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Sexual abuse of adolescents and African American children

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Sexual abuse of adolescents and African American children

Sexual abuse among the minors is generally described as any sexual act between a minor and an adult or between two minors, where one partner exerts power over the other person; coercing the other partner to engage in sexual act. It also includes non –contact sexual activity such as exposing the minors to pornography, voyeurism, sexual communication via social media and exhibitionism (Barnett, Heinze, and Arble, 2013).

This is often a traumatic experience for any person; but it is a criminal offense. Sexual abuse incidences among the adolescents in the USA are high. It is estimated that every 10children, one is sexually abused before she or he attains their 18^th birthday. Girls are more prone to sexual boys as compared to boys; one in every seven girl is sexually assaulted as compared to one in every boy (Reid, 2014).

Literature indicates that sexual abuse increases the chances of teen pregnancy, often unwanted pregnancy- which is associated with low birth outcomes. The coping strategies used by these adolescents include running away and substance abuse- putting the teenager in more risky activities (Marriott, Hamilton-Giachritsis, and Harrop, 2013). The statistics continues to rise and more of our children will be sexually assaulted if no intervention is put in place.

The proposed research question is ‘what are the risk factors of sexual abuse among the African American adolescents? Understanding the risk factors will help understand the teenagers, understand the behavioural and psychological challenges they deal with, and strategies to help them cope with these traumatic events (Hunt, Martens, and Belcher, 2011).

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Sexual abuse of adolescents and African American children

Annotated bibliography

Barnett, D., Heinze, H. and Arble, E. (2013). Risk, Resilience, and the Rorschach: A Longitudinal Study of Children Who Experienced Sexual Abuse. Journal of Personality Assessment, 95(6), pp.600-609.

The study evaluates the experiences sexual abused children, indicating that these minors are likely to develop emotion and behavioral challenges. The paper is a longitudinal study of 44 children who had undergone sexual abuse. Using Rorschach Inkblot Test, approximately three quarters of the participants reported depressive symptoms. The study evaluates the effective tools that can be used to evaluate the extent of trauma among the children and adolescents who have been sexually abused.

For instance, using Rorschach protocol, there are other ways that can be used to by the healthcare providers and school counsellors to understand the child’s processing styles including the negative thoughts associated with maltreatment and sexual assaults.

Sexual abuse of adolescents and African American children

Elwood, L., Smith, D., Resnick, H., Gudmundsdottir, B., Amstadter, A., Hanson, R., Saunders, B. and Kilpatrick, D. (2011). Predictors of rape: Findings from the National Survey of Adolescents. Journal of Traumatic Stress, 24(2), pp.166-173.

The article highlights that socioeconomic factors are the main factor that determine risk for adolescent’s sexual abuse. The internet sex crimes against minors are few but a significant percentage of the entire issue. The study highlights that there is no child who is immune, but the social cultural background determines the risk level of sexual abuse.

Family structure is one of the risk factors, with research indicating foster families children with the highest risks, gender, age, ethnicity and socioeconomic status. This very important when evaluating the ways to minimize risk factors associated with African American minor sexual abuse.

Sexual abuse of adolescents and African American children

Francisco, M., Hicks, K., Powell, J., Styles, K., Tabor, J. and Hulton, L. (2008). The Effect of Childhood Sexual Abuse on Adolescent Pregnancy: An Integrative Research Review. Journal for Specialists in Pediatric Nursing, 13(4), pp.237-248.

This article adds immense knowledge to my proposed study as it describes the current literature on adolescent’s sexual abuse, teen pregnancies and the potential of risk factors that are cross cutting. The study identifies the cross cutting risk factors such as substance abuse, mother disengagement, family constellation, and parent-adolescent conflict. The study highlights the importance of identifying the victimized adults early is vital to ensure that there is early intervention.

