Continuing Education At Home
Professional Counselor - MFT - LCSW
Human Sexuality
Credits
10 CE credit hours training
Cost
$0.99
CEUnits is working on renewing our NBCC approval and is NOT a current NBCC provider.
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Target audience and instructional level of this course: foundational
There is no known conflict of interest or commercial support related to this CE program.
Course Description
This course explores sexuality from biological, psychological, and social perspectives. Critical issues directly and indirectly associated with sexual behavior are addressed. This course delves into issues of sexual orientation, intimacy, sexual disorders, adolescents, divorce and family issues related to sexuality.
There is no known conflict of interest or commercial support related to this CE program.
Course Description
This course explores sexuality from biological, psychological, and social perspectives. Critical issues directly and indirectly associated with sexual behavior are addressed. This course delves into issues of sexual orientation, intimacy, sexual disorders, adolescents, divorce and family issues related to sexuality.
Sex has a different definition for both men and women. While men would describe sex as fun, raucous, wild, lusty, playful, ecstatic, hot, sweaty, spontaneous, exquisite women would describe sex as serious business. Both these definitions may be seen as exaggerations but both of these definitions definitely have some truth in them.
The last 20-30 years has brought significant changes in male and female sex roles. In the 1950's and 60's the roles for men and women were relatively well established and non-changing but in the recent years these roles have been changed significantly. The changes have caused many men to re think and re evaluate old notions of manhood and masculinity. While many men accept these changes, this redefinition of roles has caused confusion and problems for some men. Listed below are some ways a change in sex roles has affected men.
Men and Masculinity
Men were originally perceived to be like a sturdy oak that is strong, emotionless, independent, inflexible and often violent. The roles set for men were clear and they stated that men should work hard, they should provide for their family, they should be the head of the family and they should not get emotionally attached to any family member or outsider. Not showing any vulnerability was an integral part to this role.
Newer definitions for men are much less rigid and clear. Men are now often encouraged to help raise children and share only part of the financial responsibility of the family. They are expected by their partners and partner to be open emotionally and to be able to communicate effectively. New role models of masculinity lay importance on both strength and vulnerability that is the ability to be strong and the ability to be vulnerable. This new role can be confusing for many men especially those who have been taught that men should be strong and emotionally detached.
Relationships
Many men today are confused by the messages they get in relationships. Some of the messages are to be strong, to be independent and to be the provider. All of these messages, though confusing at times, usually reflect the changing nature of sex roles. Simply stated, men are in the process of redefining sex roles. This leads to confusing messages from partners who also struggle with want they want in a man. The result for many men is to cling to old stereotypes in an effort to clarify the situation. Unfortunately this usually doesn't work as well as it should since in today's culture men need to expand the traditional opinions of masculinity. For a man now it is important to know how strong, vulnerable independent, dependent, logical and emotional he has to be. Clinging to old notions of being the alpha male will not solve any problems since new roles are evolving and it is important for men to experiment with these new options.
Careers: New Options
New sex role expectations have led to new opportunities for men in terms of their careers and work life. Men are no longer forced into only certain majors or careers and these days men can enter professions that were previously meant for only women. This causes confusion for many men since they may desire a particular career but their families may force them to opt for a traditional career. Again the added flexibility is freeing while also being significantly confusing at the same time.
Health: The Price Men Pay
Researches indicate that men usually suffer from a variety of health problems like heart attacks, ulcers, and stress related illnesses and men usually die sooner than women. Many people think that a primary reason for this has to do with work and stress related to certain sex roles. Working long hours at stressful jobs and keeping in painful emotions eventually leads to a physical breakdown and for some men such stress along with difficulty expressing their emotions can even result in suicide. Some men who are extremely afraid to talk about their emotional problems often feel that they have no option other than suicide. Learning to slow down, change jobs if it is too stressful, take time off from work, and talk about their emotions are a few ways that men can change this unhealthy pattern. Since new sex role expectations allow males to take better care of themselves emotionally and physically men are now allowed to share their feelings and take better care of themselves.
Drugs and Alcohol: A Male Problem
Researches indicate that majority of the population that uses drugs and alcohol are men. Drugs and alcohol are one way that men trapped by the traditional sex role expectations use to numb or vent emotions. Unable to know how to feel, or if they should talk about their feelings cause many men to turn to alcohol and drugs for emotional relief. The result is often dangerous since painful feelings remain hidden and unexpressed. Since anger is vented in an alcohol-induced rage there are damaging consequences of using these substances.
Feminism and Changing Sex Roles
The term Feminism implies that men and women are equal in all ways. This statement very nicely captures the dilemma for men living in the present day. Changing sex roles now allows more equality for men and women whereas older and more traditional opinions of sex roles emphasized that, men were superior to women. The more recent ideas of sex roles on the other hand emphasize equal power for men and women. This change in sex roles is confusing and at times threatening to many men since they do not know how this new system works. An increasing number of men are embracing this radical notion of equality for men and women since they are coming to see that this system is actually emotionally better for men. According to this new and improved system men no longer have to be the sole provider and men now have more options in their careers and work life. In this new system men are also allowed to express their emotions and they are allowed to share their feelings with their partner. The changing roles of sex are both confusing and freeing for some men since these men are given opportunities that they do not know how to use.
Improved health, less stress, emotionally satisfying relationships, better career options, and less alcohol or drug abuse are but a few of the advantages of this new and improved system.
Sexual orientation
Sexual orientation is one of the four components of human sexuality and this is distinguished by a permanent emotional, romantic, sexual attraction to individuals of a particular sex. The three sexual orientations that are recognized in humans are homosexuality that is attraction to people of one's own gender, heterosexuality that is attraction to individuals of the other the opposite sex and finally bisexuality that is attraction to either males or females.
People with a homosexual orientation are usually called gay in both men and women or lesbian in women only. Sexual orientation is completely different from sexual behavior because sexual orientation refers to feelings and one?s own self concept and individuals may or may not express their sexual orientation or preference in their behaviours.
What causes a person to have a particular sexual orientation?
Some theories suggest that genetics or inborn hormonal factors and learning experiences during early childhood help a person decide his sexual orientation when he grows up. However, many scientists believe that sexual orientation is shaped for most people at an early age through various in depth interactions of biological, psychological and social encounters.
Is sexual orientation a choice?
Sexual orientation is not a choice and it emerges for most individuals in the early teenage years when the person does not have any prior sexual experience. Some people try to change their sexual orientation over many years from homosexual to heterosexual with no success. For these reasons mental health care professionals do not consider sexual orientation for most people to be a conscious choice that can be changed due to voluntary actions.
Is homosexuality a mental illness or emotional problem?
No, homosexuality is not considered as a mental illness or an emotional problem by psychologists, psychiatrists and other mental health professionals. Scientific research over the past 35 years proves that homosexual orientation in itself is not related with emotional or social problems.
A few years ago homosexuality thought to be a mental illness because mental health professionals and societies had biased information about homosexuality since most studies only involved homosexual women and men who were in therapy. When researchers examined data for homosexual people who did not opt for therapy the conclusion was that homosexuality was not a mental illness.
In 1973 the American Psychiatric Association confirmed the importance of various new researches by removing the term homosexuality from the official manual that lists all mental and emotional disorders. In the year 1975 the American Psychological Association passed a resolution supporting this action. Both associations urged all mental health professionals to help remove the emotional and social stigma that homosexuality was caused due to mental problems. After homosexuality was declassified as a mental disorder, this decision has also been reaffirmed by additional research findings along with both associations.
Can lesbians and gay men make good parents?
It is believed that homosexual men and women can make good parents. Studies comparing groups of children that were raised by homosexual and by heterosexual parents find no developmental differences between the two groups of children in the children?s intelligence, psychological adjustment, popularity with peers, social adjustment, development of social sex role identity and development of sexual preferences.
Another misconception about homosexuality is that homosexual men are more likely than heterosexual men to sexually molest children. There is no scientific evidence indicating that homosexual men are more likely to molest children compared to heterosexual men.
Why do some gay men and lesbians tell people about their sexual orientation?
Many homosexuals reveal their true identity because disclosing their identity to others is important to their own mental health. This process of disclosing the identity is known as coming out of the closed and this process has been found to be strongly related to psychological adjustment that helps the homosexual to regain self esteem and self worth.
Why is the coming out of the closet difficult for homosexuals?
Because of false stereotypes and unwarranted myths towards homosexuals, the process of coming out or revealing the true identity is a very challenging process. This process may cause emotional pain to people who have been told that being homosexual is un natural. Homosexuals often feel lonely when they first become aware of same-sex attractions and they also fear being rejected by their family, friends, co-workers and religious institutions if they do decide to reveal their sexual preference.
In addition to all the myths and preconceptions, homosexuals are usually the targets of discrimination and violence. This threat of violence and discrimination is an obstacle to the development of homosexuals. In the 1989 national survey, 5% of homosexual men and 10% of homosexual women reported physical abuse or assault related to being homosexual in the previous year and 47% reported some form of discrimination in their lifetime. Other researches have shown similar high rates of discrimination or violence.
What can be done to help homosexuals overcome prejudice and discrimination against them?
The people who have positive attitudes towards homosexuals are those who say they have one or more homosexual friends or they know someone well who is a homosexual. For this reason mental health professionals believe that negative attitudes towards homosexuals as a group are prejudices and people who have these attitudes usually do not have any interaction with homosexuals. These negative attitudes are caused due to believing in stereotypes and myths about homosexuals.
Protection against violence and discrimination for homosexuals is very important, just as protection is important for other minority groups. Some states in USA include violence against an individual on the basis of her or his sexual orientation as a hate crime and eight U.S. states have laws against discrimination on the basis of sexual preferences.
Can therapy change sexual orientation?
Therapy cannot change the sexual orientation of a person since it being homosexual is not a mental illness. Although homosexual orientation is not a mental illness and there is no scientific reason to try to convert homosexuals to prefer heterosexual relationships some individuals may seek to change their own sexual orientation or that of another individual. An instance of this would be parents seeking therapy for their homosexual child. Some therapists who undertake this kind of therapy state that they have successfully changed their clients? sexual orientation from homosexual to heterosexual through treatment. Close examination of their reports discloses several factors that prove otherwise. Also many of these claims come from organizations with an ideological perspective on sexual preferences, rather than from mental health researchers. Also the treatments and the results are poorly documented and the length of time that clients came for follow ups after the treatment is too short.
In the year 1990 the American Psychological Association stated that scientific evidence does not show that conversion therapy is effective and that this therapy do more harm than good since changing one's sexual preference is not as simple as changing one's sexual behavior. Changing one?s sexual orientation or preference would not only require significantly changing one?s ideas about sexual preference but also re identifying and re constructing one's self-concept and social identity. Although some mental health providers do attempt to convert homosexuals to heterosexuals, others question the ethics of trying to alter through therapy a trait that is not a mental disorder rather something that is extremely important to an individual's identity.
Not all homosexuals who seek therapy want to change their sexual orientation. Homosexual men and women may seek counselling for any of the same reasons as anyone else and in addition, they may seek for psychological assistance to simply come out of the closet or to deal with prejudice, discrimination and violence.
Why is it important for society to be better educated about homosexuality?
Educating people about sexual orientation and homosexuality is likely to reduce anti-gay prejudice. Accurate information about homosexuality is especially important to young people struggling with their own sexual identity. Fears that access to information about homosexuality will affect one's sexual orientation are in valid.
Understanding Transgender
What Does Transgendered Mean?
A Transgendered or TG person is someone whose gender identity that is man or woman does not match their biological sex that is male or female. For most people, there is no connection between their biological sex and their internal gender identification. For most transgender, their gender identity is in constant conflict with their biological sex.
Are there different types of Transgendered individuals?
The term Transgendered is a broad term used for many kinds of people with differing gender expression.
The term transgendered is also used for someone who feels more comfortable as a member of another gender. Transgender individuals may live part or full-time as the other gender.
Transsexuals on the other hand seek to permanently change their bodies by changing their genders permanently through gender reassignment surgery.
"Non-op" refers to a person who has opted for all the hormonal/surgical treatment except the gender re assignment surgery because he or she cannot afford it or does not have any desire to proceed with the surgery.
Transvestites are people who wear clothing of the opposite gender for emotional or sexual gratification.
Two Spirited people have both female and male spirits as usually found in Native American culture. These people are often viewed with respect because they were able to hold both gender spirits in their bodies.
Inter sexed or Hermaphrodite. This is a rare medical condition where babies are born with both male and female sexual organs and the sex is assigned at birth through removing one of the reproductive organs.
Can people stop being Transgendered?
No, people cannot change their gender identity since gender identity is believed to be related to hormones, genetics and the functionality of the brain. Although some people will give up being transgender for a while, they typically return to cross dressing once they recognize that they cannot fight their true identity.
Gender identity is not the same as sexual preference since gender identity refers to how a person identifies himself or herself. Sexual orientation on the other hand refers to a romantic and sexual connection to a particular gender that is men, women or both.
A person's sexual orientation does not change after hormonal therapy or surgery. For instance when a man who is attracted to women undergoes the surgery thereby becoming a woman, she would call herself a homosexual. She now identifies herself as a woman who is attracted to other women.
Physical Intimacy
Physical intimacy includes both sensuous and sexual activity usually between two people and the sharing of emotions, thoughts and various reactions that are involved in these activities.
Physical intimacy includes a wide range of behavior and everything from hand holding to sexual intercourse is included in physical intimacy. Physical intimacy includes a broad range of physical contact such as:
Physical intimacy is sometimes difficult to develop between two individuals and at times since certain barriers may emerge:
One of the main barriers is the narrow focus that most people place about certain sexual behaviours. Usually, people believe that sexual intercourse as is the only expression of sensuous feelings toward another person. If fact, proceeding too fast to sexual intercourse is one of the major complaints many women have about their physical intimate relationships with their partner.
Another barrier to comfortable expression of physical intimacy occurs when the person ignores his or her own discomfort about a particular sexual activity. When the person ignores personal discomfort as a result sexual barriers, mental blocks, and turn-offs are usually created. One of the sources of discomfort may be physical or mental fears that are associated with physical intimacy.
The most common fear is the fear of being touched by another person. This means that some people are not very accustomed to being touched or caressed and they are not comfortable with tactile stimulation. There may also be the fear of breaking a taboo since there are a number of taboos in many cultures related directly to physical intimacy. Even when a person is married, it is often difficult to turn off the thoughts related to these taboos with which they have lived prior to marriage. There is also the fear of losing control of oneself or of allowing oneself to enjoy one?s body. Physical intimacy usually involves giving up all control and letting go of fears. For a person who is afraid of losing control, this can be an tough situation that can cause anxiety.
Many people fear pregnancy as a result of physical intimacy. Even though contraceptive information and birth control techniques are available to everyone, people have a lot of fears about pregnancy and all these fears are usually based on information or myths from childhood or adolescence knowledge. All these fears can interfere with feeling comfortable in a relationship that demands physical intimacy. There is also the fear of sexually transmitted disease (STDs), which in most cases is an actual or realistic fear especially in the case of multiple partners or if the couple is not practicing safe techniques. Another fear is the fear of guilt or being condemned either by peers, family members, or in some cases from a religious institution.
For many people, physical intimacy is a new experience since there are many new things to experience. If a person is apprehensive about new experiences then the fear associated with any kind of new experiences will create mental barriers to physical intimacy.
Ways to Overcome Obstacles to Physical Intimacy
One of the main things a person can do is to take things at his or her own speed, a personal speed with which he or she is comfortable.
It is important to give oneself permission to say no when he or she feels that no is the right answer and similarly to give oneself permission to say yes when the person feels that yes is the right answer. The person should also be willing to take responsibility for the consequences of his own decisions and actions. When the answers about the problems with physical intimacy come from the person?s own values then the person?s personal discomfort levels related to physical intimacy deceases.
The best way to reduce barriers is to become aware of one's fear and what may be producing the various fears or uncomfortable sensations about physical intimacy. Once the fear is identified, the person can work to reduce the fear. In a nutshell there is no one norm for physical intimacy other than behavior that is compatible with the feelings and beliefs of each partner involved in the relationship.
Being Open to New Relationships
The word open is really used a lot and this word is used from the time a child is born till the time of death. While some people open up to their families, other turn to friends or co workers to disclose personal information. The term ?open up? is used to suggest that the person does not disclose enough information about himself and he needs to trust others and disclose some personal information.
Most people find it hard to being open about their feelings since they feel that they cannot trust anyone with their secrets. Most people usually have a conflict of interests while opening up since they feel the need to share but they cannot due to trust issues. Some people do not open up due to the fear of being rejected or not appreciated by others.
While opening up or disclosing information the person should remember that it is up to him what information to disclose and when. The person can talk about information that sounds unimportant or he can talk about information that has a deeper meaning. Some people begin by opening up about small things such as new shoes or new items they have shopped for and then slowly start to disclose more information about themselves.
The process of opening up is not easy for most people due to the reasons mentioned above and the best way to open up is to first disclose general information. After the person believes that the listener is trustworthy then he can divulge more personal information about himself. While disclosing information the person also suggests that he is open to suggestions. The person in question should disclose information to people he trusts and to avoid disappointments he should not disclose information to people he does not know well. In certain situations like the office, the person should not open up to his boss especially if the matter he is going to say is going to hamper his job in any way.
While opening up the person should be direct and he should talk about his emotions. If the person feels happy or sad then he should communicate the right emotions to avoid any confusion. The person listening to him may or may not be able to pick up on body language so words should be used to communicate emotions.
While disclosing personal information the person should keep in mind that by disclosing too much personal information at once he can make the other person feel awkward. The person talking should also keep the other person?s emotions, sentiments and religious beliefs in mind while he is disclosing his own thoughts. An important part of opening up is mutual trust. The person talking should divulge information that is not offensive to the other person and the listener should make an attempt to listen carefully to what the other person has said. The listener should also make an attempt to participate in the other person?s conversation but he should not give suggestions and advice unless the person talking asks for advice or suggestions. Here are some common ways to open up or disclose information about oneself.
Sexual problems are disorders related to a particular part of the sexual response cycle. Sexual dysfunctions include sexual arousal disorders, sexual desire disorders, sexual pain disorders and orgasm disorders. If the participant has certain difficulties with some phase or part of the sexual response cycle or the participant feels pain while sexual intercourse then he or she may have a sexual dysfunctional problem.
Some examples of sexual dysfunction include:
Hypoactive Sexual Desire Disorder- People who have a decreased sexual drive or very few fantasies may suffer from this disorder. If the person feels that he is suffering due to a lack of sex drive then the problem will be considered as a disorder. In this sexual disorder the participant does not initiate any sexual activity and he may be very slow to reciprocate to his partner?s advances. This disorder can start at adolescence and it can continue till the later parts of life. Most of the times this disorder occurs in adults that have experienced stress a short while ago.
Sexual Aversion Disorder - A person who avoids sexual intercourse and dislikes the idea of being in contact with genitalia may suffer from this disorder. This problem is only considered a disorder if the person feels that his dislike is getting in the way of having a normal relationship. People who have sexual aversion disorder usually report anxiety, fear, or disgust when they have to indulge in sexual activity. In certain cases even touching or kissing another person may be avoided by people who have this disorder. The person may feel nauseated, panic stricken and the person may also experience severe panic attacks.
