% (n = 130) of those sexually active had ever been screened for STI/HIV and 17.8% (n = 23) had been diagnosed with an STI. No participant reported living with HIV. For Aboriginal participants, being male (aOR 3.6, 95% CI 1.3–10.1) and having under three sexual partners in the past 12 months (aOR 3.1, 95% CI 1.2–8.0) was associated with never having had an STI/HIV test. For non-Aboriginal participants, being male (aOR 2.7, 95%CI 1.2–5.7), single (aOR 2.4, 95% CI 1.2–4.9), attending school (aOR 2.4, 95% CI 1.1–5.1), not having sought sexual health information (aOR 2.8, 95% CI 1.4–5.8), and having a lower STI/HIV knowledge score (aOR 2.3, 95% CI 1.1–5.0) were associated with never having had an STI/HIV test. Factors associated with STI diagnosis were non-heterosexual sexual orientation (aOR 5.6, 95% CI 1.1–28.2), transactional sex (aOR 11.2, 95% CI 3.0–41.3), and having sought sexual health information (aOR 3.5, 95% CI 1.0–12.5). Conclusions: Males, particularly Aboriginal male adolescents, should be engaged with sexual health promotion and testing services as soon as they come into contact with the justice system. Approaches should consider different cultural, gender and sexual orientations. This paper reports on the sexual behaviours of Aboriginal and non-Aboriginal adolescents who have come into contact with the Australian justice system and looks at factors associated with testing for sexually transmissible infections (STI) and HIV, and diagnosis of sexually transmissible infections. Findings suggest there are different factors associated with STI/HIV testing for Aboriginal and non-Aboriginal justice-involved adolescents. Sexual health education should start early and consider gender, cultural and sexual orientation differences. [ABSTRACT FROM AUTHOR]

Gay and bisexual men (GBM) report higher rates of sexualised and injecting drug use (IDU) than heterosexual men. Injecting-related stigma is linked to negative health outcomes among people who inject drugs (PWID). This paper describes the ways in which stigmatisation manifests in the narratives of GBM who inject drugs. We conducted in-depth interviews with Australian GBM with IDU histories, exploring drug use, pleasure, risk, and relationality. Data were analysed using discourse analytical approaches. Interviewees (n = 19), aged 24–60 years, narrated their experiences of IDU practice over 2–32 years. Most (n = 18) injected methamphetamine, and used other (non-injected) drugs, in sexual contexts. From participants' narratives, we developed two themes related to stigmatisation of PWID that illustrate the limitations of conventional drug discourses to narrate GBM's experiences. The first theme captures participants' attempts to pre-empt stigmatisation, outlining the layering of stigma faced by GBM who inject drugs. Linguistically, participants transformed injecting stigma by distinguishing their personal practice from that of more discreditable drug users. Practically, they mitigated stigmatisation by keeping discrediting information from others. The second theme illustrates how by complicating the stereotypes of IDU, participants took up prominent discursive practices linking IDU with trauma and pathology. Participants exerted agency by broadening available interpretive repertoires for understanding IDU among GBM, thus creating a counter-discourse. We argue that mainstream discursive practices reverberate through gay communities, perpetuating stigmatisation of PWID and inhibiting care-seeking. More narration of unconventional experiences, beyond insular social groups and critical scholarship, is needed in public discourse to effect destigmatisation. [ABSTRACT FROM AUTHOR]

Intimate partner sexual violence (IPSV) is a common yet hidden form of violence. It is primarily perpetrated against women by their male partners and is associated with a range of serious mental and physical health outcomes. Despite these harms, it is chronically under-researched. In particular, the overlaps between IPSV and psychological abuse in relationships are poorly understood. Extant literature has focused primarily on the relationship between IPSV and physical violence, neglecting the fact that IPSV often involves verbal or emotional coercion, threats or blackmail rather than the use of 'force'. In this paper, we draw on reflexive thematic analysis of qualitative interviews with n = 38 victim/survivors of IPSV to explore how they understood the relationship between sexual and psychological abuse in their heterosexual relationships. Four themes were developed from this analysis: 1. I felt like I couldn't say Nno'; 2. I felt degraded and worthless; 3. Letting me know who's boss; and 4. Making me feel crazy. These themes broadly correspond to four distinct patterns or interactions between IPSV and psychological abuse. Our findings strongly suggest that the relationship between sexual and psychological abuse in relationships is far more complex than previous research would indicate. Psychological abuse is not simply a tool to obtain sex and sexual violence is not only used as a mechanism of psychological control. Instead, the two forms of abuse interact in ways that can be unidirectional, bi-directional or simultaneous to develop and maintain an environment of fear and control and erode women's self-worth. [ABSTRACT FROM AUTHOR]

Colonialist views of Indigenous bodies and sexualities continue to affect Indigenous peoples worldwide. For Indigenous Australians, this burden has resulted in repression and oppression of power, sex and desire. Focusing on the sexual intimacies of Indigenous Australian women, this paper provides an account of the dominant Australian historical discourses, finding that Indigenous women were viewed as exotic, erotic, something to be desired, yet simultaneously something to be feared. Our sexualities were described as savage, promiscuous and primitive and we were often viewed as prostitutes with our voices and views constrained by patriarchal and imperial regimes of power. But within this context, Indigenous women fought back through both individual and collective acts of agency. This paper demonstrates how Indigenous Australian women's agency not as a new phenomenon but rather as a position that disrupts the popular discourses of exploitation and victimhood that have been persistently perpetrated against Indigenous women. [ABSTRACT FROM AUTHOR]

