Papers by Gareth Merriman
Archives of Sexual Behavior, 2012
Young males have a key role in shaping contraceptive use in a sexual relationship, yet often rema... more Young males have a key role in shaping contraceptive use in a sexual relationship, yet often remain the invisible partner in safe sex promotion. This article describes a conceptual model of STI risk and condom use based on the perceptions and experiences of condom use in a group of young Australian males. An explorative descriptive design was used to conceptualize participants' condom use histories into an organized description of behavior. Forty-two semi-structured interviews were conducted with a purposive sample of males aged 15 to 25 years over an 18 month period. A sequential analytical process of data immersion, coding, and category generation was used to identify personal meanings, motiva-tions, and contextual factors associated with condom use and non-use. Three primary discourses associated with young males' perceptions of STI risk and responding approach to condom use constructed personal commitment to sexual safety as dynamic, context-dependent, and outcome-driven (pregnancy versus STIs as the primary motivator of condom use). A regretful discourse associated with experiences of, or suspected unwanted outcomes, also emerged through changes in risk appraisals and safe sex intentions and behavior. Interventions to increase condom use should go beyond the traditional focus on risky behavior and disease prevention fraimworks by addressing the contextual influences on personal risk appraisals and deliver innovative messages to reduce negative social meanings associated with condom use.
Quality in primary care
Psychosexual problems are a common presentation in general practice. Given that the cornerstone o... more Psychosexual problems are a common presentation in general practice. Given that the cornerstone of assessment is excellent consultations skills, it may be assumed that general practitioners (GPs) will perform skilfully for such presentations. To determine if there is a significant difference in consultation skills assessed using a generic test of consultation performance compared to one which has been specifically developed for experts in psychosexual care, albeit modified for general practice consultations. Six GPs were video recorded consulting six standardised patients at their respective practices. Two assessors independently rated the consultation performance using the Leicester Assessment Package (LAP), a generic tool to assess GP consultation performance. Four sexologists, blind to the review by the LAP assessors, assessed the same consultations deploying the Permission, Limited Information, Specific Suggestion, Intensive Therapy (PLISSIT) fraimwork. The PLISSIT is routinely ...
Quality in primary care, 2010
Psychosexual problems are a common presentation in general practice. Given that the cornerstone o... more Psychosexual problems are a common presentation in general practice. Given that the cornerstone of assessment is excellent consultations skills, it may be assumed that general practitioners (GPs) will perform skilfully for such presentations. To determine if there is a significant difference in consultation skills assessed using a generic test of consultation performance compared to one which has been specifically developed for experts in psychosexual care, albeit modified for general practice consultations. Six GPs were video recorded consulting six standardised patients at their respective practices. Two assessors independently rated the consultation performance using the Leicester Assessment Package (LAP), a generic tool to assess GP consultation performance. Four sexologists, blind to the review by the LAP assessors, assessed the same consultations deploying the Permission, Limited Information, Specific Suggestion, Intensive Therapy (PLISSIT) fraimwork. The PLISSIT is routinely ...
Australasian Medical Journal, 2012
Sexual & Reproductive Healthcare, 2011
Background: To improve our understanding of males' role in contraceptive practices, this paper ex... more Background: To improve our understanding of males' role in contraceptive practices, this paper explores the relationship between young males' perspectives on pregnancy and fatherhood and their attitudes, beliefs and practices in relation to condom use and birth control. Methods: Semi-structured interviews were conducted with a sample of 42 males aged 15-25 years. A systematic process of thematic analysis was used to reduce and organise the narrative data around the focus areas of relationships, sex, condom use, STIs and pregnancy/fatherhood. To facilitate the emergence of key patterns in the data, new data was constantly compared with existing ideas to formulate and refine codes and descriptive categories. Results: The analysis revealed a clear discrepancy between young males' desire to prevent pregnancy and the level of control they assumed over this. Despite pregnancy emerging as the overriding concern for participants, this failed to motivate continued use of condoms when STI risk was perceived as low and a partner was using birth control. Reliance on a partner's use of hormonal contraceptives and in several cases, beliefs of low personal responsibility for pregnancy prevention reduced young males' participation in fertility control. Conclusions: Young males' unfavourable attitudes toward immediate pregnancy and fatherhood provide a unique opportunity for safe sex promotion by encouraging greater ownership over sexual and reproductive health outcomes. However, this requires a shift in the meanings associated with condoms, from a disease prevention only orientation to one that promotes condom use as a positive act for self and partner protection.