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Sexual abuse of adolescents and African American children

George, A., Abatemarco, D., Terry, M., Yonas, M., Butler, J. and Akers, A. (2013). A qualitative exploration of the role of social networks in educating urban African American adolescents about sex. Ethnicity & Health, 18(2), pp.168-189.

The article explores the role of social networks in sexual health issues among the African American adolescents. The article identifies the social media to have major roles including guide, challenger, confidant, shelter, role model, and supervisor –chaperone and the main source of sexual health information. This is one of the platforms that could be used to reach millions of youth’s sexual assaults among African American community.

Sexual abuse of adolescents and African American children

Hunt, K., Martens, P. and Belcher, H. (2011). Risky business: Trauma exposure and rate of posttraumatic stress disorder in African American children and adolescents. Journal of Traumatic Stress, 24(3), pp.365-369.

This article highlights the consequences associated with sexual abuse among the African American adolescents. The study indicates that domestic violence and sexual abuse is correlated to childhood posttraumatic stress disorder (PDTSD). The study indicates that exposure to such type of violence increases the likely hood of post traumatic disorders by two fold among the African American adolescents. Other consequences highlighted by the study includes social isolation, low self-esteem and low self-confidence.

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Sexual abuse of adolescents and African American children

Marriott, C., Hamilton-Giachritsis, C. and Harrop, C. (2013). Factors Promoting Resilience Following Childhood Sexual Abuse: A Structured, Narrative Review of the Literature. Child Abuse Rev., 23(1), pp.17-34.

The article is important as it adds great knowledge to my literature review on factors associated with resilience after adolescent sexual abuse. Examples of such factors include interpersonal features such as the adaptive coping strategies; but the most important factors highlighted by the article is familial stability, support from peers and schools- these creates a sense of community that understands and is willing to support the victims. The article proposes more research on the effectiveness of using the systematic interventions such as social programs and policies to improve the outcomes of sexual adults’ victims.

Payne, J., Galvan, F., Williams, J., Prusinski, M., Zhang, M., Wyatt, G. and Myers, H. (2014). Impact of childhood sexual abuse on the emotions and behaviors of adult men from three ethnic groups in the USA. Culture, Health & Sexuality, 16(3), pp.231-245.

This article describes the impact of childhood sexual abuse on lives of the adults from three ethnic groups. The study evaluates the psychological and behavioral struggles of survivors of childhood sexual assaults. This article is important for my study as it aids in understanding the behavioral challenges which includes shame issues, sexual identity crisis, hyper-vigilance, anger and low self-esteem.

The article highlights that there are cultural context influences, such that people from different community will respond differently; suggesting that effective coping strategies are those that are tailor made to match the victim’s sociocultural background.

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Sexual abuse of adolescents and African American children

Reid, J. (2014). Risk and resiliency factors influencing onset and adolescence-limited commercial sexual exploitation of disadvantaged girls. Crim Behav Ment Health, 24(5), pp.332-344.

The previous studies have focused mainly on age related variables when analyzing the young women involved in sexual assaults, especially among those involved in sexual exploitation commercially. The study evaluated the variables associated with adolescents of sexual exploitation with the aim of identifying the resiliency factors and potential risks involved. This is important in my proposal as it facilitates understanding the concept of sexual victimization of adolescents, the effects of substance use and sexual violence.

Trickett, P., Negriff, S., Ji, J. and Peckins, M. (2011). Child Maltreatment and Adolescent Development. Journal of Research on Adolescence, 21(1), pp.3-20.

This article explores the collective impact of child maltreatment in the USA. The study highlights that childhood maltreatment which is associated with a myriad of mental health issues as well as developmental issues. The study helps improve the literature review of the proposed study, as it helps understand the reasons the maltreated adolescents tend to be more vulnerable bad outcomes; a predictive of long lasting effects in intimate relationships. This helps when developing early specific intervention that targets establishing effective coping strategies.