Female Sexual Arousal Disorder -This disorder is described as the inability of a woman to have sexual intercourse even with a lubricant. Swelling of the external genitalia and vaginal lubrication may or may not be present. In order to be considered a disorder the lack of sex should cause a problem in a relationship. Some women who have this disorder do not feel aroused when they are touched by their partners and often these women experience pain during sexual intercourse due to which they avoid sexual intercourse.
Male Erectile Disorder- If a man is unable to maintain an erection while intercourse along with other sexual activity then he may have male erectile disorder. In order to be classified as a disorder this problem has to either be recurrent or persistent and erectile dysfunction should cause problems in the relationship. People who have this disorder may get an erection but they may not be able to maintain it for long but it is also possible for affected men to completely not get any erections. This complex disorder may be accompanied with fear of failure and a hurt self esteem. Sometimes this sexual disorder is present throughout the individual?s life but in many cases this disorder occurs when the individual is with a certain person or in a certain type of relationship.
Female Orgasmic Disorder. Female orgasmic disorder occurs when the woman takes a while to experience an orgasm or if the woman does not experience an orgasm at all. If this condition causes problems in the relationship then it will be classified as a disorder.
Male Orgasmic Disorder. If a man experiences a delayed orgasm or does not experience an orgasm after sexual activity then he has male orgasmic disorder. In order to be qualified as a disorder this condition must cause problems in the relationship.
Premature Ejaculation. ? If the man ejaculates without significant stimuli and if the problem is persistent then the person may have this disorder. This problem is classified as a disorder only if the condition causes issues in the relationship. Premature ejaculation is usually seen in young men who have experienced this condition since their first attempt at sexual intercourse.
Dyspareunia - Dyspareunia is a sexual pain disorder. Dyspareunia is pain in the gentiles that accompanies with sexual intercourse and both men and women can experience this disorder, but the disorder is more common in women. Dyspareunia tends to be chronic in nature.
PARAPHILIAS
Paraphilias is a sexual disorder that is classified with re occurring intense sexual urges and sexual fantasies that generally involve either nonhuman objects or physical suffering or humiliation of onesele or one's sexual partner, children or other non-consenting persons. The specific of this sexual disorder are described below:
Exhibitionism characterized by reoccurring intense sexual urges and sexual fantasies that involve the exposure of the person?s genitalia to a stranger. Sometimes the person masturbates while exposing himself to others or he fantasizing about exposing himself in front of a stranger.
Fetishism characterized by reoccurring intense sexual urges and sexual fantasies that involve the use of nonliving objects known as fetishes. Some of the common fetish objects are stockings, shoes, boots, bras, women's underpants or other clothes. The person with fetishism often masturbates while touching, rubbing, or smelling the fetish object or he may ask his partner to wear the specified object during sexual activities.
Frotteurism: characterised by reoccurring intense sexual urges and sexual fantasies that involve touching and rubbing one?s body against a non-consenting person. The act of touching and not the coercive nature of the act is sexually exciting to people who have this disorder. The person with Frotteurism usually satisfies his sexual needs in crowded places such as on busy sidewalks or in public transportation vehicles from which he can escape without being confronted or arrested.
Paedophilia is characterized by reoccurring intense sexual urges and sexual fantasies that involve sexual activity with a non sexually mature child. The age of children selected for this activity is between 6 ? 13 years. The age of the person affected by this disorder is usually set at age 16 years of age or older and the person is at least 5 years older than the victim.
Sexual Masochism is characterized by reoccurring, intense sexual urges and sexual fantasies that involve being humiliated while indulging in sexual activity. Some of the actions that affected people like include being beaten, walked upon or tied
Sexual Sadism is characterized by reoccurring intense sexual urges and sexual fantasies that involve sexual activity in which the partner is made to suffer psychologically or physically.
Transvestic Fetishism is characterized by reoccurring intense sexual urges and sexual fantasies that involve cross-dressing. Men that are affected by this disorder usually keep a collection of women's clothes that they periodically use to cross-dress when alone. While wearing female attire the man usually masturbates and imagines other men being attracted to him as a woman when wearing women?s clothes.
Voyeurism is characterized by reoccurring intense sexual urges and sexual fantasies that involve the act of observing unsuspecting strangers who are either naked in the process of removing their clothes or engaging in sexual activity. The act of looking also known as peeping is for the purpose of achieving sexual excitement and the person observing generally does not want any sexual activity with the people he is observing.
Sexual Intercourse
In United States most people experience sexual intercourse during their teenage years. Researches indicate that slightly more than half of women and nearly two-thirds of men have had intercourse before they turn 18 years old. In the last several years there have been significant increases in the number of adolescents who report sexual activity at each year of age and these increases have been greater for young women.
The first sexual intercourse experience is an important event in the lives of adolescents. The main two reasons early timing is given importance is because the younger the age of first sexual intercourse, the more the chances are that that the experience was forced sexual intercourse that has long lasting effects. The second reason is that the younger the age of first sexual intercourse the greater the chances are of unwanted pregnancies and sexually transmitted diseases.
There are strong effects of developmental characteristics like early puberty and high levels of testosterone which are associated with increased sexual behaviour in young adults. Unconventional attitudes and behaviours like early use of alcohol, tobacco and other harmful substances along with delinquency, school problems, and physical aggression are usually related with earlier onset of adolescent sexual intercourse. Marital disruption of parents and living with a single parent has also been found to be related with premature adolescent sexual behavior.
These findings reflect on a variety of factors that include lower family incomes, un safe neighborhoods, insufficient supervision, in adequate parental modelling, and more tolerable attitudes in families with single parents. Similarly, having sexually active siblings and friends is also related to adolescents indulging in premature sexual activity. If a child has educated parents, supportive family relationships, adequate parental supervision, sexually abstinent friends, good school grades and then he is more likely to have sex once he is an adult.
In addition to families and schools the neighbourhood also provide an environment through which the adolescent make a decision that is related to sexual activity. The effects of the environment he lives in such as the community economic base for men and labor market conditions for women, account for a substantial portion of the racial differences among Caucasians and African Americans in the timing of first sexual intercourse.
The following methods are usually used by teenagers to date: Group Dating - Many boys and girls go out together and time may be sent with couples or friends of the same sex. Group dating is usually best for adolescents because it takes stress off an adolescents first date as a couple.
Casual Dating - A couple go out once in a while with no commitment or name to the relationship. This gives adolescents a chance to date a few people before they realize who they are compatible with.
Serious Dating - The couple has a strong commitment to each other and neither member is expected to date another person.
Contraception
Effective contraceptive use usually requires planning and preparation before having sexual intercourse. Planning and preparation is usually a problem for most adolescents because most young adults do not plan for an intercourse to happen and it happens in the spur of the moment. Due to this condoms are usually used during the first intercourse but researches indicate that 35% of adolescents do not use any contraceptives at all.
Avoiding pregnancy after the first and unplanned sexual intercourse requires regular use of an effective contraceptive method. This can be especially problematic for young girls because young men and women tend to be less aware and worried about sexual problems compared to older people.
A major challenge to preventing pregnancies in young girls is the fact that so many adolescent girls seek contraceptives only after a few days or weeks and some seek contraceptives only after a few months of their first sexual intercourse.
According to researches most adolescents both boys and girls seek for contraceptives only after a year of becoming sexually active. Procrastination, not understanding that they could get pregnant or being ignorant about sex, contraception and pregnancy, and worrying about their secret from being disclosed are the reasons sexually active teenagers usually give for not seeking contraceptives sooner. Helping adolescents to plan for effective contraception before sex could be an important strategy for reducing unwanted pregnancies. After a while sexually active adolescents especially those in long-term couple relationships, use the pill.
The National Marriage Project
The National Marriage Project is a nonpartisan, nonsectarian and interdisciplinary initiative located at the State University of New Jersey in Rutgers. The project is financially supported by both the university and private co-operations. This project?s main mission is to provide data on the state of marriage in America and to educate people on the social, economic and cultural conditions that affect marital success and wellbeing.
The National Marriage Project has five goals:
The project is co-directed by two nationally prominent experts about families. The first expert is David Popenoe, Ph.D., a professor and former social and behavioral sciences dean at Rutgers who is the author of many scholarly and popular publications on marriage and family. The second expert is Barbara Dafoe Whitehead, Ph.D., an author and social critic, who writes mainly about issues of marriage, family and child wellbeing.
Social Indicators of Marital Health and Wellbeing
Trends of the Past Four Decades
Key Finding: Marriage trends in recent decades indicate that Americans have become less inclined to marry and recent researches show that the percentage of people likely to get married in USA continues to decline. Out of the people who are married there has been a moderate drop since the year 1970 in the rate of married couples who consider their marriages to be successful but in the past 10 years the number of happy couples has increased significantly.
The fact that Americans have become less inclined to marry is reflected in a steady decline of nearly 50 percent, from the year 1970 to the year 2004 as shown in figure one that represents the yearly number of marriages for every 1000 unmarried adult women. Other factors accounting for lesser people marrying are an increase of unmarried cohabitation and a small decrease in the inclination of divorced people to remarry. This decline also reflects some increase in increased single life, although the actual number cannot be determines until current young and middle-aged adults pass through the course of life.
The percentage of adults in USA who are currently married has also significantly diminished. Since the year 1960 the percentile decline of those married aged 15 and older has been 14% and over 29 % for African American women.
It is important to note that the reduced percentage of marriages does not imply that people have given up living with partners. On the contrary the percent of people living together without marrying has increased significantly. Many people these days are opting for live in relationships that allow the couple to stay together without opting for marriage. An even higher percentage of those divorced who later on remarry first opt for a live in relationship and an increasing number of people both young and old are living together with no plans for marriage.
There is a common belief that although a smaller percentage of Americans are now marrying as compared to a few decades ago those who marry these days have marriages of a higher quality. The main reason for this is that the people who are unhappy in marriages often seek divorce and the small percentages of people who remain married are happy. The best available resource on the topic, however contradicts these notions. Since the year 1973the General Social Survey periodically has asked a group of married Americans to rate their marriages as either "very happy," "pretty happy," or "not too happy as stated in figure 3. As Figure 4 indicates, the percentage of both married men and women stating that they are "very happy" has declined moderately over the past 25 years but this trend is now heading in a positive direction.
THE SURPRISING ECONOMIC BENEFITS OF MARRIAGE
While thinking of the many benefits of marriage, the economic aspects of marriage are often overlooked. The economic benefits of marriage are substantial both for married couples and for society as a whole. Marriage can be considered as a wealth generating institution since married couples create more economic assets on average compared to single people and couples who stay together without getting married. A study in 1992 related to retirement data derived that individuals who have remained single for a while have significantly lower wealth compared to individuals who have remained married throughout their lives. Compared to those that remained continuously married and those who never married the latter have a reduction in wealth of 75% and those who divorced and didn't remarry have a reduction of 73%.
One of the explanations for why marriage generates economic assets is because those people who are more likely to be financially stable are also more likely to marry and remain married. The institution of marriage in itself provides an economic bonus since it often costs lesser for two people to live together compared to two people living separately.
Another reason married couples are financially stable is because married couples save and invest more for the future and they usually serve as a small insurance pool against life uncertainties such as unemployment and illnesses. Men usually start earning more after they get married since according to society?s norms they need to support the family. Most married men earn between 10 and 40 percent more than single men earn with similar qualifications and job experiences. Other than all the benefits mentioned above couples also receive more work-related and government-provided support along with more help from friends and relatives.
Beyond the economic benefits of marriage for the married couples, marriage has a tremendous economic impact on society since marriage is a major contributor to family income levels and inequality. Between 1947 and 1977 it was noticed that family incomes had doubled in median families but in the last 20 years income has slowed increasing by just 9.6%. The main reason for this decline is that married couples have been a rapidly decreasing proportion of total families. In this same 20 year period, mainly because of changes in family structure, in equal distribution of family income has increased significantly.
Researches have shown consistently that divorce and unplanned pregnancies before marriage have increased child poverty. In recent years the majority of children who are not part of married families have experienced at least one year of extreme poverty. According to one particular study, if family structure had not changed between the years 1960 and 1998, the African American child poverty rate in the year1998 would have been 28.4% instead of 45.6%, and the Caucasian child poverty rate would have been 11.4% instead of 15.4%. The rise in child poverty also causes a significant increase in public costs in health and welfare programs.
Marriages that end in divorce are also very costly to society. One researcher determined that a single divorce costs both the federal and state governments about $30,000, due to things such as the higher use of food stamps, an increase in public housing as well as increased bankruptcies and juvenile delinquency. The 1.4 million divorces in the year 2002 in USA are estimated to have cost the taxpayers more than $30 billion.
DIVORCE
Key Finding: The American divorce rate today is almost double compared to 1960, but this rate has declined slightly since reaching the highest point in the early 1980s. For the average couple marrying in the recent years the possibility of divorce or separation remains between 40 and 50 percent.
Although the long-term trend in divorce has increased since colonial times, the divorce rate did not change for about two decades after World War II during the period of the baby boom. By 1960s the percentage of divorces started to increase again and the rate increased by more than double over the next fifteen years to reach an historical high point in the early 1980s. Since then the divorce rate has significantly declined, a trend that is described by many experts as levelling off at a high level. This sudden decline represents a slight increase in marital stability and two possible reasons for this are an increase in the age at which people marry for the first time, and a higher educational level of getting married, both of which caused stability.
Although majority of divorced people eventually remarry the increase of percentage of divorces has led to a steep increase in the percentage of all adults who are currently divorced. The percentage of divorce which was only 1.8 percent for men and 2.6 percent for women in the year 1960 increased four times by the year 2000. This research indicated that the percentage of divorced is higher for women than for men mainly because divorced men are more likely to remarry compared to divorced women. Another reason is that divorced men are more likely to remarry sooner than divorced women.
Overall the possibility remains estimated between 40 and 50 percent-that a marriage started in recent years will end in either divorce or separation before one of the partner dies. The likelihood of divorce has changed considerably over time among different segments of the American population, being higher for African Americans compared to Caucasians but these variations have been reducing. The trend toward a greater similarity of divorce rates between African Americans and Caucasians is largely attributable to the fact that fewer African Americans are marrying.
At the same time, there has been little change in such traditionally large divorce percentage differences as between those who marry when they are less than 18 compared to those who marry after age 21, high-school drop outs compared tocollege graduates, and the non-religious compared to the religiously committed. Teenagers who are high-school drop outs and the non-religious who marry have considerably higher divorce rates tend to have a higher rate of divorce.
YOUR CHANCES OF DIVORCE MAY BE MUCH LOWER THAN YOU THINK
Most people are aware that the national divorce rate is close to 50% and while this is true it is important to keep in mind that this divorce rate depends on many factors.
An important factor that determines if the marriage will be a success or end up in divorce is the background characteristic of the people getting married. Here is a table that displays decreases in the risk of divorce or separation during the first ten years of marriage, depending on various personal and social factors
Hence it can be said that people who are well educated, have a good income, come from an intact family, have religious beliefs and marry after the age of 25 without having a baby after marriage are more likely to succeed at marriages.
As mentioned above there are various factors to be taken into account while assuming that the rate of divorce is 50 percent. One of these factors is that the percentile of 50% was taken for that current year and it includes deaths of spouses. Divorce rates have actually has been dropping slowly after they reached a peak around 1980, and experts say that the divorce rate could even be lower in the future than it is today.
The table shown below elaborates on the number of divorces in the past few years for married women older than 15 years.
UNMARRIED COHABITATION
The number of un married couples living together has significantly increased in the last 4 decades and a significant number of younger Americans now live together outside of marriage, and living together without being married commonly precedes marriage.
Between the years 1960 and 2004 the number of unmarried couples in America increased by nearly 1200 percent. Unmarried cohabitation of couples who are sexual partners but not married to each other and sharing a living arrangement is particularly common among the young. It is estimated that about one quarter of unmarried women between the ages of 25 to 39 are currently living with a male or partner and in additional another quarter of women have lived with a partner in the past. According to statistics more than 50% of first marriages are now preceded by living together compared to virtually none 50 years ago.
For many living together with a sexually active partner is a step before marriage but for others this is simply an alternative to living alone, and for a small but increasing number of people it is considered as an alternative to marriage. Living together before marriage is more common among those of lower educational and lower income levels. Recent data show that among women in the 19 to 44 age range out of which 60 percent of high school dropouts have lived together before marriage compared to 37 percent of college graduates who prefer marriage. Living together before marriage is also more common among those who are less religious than others, those of whom have been divorced, and those who have in the past experienced parental divorce, lived without a father or experienced high levels of marital problems during childhood. A growing percentage of live in relationship households now over 40 percent contains children.
The belief that living together before marriage is the best way to find out whether the couple can adjust with each other and thus avoid a bad marriage or eventual a divorce is now widespread among young people. Contrary to this belief the available data on the effects of living together before marriage does not confirm this belief and in reality there is substantial evidence indicating that those who live together before marriage are more likely to get divorced after marriage. This evidence is controversial mainly because it is difficult to differentiate the selection effect from the experience of living together before marriage. The selection effect refers to the fact that people who live together before marriage have different characteristics from those who do not, and it is possible that these specific characteristics and not the experience of living together that leads to marital problems. In addition, a recent study based on a nationally-representative sample of women suggested that living together with a sexually active partner when limited to a woman's future husband, is not associated with an increased risk of marital problems. As of now it can be concluded that there is no strong evidence that those who live together before marriage have stronger marriages than those who do not.
LOSS OF CHILD CENTEREDNESS
Key Finding: The presence of children in America has significantly reduces since the year 1960 compared to fertility rates and the percentage of families with children. Researches suggest that this decline has reduced the child centeredness of USA as a country and also contributed to the weakening of the institution of marriage.
In the past marriage has first and foremost been an institution for procreation and raising children and it has provided the cultural tie that held the father to the mother-child bond. In the recent past children increasingly have been pushed aside and families now do not consider the child as the glue that keeps parents together.
Americans on average have been having fewer children as compared to the past. It is important to note that fertility problems have been gradually increasing throughout American history, reaching an all time high in the Great Depression of the 1930s before suddenly reducing with the baby-boom generation starting in 1945. By the year 1960 the birth rates were back to where it had been in the year 1920, with the average woman giving birth to three and one half children over the course of her life. Since 1960 the birth rates have decreased rapidly although it increased for some time in the 1980s and again in the late 1990s.
Since the year 2000 the birth rates have been reducing significantly and in the year 2003, the latest year for which there is adequate information available for the American total fertility rate was at 2.044 that is significantly below the level in the year 1999 and slightly above two children per woman. This rate is also below the level of replacement at 2.1 which is the level at which the population would be replenished through births alone, but this is still one of the highest rates found today in modern societies. In many European and Asian nations the total fertility rate has below the level of United States and in some countries the rate is currently at one child per woman. Some observers believe that the birth rate in United States will reduce even more in future decades to become more like that of Europe today.
