Umsebenzi wobulili ku-16- ku-21-Olds Olds eBrithani (2016)

I-YBOP COMMENTS:

Lolu cwaningo lubike amanani alandelayo wezinkinga zokusebenza ngocansi kumadoda amadala akwa-16-21 (idatha esuka ku-2010-2012):

• Intshisekelo engekho ebusweni: 10.5%
• Ukubunzima kuya ekufinyeleleni komgogodla: 8.3%
• Kunzima ukuthola noma ukugcina ukulungiswa: i-7.8%

Amanani angenhla anjalo liphakeme kakhulu kunelabo ababikiwe ngaphambi kokufika komphakathit. Isibonelo, amazinga wokungasebenzi kahle kwe-erectile emadodeni angaphansi kweminyaka engama-40 abikwa ngokungaguquguquki njenge I-2% kwizifundo ezenziwe ngaphambi konyaka we-2000. Ku-1940s, i Umbiko weKinsey waphetha ukuthi ukusabalala kwe-ED kwakungu ngaphansi kwe-1% kumadoda amancane kune-30 iminyaka. Ama-ED Amanani we-21 amadoda angase asondele ku-1%. Uma lezi zinombolo ze-6-8 ezindala ubudala zinembile lokhu ingabonisa ukwanda kwe-400% -800% kuma-ED amanani kubantu abaneminyaka engu-16-21! Lokho kusho, amanani alolu cwaningo aphansi kakhulu kunezinye izifundo ezimbalwa zakamuva ezenzelwe izinsizwa (ikakhulukazi amazinga we-ED). Bona lokhu kubuyekezwa ukuthola eminye imininingwane nezifundo eziningi: Ingabe Izithombe Zobulili Ezingcolile Zase-Internet Zibangela Ukuhlukunyezwa Ngokobulili? Ukubukezwa Ngemibiko Yomtholampilo (2016).

Izici ezimbalwa zingase zilandele ukubika okungaphansi kwezinkinga zocansi zesilisa:

I-1) Ukuqoqwa kwedatha:

"Ababambiqhaza baxoxwa emakhaya ngumuntu oxoxisane naye oqeqeshiwe, besebenzisa inhlanganisela yokusizwa ngamakhompiyutha okusizw a nabo ubuso nobuso nokusizwa yikhompyutha ukuthola imibuzo ebucayi"

Kungenzeka ukuthi intsha ibe ngaphansi kokuvela ngokugcwele lapho kuxoxwa ubuso nobuso ekhaya. Ucwaningo lwakamuva oluthola amazinga aphezulu ezinkinga zocansi kubantu abasha bekungukucwaninga okungaziwa ku-inthanethi. Isibonelo, lokhu Ucwaningo lwe-2014 kuma-Canadian asebasha kubika ukuthi i-53.5% yabesilisa abaneminyaka engu-16-21 inezinkomba ezibonisa inkinga yocansi. Ukungasebenzi kahle kwe-Erectile kwakuvame kakhulu (27%), kulandelwa isifiso sobulili esifanele (24%), nezinkinga nge-orgasm (11%).

2) Ucwaningo luqoqe imininingwane yalo phakathi kuka-Agasti, 2010 noSepthemba, 2012. Lokho sekuyiminyaka engu-6-8 edlule. Izifundo ezibika ukukhuphuka okuphawulekayo Ku-ED osemusha zavela okokuqala ku-2011.

I-3) Eziningi zezinye izifundo zazisebenzisa I-IIEF-5 noma i-IIEF-6, ehlola izinkinga zobulili ngesilinganiso, ngokumelene nokulula Yebo or cha (ezinyangeni ezedlule ze-3) ezisetshenziswe ephepheni lamanje.

I-Journal ye-Health Adolescent

Itholakala ku-3 Agasti 2016

UKirstin R. Mitchell, Ph.D.^{a, b,,} ,Rebecca Geary, Ph.D.^c, Cynthia Graham, Ph.D.^d, Soazig Clifton^c, Catherine H. Mercer, Ph.D.^c, Ruth Lewis, Ph.D.^{a, e}, I-Wendy Macdowall, M.Sc.^a, Jessica Datta, M.Sc.^a, Anne M. Johnson, MD^c, Kaye Wellings, I-FRCOG^a

i-doi: 10.1016 / j.jadohealth.2016.05.017

abstract

Injongo

Ukukhathazeka ngezocansi zabantu abasha kugxile esidingweni sokuvimbela imiphumela enobungozi efana nezifo ezithathelwana ngocansi nokukhulelwa okungahleliwe. Yize inzuzo yombono obanzi yaziwa, imininingwane kwezinye izici zocansi, ikakhulukazi umsebenzi wezocansi, incane. Sifune ukulungisa leli gebe ngokukala ukwanda kwenani labantu ngezinkinga zokusebenza ngokocansi, ukusiza ukufuna, nokugwema ukuya ocansini kubantu abasha.

izindlela

Ucwaningo lwesampula olunamathekisthi olwenziwe ngezansi (Natsal-3) lwabesifazane be-15,162 namadoda aseBrithani (izinga lokuphendula: 57.7%), besebenzisa imibuzo yokuzibuza nge-computer. Idatha ivela ku-1875 (71.9%) ngokocansi, futhi i-517 ayisebenzanga ngokocansi (18.7%), abahlanganyeli abaneminyaka engu-16-21. Izindlela zaziyizinto ezingabodwa ezilinganisweni zomsebenzi wocansi (i-Natsal-SF).