Wang, Y., Storr, C., Browne, D. and Wagner, F. (2010). Early Sexual Experience and Later Onset of Illegal Drug Use Among African American Students on HBCU Campuses. Substance Use & Misuse, 46(4), pp.543-551.

The study examines if early sexual exposure and sexual abuse is associated with subsequent drug use among the African American adolescents. The study evaluates a sample of 7372 African American students; which indicated that sexual assault is modestly associated with subsequent initiation of illicit drug abuse, especially among the females. This is also correlated with risky behaviors activities such as multiple sexual partners. The article concludes that school based programs will help empower the victims with coping strategies, effective enough, thus reducing the incidences of illicit drug use and other associated risky behaviors.

Sexual abuse of adolescents and African American children

References

Payne, J., Galvan, F., Williams, J., Prusinski, M., Zhang, M., Wyatt, G. and Myers, H. (2014). Impact of childhood sexual abuse on the emotions and behaviours of adult men from three ethnic groups in the USA. Culture, Health & Sexuality, 16(3), pp.231-245.

Reid, J. (2014). Risk and resiliency factors influencing onset and adolescence-limited commercial sexual exploitation of disadvantaged girls. Crim Behav Ment Health, 24(5), pp.332-344.

Trickett, P., Negriff, S., Ji, J. and Peckins, M. (2011). Child Maltreatment and Adolescent Development. Journal of Research on Adolescence, 21(1), pp.3-20.

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STIs Practicum Journal Entry

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STIs Practicum Journal Entry

This practicum is one of the most fascinating experiences in my clinical practice. Dealing with patients diagnosed with sexually transmitted infections (STIs) is challenging as most of the patient are hesitant to talk openly to a nurse or doctor about their experiences, which makes it challenging during clinical decision making processes (American Congress of Obstetricians and Gynaecologists, 2011).

Mrs. Kate (pseudo name) a 21 year old college student presented to the clinic with complaints of itchiness around her genitalia, sharp burning sensation during sexual intercourse and had noted whitish discharge that had foul smell. From the clinical manifestation, I gathered that the patient is suffering from an infection, which could be either sexually transmitted infections (STIs) or urinary tract infections (UTIs). There is a thin line that separated the two, which indicated the need for further laboratory test.

According to Centre for disease control and prevention (CDC), UTIs and STIs clinical manifestations are non-specific and are a common to problem for females. This highlights the likelihood of misdiagnosis. The common clinical manifestation for the urogenital diseases includes a burning sensation during urination, vaginal discharges and pelvic pain. However, in UTIs infection, vaginal discharge with awful smell is normally absent. The patient with urinary tract infection tends to have fever. A pelvic exam, urine culture and vaginal culture results indicate that the patient had yeast vaginal infection (CDC, 2013).

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One of the challenges experienced during this practicum was during sexual history assessment. Initially, the patient was hesitant to disclose the information because it is a taboo and also she believed that disclosing this information would victimize her. After reinforcing the issue of confidentiality, the patient became relaxed and disclosed the sensitive information.

The sexual history assessment was done using the general guide of the ‘5 Ps.’ This included the number of sex partners, the type of sexual activity, the rates of use of protection, and use of contraceptives. This helped me understand the patient literacy and perspectives about UTI (Schuiling and Likis, 2013).

The patients seemed somewhat distressed when I gave her the diagnosis results. However, she was cooperative all through the care plan. The patient was advised to have regular check up with the gynaecologists. This is because sexually transmitted infections (STIs) have short and long term impacts that can be life threatening. The short term impacts include emotional disturbances due to physical changes.

The long term effects include genital sores, inflammation, infertility issues and pelvic inflammatory reactions. Fortunately, genital yeast infections like other sexually transmitted infections (STIs) is manageable if diagnosed early and proper medication regimen is provided (CDC, 2013).