The significant long-term decline of birth rate has marked an effect on the families of the American population. It is estimated that in the mid 1800s more than 75 percent of all families had children under the age of 18 but in 1960 this number dropped to slightly less than half of all families. In the year 2000 just 40 years later, less than 33 percent of families included children, and the percentage is said to drop to 28 by 2010. This means that adults are less likely to be living with children and that neighbourhoods are less likely to contain children. This also means that children are less likely to be a consideration in daily life. This suggests that the needs and concerns of children-especially young children-gradually may be reduced from our national consciousness.
Several experts determined that in the year 1960 the proportion of one's life spent living with a spouse and child was 62 percent that is the highest in our history. By that year the death rate had reduced significantly which means that fewer marriages ended through the death of a partner, and the divorce revolution of recent decades had not yet started. By the year 1985, however, that is 25 years later the proportion of one's life spent with spouse and children reduced to 43 percent which was the lowest in our history. This significant drop was caused mainly by the decline of fertility and the weakening of marriage through divorce pregnancies before marriage.
In a recent cross-national comparison of industrialized nations, United States ranked at the top in the percentage disagreeing with the statement that the main purpose of marriage is having children. Nearly 70 percent of Americans now believe the main purpose of marriage is something else compared to just 51 percent of Norwegians or 45 percent of Italians. Consistent with this view is a dramatic change in the view that children are important to keep parents together. In a Detroit area sample of women answered no to the question "Should a couple stay together for the sake of the children?" increased from 51 percent to 82 percent between the years 1962 and 1985. A nationally-representative 1994 ssurvey found only 15 percent of the population agreed that when there are children present in the family, parents should stay together even if they don't get along.
A careful analysis of divorce statistics suggests that starting around 1975, the presence of children in a marriage has become only a very minor inhibitor of divorce and this also depends on the sex of the child.
WHAT'S HAPPENING TO CHILD-REARING FAMILIES?
Experts are now unanimously agreeing that the best family situation for children and adolescents is to live with married parents who have a strong marriage. Unfortunately, the percentage of families that have children with these characteristics has dropped significantly in the last few decades. In the 1973-1976 period 51% of children under the age of eighteen were living with married adults that were happily married. By the 1997-2002 period this percentage dropped to 37%. This sudden drop is the result of two trends that is fewer children living in families headed by married couples and a drop over time in the marital bond of those couples.
Several reasons for this deterioration in children's family situation are troublesome. One of the main reasons is that Americans are these days viewing marriage and child rearing as separate tasks. An example of this is an agreement among never-married young people between ages 18-34 that state those who want children should get married. In national surveys conducted it was suggested that 64% of the males in this category agreed that children are important in 1988, but only 51% agreed in 2002. For women the drop was slightly more, from an original 56% to 42% in 2002. In an annual reporting of the family life opinions of American high school seniors a significant increase has been in relation to the statement that having a child without being first married is experimenting with a worthwhile lifestyle and not affecting anyone else. More than half of senior boys now agree with this statement and an increase from 49% in the late 1990s even with the percentage of senior girls who agree.
A second reason for families not having children these days is that children seem to be a growing reason for the decline of happiness in marriages. Many studies have shown that after the arrival of the first baby mother and father are being pushed apart bringing stress to the marriage. One recent review of more than 100 researches found that parents report significantly lower marital happiness than non married parents. This is especially true for parents of infants since only 38% of mothers of infants are happy compared to 62% of childless women. This review also concluded that the effect of parenthood on marital happiness is even worse among younger birth cohorts along with higher socioeconomic groups and there are signs that the negative effect may be on the increase.
FRAGILE FAMILIES WITH CHILDREN
Key Finding: The number of children that have up in fatherless-families has grown significantly over the past four decades. This is primarily due to increases in divorce, pregnancies before marriage and couples living together before marriage. The trend toward fragile families reduced in the late 1990s, but the most recent data shows a slight increase.
There is now enough evidence to suggest that strong, steady and happy marriages are very important for the wellbeing of adults. These marriages are even more important for the proper upbringing and overall wellbeing of young children. The main purpose of the institution of marriage is to ensure that the responsible and long-term involvement of both biological parents in the difficult and time-consuming task is of taking care of the next generation.
The increasing trend of single-parent families is by large the most important of the recent family trends that have significantly adversely affected children and adolescents. This trend has adversely affected children because the children in such families have negative life outcomes twice or thrice the rate compared to children in married two-parent families. While in the year 1960 only 9% of all children lived with only one parent, a figure that had hardly changed over the course of the 20th century, by the year 2004 this percentage had increased to an alarming 28 percent. The majority of single-parent families are mothers only although the percentage of single parent families with only fathers has recently grown to about 18 percent.
An indirect indicator of unsteady families is the decreasing percentage of children under age 18 living with two parents. Since the year 1960 this percentage has declined significantly, by 20 percentile points. Unfortunately, this measure makes no distinction between biological families and stepfamilies. Additionally, it is estimated that out of the percentage mentioned above 88 percent of families with both parents consist of both biological parents, while nine percent are stepfamilies. According to a substantial and growing body of social science evidence, children that live in step families do not fare any better in life than children living in single-parent families. Data on stepfamilies probably are more reasonably combined with single-parent compared to with biological families with two parents. An important indicator that helps to resolve this problem is the percentage of children who do not live with their biological fathers has doubled since 1960, from a mere 17 percent to an increased 34 percent.
The significant shift in the basic family structure indicated by the measures mentioned above has been created mainly by three trends that are divorce, pregnancies without marriage, and living together without being married. The incidence of divorce began to increase rapidly during the 1960s. The number of children under the age of 18 that were affected by parental divorce each year, most of whom have lost a resident father, increased from less than 500,000 in the year 1960 to more than a million in the year 1975. After reaching an all time increase around 1980 the numbers stopped increasing and remained close to a million new children every year. Much of the reason for this leveling off is a reduction in the average family size and each divorce that occurs these days typically affect a smaller number of children compared to the past.
The second reason for the shift in family structure is an increase in the percentage of babies born to mothers that have not been married which suddenly and unexpectedly began to increase very fast in the 1970s. Since the year 1960, the percentage of babies born to these mothers has increased more than six fold times. Additionally surveys indicate that more than a third of all new births and more African American unwed births reduced slightly in the late 1990s, but now the numbers have started to increase again.
A third and a recent family trend that has affected family structure is the quick growth of living together without marriage Especially as living together has become common among those previously married as well and the young that have not-yet-married there has been over 900 percent increase in the number of couples living together who live with children. Researches also indicate that 40 percent of all children are expected live with parents that are not married during their growing up years.
In the year 2000 approximately 40 percent of unmarried parent households included one or more children under the age of 18. For unmarried couples between the ages of 25 to 34 the percentage with children is still higher, reaching nearly 50%. Seventy percent of the children living with parents that are not married are the children of only one partner. If cohabitation of stepfamily is also included then almost one half of stepfamilies these days would consist of a one biological parent and one unrelated cohabiting partner.
Surveys also indicate that children who grow up with parents who live together without being married tend to have worse life outcomes compared to those children growing up with married parents. Prominent reasons for this conclusion are that couples that live together without being married have a much higher breakup rate compared to married couples. Also partners that live together without marriage have a lower level of household income along with a higher level of child abuse and domestic violence. The percentage of cohabiting mothers that eventually marry the fathers of their children is significantly declining to 44 percent in 1997 from a comparatively higher rate of 57 percent 10 years earlier.
TEEN ATTITUDES ABOUT MARRIAGE AND FAMILY
Key Finding: Since the last few decades? teenagers of both sexes now desire good marriages a little more than before. Girl teenagers desire good marriages 10 percent more than boys and boys are also a little more pessimistic about the possibility of a long-term marriage. Both boys and girls are now more accepting of lifestyles that are alternatives to marriage like children outside of marriage although the latest data show a surprising drop in acceptance of living together before marriage.
To understand what the future may have in store for marriages as an institution it is important to determine what our nation's youth now say, think about marriages and how their views have changed over time. It has become important to determine if these developments of the divorce revolution going to continue the family ways of their parents or might there be a cultural counter-revolution among teenagers that could lead to a change in current family trends?
Since the year 1976 a nationally representative survey of high school seniors known as Monitoring the Future that is conducted annually by the Institute for Social Research has asked teenagers numerous questions about family-related topics. Based on these youth centred survey, the percentage of male and female teenagers who stated that having a good marriage and family life was significantly important to them has increased by a few percentage over the last few years. Eighty-two percent of young women stated this belief in the latest survey while young men lagging behind at 70 percent.
Other data from the same survey shows a moderate increase in the percentage of young adults who said that they expect to marry or have already married recently with 84 percent for young women and 78 percent for young men. Among teenagers, young men are a little more pessimistic than young women in the belief that their marriage with a single partner will last a lifetime. However, this difference has reduced significantly and since 1986 to 1990 the trend has been slightly more optimistic.
There is also widespread acceptance by teenagers of non-marital lifestyles like living together without getting married. An instance of this is the agreement with the proposition that states ?most people will have fuller and happier lives if they choose to get legally marriage rather than staying single or living with a partner without marriage. Less than one third of young women and only slightly more than one third of the young men answered that marriage is more beneficial to individuals compared to various alternatives. These answers are however contrary to the available undeniable evidence which indicates that there are personal gains to getting married as well as social benefits of being married compared to staying single or just living with someone without getting legally married.
In the past few decades people have become more acceptant of the fact that pregnancies can occur out of marriages and while in 1970s young women tended to be more traditional than young men on this delicate issue, now young women are slightly less so. With more than 50 percent of teenagers now accepting pregnancies before marriage or out of marriage as a worthwhile lifestyle, the others yet do not seem to agree with the suggested economic, social and personal costs of single parenthood.
More than 50% teenagers also state that living together without getting married is a worthwhile alternative. In this issue young women currently remain more traditional than young men however recently the trend to live together without being married has taken an unexpected reversal for both young men and women. This may be an indication that teenagers are more aware of the evidence that has been widely publicized in recent years, linking living with a sexual partner before marriage to a higher divorce risk.
In conclusion it can be said that marriage and family life remains very important for today's teenagers but at the same time young adults also accept other non-marital lifestyles. As of now there are no strong signs of a generational shift that could lead to a reversal of recent family trends, but some data from the past few years suggests that the views of teenagers are, with the exception of pregnancies before marriage moving in a more conservative direction.
Time to Have a Child
The decision when to have a child is one of the most important decisions two people can make. Due to many scientific advances, this particular decision is one that has more dimensions than evident. It is possible for couples now to decide when to begin a family, the size of their family, or whether to have a child or not. Hence if a couple is planning to have a child then they have the luxury as well as the additional responsibility to consider and discuss the various things involved in being a parent. This will assist couples who are considering having a child to discuss or try to resolve problems before the birth of their child and to identify resources that a couple can use so to their advantage to help them with such questions.
Initial Considerations
Do We Want to Have Children?
The first question a couple has to answer is if they want to or do not want to have children. Not having children is an option that has not always been available to couples. In the past it was always assumed that if a couple married then they were also going to have children. These days however there is an alternative of not having children at all. While some people and experts argue that the decision not to have children is selfish, many others believe that the decision to have children is of such importance and responsibility that people should not be forced to have children if they can?t fulfil the responsibility involved. Similarly, the decision to remain childless is becoming more accepted due to neglect, abuse, and violence in the world - and the way children are often victims of such social ills. Due to these factors some couples may decide that they would like to help society through other roles like vocation, religion, volunteering and mentoring.
We Want Children, But When?
If a couple decides together that they do want to have children then the next decision often concerns the time when to have children. Due to the many advances in the field of gynaecology and obstetrics along with pharmacy, it is now possible to time conception. Before deciding when to have a child partners need to consider the state of their relationship, their financial status, their work goals or demands, their respective ages and their overall level of functioning. Some questions that need to be answered include why are both partners seeking to have a child at this particular time, can they partners afford a child, how is the health of both partners and are both partners content with their educational level or are one or both of the partners planning to return to school for additional training sometime in the future? Furthermore it is important to discuss what are the fears and dreams of each partner in relation to being a parent?
Having children can definitely be a wonderful, exciting and significant time in a couple's life but at the same time it can also cause additional stress physically, emotionally, and financially. Children can be a source of happiness but the decision to have children should not be based on an attempt to make a marriage stronger since even the strongest of marriages can get tested during pregnancy and the years to come.
We Want Children, But How Many?
A couple now has more choices regarding how many children they will be comfortable raising and how many children the couple can take care of without feeling burdened. Many partners look to their own family of birth as a way to decide the number of children to have. An instance of this would be if one partner may have been an only child and seeks the same in his or her own family or that the same partner may have always wished that he or she had a sibling to grow up with and thus may or may not wish to have more than one child. Hence, it is important for both partners to discuss a possible preference of the number of children to have and also be able to identify and share their reasons for their decision.
Couples benefit from also discussing whether or not prefer a male child or a female child and if the sex of the child will influence the decision to have more children. An instance of this would be a couple who had decided to have two children may have assumed that they would have a child of each sex. However, if this same couple then has 2 daughters or 2 sons, then one or both partners may then decide that they would like to have a third child of the other sex.
Before having a child it is important to consider and discuss the reasons behind each partner's opinions and needs. Things that should be discussed include what are the benefits of having a child as well as the additional stressors related to additional children and the various reasons behind each partner's beliefs? Financial factors as well as cultural and religious factors need to be considered and also each partner's mental and physical health along with their intrapersonal needs, dreams, and fears.
Child Care Decisions
Other important and more specific issues that need to be discussed include, which partner is going to stay home and take care of the new baby, will one partner be forced to feel as if he or she is sacrificing his or her career to take care of the baby? Couples may decide to share the responsibility equally or maybe one partner may decide to take on more responsibility compared to the other partner. Couples may even decide to hire someone to take care of their child such as a nanny. When considering the option to hire a nanny the partners will need to spend some time to consider how comfortable each of them are with this and why. For instance how partners will resolve possible feelings of guilt or neglect and how both partners might later feel if both of them did not stay at home with the child?
These questions are structured not as a way to create guilt, but rather to help the couple understand consideration of likely feelings that may occur due to the society's continued belief that a child does best only when cared for by a parent, and the child does just okay when cared for by someone else.
Thus, regardless of a couple's eventual decision as to who a parent, grandparent, friend, nanny, or public day care shall care for their child and for the period of time someone else will take care of the child, the couple still needs to work together to understand ways to avoid current as well as potentially future concerns. In addition, such child care decisions must also include consideration of the amount of time the couple is going to spend together. Some couples need a lot of time together while others need a little. The couple will also have to decide how the couple will plan for time alone. Will they hire a sitter one night a week so as to ensure some much needed alone time or will they ask their friends or family to baby sit their child while the couple goes away for a few hours? Couples benefit from being creative about making time for each other as couple-time is very hard to get without thinking of solutions beforehand.
Financial Considerations
Children can also place a financial burden on parents and this is often not thought out clearly before having children. Couples need to decide how much they can spend on children without feeling burdened and they need to ask each other the following questions: Will we need to give up on certain luxuries so that we have enough money to raise the child and if yes then what are the luxuries that we are willing to sacrifice?
Other Feelings
Feelings of jealousy may appear with the birth of a child and this occurs when the parents have had lots of time for each other but after the birth of a first child that one or both the parents get involved in child care. It is important for new parents to inform each other if they feel that they are being left out, and if they are feeling resentful due to spending a lot of time taking care of the new born.
Expectations of Child
Parents at times have different expectations or goals for their children and this causes problems between parents. This topic is something very few parents sit down and think about when planning children, yet it is crucial for partners to discuss their thoughts of such expectations. While discussing about expectations the parents should include areas of concern such as religious affiliation, academic expectations, schooling preferences such as private or public school, vocational school or college and social behaviors like introvert or extrovert. Discussion of these areas of concern is necessary to identify where differences in expectations lie and after identification differences parents can discuss about their reasons for such expectations and work together to reach a middle ground.
Rearing Children
Parents may also differ in their ideas on the upbringing of children. One parent may tend to be very lenient or permissive and comfortable in having the children play without restrictions while the other parent might become uptight or anxious with this parenting approach and he or she may prefer an authoritarian approach of parenting in which there are set limits and boundaries for the child. While setting limit and boundaries, there are many different approaches and the approach the parents choose is probably not as important compared to if the parents are or are not consistently use the same parenting approach. Before planning for children parents will need discuss the things mentioned and arrive at some mutually decision if there a lot of differences between them.
Teenage Pregnancy
For several decades, there have been increasing concerns about adolescent sexual behavior, along with pregnancy, and parenthood. These concerns have been triggered by several realizations such as rates of adolescent births in the United States are much higher from 10% to 50% higher than in other industrialized societies. Another reason for an increasing concern of adolescent pregnancy and birth is that majority of adolescents do not want to become parents at this age.
There is also an increasing concern about adolescent sexual intercourse because it leads to unintended pregnancy and parenthood and because sexually active adolescents are at a risk of getting of sexually transmitted infections and along with the human immunodeficiency virus (HIV).
Finally, initial sexual experiences for women are often forced upon and before the age of 5, a majority of first intercourse experiences for teenage girls are reported to be non-voluntary. Coercion not only causes mental problems but it is also associated with poor protection from pregnancy and sexually transmitted infections.
The process leading to teenage pregnancy involves a series of events such as sexual intercourse, use of contraception devices, pregnancy, and pregnancy resolution. Interventions can be implemented at any one of these stages. The initial and main risk behavior for adolescent pregnancy and teenage parenthood is indulging in sexual intercourse, including the frequency of sexual intercourse. Among sexually active adolescents, the severity of pregnancy risks depends largely on their frequency of intercourse and the type along with the consistency of contraceptive usage. Sexually active adolescents who do not always use contraceptives have a higher risk of becoming pregnant and they also have to face a potentially life altering decision about resolving their pregnancy through techniques such as abortion, adoption, or admitting to parenthood.
Pregnancy Resolution
When adolescents become pregnant before marriage due to not using contraceptives then they face several difficult choices. Due to their young age and the future implications of these choices various people play an important role in teenage pregnancies. At times relatives decide what has to be done and at times partners and friends would be expected to play an important role in adolescent pregnancy related problems. Abortion is the most likely outcome when a female adolescent who is pregnant has poor relationships with her partner who impregnated her. As of now only about two percent of premarital births are given up for adoption. Decisions about abortion or adoption and parenthood are influenced not only by the adolescent?s perceptions of their families and friends opinions but also by opportunities given by his or her communities. An instance of this would be better employment opportunities are found to be associated with a lower probability of childbearing. Adolescents who opt for adoption usually are from higher socioeconomic backgrounds and they have done well in school hence they have higher educational aspirations. Usually adolescents from more advantaged families and communities are more likely to terminate the pregnancy since such adolescents have attainable future plans that they do not want to give up.
Prevention
For the last 20 years varied approaches to prevention and intervention have been tried in United States. There are several points at which interventions and preventive programs can be started. Interventions are used to try to delay the initiation of sexual activity, to improve the knowledge of contraceptive use among sexually active adolescents, to help with pregnancy resolutions among those who become pregnant and to reduce or delay births out of marriages. Some programs are indirect and they focus on issues that suggest that adolescents who perceive better educational, occupational, and economic opportunities for themselves will decide to postpone parenthood. Prevention programs are often part of schools curriculum because students are accessible and can be made to understand at this stage however, many effective programs are also based in clinics and agencies and sometimes they are based in religious institutions such as churches and are provided directly to families. Some prevention programs are also embedded in a community wide intervention context that includes all of the techniques mentioned above.