Imiphumela

Phakathi kwabahlanganyeli abaneminyaka engu-16 kuya kwengu-21 abaya ocansini, abesilisa abayi-9.1% nabesifazane abangu-13.4% babike inkinga yezocansi ecindezelayo ehlala izinyanga ezintathu noma ngaphezulu ngonyaka odlule. Okuvame kakhulu emadodeni bekufinyelela umvuthwandaba ngokushesha okukhulu (3%), futhi kwabesifazane bekunzima ukufinyelela kuvuthondaba (4.5%). Ngaphezulu kwesithathu (6.3%) sabesilisa kanye no-35.5% wabesifazane ababika inkinga babefuna usizo, kepha kuyaqabukela emithonjeni yobuchwepheshe. Phakathi kwalabo ababengazange baye ocansini ngonyaka odlule, kuphela> i-42.3% yezinsizwa nezintombi ezithi zaluvika ucansi ngenxa yobunzima bezocansi.

iziphetho

Izinkinga zomsebenzi zobulili ezicindezelayo zibikwa ubuncane obuncane bezingane ezisencane zocansi. Imfundo iyadingeka, futhi ukwelulekwa kufanele kutholakale, ukuvimbela ukungabi nolwazi, ukukhathazeka, namahloni okuqhubekayo ezinkingeni zobulili.

Amagama angukhiye

• Abantu abasha;
• Ukukhula kwabantu abadala;
• Izinkinga zokusebenza ngokocansi;
• Ukukhubazeka ngokocansi;
• Inhlalakahle yezocansi;
• Usizo lokufuna;
• Ukugwema ucansi;
• Ukuvama;
• Ucwaningo lwabantu

Imiphumela kanye negalelo

Idatha emele izwe evela eBrithani ibonisa ukuthi izinkinga zomsebenzi zobulili ezicindezelayo azivamile kubantu abasha (abaneminyaka engu-16-21 ubudala). Emfundweni yezocansi kanye nezinsizakalo zempilo yezocansi, ochwepheshe kufanele bavume ukubaluleka kokuphila kahle ngokobulili futhi banike amathuba okuba abantu abasha baphakamise futhi baxoxisane nokukhathazeka kwabo.

Intshisekelo yobungcweti ekuziphatheni kwabantu abasha ngokocansi ivame ukuqhutshwa ukukhathazeka ukuvimbela ukulimala kocansi, ikakhulukazi ukukhulelwa okungahlelelwe kanye nokudluliswa kwezifo ezithathelwana ngocansi (STI) [1], [2] futhi [3] futhi, ngokuya, ubulili obungenasidlangalaleni. Umsebenzi wokulinganisa ukhombisa ukuthi abantu abasha ngokwabo bakhathazeke ngokufanayo ngezindaba eziphathelene nokuphila kwabo ngokocansi. Bangase bakhathazeke ngesimo sabo sobulili noma ubunikazi babo [4], uzizwa ucindezelekile ukuba uvumele imisebenzi engayithandi noma yokuthola ubuhlungu [5], noma ukulwa nemigomo eyenza kube nzima ukuvuma okuhlangenwe nakho okungaphansi kokuhle [6] futhi [7].

Ngenkathi izingqinamba eziphathelene nokuzikhethela, ubunikazi bezocansi, kanye nedumela lezocansi kubhalwe phansi kahle, kuncane okwaziwayo ngezinkinga abantu abasha abangaba nazo ngokuphendula nokusebenza ngokocansi. Lokhu kungenxa yokuthi izinkinga zomsebenzi wezocansi kucatshangwa ukuthi zihambisana kakhulu nabantu abadala. Umsebenzi wezocansi uchazwa njengamandla omuntu okuphendula ngokocansi noma ukuzwa ubumnandi bezocansi [8] nezinkinga zomsebenzi wezocansi yilezo eziphazamisa lezi. Ucwaningo lokusabalala kwabantu ngezinkinga zomsebenzi wezocansi luhlanganisa ababambiqhaza abancane njengeminyaka eyi-16 noma eyi-18, kepha imvamisa basebenzisa izigaba zobudala ezibanzi, kuze kube yiminyaka engama-29 [9] futhi okungajwayelekile ukunikeza imininingwane ethile kubantu abasha ngaphansi kweminyaka ye-24 [10], [11] futhi [12]. Zimbalwa izifundo ezigxile ikakhulukazi ekukhuleni kwasekuqaleni, futhi lezi zincwadi azivame ukusetshenziswa kwedatha emele izwe [13] futhi [14].

Kukhona ukuqaphela okwandayo ukuthi impilo yezocansi kufanele ibhekwe kabanzi [15] futhi [16], kanye nencazelo ephelele eqinisekisiwe yi-WHO- "isimo senhlalakahle ngokomzimba, ngokomzwelo, engqondweni nasenhlalakahle ngokuphathelene nobulili" [17]-Suka kancane kancane ukuthola imali. Kubantu abasha, impilo yezocansi ihlanganisa "iminikelo enhle yokuthuthukisa ubulili, kanye nokuthola amakhono afanelekile ekugwemeni imiphumela emibi yezocansi" [18]. Kunobufakazi bokuthi imigomo ephathelene nokwaneliseka ngokocansi nokuthokozisa kubandakanya kokubili ukuthatha ingozi kanye nemikhuba yokunciphisa ingozi [16] futhi [19]. Ngokwesibonelo, ukwesaba mayelana nokusebenza kwe-erectile phakathi kwamadoda amasha kuye kwaboniswa ukuthi kunomthelela wokumelana nokusetshenziswa kondomu [20] nokusetshenziswa okungahambisani [21]. Impilo emihle yezocansi kubantwana ihlotshaniswa nokuziphatha kokunciphisa ingozi, njengokusebenzisa ikhondomu nokuzigwema ngokocansi [18], futhi umsebenzi wobulili kubantu abadala uhlotshaniswa nokuziphatha kokungcupheni [22]. Ukungenelela okulondeka injabulo kungase kusebenze kakhudlwana kunalabo abangazinaki lesi sici [16] futhi [23]. Ukuntuleka kwedatha okwamanje kumsebenzi wezocansi kubantu abasha kunqanda imizamo yokubhekana nempilo yezocansi ngokugcwele futhi kuqinisa inkolelo yokuthi umsebenzi wezocansi nenhlalakahle ayihambisani nokungenelela kokuvimbela abantu abasha [1] futhi [24].

