Hong Kong women Sexual health
Reported, December 21, 2011
Sexual health issues have major implications for womens health status. Contraceptiona fundamental right of all womenhas transformed the health of many women who now have control over their fertility.
Their choice of delaying pregnancies, however, has led to infertility and associated psychological morbidity among some women.Sexual health also includes sexually transmitted infections (STIs), which include infection with human immunodeficiency virus (HIV).
The similarities of STIs and HIV infection in terms of behaviour, transmission, and control measures indicate the significance of HIV infection to womens health, particularly in view of the steady increase in the number of newly reported infections among women and the
fact that the most common form of transmission is through heterosexual relationships.Other aspect to consider within the context of
sexual health is cervical cancer, which claims approximately 140 lives each year in Hong Kong and is the fourth most common form of cancer among women locally.Cervical cancer provides an example of the consequences of poor sexual health for women and
is perhaps of particular relevance to health care practitioners,because many have the opportunity of discussing these issues with women during screening programmes or opportunistically.
A study of Hong Kong Chinese women has demonstrated low uptake rates for cervical screening compared with similar populations overseas. In addition, local research of womens perceptions of some screening programmes
that are currently offered in Hong Kong has identified some important factors that influence womens sexual health and health status.The first issue relates to womens lack of awareness of the importance of cervical screening to their sexual health. A study of 242 Hong Kong Chinese women that investigated the extent to which the current cervical screening service meets their needs has demonstrated that few women acknowledge the importance of screening for the sake of their own health.Women without children and who are sexually active
frequently stated they were too busy to attend for a cervical smear. Once women became parents of small children, however, the acknowledged responsibility for their young children indicated they were more likely to attend for screening.
The same study also highlighted womens demand for information about the screening procedure and their lack of satisfaction with the level of information that was provided. Their perception of a lack of information not only related to information given to them while
attending the clinic, but also in the mediathat is, the available publicity provided insufficient information to highlight the importance of attending for screening.The lack of information also influenced womens patterns of attendance and resulted in their being unaware of the significance of attending regularly for cervical smears and their relying on the advice of practitioners to return for further smears.
Some womens attitudes to both the disease and screening procedure also highlight some important factors. The lack of knowledge about the disease has led to an inappropriate association of the disease with promiscuity. Although rightly identifying multiple sexual partners as a risk factor of the disease, women are frequently unaware that having been sexually active adds to their risk of the development of cervical cancer.
Womens embarrassment about the screening procedure and concern about the associated discomfort and pain are important factors that influence their attendance. Indeed, a major factor in this respect is the technical skill of the practitioner in reducing pain and his or her interpersonal and communication skills in minimising fear and embarrassment.
The final issue relates to age and the particular needs of older women. Although younger women have cited increasing age as a risk factor, there is little awareness among many older women of any increased risk with age. Furthermore, many women may consider
themselves no longer at risk once menopausal.Another important issue relates to older womens lack of knowledge about their cervical smear status.Although many of these women have children and have undergone gynaecological examinations, they have little knowledge about what is involved in the examination or whether they have undergone cervical smear screening. These women are, however, keen to receive information about screening, so that they can make an informed decision about their attendance pattern.
Conclusion
Evidence clearly identifies the significant implications of social factors on womens health status, and the multidimensional nature of health highlights the complexity of these implications. A consistent issue to emerge from the literature is the need for women to
share concerns about their health with practitioners.