Lesbian, bisexual, transgender, queer and asexual (LGBTQA+) Australians are vulnerable to religion-based attempts to change or suppress their sexuality and/or gender identity, including conversion ideology messaging in school-based sex education. Conversion bans are currently being debated across the country. This paper reports on a critical survivor-driven study which retrospectively explored Australian LGBTQA+ youth exposure to conversion practices both within and outside of education settings. It privileges the perspectives of self-titled 'survivors' of conversion ideology and practices through the use of a reference group and constructivist grounded theory. Qualitative data were collected 20 from Australian LGBTQA+ conversion ideology and/or practice survivors aged 18 years and over, using focus groups and 35 individual interviews between 2016 and 2020. In conversion-promoting religious contexts including education institutions and groups, messages concerning sexuality and gender changed as individuals grew older and were drawn into more/enclosed settings in which core conversion messages of LGBTQA+ 'brokenness' were prevalent. While individuals progressed through the conversion experience in different ways, their experience was characterised by the absence of any form of affirming LGBTQA+ education – enabling conversion itself to become their LGBTQA+ (mis)information source. School policy addressing conversion, alongside enhanced provision of affirmative age-appropriate gender and sexuality education, may mediate this issue. [ABSTRACT FROM AUTHOR]

People with an intellectual disability experience a protective regime when it comes to their sexuality. Families, carers, services and others mediate their experiences and act as gatekeepers through policies and practices that focus on the regulation and management of sexuality. Sex education has traditionally been 'for' people with intellectual disabilities provided 'by' health professionals, teachers and other professions who position themselves as experts with the power to shape the sex education, information and learning opportunities that people with an intellectual disability access. This paper presents an alternative programme developed in collaboration with people with intellectual disabilities, which uses the stories of people with an intellectual disability and is facilitated by people with intellectual disabilities as peer educators. Crip theory rejects approaches to understanding the disability experience that privilege particular characteristics of disability experience over others including cognition. This paper argues this idea can offer a 'way in' for people with intellectual disabilities to research, debate and progress sexual rights within the current sexual rights vacuum in international law and policy. The paper demonstrates how an Australian peer education programme provides a liberating sex education for those involved through a focus on rights and use of peer education. [ABSTRACT FROM AUTHOR]

This literature review presents a critical appraisal of the dominant approaches toward the sexuality and relationships of people with acquired brain injury. In particular, we sought to identify and review existing programs focusing on sexuality and relationships which use an educational and/or peer–peer approach. A systematic and comprehensive search of the EBSCOHOST database was conducted within an unlimited time-frame to yield the highest number of relevant results possible, along with hand-searching of key journals and databases. Reports, papers and webpages, documents commonly referred to as 'grey literature' that are not published in peer-reviewed journals, were also hand searched as a part of this review. The database search yielded 862 results, 14 of which were found to be relevant to our research interests. All of the sexuality education programs identified in this review were experienced positively by participants, families, caregivers, and professionals working with people with acquired brain injury. No peer–peer sexuality and relationships programs were identified. However, we found strong support for the use of peer–peer approaches in other programs for people with acquired brain injury. This literature review provides strong support for the development peer–peer sexuality and relationships programs for people with acquired brain injury. However, any future programs would have to overcome the limitations of existing sexuality and relationships programs. [ABSTRACT FROM AUTHOR]

This paper explores attitudes toward dating people with disability amongst young people in Australia and Hong Kong. Data relating to disability were extracted from an e-survey that investigated young people's (n = 2208) experiences of and attitudes toward dating. Quantitative data were analysed using descriptive statistics while open ended responses were subjected to interpretive content analysis. When asked about preferred characteristics for potential dates, young people identified factors that were unlikely to be negatively influenced by disability, such as loyalty, honesty, dedication, humour, and kindness. Yet when asked whether disability would influence their dating choices, most said that it would and expressed an unwillingness to date people with disability. Young adults in Hong Kong expressed less openness to dating people with disability than those in Australia. Physical disability and mental health issues were seen as less of a barrier to dating than intellectual or developmental disability. Despite recent gains in public attitudes toward people with disability, improvements are needed in terms of young people in the general population viewing people with disability as suitable partners and thus, allowing them to enjoy equal rights to relationships and sexuality. Culture is an important determinant, indicating a potential for change. [ABSTRACT FROM AUTHOR]

