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Borges ALV, Duarte LS, Cabral CDS, Lay AAR, Viana OA, Fujimori E. Male condom and dual protection use by adolescent men in Brazil. Rev Saude Publica 2021; 55:109. [PMID: 34910032 PMCID: PMC8621551 DOI: 10.11606/s1518-8787.2021055003298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/13/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To assess the use of male condoms and dual protection by Brazilian adolescent men, as well as their associated aspects. METHODS A database from the Study of Cardiovascular Risks in Adolescents (ERICA) was used for this national cross-sectiotabelnal school-based research. The sample included adolescents of both sexes, aged between 12 and 17 years old, selected through cluster sampling in 2014 (n = 75,060). This study analyzed information from adolescent men who reported having had sexual intercourse (n = 12,215). The dependent variables were the use of male condoms and the use of dual protection (simultaneous use of male condoms and oral hormonal contraceptives) in the last sexual intercourse. Data were analyzed using univariate and multiple logistic regression. RESULTS Most adolescents used a male condom in the last sexual intercourse, while the use of double protection was quite low. The use of male condoms, reported by 71% (95%CI 68.7-73.1), was positively associated with age, living with both parents, and having used alcohol in the previous 30 days. The use of double protection, reported by 3.6% (95%CI 2.8-4.5) was positively associated with age and studying in a private school, as well as negatively associated with tobacco use in the previous 30 days. CONCLUSIONS The wide difference shown in the proportion of condom or dual protection use in the last sexual intercourse draws attention to the different logics that govern juvenile sexual relations. The low proportion of dual protection use may be a reflection of men's lack of knowledge about a function that has historically been attributed to women, which is contraception. Thus, one must deconstruct such dichotomy that the sphere of sexuality is of the domain/interest of men, while that of reproduction concerns only women.
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Affiliation(s)
- Ana Luiza Vilela Borges
- Universidade de São PauloEscola de EnfermagemDepartamento de Enfermagem em Saúde ColetivaSão PauloSPBrasilUniversidade de São Paulo. Escola de Enfermagem. Departamento de Enfermagem em Saúde Coletiva. São Paulo, SP, Brasil
| | - Luciane Simões Duarte
- Secretaria de Estado da Saúde de São PauloCentro de Vigilância EpidemiológicaDivisão de Doenças Crônicas Não TransmissíveisSão PauloSPBrasilSecretaria de Estado da Saúde de São Paulo. Centro de Vigilância Epidemiológica. Divisão de Doenças Crônicas Não Transmissíveis. São Paulo, SP, Brasil
| | - Cristiane da Silva Cabral
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento Saúde, Ciclos de Vida e SociedadeSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento Saúde, Ciclos de Vida e Sociedade. São Paulo, SP, Brasil
| | - Alejandra Andrea Roman Lay
- Universidad de TarapacáFacultad de Ciencias de la SaludAricaChileUniversidad de Tarapacá. Facultad de Ciencias de la Salud. Arica, Chile
| | - Osmara Alves Viana
- Universidade de São PauloEscola de EnfermagemDepartamento de Enfermagem em Saúde ColetivaSão PauloSPBrasilUniversidade de São Paulo. Escola de Enfermagem. Departamento de Enfermagem em Saúde Coletiva. São Paulo, SP, Brasil
| | - Elizabeth Fujimori
- Universidade de São PauloEscola de EnfermagemDepartamento de Enfermagem em Saúde ColetivaSão PauloSPBrasilUniversidade de São Paulo. Escola de Enfermagem. Departamento de Enfermagem em Saúde Coletiva. São Paulo, SP, Brasil
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Lung SLM, Wincentak J, Gan C, Kingsnorth S, Provvidenza C, McPherson AC. Are healthcare providers and young people talking about sexuality? A scoping review to characterize conversations and identify barriers. Child Care Health Dev 2021; 47:744-757. [PMID: 34240445 DOI: 10.1111/cch.12892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/25/2021] [Accepted: 07/02/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Conversations about sexuality with healthcare providers (HCPs) are critical to youth's positive development, including youth with disabilities or chronic conditions. Yet, little is known about the characteristics of sexuality conversations with youth in healthcare settings. This scoping review examined the nature and extent of sexuality conversations between HCPs and youth (with and without a disability or chronic condition) and aimed to identify barriers to these conversations. METHODS Scoping review methodology using rapid review principles was employed. INCLUSION CRITERIA studies published between 2009 and 2019; examined conversations between HCPs and youth aged 21 and below; addressed sexuality; and took place in a healthcare setting. Study characteristics were described and clustered into thematic groups. RESULTS Of the 5543 identified, 32 articles were included. Articles addressed (i) the content of sexuality conversations, (ii) prevalence of sexuality conversations and (iii) barriers to discussing sexuality. The content of sexuality discussions was largely biologically focused. The prevalence of sexuality discussions varied, with some discrepancy between youth-reported and HCP-reported rates. Seven barriers (three personal and four systemic) were identified. Youth with disabilities or chronic conditions were vastly under-represented in the published literature. CONCLUSIONS This study highlighted that sexuality is an underexplored topic between HCPs and young people, especially young people with disabilities and/or chronic conditions. Given the importance of sexuality to young people's mental and physical health, research addressing barriers to these discussions and development of evidence-informed resources to support HCPs and youth to engage in conversations about sexuality should be a priority.
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Affiliation(s)
- Stephanie Lock Man Lung
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Joanne Wincentak
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Evidence to Care, Teaching and Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Department of Occupational Therapy, University of Toronto, Ontario, Canada
| | - Caron Gan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Shauna Kingsnorth
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Evidence to Care, Teaching and Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Department of Occupational Therapy, University of Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Ontario, Canada
| | - Christine Provvidenza
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Evidence to Care, Teaching and Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
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Woods JL, Hensel DJ. Improving Male Genital Examinations in Adolescent Patients: Creation and Preliminary Validation of an Assessment Tool. MEDICAL SCIENCE EDUCATOR 2019; 29:977-986. [PMID: 34457574 PMCID: PMC8368327 DOI: 10.1007/s40670-019-00785-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Providers cite lack of training and knowledge as reasons for omitting male genitourinary (GU) examinations. Also, no standard tools exist for assessment of male GU exams despite instruments for female pelvic exams. The objective of this project was to create and validate a male GU assessment instrument to evaluate trainee skill level. METHODS A first-author created 18-item assessment instrument (addressing preparation, exam, communication) was reviewed by a seven-member expert panel of adolescent medicine providers who reviewed items using a 4-point Likert scale. Adolescent medicine faculty completed the instrument (n = 48) for trainees, and differences in assessments were analyzed utilizing chi-square (SPSS, v. 24.0 p < .05). Exempt status was granted by the Institutional Review Board. RESULTS Nineteen trainees (13 female, 6 male) completed the instrument; no significant differences existed in assessments by gender. Trainees who completed the assessment > 2 times inspected the glans/meatus (p = .045), palpated the inguinal canals (p = .02), and informed of exam steps (p = .04) well compared to their first assessment. There were differences between provider assessments washing hands (p = .001); inspecting pubic hair (p = .000), glans (p = .001), and penis shaft (p = .002); palpating inguinal canals (p = .000); explaining exam steps (p = .000); being professional (p = .000); and explaining exam findings (p = .000). Excluding the creator, only professionalism was rated differently among providers (p = .023). CONCLUSIONS The male genital exam assessment tool was preliminarily validated as highly relevant to the male GU exam, was not affected by learner gender, and showed learner improvement over time. There are differences between faculty, indicating individual perception of exam items and need for increased discussion before implementing the assessment instrument into practice.
