Archive for February, 2007

The hard –to-tell relationship between excessive alcohol consumption and risky sexual behaviour

February 13th, 2007

There is certain relationship between alcohol use and risky sexual behavior. However, accurately describing this relationship is very difficult.


Some studies ascertained that participants who use alcohol, and those who use alcohol more heavily, are more likely to engage in sexual HIV-risk behavior (Weinhardt, Lance S and Carey, Michael P, 2000). This opinion is supported by both economists and psychologists.

Economists have used a variety of methods to provide evidence on the relationship between alcohol use and risky sexual behavior. One recent approach taken by researchers in this field involves estimation of the reduced form relationship between the price of alcohol — usually beer taxes — and some measure of sexual behavior such as the state gonorrhea rate. A statistically significant coefficient on the beer tax — which is presumed to reduce alcohol consumption — is taken as suggestive evidence for a causal relationship between alcohol consumption and the outcome variable of interest. Chesson, Harrison, and Kassler (henceforth CHK) use state panel data on STD rates over a 16-year period and estimate that increases in the beer tax are associated with statistically significant reductions in a state’s gonorrhea rate for 15–19-year-old males after controlling for state and year effects.

Psychologist used the alcohol myopia model (Steele & Josephs, 1990) to explain the effects of alcohol on social behavior. According to this model, alcohol reduces cognitive capacity and causes people to focus on the cues that are most salient in the environment. And in many HIV-risk-reduction programs, substance use prior to sexual behavior is discussed as a risk behavior and is assessed as an outcome (e.g., Carey et al., 1997a; Fullilove, Fullilove, Bowser, & Gross, 1990). Theory and experimental research provide support for this association.

Some studies indicate that people who use condoms when they are sober also tend to use them when drinking; people who fail to use condoms when drinking probably also fail to use them when sober (George, William H and Stoner, Susan A, 2000).

Other studies proved that both excessive drinking and risky sexual behaviour are determined by psychological or emotional factors and drinking is not necessarily lead to risky sexual behaviour or more risky sexual behaviour. The causal-effect relationship between drinking and risk sexual behaviour could be rather weak.

Surprisingly, it’s also possible that men tend to become physically more sexually aroused when they think they have been drinking alcohol, even when they haven’t. Women report feeling more sexually aroused when they falsely believe the beverages they have been consuming contain alcohol, although a measure of their physological arousal shows that they are physically becoming less aroused.
Men become more aggressive in laboratory studies in which they are drinking only tonic water but believe that it contains alcohol. They also become relatively less aggressive when they think they are drinking only tonic water, but are actually drinking tonic containing alcohol.
Thus, much sexual behavior as well as aggression associated with alcohol may be more a result of our beliefs than of the alcohol we consume (David J. Hanson). The causality is more emotional and psychological rather than physical and clinical.

How messy it is!

1, Understanding acute alcohol effects on sexual behavior

Annual Review of Sex Research,  2000  by George, William H,  Stoner, Susan A

2, Does alcohol lead to sexual risk behavior? Findings from event-level research

Annual Review of Sex Research,  2000  by Weinhardt, Lance S,  Carey, Michael P

3, Alcohol myopia. Its prized and dangerous effects

Am Psychol. 1990 Aug;45(8):921-33 by Steele CM, Josephs RA.

4, Alcohol and sexual violence: key findings from the re s e a rc h, HOME OFFICE

http://www.homeoffice.gov.uk/rds/pdfs04/r215.pdf

5, Youth alcohol use and risky sexual behavior: evidence from underage drunk driving laws

Journal of Health Economics 24 (2005) 613–628, Christopher Carpenter

AND MORE AND MORE……………


 

The festive season=? The abortion season

February 13th, 2007

Marie Stopes International performed 5, 992 terminations in January, the biggest number for a single month in the charity’s 32-year history. MAI blamed excessive boozing in the party season, while British Pregnancy Advisory Service said it was a treatment bottleneck caused by NHS cutback. BPAS think the increased figures may reflect a difficult struggle to access proper services, rather than the results of being careless after drinking. NHS provision ranges from more than 90% of local demand to less than 60% in some areas (NHS website). MSI carried out one third terminations accounting for more abortions in this country than it did before. Therefore, the total number of abortion may not significantly increase insides and outsides NHS.
They two explanations are all possible and lack of evidences. The first explanation could be illuminated by the following causal-effect diagram:

We admit that during the festive season, there were much more parties and more drinking. It’s very likely there were more people times got drunk.
There is certain relationship between alcohol use and risky sexual behavior. However, accurately describing this relationship is very difficult.

