Background
Methods
Development of the core set of sexual health indicators
Pilot study: Bio-behavioral surveys in Catalonia and Barnaul
Sampling and data collection (Catalonia)
Sampling and data collection (Barnaul)
National Commitments and policy instrument on sexual health
Policies and laws related to sexual health indicators
Availability/access to sexual health services
Sexual health indicators
-
Sexual safety: “The sex I have had was always as safe as I wanted it to be”.
-
Sexual autonomy: “I have always been able to refuse sexual practice/s I don’t want”.
-
Sexual satisfaction: “I have been happy with my sex life”.
-
One can have sex without loving the partner.
-
Because of nature, men have a greater sexual need than women.
-
Homosexuality is sexuality, the same as any other.
Statistical analysis
Results
National Commitments and policy instrument on sexual health in Barnaul and Catalonia
Catalonia | Barnaul | |
---|---|---|
Legal age for marriage without consent1,14,26 | 16 years | 18 years; 16 years for partners of the same age |
Same-sex marriage2 | Legal | Not legal |
% of national population under laws, regulations, and/or policies supporting non-discrimination on grounds of age, sex, sexual orientation, gender identity, disability, race/ethnicity, marital status, HIV status, involvement in sex work, and socioeconomic status3,15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 | 100% | 100% |
% of national population under laws, regulations, and/or policies supporting non-discrimination on grounds of: | ||
Women4,15, 16, 17, 18, 19, 20, 21, 22 | 100% | 100% |
Adolescents5,15, 16, 17, 18, 19, 20, 21 | 100% | 100% |
People living with HIV/AIDS6,15, 16, 17, 18, 19, 20, 21, 23 | 100% | 100% |
The poor3,15, 16, 17, 18, 19, 20, 21 | 100% | 100% |
Men who have sex with men7,15, 16, 17, 18, 19, 20, 21 | 100% | 100% |
Women who have sex with women7,15, 16, 17, 18, 19, 20, 21 | 100% | 100% |
Transgender7,15, 16, 17, 18, 19, 20, 21 | 100% | 100% |
Intersex people7,15, 16, 17, 18, 19, 20, 21 | 100% | 100% |
Migrants, indigenous populations8,9,15, 16, 17, 18, 19, 20, 21, 24 | 100% | 100% |
Sex workers3,15, 16, 17, 18, 19, 20, 21 | 100% | 100% |
People with disabilities3,15, 16, 17, 18, 19, 20, 21, 25 | 100% | 100% |
Regulation of sex work | Prostitution itself is not regulated, but exploitation such as pimping is illegal | Not regulated by the Government |
% of national population under formal laws, regulations, and/or policies prohibiting sexual violence10,14,27, 28, 29, 30 , 31, 32, 33, 34, 35, 36, 37, 38, 39, 40 | 100% | 100% |
Existence of a national law, regulation, policy, and/or strategy to prevent and respond to sexual violence and domestic violence, including intimate partner violence, child abuse, and marital rape11,12,27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40 | Yes | Yes |
Provision of medical, psychological, and legal support for victims of sexual violence13,27,28,29,30 | Yes | Yes |
Support services for people with sexual dysfunction | Attention to sexual and reproductive health units at primary health care centres | Not regulated |
Sample characteristics
Catalonia (n = 735) | Barnaul (n = 500) | |
---|---|---|
Age (mean, SD) | 38.0 (8.1) | 32.3 (7.2) |
Sex: Male | 82.9 | 69.0 |
Migrants | 39.5 | NA |
University studies | 7.3 | 8.6 |
Employed | 13.2 | 29.5 |
Years of injection (mean, SD) | 15.8 (9.9) | 12.8 (6.9) |
History of incarceration | 68.0 | 40.6 |
Last injection: last month | 91.6 | 58.4 |
Sexual activity* | 82.3 | 94.2 |
Number of partners** | ||
One | 82.9 | 69.0 |
Two | 48.6 | 46.3 |
Three or more | 20.6 | 15.5 |
IDU sex partner | 30.8 | 30.8 |
Sex work*** | 20.3 | 51.8 |
Sexual violence* | 5.0 | 1.7 |
Condom (last sex) | 2.6 | 3.8 |
Condom (last sex with steady partner) | NA | 27.8 |
Condom (last sex with casual partner) | 38.8 | NA |
Always using condoms* | 74.6 | NA |
Sexual health indicators
Sexual competency
Cataloniaa |
p
| Barnaulb |
p
| |||||
---|---|---|---|---|---|---|---|---|
Global n = 549 | Male n = 444 | Female n = 105 | Global n = 471 | Male n = 325 | Female n = 146 | |||
Protection self-efficacy1 | 77.5 | 82.0 | 58.1 | < 0.001 | 53.4 | 56.0 | 47.3 | 0.079 |
Consensual sex2 | 86.8 | 90.3 | 71.4 | < 0.001 | 79.6 | 80.3 | 78.1 | 0.579 |
Satisfaction3 | 72.8 | 75.7 | 60.0 | < 0.001 | 63.0 | 65.5 | 56.8 | 0.071 |
Social norms on sexuality
Catalonia | Barnaul | |||||
---|---|---|---|---|---|---|
Global n = 731 | Male n = 606 | Female n = 125 | Global n = 471 | Male n = 326 | Female n = 145 | |
One can have sex without loving the partner | 70.6 | 72.8a | 60.0a | 69.9 | 73.3a | 62.1a |
Because of nature, men have more sexual needs than women | 38.1 | 34.2a | 56.0a | 60.3 | 61.0 | 58.6 |
Homosexuality is a sexuality as any other | 66.6 | 63.3a | 81.6a | 7.4 | 3.4a | 16.6a |
Construct validity on protection self-efficacy and consensual sex
Item | Test group | Mean (SD) |
p
| Mean (SD) |
p
|
---|---|---|---|---|---|
Protection self-efficacy scale | Condom use: always | 4.61 (0.82) | < 0.001 | 4.11 (0.79) | < 0.001 |
Condom use: not always | 3.85 (1.42) | 3.43 (1.05) | |||
Consensual sex scale | Previous sexual assault | 3.53 (1.59) | < 0.001 | 3.47 (1.22) | 0.015 |
No previous sexual assault | 4.45 (1.02) | 4.00 (0.90) |
Factors associated with a low level of sexual satisfaction (or sexual dissatisfaction)
aOR | 95%IC |
p
| aOR | 95%IC |
p
| |
---|---|---|---|---|---|---|
Sex | ||||||
Male | 1.00 | 1.00 | ||||
Female | 2.56 | 1.51–4.32 | < 0.0001 | 1.31 | 0.84–2.04 | 0.227 |
Age group | ||||||
Less than 30 | 1.00 | 1.00 | ||||
30 or more | 1.81 | 1,06–3,09 | 0,029 | 1.12 | 0.73–1.70 | 0.607 |
Perception of sexual safety | ||||||
High | 1.00 | 1.00 | ||||
Low | 2.09 | 1,29–3,38 | 0.003 | 3.42 | 2.25–5.22 | < 0.0001 |
Perception of sexual autonomy | ||||||
High | 1.00 | 1.00 | ||||
Low | 1.88 | 1.06–3.32 | 0.030 | 3.43 | 2.07–5.69 | < 0.0001 |
Men more needs than women | ||||||
Agree/totally agree | _ | 1.00 | ||||
Disagree/totally disagree | _ | 1.93 | 1.27–2.94 | 0.002 |