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Alves Firmeza M, de Vasconcelos Oliveira NM, Mendes Alves F, Teixeira Moreira Vasconcelos C, Ananias Vasconcelos Neto J. Urinary symptoms and sexual function after hysterectomy secondary to cervical cancer: A prospective, cohort study. Eur J Obstet Gynecol Reprod Biol 2024; 296:208-214. [PMID: 38461785 DOI: 10.1016/j.ejogrb.2024.02.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 11/19/2023] [Accepted: 02/22/2024] [Indexed: 03/12/2024]
Abstract
INTRODUCTION AND HYPOTHESIS The estimated worldwide incidence of cervical cancer (CC) is half a million cases per year. Surgical treatment is the mainstay approach for this condition. OBJECTIVES To assess the effects of hysterectomy due to cervical cancer in urinary symptoms and sexual function and the disorder related impact on the quality of patients life. STUDY DESIGN A cohort study was performed in Fortaleza/CE (Brazil) with 71 patients; of these, 31 were diagnosed with cervical cancer (G-CCU) and 40 with gynecological benign disease (G-PB). Sexual function (FSFI questionnaire), quality of life (SF-36 questionnaire) and urinary symptoms (KHQ instrument) were investigated in both groups at baseline (T0), one month (T1) and four months after surgery (T2). RESULTS Both groups presented at baseline, similar urinary symptoms (p > 0.05), but this frequency doubled for the G-CCU group at T1 and remained unchanged at T2 (p = 0.012). G-PB's frequency of symptoms remained the same for 4 months after surgery. At baseline G-PB had higher risk for sexual dysfunction than G-CCU (82.5 % versus 54.8 %, p = 0.011). However for G-CCU, an increase of this percentage was perceived at T2.Women from the G-CCU group presented worse general and specific quality of life results. CONCLUSION Women underwent to hysterectomy due to cervical cancer presented higher percentages of urinary symptoms, higher risk for sexual dysfunction and worse general and specific quality of life scores.
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Affiliation(s)
- Mariana Alves Firmeza
- Nursing Department, Federal University of Ceará, St Alexandre Baraúna, n.1115 - 1° floor, room 3 - Rodolfo Teófilo district, city of Fortaleza, state of Ceará, 60430-160, Brazil
| | - Natália Maria de Vasconcelos Oliveira
- Woman's Health Department, Federal University of Ceará, 1608 Prof. Costa Mendes St - 2° floor - Rodolfo Teófilo district, city of Fortaleza, state of Ceará 60416-200, Brazil.
| | - Flávio Mendes Alves
- Woman's Health Department, Federal University of Ceará, 1608 Prof. Costa Mendes St - 2° floor - Rodolfo Teófilo district, city of Fortaleza, state of Ceará 60416-200, Brazil.
| | - Camila Teixeira Moreira Vasconcelos
- Nursing Department, Federal University of Ceará, St Alexandre Baraúna, n.1115 - 1° floor, room 3 - Rodolfo Teófilo district, city of Fortaleza, state of Ceará, 60430-160, Brazil.
| | - José Ananias Vasconcelos Neto
- Woman's Health Department, Federal University of Ceará, 1608 Prof. Costa Mendes St - 2° floor - Rodolfo Teófilo district, city of Fortaleza, state of Ceará 60416-200, Brazil.
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Fernández-Fernández MJ, de Medina-Moragas AJ. Comparative study of postpartum sexual function: Second-degree tears versus episiotomy outcomes. Arch Gynecol Obstet 2024:10.1007/s00404-024-07494-2. [PMID: 38613578 DOI: 10.1007/s00404-024-07494-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/24/2024] [Indexed: 04/15/2024]
Abstract
PURPOSE The effects of episiotomy and second-degree tears on postpartum sexual function are key areas of enquiry in women's health research. Episiotomy and second-degree tears are common procedures and injuries that occur during childbirth. Understanding their impact on post-childbirth sexuality is crucial to women's overall well-being. This study aimed to examine the relationship between episiotomy, second-degree tears, and post childbirth sexuality. METHODS A cross-sectional design was employed, including 83 women who gave birth to Cáceres in 2017. Participants were evaluated based on sociodemographic and sexual health factors. RESULTS No significant differences were found in dyspareunia or sexual function between women who underwent episiotomies and those with second-degree tears. However, women who underwent episiotomies waited longer before resuming sexual activity after childbirth. Factors such as age, number of previous births, employment status, educational level, and breastfeeding status affected the timing and frequency of postpartum sexual activity. CONCLUSION Dyspareunia negatively affects various aspects of sexual function. When comparing episiotomy and second-degree tears, their impacts on postpartum sexual function were similar. However, episiotomy delays the resumption of sexual activity. Sociodemographic factors significantly influence postpartum sexual health. These findings highlight the importance of individualised interventions and support for new mothers during the postpartum period to address potential sexual health concerns.
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Bosas J, Toffol E, Pohjoranta E, Mentula MJ, Hurskainen R, Suhonen S, Heikinheimo O. Factors affecting female sexual well-being: a 5-year follow-up of a randomised clinical trial on post-abortion contraception. BMJ Sex Reprod Health 2024; 50:92-98. [PMID: 37857463 DOI: 10.1136/bmjsrh-2023-201879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023]
Abstract
INTRODUCTION Sexual well-being is associated with general well-being. Several factors, such as overweight, infertility, anxiety and sex hormones, also play a role, but the effects of hormonal contraception remain a point of debate. We characterised the factors associated with sexual well-being in fertile-aged women following induced abortion. METHODS A 5-year follow-up of a nested, longitudinal, cohort study examining the effects of routine provision of intrauterine contraception as part of abortion care. Sexual well-being, anxiety and quality of life were assessed annually using validated questionnaires (McCoy Female Sexuality Questionnaire, State-Trait Anxiety Inventory and EuroQoL), along with data on general and reproductive health, and relationship status. Of the 742 women participating in the trial, 290 (39%) provided sufficient follow-up data and were included in this study. RESULTS Based on trajectories of McCoy scores across the 5-year follow-up, two groups were identified: those with stable and higher (n=223, 76.9%) and those with declining sexual well-being (n=67, 23.1%). Women in the group of declining sexual well-being had significantly higher levels of anxiety and lower quality of life at all time points. They also had chronic diseases more often and were less happy in their relationships. No differences were found in method of contraception when classified as hormonal versus non-hormonal, or long-acting versus short-acting reversible contraception. CONCLUSIONS Lower anxiety and higher quality of life are associated with stable and higher sexual well-being. Method of contraception or relationship status are not associated with sexual well-being during long-term follow-up in fertile-aged women.
