Sexual and reproductive health: Health in Sweden: The National Public Health Report 2012. Chapter 9

Abstract

In many ways our sexual and reproductive health reflects our way of life and living conditions. In a long-term perspective, advances in welfare combined with a well-developed health and medical care system, have meant that by international standards it is now rare for mothers to die during delivery and infant mortality continues to decline to new record lows. Pregnancy and childbirth, however, continue to be a time in a woman's life associated with many health problems, and absence from work due to illness is common. The age of parents at the birth of their first child is no longer rising; it has remained the same for women and men since 2004. The fact that more and more people are having children later in life means many people are compelled for a long time beforehand to take precautions to avoid unwanted pregnancies and sexually transmitted infections (STIs) that can put fertility at risk. This has been accompanied by a parallel trend: an increasingly liberal view of sex as an activity independent of permanent relationships. As a result of these developments, young people in particular tend to have more sexual partners than formerly. In addition, condom use has not increased, resulting in a rise in the number of unprotected encounters. The incidence of chlamydia, the most common notifiable sexually transmitted disease, has risen very rapidly in the last decade. In 2011, 37,000 cases were reported, most of them (86 %) among young men and women (15-29 years) irrespective of sexual orientation. Sweden, along with Finland, has one of the lowest percentages of HIV-infected people in Western Europe. Despite this, there are grounds for continued vigilance. The domestic spread of the disease among men who have sex with men climbed sharply in 2007. Another factor was a sudden outbreak of HIV among intravenous drug users. However, statistics from 2010 and 2011 shows a significant decline in notified cases among intravenous drug users after 2007 and a decreasing trend also among MSM. A sustained picture of the HIV epidemic in Sweden is that more than half (ca 55 %) the present incidence has been observed among migrants and ethnic groups closely connected to countries where there are generalised epidemics. This, combined with the growing trend towards unprotected sex, points to a risk of further transmission, even outside high risk groups. Cervical cancer is caused by a group of sexually transmitted viruses-collectively the human papillomavirus (HPV). At present there are vaccines against some types of HPV. A general vaccination programme for 12-year old girls has just started. Pap tests 1 will also continue to be needed to prevent cervical cancer since the vaccine does not cover all potential carcinogenic viruses. Involuntary childlessness affects an estimated 10-15 per cent of all couples. Women's fertility declines sharply at around the age of 35. Couples planning to have children do not appear to be sufficiently aware of this and thus risk being over-optimistic about the number of children they intend to have. The grow...

<xhtml:span xmlns:xhtml="http://www.w3.org/1999/xhtml" xml:lang="en">Travel-associated gonorrhoea in four Nordic countries, 2008&#160;to&#160;2013</xhtml:span>

“…Danish data also showed that the risk for travel-associated gonorrhoea in men is six times higher compared with women. This is consistent with the finding that younger people and men are more likely to report having a new sex partner while travelling [16]; younger people are also more likely to have a higher number of sex partners in general [17], which is a risk factor for having a new sex partner while overseas [16]. …”

The Impact of Paternal and Maternal Smoking on Semen Quality of Adolescent Men

“…Since participation rate was only 14%, one may argue for a selection bias related to reproductive capacity but this seems somewhat unlikely, since pregnancy rates are as low as 3% in Swedish 15–19 year-old women [49] and only 19 (6.4%) out of the 295 included men reported to have made a partner pregnant and 11 men (3.7%) to have had regular unprotected intercourse during at least a year without causing a pregnancy. Further, similar semen parameters have been found in conscripts and men recruited through schools or through other participants [50].…”

Sexual behaviour of backpackers who visit Koh Tao and Koh Phangan, Thailand: a cross-sectional study

“…Rates of gonorrhoea infection have risen in both countries over recent years 5 18. Previous research has found that almost half (43% in 2011) of Swedish men who are infected with gonorrhoea by women acquire the disease abroad, especially in Thailand 18. German backpackers were less likely than Britons to engage in unsafe sex due to lower levels of new partner acquisition.…”