Siphinde sabika ngokusabalalisa kwezinkinga zomsebenzi wezocansi kubantu abadala abaneminyaka engu-16-74 esebenzisa idatha evela ku-Survey kazwelonke yesimo sengqondo socansi kanye nokuphila (Natsal-3) [22]. Lapha, sisebenzisa le datha efanayo esethelwe ukubhekana negebe lemininingwane yezinkinga zomsebenzi wezocansi (kufaka phakathi lezo ezibangela ukucindezeleka), ukusiza ukufuna ngempilo yomuntu wobulili, nokugwema ukuya ocansini ngenxa yezinkinga, kubantu abasha abaneminyaka eyi-16-21 eBrithani.

izindlela

Abahlanganyeli nenqubo

Sethula idatha kusuka kubahlanganyeli abaneminyaka engu-16 kuya kwengama-21 kuNatsal-3, okuyisibonelo sesampula yocwaningo lwamadoda nabesifazane abayi-15,162 abaneminyaka engu-16-74 eBrithani, okwaxoxwa nabo phakathi kukaSepthemba 2010 no-Agasti 2012. Sigxila ebudaleni bokuqala isikhathi kanye nezigaba zokuqala zemisebenzi yezocansi ngaphambi kokuba abantu abasha "bazinze" ebudlelwaneni besikhathi eside nemikhuba yezocansi. Sisebenzise ukwakheka kwesampula kwamacala amaningi, okuhlanganisiwe, futhi okuhlukanisiwe, nefayela lekheli lase-UK njengekhodi yesampula nemikhakha yekhodi yeposi (n = 1,727) ekhethwe njengeyunithi eyisampula eyinhloko. Ngaphakathi kweyunithi ngayinye eyisampula eyinhloko, amakheli angama-30 noma angama-36 akhethwe ngokungahleliwe, futhi ngaphakathi kwendlu ngayinye, umuntu omdala ofanelekile wakhethwa esebenzisa igridi yeKish. Ngemuva kwesisindo sokulungiselela amathuba angalingani okukhethwa, isampula le-Natsal-3 belimele kabanzi inani labantu baseBrithani njengoba kuchazwe izibalo zeCensus ka-2011 [25].

Abahlanganyeli baxoxwa ekhaya ngodliwano oluqeqeshiwe, besebenzisa inhlanganisela yokubhekana ubuso nobuso kanye nokusizwa komuntu oxhumana naye ngekhompiyutha (CASI) yemibuzo ezwelayo. Oxoxisana naye ukhona futhi uyatholakala ukusiza ngenkathi abahlanganyeli beqedile i-CASI kodwa abazange babuke izimpendulo. Ekupheleni kwezigaba ze-CASI, izimpendulo "zavalwa" kwikhompyutheni futhi zazingenakufinyeleleka kulowo oxhumana naye. Le ngxoxo yahlala cishe ihora, futhi abahlanganyeli bathola i-£ 15 njengesibonakaliso sokubonga. Isixhobo sokuhlola sathola ukuhlolwa okujulile nokuhlola [26].

Izinga lokuphendula jikelele liyi-57.7% yazo zonke amakheli afanelekile (64.8% phakathi kwabahlanganyeli abaneminyaka engu-16-44 iminyaka). Izinga lokubambisana (inani labaphendulile emakhemeni afanelekile lapho ukuxhumana okwenziwe khona ukuvuma ukuhlanganyela kulolu cwaningo) kwaba yi-65.8%. Imininingwane yendlela yokuhlola iyashicilelwa kwenye indawo [25] futhi [27]. I-Natsal-3 ivunywe yiKomiti Yezokuziphatha Yokucwaninga E-Oxfordshire A. Abahlanganyeli banikeze imvume yomlomo yokuxoxisana.

Imiphumela yokwenza

Ababambiqhaza ababika ucansi lwesitho sangasese sowesifazane, somlomo, noma sangasese nomlingani oyedwa noma ngaphezulu ngonyaka owedlule bahlukaniswa njengabantu “abaya ocansini” futhi babuza ukuthi ngabe baluthole yini uhla lobunzima obuyisishiyagalombili ngempilo yabo yezocansi ehlala izinyanga ezi-3 noma ngaphezulu esikhathini esedlule unyaka. Laba babengenayo intshisekelo yokuya ocansini, bengenakho ukujabula ocansini, bezizwa bekhathazekile ngesikhathi socansi, bezwa ubuhlungu ngokomzimba ngenxa yocansi, bengazizwa ngijabule noma bevukile ngesikhathi socansi, abafinyelelanga kuvuthondaba (bahlangabezana ne-orgasm) noma bathatha isikhathi eside ukufinyelela kuvuthondaba yize uzizwa ujabule noma uvukile, wafinyelela kuvuthondaba (wazibonela i-orgasm) ngokushesha okukhulu kunalokho ongathanda, waba nesitho sangasese sowesifazane esomile (esabuzwa ngabesifazane kuphela), futhi waba nenkinga yokuthola noma ukugcina ukwakhiwa (kubuzwa amadoda kuphela) . Kwinto ngayinye, bavume (baphendula ngoyebo), ababambiqhaza babuzwa ukuthi bazizwa kanjani ngale nkinga (izinketho zokuphendula: abakhathazekile nakancane; bakhathazekile kancane; bakhathazekile ngokwanele; bakhathazeke kakhulu). Siphinde sabuza ukuthi babhekane nobunzima isikhathi esingakanani nokuthi izimpawu zenzeka kangaki (idatha engakhonjisiwe kule ndatshana).

