A Critical Examination of Sexual Health Challenges in Young Adults
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This report critically examines the sexual health challenges faced by young adults, using the case of Fred, a homeless nineteen-year-old engaging in risky sexual behavior. It explores the complexities of the situation, considering socioeconomic factors and the need for multidisciplinary healthcare approaches. The report discusses the importance of professional ethics, theoretical principles, and moral reasoning in addressing these challenges. It highlights the prevalence of unhealthy sexual behaviors, the risk of STDs and unintended pregnancies, and the impact of homelessness. The report emphasizes the need for healthcare professionals to provide comprehensive, tailored care, considering the emotional and social needs of adolescents. It also addresses the importance of open communication, privacy, and awareness of the stigma surrounding sexual health issues.

Running head: CRITICAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
CRITICAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
Name of the Student:
Name of the University:
Author note:
CRITICAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
Name of the Student:
Name of the University:
Author note:
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1CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
Executive Summary
Despite the adequate public educational dissemination of information and policies
pertaining to the need for maintaining healthy and appropriate sexual health practices, there still
lies considerable prevalence of unhealthy, risky sexual behavior amongst adolescents.
Considering the complex social, developmental and functional needs of adolescents,
maintenance of adequate sexual health often becomes a contentious issue. The following report
discusses the complex case scenario of Fred, a young adult who is homeless and is actively
involved in undertaking unhealthy sexual behaviors for the purpose of living. For the
management of this case, healthcare professionals must critically consider moral and ethical
principles along with a variety of theoretical principles. Likewise, the need of the hour is the
adoption of multidisciplinary approach for the treatment of adolescent sexual problems, along
with the appropriate dissemination of information concerning the associated health outcomes,
with due consideration of unprotected sexual engagement amongst the youth.
Executive Summary
Despite the adequate public educational dissemination of information and policies
pertaining to the need for maintaining healthy and appropriate sexual health practices, there still
lies considerable prevalence of unhealthy, risky sexual behavior amongst adolescents.
Considering the complex social, developmental and functional needs of adolescents,
maintenance of adequate sexual health often becomes a contentious issue. The following report
discusses the complex case scenario of Fred, a young adult who is homeless and is actively
involved in undertaking unhealthy sexual behaviors for the purpose of living. For the
management of this case, healthcare professionals must critically consider moral and ethical
principles along with a variety of theoretical principles. Likewise, the need of the hour is the
adoption of multidisciplinary approach for the treatment of adolescent sexual problems, along
with the appropriate dissemination of information concerning the associated health outcomes,
with due consideration of unprotected sexual engagement amongst the youth.

2CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
Table of Contents
Introduction..........................................................................................................................2
Concise Overview................................................................................................................3
Professionalism and Decision-Making................................................................................5
Theoretical Principles..........................................................................................................8
Moral Reasoning................................................................................................................10
Contemporary Sexual Healthcare......................................................................................12
Critical Reflection..............................................................................................................15
Conclusion.........................................................................................................................16
References..........................................................................................................................18
Table of Contents
Introduction..........................................................................................................................2
Concise Overview................................................................................................................3
Professionalism and Decision-Making................................................................................5
Theoretical Principles..........................................................................................................8
Moral Reasoning................................................................................................................10
Contemporary Sexual Healthcare......................................................................................12
Critical Reflection..............................................................................................................15
Conclusion.........................................................................................................................16
References..........................................................................................................................18

3CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
Introduction
According to Edelman et al., (2015), optimum sexual healthcare services imply the
provision of a range of professional and quality services which aid an individual to embrace their
sexuality with enjoyment and liberty. ‘Sexual health’ also refers to a collection of treatment
principles and procedures which aid in the prevention of sexually transmitted diseases (Meyrick
& Gray, 2018). As stated by Epstein and Mamo (2017), optimum sexual health encompasses the
freedom of all individuals to practice their varied sexual needs with ease, along with providing
everyone the right to access all health services concerned with the optimum maintenance and
treatment of the same. In accordance to the World Health Organization, optimum sexual health
refers to the state of wellness and wellbeing, at the social, physical as well as mental platforms. It
also implies the requirement of individuals to approach their own as well other’s sexual needs
with respect and consent for the purpose of engagement in sexual relationships which are safe
and devoid of violence, disparities and force (Costello et al., 2016).
According to Sarver et al., (2014), despite the increased awareness and dissemination of
public education on maintenance and practice of appropriate sexual health, there still lies and
increased prevalence and tendencies of adolescents and youngsters to engage in sexual behaviors
which are risky, resulting in an increase in their susceptibility to affliction of additional harmful
disorders and associated negative health outcomes. Hence, according to DiClemente (2016), the
need of the hour is to undertake a critical examination of the concerned professionalism and
decision-making associated with the same, for the purpose of prevention of undertaking specific,
uninformed sexual health activities amongst the youth, which will yield harmful consequences
on the health of the individual as well as others.
Introduction
According to Edelman et al., (2015), optimum sexual healthcare services imply the
provision of a range of professional and quality services which aid an individual to embrace their
sexuality with enjoyment and liberty. ‘Sexual health’ also refers to a collection of treatment
principles and procedures which aid in the prevention of sexually transmitted diseases (Meyrick
& Gray, 2018). As stated by Epstein and Mamo (2017), optimum sexual health encompasses the
freedom of all individuals to practice their varied sexual needs with ease, along with providing
everyone the right to access all health services concerned with the optimum maintenance and
treatment of the same. In accordance to the World Health Organization, optimum sexual health
refers to the state of wellness and wellbeing, at the social, physical as well as mental platforms. It
also implies the requirement of individuals to approach their own as well other’s sexual needs
with respect and consent for the purpose of engagement in sexual relationships which are safe
and devoid of violence, disparities and force (Costello et al., 2016).
According to Sarver et al., (2014), despite the increased awareness and dissemination of
public education on maintenance and practice of appropriate sexual health, there still lies and
increased prevalence and tendencies of adolescents and youngsters to engage in sexual behaviors
which are risky, resulting in an increase in their susceptibility to affliction of additional harmful
disorders and associated negative health outcomes. Hence, according to DiClemente (2016), the
need of the hour is to undertake a critical examination of the concerned professionalism and
decision-making associated with the same, for the purpose of prevention of undertaking specific,
uninformed sexual health activities amongst the youth, which will yield harmful consequences
on the health of the individual as well as others.
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4CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
The following paragraphs of the report aim to critically examine a sexual health scenario,
along with the deconstructed and critical examination of the professionals involved in the
situation, a range of theoretical principles involved for further understanding, the principles of
morality involved along with a critical overview of treatment principles associated with sexual
healthcare services at contemporary platforms.
Concise Overview
We shall be critically considering the scenario of Fred. Fred, who is aged nineteen years
old, is engaged in the conductance of unhealthy and risky sexual health behaviors. Considering
his critical situation of homelessness, he takes part in the engagement of sexual practices with a
female friend, as a result of which, the concerned female friend in question returns the favor by
allowing Fred to reside in her house, for free of cost. Despite adequate knowledge and awareness
concerning his wrong doing, Fred is unable to break free from the act since he will be at a loss of
his basic living standards.
Hence, as observed from the above scenario, along with the engagement in risky and
unhealthy sexual behavior, a number of factors are to be taken into concern, due to multi-faceted
nature of the above, encompassing compromised sexual health, along with detrimental
socioeconomic standards leading to homelessness.
The rationale behind this scenario is the prevalence of adolescents undertaking risky
sexual behavior leading to their increased susceptibility and infliction to a variety of diseases and
co-morbidities (Simons et al., 2016). According to Kerpelman et al., (2016), the practice of
adolescents undertaking unhealthy sexual behaviors is emerging as a major population
shortcoming and critical health scenario on a global platform. The engagement of young adults
The following paragraphs of the report aim to critically examine a sexual health scenario,
along with the deconstructed and critical examination of the professionals involved in the
situation, a range of theoretical principles involved for further understanding, the principles of
morality involved along with a critical overview of treatment principles associated with sexual
healthcare services at contemporary platforms.
Concise Overview
We shall be critically considering the scenario of Fred. Fred, who is aged nineteen years
old, is engaged in the conductance of unhealthy and risky sexual health behaviors. Considering
his critical situation of homelessness, he takes part in the engagement of sexual practices with a
female friend, as a result of which, the concerned female friend in question returns the favor by
allowing Fred to reside in her house, for free of cost. Despite adequate knowledge and awareness
concerning his wrong doing, Fred is unable to break free from the act since he will be at a loss of
his basic living standards.
Hence, as observed from the above scenario, along with the engagement in risky and
unhealthy sexual behavior, a number of factors are to be taken into concern, due to multi-faceted
nature of the above, encompassing compromised sexual health, along with detrimental
socioeconomic standards leading to homelessness.
The rationale behind this scenario is the prevalence of adolescents undertaking risky
sexual behavior leading to their increased susceptibility and infliction to a variety of diseases and
co-morbidities (Simons et al., 2016). According to Kerpelman et al., (2016), the practice of
adolescents undertaking unhealthy sexual behaviors is emerging as a major population
shortcoming and critical health scenario on a global platform. The engagement of young adults

5CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
in harmful sexual practices amongst multiple partners or the like results in higher susceptibility
to the acquisition of sexually transmitted diseases. As stated by Ritchwood et al, (2016), the
critical and highly receptive age of adolescent is characterized by tendencies in the engagement
of experimentation which puts them at a greater vulnerability towards harmful health outcomes.
A majority of adolescents who have underwent risk taking ventures associated with sexual
intercourse, present a wide range of complications in addition to sexually transmitted diseases.
These include: hepatitis, arthritis of infectious skin rashes (Boyer et al., 2017). A stated by
Sedgh et al., (2015), in the United Kingdom, one of the salient national objectives requiring
fulfillment, for the purpose of maintenance of optimum health amongst the population is the
implementation of efforts aimed at decreasing the adolescent infliction of premature teenage
pregnancies, untimely and inappropriate abortions and most importantly, sexually transmitted
diseases and HIV. In accordance to the data published by the Family Planning Association and
Brook Sexual Health Charity, titled as the ‘Unprotected Nation’ report, if the prevalent trends
outlining engagement in unhealthy sexual health amongst adolescents remained untreated for
prolonged periods, the estimated financial consequences associated with untimed pregnancies,
abortions and sexually transmitted diseases will amount to 130 million Euros (Marcell et al.,
2018).
The additional rationale outlining the selection of the above case scenario of Fred, is the
prevalent situation of homelessness amongst the youth of the United Kingdom. In accordance to
‘Center Point’ – an organization in the United Kingdom, dedicated for the provision of help and
services to the youngsters devoid of appropriate residential and occupational surroundings, there
is an annual reporting of homelessness amongst almonds 103, 000 youngsters (Montgomerie &
Büdenbender, 2015). As opined by Watson, Crawley & Kane (2016), along with the prevalence
in harmful sexual practices amongst multiple partners or the like results in higher susceptibility
to the acquisition of sexually transmitted diseases. As stated by Ritchwood et al, (2016), the
critical and highly receptive age of adolescent is characterized by tendencies in the engagement
of experimentation which puts them at a greater vulnerability towards harmful health outcomes.
A majority of adolescents who have underwent risk taking ventures associated with sexual
intercourse, present a wide range of complications in addition to sexually transmitted diseases.
These include: hepatitis, arthritis of infectious skin rashes (Boyer et al., 2017). A stated by
Sedgh et al., (2015), in the United Kingdom, one of the salient national objectives requiring
fulfillment, for the purpose of maintenance of optimum health amongst the population is the
implementation of efforts aimed at decreasing the adolescent infliction of premature teenage
pregnancies, untimely and inappropriate abortions and most importantly, sexually transmitted
diseases and HIV. In accordance to the data published by the Family Planning Association and
Brook Sexual Health Charity, titled as the ‘Unprotected Nation’ report, if the prevalent trends
outlining engagement in unhealthy sexual health amongst adolescents remained untreated for
prolonged periods, the estimated financial consequences associated with untimed pregnancies,
abortions and sexually transmitted diseases will amount to 130 million Euros (Marcell et al.,
2018).
The additional rationale outlining the selection of the above case scenario of Fred, is the
prevalent situation of homelessness amongst the youth of the United Kingdom. In accordance to
‘Center Point’ – an organization in the United Kingdom, dedicated for the provision of help and
services to the youngsters devoid of appropriate residential and occupational surroundings, there
is an annual reporting of homelessness amongst almonds 103, 000 youngsters (Montgomerie &
Büdenbender, 2015). As opined by Watson, Crawley & Kane (2016), along with the prevalence

6CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
of homelessness amongst youth who are inflicted with critical family or domestic issues, the
additional scenario of ‘hidden homelessness’ is often associated with greater and far more
dangerous health and lifestyle consequences. The situation of homelessness can be observed
amongst youngsters spending days and nights with strangers, at bus or subway stops or sofas and
floors of unsafe and unknown environments. As evident in the case study, the situation of Fred
clearly outlines similarities of hidden homelessness. According to Hada et al., (2017), the
prevalence of homelessness is associated with a number of physiological and psychological
negative health outcomes along with presence of barriers in occupational and educational
environments.
Professionalism and Decision-Making
According to Slater and Robinson (2014), the developmental stage of adolescence
encompasses a wide range of functional, developmental and emotional alterations in their
physiological as well as psychological health, resulting in an increased receptivity to their
surroundings. Hence, as stated by Lundgren and Amin (2015), the stage of development amongst
young individuals are outlined by the necessity to engage and acquire security, acceptance,
confidence and most importantly respect, amongst a wide range of social relationships and
platforms, further resulting in a increased to their self confidence and self-esteem. Hence, in
accordance to Guilamo-Ramos et al., (2015), considering the emerging social needs of
adolescents along with a lack of control on the strong impulse to engage in novel, risk-taking and
experimental behavior, the sexual health of adolescents continue to reach a platform of
compromise which professionals must consider in the decision-making process of dissemination
of sexual health education and treatment procedures.
of homelessness amongst youth who are inflicted with critical family or domestic issues, the
additional scenario of ‘hidden homelessness’ is often associated with greater and far more
dangerous health and lifestyle consequences. The situation of homelessness can be observed
amongst youngsters spending days and nights with strangers, at bus or subway stops or sofas and
floors of unsafe and unknown environments. As evident in the case study, the situation of Fred
clearly outlines similarities of hidden homelessness. According to Hada et al., (2017), the
prevalence of homelessness is associated with a number of physiological and psychological
negative health outcomes along with presence of barriers in occupational and educational
environments.
Professionalism and Decision-Making
According to Slater and Robinson (2014), the developmental stage of adolescence
encompasses a wide range of functional, developmental and emotional alterations in their
physiological as well as psychological health, resulting in an increased receptivity to their
surroundings. Hence, as stated by Lundgren and Amin (2015), the stage of development amongst
young individuals are outlined by the necessity to engage and acquire security, acceptance,
confidence and most importantly respect, amongst a wide range of social relationships and
platforms, further resulting in a increased to their self confidence and self-esteem. Hence, in
accordance to Guilamo-Ramos et al., (2015), considering the emerging social needs of
adolescents along with a lack of control on the strong impulse to engage in novel, risk-taking and
experimental behavior, the sexual health of adolescents continue to reach a platform of
compromise which professionals must consider in the decision-making process of dissemination
of sexual health education and treatment procedures.
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7CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
According to Macintyre, Vega and Sagbakken (2015), considering the compromised
sexual health scenario of Fred outlined in the above case study, the concerned professional or
clinician must engage in theoretical principles of adequate interpersonal communication which
includes imparting education on the negative health consequences associated with Fred’s
engagement in unhealthy sexual practices with his female friend, questioning directly concerning
the details of complexities of the case as well as engaging in adequate inquiry of the conductance
of medical examinations of sexually transmitted diseases (STDs) and Human Immunodeficiency
Virus (HIV). Further appropriate professionalism, as stated by Sandberg Thoma and Kamp Dush
(2014), required in the mitigation of Fred’s complex sexual health scenario would require
obtaining detailed information about previous medical history as well as sexual history of past
engagement in sexual health practices. Such information is crucial for the implementation of
decision-making further resulting in provision of appropriate sexual health education and
services for Fred.
However, critical examination can uncover crucial loopholes in the professionalism
associated with decision-making for appropriate sexual health services. As stated by Liu et al.,
(2015), despite the prevalence of adequate public policies and sexual health education, there
continues to remain a strong taboo, discrimination and emotional suppression associated with the
direct and open discussion of sexual behaviors. Further, as stated by Jackson et al., (2015), the
prevalence of fear of being stigmatized, ridiculed and the possibilities of acquisition of alarming
and critical reactions from elders, continue to traumatize adolescents in the discussion of sexual
practices. Also, as stated by Johns, Jayne and Steiner (2016), in addition to the above stigma
which professionals must consider, the lack of privacy in primary healthcare surroundings aim to
be an added burden in the transmission of sexual health services to the youth by professionals.
According to Macintyre, Vega and Sagbakken (2015), considering the compromised
sexual health scenario of Fred outlined in the above case study, the concerned professional or
clinician must engage in theoretical principles of adequate interpersonal communication which
includes imparting education on the negative health consequences associated with Fred’s
engagement in unhealthy sexual practices with his female friend, questioning directly concerning
the details of complexities of the case as well as engaging in adequate inquiry of the conductance
of medical examinations of sexually transmitted diseases (STDs) and Human Immunodeficiency
Virus (HIV). Further appropriate professionalism, as stated by Sandberg Thoma and Kamp Dush
(2014), required in the mitigation of Fred’s complex sexual health scenario would require
obtaining detailed information about previous medical history as well as sexual history of past
engagement in sexual health practices. Such information is crucial for the implementation of
decision-making further resulting in provision of appropriate sexual health education and
services for Fred.
However, critical examination can uncover crucial loopholes in the professionalism
associated with decision-making for appropriate sexual health services. As stated by Liu et al.,
(2015), despite the prevalence of adequate public policies and sexual health education, there
continues to remain a strong taboo, discrimination and emotional suppression associated with the
direct and open discussion of sexual behaviors. Further, as stated by Jackson et al., (2015), the
prevalence of fear of being stigmatized, ridiculed and the possibilities of acquisition of alarming
and critical reactions from elders, continue to traumatize adolescents in the discussion of sexual
practices. Also, as stated by Johns, Jayne and Steiner (2016), in addition to the above stigma
which professionals must consider, the lack of privacy in primary healthcare surroundings aim to
be an added burden in the transmission of sexual health services to the youth by professionals.

8CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
Likewise, as opined by Svanemyr et al., (2015), the engagement in unhealthy sexual health
practices is often associated with a plethora of negative social and emotional histories of abuse
and emotional trauma, which often adolescents avoid discussion due to the absence of
professional privacy along with a shortcoming amongst professionals to adhere to the multiple
emotional and physical needs of the youth, in additional to just dealing with their sexual
counterparts.
Hence, the need of the hour, for the management of Fred’s scenario, is the deliverance of
multidisciplinary care by professionals in the dissemination of sexual health services,
considering the various socioeconomic factors associated with the Fred (Stenström et al., 2014).
According to Mustanski et al., (2015), despite the relative open-mindedness exhibited by a
majority of professionals engaged in sexual healthcare professionals, youngsters at present seek
additional healthcare benefits beyond the mere provision of supportive environments in sexual
health education and discussion. As stated by Denno, Hoopes and Chandra-Mouli (2015),
majority of adolescents and youngsters feel the lack of acceptance or openness to information or
situational details by the professionals, along with the exhibition of excessive assumptions
concerning the situation with due ignorance of additional salient details and causative factors.
Hence, with respect to Fred, the concerned professional must take into consideration the
prevalence of additional associating factors, such as homelessness, which act as key determining
constructs to the situation.
Hence, according to Widman et al., (2014), for the optimum maintenance as well as
treatment of sexual health amongst adolescents like Fred who are undertaking risky sexual
behavior, the concerned health professional must engage actively in safeguarding the health of
Fred, since he may present additional symptoms of self harm, abuse, sexually transmitted
Likewise, as opined by Svanemyr et al., (2015), the engagement in unhealthy sexual health
practices is often associated with a plethora of negative social and emotional histories of abuse
and emotional trauma, which often adolescents avoid discussion due to the absence of
professional privacy along with a shortcoming amongst professionals to adhere to the multiple
emotional and physical needs of the youth, in additional to just dealing with their sexual
counterparts.
Hence, the need of the hour, for the management of Fred’s scenario, is the deliverance of
multidisciplinary care by professionals in the dissemination of sexual health services,
considering the various socioeconomic factors associated with the Fred (Stenström et al., 2014).
According to Mustanski et al., (2015), despite the relative open-mindedness exhibited by a
majority of professionals engaged in sexual healthcare professionals, youngsters at present seek
additional healthcare benefits beyond the mere provision of supportive environments in sexual
health education and discussion. As stated by Denno, Hoopes and Chandra-Mouli (2015),
majority of adolescents and youngsters feel the lack of acceptance or openness to information or
situational details by the professionals, along with the exhibition of excessive assumptions
concerning the situation with due ignorance of additional salient details and causative factors.
Hence, with respect to Fred, the concerned professional must take into consideration the
prevalence of additional associating factors, such as homelessness, which act as key determining
constructs to the situation.
Hence, according to Widman et al., (2014), for the optimum maintenance as well as
treatment of sexual health amongst adolescents like Fred who are undertaking risky sexual
behavior, the concerned health professional must engage actively in safeguarding the health of
Fred, since he may present additional symptoms of self harm, abuse, sexually transmitted

9CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
diseases or physiological complications like abdominal pain. Further, as stated by Mustanski et
al., (2014), considering the complexities of the situation, adolescents like Fred will require
treatment services and information which goes beyond generalized sexual health matters and
which are customized to their complex needs. According to Chandra-Mouli, Lane and Wong
(2015), youth at present, expect a range of professional information such as technical statistics,
contraceptive use and the like. The sensitive receptiveness of adolescent cognition may lead to
them finding difficulty in understanding and retention in a situation of excessive information
dissemination and hence, professionals must consider imparting specific information in a step-
by-step process for ease in perception, in the decision-making process.
Likewise, as stated by Cima and Parker (2017), the professional concerned with the
management of Fred’s case must also consider his state of homelessness for which an inter-
professional approach may be required due to the various social, psychological and health
complications associated with the situation, as observed in the case scenario.
Theoretical Principles
For the provision of adequate sexual health treatment services considering the complex
case scenario of Fred, professionals and nurses involved in clinical practices must consider the
principles of various theories associated with sexual behavior amongst individuals as well as the
treatment concerning Fred (Alessi, 2014).
In accordance to some of the earliest theories of sexual behavior as stated by Aristotle,
Plato and even Sigmund Freud, sexuality amongst humans have been described as an intrinsic
and innate need, required for the channeling of energies, directed towards release (Maxwell et
al., 2017). However, as discussed by Muise and Impett (2016), despite the existence of this
diseases or physiological complications like abdominal pain. Further, as stated by Mustanski et
al., (2014), considering the complexities of the situation, adolescents like Fred will require
treatment services and information which goes beyond generalized sexual health matters and
which are customized to their complex needs. According to Chandra-Mouli, Lane and Wong
(2015), youth at present, expect a range of professional information such as technical statistics,
contraceptive use and the like. The sensitive receptiveness of adolescent cognition may lead to
them finding difficulty in understanding and retention in a situation of excessive information
dissemination and hence, professionals must consider imparting specific information in a step-
by-step process for ease in perception, in the decision-making process.
Likewise, as stated by Cima and Parker (2017), the professional concerned with the
management of Fred’s case must also consider his state of homelessness for which an inter-
professional approach may be required due to the various social, psychological and health
complications associated with the situation, as observed in the case scenario.
Theoretical Principles
For the provision of adequate sexual health treatment services considering the complex
case scenario of Fred, professionals and nurses involved in clinical practices must consider the
principles of various theories associated with sexual behavior amongst individuals as well as the
treatment concerning Fred (Alessi, 2014).
In accordance to some of the earliest theories of sexual behavior as stated by Aristotle,
Plato and even Sigmund Freud, sexuality amongst humans have been described as an intrinsic
and innate need, required for the channeling of energies, directed towards release (Maxwell et
al., 2017). However, as discussed by Muise and Impett (2016), despite the existence of this
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10CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
innate need, individual sexual needs must be adequate directed and channeled, for the ordered
functioning of the community. Hence, the professionals and nurses involved in the treatment and
educational dissemination of Fred must consider the natural need for adolescents like Fred to
engage in sexual practices, with however, the requirement for controlling these practices, for the
purpose of regulating his health.
An additional theory outlining sexuality in individuals emphasizes on the principles of
social constructivism, by notable psychologists and sociologists such as Freud, Frank Beach and
Clellan Ford. Hence, as stated by Carlson (2016), the exhibition of sexual behaviors by
individuals, especially adolescents are often the results of social expectations further resulting in
either openness or the prevalence of taboo leading to suppression of expression. Hence, in the
situation of Fred, he may find difficulties in the discussion of the complex nature of
homelessness and unhealthy sexual practices, due to societal taboo and misunderstanding which
the concerned professionals must take into consideration and engage in the provision of a
clinically and socially acceptable, safe, supportive and empathetic environment for enhanced
decision-making further resulting high quality mitigation.
In addition to the above theoretical perspectives, the professional must consider
additional theoretical aspects associated with nursing practice and provision of optimum health
and treatment care. A key nursing and treatment theory which may be considered here is the
theory of ‘Unitary Human Beings’ by Martha Rogers. This theory as discussed by Phillips
(2016), emphasizes active interaction between a patient and their environment which is required
for the holistic treatment of the individual. Hence, health professionals must consider this theory
at the forefront since Fred’s compromised and risky sexual health situation is highly associated
with this environment of homelessness and hence the need of the hour is the provision of an
innate need, individual sexual needs must be adequate directed and channeled, for the ordered
functioning of the community. Hence, the professionals and nurses involved in the treatment and
educational dissemination of Fred must consider the natural need for adolescents like Fred to
engage in sexual practices, with however, the requirement for controlling these practices, for the
purpose of regulating his health.
An additional theory outlining sexuality in individuals emphasizes on the principles of
social constructivism, by notable psychologists and sociologists such as Freud, Frank Beach and
Clellan Ford. Hence, as stated by Carlson (2016), the exhibition of sexual behaviors by
individuals, especially adolescents are often the results of social expectations further resulting in
either openness or the prevalence of taboo leading to suppression of expression. Hence, in the
situation of Fred, he may find difficulties in the discussion of the complex nature of
homelessness and unhealthy sexual practices, due to societal taboo and misunderstanding which
the concerned professionals must take into consideration and engage in the provision of a
clinically and socially acceptable, safe, supportive and empathetic environment for enhanced
decision-making further resulting high quality mitigation.
In addition to the above theoretical perspectives, the professional must consider
additional theoretical aspects associated with nursing practice and provision of optimum health
and treatment care. A key nursing and treatment theory which may be considered here is the
theory of ‘Unitary Human Beings’ by Martha Rogers. This theory as discussed by Phillips
(2016), emphasizes active interaction between a patient and their environment which is required
for the holistic treatment of the individual. Hence, health professionals must consider this theory
at the forefront since Fred’s compromised and risky sexual health situation is highly associated
with this environment of homelessness and hence the need of the hour is the provision of an

11CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
acceptable and conducive environment required for holistic recovery. Additional professional
treatment and care theories which the professional must consider is the ‘Need Theory’ by
Virginia Henderson, which emphasizes the role of professionals in empowering and inspiring
individuals to take control of their lives and associated health through undertaking appropriate
health promotion activities. Hence, the professional must seek to educate Fred adequately on
sexual health and required practices for optimum health, which he may implement successfully
in the future, as in the present scenario, Fred clearly lacks direction and confidence in
undertaking healthy sexual behaviors on his own (Ahtisham & Jacoline, 2015).
Moral Reasoning
According to Chávez et al., (2016), the topic of sexual health has always been met with
increased ethical and moral conflict due to the sensitive and complex nature of sexual health
preferences and involved, along with the ever prevailing issue of consent. Thus, in a complex
scenario of compromise sexual health, where an adolescent may not agree to the usage of
condoms despite the associated lack of safety involved, the professional must engage in adequate
moral reasoning to result in healthy sexual practices with due consideration of ethical issues.
In accordance to the data published by United Nation’s Population Fund, the youth and
young adult population posses the fundamental right to engage in healthy sexual practices, along
with being granted adequate access to optimum sexual health services (Chandra-Mouli et al.,
2015). According to Knight et al., (2014), achievement of optimum sexual health is considered
as a major developmental milestone during the growing sensitive phase encompassing
adolescents and hence, societal and clinical settings are obliged to provide adequate support,
freedom and access to sexual health services without taboo or judgment. Likewise, as stated by
acceptable and conducive environment required for holistic recovery. Additional professional
treatment and care theories which the professional must consider is the ‘Need Theory’ by
Virginia Henderson, which emphasizes the role of professionals in empowering and inspiring
individuals to take control of their lives and associated health through undertaking appropriate
health promotion activities. Hence, the professional must seek to educate Fred adequately on
sexual health and required practices for optimum health, which he may implement successfully
in the future, as in the present scenario, Fred clearly lacks direction and confidence in
undertaking healthy sexual behaviors on his own (Ahtisham & Jacoline, 2015).
Moral Reasoning
According to Chávez et al., (2016), the topic of sexual health has always been met with
increased ethical and moral conflict due to the sensitive and complex nature of sexual health
preferences and involved, along with the ever prevailing issue of consent. Thus, in a complex
scenario of compromise sexual health, where an adolescent may not agree to the usage of
condoms despite the associated lack of safety involved, the professional must engage in adequate
moral reasoning to result in healthy sexual practices with due consideration of ethical issues.
In accordance to the data published by United Nation’s Population Fund, the youth and
young adult population posses the fundamental right to engage in healthy sexual practices, along
with being granted adequate access to optimum sexual health services (Chandra-Mouli et al.,
2015). According to Knight et al., (2014), achievement of optimum sexual health is considered
as a major developmental milestone during the growing sensitive phase encompassing
adolescents and hence, societal and clinical settings are obliged to provide adequate support,
freedom and access to sexual health services without taboo or judgment. Likewise, as stated by

12CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
Sun et al., (2018), considering the dynamic needs and changing clinical perspectives
emphasizing consumer satisfaction as key performance indicators of a majority of health care
institutes, present day professionals must engage in practicing patient-centered approach to
treatment which will emphasize the consideration of patient’s views and interests in the
decision-making process.
However, according to Greene et al., (2015), the issue of consent and freedom to engage
in unique sexual preferences often emerges as an ethical issue requiring adequate moral
reasoning amongst professionals for maintenance of adequate treatment and health of the
concerned individual. However, as stated by Erlingsdóttir and Lindholm, (2015). it is
worthwhile to mention that for optimum nursing and professional clinical practice, healthcare
professionals are required to engage in autonomy as a code of professional conduct. Hence, as
stated by Friedberg et al., (2014), despite the liberal and flexible principles of patient-centered
approach, the healthcare professional reserves the final right to undertake a decision on what
will be the best treatment for the patient. Likewise, as opined by Toska et al., (2017), in the
situation of condom usage of experimentation of novel sexual behaviors, the healthcare
professional involved must impart adequate information on the possibilities of acquiring negative
health consequences such as sexually transmitted diseases, human papillomavirus, Chlamydia,
gonorrhea, hepatitis, human immunodeficiency virus, hepatics, pain and pelvic inflammatory
disease, further coupled with the emotional and financial constraints associated with untimely
pregnancy, abortions and maternal health of teenage mothers.
In addition to this, as stated by Ashenhurst et al., (2017), healthcare professionals must
take into considerations the complex interplay of underlying factors resulting in adolescents
undertaking risky sexual behavior. The sensitive developmental stage of adolescents is
Sun et al., (2018), considering the dynamic needs and changing clinical perspectives
emphasizing consumer satisfaction as key performance indicators of a majority of health care
institutes, present day professionals must engage in practicing patient-centered approach to
treatment which will emphasize the consideration of patient’s views and interests in the
decision-making process.
However, according to Greene et al., (2015), the issue of consent and freedom to engage
in unique sexual preferences often emerges as an ethical issue requiring adequate moral
reasoning amongst professionals for maintenance of adequate treatment and health of the
concerned individual. However, as stated by Erlingsdóttir and Lindholm, (2015). it is
worthwhile to mention that for optimum nursing and professional clinical practice, healthcare
professionals are required to engage in autonomy as a code of professional conduct. Hence, as
stated by Friedberg et al., (2014), despite the liberal and flexible principles of patient-centered
approach, the healthcare professional reserves the final right to undertake a decision on what
will be the best treatment for the patient. Likewise, as opined by Toska et al., (2017), in the
situation of condom usage of experimentation of novel sexual behaviors, the healthcare
professional involved must impart adequate information on the possibilities of acquiring negative
health consequences such as sexually transmitted diseases, human papillomavirus, Chlamydia,
gonorrhea, hepatitis, human immunodeficiency virus, hepatics, pain and pelvic inflammatory
disease, further coupled with the emotional and financial constraints associated with untimely
pregnancy, abortions and maternal health of teenage mothers.
In addition to this, as stated by Ashenhurst et al., (2017), healthcare professionals must
take into considerations the complex interplay of underlying factors resulting in adolescents
undertaking risky sexual behavior. The sensitive developmental stage of adolescents is
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13CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
associated with a need for social acceptance which is often associated with young adults
engaging in unhealthy behaviors such as premature sexual intercourse, maintenance of multiple
partners and engagement in unprotected sexual behaviors. Further aggravating the alarming
situation is the societal acceptance of male sexual expression and the rebuking of their female
counterparts. Hence, healthcare professionals must considered the adolescents social
developmental needs in the practicing of the sexual behaviors (McCauley et al., 2016).
According to Allen (2018), with due consideration of the case scenario of Fred, the
primary causative factor of homelessness requires considerable moral reasoning by the
professional since it has been documented underprivileged socioeconomic status, lack of
residence and adequate education has been associated with compromised sexual health. Further,
the lack of a home for Fred calls for appropriate moral reasoning by the healthcare professional
since abstinence from sex may result in his detrimental lifestyle. Hence, considering the complex
ethical issues involved, adoption of a multidisciplinary approach may be required for the
provision of adequate living standards, education and occupational engagement for Fred apart
from ensuring healthy sexual practices (Brotto et al., 2015).
Contemporary Sexual Healthcare
Considering the complex case scenario of Fred along with the varied social and
developmental needs of adolescents who are interested to engage in sexual behaviors, we must
critically consider the adoption of a multidisciplinary approach encompassing a wide range of
professionals (Faubion & Rullo, 2015).
According to Jaspers (2016), the key providers who must be engaged in the
multidisciplinary team are primary healthcare providers. These must include professionals such
associated with a need for social acceptance which is often associated with young adults
engaging in unhealthy behaviors such as premature sexual intercourse, maintenance of multiple
partners and engagement in unprotected sexual behaviors. Further aggravating the alarming
situation is the societal acceptance of male sexual expression and the rebuking of their female
counterparts. Hence, healthcare professionals must considered the adolescents social
developmental needs in the practicing of the sexual behaviors (McCauley et al., 2016).
According to Allen (2018), with due consideration of the case scenario of Fred, the
primary causative factor of homelessness requires considerable moral reasoning by the
professional since it has been documented underprivileged socioeconomic status, lack of
residence and adequate education has been associated with compromised sexual health. Further,
the lack of a home for Fred calls for appropriate moral reasoning by the healthcare professional
since abstinence from sex may result in his detrimental lifestyle. Hence, considering the complex
ethical issues involved, adoption of a multidisciplinary approach may be required for the
provision of adequate living standards, education and occupational engagement for Fred apart
from ensuring healthy sexual practices (Brotto et al., 2015).
Contemporary Sexual Healthcare
Considering the complex case scenario of Fred along with the varied social and
developmental needs of adolescents who are interested to engage in sexual behaviors, we must
critically consider the adoption of a multidisciplinary approach encompassing a wide range of
professionals (Faubion & Rullo, 2015).
According to Jaspers (2016), the key providers who must be engaged in the
multidisciplinary team are primary healthcare providers. These must include professionals such

14CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
as general practitioners, nursing clinical practitioners, internist, doctors engaged in the provision
of family care, nursing midwives, assistants in nursing, psychologists and nursing unit managers.
Adequate sexual health begins with the maintenance of optimum physiological functioning
throughout the body, for which the above professional medical care providers will prove to be
beneficial due to their adequate knowledge of health and medicine. Hence, in a situation where
Fred or any concerned adolescent may feel scared or skeptical to engage in conversation with a
sexual healthcare professional, communicating with the above professionals will prove to be a
beneficial start. Such services can be available in healthcare clinics, hospitals, family health
clinics, sexually transmitted disease care clinics, general practitioner clinics, community
healthcare centers or school and community health settings (Wylie et al., 2016).
According to Connor et al., (2016), females as compared to males are often susceptible to
more serious complications associated with unhealthy sexual health behavior, and hence, the
key professionals for sexual healthcare must encompass specialist experts such as urologist,
women’s nursing health practitioners, gynecologists and obstetricians. Hence, in accordance to
Fred’s case scenario, his homelessness along with the relative lack of cooperation of his female
friend are key reasons for his unhealthy sexual behavior. Hence, visiting health professionals
specializing in female sexual health will aid in imparting effective sexual healthcare education to
Fred and his female friend, along with increasing awareness on the harmful impacts of such risky
sexual behavior engagement.
According to Peskin et al., (2015), for the purpose of contemporary sexual healthcare,
there is a lack of appropriate education amongst youth due to the prevalence of societal taboo,
the attachment of social stigma and the lack of expression for fear of judgment. Hence,
contemporary sexual healthcare will require professionals such as health educators and
as general practitioners, nursing clinical practitioners, internist, doctors engaged in the provision
of family care, nursing midwives, assistants in nursing, psychologists and nursing unit managers.
Adequate sexual health begins with the maintenance of optimum physiological functioning
throughout the body, for which the above professional medical care providers will prove to be
beneficial due to their adequate knowledge of health and medicine. Hence, in a situation where
Fred or any concerned adolescent may feel scared or skeptical to engage in conversation with a
sexual healthcare professional, communicating with the above professionals will prove to be a
beneficial start. Such services can be available in healthcare clinics, hospitals, family health
clinics, sexually transmitted disease care clinics, general practitioner clinics, community
healthcare centers or school and community health settings (Wylie et al., 2016).
According to Connor et al., (2016), females as compared to males are often susceptible to
more serious complications associated with unhealthy sexual health behavior, and hence, the
key professionals for sexual healthcare must encompass specialist experts such as urologist,
women’s nursing health practitioners, gynecologists and obstetricians. Hence, in accordance to
Fred’s case scenario, his homelessness along with the relative lack of cooperation of his female
friend are key reasons for his unhealthy sexual behavior. Hence, visiting health professionals
specializing in female sexual health will aid in imparting effective sexual healthcare education to
Fred and his female friend, along with increasing awareness on the harmful impacts of such risky
sexual behavior engagement.
According to Peskin et al., (2015), for the purpose of contemporary sexual healthcare,
there is a lack of appropriate education amongst youth due to the prevalence of societal taboo,
the attachment of social stigma and the lack of expression for fear of judgment. Hence,
contemporary sexual healthcare will require professionals such as health educators and

15CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
counselors who will provide adequate informative materials to the concerned clients. Such
professionals are commonly engaged in community as well as school and university health
settings. Hence, according to Martel, Crawford and Riden (2017), initiating conversation with
such professionals will prove to be beneficial for young adults like Fred and his female
friend due to their convenient social settings in universities and school and the resultant
understanding of dynamic youth needs.
As stated by Mitchie et al., (2016), the incidences of unplanned pregnancies, untimely
abortions and associated complications such as pain are the chief negative health consequences
associated with adolescents who are engaged in unhealthy sexual behaviors. Hence, pharmacists
are an additional professional requirement in the provision of appropriate sexual healthcare due
to availability of various contraceptive methods. Hence, in a situation of lack of protection or
condom usage, pharmacists lie at the forefront in the management and prevention of sexually
transmitted diseases and associated unplanned conceiving.
The complex situation of homelessness of Fred may result in additional detrimental
effects on his emotional and psychological health which will require detailed examination of
previous medical, familial and sexual behavior history. Hence, contemporary sexual health
services will require mental health professionals such as counselors, psychologists, psychiatrists
and sex therapists who will address the additional complications faced by Fred along with his
dilemma (Decker, Gutmann-Gonzalez & Brindis, 2017). Further the added burden of lack of an
appropriate residence, will require the engagement of public health workers, community service
professionals, community nurses, residential care homes or non-profit organizations engaged in
aiding youngsters who are homeless or in need of appropriate employment and education.
Such professionals will be engaged in community healthcare centers and clinics, social
counselors who will provide adequate informative materials to the concerned clients. Such
professionals are commonly engaged in community as well as school and university health
settings. Hence, according to Martel, Crawford and Riden (2017), initiating conversation with
such professionals will prove to be beneficial for young adults like Fred and his female
friend due to their convenient social settings in universities and school and the resultant
understanding of dynamic youth needs.
As stated by Mitchie et al., (2016), the incidences of unplanned pregnancies, untimely
abortions and associated complications such as pain are the chief negative health consequences
associated with adolescents who are engaged in unhealthy sexual behaviors. Hence, pharmacists
are an additional professional requirement in the provision of appropriate sexual healthcare due
to availability of various contraceptive methods. Hence, in a situation of lack of protection or
condom usage, pharmacists lie at the forefront in the management and prevention of sexually
transmitted diseases and associated unplanned conceiving.
The complex situation of homelessness of Fred may result in additional detrimental
effects on his emotional and psychological health which will require detailed examination of
previous medical, familial and sexual behavior history. Hence, contemporary sexual health
services will require mental health professionals such as counselors, psychologists, psychiatrists
and sex therapists who will address the additional complications faced by Fred along with his
dilemma (Decker, Gutmann-Gonzalez & Brindis, 2017). Further the added burden of lack of an
appropriate residence, will require the engagement of public health workers, community service
professionals, community nurses, residential care homes or non-profit organizations engaged in
aiding youngsters who are homeless or in need of appropriate employment and education.
Such professionals will be engaged in community healthcare centers and clinics, social
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16CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
welfare organizations, college and school health community centers. Hence, such professionals
will not only aid in the provision of appropriate sexual healthcare services to Fred, but also
in the dissemination of adequate sexual healthcare education, residential services and
possible employment opportunities (Agénor et al., 2017).
Hence, as observed in the above scenario and the complex social, ethical and emotional
and developmental needs of adolescents, the need of the hour is the provision of a
multidisciplinary approach for the optimum maintenance of sexual health literacy and behavior
engagement amongst adolescents. Healthcare providers and professionals must focus beyond the
mere addressing of sexual health needs, with the inclusion of various social and economic factors
as observed in the situation of homelessness. Further, the prevalence of appropriate education
and knowledge concerned with healthy sexual practices must also be considered by healthcare
professionals as observed in the ignorance concerning the risks associated with unprotected
sexual intercourse engagement (Panaretto et al., 2014).
Critical Reflection
Upon critical reflection of the above scenario of Fred, I was able to observe the
prevalence of a number of factors which have led to a compromise in his sexual health. One of
the key issues reflected here is the increased engagement of unhealthy sexual practices, where
Fred may be oblivious to the medial history or the prevalence of any sexual disorders in his
female friend, who is associated with providing a home in return for the favor of sexual
intercourse. Hence, this situation could have been managed differently had Fred possessed
adequate sexual knowledge on the need to engage in healthy sexual practices, which would
require acquiring past medical information on the concerned partner’s health. Hence, the
welfare organizations, college and school health community centers. Hence, such professionals
will not only aid in the provision of appropriate sexual healthcare services to Fred, but also
in the dissemination of adequate sexual healthcare education, residential services and
possible employment opportunities (Agénor et al., 2017).
Hence, as observed in the above scenario and the complex social, ethical and emotional
and developmental needs of adolescents, the need of the hour is the provision of a
multidisciplinary approach for the optimum maintenance of sexual health literacy and behavior
engagement amongst adolescents. Healthcare providers and professionals must focus beyond the
mere addressing of sexual health needs, with the inclusion of various social and economic factors
as observed in the situation of homelessness. Further, the prevalence of appropriate education
and knowledge concerned with healthy sexual practices must also be considered by healthcare
professionals as observed in the ignorance concerning the risks associated with unprotected
sexual intercourse engagement (Panaretto et al., 2014).
Critical Reflection
Upon critical reflection of the above scenario of Fred, I was able to observe the
prevalence of a number of factors which have led to a compromise in his sexual health. One of
the key issues reflected here is the increased engagement of unhealthy sexual practices, where
Fred may be oblivious to the medial history or the prevalence of any sexual disorders in his
female friend, who is associated with providing a home in return for the favor of sexual
intercourse. Hence, this situation could have been managed differently had Fred possessed
adequate sexual knowledge on the need to engage in healthy sexual practices, which would
require acquiring past medical information on the concerned partner’s health. Hence, the

17CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
concerned sexual healthcare professional must aim to impart adequate information and education
to Fred (Haberland & Rogow, 2015). The additional factor underlying Fred’s condition is the
prevalence of his homelessness. Hence, I believe that had Fred possessed sufficient knowledge
on the existence of non-profit organizations or community youth health centers, then the
situation would have been different resulting in Fred consulting additional social services where
he could have received additional facilities for residence, employment and education for future
self health promotion activities (Traore et al., 2015).
In another scenario encompassing the preference of avoidance of condom usage by an
individual despite fair warnings of the consequences exhibited by the health professionals, I
believe that the situation could have been managed differently had the concerned individual
possesses adequate information concerning the need to adopt healthy sexual practices. Hence, for
better management, the concerned healthcare professional must sufficiently impart not just
sexual education and information of healthy sexual practices, but also in the negative health
consequences associated with the avoidance of protection such as the increased susceptibility to
sexually transmitted diseases (Fonner et al., 2014).
Conclusion
Despite the prevalence of ample amount of public policy initiatives and transmission of
sexual healthcare information, the prevalence of engagement of risky sexual practices, continue
to rise in alarming rates among the youth of the present day generation. Coupled with the lack of
adequate information associated with healthy sexual behaviors, along with the interplay of
associated factors such as social stigma, peer group acceptance and judgmental views amongst
practitioners, the current sexual health scenarios of adolescents continue to remain a contentious
concerned sexual healthcare professional must aim to impart adequate information and education
to Fred (Haberland & Rogow, 2015). The additional factor underlying Fred’s condition is the
prevalence of his homelessness. Hence, I believe that had Fred possessed sufficient knowledge
on the existence of non-profit organizations or community youth health centers, then the
situation would have been different resulting in Fred consulting additional social services where
he could have received additional facilities for residence, employment and education for future
self health promotion activities (Traore et al., 2015).
In another scenario encompassing the preference of avoidance of condom usage by an
individual despite fair warnings of the consequences exhibited by the health professionals, I
believe that the situation could have been managed differently had the concerned individual
possesses adequate information concerning the need to adopt healthy sexual practices. Hence, for
better management, the concerned healthcare professional must sufficiently impart not just
sexual education and information of healthy sexual practices, but also in the negative health
consequences associated with the avoidance of protection such as the increased susceptibility to
sexually transmitted diseases (Fonner et al., 2014).
Conclusion
Despite the prevalence of ample amount of public policy initiatives and transmission of
sexual healthcare information, the prevalence of engagement of risky sexual practices, continue
to rise in alarming rates among the youth of the present day generation. Coupled with the lack of
adequate information associated with healthy sexual behaviors, along with the interplay of
associated factors such as social stigma, peer group acceptance and judgmental views amongst
practitioners, the current sexual health scenarios of adolescents continue to remain a contentious

18CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
and complex issue, as evident in the added burden of homelessness in Fred’s scenario.
Healthcare professionals must consider the ethical and moral reasoning behind their practices,
when discussing the health consequences of adolescent sexual preferences, through exercising of
adequate authority. Consideration of nursing ‘Need’ and ‘Unitary Human Being’ theoretical
principles, coupled with innate and social constructivism theories, must be adopted by healthcare
professionals for understanding the sexual needs and required clinical practices for the sexual
healthcare treatment of adolescents. The provision of a multidisciplinary team of professionals is
the need of the hour since a wide group of clinicians engaged in various fields of expertise will
be required to meet the complex social and emotional factors associated with adolescent sexual
health. Present day sexual healthcare services must also consider the socioeconomic factors
associated with the lifestyle of adolescents due to their association with the engagement in
unhealthy sexual behaviors, as evident in the case history of Fred. To conclude, healthcare
professionals must exercise considerable authority in disseminating appropriate healthcare
information on differential health outcomes associated with sexual practices, as evident in the
scenario where an individual refuses to use protection despite the clinician’s consultation.
and complex issue, as evident in the added burden of homelessness in Fred’s scenario.
Healthcare professionals must consider the ethical and moral reasoning behind their practices,
when discussing the health consequences of adolescent sexual preferences, through exercising of
adequate authority. Consideration of nursing ‘Need’ and ‘Unitary Human Being’ theoretical
principles, coupled with innate and social constructivism theories, must be adopted by healthcare
professionals for understanding the sexual needs and required clinical practices for the sexual
healthcare treatment of adolescents. The provision of a multidisciplinary team of professionals is
the need of the hour since a wide group of clinicians engaged in various fields of expertise will
be required to meet the complex social and emotional factors associated with adolescent sexual
health. Present day sexual healthcare services must also consider the socioeconomic factors
associated with the lifestyle of adolescents due to their association with the engagement in
unhealthy sexual behaviors, as evident in the case history of Fred. To conclude, healthcare
professionals must exercise considerable authority in disseminating appropriate healthcare
information on differential health outcomes associated with sexual practices, as evident in the
scenario where an individual refuses to use protection despite the clinician’s consultation.
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19CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
References
Agénor, M., Muzny, C. A., Schick, V., Austin, E. L., & Potter, J. (2017). Sexual orientation and
sexual health services utilization among women in the United States. Preventive
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Ahtisham, Y., & Jacoline, S. (2015). Integrating Nursing Theory and Process into Practice;
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sexual health services utilization among women in the United States. Preventive
medicine, 95, 74-81.
Ahtisham, Y., & Jacoline, S. (2015). Integrating Nursing Theory and Process into Practice;
Virginia's Henderson Need Theory. International Journal of Caring Sciences, 8(2).
Alessi, E. J. (2014). A framework for incorporating minority stress theory into treatment with
sexual minority clients. Journal of Gay & Lesbian Mental Health, 18(1), 47-66.
Allen, B., Berliner, L., Shenk, C. E., Bendixsen, B., Zellhoefer, A., Dickmann, C. R., ... & Chen,
M. J. (2018). Development and pilot testing of a phase-based treatment for preteen
children with problematic sexual behavior. Evidence-Based Practice in Child and
Adolescent Mental Health, 1-12.
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partners and relationship status are associated with unprotected sex across emerging
adulthood. Archives of sexual behavior, 46(2), 419-432.
Boyer, C. B., Greenberg, L., Chutuape, K., Walker, B., Monte, D., Kirk, J., ... & Adolescent
Medicine Trials Network. (2017). Exchange of sex for drugs or money in adolescents and
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community context. Journal of community health, 42(1), 90-100.

20CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
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Carlson, Å. (2016). Sex, Biological Functions and Social Norms: A Simple Constructivist
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Chandra-Mouli, V., Lane, C., & Wong, S. (2015). What does not work in adolescent sexual and
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Connor, J. J., Hunt, S., Finsaas, M., Ciesinski, A., Ahmed, A., & Robinson, B. B. E. (2016).
Sexual health care, sexual behaviors and functioning, and female genital cutting:
Perspectives from Somali women living in the United States. The Journal of Sex
Research, 53(3), 346-359.

21CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
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Decker, M., Gutmann-Gonzalez, A., & Brindis, C. (2017). Cultivating Clinical Connections:
Opportunities and Barriers to Increasing Youth Access to Clinical Sexual Health Services
in California. Journal of Adolescent Health, 60(2), S108.
Denno, D. M., Hoopes, A. J., & Chandra-Mouli, V. (2015). Effective strategies to provide
adolescent sexual and reproductive health services and to increase demand and
community support. Journal of adolescent health, 56(1), S22-S41.
DiClemente, R. J. (2016). Validity of self-reported sexual behavior among adolescents: where do
we go from here?. AIDS and Behavior, 20(1), 215-217.
Edelman, N. L., de Visser, R. O., Mercer, C. H., McCabe, L., & Cassell, J. A. (2015). Targeting
sexual health services in primary care: A systematic review of the psychosocial correlates
of adverse sexual health outcomes reported in probability surveys of women of
reproductive age. Preventive medicine, 81, 345-356.
Epstein, S., & Mamo, L. (2017). The proliferation of sexual health: Diverse social problems and
the legitimation of sexuality. Social Science & Medicine, 188, 176-190.
Erlingsdóttir, G., & Lindholm, C. (2015). When patient empowerment encounters professional
autonomy: The conflict and negotiation process of inscribing an eHealth
service. Scandinavian journal of public administration, 19(2), 27-48.
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22CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
Faubion, S. S., & Rullo, J. E. (2015). Sexual dysfunction in women: a practical approach. Am
Fam Physician, 92(4), 281-288.
Fonner, V. A., Armstrong, K. S., Kennedy, C. E., O'Reilly, K. R., & Sweat, M. D. (2014).
School based sex education and HIV prevention in low-and middle-income countries: a
systematic review and meta-analysis. PloS one, 9(3), e89692.
Friedberg, M. W., Chen, P. G., Van Busum, K. R., Aunon, F., Pham, C., Caloyeras, J., ... &
Crosson, F. J. (2014). Factors affecting physician professional satisfaction and their
implications for patient care, health systems, and health policy. Rand health
quarterly, 3(4).
Greene, G. J., Fisher, K. A., Kuper, L., Andrews, R., & Mustanski, B. (2015). “Is this normal? Is
this not normal? There is no set example”: Sexual health intervention preferences of
LGBT youth in romantic relationships. Sexuality research and social policy, 12(1), 1-14.
Guilamo-Ramos, V., Lee, J. J., Kantor, L. M., Levine, D. S., Baum, S., & Johnsen, J. (2015).
Potential for using online and mobile education with parents and adolescents to impact
sexual and reproductive health. Prevention Science, 16(1), 53-60.
Haberland, N., & Rogow, D. (2015). Sexuality education: emerging trends in evidence and
practice. Journal of adolescent health, 56(1), S15-S21.
Hada, E., Long, C., Man, A., & Bushnik, T. (2017). Hidden Homelessness and Traumatic Brain
Injury: Defining and Characterizing Housing Instability. Archives of Physical Medicine
and Rehabilitation, 98(12), e175.
Faubion, S. S., & Rullo, J. E. (2015). Sexual dysfunction in women: a practical approach. Am
Fam Physician, 92(4), 281-288.
Fonner, V. A., Armstrong, K. S., Kennedy, C. E., O'Reilly, K. R., & Sweat, M. D. (2014).
School based sex education and HIV prevention in low-and middle-income countries: a
systematic review and meta-analysis. PloS one, 9(3), e89692.
Friedberg, M. W., Chen, P. G., Van Busum, K. R., Aunon, F., Pham, C., Caloyeras, J., ... &
Crosson, F. J. (2014). Factors affecting physician professional satisfaction and their
implications for patient care, health systems, and health policy. Rand health
quarterly, 3(4).
Greene, G. J., Fisher, K. A., Kuper, L., Andrews, R., & Mustanski, B. (2015). “Is this normal? Is
this not normal? There is no set example”: Sexual health intervention preferences of
LGBT youth in romantic relationships. Sexuality research and social policy, 12(1), 1-14.
Guilamo-Ramos, V., Lee, J. J., Kantor, L. M., Levine, D. S., Baum, S., & Johnsen, J. (2015).
Potential for using online and mobile education with parents and adolescents to impact
sexual and reproductive health. Prevention Science, 16(1), 53-60.
Haberland, N., & Rogow, D. (2015). Sexuality education: emerging trends in evidence and
practice. Journal of adolescent health, 56(1), S15-S21.
Hada, E., Long, C., Man, A., & Bushnik, T. (2017). Hidden Homelessness and Traumatic Brain
Injury: Defining and Characterizing Housing Instability. Archives of Physical Medicine
and Rehabilitation, 98(12), e175.

23CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
Jackson, J. M., Seth, P., DiClemente, R. J., & Lin, A. (2015). Association of depressive
symptoms and substance use with risky sexual behavior and sexually transmitted
infections among African American female adolescents seeking sexual health
care. American journal of public health, 105(10), 2137-2142.
Jaspers, L., Feys, F., Bramer, W. M., Franco, O. H., Leusink, P., & Laan, E. T. (2016). Efficacy
and safety of flibanserin for the treatment of hypoactive sexual desire disorder in women:
a systematic review and meta-analysis. JAMA internal medicine, 176(4), 453-462.
Johns, M. M., Jayne, P. E., & Steiner, R. J. (2016). Differences in Sources of Sexual Health
Information by Sexual Orientation: Findings from a Nationally Representative Sample of
Adolescents. Journal of Adolescent Health, 58(2), S104.
Kerpelman, J. L., McElwain, A. D., Pittman, J. F., & Adler-Baeder, F. M. (2016). Engagement in
risky sexual behavior: Adolescents’ perceptions of self and the parent–child relationship
matter. Youth & Society, 48(1), 101-125.
Knight, R. E., Shoveller, J. A., Carson, A. M., & Contreras-Whitney, J. G. (2014). Examining
clinicians’ experiences providing sexual health services for LGBTQ youth: considering
social and structural determinants of health in clinical practice. Health education
research, 29(4), 662-670.
Liu, G., Hariri, S., Bradley, H., Gottlieb, S. L., Leichliter, J. S., & Markowitz, L. E. (2015).
Trends and patterns of sexual behaviors among adolescents and adults aged 14 to 59
years, United States. Sexually transmitted diseases, 42(1), 20-26.
Jackson, J. M., Seth, P., DiClemente, R. J., & Lin, A. (2015). Association of depressive
symptoms and substance use with risky sexual behavior and sexually transmitted
infections among African American female adolescents seeking sexual health
care. American journal of public health, 105(10), 2137-2142.
Jaspers, L., Feys, F., Bramer, W. M., Franco, O. H., Leusink, P., & Laan, E. T. (2016). Efficacy
and safety of flibanserin for the treatment of hypoactive sexual desire disorder in women:
a systematic review and meta-analysis. JAMA internal medicine, 176(4), 453-462.
Johns, M. M., Jayne, P. E., & Steiner, R. J. (2016). Differences in Sources of Sexual Health
Information by Sexual Orientation: Findings from a Nationally Representative Sample of
Adolescents. Journal of Adolescent Health, 58(2), S104.
Kerpelman, J. L., McElwain, A. D., Pittman, J. F., & Adler-Baeder, F. M. (2016). Engagement in
risky sexual behavior: Adolescents’ perceptions of self and the parent–child relationship
matter. Youth & Society, 48(1), 101-125.
Knight, R. E., Shoveller, J. A., Carson, A. M., & Contreras-Whitney, J. G. (2014). Examining
clinicians’ experiences providing sexual health services for LGBTQ youth: considering
social and structural determinants of health in clinical practice. Health education
research, 29(4), 662-670.
Liu, G., Hariri, S., Bradley, H., Gottlieb, S. L., Leichliter, J. S., & Markowitz, L. E. (2015).
Trends and patterns of sexual behaviors among adolescents and adults aged 14 to 59
years, United States. Sexually transmitted diseases, 42(1), 20-26.

24CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
Lundgren, R., & Amin, A. (2015). Addressing intimate partner violence and sexual violence
among adolescents: emerging evidence of effectiveness. Journal of Adolescent
Health, 56(1), S42-S50.
Macintyre, A. K., Vega, A. R. M., & Sagbakken, M. (2015). From disease to desire, pleasure to
the pill: A qualitative study of adolescent learning about sexual health and sexuality in
Chile. BMC public health, 15(1), 945.
Marcell, A. V., Gibbs, S. E., Pilgrim, N. A., Page, K. R., Arrington-Sanders, R., Jennings, J.
M., ... & Dittus, P. J. (2018). Sexual and reproductive health care receipt among young
males aged 15–24. Journal of Adolescent Health, 62(4), 382-389.
Martel, R., Crawford, R., & Riden, H. (2017). ‘By the way…. how’s your sex life?’–A
descriptive study reporting primary health care registered nurses engagement with youth
about sexual health. Journal of primary health care, 9(1), 22-28.
Maxwell, J. A., Muise, A., MacDonald, G., Day, L. C., Rosen, N. O., & Impett, E. A. (2017).
How implicit theories of sexuality shape sexual and relationship well-being. Journal of
personality and social psychology, 112(2), 238.
McCauley, K. L., Shadur, J. M., Hoffman, E. M., MacPherson, L., & Lejuez, C. W. (2016).
Adolescent callous-unemotional traits and parental knowledge as predictors of
unprotected sex among youth. Behavior modification, 40(1-2), 70-96.
Meyrick, J., & Gray, D. (2018). Evidence-based patient/public voice: a patient and public
involvement audit in the field of sexual health. BMJ Sex Reprod Health, 44(4), 267-271.
Lundgren, R., & Amin, A. (2015). Addressing intimate partner violence and sexual violence
among adolescents: emerging evidence of effectiveness. Journal of Adolescent
Health, 56(1), S42-S50.
Macintyre, A. K., Vega, A. R. M., & Sagbakken, M. (2015). From disease to desire, pleasure to
the pill: A qualitative study of adolescent learning about sexual health and sexuality in
Chile. BMC public health, 15(1), 945.
Marcell, A. V., Gibbs, S. E., Pilgrim, N. A., Page, K. R., Arrington-Sanders, R., Jennings, J.
M., ... & Dittus, P. J. (2018). Sexual and reproductive health care receipt among young
males aged 15–24. Journal of Adolescent Health, 62(4), 382-389.
Martel, R., Crawford, R., & Riden, H. (2017). ‘By the way…. how’s your sex life?’–A
descriptive study reporting primary health care registered nurses engagement with youth
about sexual health. Journal of primary health care, 9(1), 22-28.
Maxwell, J. A., Muise, A., MacDonald, G., Day, L. C., Rosen, N. O., & Impett, E. A. (2017).
How implicit theories of sexuality shape sexual and relationship well-being. Journal of
personality and social psychology, 112(2), 238.
McCauley, K. L., Shadur, J. M., Hoffman, E. M., MacPherson, L., & Lejuez, C. W. (2016).
Adolescent callous-unemotional traits and parental knowledge as predictors of
unprotected sex among youth. Behavior modification, 40(1-2), 70-96.
Meyrick, J., & Gray, D. (2018). Evidence-based patient/public voice: a patient and public
involvement audit in the field of sexual health. BMJ Sex Reprod Health, 44(4), 267-271.
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25CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
Michie, L., Cameron, S. T., Glasier, A., Chen, Z. E., Milne, D., & Wilson, S. (2016). Provision
of contraception after emergency contraception from the pharmacy: evaluating the
acceptability of pharmacy for providing sexual and reproductive health services. Public
health, 135, 97-103.
Montgomerie, J., & Büdenbender, M. (2015). Round the houses: Homeownership and failures of
asset-based welfare in the United Kingdom. New Political Economy, 20(3), 386-405.
Muise, A., & Impett, E. A. (2016). Applying theories of communal motivation to
sexuality. Social and Personality Psychology Compass, 10(8), 455-467.
Mustanski, B., Greene, G. J., Ryan, D., & Whitton, S. W. (2015). Feasibility, acceptability, and
initial efficacy of an online sexual health promotion program for LGBT youth: the Queer
Sex Ed intervention. The Journal of Sex Research, 52(2), 220-230.
Mustanski, B., Van Wagenen, A., Birkett, M., Eyster, S., & Corliss, H. L. (2014). Identifying
sexual orientation health disparities in adolescents: analysis of pooled data from the
Youth Risk Behavior Survey, 2005 and 2007. American journal of public health, 104(2),
211-217.
Panaretto, K. S., Wenitong, M., Button, S., & Ring, I. T. (2014). Aboriginal community
controlled health services: leading the way in primary care. The Medical Journal of
Australia, 200(11), 649-652.
Peskin, M. F., Shegog, R., Markham, C. M., Thiel, M., Baumler, E. R., Addy, R. C., ... & Emery,
S. T. (2015). Efficacy of It's Your Game-Tech: a computer-based sexual health education
program for middle school youth. Journal of Adolescent Health, 56(5), 515-521.
Michie, L., Cameron, S. T., Glasier, A., Chen, Z. E., Milne, D., & Wilson, S. (2016). Provision
of contraception after emergency contraception from the pharmacy: evaluating the
acceptability of pharmacy for providing sexual and reproductive health services. Public
health, 135, 97-103.
Montgomerie, J., & Büdenbender, M. (2015). Round the houses: Homeownership and failures of
asset-based welfare in the United Kingdom. New Political Economy, 20(3), 386-405.
Muise, A., & Impett, E. A. (2016). Applying theories of communal motivation to
sexuality. Social and Personality Psychology Compass, 10(8), 455-467.
Mustanski, B., Greene, G. J., Ryan, D., & Whitton, S. W. (2015). Feasibility, acceptability, and
initial efficacy of an online sexual health promotion program for LGBT youth: the Queer
Sex Ed intervention. The Journal of Sex Research, 52(2), 220-230.
Mustanski, B., Van Wagenen, A., Birkett, M., Eyster, S., & Corliss, H. L. (2014). Identifying
sexual orientation health disparities in adolescents: analysis of pooled data from the
Youth Risk Behavior Survey, 2005 and 2007. American journal of public health, 104(2),
211-217.
Panaretto, K. S., Wenitong, M., Button, S., & Ring, I. T. (2014). Aboriginal community
controlled health services: leading the way in primary care. The Medical Journal of
Australia, 200(11), 649-652.
Peskin, M. F., Shegog, R., Markham, C. M., Thiel, M., Baumler, E. R., Addy, R. C., ... & Emery,
S. T. (2015). Efficacy of It's Your Game-Tech: a computer-based sexual health education
program for middle school youth. Journal of Adolescent Health, 56(5), 515-521.

26CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
Phillips, J. R. (2016). Rogers’ science of unitary human beings: Beyond the frontier of
science. Nursing science quarterly, 29(1), 38-46.
Ritchwood, T. D., Ford, H., DeCoster, J., Sutton, M., & Lochman, J. E. (2015). Risky sexual
behavior and substance use among adolescents: A meta-analysis. Children and youth
services review, 52, 74-88.
Sandberg-Thoma, S. E., & Kamp Dush, C. M. (2014). Casual sexual relationships and mental
health in adolescence and emerging adulthood. The Journal of Sex Research, 51(2), 121-
130.
Sarver, D. E., McCart, M. R., Sheidow, A. J., & Letourneau, E. J. (2014). ADHD and risky
sexual behavior in adolescents: Conduct problems and substance use as mediators of
risk. Journal of Child Psychology and Psychiatry, 55(12), 1345-1353.
Sedgh, G., Finer, L. B., Bankole, A., Eilers, M. A., & Singh, S. (2015). Adolescent pregnancy,
birth, and abortion rates across countries: levels and recent trends. Journal of Adolescent
Health, 56(2), 223-230.
Simons, L. G., Sutton, T. E., Simons, R. L., Gibbons, F. X., & Murry, V. M. (2016).
Mechanisms that link parenting practices to adolescents’ risky sexual behavior: A test of
six competing theories. Journal of youth and adolescence, 45(2), 255-270.
Slater, C., & Robinson, A. J. (2014). Sexual health in adolescents. Clinics in dermatology, 32(2),
189-195.
Phillips, J. R. (2016). Rogers’ science of unitary human beings: Beyond the frontier of
science. Nursing science quarterly, 29(1), 38-46.
Ritchwood, T. D., Ford, H., DeCoster, J., Sutton, M., & Lochman, J. E. (2015). Risky sexual
behavior and substance use among adolescents: A meta-analysis. Children and youth
services review, 52, 74-88.
Sandberg-Thoma, S. E., & Kamp Dush, C. M. (2014). Casual sexual relationships and mental
health in adolescence and emerging adulthood. The Journal of Sex Research, 51(2), 121-
130.
Sarver, D. E., McCart, M. R., Sheidow, A. J., & Letourneau, E. J. (2014). ADHD and risky
sexual behavior in adolescents: Conduct problems and substance use as mediators of
risk. Journal of Child Psychology and Psychiatry, 55(12), 1345-1353.
Sedgh, G., Finer, L. B., Bankole, A., Eilers, M. A., & Singh, S. (2015). Adolescent pregnancy,
birth, and abortion rates across countries: levels and recent trends. Journal of Adolescent
Health, 56(2), 223-230.
Simons, L. G., Sutton, T. E., Simons, R. L., Gibbons, F. X., & Murry, V. M. (2016).
Mechanisms that link parenting practices to adolescents’ risky sexual behavior: A test of
six competing theories. Journal of youth and adolescence, 45(2), 255-270.
Slater, C., & Robinson, A. J. (2014). Sexual health in adolescents. Clinics in dermatology, 32(2),
189-195.

27CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
Stenström, P., Kockum, C. C., Benér, D. K., Ivarsson, C., & Arnbjörnsson, E. (2014).
Adolescents with anorectal malformation: physical outcome, sexual health and quality of
life. International journal of adolescent medicine and health, 26(1), 49-59.
Sun, W. H., Miu, H. Y. H., Wong, C. K. H., Tucker, J. D., & Wong, W. C. W. (2018). Assessing
participation and effectiveness of the peer-led approach in youth sexual health education:
systematic review and meta-analysis in more developed countries. The Journal of Sex
Research, 55(1), 31-44.
Svanemyr, J., Amin, A., Robles, O. J., & Greene, M. E. (2015). Creating an enabling
environment for adolescent sexual and reproductive health: a framework and promising
approaches. Journal of Adolescent Health, 56(1), S7-S14.
Toska, E., Cluver, L. D., Boyes, M. E., Isaacsohn, M., Hodes, R., & Sherr, L. (2017). School,
supervision and adolescent-sensitive clinic care: combination social protection and
reduced unprotected sex among HIV-positive adolescents in South Africa. AIDS and
Behavior, 21(9), 2746-2759.
Traore, I. T., Meda, N., Hema, N. M., Ouedraogo, D., Some, F., Some, R., ... & Mayaud, P.
(2015). HIV prevention and care services for female sex workers: efficacy of a targeted
community‐based intervention in Burkina Faso. Journal of the International AIDS
Society, 18(1), 20088.
Watson, J., Crawley, J., & Kane, D. (2016). Social exclusion, health and hidden
homelessness. Public health, 139, 96-102.
Stenström, P., Kockum, C. C., Benér, D. K., Ivarsson, C., & Arnbjörnsson, E. (2014).
Adolescents with anorectal malformation: physical outcome, sexual health and quality of
life. International journal of adolescent medicine and health, 26(1), 49-59.
Sun, W. H., Miu, H. Y. H., Wong, C. K. H., Tucker, J. D., & Wong, W. C. W. (2018). Assessing
participation and effectiveness of the peer-led approach in youth sexual health education:
systematic review and meta-analysis in more developed countries. The Journal of Sex
Research, 55(1), 31-44.
Svanemyr, J., Amin, A., Robles, O. J., & Greene, M. E. (2015). Creating an enabling
environment for adolescent sexual and reproductive health: a framework and promising
approaches. Journal of Adolescent Health, 56(1), S7-S14.
Toska, E., Cluver, L. D., Boyes, M. E., Isaacsohn, M., Hodes, R., & Sherr, L. (2017). School,
supervision and adolescent-sensitive clinic care: combination social protection and
reduced unprotected sex among HIV-positive adolescents in South Africa. AIDS and
Behavior, 21(9), 2746-2759.
Traore, I. T., Meda, N., Hema, N. M., Ouedraogo, D., Some, F., Some, R., ... & Mayaud, P.
(2015). HIV prevention and care services for female sex workers: efficacy of a targeted
community‐based intervention in Burkina Faso. Journal of the International AIDS
Society, 18(1), 20088.
Watson, J., Crawley, J., & Kane, D. (2016). Social exclusion, health and hidden
homelessness. Public health, 139, 96-102.
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28CRITIAL EXAMINATION OF SEXUAL HEALTH CHALLENGES
Widman, L., Noar, S. M., Choukas-Bradley, S., & Francis, D. B. (2014). Adolescent sexual
health communication and condom use: a meta-analysis. Health Psychology, 33(10),
1113.
Wylie, K., Knudson, G., Khan, S. I., Bonierbale, M., Watanyusakul, S., & Baral, S. (2016).
Serving transgender people: clinical care considerations and service delivery models in
transgender health. The Lancet, 388(10042), 401-411.
Widman, L., Noar, S. M., Choukas-Bradley, S., & Francis, D. B. (2014). Adolescent sexual
health communication and condom use: a meta-analysis. Health Psychology, 33(10),
1113.
Wylie, K., Knudson, G., Khan, S. I., Bonierbale, M., Watanyusakul, S., & Baral, S. (2016).
Serving transgender people: clinical care considerations and service delivery models in
transgender health. The Lancet, 388(10042), 401-411.
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