Unfortunately, none of the programs have had much of an impact on young adults. It is unclear why many programs are effective and why certain programs fail. Some programs appear to be effective, but more often most programs have not shown any noticeable effects.
Family life or sex education in the public schools which has consisted mainly of providing information based on facts at the secondary school level is the most general and persuasive approach to preventing pregnancy among adolescents. The effects of sex education in the public schools continue to be widely debated however recent perspectives state that school sex education is wrong or has simply failed but some people also believe that too little is being provided often too late. Data proves that traditional sex education that is being offered in United States increases sexual knowledge of teenagers but it has little or no effect on the decision of teens to delay sex or use contraception. Quite surprisingly, traditional school sex education is found to be unrelated to adolescent pregnancies and the most consistent finding is that sex education does not cause adolescents to initiate sex if they did not plan to do so already.
School-based clinics which typically provide comprehensive adolescent health services but may or may not provide contraceptive services have not shown any convincing evidence of success at reducing teenage pregnancies. In addition, school-based programs do not reach older non-teen partners or school dropouts that would have benefited from sex education.
Another limit of current interventions is the lack of attention to educate young men. The majority of interventions are for young women and these interventions either fail to include young men in the intervention or fail to consider the role of young men in teen pregnancy. In addition, sexual coercion has been linked with early sexual activity among teenage girls however few programs take this fact into account while designing interventions. It can be stated that it is difficult to prevent pregnancy by increasing a young girl?s knowledge and motivation to prevent pregnancy if the young girl is becoming pregnant due to of a non-voluntary sexual experience.
HIV/AIDS overview
AIDS is an acronym for acquired immune deficiency syndrome and this disease slowly destroys the body's immune system. Without the body?s natural defences a person with AIDS can't fight off germs, infections and disease like cancers. HIV is the virus that causes AIDS and this harmful virus kills an important kind of blood cell like the CD4 T lymphocyte also known as the T cell. These T cells are very important parts of the immune system and as these cells die the body becomes more vulnerable to a large number of diseases. Germs take this opportunity to invade the body and the various diseases they cause are called opportunistic infections. When people with HIV get these dangerous infections or when their T-cell levels goes below normal they have AIDS.
Usually it takes half a decade or more for HIV to weaken the body's immune system to the point where the T cells go below count and cause AIDS. HIV may not cause symptoms until 10 or more years or it can even longer than that for damage to the white blood cells to show up. White blood cells are very important since they are part of the body's immune defence against external germs that cause infections and illnesses. The virus, HIV causes certain white blood cells to become weak or die which causes the body to becomes immuno-deficient. That means that the body is no longer capable of fighting off infection. This stage of the illness is called Immuno-deficiency Syndrome and this syndrome is acquired since there are originally nothing wrong with the immune system. This is why the disease caused by the virus, HIV is called the Acquired Immuno-Deficiency Syndrome or AIDS. It is possible for a person to be infected with HIV and not have AIDS and this occurs when the person hasthe virus but the white cells cells have not been severely damaged and the immune system is not yet compromised.
Anti-HIV drugs help prevent the body?s immune system to die completely. Even when a person already has AIDS these drugs can prevent any serious illnesses and in certain cases they can even help the person get better. Anti-HIV drugs let many people with HIV infection live healthy or normal lives. Combinations of various powerful anti HIV medicines work very well, but at times there are serious side effects, such as vomiting, diarrhea, and fatigue. People with HIV have to keep taking these drugs every day for the rest of their lives and people who have AIDS often state that it's best to avoid getting HIV in the first place.
AIDS is a worldwide epidemic and while most cases are in Africa this disease is also spreading widely in Eastern Europe and Asia. If a cure was found for AIDS sometime in the future, this disease will still be the most deadly disease ever to plague mankind.
HIV is the most feared sexually transmitted disease because there is no known cure for it and it can cause premature death. Many patients who have AIDS die because their immune system was compromised and their bodies were unable to fight off severe infections.
What Causes It?
HIV is the human immunodeficiency virus that causes AIDS. HIV is an infection that lasts for the person?s life time. There is no cure to this illness but anti-HIV drugs keep HIV in check. Unfortunately, 95% of the world's HIV infected people cannot afford these expensive medicines.
There are a minority group of people that state that HIV does not cause AIDS. Some of these people are scientists but none of them are experts on the subject of AIDS. Overwhelming medical and scientific evidence shows that HIV is responsible for causing AIDS and every major health organization in the world says that HIV is a serious hazard to humans.
Babies and children can also get infected with the HIV virus if they come in contact with vaginal fluids or blood that is infected with HIV. This infection usually occurs during or before birth. Babies can also contract HIV by HIV infected breast milk and additionally children in USA can also be infected by the HIV virus by having a blood transfusion prior to 1985.
A baby born to an HIV positive woman will test positive for the HIV antibody since the mother passes her antibodies to the child which includes the antibodies for. Babies that have these antibodies may not be infected with the HIV virus however theses antibodies will induce a positive HIV test. The baby who has these antibodies will need to be tested over a period of time until he or she reaches the age of 24 months. At this age the baby will lose the mother?s antibodies but usually most children lose the mother?s antibodies by 15 months of age.
Babies and children with HIV disease can suffer from one or many of the following symptoms:
The medications that have resulted in many people living longer and healthier lives also has a direct impact on daily eating habits. Certain HIV medications need to be taken on an empty stomach where as certain medications need to be taken after meals. In order to get maximum benefit from these medications the person has to follow the instructions and has to take the medicines as directed.
Weight loss has known to be a problem with HIV hence people who have this infection must also eat good quality good that is rich in calories so that they do not feel weak or tired.
After Infection
Soon after being infected with HIV the body makes antibodies to fight the virus. The HIV test does not look for the virus in the body, but it looks for antibodies in the blood. Most people do not have enough antibodies in 3 months or lesser hence it is important to take the test every few months up to a year from the date of the infection.
HIV Testing
HIV Antibody Negative
Give the test results promptly. If you are giving new information then wait for the patient to first absorb the fact that he is HIV negative. Allow the patient some time to adjust to the new situation and plenty of time for supportive counselling for the patient's personal concerns. Finally move on to education and counselling about being HIV negative and to practice safe sex or no needle sharing to avoid HIV in the future. Information can be given in the form of printed booklets in the same session.
What the HIV antibody test looked for: Antibodies the body built against for HIV, not the virus itself Evidence of infection contracted more than 3 ? 6 months ago
HIV Positive Test Result
Give results promptly and do not offer information immediately. Do not expect people to take in or fully comprehend new information after they have immediately heard that they are infected. Give the patient enough time for supportive counselling about feelings after the patient suggests he needs emotional support. Information should be given in the form of printed booklets in the next appointment and not immediately. Make a return appointment or referral for ongoing counselling and care. Be sure that the patient has a reasonable plan of action such as where to go when they leave you and whom to inform before she/he leaves your office.
What a positive HIV antibody test means
Under rare circumstances the patient's test result may show as positive even though he or she is not infected with HIV. The chance of a false positive test result is usually less than 1 in 1000 people but the best way to be sure is to get re-tested using a different testing laboratory.
Things to Remember:
AIDS symptoms may not show up until months or years after the virus enters the body. Many people have the virus and do not display symptoms hence it is important to be vigilant for any new symptoms. Some symptoms of AIDS include but are not limited to high fever, night sweats and swollen lymph glands. These symptoms can show up anywhere from 4 weeks to several months after the immune system is compromised. These symptoms can last for a month or so and often then they will go away. These early symptoms are not present in all cases and since most of these symptoms resemble the flu many people may experience these symptoms without thinking that it may be anything more than the flu.
Kaposi's Sarcoma
The immune system helps protect our bodies from certain types of cancers and when a person has AIDS their body is unable to fight off such cancers. One type of cancer that an AIDS patient can contract is Kaposi's Sarcoma. This type of cancer affects not only the skin but also other body organs. Symptoms of this cancer include markings that look like bruises or black and blue marks and these markings do not go away on their own. This type of cancer has been a leading cause of death among AIDS clients.
Treatment
Treatment includes a combination of AIDS drugs. These drugs can prevent people from HIV from getting AIDS.
It is important to remember that not all of these drugs work for each and every one. It's absolutely essential to take the drugs at the right time of day and every single day for maximum benefits. Due to the drugs' side effects or due to being preoccupied with another task people may not take the drugs at the right time and this can be very harmful. Treatment for HIV or AIDS must be planned and adjusted for every individual person affected by this virus. Medical professionals agrees that starting aggressive treatment in the early days after infection that is the stage of acute HIV infection is most effective but most people don't find out they have HIV until the stage of chronic HIV infection that is when the virus has a firm hold on the body. Most AIDS/HIV experts now recommend holding starting treatment only when the patient?s immune system starts to fail and this decision is based on the CD4 T-cell count that is the best measure of HIV disease. Another factor is the amount of the viris in the blood that is the measure called viral load.
When treatment begins the decision of choosing the right anti-HIV drugs is crucial. Certain new tests can tell which drugs will work best on the HIV infecting an individual patient.
There are several types of anti-HIV drugs to prevent the early onset of AIDS. Because HIV mutates so quickly this virus is able to resist any single treatment and that's why doctors use combinations or cocktails of anti-HIV drugs. By using a combination of Anti Retro HIV drugs the patient increases his chances of fighting the virus. Over time, even this strategy isn't always enough, and resistant to multiple drugs may appear. At this point, a doctor will switch to another drug combination. While there are many AIDS drugs, the possibilities are not endless. Researchers are working hard to find new ways to treat clients who have run through several different combination treatments. The different types of anti-HIV drugs each target a different aspect of HIV's life cycle:
HIV has to get into a T cell to start infecting the immune system. This virus has to latch on to the cell and then it has to fuse its own outer membrane to that of the cell. Drugs to stop this process are called attachment inhibitors. These drugs are also called fusion inhibitors and these new drugs are still being tested in humans.
The virus?s main goal is to overrun T cells genetic machinery. This is done by the virus by first joining with a cell and then splitting its genetic material into the cell. The genetic code of the HIV (virus) is written in a form called RNA but in humans the genetic code is written in DNA. The virus solves this issue by making an enzyme named reverse transcriptase that converts the virus?s RNA into DNA. AIDS drugs called RT inhibitors work by tricking HIV into making defective and useless reverse transcriptase out of raw materials. Another class that is the non-nucleoside RT inhibitors that basically gum up reverse transcriptase so they do not work effectively. Several RT inhibitors and Non Nucleoside RT inhibitors are now in use.
HIV has to snip apart the cell's DNA to put its own DNA in and then stick back the DNA strand back together. The method the virus uses to complete this process is called integrase. Human tests for integrase inhibitors began in 2001.
Once HIV has taken over a cell's genetic material, it gets the cell to reproduce from which a new virus is made. These pieces have to be exactly the right size and that's what HIV's protease enzyme does. Several protease inhibitors known as PIs are now available in the market.
Another approach is to make the body's immune system fight HIV more effectively. One way to do this is with a chemical messenger called interleukin-2 or IL-2 which is now in advanced human tests. Other immune stimulators are in various stages of development.
Yet another strategy is to use antisense drugs. These are strands of genetic material that form a kind of mirror image of HIV's genetic code. These genetic materials fools the virus's replication machinery. One antisense drug has entered human tests. Side effects are common with all of these medications. These can include:
HIV-Associated Dementia Complex also known as AIDS Dementia Complex is a progressive neurological disorder that can affect patients who are infected with HIV. HIV-Associated Dementia Complex commonly known as HAD is thought to be a sub cortical dementia and this illness is characterized by cognitive, motor and behavioral impairments that is severe enough to interfere with an patient's ability to function at work or in social situations.
It has been estimated that up to 2/3rds of the individuals with AIDS will develop dementia or related neurological disorders. It is believed that HAD is caused by direct infection of the brain by the Virus that is the cause of AIDS. In the year 1987 the Centers for Disease Control included HIV-Associated Dementia Complex as a primary diagnostic condition that acts as a diagnosis of AIDS.
The last 20-30 years has brought significant changes in male and female sex roles. In the 1950's and 60's the roles for men and women were relatively well established and non-changing but in the recent years these roles have been changed significantly. The changes have caused many men to re think and re evaluate old notions of manhood and masculinity. While many men accept these changes, this redefinition of roles has caused confusion and problems for some men. Listed below are some ways a change in sex roles has affected men.
Men and Masculinity
Men were originally perceived to be like a sturdy oak that is strong, emotionless, independent, inflexible and often violent. The roles set for men were clear and they stated that men should work hard, they should provide for their family, they should be the head of the family and they should not get emotionally attached to any family member or outsider. Not showing any vulnerability was an integral part to this role.
Newer definitions for men are much less rigid and clear. Men are now often encouraged to help raise children and share only part of the financial responsibility of the family. They are expected by their partners and partner to be open emotionally and to be able to communicate effectively. New role models of masculinity lay importance on both strength and vulnerability that is the ability to be strong and the ability to be vulnerable. This new role can be confusing for many men especially those who have been taught that men should be strong and emotionally detached.
Relationships
Many men today are confused by the messages they get in relationships. Some of the messages are to be strong, to be independent and to be the provider. All of these messages, though confusing at times, usually reflect the changing nature of sex roles. Simply stated, men are in the process of redefining sex roles. This leads to confusing messages from partners who also struggle with want they want in a man. The result for many men is to cling to old stereotypes in an effort to clarify the situation. Unfortunately this usually doesn't work as well as it should since in today's culture men need to expand the traditional opinions of masculinity. For a man now it is important to know how strong, vulnerable independent, dependent, logical and emotional he has to be. Clinging to old notions of being the alpha male will not solve any problems since new roles are evolving and it is important for men to experiment with these new options.
Careers: New Options
New sex role expectations have led to new opportunities for men in terms of their careers and work life. Men are no longer forced into only certain majors or careers and these days men can enter professions that were previously meant for only women. This causes confusion for many men since they may desire a particular career but their families may force them to opt for a traditional career. Again the added flexibility is freeing while also being significantly confusing at the same time.
Health: The Price Men Pay
Researches indicate that men usually suffer from a variety of health problems like heart attacks, ulcers, and stress related illnesses and men usually die sooner than women. Many people think that a primary reason for this has to do with work and stress related to certain sex roles. Working long hours at stressful jobs and keeping in painful emotions eventually leads to a physical breakdown and for some men such stress along with difficulty expressing their emotions can even result in suicide. Some men who are extremely afraid to talk about their emotional problems often feel that they have no option other than suicide. Learning to slow down, change jobs if it is too stressful, take time off from work, and talk about their emotions are a few ways that men can change this unhealthy pattern. Since new sex role expectations allow males to take better care of themselves emotionally and physically men are now allowed to share their feelings and take better care of themselves.
Drugs and Alcohol: A Male Problem
Researches indicate that majority of the population that uses drugs and alcohol are men. Drugs and alcohol are one way that men trapped by the traditional sex role expectations use to numb or vent emotions. Unable to know how to feel, or if they should talk about their feelings cause many men to turn to alcohol and drugs for emotional relief. The result is often dangerous since painful feelings remain hidden and unexpressed. Since anger is vented in an alcohol-induced rage there are damaging consequences of using these substances.
Feminism and Changing Sex Roles
The term Feminism implies that men and women are equal in all ways. This statement very nicely captures the dilemma for men living in the present day. Changing sex roles now allows more equality for men and women whereas older and more traditional opinions of sex roles emphasized that, men were superior to women. The more recent ideas of sex roles on the other hand emphasize equal power for men and women. This change in sex roles is confusing and at times threatening to many men since they do not know how this new system works. An increasing number of men are embracing this radical notion of equality for men and women since they are coming to see that this system is actually emotionally better for men. According to this new and improved system men no longer have to be the sole provider and men now have more options in their careers and work life. In this new system men are also allowed to express their emotions and they are allowed to share their feelings with their partner. The changing roles of sex are both confusing and freeing for some men since these men are given opportunities that they do not know how to use.
Improved health, less stress, emotionally satisfying relationships, better career options, and less alcohol or drug abuse are but a few of the advantages of this new and improved system.
Sexual orientation
Sexual orientation is one of the four components of human sexuality and this is distinguished by a permanent emotional, romantic, sexual attraction to individuals of a particular sex. The three sexual orientations that are recognized in humans are homosexuality that is attraction to people of one's own gender, heterosexuality that is attraction to individuals of the other the opposite sex and finally bisexuality that is attraction to either males or females.
People with a homosexual orientation are usually called gay in both men and women or lesbian in women only. Sexual orientation is completely different from sexual behavior because sexual orientation refers to feelings and one?s own self concept and individuals may or may not express their sexual orientation or preference in their behaviours.
What causes a person to have a particular sexual orientation?
Some theories suggest that genetics or inborn hormonal factors and learning experiences during early childhood help a person decide his sexual orientation when he grows up. However, many scientists believe that sexual orientation is shaped for most people at an early age through various in depth interactions of biological, psychological and social encounters.
Is sexual orientation a choice?
Sexual orientation is not a choice and it emerges for most individuals in the early teenage years when the person does not have any prior sexual experience. Some people try to change their sexual orientation over many years from homosexual to heterosexual with no success. For these reasons mental health care professionals do not consider sexual orientation for most people to be a conscious choice that can be changed due to voluntary actions.
Is homosexuality a mental illness or emotional problem?
No, homosexuality is not considered as a mental illness or an emotional problem by psychologists, psychiatrists and other mental health professionals. Scientific research over the past 35 years proves that homosexual orientation in itself is not related with emotional or social problems.
A few years ago homosexuality thought to be a mental illness because mental health professionals and societies had biased information about homosexuality since most studies only involved homosexual women and men who were in therapy. When researchers examined data for homosexual people who did not opt for therapy the conclusion was that homosexuality was not a mental illness.
In 1973 the American Psychiatric Association confirmed the importance of various new researches by removing the term homosexuality from the official manual that lists all mental and emotional disorders. In the year 1975 the American Psychological Association passed a resolution supporting this action. Both associations urged all mental health professionals to help remove the emotional and social stigma that homosexuality was caused due to mental problems. After homosexuality was declassified as a mental disorder, this decision has also been reaffirmed by additional research findings along with both associations.
Can lesbians and gay men make good parents?
It is believed that homosexual men and women can make good parents. Studies comparing groups of children that were raised by homosexual and by heterosexual parents find no developmental differences between the two groups of children in the children?s intelligence, psychological adjustment, popularity with peers, social adjustment, development of social sex role identity and development of sexual preferences.
Another misconception about homosexuality is that homosexual men are more likely than heterosexual men to sexually molest children. There is no scientific evidence indicating that homosexual men are more likely to molest children compared to heterosexual men.
Why do some gay men and lesbians tell people about their sexual orientation?
Many homosexuals reveal their true identity because disclosing their identity to others is important to their own mental health. This process of disclosing the identity is known as coming out of the closed and this process has been found to be strongly related to psychological adjustment that helps the homosexual to regain self esteem and self worth.
Why is the coming out of the closet difficult for homosexuals?