Bonke ababambiqhaza abanolwazi ngocansi (labo abake baba nokuhlangenwe nakho kocansi), ngaphandle kokwenza kwabo ucansi ngonyaka odlule, babuzwa ukuthi bahlole impilo yabo yezocansi iyonke, kufaka phakathi ukuthi ngabe bayakugwema yini ukuya ocansini ngenxa yezinkinga zocansi ababhekana nazo noma abalingani babo (vuma kakhulu, vuma, ungavumi noma awuvumelani, awuvumi, awuvumi kakhulu). Ababambiqhaza abavuma ngokuqinile noma bevuma babe sebenikezwa uhlu olufanayo lwezinkinga futhi bacelwa ukuthi basho ukuthi yikuphi, uma kukhona, okubenze bagwema ukuya ocansini. Izinketho ezingeziwe zokuphendula zazimi ngokulandelayo: "umlingani wami wayenenkinga eyodwa (noma ngaphezulu) yocansi" futhi "azikho kulezi zinto ezangenza ngagwema ukuya ocansini." Izimpendulo eziningi zavunyelwa. Ababambiqhaza babuzwa nokuthi bazizwa bekhathazekile noma bekhathazekile ngempilo yabo yezocansi besebenzisa isikali samaphuzu amahlanu se-Likert. Ekugcineni, ababambiqhaza babuzwa ukuthi ngabe balufunile yini usizo noma iseluleko maqondana nempilo yabo yezocansi kunoma yiluphi uhlu lwemithombo ngonyaka odlule, futhi uma kunjalo, ukukhetha konke okusebenzayo. Lezi zinketho zaqoqwa njengelungu lomndeni / umngani, abezindaba / usizo lokuzisiza (kufaka phakathi amasayithi olwazi nokusekelwa ku-intanethi; izincwadi zokuzisiza / amapheshana olwazi; amaqembu okuzisiza; ucingo losizo), kanye nochwepheshe (kufaka phakathi udokotela / umndeni jikelele udokotela; impilo yezocansi / umuthi wokuzala womchamo / umtholampilo wezifo ezithathelana ngokocansi; udokotela wezifo zengqondo noma isazi sokusebenza kwengqondo; umeluleki wezobudlelwano; olunye uhlobo lomtholampilo noma udokotela), noma abakaze bafune usizo Lezi zinto zivela kwaNatsal-SF; isilinganiso somsebenzi wezocansi owenzelwe ngokukhethekile futhi waqinisekiswa ukuze usetshenziswe kulolu cwaningo lokutholakala kwabantu. Isilinganiso sento engu-17 se-Natsal-SF sinokulingana okuhle (isilinganiso sokuqhathanisa esilinganayo = .963; iTucker Lewis index = .951; impande isho iphutha lesikwele lokulinganisa = .064), ingabandlulula phakathi kwamaqembu emitholampilo nakubantu abajwayelekile, futhi inokuhlolwa okuhle Ukuthembeka okuphelele (r = .72) [22] futhi [28].

Ukuhlaziywa kwesitatimende

Konke ukuhlaziywa kwenziwa ngokusebenzisa imisebenzi eyinkimbinkimbi yocwaningo lweStata (inguqulo 12; iStataCorp LP, iCollege Station, i-TX) ukuphendula ukukalwa, ukuqoqwa, kanye nokuhlukaniswa kwedatha. Ukuhlaziywa kwakukhawulelwe kubo bonke abesilisa nabesifazane abaneminyaka yobudala eyi-16-21. Ukungaphenduli kwento kuNatsal-3 bekuphansi (cishe njalo <5%, futhi imvamisa 1% -3%), ngakho iziguli ezinedatha elahlekile azifakwanga ekuhlaziyweni. Phakathi kwabahlanganyeli ababamba iqhaza ocansini (labo ababika okungenani umlingani oyedwa ocansini ngonyaka ngaphambi kwengxoxo), sethula izibalo ezichazayo zokubika ngezinkinga zomsebenzi wezocansi (ezihlala izinyanga ezi-3 noma ngaphezulu ngonyaka odlule), kanye nenani elicindezelwe inkinga yabo. Siphinde sibike inani lokufuna usizo oluvela emithonjeni eminingi, ehlukaniswe ngokubika inkinga eyodwa noma ngaphezulu yomsebenzi wezocansi. Kubahlanganyeli ababengazibandakanyi ocansini ngonyaka odlule, sibika izibalo ezichazayo zemiphumela emithathu: ukwaneliseka ngokocansi, ukukhathazeka ngempilo yezocansi, nokugwema ukuya ocansini ngenxa yobunzima bocansi.

Imiphumela

Amadoda nabesifazane abaningi (i-72%) abaneminyaka engu-16-21 babike ukuthi babe nomlingani oyedwa noma ngaphezulu ngonyaka owedlule futhi ngakho babekwa njengabantu abasebenza ngokobulili (amadoda we-854 nabesifazane be-1,021). Ithebula 1 ikhombisa inani lala madoda abika inkinga ngayinye kwezingu-3 zomsebenzi wezocansi ehlala izinyanga ezi-33.8 noma ngaphezulu ngonyaka odlule. Ingxenye yesithathu yala madoda (i-XNUMX%) ithole inkinga eyodwa noma ngaphezulu yomsebenzi wezocansi (ikholomu yokuqala ye- Ithebula 1), futhi i-9.1% ibike inkinga (noma) yezinkinga zokusebenza zocansi eyodwa noma ngaphezulu (ikholomu yesibili); okusho ukuthi phakathi kwamadoda abika inkinga eyodwa noma ngaphezulu, ngaphezu kwengxenye yesine (26.9%) bezwe bekhathazekile (ikholomu yesithathu).