The patient had tried to manage the itchiness and pain using Tylenol (OTC) and vaginal cream, which yielded little success. The patient was given fluconazole 150 mg and Terconazole 80 mg both orally administered one suppository/day for at least 3 days. The medication ensured that the patient did not get recurrent infection. The patient was encouraged to observe hygiene and practice abstinence during the medication regimen. Other hygiene measures such as mutual monogamy, abstinence and avoid of douching practices.

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This practicum was very enlightening, especially on ways to practice cultural competency. I noticed that sexually transmitted infections (STIs) education focuses in specific information on signs and symptoms which seems to be the worst case scenarios and a taboo to most of the community.

The only down to earth guidance is abstinence and use of condom. If not handled with care, the interaction with the patient could affect patient psychosocial status. I have learnt a lot from this practicum and will use the knowledge to help other patients to identify risk factors and practice preventive measures (Schuiling and Likis, 2013).

References

American Congress of Obstetricians and Gynecologists. (2011). Guideline for adolescent health care (2nd ed.). Retrieved from http://www.acog.org

Centers for Disease Control and Prevention (CDC). (2013). Incidence, prevalence, and cost of sexually transmitted infections in the United States. Retrieved from http://stacks.cdc.gov/view/cdc/13174

Schuiling, K. D., & Likis, F. E. (2013). Women’s gynecologic health (2nd ed.). Burlington, MA: Jones and Bartlett Publishers.

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Sexually Transmitted Infections (STIs)

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Sexually Transmitted Infections (STIs)

Sexually transmitted disease among the youths is a global concern to public health. The rates of sexually transmitted infections (STIs) such as syphilis, simplex virus, chlamydia, and gonorrhoea have dramatically increased among the heterosexual youths, especially among women of childbearing age. Research indicates that two-thirds of the estimated 12 million new incidences of STIs in the USA are women.

Women are twice likely to acquire infections after a single exposure to pathogens causing Hepatitis B, Chlamydia infection, Chancroid, and gonorrhoea as compared to men. These STIs are the leading causes of reproductive morbidity among the women of childbearing age (Mittal, Senn, & Carey, 2011).

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This highlights that STIs are of particular distress among women due to their potential acute complications which can be life threatening especially during pregnancy. These include complications such as fetal death secondary, pneumonia, sepsis and premature delivery. My main inspiration for this topic is derived from the many cultural and religion expectations of women on mutual monogamy during and after their marriage.

This expectation contradicts most STI teachings resulting into the dramatic increase in STIs prevalence rates among this group. I feel obliged to conduct this research as women need to understand their STI risks, and learn the most effective preventive measures, chiefly because we live in a generation that lacks any assurance of mutual monogamy (Mittal, Senn, & Carey, 2011).

Without any interventions, a dramatic increase of the incidences is anticipated. This is has earned my interest as there is limited research on knowledge and perceived risk among women in the childbearing age. Due to the rising incidences of the STIs among the youths, evidence-based research indicates that behavioural interventions should aim at empowering women to increase their knowledge and perceptions of risk factors (Mittal, Senn, & Carey, 2011). Well, it is said that when a woman is educated (empowered) the whole nation is educated.

References

Mittal, M., Senn, T., & Carey, M. (2011). Mediators of the Relation between Partner Violence and Sexual Risk Behavior among Women Attending a Sexually Transmitted Disease Clinic. Sexually Transmitted Diseases, 1. http://dx.doi.org/10.1097/olq.0b013e318207f59b

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Sexually Transmitted Infections Practicum Journal Entry

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Sexually Transmitted Infections

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References

American Congress of Obstetricians and Gynecologists. (2011). Guideline for adolescent health care (2nd ed.). Retrieved from http://www.acog.org

Schuiling, K. D., & Likis, F. E. (2013). Women’s gynecologic health (2nd ed.). Burlington, MA: Jones and Bartlett Publishers.