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Affiliation(s)
- Jennifer L. Woods
- Section of Adolescent Medicine, University of Colorado/Children’s Hospital Colorado, Aurora, CO USA
| | - Devon J. Hensel
- Division of Adolescent Medicine and Department of Sociology, Indiana University School of Medicine, 107 S Indiana Ave, Indianapolis, IN 47405 USA
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Wheeler NJ, Pilgrim N, Jennings JM, Sanders R, Page KR, Loosier PS, Dittus PJ, Marcell AV. Missed Opportunities to Address Pregnancy Prevention With Young Men in Primary Care. Clin Pediatr (Phila) 2018; 57:1558-1566. [PMID: 30095017 PMCID: PMC6631036 DOI: 10.1177/0009922818793351] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Young men (aged 15-24 years) have pregnancy prevention needs, yet little is known about whether they perceive they learn about pregnancy prevention in primary care. A sample of 190 young men seen in primary care in one city from April 2014 to September 2016 were assessed on perceived learning about pregnancy prevention, background and visit characteristics, pregnancy prevention care receipt, and contraception needs at last sex. The majority of participants were non-Hispanic black (92%), aged 15 to 19 years (54%), seen for a physical examination (52%), and established patients (87%). Few participants perceived they learned about pregnancy prevention (32%), regardless of sexual activity (33% among sexually active participants, 26% among never sexually active). Poisson regression models determined that perceived learning about pregnancy prevention was independently associated with young men's pregnancy prevention care receipt and contraception needs at last sex. Findings highlight the need to improve providers' delivery of pregnancy prevention services to young men.
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Affiliation(s)
- Noah J. Wheeler
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- School of Medicine, Baltimore, MD, USA
| | - Nanlesta Pilgrim
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Population Council, Washington, DC, USA
| | | | | | | | | | | | - Arik V. Marcell
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- School of Medicine, Baltimore, MD, USA
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Merki-Feld GS, Felder S, Roelli C, Imthurn B, Stewart M, Bateson D. Is there a need for better sexual education of young men? Sexual behaviour and reproductive health in Swiss university students: a questionnaire-based pilot study. EUR J CONTRACEP REPR 2018; 23:154-160. [PMID: 29683023 DOI: 10.1080/13625187.2018.1458226] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES There is evidence that men's perception of contraceptive methods and of their effectiveness and health risks have a major impact on couples contraceptive choices. Engaging men in decision making improves reproductive health outcomes. If they are better informed, men can potentially contribute to more effective use of contraception, thus reducing the rate of sexually transmitted infections and abortion. In Central European countries, few data are available on male contraceptive knowledge and behaviour. METHODS To collect more data we conducted an anonymous survey among young men studying at Zürich University in Switzerland. A questionnaire was distributed to 1500 male students which included a broad range of items addressing sexual behaviour, condom use and knowledge, and attitudes regarding contraceptive methods. RESULTS Three hundred and sixty-one questionnaires were eligible for evaluation. Condoms and the combined oral contraceptive pill were the most frequently used methods. However, at last intercourse 15.6% of respondents had not used any method of contraception. Many respondents (37%) had had a one-night stand without protection. Contraceptive methods most regarded as unhealthy for women were the combined oral contraceptive pill, progestin-only methods, intrauterine devices (IUDs) and emergency contraception. Characteristics considered by young men to be important in determining contraceptive method choice were: efficacy, partner satisfaction and no impact on fertility and libido. CONCLUSIONS Awareness among male Swiss students about contraceptive methods is high, but in-depth knowledge is limited. Myths were expressed about the combined oral contraceptive pill, progestin-only methods, IUDs and the emergency contraceptive pill. High-risk behaviour occurs frequently. The internet was reported to be the most important source of information about contraception.