Ithebula 1.

Isipiliyoni sezinkinga zomsebenzi wezocansi, nokucindezeleka ngalezi zinkinga, phakathi kwezinsizwa ezisebenza ngocansi, ezineminyaka eyi-16-21

CI = isikhathi sokuzethemba.

a

I-Denominator ihlukahluka ngezinkinga zomsebenzi ngamunye wezocansi kule kholomu. I-denominated and weighted denominator ehlongozwayo yilabo ababhekana nenye noma ngaphezulu yalezi zinkinga.

Izinketho zethebula

Phakathi kwamadoda, ukufinyelela kuvuthondaba ngokushesha okukhulu kwakuyinkinga ejwayelekile (13.2%). Abesilisa abangaphezu kwengxenye eyodwa kwezintathu abanale nkinga (34.2%) bazizwe bekhathazekile ngayo, okwenza kube yinkinga ejwayelekile kunazo zonke phakathi kwabesilisa abaneminyaka engu-16 kuya kwengama-21 ubudala (4.5%). Ubunzima bokuthola nokugcina ukwakhiwa kwakungabikwa kakhulu (i-7.8%), kepha kwakuvame ukubangela ukucindezeleka (phakathi kwe-42.1%) futhi ngenxa yalokho kwaba inkinga yesibili ecindezela kakhulu (ngo-3.3% wamadoda eqenjini leminyaka). Yize ukungabi nentshisekelo kwezocansi kwakuyinkinga yesibili evame ukubikwa (etholwa yi-10.5%), kuphela u-13.2% wamadoda abika le nkinga abecindezelwe yiyo, futhi sekukonke, i-1.4% yabhekana nayo njengenkinga ecindezelayo. Izinkinga ezintathu ezicindezelayo zabikwa ngu- <1% wezinsizwa eziya ocansini: ubuhlungu, ukuntula isasasa / ukuvuka, nokuntula ukujabula.

Ithebula 2 ikhombisa inani labesifazane abasebancane abenza ucansi ababika inkinga ngayinye yomsebenzi wezocansi, nakulabo ababhekene nale nkinga, isilinganiso sikhathazekile ngakho. Ngaphansi nje kwengxenye (44.4%) yalaba besifazane babhekene nenkinga eyodwa noma ngaphezulu yomsebenzi wezocansi owathatha izinyanga ezi-3 noma ngaphezulu ngonyaka odlule, kwathi abangu-13.4% babika inkinga ecindezelayo; okusho ukuthi kulabo ababika inkinga eyodwa noma ngaphezulu, ngaphansi nje kwengxenye yesithathu (30.2%) babecindezelekile.

Ithebula 2.

Isipiliyoni sezinkinga zomsebenzi wezocansi, nokucindezeleka ngalezi zinkinga, phakathi kwabesifazane abancane abaya ocansini, abaneminyaka engu-16-21

CI = isikhathi sokuzethemba.

a

I-Denominator ihlukahluka ngezinkinga zomsebenzi ngamunye wezocansi kule kholomu. I-denominated and weighted denominator ehlongozwayo yilabo ababhekana nenye noma ngaphezulu yalezi zinkinga.

Izinketho zethebula

Izinkinga ezivame kakhulu kwabesifazane bezintula intshisekelo kwezocansi (22.0%) futhi behlangabezana nobunzima ekufinyeleleni kuvuthondaba (21.3%), futhi lezi futhi bekuyizinkinga ezivame kakhulu ukucindezela (5.3% no-6.3%, ngokulandelana). Izinkinga ezivame ukuhlotshaniswa nosizi zazizizwa zikhathazekile ngesikhathi socansi (34.7%), zizwa ubuhlungu ngokomzimba ngenxa yocansi (35.9%), nokuntula injabulo noma ukuvusa inkanuko (31.6%), kepha lezi zinkinga zazingabikwa kakhulu, kwaholela ekutheni ukulinganiselwa kokutholakala jikelele kwezinkinga ezicindezelayo ku-2.8%, 3.2%, naku-2.5%, ngokulandelana. Ukufinyelela kuvuthondaba ngokushesha okukhulu kwakungabikwa kakhulu (3.9%) futhi kwabonwa njengokucindezela ngo-10.8% kuphela wabesifazane ababikayo, okwaholela ekusakazekeni okuphelele komvuthwandaba wokuqala we-1%.

Phakathi kwabantu abasha ababesebenza ngokocansi ngonyaka odlule, amadoda angu-6.3% kanye no-6.8% wabesifazane bathi baye bagweme ucansi ngenxa yobunzima bobulili. Phakathi kwamadoda amasha (Umdwebo 1), izizathu ezivame kakhulu zokugwema kwakunzima ukuthola noma ukugcina ukulungiswa, ukufinyeleleka ngesivinini ngokushesha, nokungabi nentshisekelo (kubike i-26.1%, i-24.4%, ne-25.1%, ngokulandelana, kuzo zonke izinsizwa ezazisithi zigweme ubulili). Phakathi kwabesifazane abasebasha (Umdwebo 1), izizathu ezivame kakhulu zokugwema kwakungenalo isithakazelo (kubikwe yi-45.5% yabesifazane abaye bagweme ucansi), kulandelwa ukungabi namnandi, ukukhathazeka nobuhlungu (kubike i-21.2%, i-25.3%, ne-23.7%, ngokulandelana, yabesifazane abaye bagweme ucansi).

Umdwebo 1.

Izizathu zokugwema ucansi phakathi kwabantu abasha ngokobulili ababika ukugwema ucansi ngenxa yobunzima bobulili.

