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This narrative review explored the efficacy of school-based child sexual abuse prevention programmes between 1990 and 2002. There were 22 efficacy studies that met clear inclusion criteria. Results covered both methodological design and the range of outcome measures. Methodology was analysed through four dimensions (target population, prevention programme implementation, evaluation methodology and cost-effectiveness). Outcomes for children covered nine categories (knowledge, skills, emotion, perception of risk, touch discrimination, reported response to actual threat/abuse, disclosure, negative effects and maintenance of gains). The studies had many methodological limitations. Prevention programmes had a measure of effectiveness in increasing children ' s awareness of child sexual abuse as well as self-protective skills. Beyond minimal disclosure rates, there was no evidence to demonstrate that programmes protected children from intra-familial sexual abuse. For a small number of children prevention programmes produced minimal negative emotional effects. Recommendations for future research, policy and practice, include realistic outcomes for child participants and locating programmes within wider abuse prevention measures.

This paper explores the benefits of teaching young people about sex through a sexual debut framework.

Dominant conceptual frameworks that shape young people’s introduction to sexual intimacy are analyzed.

Sexual debut is a process by which young people are given the power to decide the who, what, when, where, why, and how of their first sexual encounters. The evolution and nuances of young people’s first sexual engagements can be understood through the interface of culture, social, and psychological contexts, language, actions, experiences, and how they transform those processes into their own conceptualization of sexual behavior and involvement with it.

This framework explains a process by which young people engage in particular sexual acts at a particular time and place with a certain partner. It allows for future data gathering and analysis to refine this model.

Benefits of teaching children they have power to influence with whom they want to become sexually active, what types of sexual activities they want to experience, when they wish to engage in those actions, and where they occur should reduce the risk of abuse, rape, and harm.

The debut model challenges abstinence approaches to sex education. The implications of this research reinforce the United Nations Convention on the Rights of the Child to support young people’s participation to influence their lives and well-being.

It provides a realistic view of sexual experimentation and has the potential to reduce risk and increase young people’s well-being.

Purpose – This chapter explores claims of social problem workers in criminal justice and mental health with regard to how to manage males who are identified as or self-identify as both victims and perpetrators (V/Ps) of sexual abuse. We also examine the claims of V/Ps with regard to how they manage their dual status.

Methodology – This chapter is based on an action research project on intervention services for V/Ps in Ontario, Canada. Our data include literature reviews, interviews with intervention professionals, V/P narratives, and a transcription of a stake-holder's workshop.

Findings – Intervention workers whose mandate is offender risk management state they give little attention to victimization-related issues of V/Ps, whereas workers in victims’ services often state that adult V/Ps are not covered under their mandate. This suggests that the status of offender is the master status for adult V/Ps. Our V/P narratives recount efforts at self-management and some V/Ps and intervention professionals have expressed interest in the possibility of developing programs specially designed for V/Ps.

Practical Implications – An examination of issues related to the dual status of sexual abuse V/Ps suggests that V/Ps may require special services that cannot be provided by existing programs for perpetrators and victims.

Originality/Value of Paper – Studies of social problem work might benefit from considering not only professionals’ viewpoints but also those of their clients. This chapter explores new intervention models (GLM and RJ) that incorporate ethical concerns based on a rights perspective (“moral repair”) and the experiential concerns of V/Ps.

Older adults’ sexual health is becoming an increasingly important component of healthy aging in the wake of the HIV/AIDS epidemic and rising infection rates among this age cohort. The increase in HIV/AIDS diagnoses in the older adult population ignites the need to understand the reasons why older adults are omitted from HIV/AIDS prevention education policy.

This chapter examines the social forces that influence HIV/AIDS policy at the state and community levels. Through qualitative methodology and analysis, including interviews with state policymakers and managers of AIDS service organizations in four Midwestern states (n=31), I look for trends and patterns as to whether or not older adults are considered as an “at-risk” group for HIV infection.

Findings reveal that HIV/AIDS policy may be impacted by enduring sexual scripts about older adults. To some extent both state policymakers and AIDS service organization personnel adhere to stereotypes about older adults’ sexuality and sexual activity, which is then implemented in their health promotion activities. The result is that gaps exist in HIV/AIDS prevention education for older adults, despite the fact that current trends show an increase in new HIV infections and AIDS diagnoses among people over the age of 50.

While this is an exploratory study of the available HIV/AIDS prevention education and health promotion activities for older adults, as well as the viewpoints of state policymakers and AIDS service organization personnel, the findings do indicate the need for additional research on the potentially dangerous sexual behaviors – lack of HIV testing, low condom usage, multiple partners – exhibited by older adults. Future research involving interviews with older adults, physicians, and medical personnel may add new perspectives to the current research.