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Affiliation(s)
- Janina Bosas
- University of Helsinki Faculty of Medicine, Helsinki, Finland
| | - Elena Toffol
- University of Helsinki Faculty of Medicine, Helsinki, Finland
| | - Elina Pohjoranta
- University of Helsinki Faculty of Medicine, Helsinki, Finland
- Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland
| | - Maarit J Mentula
- University of Helsinki Faculty of Medicine, Helsinki, Finland
- Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland
| | | | - Satu Suhonen
- University of Helsinki Faculty of Medicine, Helsinki, Finland
| | - Oskari Heikinheimo
- University of Helsinki Faculty of Medicine, Helsinki, Finland
- Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland
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Blaylock R, Lewandowska M, Kelly C, Gunn B, Meiksin R, Scott RH, Palmer MJ, Wellings K, Lohr PA, French RS, N/A TSST. Patient and public involvement in abortion research: reflections from the Shaping Abortion for Change (SACHA) Study. BMJ Sex Reprod Health 2024; 50:142-145. [PMID: 38336465 DOI: 10.1136/bmjsrh-2023-202018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/25/2023] [Indexed: 02/12/2024]
Abstract
Patient and public involvement (PPI) is limited within abortion-related research. Possible reasons for this include concerns about engaging with a stigmatised patient group who value confidentiality and may be reluctant to re-engage with services. Structural barriers, including limited funding for abortion-related research, also prevent researchers from creating meaningful PPI opportunities. Here, we describe lessons learnt on undertaking PPI as part of the Shaping Abortion for Change (SACHA) Study, which sought to create an evidence base to guide new directions in abortion care in Britain.Two approaches to PPI were used: involving patients and the public in the oversight of the research and its dissemination as lay advisors, and group meetings to obtain patients' views on interpretation of findings and recommendations. All participants observed the SACHA findings aligned with their own experiences of having an abortion in Britain. These priorities aligned closely with those identified in a separate expert stakeholder consultation undertaken as part of the SACHA Study. One additional priority which had not been identified during the research was identified by the PPI participants.We found abortion patients to be highly motivated to engage in the group meetings, and participation in them actively contributed to the destigmatisation of abortion by giving them a space to share their experiences. This may alleviate any ethical concerns about conducting research and PPI on abortion, including the assumption that revisiting an abortion experience will cause distress. We hope that our reflections are useful to others considering PPI in abortion-related research and service improvement.
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Affiliation(s)
- Rebecca Blaylock
- Centre for Reproductive Research & Communication, British Pregnancy Advisory Service, London, UK
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Maria Lewandowska
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Rebecca Meiksin
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Rachel H Scott
- Department of Population Health, London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, UK
| | - Melissa J Palmer
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Kaye Wellings
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Patricia A Lohr
- Centre for Reproductive Research & Communication, British Pregnancy Advisory Service, London, UK
| | - Rebecca S French
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
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Hakariya H, Hashimoto T, Suzuki Y, Hamaki T, Tanimoto T. Japan initiates a groundbreaking market test of over-the-counter emergency contraceptive pills with pharmacies as a first access point. BMJ Sex Reprod Health 2024:bmjsrh-2024-202221. [PMID: 38569744 DOI: 10.1136/bmjsrh-2024-202221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Affiliation(s)
- Hayase Hakariya
- Eberhard Karls University Tübingen Interfaculty Institute of Biochemistry, Tübingen, Germany
- Institute for Pharmaceutical and Social Health Sciences, Kyoto, Japan
| | | | - Yosuke Suzuki
- Department of Obstetrics and Gynecology, Tone Chuo Hospital, Numata, Gunma, Japan
| | - Tamae Hamaki
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
- Navitas Clinic, Tokyo, Japan
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
- Navitas Clinic, Tokyo, Japan
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Bittleston H, Hocking JS, Temple-Smith M, Sanci L, Goller JL, Coombe J. What sexual and reproductive health issues do young people want to discuss with a doctor, and why haven't they done so? Findings from an online survey. Sex Reprod Healthc 2024; 40:100966. [PMID: 38522395 DOI: 10.1016/j.srhc.2024.100966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/28/2024] [Accepted: 03/19/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVE Young people are a priority group for sexual and reproductive health (SRH) care. We considered which SRH topics young Australians want to discuss with a general practitioner (GP) and explored barriers they encounter to discussing these issues. METHODS We conducted an online survey (2nd May - 21st June 2022) of Australians aged 16-29 years. Participants were asked to identify from a list of SRH topics which they wanted to discuss, but never had, with a GP. Those who selected any topic/s (with 'undiscussed SRH issues') were asked a free-text follow-up question about what prevented them from discussing issues. We explored characteristics associated with having undiscussed issues using multivariate logistic regression. Free-text comments were analysed using content analysis. RESULTS A total of 1887 people completed relevant survey questions. Most (67.1 %) were women and 48.5 % were heterosexual. Two-thirds (67.0 %) had a usual GP. Nearly half (45.6 %) had undiscussed issues. Most commonly, women wanted to discuss cervical screening and sexual problems, and men wanted to discuss sexual problems and STIs. Participants who were male, older, heterosexual, and with a usual GP were least likely to have undiscussed issues. Barriers to accessing care for SRH were identified from free-text comments, including discomfort, lack of opportunity, fear of negative outcomes, low priority of SRH issues, and perceptions about the role and expertise of GPs. CONCLUSIONS Many young people would welcome more preventative SRH care. Young people may be reassured that all issues, including sexual difficulties and dysfunction, are appropriate to discuss with a GP.
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Affiliation(s)
- H Bittleston
- Centre for Epidemiology and Biostatistics, The University of Melbourne School of Population and Global Health, Melbourne, Australia.
| | - J S Hocking
- Centre for Epidemiology and Biostatistics, The University of Melbourne School of Population and Global Health, Melbourne, Australia
| | - M Temple-Smith
- Department of General Practice, University of Melbourne, Melbourne, Australia
| | - L Sanci
- Department of General Practice, University of Melbourne, Melbourne, Australia
| | - J L Goller
- Centre for Epidemiology and Biostatistics, The University of Melbourne School of Population and Global Health, Melbourne, Australia
| | - J Coombe
- Centre for Epidemiology and Biostatistics, The University of Melbourne School of Population and Global Health, Melbourne, Australia
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Gilmore JP, Noone C, Sibandze BT, Field DJ. What nurses can learn from the Mpox public health emergency of international concern. J Adv Nurs 2024. [PMID: 38476097 DOI: 10.1111/jan.16157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 03/05/2024] [Indexed: 03/14/2024]
Affiliation(s)
- John P Gilmore
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Chris Noone
- School of Psychology, University of Galway, Galway, Ireland
| | - Bongani T Sibandze
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - David J Field
- Gay Men's Health Service, Health Service Executive, Dublin, Ireland
- Department of Applied Health Science, University of Aberdeen, Aberdeen, UK
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Vasudevan G, Filipink R, Gaesser J, Kazmerski TM, Sogawa Y, Kirkpatrick L. Preferences and experiences of parents/guardians of youth with epilepsy and intellectual disability on reproductive health counseling. Epilepsy Behav 2024; 152:109658. [PMID: 38277851 DOI: 10.1016/j.yebeh.2024.109658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/23/2023] [Accepted: 01/19/2024] [Indexed: 01/28/2024]
Abstract
OBJECTIVE To explore the experiences and preferences of parents/guardians of adolescents and young adults (AYA) of childbearing potential with co-occurring epilepsy and intellectual disability (ID) regarding counseling by neurologists on sexual and reproductive health (SRH) topics such as pregnancy, contraception, menstruation, and folic acid supplementation. METHODS We conducted semi-structured interviews with parents/guardians of AYAs (12-28 years old) of childbearing potential with co-occurring epilepsy and ID, recruited from a tertiary-care children's hospital. We confirmed the diagnoses of epilepsy and ID with the patient's neurologist and parent/guardian. All degrees of ID (e.g. mild/moderate/severe) were eligible. We audio-recorded and transcribed interviews. Two coders performed qualitative thematic analysis. RESULTS Twenty-five parents/guardians completed interviews. Themes included: (1) Parents/guardians believe their child to be immune from sexual abuse due to their supervision, yet desire counseling about abuse recognition and prevention, which they also report not occurring (2) A common opinion was that counseling on menstruation was more relevant to their child's life than counseling about pregnancy-related topics (3) Parents/guardians reported a lack of counseling on pregnancy-related topics such as folic acid supplementation and teratogenesis and generally also reported some degree of interest in hearing about these topics from neurologists (4) Parents/guardians also reported a lack of counseling on drug interactions between contraception and ASMs, and were highly interested in learning more about this topic (5) Parents/guardians want neurologists to initiate annual comprehensive SRH counseling at puberty about most topics, but report that they often initiate SRH discussions themselves. CONCLUSION Parents/guardians of AYAs with epilepsy and ID prefer more frequent, neurologist-initiated, comprehensive conversations surrounding SRH particularly emphasizing menstruation and sexual abuse recognition/prevention. Findings may inform professional and patient education and health systems interventions including development of discussion guides and/or decision aides to improve SRH care for AYAs with epilepsy and ID.