Because of false stereotypes and unwarranted myths towards homosexuals, the process of coming out or revealing the true identity is a very challenging process. This process may cause emotional pain to people who have been told that being homosexual is un natural. Homosexuals often feel lonely when they first become aware of same-sex attractions and they also fear being rejected by their family, friends, co-workers and religious institutions if they do decide to reveal their sexual preference.
In addition to all the myths and preconceptions, homosexuals are usually the targets of discrimination and violence. This threat of violence and discrimination is an obstacle to the development of homosexuals. In the 1989 national survey, 5% of homosexual men and 10% of homosexual women reported physical abuse or assault related to being homosexual in the previous year and 47% reported some form of discrimination in their lifetime. Other researches have shown similar high rates of discrimination or violence.
What can be done to help homosexuals overcome prejudice and discrimination against them?
The people who have positive attitudes towards homosexuals are those who say they have one or more homosexual friends or they know someone well who is a homosexual. For this reason mental health professionals believe that negative attitudes towards homosexuals as a group are prejudices and people who have these attitudes usually do not have any interaction with homosexuals. These negative attitudes are caused due to believing in stereotypes and myths about homosexuals.
Protection against violence and discrimination for homosexuals is very important, just as protection is important for other minority groups. Some states in USA include violence against an individual on the basis of her or his sexual orientation as a hate crime and eight U.S. states have laws against discrimination on the basis of sexual preferences.
Can therapy change sexual orientation?
Therapy cannot change the sexual orientation of a person since it being homosexual is not a mental illness. Although homosexual orientation is not a mental illness and there is no scientific reason to try to convert homosexuals to prefer heterosexual relationships some individuals may seek to change their own sexual orientation or that of another individual. An instance of this would be parents seeking therapy for their homosexual child. Some therapists who undertake this kind of therapy state that they have successfully changed their clients? sexual orientation from homosexual to heterosexual through treatment. Close examination of their reports discloses several factors that prove otherwise. Also many of these claims come from organizations with an ideological perspective on sexual preferences, rather than from mental health researchers. Also the treatments and the results are poorly documented and the length of time that clients came for follow ups after the treatment is too short.
In the year 1990 the American Psychological Association stated that scientific evidence does not show that conversion therapy is effective and that this therapy do more harm than good since changing one's sexual preference is not as simple as changing one's sexual behavior. Changing one?s sexual orientation or preference would not only require significantly changing one?s ideas about sexual preference but also re identifying and re constructing one's self-concept and social identity. Although some mental health providers do attempt to convert homosexuals to heterosexuals, others question the ethics of trying to alter through therapy a trait that is not a mental disorder rather something that is extremely important to an individual's identity.
Not all homosexuals who seek therapy want to change their sexual orientation. Homosexual men and women may seek counselling for any of the same reasons as anyone else and in addition, they may seek for psychological assistance to simply come out of the closet or to deal with prejudice, discrimination and violence.
Why is it important for society to be better educated about homosexuality?
Educating people about sexual orientation and homosexuality is likely to reduce anti-gay prejudice. Accurate information about homosexuality is especially important to young people struggling with their own sexual identity. Fears that access to information about homosexuality will affect one's sexual orientation are in valid.
Understanding Transgender
What Does Transgendered Mean?
A Transgendered or TG person is someone whose gender identity that is man or woman does not match their biological sex that is male or female. For most people, there is no connection between their biological sex and their internal gender identification. For most transgender, their gender identity is in constant conflict with their biological sex.
Are there different types of Transgendered individuals?
The term Transgendered is a broad term used for many kinds of people with differing gender expression.
The term transgendered is also used for someone who feels more comfortable as a member of another gender. Transgender individuals may live part or full-time as the other gender.
Transsexuals on the other hand seek to permanently change their bodies by changing their genders permanently through gender reassignment surgery.
"Non-op" refers to a person who has opted for all the hormonal/surgical treatment except the gender re assignment surgery because he or she cannot afford it or does not have any desire to proceed with the surgery.
Transvestites are people who wear clothing of the opposite gender for emotional or sexual gratification.
Two Spirited people have both female and male spirits as usually found in Native American culture. These people are often viewed with respect because they were able to hold both gender spirits in their bodies.
Inter sexed or Hermaphrodite. This is a rare medical condition where babies are born with both male and female sexual organs and the sex is assigned at birth through removing one of the reproductive organs.
Can people stop being Transgendered?
No, people cannot change their gender identity since gender identity is believed to be related to hormones, genetics and the functionality of the brain. Although some people will give up being transgender for a while, they typically return to cross dressing once they recognize that they cannot fight their true identity.
Gender identity is not the same as sexual preference since gender identity refers to how a person identifies himself or herself. Sexual orientation on the other hand refers to a romantic and sexual connection to a particular gender that is men, women or both.
A person's sexual orientation does not change after hormonal therapy or surgery. For instance when a man who is attracted to women undergoes the surgery thereby becoming a woman, she would call herself a homosexual. She now identifies herself as a woman who is attracted to other women.
Physical Intimacy
Physical intimacy includes both sensuous and sexual activity usually between two people and the sharing of emotions, thoughts and various reactions that are involved in these activities.
Physical intimacy includes a wide range of behavior and everything from hand holding to sexual intercourse is included in physical intimacy. Physical intimacy includes a broad range of physical contact such as:
- foreplay or non-coital sexual activity
- bathing together
- swimming together
- pleasuring
- caressing each other's body
- sexual intercourse
- cuddling after sex
Physical intimacy is sometimes difficult to develop between two individuals and at times since certain barriers may emerge:
One of the main barriers is the narrow focus that most people place about certain sexual behaviours. Usually, people believe that sexual intercourse as is the only expression of sensuous feelings toward another person. If fact, proceeding too fast to sexual intercourse is one of the major complaints many women have about their physical intimate relationships with their partner.
Another barrier to comfortable expression of physical intimacy occurs when the person ignores his or her own discomfort about a particular sexual activity. When the person ignores personal discomfort as a result sexual barriers, mental blocks, and turn-offs are usually created. One of the sources of discomfort may be physical or mental fears that are associated with physical intimacy.
The most common fear is the fear of being touched by another person. This means that some people are not very accustomed to being touched or caressed and they are not comfortable with tactile stimulation. There may also be the fear of breaking a taboo since there are a number of taboos in many cultures related directly to physical intimacy. Even when a person is married, it is often difficult to turn off the thoughts related to these taboos with which they have lived prior to marriage. There is also the fear of losing control of oneself or of allowing oneself to enjoy one?s body. Physical intimacy usually involves giving up all control and letting go of fears. For a person who is afraid of losing control, this can be an tough situation that can cause anxiety.
Many people fear pregnancy as a result of physical intimacy. Even though contraceptive information and birth control techniques are available to everyone, people have a lot of fears about pregnancy and all these fears are usually based on information or myths from childhood or adolescence knowledge. All these fears can interfere with feeling comfortable in a relationship that demands physical intimacy. There is also the fear of sexually transmitted disease (STDs), which in most cases is an actual or realistic fear especially in the case of multiple partners or if the couple is not practicing safe techniques. Another fear is the fear of guilt or being condemned either by peers, family members, or in some cases from a religious institution.
For many people, physical intimacy is a new experience since there are many new things to experience. If a person is apprehensive about new experiences then the fear associated with any kind of new experiences will create mental barriers to physical intimacy.
Ways to Overcome Obstacles to Physical Intimacy
One of the main things a person can do is to take things at his or her own speed, a personal speed with which he or she is comfortable.
It is important to give oneself permission to say no when he or she feels that no is the right answer and similarly to give oneself permission to say yes when the person feels that yes is the right answer. The person should also be willing to take responsibility for the consequences of his own decisions and actions. When the answers about the problems with physical intimacy come from the person?s own values then the person?s personal discomfort levels related to physical intimacy deceases.
The best way to reduce barriers is to become aware of one's fear and what may be producing the various fears or uncomfortable sensations about physical intimacy. Once the fear is identified, the person can work to reduce the fear. In a nutshell there is no one norm for physical intimacy other than behavior that is compatible with the feelings and beliefs of each partner involved in the relationship.
Being Open to New Relationships
The word open is really used a lot and this word is used from the time a child is born till the time of death. While some people open up to their families, other turn to friends or co workers to disclose personal information. The term ?open up? is used to suggest that the person does not disclose enough information about himself and he needs to trust others and disclose some personal information.
Most people find it hard to being open about their feelings since they feel that they cannot trust anyone with their secrets. Most people usually have a conflict of interests while opening up since they feel the need to share but they cannot due to trust issues. Some people do not open up due to the fear of being rejected or not appreciated by others.
While opening up or disclosing information the person should remember that it is up to him what information to disclose and when. The person can talk about information that sounds unimportant or he can talk about information that has a deeper meaning. Some people begin by opening up about small things such as new shoes or new items they have shopped for and then slowly start to disclose more information about themselves.
The process of opening up is not easy for most people due to the reasons mentioned above and the best way to open up is to first disclose general information. After the person believes that the listener is trustworthy then he can divulge more personal information about himself. While disclosing information the person also suggests that he is open to suggestions. The person in question should disclose information to people he trusts and to avoid disappointments he should not disclose information to people he does not know well. In certain situations like the office, the person should not open up to his boss especially if the matter he is going to say is going to hamper his job in any way.
While opening up the person should be direct and he should talk about his emotions. If the person feels happy or sad then he should communicate the right emotions to avoid any confusion. The person listening to him may or may not be able to pick up on body language so words should be used to communicate emotions.
While disclosing personal information the person should keep in mind that by disclosing too much personal information at once he can make the other person feel awkward. The person talking should also keep the other person?s emotions, sentiments and religious beliefs in mind while he is disclosing his own thoughts. An important part of opening up is mutual trust. The person talking should divulge information that is not offensive to the other person and the listener should make an attempt to listen carefully to what the other person has said. The listener should also make an attempt to participate in the other person?s conversation but he should not give suggestions and advice unless the person talking asks for advice or suggestions. Here are some common ways to open up or disclose information about oneself.
- Make your outside behavior match with your inside feelings and thoughts.
- Focus on feelings and consider the other person?s feelings while talking. Be in touch with what you feel and talk honestly.
- Change your questions into statements and instead of asking someone if he is happy to be here you should tell the person that you are happy that he is here. Focus on your emotions and do not convert your emotions into questions for others. An instance would be if you want to tell someone that you love them you should say this instead of asking the other person if he or she loves you.
- Never use the words I do not know since this implies that you are not interested in sharing your thoughts with the other person. When required elaborate on what you mean but make sure that the other person is also interested to listen.
- Convert your emotions into words and instead of asking the other person to read your tone of voice or to read your body language you should use words to convey your feelings.
Sexual problems are disorders related to a particular part of the sexual response cycle. Sexual dysfunctions include sexual arousal disorders, sexual desire disorders, sexual pain disorders and orgasm disorders. If the participant has certain difficulties with some phase or part of the sexual response cycle or the participant feels pain while sexual intercourse then he or she may have a sexual dysfunctional problem.
Some examples of sexual dysfunction include:
Hypoactive Sexual Desire Disorder- People who have a decreased sexual drive or very few fantasies may suffer from this disorder. If the person feels that he is suffering due to a lack of sex drive then the problem will be considered as a disorder. In this sexual disorder the participant does not initiate any sexual activity and he may be very slow to reciprocate to his partner?s advances. This disorder can start at adolescence and it can continue till the later parts of life. Most of the times this disorder occurs in adults that have experienced stress a short while ago.
Sexual Aversion Disorder - A person who avoids sexual intercourse and dislikes the idea of being in contact with genitalia may suffer from this disorder. This problem is only considered a disorder if the person feels that his dislike is getting in the way of having a normal relationship. People who have sexual aversion disorder usually report anxiety, fear, or disgust when they have to indulge in sexual activity. In certain cases even touching or kissing another person may be avoided by people who have this disorder. The person may feel nauseated, panic stricken and the person may also experience severe panic attacks.
Female Sexual Arousal Disorder -This disorder is described as the inability of a woman to have sexual intercourse even with a lubricant. Swelling of the external genitalia and vaginal lubrication may or may not be present. In order to be considered a disorder the lack of sex should cause a problem in a relationship. Some women who have this disorder do not feel aroused when they are touched by their partners and often these women experience pain during sexual intercourse due to which they avoid sexual intercourse.
Male Erectile Disorder- If a man is unable to maintain an erection while intercourse along with other sexual activity then he may have male erectile disorder. In order to be classified as a disorder this problem has to either be recurrent or persistent and erectile dysfunction should cause problems in the relationship. People who have this disorder may get an erection but they may not be able to maintain it for long but it is also possible for affected men to completely not get any erections. This complex disorder may be accompanied with fear of failure and a hurt self esteem. Sometimes this sexual disorder is present throughout the individual?s life but in many cases this disorder occurs when the individual is with a certain person or in a certain type of relationship.
Female Orgasmic Disorder. Female orgasmic disorder occurs when the woman takes a while to experience an orgasm or if the woman does not experience an orgasm at all. If this condition causes problems in the relationship then it will be classified as a disorder.
Male Orgasmic Disorder. If a man experiences a delayed orgasm or does not experience an orgasm after sexual activity then he has male orgasmic disorder. In order to be qualified as a disorder this condition must cause problems in the relationship.
Premature Ejaculation. ? If the man ejaculates without significant stimuli and if the problem is persistent then the person may have this disorder. This problem is classified as a disorder only if the condition causes issues in the relationship. Premature ejaculation is usually seen in young men who have experienced this condition since their first attempt at sexual intercourse.
Dyspareunia - Dyspareunia is a sexual pain disorder. Dyspareunia is pain in the gentiles that accompanies with sexual intercourse and both men and women can experience this disorder, but the disorder is more common in women. Dyspareunia tends to be chronic in nature.
PARAPHILIAS
Paraphilias is a sexual disorder that is classified with re occurring intense sexual urges and sexual fantasies that generally involve either nonhuman objects or physical suffering or humiliation of onesele or one's sexual partner, children or other non-consenting persons. The specific of this sexual disorder are described below:
Exhibitionism characterized by reoccurring intense sexual urges and sexual fantasies that involve the exposure of the person?s genitalia to a stranger. Sometimes the person masturbates while exposing himself to others or he fantasizing about exposing himself in front of a stranger.
Fetishism characterized by reoccurring intense sexual urges and sexual fantasies that involve the use of nonliving objects known as fetishes. Some of the common fetish objects are stockings, shoes, boots, bras, women's underpants or other clothes. The person with fetishism often masturbates while touching, rubbing, or smelling the fetish object or he may ask his partner to wear the specified object during sexual activities.
Frotteurism: characterised by reoccurring intense sexual urges and sexual fantasies that involve touching and rubbing one?s body against a non-consenting person. The act of touching and not the coercive nature of the act is sexually exciting to people who have this disorder. The person with Frotteurism usually satisfies his sexual needs in crowded places such as on busy sidewalks or in public transportation vehicles from which he can escape without being confronted or arrested.
Paedophilia is characterized by reoccurring intense sexual urges and sexual fantasies that involve sexual activity with a non sexually mature child. The age of children selected for this activity is between 6 ? 13 years. The age of the person affected by this disorder is usually set at age 16 years of age or older and the person is at least 5 years older than the victim.
Sexual Masochism is characterized by reoccurring, intense sexual urges and sexual fantasies that involve being humiliated while indulging in sexual activity. Some of the actions that affected people like include being beaten, walked upon or tied
Sexual Sadism is characterized by reoccurring intense sexual urges and sexual fantasies that involve sexual activity in which the partner is made to suffer psychologically or physically.
Transvestic Fetishism is characterized by reoccurring intense sexual urges and sexual fantasies that involve cross-dressing. Men that are affected by this disorder usually keep a collection of women's clothes that they periodically use to cross-dress when alone. While wearing female attire the man usually masturbates and imagines other men being attracted to him as a woman when wearing women?s clothes.
Voyeurism is characterized by reoccurring intense sexual urges and sexual fantasies that involve the act of observing unsuspecting strangers who are either naked in the process of removing their clothes or engaging in sexual activity. The act of looking also known as peeping is for the purpose of achieving sexual excitement and the person observing generally does not want any sexual activity with the people he is observing.
Sexual Intercourse
In United States most people experience sexual intercourse during their teenage years. Researches indicate that slightly more than half of women and nearly two-thirds of men have had intercourse before they turn 18 years old. In the last several years there have been significant increases in the number of adolescents who report sexual activity at each year of age and these increases have been greater for young women.
The first sexual intercourse experience is an important event in the lives of adolescents. The main two reasons early timing is given importance is because the younger the age of first sexual intercourse, the more the chances are that that the experience was forced sexual intercourse that has long lasting effects. The second reason is that the younger the age of first sexual intercourse the greater the chances are of unwanted pregnancies and sexually transmitted diseases.
There are strong effects of developmental characteristics like early puberty and high levels of testosterone which are associated with increased sexual behaviour in young adults. Unconventional attitudes and behaviours like early use of alcohol, tobacco and other harmful substances along with delinquency, school problems, and physical aggression are usually related with earlier onset of adolescent sexual intercourse. Marital disruption of parents and living with a single parent has also been found to be related with premature adolescent sexual behavior.
These findings reflect on a variety of factors that include lower family incomes, un safe neighborhoods, insufficient supervision, in adequate parental modelling, and more tolerable attitudes in families with single parents. Similarly, having sexually active siblings and friends is also related to adolescents indulging in premature sexual activity. If a child has educated parents, supportive family relationships, adequate parental supervision, sexually abstinent friends, good school grades and then he is more likely to have sex once he is an adult.
In addition to families and schools the neighbourhood also provide an environment through which the adolescent make a decision that is related to sexual activity. The effects of the environment he lives in such as the community economic base for men and labor market conditions for women, account for a substantial portion of the racial differences among Caucasians and African Americans in the timing of first sexual intercourse.
The following methods are usually used by teenagers to date: Group Dating - Many boys and girls go out together and time may be sent with couples or friends of the same sex. Group dating is usually best for adolescents because it takes stress off an adolescents first date as a couple.
Casual Dating - A couple go out once in a while with no commitment or name to the relationship. This gives adolescents a chance to date a few people before they realize who they are compatible with.
Serious Dating - The couple has a strong commitment to each other and neither member is expected to date another person.
Contraception
Effective contraceptive use usually requires planning and preparation before having sexual intercourse. Planning and preparation is usually a problem for most adolescents because most young adults do not plan for an intercourse to happen and it happens in the spur of the moment. Due to this condoms are usually used during the first intercourse but researches indicate that 35% of adolescents do not use any contraceptives at all.
Avoiding pregnancy after the first and unplanned sexual intercourse requires regular use of an effective contraceptive method. This can be especially problematic for young girls because young men and women tend to be less aware and worried about sexual problems compared to older people.
A major challenge to preventing pregnancies in young girls is the fact that so many adolescent girls seek contraceptives only after a few days or weeks and some seek contraceptives only after a few months of their first sexual intercourse.