Background While inclusive research has become an important stream in research with people with intellectual disabilities, there is a tension between the possibly empowering research process and the strength of the research itself to make social change happen. In this paper, we explore the contribution of two inclusive qualitative research studies in Australia and the Republic of Ireland to change in policy and legislation. Materials and methods Both studies used qualitative methods including life stories and focus groups to explore the issue of sexuality and relationships. In both studies, people with intellectual disabilities were actively involved in undertaking the research. Results Both studies revealed that it was difficult for people with intellectual disabilities to express their sexuality openly or to form adult relationships. Conclusions Both studies were used by people with intellectual disabilities and their supporters to promote change in which they had a heard voice. Accessible Abstract This paper is about how people with intellectual disabilities and their supporters can use research which they have done to change policies and laws that affect them. When people with intellectual disabilities are doing research it is called inclusive research.We write about two research studies which were about the sexual lives and relationships of people with intellectual disabilities. One research study was in Australia and one was in the Republic of Ireland.In the Australian study, Living Safer Sexual Lives, 25 people with intellectual disabilities told their life stories and talked about sexuality and relationships.In the Irish study people with intellectual disabilities told life stories and talked with other people with intellectual disabilities about their sexuality and relationships in groups. These are called focus groups.In this paper we explore 4 questions that arose from these studies. Question 1. What impact does doing research have on the people who are involved in it? People with intellectual disabilities in Australia were members of the group that guided the research. They were partners in its design, in deciding what questions should be asked about sexuality and relationships., and thinking about what was found out. They became involved in making films about the study. They learned a lot about research, sexuality and relationships and became members of a government committee to change policy about sexuality and people with disabilities. In Ireland people with intellectual disabilities involved in doing the research talked together about their lives. They then talked with 16 groups of people with intellectual disabilities about their relationships and sexuality. They learned about research and about sexuality and developed plays about their experiences., Question 2. To what extent can inclusive research change policy and practice? In Australia the research led to a change in government policy about sexuality and people with disabilities. The new policy clearly stated people with disabilities had rights to relationships and to a sexual life. It set out rights and responsibilities for people with intellectual disabilities and service providers about relationships and sexuality. It took a long time to get a change in policy and people with intellectual disabilities were part of the getting the change to happen. In Ireland there is a law which says that it is illegal to have some forms of sex with people with intellectual disabilities. From the research people with intellectual disabilities became involved in talking with government about changing this law so that it gives them more rights to a sexual life. The law has not changed yet but the voices of people with intellectual disabilities are now being heard., Question 3 When does research shift into being advocacy? How does this happen? People with intellectual disabilities in both studies became advocates to get change to happen. Partly this was because they had become more 'expert' about sexuality and relationships and the policy and law. They were angry at what they had found out in the research and wanted to get change to happen., Question 4 What added value does including people with intellectual disabilities as researchers give to the research? People with intellectual disabilities had knowledge and experience that made it possible for the research in both Australia and Ireland to happen. They were important in how the research was done and what was done with it after it was finished. [ABSTRACT FROM AUTHOR]

This paper reports on findings of the Sex Ed Dads survey which sought Australian fathers' perspectives on communicating with their young children about relationships and sexuality, as informal sexuality educators. Given the majority of existing family-based sexuality education research draws on the experiences of mothers, gaining insights from fathers is a much needed first step in designing resources to support paternal engagement in sexuality education. A diverse sample of 612 Australian fathers completed an online survey about their views on sexuality education and their role within it. Participating fathers valued sexuality education for their children and believed that their own informal contribution to its provision was important. Fathers reported high levels of comfort discussing a wide range of topics with their child at the age they deemed appropriate, although a gap between what fathers believed they should discuss and what they actually discussed was found. Findings offer insights for schools, resource developers and sexuality education providers seeking to support increased engagement of fathers in the sexuality education domain. [ABSTRACT FROM AUTHOR]

This paper describes the process of engaging young people in a user centred, co-design strategy to define their perfect condom. Our aims were 1) to find a way to destigmatise discussions about sexuality and contraception and 2) to provide information about what characteristics a perfect condom might embody for adolescents. We used arts-based methods to introduce creativity and enjoyment into discussing sensitive topics related to sexual and reproductive health, which is often avoided in relation to youth and usually nuanced by themes of risk and danger. Using theories of objects becoming things through their sociality, we explored what a condom could be to young people through our method of embedding the condom design process into narratives of young people's lives and integration of these ideas into the development of a next-generation condom. [ABSTRACT FROM AUTHOR]

Background Prevalence of sexually transmissible infections (STIs) has been associated with availability of alcohol. This paper investigates potential associations between prevalent cases of chlamydia in young people in Australia and the availability of alcohol within their local area, defined as postcode of residence. Methods Alcohol availability was determined at the postcode level using liquor licensing data, classified as total number of licences, number of 'take-away' licences and number of licenses by population. Participant data were drawn from a survey targeting Australians aged 16-29years in rural and regional Australia, capturing demographic details including postcode of residence, indicators of sexual behaviour including condom use and chlamydia test results. Mixed-effects logistic regression was used to examine potential associations between first, alcohol availability and chlamydia, and second, between condom use and chlamydia. Results We found little evidence of associations between alcohol availability and chlamydia in either unadjusted or adjusted models. After adjusting for alcohol availability, we observed significant associations between inconsistent condom use and chlamydia prevalence, whether alcohol availability was measured as total number (adjusted odds ratio (AOR) 2.20; 95% confidence interval (CI) 1.20, 3.70), number of take-away licenses (AOR 2.19; 95% CI1.30, 3.69) or licenses per 1000 population (AOR 2.19; 95% CI 1.30, 3.68). Conclusion Little evidence of association between alcohol availability and chlamydia at the postcode level was found. Further research is required to determine appropriate measures of 'local area' and how characteristics thereof may impact on sexual health. [ABSTRACT FROM AUTHOR]

Background Rising demand for sexual health services requires publicly funded service providers to ensure they are seeing members of priority populations. Sydney Sexual Health Centre in New South Wales, Australia developed an innovative online triage tool called 'Am I OK?' to support this goal. Methods This paper outlines the findings of a review that examined the use of the triage tool using retrospective cross-sectional analysis of 2017 data. Results The tool has achieved its purpose in ensuring that non-priority populations are referred to other services, consequently saving a significant amount (approximately 6months equivalent) of phone triage nurse time. Conclusion More work may need to be done to ensure that the tool is not creating a barrier for priority populations wishing to access the service. [ABSTRACT FROM AUTHOR]