Izinketho zesithombe

Usizo noma iseluleko ekufuneni phakathi kwabahlanganyeli ocansini

Ngokuvamile, i-26% (22.9-29.5) yabesilisa abanezicansi kanye ne-36.3% (33.1-39.7) yabesifazane abesilisa ocansini babesefuna usizo mayelana nokuphila kwabo ngokobulili ngonyaka odlule (umugqa wokugcina, Amathebula 1 futhi 2). Umdwebo 2 ikhombisa ukulinganisela okubonisana nemithombo ehlukene, ehlanjululwe yinkinga yenkinga yomsebenzi wezocansi. Labo ababika inkinga eyodwa noma ngaphezulu abaye bafuna usizo ngokuvamile uma kuqhathaniswa nalabo abangabonisi izinkinga (35.5% vs. 21% yamadoda; p <.001 no-42.3% kuqhathaniswa nama-31.1%; p = .001). Lapho abantu abasha bafuna khona usizo, amalungu omndeni nabangane bewumthombo ovame kakhulu olandelwa yizindaba / ezokusiza. Usizo lobuchwepheshe oluthile luvame ukufunwa. Phakathi kwabantu abasha ababika inkinga yomsebenzi oyedwa noma ngaphezulu, i-3.6% (1.9-6.8) yamadoda no-7.9% (5.8-10.6) yabesifazane babebonane nabachwepheshe ngokuphila kwabo ngokocansi ngonyaka odlule.

Umdwebo 2.

Ukulandelana kwabantu abasha abafuna usizo noma iseluleko mayelana nokuphila kwabo ngokocansi ngokubhekana nesimo somsebenzi wobulili kanye nobulili. SF = umsebenzi wobulili.

Izinketho zesithombe

Ukucindezeleka nokugwema phakathi kwabantu abasha abangazange babe nobulili ngonyaka odlule

Ngokuphelele, amadoda e-262 nabesifazane be-255 babhekana nakho ngokobulili (babeke bahlangabezana nesipiliyoni) kepha abazange babike ukuthi bahlanganyele ngokocansi ngonyaka ngaphambi kokuxoxisana (Ithebula 3). Ngaphezulu kweyodwa kwabayisithupha kulaba bantu (17.4%) nabangaphansi kwabayisishiyagalombili kulaba besifazane (i-12%) babike ukuthi bacindezelekile ngokuphila kwabo ngokocansi, futhi nxazonke ku-10 (10%) yamadoda nabesifazane bathi baye bagwema ucansi ngenxa yobunzima bobulili okungenzeka ukuthi bona noma umlingani wabo bahlangene. Kubekho umehluko wobulili ekubikeni ukucindezeleka noma ukugwema.

Ithebula 3.

Ukuphakama kwe-16 engasebenzi ngokobulili - ku-21 oneminyaka engu-ubudala okubika ukucindezeleka ngokuphila kocansi, ukwaneliseka ngokuphila ngokocansi nokugwema ubulili

CI = isikhathi sokuzethemba.

Izinketho zethebula

Ingxoxo

Le datha emele izwe ibonisa ukuthi cishe oyedwa kwabesilisa abasebasha be-10 ocansini futhi omunye wabesifazane abesilisa abesilisa abesilisa abayisishiyagalombili abakhuluma ngocansi baveza inkinga ecindezelayo yocansi ehlala izinyanga ezingu-3 noma ngaphezulu ngonyaka odlule. Inkinga evame ukukhathazeka kakhulu phakathi kwabo bonke abesilisa abesilisa ocansini yayifinyelela emvuthwandaba ngokushesha (4.5%), futhi phakathi kwabesifazane abasebasha, kwakunzima ukufinyelela ekugcineni (6.3%). Amaphesenti angaphezu kwesithathu kwabesilisa nabangaphezu kwamane ku-10 besifazane ababika inkinga eyodwa noma ngaphezulu yokusebenza kwezocansi bebefuna usizo, kodwa abavame ukuvela emithonjeni yobuchwepheshe. Phakathi kwalabo ababengazange bahlanganyele ngokocansi ngonyaka ngaphambi kokuxoxisana, omunye wabesilisa nabesifazane abase 10 bathi baye bagweme ucansi ngenxa yobunzima bobulili.

Amandla alolu cwaningo ukuthi asekelwe kwisampula esikhulu esisekelwe emphakathini futhi ahambela igebe elibalulekile ebufakazini obunamandla emisebenzini yezocansi phakathi kwezinsizwa. Nakuba izinga lokuphendula lomcwaningi jikelele (57.7%) limelela umthombo ongase ube ngumthombo wobandlululo, izinga lokuphendula phakathi kwe-16- kuya ku-44 ubudala lineminyaka ephakeme, ku-64.8%. Sibheke ngaphambili ukwehla okujwayelekile kwamuva kwenzalo yokuphendula yocwaningo, kuhlanganise nezindlela ezinamandla kakhulu zokubala, futhi uye waphawula ukuthi izinga lethu lokuphendula lihambisana nezinye izinhlolo zomphakathi ezinkulu e-United Kingdom [25] futhi [27]. Noma kunjalo, ukuhlaziywa okuhlelekile okuvumelanako okubamba iqhaza kuyakwenzeka, futhi sasebenzisa izisindo zokuhlola ukunciphisa lokhu kuhlaselwa (bheka izindlela). Izinto ezinkingeni zobulili zibucayi, futhi idatha ebikwayo ingase ibe ngaphansi kokukhumbula i-bias futhi ijwayele ukubika ngaphansi. Sifuna ukunciphisa ukuxhaswa kokubika ngokuchaza izinkinga zomsebenzi wezocansi njenge "izinkinga ezivamile" [22], ngokucubungula izinto ngokucophelela [28], nangokusebenzisa ukukhulumisana komuntu siqu ngekhompiyutha [25].