As the baby boomers continue to age and challenge cultural stereotypes of sexual behaviors among older adults, research in the area of sexual health and HIV/AIDS prevention education will remain an important component of healthy aging. This research begins what will ultimately be a necessary conversation.

The purpose of this research is to understand the vulnerabilities of male youth in the sex trade in Manila, Philippines. Using purposive and a modified respondent-driven sampling methodology, interviews were conducted with 51 young males working as masseurs in the Metro Manila area exploring a wide range of their experiences and vulnerabilities throughout the work including physical, sexual and emotional violence. The mixed method, mostly qualitative research is based on similar surveys conducted throughout the South and South Asia regions.

Research on sexual exploitation of boys and men has largely focused on sexual health and prevention of HIV (Human Rights Watch Philippines, 2004). This research uniquely focuses on a broader range of vulnerabilities for males in the sex trade.

Qualitative discussions reveal instances of forced sex that can take a variety of forms, including physical force and/or violence or coercion involving bribes, verbal abuse or other forms of pressure to provide sexual services. Data also demonstrate stigma and discrimination outside of sex work. This study provides a qualitative assessment of the broader male-to-male sex industry within the Metro-Manila area, including escort services and both direct and indirect male sex work.

For observers, who consider male sexual abuse to be free of violence or discrimination, this provides evidence to the contrary and considerations for organizations that are able to provide funding to support their needs. Education of those involved in addressing the prevention of sexual exploitation should include gendered differences.

This paper aims to describe the unique health challenges facing female commercial sex workers (FSWs), including issues related to their marginalisation and difficulty accessing health care. It proposes solutions to some of these problems.

This paper addresses this sensitive subject through the methodology of a literature review, drawing on a variety of relevant published literature to inform a modern understanding of the current health challenges faced by this population.

This paper discusses issues around criminalisation of commercial sex workers, complexities of family planning, sexually transmitted infection prevention, mental health and substance abuse and how increasing health-care worker awareness of the health needs of this vulnerable population can be a positive step in building trust within this relationship. Although adoption of the proposed recommendations put forth in this paper may help to eliminate some of the barriers encountered by female sex workers, further research is recommended.

The subject of commercial sex worker health care is neglected in the academic literature. This review explores the topic in an open and balanced manner and presents a broad and updated overview of the current health-care challenges faced by FSWs as well as opportunities for optimising access and quality of sex worker health care.

Complex inequalities have shaped the trajectory of the HIV epidemic in South Africa. These include factors related to gender disempowerment, poverty, family disruption and violence – all of which have intensified the risk of HIV infection among the majority of South Africans, contributing to one of the most severe country-level HIV epidemics globally. Neo-liberal economic policies adopted in the post-apartheid period failed to address poverty and burgeoning urban migration – both of which were key factors exacerbating vulnerability to HIV. While there was, ostensibly, a strong commitment to addressing the HIV epidemic by the post-apartheid government, HIV prevalence among pregnant women quadrupled from 7.6% in 1994 to 30.2% in 2005. Contributing to this rise, was a series of missteps by the national Department of Health in the late 1990s, which constrained HIV prevention efforts and stifled HIV treatment. The mid-2000s saw a reprioritisation of the response to the epidemic, with international guidelines supported by biomedical and social research underpinning a rights- and evidence-based response. Multisectoral HIV prevention activities were complemented by high levels of investment in implementing prevention of mother to child HIV transmission and expanding access to antiretroviral therapy (ART) for HIV through the public sector. While these efforts contributed to stabilising the epidemic, stark inequalities in vulnerability and susceptibility to HIV infection continued – in particular, among youth. In this chapter, we draw on a review of the research literature to describe concerns and explore opportunities for a response.

School-going young people in South Africa engage in HIV risk behaviour despite high levels of HIV knowledge and a variety of interventions focusing on HIV prevention. The lack of empirical evidence on the effectiveness of current interventions leaves programme implementers with little consensus about how best to prevent HIV infection among young people. This research was done to explore factors underlying HIV risk of young people with the aim of developing HIV prevention in the third decade of the epidemic. Focus group discussions were conducted with young people, educators and parents in eight schools in four provinces of the country. A thematic analysis revealed risk factors especially on the interpersonal and community level. Peer pressure, gender norms and culture, poverty and financial gain and a culture of alcohol use were prominent themes. Negative family relationships, lack of role models and lack of sexual education from home contributed to risk behaviour. Community processes such as exposure to media, lack of recreational facilities, and an erosion of supportive culture and community structures created an environment which did not support healthy behaviour. Factors that prevented risk behaviour were identified as self-respect, open communication with parents, implementation of school programmes, positive peer pressure and a focus on young people's future. Prevention programmes should therefore not only focus on individual factors but should be multi-layered interventions involving various community structures aimed at changing the social ecology in communities to support an alternative lifestyle for young people.