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Affiliation(s)
- Gabriele Susanne Merki-Feld
- a Department for Reproductive Endocrinology, Department of Gynaecology and Obstetrics , Zürich University Hospital , Zürich , Switzerland
| | - Stephanie Felder
- a Department for Reproductive Endocrinology, Department of Gynaecology and Obstetrics , Zürich University Hospital , Zürich , Switzerland
| | - Conrad Roelli
- a Department for Reproductive Endocrinology, Department of Gynaecology and Obstetrics , Zürich University Hospital , Zürich , Switzerland
| | - Bruno Imthurn
- a Department for Reproductive Endocrinology, Department of Gynaecology and Obstetrics , Zürich University Hospital , Zürich , Switzerland
| | | | - Deborah Bateson
- b Family Planning NSW , Ashfield , Australia.,c Discipline of Obstetrics, Gynaecology and Neonatology , University of Sydney , Sydney , Australia
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Buzi RS. Young Males and Reproductive Health Care: Are We There? J Adolesc Health 2018; 62:359-360. [PMID: 29571432 DOI: 10.1016/j.jadohealth.2017.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 12/21/2017] [Indexed: 10/17/2022]
Affiliation(s)
- Ruth S Buzi
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
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Marcell AV, Gibbs SE, Pilgrim NA, Page KR, Arrington-Sanders R, Jennings JM, Loosier PS, Dittus PJ. Sexual and Reproductive Health Care Receipt Among Young Males Aged 15-24. J Adolesc Health 2018; 62:382-389. [PMID: 29128296 PMCID: PMC6080721 DOI: 10.1016/j.jadohealth.2017.08.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/01/2017] [Accepted: 08/24/2017] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to describe young men's sexual and reproductive health care (SRHC) receipt by sexual behavior and factors associated with greater SRHC receipt. METHODS There were 427 male patients aged 15-24 who were recruited from 3 primary care and 2 sexually transmitted disease (STD) clinics in 1 urban city. Immediately after the visit, the survey assessed receipt of 18 recommended SRHC services across four domains: screening history (sexual health, STD/HIV test, family planning); laboratories (STDs/HIV); condom products (condoms/lubrication); and counseling (STD/HIV risk reduction, family planning, condoms); in addition, demographic, sexual behavior, and visit characteristics were examined. Multivariable Poisson regressions examined factors associated with each SRHC subdomain adjusting for participant clustering within clinics. RESULTS Of the participants, 90% were non-Hispanic black, 61% were aged 20-24, 90% were sexually active, 71% had female partners (FPs), and 20% had male or male and female partners (M/MFPs). Among sexually active males, 1 in 10 received all services. Half or more were asked about sexual health and STD/HIV tests, tested for STDs/HIV, and were counseled on STD/HIV risk reduction and correct condom use. Fewer were asked about family planning (23%), were provided condom products (32%), and were counseled about family planning (35%). Overall and for each subdomain, never sexually active males reported fewer services than sexually active males. Factors consistently associated with greater SRHC receipt across subdomains included having M/MFPs versus FPs, routine versus non-STD-acute visit, time alone with provider without parent, and seen at STD versus primary care clinic. Males having FPs versus M/MFPs reported greater family planning counseling. CONCLUSIONS Findings have implications for improving young men's SRHC delivery beyond the narrow scope of STD/HIV care.
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Affiliation(s)
- Arik V Marcell
- Department of Pediatrics, The Johns Hopkins University, School of Medicine, Baltimore, Maryland; Department of Population, Family, and Reproductive Health, The Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland.
| | - Susannah E Gibbs
- Department of Population, Family, and Reproductive Health, The Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland
| | - Nanlesta A Pilgrim
- Department of Population, Family, and Reproductive Health, The Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland
| | - Kathleen R Page
- Department of Medicine, The Johns Hopkins University, School of Medicine, Baltimore, Maryland
| | | | - Jacky M Jennings
- Department of Pediatrics, The Johns Hopkins University, School of Medicine, Baltimore, Maryland
| | - Penny S Loosier
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Patricia J Dittus
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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Abstract
PURPOSE OF REVIEW Although teenage pregnancy is declining in many parts of the world, it remains associated with considerable social, health, and economic outcomes. Pregnancy prevention efforts focus primarily on young women, with minimal attention to young men. This review highlights recent literature pertaining to the role of young men in pregnancy prevention. RECENT FINDINGS Young men have varying views on contraception as well as which partner(s) should be responsible for its use. Limited contraception knowledge reduces young men's sexual health communication as well as their contraception use. Healthcare providers play a major role as one of the main sources of sexual health information for young men, but there are gaps in young men's sexual health care so new guidelines have emerged. SUMMARY Recent literature highlights young men's range of views on contraception as well as their low sexual health knowledge and sexual health communication. To address teenage pregnancy and improve young men's overall wellness, healthcare providers should routinely address sexual health. Healthcare providers may use our newly proposed acronym, HIS BESTT, (Hello. Initiate. Sexual health assessment. Both condoms and female dependent methods. Examine genitals. STI screening. Talking to partner(s). Talking to parent(s) or guardians), to incorporate current clinical recommendations.
