Assessing the delivery of alcohol screening and brief intervention in sexual health clinics in the north east of England

Acceptability of integrating mental health and substance use care within sexual health services among young sexual and gender minority men in Vancouver, Canada

BACKGROUND

Despite well-established evidence showing that young sexual and gender minority (SGM) men experience disproportionate mental health and substance use inequities, few sexual health services provide mental health and substance use care. This qualitative study examined the experiences and perspectives about integrated care models within sexual health services among young SGM men experiencing mental health and substance use challenges.

METHODS

Semi-structured interviews were conducted with 50 SGM men aged 18-30 years who reported using substances with sex in Vancouver, Canada. Interviews were analyzed using thematic analysis.

RESULTS

Three themes were identified: 1) participants asserted that their sexual health, mental health and substance use-related health needs were interrelated and that not addressing all three concurrently could result in even more negative health outcomes. These concurrent health needs were described as stemming from the oppressive social conditions in which SGM men live. 2) Although sexual health clinics were considered a safe place to discuss sexual health needs, participants reported not being invited by health providers to engage in discussions about their mental health and substance use health-related needs. Participants also perceived how stigmas associated with mental health and substance use limited their ability to express and receive support. 3) Participants identified key characteristics they preferred and wanted within integrated care, including training for health providers on mental health and SGM men's health and connections (e.g., referral processes) between services. Participants also recommended integrating social support programs to help them address SGM-related social challenges.

CONCLUSION

Our findings highlight that SGM men's sexual health, mental health and substance use-related health needs and preferences are interrelated and should be addressed together. Tailored training and resources as well as structural adaptations to improve communication channels and collaborative connections between health providers are required to facilitate the development of integrated care for young SGM men.

Exploring multimorbidity profiles in middle-aged inpatients: a network-based comparative study of China and the United Kingdom

BACKGROUND

Multimorbidity is better prevented in younger ages than in older ages. This study aims to identify the differences in comorbidity patterns in middle-aged inpatients from China and the United Kingdom (UK).

METHODS

We utilized 184,133 and 180,497 baseline hospitalization records in middle-aged populations (40-59 years) from Shaanxi, China, and UK Biobank. Logistic regression was used to calculate odds ratios and P values for 43,110 unique comorbidity patterns in Chinese inpatients and 21,026 unique comorbidity patterns in UK inpatients. We included the statistically significant (P values adjusted by Bonferroni correction) and common comorbidity patterns (the pattern with prevalence > 1/10,000 in each dataset) and employed network analysis to construct multimorbidity networks and compare feature differences in multimorbidity networks for Chinese and UK inpatients, respectively. We defined hub diseases as diseases having the top 10 highest number of unique comorbidity patterns in the multimorbidity network.

RESULTS

We reported that 57.12% of Chinese inpatients had multimorbidity, substantially higher than 30.39% of UK inpatients. The complete multimorbidity network for Chinese inpatients consisted of 1367 comorbidities of 341 diseases and was 2.93 × more complex than that of 467 comorbidities of 215 diseases in the UK. In males, the complexity of the multimorbidity network in China was 2.69 × more than their UK counterparts, while the ratio was 2.63 × in females. Comorbidities associated with hub diseases represented 68.26% of comorbidity frequencies in the complete multimorbidity network in Chinese inpatients and 55.61% in UK inpatients. Essential hypertension, dyslipidemia, type 2 diabetes mellitus, and gastritis and duodenitis were the hub diseases in both populations. The Chinese inpatients consistently demonstrated a higher frequency of comorbidities related to circulatory and endocrine/nutritional/metabolic diseases. In the UK, aside from these comorbidities, comorbidities related to digestive and genitourinary diseases were also prevalent, particularly the latter among female inpatients.

CONCLUSIONS

Chinese inpatients exhibit higher multimorbidity prevalence and more complex networks compared to their UK counterparts. Multimorbidity with circulatory and endocrine/nutritional/metabolic diseases among both Chinese and UK inpatients necessitates tailored surveillance, prevention, and intervention approaches. Targeted interventions for digestive and genitourinary diseases are warranted for the UK.

Characterizing HIV Syndemics and the Role of Incarceration Among Men Who have Sex with Men Presenting for Care at a Sexually Transmitted Infections Clinic

Men who have sex with men (MSM) with a history of incarceration experience unique risk factors for HIV acquisition. The current study examined unique risk factors for HIV among MSM with a history of incarceration presenting to a sexually transmitted infections (STI) clinic. We analyzed self-reported behavioral data from clinical encounters among patients attending the clinic between January 2012 and April 2021. There were 17,221 unique visits, of which 5988 were MSM. Of these, 4.34% (N = 206) were MSM with a history of incarceration. MSM with a history of incarceration were significantly more likely to report a range of behavioral risk factors for HIV, yet also were significantly less likely to perceive themselves at risk for HIV. Future research and practice should develop culturally tailored biobehavioral HIV prevention services and consider embedding these programs within criminal justice settings to better reach this at-risk group.

Is There Association between Risky Sexual Behaviors and Depression Symptoms among Youth? A Case of Jimma University Students, Ethiopia

BACKGROUND

Risky Sexual Behaviors (RSB) and Depression symptoms expose young people to various reproductive health problems including sexually transmitted infections and HIV/AIDS. To date the link between these two major public health problems lacks empirical evidence in the context of higher education institutions in Ethiopia.

OBJECTIVE

The aim of this study was to assess association between risky sexual behavior and depression symptoms among Jimma University main campus students, Jimma, Ethiopia, 2016.

METHODS

An institution based quantitative cross sectional study was conducted. A pre-tested questionnaire and modified Beck Depression Inventory II were administered to 700 students, selected by multi-stage stratified sampling, from the main campus of Jimma University. Descriptive statistics, simple and multiple logistic regression models were used to analyze possible confounders. Presence of crude association between the dependent and independent variables was detected by bivariate logistic regression analysis. Variables with p value < 0.25 in bivariate analysis were analyzed by multivariable logistic regression to exclude the confounders. Adjusted odd ratios with 95%CI were computed to examine depression symptoms and other independent variables as predictors of RSB.

RESULTS

RSB were reported by 30.2% students. Out of 222 (33.6%) students with depression symptoms 105 (47.3%) reported RSB. Students with moderate depression symptoms are nearly two times more likely to experience risky sexual behavior than students with no depression symptoms (AOR 1.9, 95% CI: 1-3.1). Students with severe depression symptoms are nearly two and half times more likely to experience RSB than students with no depression symptoms counterparts (AOR 2.6, 95%CI: 1.3- 5.1).

CONCLUSION

RSB were high among students with depression symptoms in the main campus of Jimma University. To help students overcome the challenges, recommendation was given for concerted action from the University, governmental and NGO, and the surrounding community to establish support services and various reproductive and mental health awareness programs within the campus.