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Teenage Sexual Education Project Paper

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Teenage Sexual Education

My project is on the provision of sexual education to teenagers. Teenagers that are sexually active are a matter of serious public concern. In the past years, several school-based programs have been designed for sole aim of holding up the initiation of sexual activity. Schools can play a central role in offering teenagers with a wide knowledge base that can aid them in molding their healthy lifestyle and coming up with informed decisions about their behavior (Shindel& Parish, 2013).

Detailed sexual education provides accurate information about gender identity, human sexuality, sexual health, reproduction and develops skills for communicating and relating to others in meaningful and satisfying ways. Additionally, it supports one’s ability to make sexual decisions with integrity and respect to other people.

Noddings (2015) reports that equal access to sexual education for teenagers of all cultures, races, gender identities, economic circumstances, and ethnicities are a matter of social justice. Young people who learn how to make respectful and intentional sexual decisions manage leading a healthy and safe lifestyle free from early teenage pregnancies, STIs such as HIV/AIDS, syphilis and gonorrhea as well as lost opportunities and barriers of economy that often follow. Parents, schools, religious institutions, and community based organizations have a crucial role of providing detailed sex education to young people (Wight & Fullerton, 2013).

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How it relates to the Field

As a health care practitioner, this project of sexual education is central to my practice. We are charged with the responsibility of ensuring that the public engages in activities that do not predispose them to health risks. We have a mandate of ascertaining that high health standards are maintained in the community. It is our duty to enlighten the public on the consequences of certain activities that impair the quality of life of the people and may lead to high mortality rates.

Therefore, provision of sexual education is one way of ensuring that people lead a healthy lifestyle by avoiding STIs and teenage pregnancies. The school is the appropriate environment of offering sexual education since it is often in regular contact with a large percentage of young people, with virtual all teenagers attending it before they engage in risky sexual behavior.

PICOT Question

Population: Teenagers attending public schools in the US. Students that were cognitively handicapped, school dropouts, delinquent, institutionalized, or emotionally disturbed were not considered for this project since they address different needs and characteristics.

Intervention: Sexual education on the importance of abstinence behavior.

Comparison: The results of this study were compared to those of studies that focused of a group of students in public schools who had not received sexual education

Outcome: The results that were determined include; delay in onset of intercourse, decease in intercourse frequency, and decrease in the number of sexual partners.

Timing: Evidence was gathered from studies where by the intervention was implemented for a period of one year and results obtained.

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IOWA Model

According to Schaffer et al., 2013, health care providers are encouraged to use updated research evidence to promote better patient outcomes and inform actions, decisions, and patient interactions to deliver quality care to patients. Different models have been developed by scholars to promote the use of EBP in healthcare.

One of these models is the IOWA model. This model is quite crucial in my project since it will serve as a guide on the steps I should follow for successful completion of this project. For instance, it has seven steps that each researcher should follow when conduct a study. These steps are;

Selection of a topic
Forming a team
Retrieval of evidence
Evidence grading
Developing an EBP standard
Implementing EPB
Evaluation

With this model, I will be in a better position to actively read, critique, and grade evidence that will aid in promoting my project of sexual education among young people.

Feedback

A well designed PICOT question is an essential guide in retrieval of evidence in literature research. The question provides information on the type of population to be considered in the study, the implemented interventions, the control parameter, the outcome as well as the timing of the research.

Adhering to these steps makes a literature research simple even for novice researchers. The formulation of the PICOT question also supports an EBP project since one can select literature on the research topic and use the steps to gather evidence, implement it, and determine the outcomes of the project.

References

Noddings, N. (2015). The Challenge to Care in Schools, 2nd Editon. Teachers College Press.

Schaffer, M. A., Sandau, K. E., & Diedrick, L. (2013). Evidence‐based practice models for organizational change: overview and practical applications. Journal of advanced nursing, 69(5), 1197-1209.

Shindel, A. W., & Parish, S. J. (2013). Sexuality education in North American medical schools: Current status and future directions (CME). The journal of sexual medicine, 10(1), 3-18.