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Pastuszak AW, Wenker EP, Smith PB, Abacan A, Lamb DJ, Lipshultz LI, Buzi R. Comprehensive Assessment of Health Needs of Young Minority Males Attending a Family Planning Clinic. Am J Mens Health 2017; 11:542-551. [PMID: 26846408 PMCID: PMC5675233 DOI: 10.1177/1557988316629627] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to assess the overall health, including sexual and reproductive health (SRH) knowledge and needs, sexual behaviors, and testicular health practices among young minority males. Anonymous questionnaires were administered to 18- to 25-year-old males receiving services at health clinics in a large southwestern U.S. city. The survey was completed by 258 males with a mean age of 20.8 years. Most young males (67.1%) identified as African American, and 32.9% as Hispanic. Results suggest study participants lack SRH knowledge related to pregnancy and condom effectiveness, and engage in risky sexual behavior including not using birth control at their last sexual encounter. Although 21.6% of participants had a sexually transmitted infection (STI) in the past year, approximately 80% perceived their STI/HIV risk as very low or low. Respondents had low engagement and lack of knowledge of testicular health practices. The majority of respondents (71.1%) reported having been in a physical fight one or more times and 18.1% reported being victims of intimate partner violence. These data support a need for comprehensive health services for minority young males.
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Affiliation(s)
| | | | | | | | | | | | - Ruth Buzi
- Baylor College of Medicine, Houston, TX, USA
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Marcell AV, Gavin LE, Moskosky SB, McKenna R, Rompalo AM. Developing Federal Clinical Care Recommendations for Men. Am J Prev Med 2015; 49:S14-22. [PMID: 26190843 PMCID: PMC10472453 DOI: 10.1016/j.amepre.2015.03.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Revised: 03/04/2015] [Accepted: 03/16/2015] [Indexed: 11/16/2022]
Abstract
U.S. men experience substantial sexual and reproductive health needs across the life span. A significant barrier for providers in serving men in family planning, primary care, and sexually transmitted disease clinics has been the lack of standards for men's sexual and reproductive health care. The goal of this synthesis paper is to describe the development of clinical recommendations for the delivery of family planning services for men that were developed and published by CDC and the U.S. Office of Population Affairs. This paper is intended to describe the process used from 2011 to 2014 to develop the recommendations for the delivery of comprehensive reproductive healthcare services to men, and the rationale underpinning them.
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Affiliation(s)
- Arik V Marcell
- Johns Hopkins School of Medicine, Johns Hopkins University, with collaboration with Johns Hopkins Medical Institutions, School of Medicine, Center for Sexually Transmitted Disease and Reproductive Health Research, Prevention, and Training, Baltimore, Maryland; Bloomberg School of Public Health, Johns Hopkins University, with collaboration with Johns Hopkins Medical Institutions, School of Medicine, Center for Sexually Transmitted Disease and Reproductive Health Research, Prevention, and Training, Baltimore, Maryland.