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Affiliation(s)
- Geetha Vasudevan
- UPMC Children's Hospital of Pittsburgh, 4401 Penn Ave, Pittsburgh, PA 15224, USA.
| | - Robyn Filipink
- UPMC Children's Hospital of Pittsburgh, 4401 Penn Ave, Pittsburgh, PA 15224, USA.
| | - Jenna Gaesser
- UPMC Children's Hospital of Pittsburgh, 4401 Penn Ave, Pittsburgh, PA 15224, USA.
| | - Traci M Kazmerski
- UPMC Children's Hospital of Pittsburgh, 4401 Penn Ave, Pittsburgh, PA 15224, USA; Division of Adolescent and Young Adult Medicine, University Center, 120 Lytton Avenue, Mezzanine Floor, Suite M060, Pittsburgh, PA 15213, USA; Center for Innovative Research on Gender Health Equity, 230 McKee Place, Pittsburgh, PA 15213, USA.
| | - Yoshimi Sogawa
- UPMC Children's Hospital of Pittsburgh, 4401 Penn Ave, Pittsburgh, PA 15224, USA.
| | - Laura Kirkpatrick
- UPMC Children's Hospital of Pittsburgh, 4401 Penn Ave, Pittsburgh, PA 15224, USA.
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Withanage NN, Botfield JR, Black K, Mazza D. Preconception health risk factors documented in general practice electronic medical records. BMJ Sex Reprod Health 2024:bmjsrh-2023-202038. [PMID: 38336467 DOI: 10.1136/bmjsrh-2023-202038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/17/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Documenting medical and lifestyle preconception health risk factors in electronic medical records (EMRs) could assist general practitioners (GPs) to identify those reproductive-aged women who could most benefit from preconception care (PCC). However, it is unclear to what extent PCC risk factors are identifiable in general practice records. This study aimed to determine the extent to which medical and lifestyle preconception health risk factors are documented in general practice EMRs. METHODS We conducted an audit of the documentation of medical and lifestyle preconception risk factors in 10 general practice EMRs in Melbourne, Australia. We retrospectively analysed the EMRs of 100 consecutive women aged 18-44 years who visited each practice between January and September 2022. Using a template informed by PCC guidelines, we extracted data from structured fields in the EMR and conducted a descriptive analysis. RESULTS Among the data extracted, the more commonly documented medical and lifestyle preconception health risk factors in the EMRs included smoking (79%), blood pressure (74%), alcohol consumption (63%) and body mass index (57%). Among the women audited, 14% were smokers, 24% were obese, 7% had high blood pressure, 5% had diabetes, 28% had a mental health condition, 13% had asthma, 6% had thyroid disease and 17% had been prescribed and could be using a potentially teratogenic medication. CONCLUSIONS Better documentation of medical and lifestyle preconception health risk factors in structured fields in EMRs may potentially assist primary care providers including GPs in identifying and providing PCC to women who could most benefit from it.
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Affiliation(s)
- Nishadi Nethmini Withanage
- SPHERE, NHMRC Centre of Research Excellence, Department of General Practice, Monash University, Melbourne, Victoria, Australia
| | - Jessica R Botfield
- SPHERE, NHMRC Centre of Research Excellence, Department of General Practice, Monash University, Melbourne, Victoria, Australia
| | - Kirsten Black
- SPHERE, NHMRC Centre of Research Excellence, Department of General Practice, Monash University, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynaecology, University of Sydney, Camperdown, New South Wales, Australia
| | - Danielle Mazza
- SPHERE, NHMRC Centre of Research Excellence, Department of General Practice, Monash University, Melbourne, Victoria, Australia
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MacGilleEathain R, Smith T, Steele I. Sexual well-being among young people in remote rural island communities in Scotland: a mixed methods study. BMJ Sex Reprod Health 2024; 50:7-12. [PMID: 37295934 PMCID: PMC10850708 DOI: 10.1136/bmjsrh-2023-201822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND It has been identified that rural young people face barriers to accessing support for their sexual well-being such as availability and transport, knowing healthcare staff personally, and fear of being judged negatively within their community. These factors may contribute to widening health inequalities and expose young people living in rural areas to increased risk of poor sexual well-being. Little is known about the current needs of adolescents residing in remote rural island communities (RRICs). METHODS A cross sectional mixed methods study was conducted with 473 adolescents aged 13-18 across the islands of the Outer Hebrides of Scotland. Analysis included descriptive, inferential statistics and thematic analysis. RESULTS 59% (n=279) of participants held the perception there was no support, or did not know if there was support, about condoms and contraception in their local area. 48% (n=227) said that free condoms were not easily available for local young people. 60% (n=283) said they would not use youth services if they were locally available. 59% (n=279) said they did not receive enough relationships, sexual health and parenthood (RSHP) education. Opinion differed significantly by gender, school year group, and sexual orientation. Qualitative analysis identified three key themes: (1) alone yet visible, (2) silence and disapproval, and (3) safe spaces, with an underpinning theme of island cultures. CONCLUSIONS A need for further sexual well-being support that addresses the complexities and challenges for young people residing in RRICs is identified. The intersectionality of being LGBT+ and residing in this context may increase the experience of inequality in sexual well-being support.