Idatha yethu ibonisa izinkinga zomsebenzi wezocansi azivamile kule nkathi yobudala. Ukulinganiswa kokulingana kwe-16-ngokobulili kumadoda nabesifazane abaneminyaka engu-21 abanokubika izinkinga zomsebenzi wezocansi akuzona ezansi kunabo bonke abantu baseNatsal-3, i-41.6% yamadoda ne-51.2% yabesifazane [22]. Izifundo eziningana ezisekelwe emphakathini zifake futhi zabika ngamaqembu amancane [10], [11], [12] futhi [29] nakuba ukuqhathaniswa kunciphile ngokuhlukahluka kohlelo lokuhlola kanye nokuhlukaniswa kwezinkinga zombili zobulili nokuqina kwawo. Ucwaningo lwamuva lwaseCanada [13], isibonelo, wathola ukuthi i-50% ye-16 yokuziphatha ngokobulili-kwabesilisa nabesifazane abaneminyaka engu-21 yabika inkinga yezocansi, okungukuthi, ukucindezeleka okubikiwe okuyi-half, nakuba isampula encane, isampula kanye nokungafani kuncazelo ichaza isidingo sokuqapha ngokuhunyushwa. Phakathi kwabesilisa abasha, ukulinganisa kwethu ukusabalala kwezinkinga ze-erectile (7.8%) kungaphakathi phakathi kwe-4.3% etholakala ocwaningweni lwase-Australia mayelana ne-16 enobulili-kuminyaka eyi-19 [10] no-11% phakathi kwe-16 enobulili- ku-24 oneminyaka engu-ubudala ekufundweni ePortugal [12]. Ukulinganisa kwethu kwe-13.2% kokuqala kwe-ejaculation kuncane kakhulu kunesifundo se-Australia (i-15.3%) futhi sincane kakhulu kunomfundi wesiPutukezi (40%). Phakathi kwabesifazane abasebasha, ukulinganisa kwethu ukusabalalisa ukungabi nentshisekelo (22%) nobunzima ekufinyeleleni i-orgasm (i-21.3%) kuncane kakhulu kunalawo ocwaningweni lwase-Australia (36.7% no-29%, ngokulandelana) futhi kufaniswa namanani cishe a-20% no-27% kusifundo saseSweden sabesifazane abaneminyaka engu-18-24 [11].

Kuphakanyisiwe ukuthi ingxenye yezinkinga kubantu abasha ivela "kumphumela wokuzijwayeza" nokuthi iyanyamalala ngokuhamba kwesikhathi njengoba abantu abasha bezethemba futhi benolwazi. Ukusekela lokhu, u-O'Sullivan et al. [13] ithole ukuthi ezinsizweni, inkathi ende yolwazi lobulili yayihlotshaniswa nokusebenza okungcono kwe-erectile nokwaneliseka okukhulu ngokuya ocansini. Ngakolunye uhlangothi, isibalo sabantu abadala abanezinkinga zomsebenzi wezocansi babika izimpawu zempilo yonke, ngamanye amagama, izimpawu ezivele ngaphambi noma ngaphambi kwesikhathi sokuqala kwabo ngokocansi futhi ezingazange zinciphe [8] futhi [30]. Kunezici eziningi ezinomthelela ebunzimeni bezocansi ezijwayele ukwakheka ebuntwaneni nasebusheni. Lokhu kubandakanya imfundo enganele yezocansi, ubunzima bokukhuluma ngezocansi, ukukhathazeka ngomzimba wakho noma ezocansi, nokudideka noma amahloni ngokuya ocansini komuntu noma izifiso zakhe [31]. Izinkinga zobulili zingase zibonise umzabalazo wokufeza ubulili obuhle ngaphakathi kwemigomo yezenhlalakahle ezithintekayo, isibonelo, ukwamukelwa ukuthi abesifazane kufanele balindele futhi babekezele ubuhlungu [5]. Izinga eliphindwe kabili ngokobulili lapho abesifazane bahlungwa khona futhi amadoda avuzwa ngesifiso sabo socansi livela ikakhulukazi emelene nokuguquka kwamasiko [32], nakuba ucwaningo lwamuva luchaza ukuhlukahluka ngendlela abantu abasha abazobhekana ngayo nalezi zincwadi zamasiko ebuhlotsheni babo [33].

Ngaphezulu kweminyaka engama-25 selokhu i-eseyi kaFine noMcClelland [34] ekukhulumeni okungahambi kwesifiso emfundweni yezocansi, abantu abasha bayaqhubeka bebona igebe kolwazi lwabo oluphathelene nezici zengqondo zobulili futhi bavame ukubika ukuthi abakulungele ukuphatha ubuhlobo bobulili. Idatha ye-Natsal-3 ibonisa ukuthi amadoda angu-42% nabangu-47% besifazane bafisa ukuthi bebazi kabanzi ngezihloko zobungqingili ngesikhathi baqala ukuzizwa belungele ukuya ocansini, kufaka phakathi cishe amadoda angu-20% no-15% wabesifazane abafisa ukuba bazi indlela yokwenza ucansi ukwanelise ukwedlula [35]. Ngokufanayo, esimweni sokuxubha se-New Zealand, abafundi abaneminyaka engu-16-19 babeka "indlela yokwenza umsebenzi wobulili ujabule kubo bobabili abalingani" kanye "nemizwelo ebuhlotsheni" phakathi kwezihloko eziyisihlanu eziphezulu abafisa ukwazi okwengeziwe mayelana nesondo imfundo [24]. Ngenkathi abantu abasha bethi bafuna ukukhuluma ngenjabulo, izindlela ezingezona ezenzelwe ukulala, ubudlelwane bamandla ebuhlotsheni bobulili, imfundo yezocansi esikoleni ivame ukungayinaki lezi zihloko, okuqukethwe kunalokho kubonisa ukukhathazeka kokuvikela kwabantu abadala [36].