| | | | | | - Robert McKenna
- National Male Training Center for Family Planning and Reproductive Health, a program of Access Matters (formerly Family Planning Council), Philadelphia, Pennsylvania
| | - Anne M Rompalo
- Johns Hopkins School of Medicine, Johns Hopkins University, with collaboration with Johns Hopkins Medical Institutions, School of Medicine, Center for Sexually Transmitted Disease and Reproductive Health Research, Prevention, and Training, Baltimore, Maryland; Bloomberg School of Public Health, Johns Hopkins University, with collaboration with Johns Hopkins Medical Institutions, School of Medicine, Center for Sexually Transmitted Disease and Reproductive Health Research, Prevention, and Training, Baltimore, Maryland
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11
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Bayer CR, Satcher D. Moving Medical Education and Sexuality Education Forward. CURRENT SEXUAL HEALTH REPORTS 2015. [DOI: 10.1007/s11930-015-0050-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Albright JN, Fair CD. Providers caring for adolescents with perinatally-acquired HIV: Current practices and barriers to communication about sexual and reproductive health. AIDS Patient Care STDS 2014; 28:587-93. [PMID: 25290765 DOI: 10.1089/apc.2014.0162] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The population of adolescents and young adults (AYA) with perinatally-acquired HIV (PHIV) present challenges to HIV healthcare providers (HHCPs). Originally not expected to survive childhood, they are now living well into young adulthood. Little is known about the type of sexual and reproductive (SRH) information/services offered to AYA with PHIV by HHCPs. HHCPs (n=67) were recruited using snowball sampling, and completed an online survey. Providers' most frequently endorsed SRH topics discussed with both male and female patients included condom use (77.3%), STD prevention (73.1%), and screening (62.1%). Providers' reports indicated that females received significantly more education about SRH topics overall. The most frequently noted barriers to SRH communication included more pressing health concerns (53.0%), parent/guardian not receptive (43.9%), and lack of time during appointment (43.9%). Provider-reported SRH conversations with HHCPs were highly focused on horizontal transmission and pregnancy prevention. Salient social aspects of SRH promotion for AYAs with PHIV (e.g., managing disclosure and romantic relationships) were less commonly discussed, though such conversations may serve to reduce secondary transmission and enhance the overall well-being of AYA with PHIV. Findings indicated that further work must be done to identify strategies to address unmet SRH needs of the aging population of AYA with PHIV.
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Affiliation(s)
- Jamie N. Albright
- Department of Psychology, University of Virginia, Charlottesville, Virginia
| | - Cynthia D. Fair
- Department of Human Service Studies, Elon University, Elon, North Carolina
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Garcia CM, Ptak SJ, Stelzer EB, Harwood EM, Brady SS. "I connect with the ringleader:" health professionals' perspectives on promoting the sexual health of adolescent males. Res Nurs Health 2014; 37:454-65. [PMID: 25354398 DOI: 10.1002/nur.21627] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2014] [Indexed: 11/08/2022]
Abstract
In-depth interviews with nine professionals in adolescent health were used to identify perceived barriers, facilitators, and innovative strategies to reach, engage, and serve adolescent males for sexual and reproductive health care. Barriers included stigma, embarrassment, and lack of social norms around sexually transmitted infection (STI) testing for men. Facilitators included crisis situations and partner support. Clinic-based approaches to reach and engage young men included developing authentic staff-youth engagement and ensuring that access to services is easy and appealing. To be innovative, providers should become part of the real-world context of adolescent males. Technology (e.g., text messaging) and social media can be utilized to target and eliminate barriers to health care among young men.