According to researches most adolescents both boys and girls seek for contraceptives only after a year of becoming sexually active. Procrastination, not understanding that they could get pregnant or being ignorant about sex, contraception and pregnancy, and worrying about their secret from being disclosed are the reasons sexually active teenagers usually give for not seeking contraceptives sooner. Helping adolescents to plan for effective contraception before sex could be an important strategy for reducing unwanted pregnancies. After a while sexually active adolescents especially those in long-term couple relationships, use the pill.
The National Marriage Project
The National Marriage Project is a nonpartisan, nonsectarian and interdisciplinary initiative located at the State University of New Jersey in Rutgers. The project is financially supported by both the university and private co-operations. This project?s main mission is to provide data on the state of marriage in America and to educate people on the social, economic and cultural conditions that affect marital success and wellbeing.
The National Marriage Project has five goals:
- Annually publish The State of Our Unions which is an index of the health of marriage and marital relationships in America
- Investigate and document about younger adults' attitudes toward marriage
- Examine the popular media's perspective of marriage
- Serve as a clearinghouse resource for research and expertise on in this field
- Bring together marriage and family experts to develop techniques to revitalize marriage.
The project is co-directed by two nationally prominent experts about families. The first expert is David Popenoe, Ph.D., a professor and former social and behavioral sciences dean at Rutgers who is the author of many scholarly and popular publications on marriage and family. The second expert is Barbara Dafoe Whitehead, Ph.D., an author and social critic, who writes mainly about issues of marriage, family and child wellbeing.
Social Indicators of Marital Health and Wellbeing
Trends of the Past Four Decades
- Marriage
- Divorce
- Unmarried Cohabitation
- Loss of Child Centeredness
- Fragile Families with Children
- Teen Attitudes About Marriage and Family
Key Finding: Marriage trends in recent decades indicate that Americans have become less inclined to marry and recent researches show that the percentage of people likely to get married in USA continues to decline. Out of the people who are married there has been a moderate drop since the year 1970 in the rate of married couples who consider their marriages to be successful but in the past 10 years the number of happy couples has increased significantly.
The fact that Americans have become less inclined to marry is reflected in a steady decline of nearly 50 percent, from the year 1970 to the year 2004 as shown in figure one that represents the yearly number of marriages for every 1000 unmarried adult women. Other factors accounting for lesser people marrying are an increase of unmarried cohabitation and a small decrease in the inclination of divorced people to remarry. This decline also reflects some increase in increased single life, although the actual number cannot be determines until current young and middle-aged adults pass through the course of life.
The percentage of adults in USA who are currently married has also significantly diminished. Since the year 1960 the percentile decline of those married aged 15 and older has been 14% and over 29 % for African American women.
It is important to note that the reduced percentage of marriages does not imply that people have given up living with partners. On the contrary the percent of people living together without marrying has increased significantly. Many people these days are opting for live in relationships that allow the couple to stay together without opting for marriage. An even higher percentage of those divorced who later on remarry first opt for a live in relationship and an increasing number of people both young and old are living together with no plans for marriage.
There is a common belief that although a smaller percentage of Americans are now marrying as compared to a few decades ago those who marry these days have marriages of a higher quality. The main reason for this is that the people who are unhappy in marriages often seek divorce and the small percentages of people who remain married are happy. The best available resource on the topic, however contradicts these notions. Since the year 1973the General Social Survey periodically has asked a group of married Americans to rate their marriages as either "very happy," "pretty happy," or "not too happy as stated in figure 3. As Figure 4 indicates, the percentage of both married men and women stating that they are "very happy" has declined moderately over the past 25 years but this trend is now heading in a positive direction.
| Figure 1. Number of Marriages per 1,000 Unmarried Women Age 15 and Older, by Year, United States (a) | |
| Year | Number |
| 1960 | 73.5 |
| 1970 | 76.5 |
| 1975 | 66.9 |
| 1980 | 61.4 |
| 1985 | 56.2 |
| 1990 | 54.5 |
| 1995 | 50.8 |
| 2000 | 46.5 |
| 2004 | 39.9 |
| http://www.bls.census.gov:80/cps/ads/2002/ssampwgt.htm | |
| Figure 2. Percentage of All Persons Age 15 and Older Who Were Married, by Sex and Race, 1960-2004 United States | ||||||
| Total Males | Black Males | White Males | Total Females | Black Females | White Females | |
| 1960 | 69.3 | 60.9 | 70.2 | 65.9 | 59.8 | 66.6 |
| 1970 | 66.7 | 56.9 | 68 | 61.9 | 54.1 | 62.8 |
| 1980 | 63.2 | 48.8 | 65 | 58.9 | 44.6 | 60.7 |
| 1990 | 60.7 | 45.1 | 62.8 | 56.9 | 40.2 | 59.1 |
| 2000 | 57.9 | 42.8 | 60 | 54.7 | 36.2 | 57.4 |
| 2004(b) | 55.1 | 38.1 | 57.4 | 51.7 | 30.4 | 54.7 |
| America's Families and Living Arrangements: March 2000 and earlier reports; and data calculated from the Current Population Surveys, March 2004 Supplement. | ||||||
| Figure 3. Percentage of Persons Age 35 through 44 Who Were Married by Sex, 1960-2004, United States | ||
| Year | Males | Females |
| 1960 | 88.0 | 87.4 |
| 1970 | 89.3 | 86.9 |
| 1980 | 84.2 | 81.4 |
| 1990 | 74.1 | 73.0 |
| 2000 | 69.0 | 71.6 |
| 2004 | 65.7 | 67.3 |
| http://www.bls.census.gov:80/cps/ads/2002/ssampwgt.htm | ||
| Figure 4. Percentage of Married Persons Age 18 and Older Who Said Their Marriages Were "Very Happy," by Period, United States | ||
| Period | Men | Women |
| 1973-1976 | 69.6 | 68.6 |
| 1977-1981 | 68.3 | 64.2 |
| 1982-1986 | 62.9 | 61.7 |
| 1987-1991 | 66.4 | 59.6 |
| 1993-1996 | 63.2 | 59.7 |
| 1998-2002 | 64.6 | 60.3 |
| Source: The General Social Survey, conducted by the National Opinion Research Center of the University of Chicago | ||
THE SURPRISING ECONOMIC BENEFITS OF MARRIAGE
While thinking of the many benefits of marriage, the economic aspects of marriage are often overlooked. The economic benefits of marriage are substantial both for married couples and for society as a whole. Marriage can be considered as a wealth generating institution since married couples create more economic assets on average compared to single people and couples who stay together without getting married. A study in 1992 related to retirement data derived that individuals who have remained single for a while have significantly lower wealth compared to individuals who have remained married throughout their lives. Compared to those that remained continuously married and those who never married the latter have a reduction in wealth of 75% and those who divorced and didn't remarry have a reduction of 73%.
One of the explanations for why marriage generates economic assets is because those people who are more likely to be financially stable are also more likely to marry and remain married. The institution of marriage in itself provides an economic bonus since it often costs lesser for two people to live together compared to two people living separately.
Another reason married couples are financially stable is because married couples save and invest more for the future and they usually serve as a small insurance pool against life uncertainties such as unemployment and illnesses. Men usually start earning more after they get married since according to society?s norms they need to support the family. Most married men earn between 10 and 40 percent more than single men earn with similar qualifications and job experiences. Other than all the benefits mentioned above couples also receive more work-related and government-provided support along with more help from friends and relatives.
Beyond the economic benefits of marriage for the married couples, marriage has a tremendous economic impact on society since marriage is a major contributor to family income levels and inequality. Between 1947 and 1977 it was noticed that family incomes had doubled in median families but in the last 20 years income has slowed increasing by just 9.6%. The main reason for this decline is that married couples have been a rapidly decreasing proportion of total families. In this same 20 year period, mainly because of changes in family structure, in equal distribution of family income has increased significantly.
Researches have shown consistently that divorce and unplanned pregnancies before marriage have increased child poverty. In recent years the majority of children who are not part of married families have experienced at least one year of extreme poverty. According to one particular study, if family structure had not changed between the years 1960 and 1998, the African American child poverty rate in the year1998 would have been 28.4% instead of 45.6%, and the Caucasian child poverty rate would have been 11.4% instead of 15.4%. The rise in child poverty also causes a significant increase in public costs in health and welfare programs.
Marriages that end in divorce are also very costly to society. One researcher determined that a single divorce costs both the federal and state governments about $30,000, due to things such as the higher use of food stamps, an increase in public housing as well as increased bankruptcies and juvenile delinquency. The 1.4 million divorces in the year 2002 in USA are estimated to have cost the taxpayers more than $30 billion.
DIVORCE
Key Finding: The American divorce rate today is almost double compared to 1960, but this rate has declined slightly since reaching the highest point in the early 1980s. For the average couple marrying in the recent years the possibility of divorce or separation remains between 40 and 50 percent.
Although the long-term trend in divorce has increased since colonial times, the divorce rate did not change for about two decades after World War II during the period of the baby boom. By 1960s the percentage of divorces started to increase again and the rate increased by more than double over the next fifteen years to reach an historical high point in the early 1980s. Since then the divorce rate has significantly declined, a trend that is described by many experts as levelling off at a high level. This sudden decline represents a slight increase in marital stability and two possible reasons for this are an increase in the age at which people marry for the first time, and a higher educational level of getting married, both of which caused stability.
Although majority of divorced people eventually remarry the increase of percentage of divorces has led to a steep increase in the percentage of all adults who are currently divorced. The percentage of divorce which was only 1.8 percent for men and 2.6 percent for women in the year 1960 increased four times by the year 2000. This research indicated that the percentage of divorced is higher for women than for men mainly because divorced men are more likely to remarry compared to divorced women. Another reason is that divorced men are more likely to remarry sooner than divorced women.
Overall the possibility remains estimated between 40 and 50 percent-that a marriage started in recent years will end in either divorce or separation before one of the partner dies. The likelihood of divorce has changed considerably over time among different segments of the American population, being higher for African Americans compared to Caucasians but these variations have been reducing. The trend toward a greater similarity of divorce rates between African Americans and Caucasians is largely attributable to the fact that fewer African Americans are marrying.
At the same time, there has been little change in such traditionally large divorce percentage differences as between those who marry when they are less than 18 compared to those who marry after age 21, high-school drop outs compared tocollege graduates, and the non-religious compared to the religiously committed. Teenagers who are high-school drop outs and the non-religious who marry have considerably higher divorce rates tend to have a higher rate of divorce.
YOUR CHANCES OF DIVORCE MAY BE MUCH LOWER THAN YOU THINK
Most people are aware that the national divorce rate is close to 50% and while this is true it is important to keep in mind that this divorce rate depends on many factors.
An important factor that determines if the marriage will be a success or end up in divorce is the background characteristic of the people getting married. Here is a table that displays decreases in the risk of divorce or separation during the first ten years of marriage, depending on various personal and social factors
| Factors | Percent Decrease in Risk of Divorce |
| Annual income over $50,000 (versus. under $25,000) | -30 |
| Having a baby seven months or more after marriage (versus. before marriage) | -24 |
| Marrying over 25 years of age (versus. under 18) | -24 |
| Own family of origin intact (versus. divorced parents) | -14 |
| Religious affiliation (versus. none) | -14 |
| Some college (versus. high-school dropout) | -13 |
Hence it can be said that people who are well educated, have a good income, come from an intact family, have religious beliefs and marry after the age of 25 without having a baby after marriage are more likely to succeed at marriages.
As mentioned above there are various factors to be taken into account while assuming that the rate of divorce is 50 percent. One of these factors is that the percentile of 50% was taken for that current year and it includes deaths of spouses. Divorce rates have actually has been dropping slowly after they reached a peak around 1980, and experts say that the divorce rate could even be lower in the future than it is today.
The table shown below elaborates on the number of divorces in the past few years for married women older than 15 years.
| Figure 5. Number of Divorces per One thousand Married Women Aged 15 and Older | |
| Year | Divorces |
| 1960 | 9.2 |
| 1965 | 10.6 |
| 1970 | 14.9 |
| 1975 | 20.3 |
| 1980 | 22.6 |
| 1985 | 21.7 |
| 1990 | 20.9 |
| 1995 | 19.8 |
| 2000 | 18.8 |
| 2004 | 17.7 |
| Percentage of People Aged 15 and Older Who Are Divorced | ||||||
| Males | Females | |||||
| Year | Total number | Africans | Caucasians | Total number | Africans | Caucasians |
| 1960 | 1.8 | 2 | 1.8 | 2.6 | 4.3 | 2.5 |
| 1970 | 2.2 | 3.1 | 2.1 | 3.5 | 4.4 | 3.4 |
| 1980 | 4.8 | 6.3 | 4.7 | 6.6 | 8.7 | 6.4 |
| 1990 | 6.8 | 8.1 | 6.8 | 8.9 | 11.2 | 8.6 |
| 2000 | 8.3 | 9.5 | 8.4 | 10.2 | 11.8 | 10.2 |
| 2004 | 8.2 | 9.1 | 8.3 | 10.9 | 12.9 | 10.9 |
UNMARRIED COHABITATION
The number of un married couples living together has significantly increased in the last 4 decades and a significant number of younger Americans now live together outside of marriage, and living together without being married commonly precedes marriage.
Between the years 1960 and 2004 the number of unmarried couples in America increased by nearly 1200 percent. Unmarried cohabitation of couples who are sexual partners but not married to each other and sharing a living arrangement is particularly common among the young. It is estimated that about one quarter of unmarried women between the ages of 25 to 39 are currently living with a male or partner and in additional another quarter of women have lived with a partner in the past. According to statistics more than 50% of first marriages are now preceded by living together compared to virtually none 50 years ago.
For many living together with a sexually active partner is a step before marriage but for others this is simply an alternative to living alone, and for a small but increasing number of people it is considered as an alternative to marriage. Living together before marriage is more common among those of lower educational and lower income levels. Recent data show that among women in the 19 to 44 age range out of which 60 percent of high school dropouts have lived together before marriage compared to 37 percent of college graduates who prefer marriage. Living together before marriage is also more common among those who are less religious than others, those of whom have been divorced, and those who have in the past experienced parental divorce, lived without a father or experienced high levels of marital problems during childhood. A growing percentage of live in relationship households now over 40 percent contains children.
The belief that living together before marriage is the best way to find out whether the couple can adjust with each other and thus avoid a bad marriage or eventual a divorce is now widespread among young people. Contrary to this belief the available data on the effects of living together before marriage does not confirm this belief and in reality there is substantial evidence indicating that those who live together before marriage are more likely to get divorced after marriage. This evidence is controversial mainly because it is difficult to differentiate the selection effect from the experience of living together before marriage. The selection effect refers to the fact that people who live together before marriage have different characteristics from those who do not, and it is possible that these specific characteristics and not the experience of living together that leads to marital problems. In addition, a recent study based on a nationally-representative sample of women suggested that living together with a sexually active partner when limited to a woman's future husband, is not associated with an increased risk of marital problems. As of now it can be concluded that there is no strong evidence that those who live together before marriage have stronger marriages than those who do not.
| Number of Adult Couples of the Opposite Sex living together without marriage | |
| Year | Number |
| 1960 | 0.439 |
| 1970 | 0.523 |
| 1980 | 1.589 |
| 1990 | 2.856 |
| 2000 | 4.736 |
| 2004 | 5.080 |
LOSS OF CHILD CENTEREDNESS
Key Finding: The presence of children in America has significantly reduces since the year 1960 compared to fertility rates and the percentage of families with children. Researches suggest that this decline has reduced the child centeredness of USA as a country and also contributed to the weakening of the institution of marriage.
In the past marriage has first and foremost been an institution for procreation and raising children and it has provided the cultural tie that held the father to the mother-child bond. In the recent past children increasingly have been pushed aside and families now do not consider the child as the glue that keeps parents together.
Americans on average have been having fewer children as compared to the past. It is important to note that fertility problems have been gradually increasing throughout American history, reaching an all time high in the Great Depression of the 1930s before suddenly reducing with the baby-boom generation starting in 1945. By the year 1960 the birth rates were back to where it had been in the year 1920, with the average woman giving birth to three and one half children over the course of her life. Since 1960 the birth rates have decreased rapidly although it increased for some time in the 1980s and again in the late 1990s.
Since the year 2000 the birth rates have been reducing significantly and in the year 2003, the latest year for which there is adequate information available for the American total fertility rate was at 2.044 that is significantly below the level in the year 1999 and slightly above two children per woman. This rate is also below the level of replacement at 2.1 which is the level at which the population would be replenished through births alone, but this is still one of the highest rates found today in modern societies. In many European and Asian nations the total fertility rate has below the level of United States and in some countries the rate is currently at one child per woman. Some observers believe that the birth rate in United States will reduce even more in future decades to become more like that of Europe today.
The significant long-term decline of birth rate has marked an effect on the families of the American population. It is estimated that in the mid 1800s more than 75 percent of all families had children under the age of 18 but in 1960 this number dropped to slightly less than half of all families. In the year 2000 just 40 years later, less than 33 percent of families included children, and the percentage is said to drop to 28 by 2010. This means that adults are less likely to be living with children and that neighbourhoods are less likely to contain children. This also means that children are less likely to be a consideration in daily life. This suggests that the needs and concerns of children-especially young children-gradually may be reduced from our national consciousness.
Several experts determined that in the year 1960 the proportion of one's life spent living with a spouse and child was 62 percent that is the highest in our history. By that year the death rate had reduced significantly which means that fewer marriages ended through the death of a partner, and the divorce revolution of recent decades had not yet started. By the year 1985, however, that is 25 years later the proportion of one's life spent with spouse and children reduced to 43 percent which was the lowest in our history. This significant drop was caused mainly by the decline of fertility and the weakening of marriage through divorce pregnancies before marriage.
In a recent cross-national comparison of industrialized nations, United States ranked at the top in the percentage disagreeing with the statement that the main purpose of marriage is having children. Nearly 70 percent of Americans now believe the main purpose of marriage is something else compared to just 51 percent of Norwegians or 45 percent of Italians. Consistent with this view is a dramatic change in the view that children are important to keep parents together. In a Detroit area sample of women answered no to the question "Should a couple stay together for the sake of the children?" increased from 51 percent to 82 percent between the years 1962 and 1985. A nationally-representative 1994 ssurvey found only 15 percent of the population agreed that when there are children present in the family, parents should stay together even if they don't get along.
A careful analysis of divorce statistics suggests that starting around 1975, the presence of children in a marriage has become only a very minor inhibitor of divorce and this also depends on the sex of the child.
WHAT'S HAPPENING TO CHILD-REARING FAMILIES?
Experts are now unanimously agreeing that the best family situation for children and adolescents is to live with married parents who have a strong marriage. Unfortunately, the percentage of families that have children with these characteristics has dropped significantly in the last few decades. In the 1973-1976 period 51% of children under the age of eighteen were living with married adults that were happily married. By the 1997-2002 period this percentage dropped to 37%. This sudden drop is the result of two trends that is fewer children living in families headed by married couples and a drop over time in the marital bond of those couples.