Wight, D., & Fullerton, D. (2013). A review of interventions with parents to promote the sexual health of their children. Journal of Adolescent Health, 52(1), 4-27.

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Chlamydia Fact Sheet

What is chlamydia?

According to the Centers for Disease Control and Prevention (CDC, 2016), chlamydia is one of the common sexually transmitted infections (STIs). It is caused by Chlamydia trachomatis bacterium that damages women reproductive system. While the signs are mild, severe complications can lead to irreversible issues such as infertility. In addition, e Chlamydia may cause discharge from the male sexual organs.

Figure 1: Chlamydia Effects

Risk factors

Some of the factors that increases the risks of contracting chlamydia are; people below 24 years; engaging in unprotected sex; various sexual partners; and previous history of STIs.

Prevention

The effective approach of preventing transmission is abstaining from sexual behaviour or being involved in a monogamous relationship with uninfected partner. Male condoms if used correctly and consistently can significantly minimize the risks of transmitting chlamydia (CDC, 2016). Moreover, it is recommended for all active sexually female below 24 years to undertake annual screening for chlamydia. Older female with risk factors for this disease are required to undergo annual screening.

Pregnant women must also undergo screening. Screening is considered the best prevention approach since a number of reproductive complications associated with chlamydia are common among women and its symptomatic. Additionally, genital signs such as discharge, a rash, sores or burning sensation during urination is an indication to seek medical advice.

In the event that an individual has been treated for this disease or other types of STIs, he or she must notify their sex partner to be treated by a health care specialist. This is important, particularly, when it comes to minimizing the risk severe complications while reducing the chances of being re-infected. Such a person and his or her sexual partner must abstain from sex till they finish treatment.

Figure 2: Chlamydia Prevention

Prevention

The surest way to prevent chlamydia infection is to abstain from sexual activities. Short of that, you can:

Use condoms. Use a male latex condom or a female polyurethane condom during each sexual contact. Condoms used properly during every sexual encounter reduce but don’t eliminate the risk of infection.
Limit your number of sex partners. Having multiple sex partners puts you at a high risk of contracting chlamydia and other sexually transmitted infections.
Get regular screenings. If you’re sexually active, particularly if you have multiple partners, talk with your doctor about how often you should be screened for chlamydia and other sexually transmitted infections.
Avoid douching. Douching decreases the number of good bacteria in the vagina, which can increase the risk of infection.

Two-thirds of new chlamydial infections occur among youth aged 15-24 years.³It is estimated that 1 in 20 sexually active young women aged 14-24 years are infected.

More than 1 million sexually transmitted infections (STIs) are acquired every day worldwide (1, 2).
Each year, there are an estimated 376 million new infections with 1 of 4 STIs: chlamydia, gonorrhoea, syphilis and trichomoniasis (1, 2).
More than 500 million people are estimated to have genital infection with herpes simplex virus (HSV) (3).
More than 290 million women have a human papillomavirus (HPV) infection (4).
The majority of STIs have no symptoms or only mild symptoms that may not be recognized as an STI.
STIs such as HSV type 2 and syphilis can increase the risk of HIV acquisition.
988 000 pregnant women were infected with syphilis in 2016, resulting in over 350 000 adverse birth outcomes including 200 000 stillbirths and newborn deaths (5).
In some cases, STIs can have serious reproductive health consequences beyond the immediate impact of the infection itself (e.g., infertility or mother-to-child transmission)
The Gonococcal Antimicrobial Resistance Surveillance Programme has shown high rates of quinolone resistance, increasing azithromycin resistance and emerging resistance to extended-spectrum cephalosporins. Drug resistance, especially for gonorrhoea, is a major threat to reducing the impact of STIs worldwide.

References

CDC (2016) Chlamydia – CDC Fact Sheet. Accessed 10^th Sep 2016 from; http://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm

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