Izingcingo zokufaka injabulo emfundweni yezocansi akuzona ezisha [37]. Ukuthula ngokuphila kahle ngokocansi okuvela emithonjeni yokufundisa kugcwele ezinye izinto ezifana nabangani kanye nabezindaba; futhi, ngokusho kukaNatsal-3, cishe ingxenye yesine yezinsizwa zibiza izithombe zobulili ezingcolile njengenye yemithombo yazo yolwazi ngocansi [35]. Nakuba abanye abasebenzisi babona umthelela omuhle empilweni yabo yobulili [38], izithombe zobulili ezingcolile zingaholela ekulindeni okungenangqondo nokulimala kwezocansi phakathi kwezinsizwa [39], okungase kukhulise izinkinga zomsebenzi wezocansi. Imfundo yezocansi ingenza okuningi ekudaleni izinkondlo, ukuxoxa ngenjabulo, ukugqugquzela ubudlelwane obulinganayo ngokobulili, nokugcizelela izindima ezibalulekile zokuxhumana nokuhlonipha ebuhlotsheni bokulwa nezinkinga zobulili.

Inani elincane labantu abasha abanezinkinga ezicindezelayo abafuna usizo noma iseluleko mhlawumbe abangenasibindi. Ukusiza akuvamile, ngisho nabantu abadala abanezinkinga zomsebenzi wezocansi [40]. Imfundo yezocansi ingenza okuningi ekuxazululeni ukukhathazeka, (1) ngamaphutha okuhlangana kolwazi; (2) ngokuqinisekisa abantu abasha ukuthi izinkinga zivame futhi zivumelekile; kanye (3) ngokuqinisa izixhumanisi ezinsizakalo zobungane ezintsha. Abanikezeli, nabo, kudingeka baqaphele ukuthi abantu abasha abaya kwezinye izidingo zezempilo zobulili (njengokukhulelwa komzimba kanye nokuhlolwa kwe-STI) bangase bakwazi ukubhekana nokukhathazeka okuhlobene nomsebenzi wabo wezocansi. Njengoba kunikezwe ukukhathazeka kwalokhu okukhathazayo, kungase kulungele abahlinzeki ukuba baqale ingxoxo ngokubuza umsebenzi wezocansi emlandweni wesiguli ojwayelekile, kanti izifundo ezizayo zingase zihlolisise ukusebenziseka kwalendlela.

Ngaphandle kwemininingwane ethembekile yokusebenza kwabantu abasha kwezocansi nenhlalakahle, ukubiza ukunakwa kwalesi sici sempilo yabo yezocansi kungaba ukuqagela kuphela. Kunesidingo esiphuthumayo sokuqhubeka nocwaningo olubhekiswe entsheni oluhlola ubukhulu bezinkinga, i-etiology yazo kanye nokuhlelwa kabusha kwazo. Ikakhulu, kunesidingo samathuluzi wokulinganisa avumelekile aqondiswe ngqo ezindabeni zabantu abasha.

Ekuphetheni, uma sifisa ukuthuthukisa inhlalakahle yezocansi kubantu, sidinga ukufinyelela abantu nabashadikazi njengoba beqala imisebenzi yabo yezocansi, ukuvimbela ukungabi nalwazi, ukukhathazeka, nehlazo ukuphenduka kube ubunzima bezocansi impilo yonke. Imininingwane yethu inikeza umfutho oqinile wokuthatha lesi sinyathelo sokuvikela.

Ukuvuma

INatsal-3 ukusebenzisana phakathi kwe-University College London (London, UK), iLondon School of Hygiene and Tropical Medicine (London, UK), NatCen Social Research, Public Health England (phambilini eyayiyi-Health Protection Agency), ne-University of Manchester (EManchester, e-United Kingdom). Abaxhasi babengenayo indima ekwakhiweni nasekuqhubekeni kocwaningo; ukuqoqwa, ukuphathwa, ukuhlaziywa, nokuchazwa kwedatha; nokulungiswa, ukubuyekezwa, noma ukuvunywa kwendatshana; kanye nesinqumo sokuhambisa udaba ukuze lushicilelwe. Ababhali babonga ababambiqhaza bocwaningo, iqembu lababuza imibuzo abavela kuNatCen Social Research, ukusebenza, kanye nabasebenzi bekhompyutha abavela kuNatCen Social Research.

Izimali Imithombo

Ucwaningo lwalusekelwa izibonelelo ezivela eMkhandlwini woCwaningo lwezokwelapha (G0701757) kanye ne-Wellcome Trust (084840), ngeminikelo evela kuMkhandlu Wokucwaninga Komnotho Nezenhlalo kanye noMnyango Wezempilo. Kusukela ngoSepthemba 2015, i-KRM ibisekelwa ngezimali yi-UK Medical Research Council (MRC); I-MRC / CSO Social & Public Health Sciences Unit, iYunivesithi yaseGlasgow (MC_UU_12017-11).

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Izingxabano zesithakazelo: I-AMJ ngumbusi we-Wellcome Trust. Bonke abanye ababhali bamemezela ukuthi abanaziphithiphithi zenzalo.

Ukubhalelwa kwekheli ku: Kirstin R. Mitchell, Ph.D., MRC / CSO Health and Public Health Science Institute, Institute of Health and Wellbeing, University of Glasgow, 200 Renfield Street, Glasgow, Scotland G2 3QB, United Kingdom.

© I-2016 Society ye-Adolescent Health and Medicine. Ishicilelwe ngu-Elsevier Inc.

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