Background The 'Down to Test (DTT)' campaign is a sexually transmissible infection (STI) social marketing intervention delivered through outdoor music festival activations and supported by digital media communications in New South Wales, Australia. This paper investigates whether and how the tailored messages reached the intended audience. Methods Data was collected through three annual rounds of online surveys post campaign exposure, targeting young people (aged 15-29years) attending 14 music festivals in NSW from October 2017 to March 2020. Descriptive statistics, principal component analysis and multivariable logic regression were applied to identify the key client segment and factors associated with a strong intention for future STI screening. Results Of the 10044 participants with a valid urine specimen submitted, 261 (2.8%) tested positive for chlamydia. Altogether, 1776 participants (median age=22) self-completed the evaluation surveys online with more being female (73.4%) than male (26.2%). Participants were mostly Australian-born (89.5%), heterosexual (82.6%) and the majority being sexually active (96.7%). Rates of self-reported lifetime STI testing (70.4%) and intention for future STI screening ('definitely yes' in the next 12months, 39.0%) were also high. The most significant factor associated with future intention for STI testing is the Sexual Experience and Perception Factor (adjusted odds ratio [AOR]=2.02; 95%CI 1.76-2.32; P<0.001), followed by the Sexual Beliefs and Attitudes Factor (AOR=1.14; 95% CI 1.01-1.30; P<0.05). Conclusions The NSW state-wide DTT campaign has largely reached sexually active youth who are attentive to sexual health promotion messages and contributed to enhanced STI screening in a fun and peer-supportive environment. [ABSTRACT FROM AUTHOR]

This paper represents our collective engagements and productive struggles with queer pedagogical-methodological (im)possibilities across a constellation of educational contexts. Following in the footsteps of queer theorists-pedagogues before us, we approach queerness as a horizon, a unique opportunity to experiment, take risks, explore new forms of undoing and to move-be-think-do otherwise. We begin by attending to the ways in which researcherseducators in the field of sexualities and schooling are pushing these conversations forward, followed by two vignettes from our own work. Our intention in sharing these vignettes is to slow down and expose some of the methodological-pedagogical processes that guide our work, our attempts to stay in the moment that trouble creates, and the challenge of staying in that moment to learn from it. This paper suggests that embracing new forms of enquiry, which account for queer methodological-pedagogical sensibilities, requires researcherseducators to actively embrace the failures of their own practice and engage with the contestations of theories that matter/materialise. [ABSTRACT FROM AUTHOR]

This paper examines the role of the research process in shaping the construction of knowledge about sensitive topics in in-depth interviews particularly with regard to researcher identity and cultural influences or norms. We argue that these influences shape all aspects of the research process and that researchers will benefit from reflecting upon them when planning, undertaking and interpreting qualitative studies. Drawing on an empirical study interviewing Australian women aged 55 years and older about sexuality we address differences and similarities between researchers and participants; cultural constructions of sexuality and ageing, and generational influences. Using examples from our interview data we interrogate the contribution of each of these aspects to the interview dynamic and the co-production of meaning. Our analysis draws attention to the fluidity of insider and outsider status and to the existence of hidden boundaries that impact on how certain topics can be discussed in interviews. The paper argues that knowledge about sensitive topics such as older people’s sexuality must be viewed as a situated occurrence shaped by the particularities of the interview and the cultural context. Finally, we discuss the implications of these findings for qualitative inquiries into sensitive topics. [ABSTRACT FROM PUBLISHER]

Research identifies unique challenges for younger women diagnosed with breast cancer at or before 45 years of age. This paper explores the experiences of younger women from diverse cultural backgrounds with breast cancer to see if there are differing healthcare provision needs across cultures. Sandelowski and Barroso's framework for undertaking a meta-synthesis is used in this paper. Initial searches in academic databases returned 42 papers of interest. Re-reading the papers in the context of the research question identified 12 studies which met the inclusion criteria. Five key themes were identified in these 12 studies. The overarching finding is that, irrespective of cultural background, the confrontation with breast cancer transforms the younger woman's life. It seems that healthcare provision needs do not differ substantially across cultures. Health professionals should address the unique psychosocial effects of cancer in the context of the lifestage of the woman. [ABSTRACT FROM AUTHOR]