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Affiliation(s)
- Rebecah MacGilleEathain
- Division of Rural Health and Wellbeing, Institute of Health, Research and Innovation, University of the Highlands and Islands, Inverness, UK
| | - Tamsin Smith
- School of Health, Wellbeing and Social Care, The Open University in Scotland, Edinburgh, UK
| | - Isabel Steele
- Division of Public Health & Health Strategy, NHS Western Isles, Balivanich, UK
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Horan C, Cohen P, Kavanagh J. Sexual and reproductive health clinical consultations: abortion in non-specialist community-based clinics. BMJ Sex Reprod Health 2024; 50:67-69. [PMID: 38050072 DOI: 10.1136/bmjsrh-2023-202036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/01/2023] [Indexed: 12/06/2023]
Affiliation(s)
- Corrina Horan
- Community Sexual and Reproductive Health, Homerton University Hospital NHS Foundation Trust, London, UK
- EGA Institute for Women's Health, University College London, London, UK
| | - Pollyanna Cohen
- EGA Institute for Women's Health, University College London, London, UK
- Community Sexual and Reproductive Health, Central North West Thames NHS Trust, London, UK
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Sukeri S, Sulaiman Z, Hamid NA, Ibrahim SA. Decision-Making on Contraceptive Use among Women Living with Human Immunodeficiency Virus in Malaysia: A Qualitative Inquiry. Korean J Fam Med 2024; 45:27-36. [PMID: 37848368 PMCID: PMC10822730 DOI: 10.4082/kjfm.23.0088] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/21/2023] [Accepted: 07/31/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Malaysia is the first country in the Western Pacific Region to receive the validation certificate for the elimination of mother-to-child transmission of human immunodeficiency virus (HIV). The validation report recommends making sexual and reproductive health and rights of women living with HIV a priority. This article explores and assesses the sexual and reproductive health, rights, and access to healthcare services of Malaysia's women living with HIV (WLHIV). METHODS A qualitative secondary analysis conducted on 73 WLHIV from all over Malaysia comprised 11 in-depth interviews and 16 focus group discussions. Data were extracted from the original interview transcripts that emerged from the following questions: (1) "What are your experiences as a woman living with HIV in relation to your sexual and reproductive health and rights?" (2) "What are your experiences in accessing contraception?" (3) "What are your day-to-day experiences as a woman living with HIV?" Data were analyzed using thematic analysis. RESULTS Four themes emerged from the study findings: "lack of negotiation," "idealism in pregnancy," "coping with restrictions," and "past and future fears." The four themes are grounded in religion, a patriarchal culture, meaning and expectations of motherhood, taking risks and going against medical advice to pursue fertility desires, fear of HIV transmission, and the side effects of contraceptive use. CONCLUSION The complexities involved in decision-making regarding contraceptive use revealed how WLHIV may have unresolved reproductive health needs inconsistent with healthcare providers' focus on HIV management and prevention. Suggestions are made for improving the sexual and reproductive health and rights of WLHIV in Malaysia, which include establishing a reproductive health counseling program.
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Affiliation(s)
- Surianti Sukeri
- School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Zaharah Sulaiman
- School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Noor Aman Hamid
- School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Siti Aishah Ibrahim
- School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
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Day SL, McDonald G, Kellett C. Hepatitis B and hepatitis C testing outcomes among service users of Sexual Health London: an online sexually transmitted infection testing service for London residents. Sex Transm Infect 2023:sextrans-2023-055916. [PMID: 38050172 DOI: 10.1136/sextrans-2023-055916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/30/2023] [Indexed: 12/06/2023] Open
Abstract
OBJECTIVES The UK signed up to the 2016 global health strategy to eliminate viral hepatitis as a public health problem. Effective monitoring of hepatitis testing outcomes is required to track progress against targets. National reporting does not include hepatitis B and hepatitis C infections (HBV/HCV) detected by online sexually transmitted infection (STI) testing services (e-services). We identify HBV/HCV infection rates among individuals using Sexual Health London (SHL), a large e-service. METHODS SHL e-records of individuals receiving reactive HBsAg and/or HepCAb screening results between 1 January 2021 and 1 January 2022 were reviewed. Only at-risk groups are offered HBV/HCV testing, with risks captured via an online triage/consultation. Roche Cobas e801 HBV/HCV screening assay uses a cut-off index of reactivity (COI) to categorise results: low reactive (COI >1-9) and reactive (COI ≥10). SHL refers individuals with any reactive result for confirmatory testing (CT) at a sexual health clinic that provides hepatitis outpatient management. Clinic staff performing the CT access the shared SHL e-record and electronically take over the patient's care. RESULTS 67, 718 HBV and 61 064 HCV tests were performed, representing 16% of all kit returns. HBV reactivity was 1.4% (922/67 718): 474 low-reactive, 302 reactive and 146 unconfirmed-reactive. HCV reactivity was 0.3% (163/61 064): 53 low-reactive, 99 reactive and 11 unconfirmed-reactive.Among individuals with reactive (COI ≥10) screening HBV results, 85% results confirmed, 12% negative and 3% unknown. For HCV, 79% results confirmed, 13% negative and 8% unknown. 57 out of 57 new HBV/HCV infections were electronically transferred. HBV prevalence was 299/67 718 (0.4%). The rate of previously undiagnosed cases detected was 40 out of 67 338 (0.06%) for HBV and 17 out of 61 016 (0.03%) for HCV. CONCLUSIONS 16% of SHL service users received targeted testing for hepatitis in 2021. Testing volumes significantly exceeded and new HBV/HCV diagnosis rates were similar to those reported by sentinel laboratory surveillance. 100% new infections transitioned to care, demonstrating effective integration between online and local sexual health services.
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Affiliation(s)
- Sara Louise Day
- Chelsea & Westminster Hospitals NHS Foundation Trust, London, UK
| | - Gemma McDonald
- Chelsea & Westminster Hospitals NHS Foundation Trust, London, UK
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Meyrick J, Adams R, Cutland M. Co-produced patient pathway for sexual health follow-up with children and young people using a paediatric sexual assault referral centre (SARC): facilitating elements of self-care and self-testing. BMJ Sex Reprod Health 2023; 49:311-314. [PMID: 37402551 DOI: 10.1136/bmjsrh-2023-201866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/16/2023] [Indexed: 07/06/2023]
Affiliation(s)
- Jane Meyrick
- Department of Psychology, School of Social Sciences, University of the West of England (UWE), Bristol, UK
| | - Rachel Adams
- The Bridge Sexual Assault Referral Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Michelle Cutland
- The Bridge Sexual Assault Referral Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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15
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Banaha S, Pasha H, Bakhtiari A, Omidvar S, Behmanesh F, Faramarzi M, Esmailzadeh S. Effectiveness of Group Psychosexual Training for Marital Adjustment and Sexual Self-Efficacy of Infertile Women: A Randomized Controlled Trial. Iran J Psychiatry 2023; 18:275-284. [PMID: 37575610 PMCID: PMC10422948 DOI: 10.18502/ijps.v18i3.13004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 02/27/2023] [Accepted: 03/11/2023] [Indexed: 08/15/2023]
Abstract
Objective: Infertility can be associated with unfavorable psychological consequences such as a sense of marital incompatibility and sexual inadequacy. To address these issues, this study aimed to assess the effectiveness of group psycho-sexual training in improving marital adjustment and sexual self-efficacy of infertile women. Method : A randomized controlled clinical trial (RCT) study was conducted in Babol, Iran, with 72 infertile women, randomly assigned to either the intervention group (n = 36) or the control group (n = 36). The intervention group underwent psychosexual training, while the control group received routine care. The Dyadic Adjustment Scale (DAS) and Sexual Self-Efficacy Scale (SSES) were used to assess their marital adjustment and sexual self-efficacy. Data analysis was performed using various tests, including the independent t-test, Chi-squared test, paired t-test, ANCOVA, and MANCOVA. Results: Most infertile women had moderate sexual self-efficacy (80%). The intervention group had a significantly better response to group psycho-sexual training compared to the control group. This intervention improved sexual self-efficacy and marital adjustment and its subscales including marital consensus, satisfaction, cohesion (P < 0.0001), and affectional expression (P < 0.001). The mean pre-to-post treatment scores of sexual self- efficacy, marital adjustment, and its subscales increased significantly in the intervention group, while no significant difference was observed in the control group (P < 0.0001). Conclusion: Based on the findings, it is recommended to provide educational services alongside the infertility treatment process for enhancing the quality of marital adjustment and promoting sexual self-efficacy.