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Affiliation(s)
- Carolyn M Garcia
- Associate Professor, University of Minnesota School of Nursing, 5-140 Weaver Densford Hall, 308 Harvard Street SE, Minneapolis, MN, 55455
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Same RV, Bell DL, Rosenthal SL, Marcell AV. Sexual and reproductive health care: adolescent and adult men's willingness to talk and preferred approach. Am J Prev Med 2014; 47:175-81. [PMID: 24951042 DOI: 10.1016/j.amepre.2014.03.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 02/28/2014] [Accepted: 03/22/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Sexually active adolescent and adult men have substantial sexual and reproductive health (SRH) needs, but little is known about their willingness and preferred approach to talk about SRH with their healthcare provider. PURPOSE To examine participants' willingness to talk about 11 SRH topics, including sexually transmitted disease (STD) risk; human papilloma virus (HPV) vaccine; condom use; female birth control methods; emergency contraception; concerns about sexual performance or making someone pregnant; being a father; relationships; testicular cancer; and acne, with their healthcare provider and their preferred approach (provider- or self-initiated). METHODS This cross-sectional clinic-based survey of 346 men aged 16-35 years was conducted in 2011. Bivariate analyses conducted in 2012 examined variation in study outcomes by participants' predisposing (age, race/ethnicity); enabling (education, past provider SRH discussion); and need factors (SRH concern). RESULTS Almost all participants (84%-98%) were willing to talk about all SRH topics. The top three topics included STD risk (98%); testicular cancer (98%); and HPV vaccine (97%). Among those willing to talk, the majority preferred their provider initiate the discussion (52%-88%). Participants reporting past provider discussions were more likely to prefer that their provider initiate discussions on condom use, female birth control methods, concerns about sexual performance and making someone pregnant, and relationships. Study outcomes did not vary by any other participant predisposing, enabling, or need factors. CONCLUSIONS These findings indicate that adolescent and adult men are willing to discuss a wide range of SRH topics with their healthcare provider. Providers need to move beyond whether male patients want to talk about these topics and instead proactively promote these conversations.
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Affiliation(s)
- Robert V Same
- Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - David L Bell
- Columbia University Medical Center, Columbia University, New York, New York
| | - Susan L Rosenthal
- Columbia University Medical Center, Columbia University, New York, New York
| | - Arik V Marcell
- Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland.
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Lozano R, Summers S, Lozano C, Mu Y, Hessl D, Nguyen D, Tassone F, Hagerman R. Association between macroorchidism and intelligence in FMR1 premutation carriers. Am J Med Genet A 2014; 164A:2206-11. [PMID: 24903624 DOI: 10.1002/ajmg.a.36624] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 05/01/2014] [Indexed: 11/08/2022]
Abstract
Characteristics of fragile X syndrome include macroorchidism and intellectual disability, which are associated with decreased FMRP levels. FMRP is highly expressed in many tissues, but primarily in the brain and testis. The relationship between these two characteristics has not previously been studied in the premutation or carrier state. To examine this among premutation carriers and a possible association with IQ, we evaluated macroorchidism status among 213 males including 142 premutation carriers and 71 controls. The prevalence of macroorchidism among premutation carriers was 32.4% (46 out of 142), and 5.6% among controls (4 out of 71, P < 0.0001). Among premutation carriers, the age-adjusted odds ratio (OR) of macroorchidism was significantly increased with increasing FMR1 mRNA (OR 1.84, 95% confidence interval [CI] 1.04-3.25; P = 0.035). With respect to the association between macroorchidism and IQ, after adjustment for number of CGG repeats and age, premutation carriers with macroorchidism had lower verbal IQ (104.67 ± 15.86, P = 0.0152) and full scale IQ (102.98 ± 15.78, P = 0.0227) than premutation carriers without macroorchidism (verbal IQ 112.38 ± 14.14, full scale IQ 110.24 ± 14.21). Similar associations were observed for both verbal IQ (P = 0.034) and full scale IQ (P = 0.039) after being adjusted for age and FMR1 mRNA. These preliminary data support a correlation between macroorchidism and lower verbal and full scale IQ in a relevant proportion of premutation carrier males. Whether this is due to higher levels of FMR1 mRNA or to lower FMRP levels it remains to be established.
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Affiliation(s)
- Reymundo Lozano
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, UC Davis Medical Center, Sacramento, California; Departments of Pediatrics, UC Davis Medical Center, Sacramento, California
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Saewyc EM. What about the boys? The importance of including boys and young men in sexual and reproductive health research. J Adolesc Health 2012; 51:1-2. [PMID: 22727069 PMCID: PMC5045302 DOI: 10.1016/j.jadohealth.2012.05.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 05/04/2012] [Indexed: 10/28/2022]
Affiliation(s)
- Elizabeth M. Saewyc
- School of Nursing, University of British Columbia, Vancouver, Canada; and Division of Adolescent Health and Medicine, University of British Columbia, Vancouver, Canada
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