palacios-ceña d., losa-iglesias m.e., álvarez-lópez c., cachón-pérez m., reyes r.a.r., salvadores-fuentes p. & fernández-de-las-peñas c. (2011) Patients, intimate partners and family experiences of implantable cardioverter defibrillators: qualitative systematic review. Journal of Advanced Nursing 67(12), 2537-2550. Abstract Aim. This paper is a report of an interpretive review of qualitative research on how an implantable cardioverter defibrillator affects adult recipients and their significant others. Background. An implantable cardioverter defibrillator detects pathological cardiac rhythms and automatically converts the rhythm with electrical counter shocks. Data sources. A systematic literature search was conducted for qualitative research papers published between January 1999 and January 2009. PubMed, Medline, ISI Web of Knowledge and CINAHL databases were searched with the following key words: internal defibrillator, implantable defibrillator and qualitative research. Review Methods. Twenty-two papers were included. The Critical Appraisal Skills Programme and Prompts were used to appraise studies. Thematic analysis and synthesis approaches were used to interpret evidence. Findings. People with an implantable cardioverter defibrillator were found to experience physical, psychological and social changes. Shocks produce fear and anxiety, affecting relationships and sexual relations. The use of support groups and the use of the Internet are important in helping adjustment to an implantable cardioverter defibrillator. Women's responses to an implantable cardioverter defibrillator appear different than men's responses and include concerns about physical appearance and relationship issues. Postdischarge follow-up and educational programmes are still underdeveloped. Conclusion. Patients need additional education, support and follow-up care after hospital discharge. Patients and significant others benefit from collaboration between patient associations and healthcare professional societies. Future research is needed to identify the specific challenges that women recipients face. [ABSTRACT FROM AUTHOR]

This paper draws on the largest and most comprehensive Australian research to date that explores the campus climate for sexuality and gender diverse (SGD) people at one university. Using a mixed-method approach that incorporated an online survey open to all students and staff (n = 2395), face-to-face in-depth interviews with key stakeholders (n = 16) and an online document analysis, the study explored participants' perceptions and attitudes to sexuality and gender diversity on campus, experiences of in/exclusion, (un)safe places, visibility in public online documents, and the campus-based services available to support SGD individuals. The findings point to the ongoing exclusion experienced by SGD people across the university. We show how exclusion serves to silence individuals across multiple levels and how this, in turn, limits the visibility of, and redress for, exclusion, impacting on health and well-being. This tension, we posit, can only be addressed safely and holistically through proactive and strategic endeavours on the part of the institution; without which, exclusion will continue to prevail. [ABSTRACT FROM AUTHOR]

The body of the one deemed mad often remains a sexual body with sexual needs. Mental health services respond to these demands of the body in various ways, including constructing rules around physical movement. In this context, we were interested in how mental health clinicians problematized the sexual needs and practices of residents of a long‐stay mental health rehabilitation facility and how solutions were constructed in relation to the residents' sexual desires. This paper reports findings from mental health clinicians, as part of a case study where we addressed this question. Mental health clinicians responded to residents' sexuality from a discourse of risk. The notion of the engagement with each resident as a sexual subject was subordinated to the paternalistic notion of protecting the patient from risk. The resident became an object to be monitored and protected rather than a subject with sexual desire and agency. This paternalism also showed itself in relation to a 'no‐sex on‐site' rule that allowed for a shift of risk from the organization to the resident. Residents, rather than having a relatively safe place to have sexual relations, were required to find a place elsewhere, potentially unsafe, outside the facility. [ABSTRACT FROM AUTHOR]

Purpose: Drawing on survey data (N = 7,826) collected in the United Kingdom, Australia, and the United States, this paper examines whether sexual orientation is a differentiating factor in explaining relationship quality and maintenance. Previous research suggests that sexual orientation is not significant in determining relationship satisfaction; however, these analyses have used traditional variable driven approaches, which do not provide an holistic view of the relationship by considering the unique combination of characteristics. Method: In this study, latent profile analyses were used, which is a person-centered approach that allows for identification of different types of long-term relationships. Results: Data suggested that LGB individuals had marginally higher levels of relationship quality compared to their heterosexual counterparts, and sexual orientation was also associated with differing types of long-term relationships. Discussion: These findings are interrogated in more detail, in particular, how sexual orientation is associated with types of long-term relationships and how everyday practices are associated with relationship quality. [ABSTRACT FROM AUTHOR]

Early childhood and primary educators' and carers' education and support in identifying and responding appropriately to children displaying problematic sexual behaviours has fallen behind the demands currently arising in care and education sites in Australia. This is a key finding of research examining professional educators' and carers' experiences of problematic sexual behaviours in their workplaces, their understanding of problematic sexual behaviours, and their source of training in this area. This paper reports on the professional development, workplace and community support for educators and affected children, which educators and carers wanted to have implemented to more adequately respond to their professional needs and the needs of affected children and their families. The research was conducted using an online survey in 2016 and involved 107 respondents from government, independent and Catholic primary schools, preschools and care organisations. [ABSTRACT FROM AUTHOR]

This paper discusses pre-service teachers' responses to a critical analysis of gender/power relations using examples from a final assessment for an intensive elective unit called Teaching Sexuality in the Middle Years. This unit critically examines gender/ power relations, the production of difference, heteronormativity and pleasure and desire, employing a feminist post-structural framework. Despite the focus on critical thinking, reflection and interrogating structural inequalities in this unit some students were resistant or unable to engage with this approach in their assessments, although appearing to do so in workshops. We consider the broad range of sexuality education discourses mobilised by this unit to try to make sense of what looks like resistance but may be something more complex and difficult to negotiate. The paper ends with a consideration of some of the implications of this approach for practice. [ABSTRACT FROM AUTHOR]