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Affiliation(s)
- Sara Banaha
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Hajar Pasha
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Afsaneh Bakhtiari
- Motion Disorder Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Shabnam Omidvar
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fereshteh Behmanesh
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mahbobeh Faramarzi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Sedigheh Esmailzadeh
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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16
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Gotsche CI, Steyn PS, Narasimhan M, Rodolph M, Baggaley R, Kiarie JN. Integrating pre-exposure prophylaxis of HIV infection into family planning services: a scoping review. BMJ Sex Reprod Health 2023; 49:210-218. [PMID: 36581443 PMCID: PMC10359582 DOI: 10.1136/bmjsrh-2021-201356] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 11/12/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION The aim of this review was to map evidence of integrating pre-exposure prophylaxis (PrEP) for HIV prevention into family planning services. A comprehensive package, using a combination of PrEP and contraceptive delivery, could reduce the number of new HIV infections and/or unintended pregnancies for at-risk women and adolescent girls. METHODS A scoping literature search was conducted between August 2020 and October 2020. After developing the review question, electronic databases (MEDLINE, Embase, Cochrane Library, Global Health, Web of Science) were systematically reviewed. All types of articles published from 2012 to August 2020 in English were included. The intended outcome was to identify barriers and enablers of integrating services at the client-level and provider-level. RESULTS 38 articles met inclusion criteria, with 16 from low-and middle-income countries and 22 from high-income countries. Barriers at the client-level included a lack of risk perception associated with low uptake and continuation of PrEP and pill burden; and at the provider-level, barriers included a lack of studies on cost-effectiveness of integrating services and provider training and knowledge. Facilitators included the initiation of PrEP and contraception at the same time and by the same provider or HIV self-testing. CONCLUSION Mapping and synthesising current evidence, this review identified key barriers and facilitators for the integration of PrEP into family planning services for women and adolescent girls. In order to address these factors, more implementation research in a variety of settings is needed to meet women's sexual and reproductive health needs globally.
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Affiliation(s)
- Caroline I Gotsche
- Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneve, Switzerland
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Petrus S Steyn
- Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneve, Switzerland
| | - Manjulaa Narasimhan
- Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneve, Switzerland
| | - Michelle Rodolph
- Global HIV, Hepatitis and STIs Programmes, World Health Organization, Geneve, Switzerland
| | - Rachel Baggaley
- Global HIV, Hepatitis and STIs Programmes, World Health Organization, Geneve, Switzerland
| | - James N Kiarie
- Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneve, Switzerland
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Simon J, Lynda H, Cathie F, Nicolas V, Karl S, Catherine GG, Zoha MV, Adrien L. Resurgence of symptomatic Mpox among vaccinated patients: first clues from a new-onset local cluster. Infect Dis Now 2023; 53:104714. [PMID: 37120092 PMCID: PMC10156087 DOI: 10.1016/j.idnow.2023.104714] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 03/27/2023] [Accepted: 04/24/2023] [Indexed: 05/01/2023]
Affiliation(s)
- Jamard Simon
- Department of Infectious Diseases, University Hospital of Tours, France.
| | - Handala Lynda
- Virology Department, University Hospital of Tours, France
| | - Faussat Cathie
- Public Vaccination Center - Center for screening and treatment of sexually transmitted infections, University Hospital of Tours, France
| | - Vincent Nicolas
- Santé publique France, the national public health agency - Centre-Val de Loire, Orléans, France
| | - Stefic Karl
- Virology Department, University Hospital of Tours, France
| | | | - Maakaroun-Vermesse Zoha
- Department of Infectious Diseases, University Hospital of Tours, France; Public Vaccination Center - Center for screening and treatment of sexually transmitted infections, University Hospital of Tours, France
| | - Lemaignen Adrien
- Department of Infectious Diseases, University Hospital of Tours, France; Education, Ethics, Health - EA7505, University of Tours, France
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18
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Wiese AL, Sease TB, Joseph ED, Becan JE, Knight K, Knight DK. Avoidance Self-Efficacy: Personal Indicators of Risky Sex and Substance Use among At-Risk Youth. Child Youth Serv Rev 2023; 147:106846. [PMID: 36844888 PMCID: PMC9957012 DOI: 10.1016/j.childyouth.2023.106846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Adolescent substance use (SU) is associated with risky sex behavior and sexually transmitted infections and is a risk factor for subsequent risky sex decisions. Based on a sample of 1,580 youth in residential SU treatment, this study investigated how a static factor (race) and two dynamic personal factors (risk-taking, assertiveness) contributed to adolescents' perceived ability to avoid high-risk SU and sex behavior (avoidance self-efficacy). Results showed that race correlated with risk-taking and assertiveness, with White youth reporting higher ratings of assertiveness and risk-taking. Self-reported assertiveness and risk-taking also predicted SU and risky sex avoidance. This study underscores the importance of race and personal factors in relation to adolescents' confidence in avoiding high-risk situations.