  • Every year, around 180,000 abortions take place in England (Abortion Rights’s Report Autumn2006).
    In the UK, the law makes it legal to have an abortion in the first 24 weeks of pregnancy providing certain criteria are met. For more information on Laws and Ethics on Abortion, visit Abortion Rights.  
    The law also states that:
  •   *Abortions must be carried out in a hospital or licensed clinic.
  •   *Two doctors must agree that the requirements of the Abortion Act 1967 have been met.
  • In England, nearly a quarter of women pay for their abortions because NHS services are restricts. Almost 90% of abortions take place in the first 12 weeks of pregnancy. Surgical abortion up to 12-week non-anaesthetic charged by MAI is about 550 pounds.

     

Recommended Books on Qualitative Research Mehtods

February 11th, 2007

Miles, Matthew B, Qualitative data analysis : an expanded sourcebook

Yin, Robert K. (Robert Kuo-Zuir), Case study research : design and methods

Uncompleted

A Method for Literature Review–Comparative Thematic Analysis

February 11th, 2007

This qualitative research analysis method was come up by Cicely Marston, Eleanor King in their journal article -Factors that shape young people’s sexual behaviour: a systematic review (Marston and King 2006). They reviewed 268 qualitative studies of young people’s sexual behaviour published between 1990 and 2004. Additionally, they developed a method of comparative thematic analysis in which they coded each document according to themes they contained. They developed this method from existing work on meta-analysis of qualitative data (Britten et al. 2002; Greenhalgh et al. 2005) and their own experience.

I think it can be generalized as a good method for reviewing all kind literatures. To illustrate this method, take their study as an example:

First, They indentified seven themes when they were reviewing 268 studies :

Theme 1: Young people subjectively assess the risks from sexual partners on the basis of whether they are “clean” or “unclean”;

Theme 2: Sexual partners have an important influence

on behaviour in general;

Theme 3: Condoms can be stigmatising and associated with lack of trust;

Theme 4: Gender stereotypes are crucial in determining social expectations and

behaviour;

Theme 5: There are penalties and rewards for sex from wider society;

Theme 6: Reputations and social displays of sexual activity or inactivity are important;

Theme 7:Social expectations hamper communication about sex.

They did 3 steps to complete this categorizing :

Step one, generate theme independently reviewing all studies;

Step two , refine these dozens of codes through discussion and the use of constant comparison within and between codes to ensure that they accurately reflected the material.

Step three, identify correlations between the different themes, grouping them into the broad overall themes. They got the seven themes above.

Second, they coded all 268 studies with 1, 2, 3, 4, 5, 6 and 7 according to the content of each study.

Finally, studies were classed as primary—of high quality or containing empirical data about sex (ie, specific reports about sexual events rather than about attitudes or opinions), or both, or they were classed as secondary—lower quality, with no empirical data about sex.

After complete the above, you can present the results in a table as following:

Study Date Study Location Study Population Data Source Theme 1 Theme
 

2

Theme
 

3

               

 

Britten N, Campbell R, Pope C, Donovan J, Morgan M, Pill R (2002) Using meta ethnography to synthesise qualitative research: A worked example. Journal of Health Services Research and Policy 7:209-215

Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O, Peacock R (2005) Storylines of research in diffusion of innovation: a meta-narrative approach to systematic review. Social Science & Medicine 61:417-430

Marston C, King E (2006) Factors that shape young people’s sexual behaviour: a systematic review. The Lancet 368:1581-1586