This paper explores the methodological politics of researching at the intersections of sexuality, culture and religion in secondary schools. It draws on experiences during a project concerned with how to address cultural and religious diversity in sexuality education in Australia and New Zealand. The paper focuses on two methodological sticking points, one occurring inside academia and the other outside, in schools. The first coheres around the process of gaining ethics approval from multiple institutional committees and the second accesses schools for participation. These sticking points are conceptualized as effects of a set of discursive and material constraints which are idiosyncratic to school-based sexualities research. We argue that discourses of sexuality and young people are mobilized in both spaces and intersect with a social moment of ‘risk anxiety’ in ways that shape the methodological possibilities of the research. These discourses serve to constitute sexualities research as ‘risky’ and ‘controversial’, an image which impedes the generation of new knowledge in the field. By rendering challenges of this research visible and discursively deconstructing the reasons for them, we refuse to dismiss school-based sexualities research as ‘too hard’. Instead, we aim to keep this topic firmly on the educational research agenda by alerting researchers to its challenges so they may prepare for them. [ABSTRACT FROM PUBLISHER]

Introduction and Aims. Mephedrone (4-methylmethcathinone) is a synthetic stimulant that has recently emerged as a recreational drug. There is currently no Australian data on prevalence and patterns of mephedrone use. This paper aims to explore patterns of mephedrone use among a large sample of same-sex attracted young people in Sydney, Australia. Design and Methods. An online survey was conducted with 572 same-sex attracted men (n = 318) and women (n = 254) aged 18 to 25 years, who lived or regularly spent time in Sydney. Data on mephedrone were collected as part of a larger study exploring sexuality and nightlife. Results. Mephedrone had been used by 4.0% (n = 23) of respondents, 2.1% (n = 12) in the preceding 6 months, 1.4% (n = 8) in the preceding month. Typical routes of use were intranasal (n = 8) and ingestion (n = 6). No respondent reported ever injecting mephedrone. Three respondents reported polydrug use with mephedrone. The most common contexts of use were respondents' homes or friends' homes (n = 8) and gay bars and clubs (n = 7). Discussion and Conclusions. This paper reports low levels of mephedrone use among a large sample of same-sex attracted young people. The proportion of respondents who had used mephedrone was much lower than reported in recent UK research. This may suggest that mephedrone has not infiltrated the Australian market to the same extent as in Europe. However, data from annual surveillance of drug users are required to better determine this.[Lea T, Reynolds R, De Wit J. Mephedrone use among same-sex attracted young people in Sydney, Australia. Drug Alcohol Rev 2011;30:438-440] [ABSTRACT FROM AUTHOR]

Discussions of the machinations of sex and pleasure (as distinct from sexuality and LGBTIQ issues) have largely been absent from Narrative practices and as a result, little has been documented on how Narrative practices could work in a sex and pleasure therapy context. This essay describes a sex-focussed group therapy project using Narrative practices conducted in Melbourne, Australia spanning 15 weeks from April 2015 to September 2015. This paper covers the structure, practices, learnings, cohort and context, and offers a rationale and structure for other therapists to consider when doing the same. It examines the value of group process when discussing sex and pleasure as a powerful tool to reduce the stigma of sex and bring pleasure forward as a valid reason for seeking therapy. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics, including the emergence of support groups in schools for transgender youth, the limited recognition of bisexual women's experiences in sexuality education and the issue of consent in sexuality education.

Purpose The purpose of this paper is to focus on the development of Keep Safe, a manualised group intervention for adolescents with intellectual disabilities (ID) who display harmful sexual behaviour (HSB) as the initial phase of a feasibility study. National reports have highlighted the need for the development of specialist programmes, as adolescents with ID make up a significant proportion of young people referred to specialist HSB services and there is a lack of evidence or practice-based interventions for them. Aims included taking account of adolescents’ and families’ needs, motivations and practical commitments, integrating best- practice and being accessible and appropriate across different types of services.Design/methodology/approach Keep Safe development progressed from the practitioner/researcher collaborative young sex offender treatment services collaborative-ID through a project team, Keep Safe development group, comprising a range of practitioners with a variety of clinical expertise across services and an Advisory Group of people with ID. An expert-consensus methodology based on the Delphi method was used. The iterative process for the manual draws on the slim practice-based evidence from UK, New Zealand, North America and Australia.Findings Keep Safe comprises six modules distributed through 36 term-time young people’s sessions, alongside 16 concurrent parental/ carer sessions (some joint). The main focus of Keep Safe is to enhance well-being and reduce harm. Four initial sites volunteered as feasibility leads, and two more were added as recruitment was more difficult than foreseen.Originality/value National reports have highlighted the need for the development of specialist programmes, as adolescents with ID make up a significant proportion of young people referred to specialist HSB services and there is a lack of evidence or practice-based interventions for them. This study is innovative and valuable given the recognition that research and practice is significantly lacking in this area. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented in which the editor discusses various reports in the issue on the topics including one on clinical psychology, the other on family therapy and the third on history resisting individualism and focusing on relational and social processes.