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Affiliation(s)
- Amanda L Wiese
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
| | - Thomas B Sease
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
| | - Elizabeth D Joseph
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
| | - Jennifer E Becan
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
| | - Kevin Knight
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
| | - Danica K Knight
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
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Houston LM. Parnellites, Playboys, and Pathology: Irish Modernist Drama and the Politics of Sexual Health. J Med Humanit 2023; 44:43-59. [PMID: 36350474 DOI: 10.1007/s10912-022-09762-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
The personal, political, and aesthetic ideals that Irish modernists found embodied in the figure of Charles Stewart Parnell-independence, self-mastery, and a capacity for radical self-fashioning-have been well attested in Irish literary historiography. What has been less often noted is the centrality of sexual health to the conception, articulation, and emulation of those virtues, particularly when attempting to translate Parnell's public persona to the stage. This essay addresses this lacuna by tracing how a medicalized and politicized conception of sex informed Irish modernist efforts to dramatize the Parnell myth at the Abbey Theatre. It begins by establishing the hitherto underexamined ways in which the Parnell myth informed the infamously divisive sexual politics of J. M. Synge's The Playboy of the Western World (1907), in which the fallen leader and his career provide a template for Christy Mahon and the virile autonomy he is held to embody. Building on this analysis, the essay proceeds to explore the ways in which Synge's restaging of the Parnell myth, and the medicalized and politicized model of sex which underpinned it, informed Lady Augusta Gregory's efforts to resuscitate (and sanitize) Parnell for Abbey audiences in 1911's The Deliverer. Finally, through a close reading of Lennox Robinson's largely overlooked 1918 play, The Lost Leader, the essay charts how the organicist and hereditarian model of sexual health upon which earlier iterations of the Parnell myth had rested began to give place to a more psychoanalytic model. It then identifies the implications of this shift for Robinson's reading of Irish politics in the wake of the 1916 Easter Rising. In doing so, the essay highlights the ways in which sexual health emerged as an extra-moral normative framework in Irish political discourse, and it demonstrates how a Medical Humanities approach and a sensitivity to the social history of medicine in Ireland can enrich critical understandings of the Parnell myth and its modernist afterlives.
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Affiliation(s)
- Lloyd Meadhbh Houston
- University of Alberta, Edmonton, AB, Canada.
- Goldsmiths College, University of London, London, UK.
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20
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Pratt MC, Isehunwa OO, Bassett IV, Kempf MC, Gordon B, Matthews LT. Rapid qualitative analysis approach to stakeholder and client interviews to inform mobile-based HIV testing in the U.S. Deep South. Arch Public Health 2023; 81:24. [PMID: 36793139 PMCID: PMC9930722 DOI: 10.1186/s13690-023-01039-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 02/08/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND The severity of the HIV epidemic in the United States' rural South highlights geographic, socioeconomic, and racial disparities that disproportionately affect poor Black Americans. Approximately 16% of Alabamians living with HIV remain undiagnosed and just 37% of rural Alabamians have ever been tested for HIV. METHODS We conducted in-depth interviews with 22 key stakeholders involved in HIV prevention, testing, treatment, or community health initiatives, and 10 adults living in rural communities across Alabama to explore HIV testing challenges and opportunities. We utilized a rapid qualitative analysis approach and engaged community partners for feedback and discussion. This analysis will inform the implementation of a mobile HIV testing service in rural Alabama. RESULTS The following themes were identified: (1) Cultural norms, racism, poverty, and rurality impair access to healthcare. (2) Lack of sex education, low knowledge of HIV and perception of risk reinforce stigmas. (3) Messaging about "Undetectable = Untransmissible" (U = U) is not well understood in communities. (4) Community involvement may promote communication and trust between communities and testing advocates. (5) Novel testing strategies are acceptable and may diminish barriers. CONCLUSIONS Working with community "gatekeepers" may be a key strategy to understand and promote acceptability of interventions new to rural Alabama and ameliorate stigma within communities. The implementation of new HIV testing strategies requires building and maintaining relationships with advocates, especially faith-based leaders, who engage people across many demographics.
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Affiliation(s)
- Madeline C. Pratt
- grid.265892.20000000106344187Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Ziegler Research Building 210, 1720 2nd Ave S, Birmingham, AL 35294 USA
| | - Oluwaseyi O. Isehunwa
- grid.265892.20000000106344187Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Ziegler Research Building 210, 1720 2nd Ave S, Birmingham, AL 35294 USA
| | - Ingrid V. Bassett
- grid.32224.350000 0004 0386 9924Division of Infectious Disease and Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA USA
| | - Mirjam-Colette Kempf
- grid.265892.20000000106344187Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Ziegler Research Building 210, 1720 2nd Ave S, Birmingham, AL 35294 USA ,grid.265892.20000000106344187Family, Community, and Health Systems, School of Nursing, University of Alabama at Birmingham, Birmingham, AL USA ,grid.265892.20000000106344187Departments of Epidemiology and Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL USA
| | | | - Lynn T. Matthews
- grid.265892.20000000106344187Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Ziegler Research Building 210, 1720 2nd Ave S, Birmingham, AL 35294 USA
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Lari A, Jarragh A, Alherz M, AlNouri A, Qasem M, Khaja AF, AlMutairi O. Pain, Pattern and Polytrauma - Predictors of Sexual Dysfunction in Pelvic Fractures: A Retrospective Multicenter Analysis. Arch Bone Jt Surg 2023; 11:263-269. [PMID: 37180296 PMCID: PMC10167534 DOI: 10.22038/abjs.2022.57958.2869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 05/26/2022] [Indexed: 05/16/2023]
Abstract
Objectives In the local and cultural setting of high trauma rates and a reserved outlook on sexual function, this study examines the incidence and underlying factors of sexual dysfunction (SD) following pelvic fractures. Methods A Multi-center retrospective cohort analysis performed in two general hospitals and one tertiary orthopedic center with collection between 2017 and 2019. Consecutive patients with pelvic fractures between January 2017 and February 2019 were followed up at 18-24 months to screen for new-onset SD using the International Index of Erectile Function-5 (IIEF-5) and Female-Sexual-Function-Index-6 (FSFI-6). Additional variables include age, sex, Young-Burgess classification, urogenital injury, injury severity score, persisting pain, sacroiliac disruption, intervention and if sexual health was discussed or patient referred for sexual healthcare. Results One-hundred and sixty-five patients (n = 165) were included, (83%) male, (16%) female with a mean age of 35.1 years (Range 18-55). Fracture patterns included lateral compression (LC) (51.5%), anteroposterior compression (APC) (27.7%), and vertical shear (VS) (20.6%). The urogenital injury occurred in 10.3%. The mean IIEF-5 and FSFI-6 scores were 20.8 and 24.7 in males and females, respectively. A total of 40 males (29%) scored below the 21 cut-off scores for SD, while only one female (3.7%) scored below the corresponding score of 19. Of all participants reporting sexual dysfunction, 56% discussed sexual health with their providers, while 46% of these patients were referred for further management. Significant predictive factors for SD using a multivariate logistic regression model include increasing age (OR-1.093, p = 0.006), APC III (OR 88.887, p = 0.006), VS (OR-15.607, p = 0.020), persisting pain (OR 3.600, p = 0.021) and increasing injury severity score (OR 1.184, p <0.001). Conclusion SD is common among pelvic fractures, and risk factors include APC or VS type fractures, increasing age, increasing injury severity score, and persisting pain. Providers should ensure patients are screened for SD and referred appropriately as patients may not willingly disclose underlying symptoms.