Several reasons for this deterioration in children's family situation are troublesome. One of the main reasons is that Americans are these days viewing marriage and child rearing as separate tasks. An example of this is an agreement among never-married young people between ages 18-34 that state those who want children should get married. In national surveys conducted it was suggested that 64% of the males in this category agreed that children are important in 1988, but only 51% agreed in 2002. For women the drop was slightly more, from an original 56% to 42% in 2002. In an annual reporting of the family life opinions of American high school seniors a significant increase has been in relation to the statement that having a child without being first married is experimenting with a worthwhile lifestyle and not affecting anyone else. More than half of senior boys now agree with this statement and an increase from 49% in the late 1990s even with the percentage of senior girls who agree.
A second reason for families not having children these days is that children seem to be a growing reason for the decline of happiness in marriages. Many studies have shown that after the arrival of the first baby mother and father are being pushed apart bringing stress to the marriage. One recent review of more than 100 researches found that parents report significantly lower marital happiness than non married parents. This is especially true for parents of infants since only 38% of mothers of infants are happy compared to 62% of childless women. This review also concluded that the effect of parenthood on marital happiness is even worse among younger birth cohorts along with higher socioeconomic groups and there are signs that the negative effect may be on the increase.
| Year | General Fertility Rate | Total Fertility Rate |
| 1960 | 118.0 | 3.654 |
| 1970 | 87.9 | 2.480 |
| 1980 | 68.4 | 1.840 |
| 1990 | 70.9 | 2.081 |
| 2000 | 65.9 | 2.056 |
| 2003 | 66.1 | 2.044 |
| Percentage of Families with a Child or with Children Under Age 18 as of the years 1960-2010 | |
| Year | Percent |
| 1960 | 48.7 |
| 1970 | 42.2 |
| 1980 | 38.4 |
| 1990 | 34.6 |
| 2000 | 32.8 |
| 2010 projected | 28.0 |
FRAGILE FAMILIES WITH CHILDREN
Key Finding: The number of children that have up in fatherless-families has grown significantly over the past four decades. This is primarily due to increases in divorce, pregnancies before marriage and couples living together before marriage. The trend toward fragile families reduced in the late 1990s, but the most recent data shows a slight increase.
There is now enough evidence to suggest that strong, steady and happy marriages are very important for the wellbeing of adults. These marriages are even more important for the proper upbringing and overall wellbeing of young children. The main purpose of the institution of marriage is to ensure that the responsible and long-term involvement of both biological parents in the difficult and time-consuming task is of taking care of the next generation.
The increasing trend of single-parent families is by large the most important of the recent family trends that have significantly adversely affected children and adolescents. This trend has adversely affected children because the children in such families have negative life outcomes twice or thrice the rate compared to children in married two-parent families. While in the year 1960 only 9% of all children lived with only one parent, a figure that had hardly changed over the course of the 20th century, by the year 2004 this percentage had increased to an alarming 28 percent. The majority of single-parent families are mothers only although the percentage of single parent families with only fathers has recently grown to about 18 percent.
An indirect indicator of unsteady families is the decreasing percentage of children under age 18 living with two parents. Since the year 1960 this percentage has declined significantly, by 20 percentile points. Unfortunately, this measure makes no distinction between biological families and stepfamilies. Additionally, it is estimated that out of the percentage mentioned above 88 percent of families with both parents consist of both biological parents, while nine percent are stepfamilies. According to a substantial and growing body of social science evidence, children that live in step families do not fare any better in life than children living in single-parent families. Data on stepfamilies probably are more reasonably combined with single-parent compared to with biological families with two parents. An important indicator that helps to resolve this problem is the percentage of children who do not live with their biological fathers has doubled since 1960, from a mere 17 percent to an increased 34 percent.
The significant shift in the basic family structure indicated by the measures mentioned above has been created mainly by three trends that are divorce, pregnancies without marriage, and living together without being married. The incidence of divorce began to increase rapidly during the 1960s. The number of children under the age of 18 that were affected by parental divorce each year, most of whom have lost a resident father, increased from less than 500,000 in the year 1960 to more than a million in the year 1975. After reaching an all time increase around 1980 the numbers stopped increasing and remained close to a million new children every year. Much of the reason for this leveling off is a reduction in the average family size and each divorce that occurs these days typically affect a smaller number of children compared to the past.
The second reason for the shift in family structure is an increase in the percentage of babies born to mothers that have not been married which suddenly and unexpectedly began to increase very fast in the 1970s. Since the year 1960, the percentage of babies born to these mothers has increased more than six fold times. Additionally surveys indicate that more than a third of all new births and more African American unwed births reduced slightly in the late 1990s, but now the numbers have started to increase again.
A third and a recent family trend that has affected family structure is the quick growth of living together without marriage Especially as living together has become common among those previously married as well and the young that have not-yet-married there has been over 900 percent increase in the number of couples living together who live with children. Researches also indicate that 40 percent of all children are expected live with parents that are not married during their growing up years.
In the year 2000 approximately 40 percent of unmarried parent households included one or more children under the age of 18. For unmarried couples between the ages of 25 to 34 the percentage with children is still higher, reaching nearly 50%. Seventy percent of the children living with parents that are not married are the children of only one partner. If cohabitation of stepfamily is also included then almost one half of stepfamilies these days would consist of a one biological parent and one unrelated cohabiting partner.
Surveys also indicate that children who grow up with parents who live together without being married tend to have worse life outcomes compared to those children growing up with married parents. Prominent reasons for this conclusion are that couples that live together without being married have a much higher breakup rate compared to married couples. Also partners that live together without marriage have a lower level of household income along with a higher level of child abuse and domestic violence. The percentage of cohabiting mothers that eventually marry the fathers of their children is significantly declining to 44 percent in 1997 from a comparatively higher rate of 57 percent 10 years earlier.
| Percentage of Children Under the Age 18 Living with A Single Parent | |||
| Year | Total(a) | Blacks | Whites |
| 1960 | 9 | 22 | 7 |
| 1970 | 12 | 32 | 9 |
| 1980 | 20 | 46 | 15 |
| 1990 | 25 | 55 | 19 |
| 2000 | 27 | 53 | 22 |
| 2004 (b) | 28 | 56.2 | 22.4 |
| Percentage of Children Under the Age of 18 Living with two parents that are married to each other | ||
| Total(a) | Blacks | Whites |
| 88 | 67 | 91 |
| 85 | 59 | 90 |
| 77 | 42 | 83 |
| 73 | 38 | 79 |
| 69 | 38 | 75 |
| 67.8 | 34.8 | 74.3 |
| Percentage of Unmarried pregnancies to women | |||
| Year | Total | Blacks | Whites |
| 1960 | 5.3 | ||
| 1965 | 7.7 | ||
| 1970 | 10.7 | 37.6 | 5.7 |
| 1975 | 14.2 | 48.8 | 7.3 |
| 1980 | 18.4 | 55.2 | 11.0 |
| 1985 | 22.0 | 60.1 | 14.5 |
| 1990 | 28.0 | 65.2 | 20.1 |
| 2000 | 33.2 | 68.5 | 27.1 |
| 2003 | 34.6 | 68.2 | 29.4 |
| Number of Adult Couples of the Opposite Sex living together without marriage with One Child or More Under Aged 15 years | |
| Year | Number |
| 1960 | 0.197 |
| 1970 | 0.196 |
| 1980 | 0.431 |
| 1990 | 0.891 |
| 2000 | 1.675 |
| 2004 | 1.789 |
TEEN ATTITUDES ABOUT MARRIAGE AND FAMILY
Key Finding: Since the last few decades? teenagers of both sexes now desire good marriages a little more than before. Girl teenagers desire good marriages 10 percent more than boys and boys are also a little more pessimistic about the possibility of a long-term marriage. Both boys and girls are now more accepting of lifestyles that are alternatives to marriage like children outside of marriage although the latest data show a surprising drop in acceptance of living together before marriage.
To understand what the future may have in store for marriages as an institution it is important to determine what our nation's youth now say, think about marriages and how their views have changed over time. It has become important to determine if these developments of the divorce revolution going to continue the family ways of their parents or might there be a cultural counter-revolution among teenagers that could lead to a change in current family trends?
Since the year 1976 a nationally representative survey of high school seniors known as Monitoring the Future that is conducted annually by the Institute for Social Research has asked teenagers numerous questions about family-related topics. Based on these youth centred survey, the percentage of male and female teenagers who stated that having a good marriage and family life was significantly important to them has increased by a few percentage over the last few years. Eighty-two percent of young women stated this belief in the latest survey while young men lagging behind at 70 percent.
Other data from the same survey shows a moderate increase in the percentage of young adults who said that they expect to marry or have already married recently with 84 percent for young women and 78 percent for young men. Among teenagers, young men are a little more pessimistic than young women in the belief that their marriage with a single partner will last a lifetime. However, this difference has reduced significantly and since 1986 to 1990 the trend has been slightly more optimistic.
There is also widespread acceptance by teenagers of non-marital lifestyles like living together without getting married. An instance of this is the agreement with the proposition that states ?most people will have fuller and happier lives if they choose to get legally marriage rather than staying single or living with a partner without marriage. Less than one third of young women and only slightly more than one third of the young men answered that marriage is more beneficial to individuals compared to various alternatives. These answers are however contrary to the available undeniable evidence which indicates that there are personal gains to getting married as well as social benefits of being married compared to staying single or just living with someone without getting legally married.
In the past few decades people have become more acceptant of the fact that pregnancies can occur out of marriages and while in 1970s young women tended to be more traditional than young men on this delicate issue, now young women are slightly less so. With more than 50 percent of teenagers now accepting pregnancies before marriage or out of marriage as a worthwhile lifestyle, the others yet do not seem to agree with the suggested economic, social and personal costs of single parenthood.
More than 50% teenagers also state that living together without getting married is a worthwhile alternative. In this issue young women currently remain more traditional than young men however recently the trend to live together without being married has taken an unexpected reversal for both young men and women. This may be an indication that teenagers are more aware of the evidence that has been widely publicized in recent years, linking living with a sexual partner before marriage to a higher divorce risk.
In conclusion it can be said that marriage and family life remains very important for today's teenagers but at the same time young adults also accept other non-marital lifestyles. As of now there are no strong signs of a generational shift that could lead to a reversal of recent family trends, but some data from the past few years suggests that the views of teenagers are, with the exception of pregnancies before marriage moving in a more conservative direction.
| Percentage of High School Seniors Who Stated that A Good Marriage and Family Life Is Extremely Important | ||
| Year | Boys | Girls |
| 1976-1980 (6000 participants) | 69.4 | 80.2 |
| 1981-1985 (6000 participants) | 69.0 | 81.3 |
| 1986-1990 (6000 participants) | 69.7 | 81.9 |
| 1991-1995 (6000 participants) | 72.0 | 83.2 |
| 1996-2000 (6000 participants) | 72.9 | 82.1 |
| 2001-2003 (3,200 participants) | 70.3 | 82.4 |
| Percentage of High School Seniors Who Stated that It Is Possible They Will Stay Married to the Same Person for Life | ||
| Year | Boys | Girls |
| 1976-1980 (6000 participants) | 57.3 | 68.0 |
| 1981-1985 (6000 participants) | 55.7 | 68.0 |
| 1986-1990 (6000 participants) | 53.7 | 62.5 |
| 1991-1995 (6000 participants) | 56.4 | 63.5 |
| 1996-2000 (6000 participants) | 57.8 | 64.6 |
| 2001-2003 (3,200 participants) | 57.4 | 63.5 |
| Percentage of High School Seniors Who Agreed That Most People Will Have Satisfied Lives If They Opt for Marriage Rather Than Remaining Single or Living together Without Being Married | ||
| Year | Boys | Girls |
| 1976-1980 (6000 participants) | 37.9 | 38.9 |
| 1981-1985 (6000 participants) | 38.4 | 35.7 |
| 1986-1990 (6000 participants) | 36.5 | 30.9 |
| 1991-1995 (6000 participants) | 37.9 | 31.1 |
| 1996-2000 (3200 participants) | 38.1 | 28.5 |
| 2001-2003 | 38.7 | 30.9 |
| Monitoring the Future surveys - Percentage of High School Seniors Who Stated that Having a Child Without Being Married is a Lifestyle that Does Not Affect Anyone Else | ||
| Year | Boys | Girls |
| 1976-1980 (6000 participants) | 41.2 | 33.3 |
| 1981-1985 (6000 participants) | 43.2 | 40.3 |
| 1986-1990 (6000 participants) | 46.6 | 47.8 |
| 1991-1995 (6000 participants) | 49.1 | 53.3 |
| 1996-2000 (6000 participants) | 49.1 | 54.3 |
| 2001-2003 (3200 participants) | 54.8 | 55.5 |
| Percentage of High School Seniors Who Agreed that It Is most likely a Good Idea for a Couple to Live Together Before Getting Married to Find Out Whether They Get Along or Not | ||
| Year | Boys | Girls |
| 1976-1980 (6000 participants) | 44.9 | 32.3 |
| 1981-1985 (6000 participants) | 47.4 | 36.5 |
| 1986-1990 (6000 participants) | 57.8 | 45.2 |
| 1991-1995 (6000 participants) | 60.5 | 51.3 |
| 1996-2000 (6000 participants) | 65.7 | 59.1 |
| 2001-2003 (3200 participants) | 65.3 | 55.6 |
Time to Have a Child
The decision when to have a child is one of the most important decisions two people can make. Due to many scientific advances, this particular decision is one that has more dimensions than evident. It is possible for couples now to decide when to begin a family, the size of their family, or whether to have a child or not. Hence if a couple is planning to have a child then they have the luxury as well as the additional responsibility to consider and discuss the various things involved in being a parent. This will assist couples who are considering having a child to discuss or try to resolve problems before the birth of their child and to identify resources that a couple can use so to their advantage to help them with such questions.
Initial Considerations
Do We Want to Have Children?
The first question a couple has to answer is if they want to or do not want to have children. Not having children is an option that has not always been available to couples. In the past it was always assumed that if a couple married then they were also going to have children. These days however there is an alternative of not having children at all. While some people and experts argue that the decision not to have children is selfish, many others believe that the decision to have children is of such importance and responsibility that people should not be forced to have children if they can?t fulfil the responsibility involved. Similarly, the decision to remain childless is becoming more accepted due to neglect, abuse, and violence in the world - and the way children are often victims of such social ills. Due to these factors some couples may decide that they would like to help society through other roles like vocation, religion, volunteering and mentoring.
We Want Children, But When?
If a couple decides together that they do want to have children then the next decision often concerns the time when to have children. Due to the many advances in the field of gynaecology and obstetrics along with pharmacy, it is now possible to time conception. Before deciding when to have a child partners need to consider the state of their relationship, their financial status, their work goals or demands, their respective ages and their overall level of functioning. Some questions that need to be answered include why are both partners seeking to have a child at this particular time, can they partners afford a child, how is the health of both partners and are both partners content with their educational level or are one or both of the partners planning to return to school for additional training sometime in the future? Furthermore it is important to discuss what are the fears and dreams of each partner in relation to being a parent?
Having children can definitely be a wonderful, exciting and significant time in a couple's life but at the same time it can also cause additional stress physically, emotionally, and financially. Children can be a source of happiness but the decision to have children should not be based on an attempt to make a marriage stronger since even the strongest of marriages can get tested during pregnancy and the years to come.
We Want Children, But How Many?
A couple now has more choices regarding how many children they will be comfortable raising and how many children the couple can take care of without feeling burdened. Many partners look to their own family of birth as a way to decide the number of children to have. An instance of this would be if one partner may have been an only child and seeks the same in his or her own family or that the same partner may have always wished that he or she had a sibling to grow up with and thus may or may not wish to have more than one child. Hence, it is important for both partners to discuss a possible preference of the number of children to have and also be able to identify and share their reasons for their decision.
Couples benefit from also discussing whether or not prefer a male child or a female child and if the sex of the child will influence the decision to have more children. An instance of this would be a couple who had decided to have two children may have assumed that they would have a child of each sex. However, if this same couple then has 2 daughters or 2 sons, then one or both partners may then decide that they would like to have a third child of the other sex.
Before having a child it is important to consider and discuss the reasons behind each partner's opinions and needs. Things that should be discussed include what are the benefits of having a child as well as the additional stressors related to additional children and the various reasons behind each partner's beliefs? Financial factors as well as cultural and religious factors need to be considered and also each partner's mental and physical health along with their intrapersonal needs, dreams, and fears.
Child Care Decisions
Other important and more specific issues that need to be discussed include, which partner is going to stay home and take care of the new baby, will one partner be forced to feel as if he or she is sacrificing his or her career to take care of the baby? Couples may decide to share the responsibility equally or maybe one partner may decide to take on more responsibility compared to the other partner. Couples may even decide to hire someone to take care of their child such as a nanny. When considering the option to hire a nanny the partners will need to spend some time to consider how comfortable each of them are with this and why. For instance how partners will resolve possible feelings of guilt or neglect and how both partners might later feel if both of them did not stay at home with the child?
These questions are structured not as a way to create guilt, but rather to help the couple understand consideration of likely feelings that may occur due to the society's continued belief that a child does best only when cared for by a parent, and the child does just okay when cared for by someone else.
Thus, regardless of a couple's eventual decision as to who a parent, grandparent, friend, nanny, or public day care shall care for their child and for the period of time someone else will take care of the child, the couple still needs to work together to understand ways to avoid current as well as potentially future concerns. In addition, such child care decisions must also include consideration of the amount of time the couple is going to spend together. Some couples need a lot of time together while others need a little. The couple will also have to decide how the couple will plan for time alone. Will they hire a sitter one night a week so as to ensure some much needed alone time or will they ask their friends or family to baby sit their child while the couple goes away for a few hours? Couples benefit from being creative about making time for each other as couple-time is very hard to get without thinking of solutions beforehand.
Financial Considerations
Children can also place a financial burden on parents and this is often not thought out clearly before having children. Couples need to decide how much they can spend on children without feeling burdened and they need to ask each other the following questions: Will we need to give up on certain luxuries so that we have enough money to raise the child and if yes then what are the luxuries that we are willing to sacrifice?
Other Feelings
Feelings of jealousy may appear with the birth of a child and this occurs when the parents have had lots of time for each other but after the birth of a first child that one or both the parents get involved in child care. It is important for new parents to inform each other if they feel that they are being left out, and if they are feeling resentful due to spending a lot of time taking care of the new born.
Expectations of Child
Parents at times have different expectations or goals for their children and this causes problems between parents. This topic is something very few parents sit down and think about when planning children, yet it is crucial for partners to discuss their thoughts of such expectations. While discussing about expectations the parents should include areas of concern such as religious affiliation, academic expectations, schooling preferences such as private or public school, vocational school or college and social behaviors like introvert or extrovert. Discussion of these areas of concern is necessary to identify where differences in expectations lie and after identification differences parents can discuss about their reasons for such expectations and work together to reach a middle ground.
Rearing Children
Parents may also differ in their ideas on the upbringing of children. One parent may tend to be very lenient or permissive and comfortable in having the children play without restrictions while the other parent might become uptight or anxious with this parenting approach and he or she may prefer an authoritarian approach of parenting in which there are set limits and boundaries for the child. While setting limit and boundaries, there are many different approaches and the approach the parents choose is probably not as important compared to if the parents are or are not consistently use the same parenting approach. Before planning for children parents will need discuss the things mentioned and arrive at some mutually decision if there a lot of differences between them.