This paper considers three pedagogical moments in the film Tomorrow, When the War Began (2010), contemplating the way in which they open a space for conversations about feelings, sexuality and gender. Tomorrow, When the War Began follows the plight of 17-year-old Ellie who returns to her rural town from a camping trip with her friends, to find Australia has been invaded. The film combines the chaos and confusion of war with the happiness and confusion of intimate relationships. In this way, the film both engages viewers and encourages them to recognise and explore their feelings. In Australian and New Zealand schools, emotions and pleasure are often absent from sex education. Considering a film, the relationships it portrays, and the way it makes an individual feel, can go some way to reducing this gap. This paper considers the sexual literacies developed while watching the film and explains how the intersection of affect and film can assist in the identification and critique of heteronormativity by considering the relationships portrayed. [ABSTRACT FROM AUTHOR]

In this paper I explore the popular Australian television character of Ja'mie King - a teenage private school girl created and performed by male comedian Chris Lilley. I conceptualise Lilley's satire as a public pedagogy of young femininity. My reading of his satire responds to recent feminist scholarship around young femininities and 'girl power', which explores representations of young femininity in popular culture in Western nations. Drawing primarily on the 2005 television mockumentary We can be heroes, I explore how King can be read in terms of exaggerated 'girl power' subjectivity. I examine the relationships, fashioned through the character of King, between 'sexuality' and global citizenship activity. I consider the extent to which King's character teaches that young women can 'have it all'. I explore the extent to which her character teaches that they can be 'beautiful' and 'brainy', 'self-determined' and 'sexy' at the same time. [ABSTRACT FROM AUTHOR]

Louis Nowra's recently published Bad Dreaming: Aboriginal Men's Violence Against Women and Children (2007} includes an ethno-historical study of gender relations in Aboriginal "traditional" society, drawing on early explorers" observations and anthropoloqical accounts. Inga Clendinnen likewise included a chapter on Aboriginal sexual politics in Dancing with Strangers (2003). This paper critiques their conclusions and methods, and closely analyses the same terrain--late eighteenth-century European representations of Aboriginal sexual relations. My aim is not to deny that there were instances of violence in the sexual conduct of eighteenth-century Aboriginal societies. Instead, this paper demonstrates that Nowra and Clendinnen's ethno-histories fail to present a holistic account of the myriad descriptions of Indigenous gender dynamics that permeate the European explorers' accounts. [ABSTRACT FROM AUTHOR]

This paper is about the body, specifically a child's body, as a site where identity becomes contested. It is also about a surface or space where we lay claim—a site of vested interest. In April 2004, the Australian Family Court ruled that a 13-year-old child (Alex) had gender identity dysphoria and decided to allow reversible hormonal treatment. The Court ruling produced considerable legal, medical and public reflection over whether these decisions were in Alex's best interests, whether Alex was able to make such a decision at his age, and to assess Alex's competency. These debates also aimed to fix sex and gender through the deployment of a nature and nurture framework. The purpose of this paper, using the example of Alex, is to illustrate the various ways that these claims over a child's body, undermine the possibility for rethinking sex and gender. [ABSTRACT FROM AUTHOR]

This paper draws on findings from an ongoing prospective cohort study with a quantitative and a qualitative arm to monitor the implementation of guidelines for non-occupational post-exposure prophylaxis in Australia. The aim of the qualitative arm was to explore in-depth details of exposures and participants' understanding of 'risk'. This paper documents the physical, social and emotional contexts in which unsafe sex leading to post-exposure prophylaxis occurred. It will be argued that unsafe sex happened in spite of participants' knowledge about safe sex and as a consequence of a temporary absence of control. Five themes characterising the social contexts of unsafe sex can be identified in the narratives: issues relating to past, current and potential future relationships, drugs and alcohol, public and private social spaces, stress, and adventure. These contextual categories are not always neatly separated but interact with each other in various ways. Findings suggest that disseminating knowledge of safe sex practices based on condom use alone is not enough. Safe sex messages need to be contextualised to make links between sexual practices and the everyday experiences of those for whom they are intended. [ABSTRACT FROM AUTHOR]

Harmful Sexual Behavior and Child Sexual Exploitation are problems of significant proportion for children & young people living in out-of-home care. The aim of this review was to conduct a scoping exercise of the evidence about preventing these problems with the intent of summarising and disseminating knowledge to policy-makers, practitioners and researchers. Five electronic databases were searched in November and December 2016, including: PscyhINFO; Applied Social Science Index and Abstracts; SocINDEX; Web of Science; and Education Resource Information Centre. The search was guided by the research question: What is known about preventing Harmful Sexual Behavior and Child Sexual Exploitation for children & young people living in residential out-of-home care settings? Twenty papers were included in the review, including: seven peer-reviewed journal articles; three reports for government; two presentation transcripts; two literature reviews; one qualitative research report; one report for a government inquiry; one submission to a government inquiry; one consultation paper for a government inquiry; one guideline; and one educational resource. Three major thematic categories were identified in the evidence: (i) constructing educative interventions for children & young people and workers ; (ii) targeting grooming and problematic sexual behavior ; and (iii) providing a holistic response and a way out . The review revealed that the current prevention response to Harmful Sexual Behavior and Child Sexual Exploitation for children & young people living in residential care is under-developed. Promising program, service or practice elements relating to the prevention of Harmful Sexual Behavior and Child Sexual Exploitation were identified and three interventions suggested for future prevention efforts. [ABSTRACT FROM AUTHOR]

According to researchers, between 20% and 25% of patients with a stoma will experience significant psychological symptoms. With the trend of early discharge and the increasing numbers of patients requiring surgery, it is very easy for health professionals to focus on just the physical wellbeing. The inadvertent impact is serious. Are we failing to meet our patients' psychological needs? This paper will explore and discuss anxieties held by patients with a stoma, with a particular focus on body image, sexuality and how we as health professionals can support and empower patients on their health care journey. [ABSTRACT FROM AUTHOR]