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Affiliation(s)
- Ali Lari
- Alrazi Orthopedic Hospital, Alsabah medical region, Kuwait
| | - Ali Jarragh
- Jaber Alahmed Alsabah Hospital, South Surra, Kuwait
| | | | | | - Mohammed Qasem
- Alrazi Orthopedic Hospital, Alsabah medical region, Kuwait
| | - Alia F. Khaja
- Alrazi Orthopedic Hospital, Alsabah medical region, Kuwait
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Latham-Cork HC, Nicol C. Progestogen only pills commentary. BMJ Sex Reprod Health 2023; 49:3-6. [PMID: 36198480 DOI: 10.1136/bmjsrh-2022-201666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Harriett Charlotte Latham-Cork
- Obstetrics and Gynaecology, University of Nottingham, Nottingham, UK
- Integrated Sexual Health Services, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Claire Nicol
- Lothian SRH Services, Chalmers Sexual Health Centre, Edinburgh, UK
- Deputy Director, Clinical Effectiveness Unit, Faculty of Sexual and Reprodctive Healthcare, Edinburgh, UK
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23
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Bosó Pérez R, Reid D, Maxwell KJ, Gibbs J, Dema E, Bonell C, Mercer CH, Sonnenberg P, Field N, Mitchell KR. Access to and quality of sexual and reproductive health services in Britain during the early stages of the COVID-19 pandemic: a qualitative interview study of patient experiences. BMJ Sex Reprod Health 2023; 49:12-20. [PMID: 35444001 PMCID: PMC9062459 DOI: 10.1136/bmjsrh-2021-201413] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/05/2022] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Access to quality sexual and reproductive health (SRH) services remains imperative even during a pandemic. Our objective was to understand experiences of delayed or unsuccessful access to SRH services in Britain during the early stages of the COVID-19 pandemic. METHODS In October and November 2020 we conducted semi-structured telephone interviews with 14 women and six men reporting an unmet need for SRH services in the Natsal-COVID survey, a large-scale quasi-representative web-panel survey of sexual health and behaviour during COVID-19 (n=6654). We purposively sampled eligible participants using sociodemographic quotas. Inductive thematic analysis was used to explore service access and quality and to identify lessons for future SRH service delivery. RESULTS Twenty participants discussed experiences spanning 10 SRH services including contraception and antenatal/maternity care. Participants reported hesitancy and self-censorship of need. Accessing telemedicine and 'socially-distanced' services required tenacity. Challenges included navigating changing information and procedures; perceptions of gatekeepers as obstructing access; and inflexible appointment systems. Concerns about reconfigured services included reduced privacy; decreased quality of interactions with professionals; reduced informal support; and fewer preventive SRH practices. However, some participants also described more streamlined services and staff efforts to compensate for disruptions. Many viewed positively the ongoing blending of telemedicine with in-person care. CONCLUSION The COVID-19 pandemic impacted access and quality of SRH services. Participants' accounts revealed self-censorship of need, difficulty navigating shifting service configurations and perceived quality reductions. Telemedicine offers potential if intelligently combined with in-person care. We offer initial evidence-based recommendations for promoting an equitable restoration and future adaption of services.
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Affiliation(s)
- Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - David Reid
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections in partnership with Public Health England, University College London, London, UK
| | - Karen J Maxwell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
| | - Emily Dema
- Institute for Global Health, University College London, London, UK
| | - Christopher Bonell
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Pam Sonnenberg
- Institute for Global Health, University College London, London, UK
| | - Nigel Field
- Institute for Global Health, University College London, London, UK
| | - Kirstin R Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Blaylock R. Patient and Public Involvement (PPI) in abortion research: an exploratory survey. BMJ Sex Reprod Health 2023; 49:69. [PMID: 36104249 DOI: 10.1136/bmjsrh-2022-201648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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25
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Farver-Vestergaard I, Frederiksen Y, Løkke A. COPD and Sexual Health: What the Sexual Medicine Clinician Needs to Know. J Sex Med 2022; 19:1725-1729. [PMID: 36151033 DOI: 10.1016/j.jsxm.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 01/06/2023]
Affiliation(s)
| | - Yoon Frederiksen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Unit for Sexology, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Anders Løkke
- Department of Medicine, Lillebaelt Hospital, Vejle, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Silva Esteves de Hollanda G, Pereira Nogueira W, Iansã de Lima Barroso B, de Lima Brito Magalhães R, Moreira Freire ME, de Oliveira E Silva AC. Quality of sexual life of riparian women: Analysis of sexual practices and attitudes. Enferm Clin (Engl Ed) 2022; 32:405-412. [PMID: 35598872 DOI: 10.1016/j.enfcle.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 04/21/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To analyse the sexual practices, attitudes, and sexual quality of life of Riparian woman and associated factors. METHOD A cross-sectional analytical study conducted among Riparian women using the Study of Sexual Behaviour (SSB) questionnaire. A bivariate analysis and binary logistic regressions were performed to identify factors associated with sexual quality of life. RESULTS A total of 138 women participated in the study (n = 138). Of the women, 34.1% and 33.3% reported pain and loss of interest during or after sex, respectively. In terms of practices during sex, women reported kissing (85.5%), cuddling (89.1%), mutual masturbation (37.2%), oral sex (34.8%), and anal sex (23.9%). However, the majority reported not using condoms during sex (63.0%). In terms of sexual quality of life, 39.9% of the women rated it as good. Higher education and early sexual initiation increase the chances of a "good" sexual quality of life. CONCLUSION Because Riparian women engage in some risky sexual behaviours, such as not using condoms, educational strategies on the prevention of sexually transmitted infections should be reinforced and incorporated in this population. This may help improve these women's sexual quality of life.
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Affiliation(s)
| | - Wynne Pereira Nogueira
- Programa de postgrado en Enfermería, Federal University of Paraíba, João Pessoa, Paraiba, Brasil
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Engelmann AJ, Nicklisch S, Nieder TO. Components of Good Sex in Young Urban Trans People Assigned Female at Birth: A Qualitative Interview Study. J Sex Med 2022; 19:1687-1706. [PMID: 36182574 DOI: 10.1016/j.jsxm.2022.08.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 07/22/2022] [Accepted: 08/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Prevalence of sexual dissatisfaction and dysfunction is high in trans people, as reflected in lower sexual pleasure scores compared to cis people. AIM The aim of this study is to explore components of good sex and sexual pleasure in young, urban trans people assigned female at birth (AFAB). METHODS 16 semi-structured interviews were conducted with young urban AFAB trans people. The interviews were analysed using qualitative content analysis. OUTCOMES Main outcomes were providing participants components of good sex and sexual pleasure. RESULTS Regarding components of good sex, the participants of this study described various influences on their ability to relax as well as strategies to increase relaxation during sex. Next to general influences on relaxation, the ability to relax was influenced by the way their partners interacted with them and thus how accepted they felt in their identities and feeling safe. Further, transition and coming-out status, physical and sexual function changes due to hormone therapy and gender affirming surgeries, specific sexual techniques and aids, social constructs and the circumstances in which sex took place were important. Strategies to increase relaxation included using aids such as penis prostheses, preferring certain sexual practices, that is, being more dominant or on eye-level, reducing visual aspects, drinking alcohol, and deconstructing gender and sexual norms. CLINICAL IMPLICATIONS When working with trans clients, inhibitors of relaxation should be assessed and addressed, which could include working on clients believes about trans sexuality, gendered sexual scripts or various techniques to reduce body dysphoria, if present, during sexual practices. STRENGTHS & LIMITATIONS Following a non-clinical community sampling with no treatment-related dependency between researchers and participants, the sample provides an open access to the participating trans people's sexuality. However, the sample is small, selective, and it includes only able-bodied trans people from Christian religious backgrounds. CONCLUSION Next to sexual problems and dysfunctions, future research on the relationship between medical transition and sexuality should additionally address positive aspects of sexuality, such as sexual pleasure and sexual satisfaction, and its possible function as a resource pre, during and post transition.