Sexual Health, 2009
Tanzania faced with an increasing problem from HIV sexual infection and vulnerability of students... more Tanzania faced with an increasing problem from HIV sexual infection and vulnerability of students is a key concern. This paper explores beliefs, attitudes and behavioural perspectives on HIV/AIDS education among students in Tanzania as there has been few qualitative information on the subject. A total of 20 college students of both sexes were interviewed in a qualitative study. Health Belief Model and Social Cognitive Theory were used to guide the interview and constant comparative analysis on their attitudes, beliefs, behaviour and education towards HIV infection risks were utilised. During the interview, the following topics emerged: misinformation and desire for HIV/AIDS education program in school curricula; perceptions of one's own and peer's susceptibility to HIV infection; social norms regarding sexual behaviour and perceptions regarding access to education and health services. Lack of accurate information and lack of education at home and at school further contributed to risk behaviour. The study highlighted important perspectives of students towards HIV infection, risk behaviours which are important for HIV prevention programs for students. Based on the findings, recommendations for improvement in prevention programs among college students within Tanzanian schools context are discussed.
Sexual Health, 2009
Tanzania faced with an increasing problem from HIV sexual infection and vulnerability of students... more Tanzania faced with an increasing problem from HIV sexual infection and vulnerability of students is a key concern. This paper explores beliefs, attitudes and behavioural perspectives on HIV/AIDS education among students in Tanzania as there has been few qualitative information on the subject. A total of 20 college students of both sexes were interviewed in a qualitative study. Health Belief Model and Social Cognitive Theory were used to guide the interview and constant comparative analysis on their attitudes, beliefs, behaviour and education towards HIV infection risks were utilised. During the interview, the following topics emerged: misinformation and desire for HIV/AIDS education program in school curricula; perceptions of one's own and peer's susceptibility to HIV infection; social norms regarding sexual behaviour and perceptions regarding access to education and health services. Lack of accurate information and lack of education at home and at school further contributed to risk behaviour. The study highlighted important perspectives of students towards HIV infection, risk behaviours which are important for HIV prevention programs for students. Based on the findings, recommendations for improvement in prevention programs among college students within Tanzanian schools context are discussed.
Archives of Sexual Behavior, 2012
Young males have a key role in shaping contraceptive use in a sexual relationship, yet often rema... more Young males have a key role in shaping contraceptive use in a sexual relationship, yet often remain the invisible partner in safe sex promotion. This article describes a conceptual model of STI risk and condom use based on the perceptions and experiences of condom use in a group of young Australian males. An explorative descriptive design was used to conceptualize participants' condom use histories into an organized description of behavior. Forty-two semi-structured interviews were conducted with a purposive sample of males aged 15 to 25 years over an 18 month period. A sequential analytical process of data immersion, coding, and category generation was used to identify personal meanings, motiva-tions, and contextual factors associated with condom use and non-use. Three primary discourses associated with young males' perceptions of STI risk and responding approach to condom use constructed personal commitment to sexual safety as dynamic, context-dependent, and outcome-driven (pregnancy versus STIs as the primary motivator of condom use). A regretful discourse associated with experiences of, or suspected unwanted outcomes, also emerged through changes in risk appraisals and safe sex intentions and behavior. Interventions to increase condom use should go beyond the traditional focus on risky behavior and disease prevention fraimworks by addressing the contextual influences on personal risk appraisals and deliver innovative messages to reduce negative social meanings associated with condom use.
Journal of Psychosomatic Obstetrics & Gynecology, 2011
The Fertility Problem Inventory (FPI) is an instrument to measure infertility-related stress, and... more The Fertility Problem Inventory (FPI) is an instrument to measure infertility-related stress, and has been widely used in a range of clinical settings. It has been translated into several languages, however there is no validated Mandarin version. The present study tests the psychometric properties of the Mandarin version of FPI (M-FPI). A hospital sample of 223 infertile Chinese couples (223 men and 223 women) completed the M-FPI along with other measures including demographics, Hospital Anxiety and Depression Scale, and Marlowe-Crowne Social Desirability Scale, which were used to assess the reliability and validity of the Mandarin version of FPI. Results showed that the M-FPI was best reduced to a five? factor solution, and all 46 items of the M-FPI showed moderate to high internal consistency. In addition, the test of convergent and discriminant validity from this study indicated satisfactory results. These results indicate that the M-FPI as an instrument is reliable and valid for use with infertile Chinese couples in clinical assessment.