This paper examines the preferred sexuality education sources of older Australian adults in later life. Drawing on findings from qualitative interviews with 30 men and 23 women aged 60 years and older, we consider the sources that participants currently use, or would like to use, in seeking information about sex. Where relevant, we examine participants’ experiences of learning about sex in later life using different sources, and the impact these had on their sexual expression, pleasure and well-being. Preferred sources of information include the Internet, the media, health care providers, books and workshops or discussion groups. A substantial number of participants did not actively seek information on sex. For those who had, these educational endeavours could profoundly shape their sexual practices. As such, learning about sex should be viewed as a lifelong endeavour. Our findings carry important implications for the development and delivery of sexuality education for older adults. [ABSTRACT FROM PUBLISHER]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction and Aims: Gay and other homosexually active men (hereafter 'gay men') are at elevated risk of becoming infected with hepatitis C virus (HCV) via injecting drug use and sexual risk practices. This paper aimed to measure HCV knowledge among gay men in Australia and whether knowledge differed according to HCV risk.Design and Methods: In 2013, a cross-sectional, online survey of 405 Australian gay men explored the social aspects of HCV. Bivariate and multivariate linear regressions were used to examine factors associated with higher HCV knowledge.Results: The mean age of respondents was 39.2 years (SD = 13.3), and most men (75.3%) were born in Australia. According to self-report, 32.1% were HIV-positive, 3.0% were HCV-positive and 8.9% were HIV/HCV co-infected. The mean number of correct HCV knowledge items was 8.2 (SD = 3.9; range 0-15). In a multivariate analysis, higher HCV knowledge was associated with higher educational attainment, being HCV-positive, being HIV-positive and injecting drug use.Discussion and Conclusions: HCV knowledge among gay men was moderately good, although knowledge of testing, treatment and natural history of HCV was generally quite poor. Encouragingly, higher knowledge was reported among men at highest HCV risk. Viral hepatitis and HIV organisations, together with general practitioners and other health services, should continue to target gay men at a high risk of acquiring HCV with education and health promotion. [Lea T, Hopwood M, Aggleton P. Hepatitis C knowledge among gay and other homosexually active men in Australia. Drug Alcohol Rev 2016;35:477-483]. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• Practice directions should recognise multiple models of CSE and a wider context of vulnerability and unmet needs. • Anxieties about young people's sexual behaviours can detract from CSE making it challenging to identify and respond. • Outreach and support that addresses young people's emotional, social and practical needs are valuable directions. • Suitable placements and ensuring young people have a safe and stable home environment is vital to any response to CSE. • CSE responses should be guided by child-centred practice and informed by young people's perspectives. There is a growing interest in understanding and responding to child sexual exploitation (CSE) in Australia, but limited empirical research from Australian contexts. The research reported here contributes to the evidence base by considering challenges and best practices for responding to CSE from the perspectives of 15 caseworkers in a statutory child protection and out of home care environment in one Australian region. In so doing, the paper also offers insight into CSE along with consideration of the emerging practice directions and systems surrounding these in the Australian context. Findings point to potential problems arising from existing frameworks for understanding and responding to CSE. Participants held concerns about a narrow focus on young people's sexualised behaviours in the wider multi-agency care context. This was understood to obscure a more complex understanding of CSE and its broader context of vulnerability and connection to unmet needs – some of which can arise from the care context itself – making identification and intervention difficult. Findings align with research that emphasises outreach and intensive support for young people centring on strengthening connections, identifying and addressing unmet needs and sustaining safety through consideration of placements and living circumstances. Consideration of practice challenges and opportunities signals the importance of child-centred, wellbeing-oriented directions allowing for multiple models of CSE victimisation, underpinned by a shared language in the multi-agency context and enhanced provision in existing systems. [ABSTRACT FROM AUTHOR]

Background: Sexual activity and intimacy contribute to wellbeing throughout adult life, including after a heart attack. Providing support and information about sexual activity and intimacy after a heart attack is recognised as part of a comprehensive approach to cardiac rehabilitation. Previous research shows that patients expect health professionals to initiate discussions about sexual activity and intimacy, but that this seldom occurs. Methods: Drawing on qualitative survey responses from a range of Australian health professionals working in cardiac care and rehabilitation, this research examined their perspectives on discussing sexual activity and intimacy with their patients, and patients' partners. Using a social constructionist approach, thematic analysis was used to identify themes expressed by participants. Results: Discussions about sexual activity and intimacy after heart attack were perceived as nebulous and taboo. The predominance of an illness – rather than wellness – framing of these discussions and a tendency for health professionals to make judgement calls contributed to discussions not occurring. Health professionals also identified a range of intrapersonal, interpersonal and structural obstacles to discussions, including embarrassment, fear of patients' embarrassment, a lack of role clarity, the absence of a clear protocol or training to guide practice, and a lack of time, privacy and patient resources. Conclusions: Such discussions require normalisation, careful timing, sufficient time and adequate privacy. Staff training, a protocol and appropriate patient resources are needed to support health professionals to initiate discussions. Further research is required that investigates the impact of specific resources and training on health professionals' practice and patient outcomes. Heart attack survivors expect that health professionals will communicate with them about sexual activity and intimacy, but previous research shows that this rarely occurs. This research qualitatively examines the perspectives of a range of health professionals working in cardiac care about barriers to discussing sexual activity and intimacy with patients. Discussions about sex and intimacy were perceived as nebulous and taboo topics; themes identified lead to recommendations for developing and implementing resources, training, and a clinical protocol to improve outcomes. [ABSTRACT FROM AUTHOR]