Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 6 Worlds Apart? Sexual Behaviour, Contraceptive Use, and Pornography Consumption Among Young Women and Men ELISABET HÄGGSTRÖM-NORDIN ACTA UNIVERSITATIS UPSALIENSIS ISSN 1651-6206 UPPSALA ISBN 91-554-6144-1 2005 urn:nbn:se:uu:diva-4779 !" #$$% !&'!% ( ) ( ( * + ( ,- . / 0/- 12)) 34 5- #$$%- 6 7 8 0 9 : * ) : 7 ) ; ) 6 - 7 - <- => - - ?094 @!%%><!>>! . ( / ) /) ( / ( ) +5:*, ) ) ) ) - / A + ? ?? ???, A / + ?B,- 7 C ( !< ) / / 5:* / / - 7 / ) 5:* / ) ) / / 5:* / - D( ) ( 5:* +?,- 7 ( ( !< ) +><E, !$ #$ - ( ( + =<E, ( + #&E,- ) ) ( ( +??,- . ( ( !" ( / A ( - 7 / / (A - / ) / / ) ) ) ( / / ) ( +???,- . ) ) / / FG ) / H ) - . / ( ) / ) ( / ( - ? / (( ) ) ) I ( ) +?B,- D )) (( / ) / ) ) A ) 5:* ) - . (( / ) ( ) - 6 )) / ) / ) - 7 ) ) (( ) ) 0/ ! "#$ %& ' ( ) ) " ' *+ + ,+' ' %-./0. ' J 5 12)) 34 #$$% ?004 !<%!<#$< ?094 @!%%><!>>! ' ''' >==@ + 'KK --K 8 L ' ''' >==@, To Sanna (my late grandmother) – the midwife and Sanna (my daughter) – the researcher List of Papers This thesis is based on the following papers, which are referred to in the text by their Roman numerals: I. Häggström-Nordin E, Tydén T. Swedish Teenagers’ Attitudes Towards the Emergency Contraceptive Pill. J Adolesc Health 2001; 28:313-318. II. Häggström-Nordin E, Hanson U, Tydén T. Sex Behavior Among High School Students in Sweden: Improvement in Con- traceptive Use Over Time. J Adolesc Health 2002; 30:288-295. III. Häggström-Nordin E, Hanson U, Tydén T. Association between pornography consumption and sexual practices among adoles- cents in Sweden. Int J of STD & AIDS. 2005; 16:102-107. IV. Häggström-Nordin E, Hanson U, Sandberg J, Tydén T. “It’s everywhere!” Thoughts and reflections about pornography among young people in Sweden. Submitted. Reprints were made with the permission from the publishers. Contents Introduction...................................................................................................11 Sexual behaviour among young people....................................................11 General introduction ............................................................................11 Adolescence.........................................................................................11 Sexual and reproductive health............................................................11 Adolescents and sexuality....................................................................12 Sex and relationships education...........................................................14 Youth centres.......................................................................................14 The role of the midwife in sexual and reproductive health .................15 Risk behaviour and risk factors ...........................................................15 Sexually transmitted infections............................................................16 Contraception – The emergency contraceptive pill..................................18 Counselling..........................................................................................18 Young peoples’ attitudes to and use of contraception .........................18 Abortion – legislation and statistics.....................................................19 Prevention of abortions........................................................................20 Emergency contraception ....................................................................20 Pornography and its influence on sexual behaviour.................................22 New trends in sexual behaviour...........................................................23 Influence of pornography ....................................................................23 A source of knowledge ........................................................................24 Risk behaviour.....................................................................................24 Theories on pornography.....................................................................24 Aims of the thesis..........................................................................................26 Methods ........................................................................................................27 Design ......................................................................................................27 Papers I, II and III ....................................................................................27 Study setting ........................................................................................28 Population and sample.........................................................................28 Measurement instruments....................................................................30 Data collection.....................................................................................31 Data analysis and statistical methods ..................................................32 Paper IV ...................................................................................................33 Sample and data collection ..................................................................33 Data analysis........................................................................................34 Ethical considerations ..............................................................................34 Results...........................................................................................................36 Paper I ......................................................................................................36 Paper II .....................................................................................................36 Paper III....................................................................................................40 Paper IV ...................................................................................................43 Discussion.....................................................................................................46 Methodological considerations.................................................................46 Paper I, II and III .................................................................................46 Paper IV ...............................................................................................48 Reflections on results ...............................................................................49 Sexual behaviour among young people...............................................49 Contraception – the emergency contraceptive pill ..............................53 Pornography and its influence .............................................................54 Implications for the future........................................................................56 Future research ....................................................................................57 Grants...................................................................................................57 Conclusions...................................................................................................58 Acknowledgements.......................................................................................61 Summary in Swedish – Svensk sammanfattning ..........................................63 Skilda världar? Ungdomars sexualvanor, preventivmedelsanvändning och pornografikonsumtion .......................................................................63 Bakgrund .............................................................................................63 Ingående delarbeten.............................................................................64 References.....................................................................................................66 Abbreviations EC Emengency Contraception ECP The Emergency Contraceptive Pill OTC Over the counter, without a prescription IUD Intrauterine Contraceptive Device OC Oral contraceptive STI Sexually Transmitted Infection STD Sexually Transmitted Disease HIV Human Immunodefiency virus AIDS Aquired Immunodefiency Syndrome The meanings of the words - attitude, adolescence, high school students, young people and gender can vary. In this work, these words have the fol- lowing meaning: Attitude – a settled way of thinking or feeling about someone or something, one typically reflected in a person’s behaviour (The New Oxford Dictionary of English. Oxford University Press, 1998). Adolescence – transitional phase of growth and development between child- hood and adulthood encompassing psychological, social and moral terrain as well as the strictly reproductive aspects of maturation (The New Encyclo- paedia Britannica 15 ed. Encyclopaedia Britannica, Inc., 1993). Gender – e.g. an individual’s self-conception as being a male or a female, as distinguished from actual biological sex