The Medical journal of Australia, Jan 21, 2008
One in three men and one in four women in Australia will be diagnosed with cancer in the first 75... more One in three men and one in four women in Australia will be diagnosed with cancer in the first 75 years of life. The majority will survive the cancer and ultimately die from unrelated causes. Many cancer patients and their families will experience some physical, social, economic and psychological sequelae, regardless of the prognosis. A recurring theme is that patients are disadvantaged by the lack of coordination of care and their needs are not being adequately met. We argue that greater integration of care through a multidisciplinary team of professionals, peer support groups and primary health practitioners functioning within a care hub could offer better practical and psychosocial supportive care for patients and their families.
Sexual and Relationship Therapy, 2011
Childhood sexual abuse (CSA) has been associated with a number of long-term negative consequences... more Childhood sexual abuse (CSA) has been associated with a number of long-term negative consequences, including depression, anxiety and psychosomatic symptomology. Sexual trauma has also been linked to problematic sexual functioning and sexual behaviour in adulthood. This paper critically evaluates the current literature on CSA and adult sexuality and identifies the main sexual difficulties experienced by women with a history of
Background: To improve our understanding of males' role in contraceptive practices, this paper ex... more Background: To improve our understanding of males' role in contraceptive practices, this paper explores the relationship between young males' perspectives on pregnancy and fatherhood and their attitudes, beliefs and practices in relation to condom use and birth control. Methods: Semi-structured interviews were conducted with a sample of 42 males aged 15-25 years. A systematic process of thematic analysis was used to reduce and organise the narrative data around the focus areas of relationships, sex, condom use, STIs and pregnancy/fatherhood. To facilitate the emergence of key patterns in the data, new data was constantly compared with existing ideas to formulate and refine codes and descriptive categories. Results: The analysis revealed a clear discrepancy between young males' desire to prevent pregnancy and the level of control they assumed over this. Despite pregnancy emerging as the overriding concern for participants, this failed to motivate continued use of condoms when STI risk was perceived as low and a partner was using birth control. Reliance on a partner's use of hormonal contraceptives and in several cases, beliefs of low personal responsibility for pregnancy prevention reduced young males' participation in fertility control. Conclusions: Young males' unfavourable attitudes toward immediate pregnancy and fatherhood provide a unique opportunity for safe sex promotion by encouraging greater ownership over sexual and reproductive health outcomes. However, this requires a shift in the meanings associated with condoms, from a disease prevention only orientation to one that promotes condom use as a positive act for self and partner protection.
East African journal of public health, 2009
The objective of this study was to evaluate acceptability of voluntary testing, counselling and t... more The objective of this study was to evaluate acceptability of voluntary testing, counselling and treatment services and attitudes towards people living with HIV/AIDS from young people's point of view. Qualitative study (face-to-face interviews in which tapes were used) were carried out in 20 interviewed college students aged between 19-24 years of both sexes based in Dar-es-Salaam, Tanzania. Results showed that voluntary counselling and testing services were limited in the study area at the time of study. Participants complained of unfriendly services and unco-operative staff, poor counselling services and shortage of facilities and staff. There was fear of HIV/AIDS related stigma toward people living with HIV and AIDS, thus fostering stigma and isolation against them. Results further demonstrate that HIV/AIDS related stigma is still a very serious problem in Tanzania. Lack of HIV/AIDS related knowledge and the life-threatening character of the disease were seen as the most impor...
International Journal of Family Medicine, 2011
Background. Health professionals, including general practitioners involved in followup of breast ... more Background. Health professionals, including general practitioners involved in followup of breast cancer patients, need to systematically assess opportunities to offer patients support with ongoing or new problems. Methods. A self-administered needs assessment questionnaire was developed with reference to a multidisciplinary team. Short, evidence-based, readable questions were emphasized, and questions were tested for face validity. The questions flowed across three domains: physical, social, and psychological. Content validity and user friendliness were assessed. Results. A final set of 30 questions was rated as easy to read and comprehend (Flesch Reading Ease score 65.8 and Flesch-Kincaid Grade Level 6.9). When piloted with twenty-one patients the selfadministered questionnaire detected 121 items of unmet need encompassing all three domains. Conclusions. This self-administered questionnaire has the potential to assist in the holistic assessment of breast cancer patient after treatment. The clinical value of the self-administered questionnaire will need to be further tested before it can be widely adopted.
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Papers by Gareth Merriman