Teenage Pregnancy
For several decades, there have been increasing concerns about adolescent sexual behavior, along with pregnancy, and parenthood. These concerns have been triggered by several realizations such as rates of adolescent births in the United States are much higher from 10% to 50% higher than in other industrialized societies. Another reason for an increasing concern of adolescent pregnancy and birth is that majority of adolescents do not want to become parents at this age.
There is also an increasing concern about adolescent sexual intercourse because it leads to unintended pregnancy and parenthood and because sexually active adolescents are at a risk of getting of sexually transmitted infections and along with the human immunodeficiency virus (HIV).
Finally, initial sexual experiences for women are often forced upon and before the age of 5, a majority of first intercourse experiences for teenage girls are reported to be non-voluntary. Coercion not only causes mental problems but it is also associated with poor protection from pregnancy and sexually transmitted infections.
The process leading to teenage pregnancy involves a series of events such as sexual intercourse, use of contraception devices, pregnancy, and pregnancy resolution. Interventions can be implemented at any one of these stages. The initial and main risk behavior for adolescent pregnancy and teenage parenthood is indulging in sexual intercourse, including the frequency of sexual intercourse. Among sexually active adolescents, the severity of pregnancy risks depends largely on their frequency of intercourse and the type along with the consistency of contraceptive usage. Sexually active adolescents who do not always use contraceptives have a higher risk of becoming pregnant and they also have to face a potentially life altering decision about resolving their pregnancy through techniques such as abortion, adoption, or admitting to parenthood.
Pregnancy Resolution
When adolescents become pregnant before marriage due to not using contraceptives then they face several difficult choices. Due to their young age and the future implications of these choices various people play an important role in teenage pregnancies. At times relatives decide what has to be done and at times partners and friends would be expected to play an important role in adolescent pregnancy related problems. Abortion is the most likely outcome when a female adolescent who is pregnant has poor relationships with her partner who impregnated her. As of now only about two percent of premarital births are given up for adoption. Decisions about abortion or adoption and parenthood are influenced not only by the adolescent?s perceptions of their families and friends opinions but also by opportunities given by his or her communities. An instance of this would be better employment opportunities are found to be associated with a lower probability of childbearing. Adolescents who opt for adoption usually are from higher socioeconomic backgrounds and they have done well in school hence they have higher educational aspirations. Usually adolescents from more advantaged families and communities are more likely to terminate the pregnancy since such adolescents have attainable future plans that they do not want to give up.
Prevention
For the last 20 years varied approaches to prevention and intervention have been tried in United States. There are several points at which interventions and preventive programs can be started. Interventions are used to try to delay the initiation of sexual activity, to improve the knowledge of contraceptive use among sexually active adolescents, to help with pregnancy resolutions among those who become pregnant and to reduce or delay births out of marriages. Some programs are indirect and they focus on issues that suggest that adolescents who perceive better educational, occupational, and economic opportunities for themselves will decide to postpone parenthood. Prevention programs are often part of schools curriculum because students are accessible and can be made to understand at this stage however, many effective programs are also based in clinics and agencies and sometimes they are based in religious institutions such as churches and are provided directly to families. Some prevention programs are also embedded in a community wide intervention context that includes all of the techniques mentioned above.
Unfortunately, none of the programs have had much of an impact on young adults. It is unclear why many programs are effective and why certain programs fail. Some programs appear to be effective, but more often most programs have not shown any noticeable effects.
Family life or sex education in the public schools which has consisted mainly of providing information based on facts at the secondary school level is the most general and persuasive approach to preventing pregnancy among adolescents. The effects of sex education in the public schools continue to be widely debated however recent perspectives state that school sex education is wrong or has simply failed but some people also believe that too little is being provided often too late. Data proves that traditional sex education that is being offered in United States increases sexual knowledge of teenagers but it has little or no effect on the decision of teens to delay sex or use contraception. Quite surprisingly, traditional school sex education is found to be unrelated to adolescent pregnancies and the most consistent finding is that sex education does not cause adolescents to initiate sex if they did not plan to do so already.
School-based clinics which typically provide comprehensive adolescent health services but may or may not provide contraceptive services have not shown any convincing evidence of success at reducing teenage pregnancies. In addition, school-based programs do not reach older non-teen partners or school dropouts that would have benefited from sex education.
Another limit of current interventions is the lack of attention to educate young men. The majority of interventions are for young women and these interventions either fail to include young men in the intervention or fail to consider the role of young men in teen pregnancy. In addition, sexual coercion has been linked with early sexual activity among teenage girls however few programs take this fact into account while designing interventions. It can be stated that it is difficult to prevent pregnancy by increasing a young girl?s knowledge and motivation to prevent pregnancy if the young girl is becoming pregnant due to of a non-voluntary sexual experience.
HIV/AIDS overview
AIDS is an acronym for acquired immune deficiency syndrome and this disease slowly destroys the body's immune system. Without the body?s natural defences a person with AIDS can't fight off germs, infections and disease like cancers. HIV is the virus that causes AIDS and this harmful virus kills an important kind of blood cell like the CD4 T lymphocyte also known as the T cell. These T cells are very important parts of the immune system and as these cells die the body becomes more vulnerable to a large number of diseases. Germs take this opportunity to invade the body and the various diseases they cause are called opportunistic infections. When people with HIV get these dangerous infections or when their T-cell levels goes below normal they have AIDS.
Usually it takes half a decade or more for HIV to weaken the body's immune system to the point where the T cells go below count and cause AIDS. HIV may not cause symptoms until 10 or more years or it can even longer than that for damage to the white blood cells to show up. White blood cells are very important since they are part of the body's immune defence against external germs that cause infections and illnesses. The virus, HIV causes certain white blood cells to become weak or die which causes the body to becomes immuno-deficient. That means that the body is no longer capable of fighting off infection. This stage of the illness is called Immuno-deficiency Syndrome and this syndrome is acquired since there are originally nothing wrong with the immune system. This is why the disease caused by the virus, HIV is called the Acquired Immuno-Deficiency Syndrome or AIDS. It is possible for a person to be infected with HIV and not have AIDS and this occurs when the person hasthe virus but the white cells cells have not been severely damaged and the immune system is not yet compromised.
Anti-HIV drugs help prevent the body?s immune system to die completely. Even when a person already has AIDS these drugs can prevent any serious illnesses and in certain cases they can even help the person get better. Anti-HIV drugs let many people with HIV infection live healthy or normal lives. Combinations of various powerful anti HIV medicines work very well, but at times there are serious side effects, such as vomiting, diarrhea, and fatigue. People with HIV have to keep taking these drugs every day for the rest of their lives and people who have AIDS often state that it's best to avoid getting HIV in the first place.
AIDS is a worldwide epidemic and while most cases are in Africa this disease is also spreading widely in Eastern Europe and Asia. If a cure was found for AIDS sometime in the future, this disease will still be the most deadly disease ever to plague mankind.
HIV is the most feared sexually transmitted disease because there is no known cure for it and it can cause premature death. Many patients who have AIDS die because their immune system was compromised and their bodies were unable to fight off severe infections.
What Causes It?
HIV is the human immunodeficiency virus that causes AIDS. HIV is an infection that lasts for the person?s life time. There is no cure to this illness but anti-HIV drugs keep HIV in check. Unfortunately, 95% of the world's HIV infected people cannot afford these expensive medicines.
There are a minority group of people that state that HIV does not cause AIDS. Some of these people are scientists but none of them are experts on the subject of AIDS. Overwhelming medical and scientific evidence shows that HIV is responsible for causing AIDS and every major health organization in the world says that HIV is a serious hazard to humans.
Babies and children can also get infected with the HIV virus if they come in contact with vaginal fluids or blood that is infected with HIV. This infection usually occurs during or before birth. Babies can also contract HIV by HIV infected breast milk and additionally children in USA can also be infected by the HIV virus by having a blood transfusion prior to 1985.
A baby born to an HIV positive woman will test positive for the HIV antibody since the mother passes her antibodies to the child which includes the antibodies for. Babies that have these antibodies may not be infected with the HIV virus however theses antibodies will induce a positive HIV test. The baby who has these antibodies will need to be tested over a period of time until he or she reaches the age of 24 months. At this age the baby will lose the mother?s antibodies but usually most children lose the mother?s antibodies by 15 months of age.
Babies and children with HIV disease can suffer from one or many of the following symptoms:
- Weight loss
- Persistent diarrhea
- Re occurring fevers
- Re occurring ear or sinus infection
- Thrush - which is a yeast infection in the mouth or in the diaper area
- Swollen lymph glands
- Bacterial infections
- Heart, liver or skin problems
- Damaged nervous system
- Slow growth
- Opportunist infections
The medications that have resulted in many people living longer and healthier lives also has a direct impact on daily eating habits. Certain HIV medications need to be taken on an empty stomach where as certain medications need to be taken after meals. In order to get maximum benefit from these medications the person has to follow the instructions and has to take the medicines as directed.
Weight loss has known to be a problem with HIV hence people who have this infection must also eat good quality good that is rich in calories so that they do not feel weak or tired.
After Infection
Soon after being infected with HIV the body makes antibodies to fight the virus. The HIV test does not look for the virus in the body, but it looks for antibodies in the blood. Most people do not have enough antibodies in 3 months or lesser hence it is important to take the test every few months up to a year from the date of the infection.
HIV Testing
- Deciding whether to take the test
- Anonymous versus confidential testing
- How and when to get test results
- Who will see the results if the test results
- Alternate sites for being tested; home collection kit
- Benefits of being tested
- Peace of mind; knowing one way or the other
- Begin treatments for HIV and HIV-related problems
- Prevent transmission to others
- Make informed childbearing decisions
- Diagnose illness or symptoms
- Access government assistance programs
- Difficulties with being tested:
- Anxiety about test results if infected:
- Telling sex or needle-sharing partners
- Possible relationship difficulties with partner, family, friends
- Possible loss of job; difficulty getting or keeping insurance
- Few experienced care providers in some locales
- You are infected
- You can pass the virus on to other people
- You are not infected ?or?
- You are infected but your body has not yet made enough antibodies for the test to detect the illness
- If infected or if infection status is unknown practice sexual abstinence.
- Do not participate in unprotected sex between infected persons since this may still expose one or both partners to a different strain of HIV
- Avoid pregnancy
- Avoid donating blood, sperm, or body organs
- Mutually agreed monogamous sex only with uninfected persons
- No drug use that lowers sexual inhibitions or even impairs judgment such as alcohol or cocaine
- No sharing of IV drug needles
- Delay pregnancy until the patient has received counselling about medications that can reduce the chance of HIV transmission to the unborn baby
- Use barriers to protect mucous membranes and bloodstream from contact with their sexual partner's blood, semen, or vaginal fluid. Barriers include
- a latex or plastic male condom during vaginal, anal, or oral intercourse
- a female condom during vaginal intercourse
- water-based sexual lubricants
- clean drug paraphernalia with bleach and water between uses
- Numbness
- Fear of loss of sexual relationship
- Fear of loss of childbearing potential
- Fear of discovery of risk behavior
- Fear of loss of job, housing or insurance
- Fear of punishment from provider, partner, family, God
- Fear of terminal illness
- Relief
- Denial - may be mild or profound
- Fear of social isolation
- Anger about having become infected
- Anxiety about medical confidentiality
- Anxiety about access to medical care services
- Difficulty in incorporating safer sex guidelines
- Trigger for addictive behaviors
HIV Antibody Negative
Give the test results promptly. If you are giving new information then wait for the patient to first absorb the fact that he is HIV negative. Allow the patient some time to adjust to the new situation and plenty of time for supportive counselling for the patient's personal concerns. Finally move on to education and counselling about being HIV negative and to practice safe sex or no needle sharing to avoid HIV in the future. Information can be given in the form of printed booklets in the same session.
What the HIV antibody test looked for: Antibodies the body built against for HIV, not the virus itself Evidence of infection contracted more than 3 ? 6 months ago
HIV Positive Test Result
Give results promptly and do not offer information immediately. Do not expect people to take in or fully comprehend new information after they have immediately heard that they are infected. Give the patient enough time for supportive counselling about feelings after the patient suggests he needs emotional support. Information should be given in the form of printed booklets in the next appointment and not immediately. Make a return appointment or referral for ongoing counselling and care. Be sure that the patient has a reasonable plan of action such as where to go when they leave you and whom to inform before she/he leaves your office.
What a positive HIV antibody test means
- Antibodies created by the body for HIV present in the patient?s blood, saliva or other tested body fluids
- Being infected with the virus may lead to AIDS
- The patient can pass the virus on to other people
- How long the patient has been infected
- Whether the patient already has AIDS
- When, if ever, the patient will develop AIDS
- The status of the patient?s immune system right now
Under rare circumstances the patient's test result may show as positive even though he or she is not infected with HIV. The chance of a false positive test result is usually less than 1 in 1000 people but the best way to be sure is to get re-tested using a different testing laboratory.
Things to Remember:
- Starting treatment immediately gives the body the chance to prevent early onset of AIDS.
- Sexually transmitted diseases also known as STDs may help the virus spread faster.
- People with HIV are more susceptible to STDs.
- Additional drugs for STDs can hurt the immune system or prevent needed medications from working properly.
- An unhealthy body has to work harder to fight HIV infection hence eating well, getting adequate rest and exercise are all extremely useful in fighting HIV/AIDS.
AIDS symptoms may not show up until months or years after the virus enters the body. Many people have the virus and do not display symptoms hence it is important to be vigilant for any new symptoms. Some symptoms of AIDS include but are not limited to high fever, night sweats and swollen lymph glands. These symptoms can show up anywhere from 4 weeks to several months after the immune system is compromised. These symptoms can last for a month or so and often then they will go away. These early symptoms are not present in all cases and since most of these symptoms resemble the flu many people may experience these symptoms without thinking that it may be anything more than the flu.
Kaposi's Sarcoma
The immune system helps protect our bodies from certain types of cancers and when a person has AIDS their body is unable to fight off such cancers. One type of cancer that an AIDS patient can contract is Kaposi's Sarcoma. This type of cancer affects not only the skin but also other body organs. Symptoms of this cancer include markings that look like bruises or black and blue marks and these markings do not go away on their own. This type of cancer has been a leading cause of death among AIDS clients.
Treatment
Treatment includes a combination of AIDS drugs. These drugs can prevent people from HIV from getting AIDS.
It is important to remember that not all of these drugs work for each and every one. It's absolutely essential to take the drugs at the right time of day and every single day for maximum benefits. Due to the drugs' side effects or due to being preoccupied with another task people may not take the drugs at the right time and this can be very harmful. Treatment for HIV or AIDS must be planned and adjusted for every individual person affected by this virus. Medical professionals agrees that starting aggressive treatment in the early days after infection that is the stage of acute HIV infection is most effective but most people don't find out they have HIV until the stage of chronic HIV infection that is when the virus has a firm hold on the body. Most AIDS/HIV experts now recommend holding starting treatment only when the patient?s immune system starts to fail and this decision is based on the CD4 T-cell count that is the best measure of HIV disease. Another factor is the amount of the viris in the blood that is the measure called viral load.
When treatment begins the decision of choosing the right anti-HIV drugs is crucial. Certain new tests can tell which drugs will work best on the HIV infecting an individual patient.
There are several types of anti-HIV drugs to prevent the early onset of AIDS. Because HIV mutates so quickly this virus is able to resist any single treatment and that's why doctors use combinations or cocktails of anti-HIV drugs. By using a combination of Anti Retro HIV drugs the patient increases his chances of fighting the virus. Over time, even this strategy isn't always enough, and resistant to multiple drugs may appear. At this point, a doctor will switch to another drug combination. While there are many AIDS drugs, the possibilities are not endless. Researchers are working hard to find new ways to treat clients who have run through several different combination treatments. The different types of anti-HIV drugs each target a different aspect of HIV's life cycle:
HIV has to get into a T cell to start infecting the immune system. This virus has to latch on to the cell and then it has to fuse its own outer membrane to that of the cell. Drugs to stop this process are called attachment inhibitors. These drugs are also called fusion inhibitors and these new drugs are still being tested in humans.
The virus?s main goal is to overrun T cells genetic machinery. This is done by the virus by first joining with a cell and then splitting its genetic material into the cell. The genetic code of the HIV (virus) is written in a form called RNA but in humans the genetic code is written in DNA. The virus solves this issue by making an enzyme named reverse transcriptase that converts the virus?s RNA into DNA. AIDS drugs called RT inhibitors work by tricking HIV into making defective and useless reverse transcriptase out of raw materials. Another class that is the non-nucleoside RT inhibitors that basically gum up reverse transcriptase so they do not work effectively. Several RT inhibitors and Non Nucleoside RT inhibitors are now in use.
HIV has to snip apart the cell's DNA to put its own DNA in and then stick back the DNA strand back together. The method the virus uses to complete this process is called integrase. Human tests for integrase inhibitors began in 2001.
Once HIV has taken over a cell's genetic material, it gets the cell to reproduce from which a new virus is made. These pieces have to be exactly the right size and that's what HIV's protease enzyme does. Several protease inhibitors known as PIs are now available in the market.
Another approach is to make the body's immune system fight HIV more effectively. One way to do this is with a chemical messenger called interleukin-2 or IL-2 which is now in advanced human tests. Other immune stimulators are in various stages of development.
Yet another strategy is to use antisense drugs. These are strands of genetic material that form a kind of mirror image of HIV's genetic code. These genetic materials fools the virus's replication machinery. One antisense drug has entered human tests. Side effects are common with all of these medications. These can include:
- Nausea and vomiting - These side effects are most common in the first weeks or months of anti retro HIV treatment. Often they go away as the body gets used to the drugs.
- Diarrhea ? This side effect is common in early treatment.
- Rash- Rash is common among people who start taking anti-HIV drugs and rashes on the body usually go away on their own. Rash on the body can also be a sign of an allergic reaction to a drug. This usually happens to patients taking Ziagen, but also it can also happen to patients taking anto retro HIV drugs like Viramune or Sustiva. Patients that notice rashes after taking these drugs should call their doctor right away.
- Insomnia or sleep disturbances
- Fatigue
- Dry skin and/or ingrown toenails sometimes happen with Crixivan.
- Pain, numbness, tingling, and or burning in extremities.
- Kidney stones sometimes occur in people who take Crixivan.
- A change in the metabolic system is another system is another side effect. This is called lipodystrophy syndrome. It includes various symptoms including a roll of fat between the shoulders often referred to as buffalo hump along with enlarged breasts; and loss of fat in the face and arms or legs.
HIV-Associated Dementia Complex also known as AIDS Dementia Complex is a progressive neurological disorder that can affect patients who are infected with HIV. HIV-Associated Dementia Complex commonly known as HAD is thought to be a sub cortical dementia and this illness is characterized by cognitive, motor and behavioral impairments that is severe enough to interfere with an patient's ability to function at work or in social situations.
It has been estimated that up to 2/3rds of the individuals with AIDS will develop dementia or related neurological disorders. It is believed that HAD is caused by direct infection of the brain by the Virus that is the cause of AIDS. In the year 1987 the Centers for Disease Control included HIV-Associated Dementia Complex as a primary diagnostic condition that acts as a diagnosis of AIDS.