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Affiliation(s)
- Anika J Engelmann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu BerlinInstitute of the History of Medicine and Ethics in Medicine, Berlin, Germany
| | - Saskia Nicklisch
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu BerlinInstitute of the History of Medicine and Ethics in Medicine, Berlin, Germany
| | - Timo O Nieder
- Interdisciplinary Transgender Health Care CenterInstitute for Sex ResearchSexual Medicine and Forensic PsychiatryUniversity Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Stern N, Dekalo S, Brock G. Sexual Medical Education Challenges During the COVID-19 Pandemic: Strategies for Academic and Community Based Clinicians. J Sex Med 2022; 19:1591-1595. [PMID: 35501255 PMCID: PMC9051934 DOI: 10.1016/j.jsxm.2022.03.612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/19/2022] [Accepted: 03/23/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Noah Stern
- Division of Urology, Department of Surgery, Western University, London, Ontario, Canada.
| | - Snir Dekalo
- Division of Urology, Department of Surgery, Western University, London, Ontario, Canada
| | - Gerald Brock
- Division of Urology, Department of Surgery, Western University, London, Ontario, Canada
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Neal S, Cox P, March-McDonald J, Hutchinson A. A place of safety? Protecting the sexual and reproductive health and rights of Ukrainian sanctuary-seeking women and young people. BMJ Sex Reprod Health 2022; 48:243-245. [PMID: 35738875 DOI: 10.1136/bmjsrh-2022-201538] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Sarah Neal
- Department of Social Statistics and Demography, University of Southampton, Southampton, UK
| | - Pat Cox
- MIDEX (Migration, Diaspora and Exile) Research Centre, University of Central Lancashire, Preston, UK
| | | | - Aisha Hutchinson
- School of Education, Communication and Society, King's College London, London, UK
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Toldam NE, Graugaard C, Meyer R, Thomsen L, Dreier S, Jannini EA, Giraldi A. Sexual Health During COVID-19: A Scoping Review. Sex Med Rev 2022; 10:714-753. [PMID: 37051956 PMCID: PMC9242892 DOI: 10.1016/j.sxmr.2022.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/08/2022] [Accepted: 06/12/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The COVID-19 pandemic impacted profoundly on the wellbeing and social interactions of the world population, and all dimensions of sexual health were potentially affected by globally implemented preventive measures. OBJECTIVES The scoping review aimed to compile existing research investigating possible effects of COVID-19 lockdowns on adult sexual health, that is, sexual behavior, functioning, and satisfaction. Further, studies on the interplay between mental health and sexual well-being during the pandemic were reviewed. METHODS The review was conducted in accordance with guidelines established by the Joanna Briggs Institute and the Extension for Scoping Reviews (PRISMA-ScR) Checklist. On October 11-12, 2021, PubMed, Embase, PsycInfo, Cinahl, Cochrane, Sociological Abstracts and Scopus were systematically searched for relevant peer-reviewed papers employing quantitative methodology. Additionally, unpublished ("grey") research studies on the subject were retrieved. The screening, data extraction, and analysis of evidence were conducted by 4 independent reviewers using an iterative approach. RESULTS Based on 107 studies included, the scoping review showed that the pandemic had had a wide impact on all dimensions of sexual health. Except for solo sex activities, mainly negative COVID-19 implications were identified, although findings were, in sum, characterized by complexity and unpredictability. Thus, sexual behavior, functioning, and satisfaction during the pandemic appeared to be mitigated by a broad range of sociodemographic and contextual factors. Finally, sexual health seemed deeply entwined with overall mental health. CONCLUSION The scoping review revealed a broad range of COVID-19-related effects on sexual health, including an overall decline in partnered sex and a concurrent increase in solo sex activities. It also emphasized a need for future research to shed light on possible long-term consequences of the pandemic in various population groups and on all aspects of sexual health. Toldam NE, Graugaard C, Meyer R, et al. Sexual Health During COVID-19: A Scoping Review. Sex Med Rev 2022;10:714-753.
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Affiliation(s)
- Nana Ernst Toldam
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Denmark,Sexological Clinic, Mental Health Center, Copenhagen, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
| | - Christian Graugaard
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Denmark
| | - Rikke Meyer
- Clinical Pharmacology Unit, Zealand University Hospital, Roskilde, Denmark
| | | | | | | | - Annamaria Giraldi
- Sexological Clinic, Mental Health Center, Copenhagen, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark,Corresponding Author: Annamaria Giraldi, MD, PhD, FECSM, IF, Sexological Clinic, Mental Health Center, Copenhagen, Copenhagen University Hospital – Mental Health Services CPH, Ole Maaloesvej 14, 2200 Copenhagen, Denmark. Tel: + 45 38 64 71 69
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Niemeyer Hultstrand J, Törnroos E, Gemzell-Danielsson K, Larsson MI, Makenzius M, Sundström-Poromaa I, Tydén T, Ekstrand Ragnar M. Induced abortion and access to contraception in Sweden during the COVID-19 pandemic. BMJ Sex Reprod Health 2022; 48:311-312. [PMID: 35332034 DOI: 10.1136/bmjsrh-2022-201464] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
| | - Elin Törnroos
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Margareta I Larsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Marlene Makenzius
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Tanja Tydén
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Maria Ekstrand Ragnar
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Health Sciences, Lund University, Lund, Sweden
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Barua M, Saha A, Chowdhury S, Chowdhury S, Sajow SH, Sarker M. Implementation of a community-based referral project to improve access to emergency obstetric and newborn care in Rohingya population during COVID-19 pandemic in Bangladesh. BMJ Innov 2022; 8:247-254. [PMID: 37556264 PMCID: PMC9157323 DOI: 10.1136/bmjinnov-2021-000831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 04/28/2022] [Indexed: 11/07/2022]
Abstract
Introduction The delay in seeking emergency obstetric care leads to significant maternal morbidity and mortality and can worsen during pandemics, especially in humanitarian conflict settings with low uptake of obstetric services. To mitigate the challenges related to the second delay caused by lack of transport in the COVID-19 pandemic, the organisation United Nations Population Fund implements a community-based referral project called Referral Hub in the Rohingya refugee population in Bangladesh. The objective of the paper is to describe the implementation process of the Referral hub and present clients' utilisation and perception of the service. Methods Findings from part of a larger mixed-method study, the analysis of the standard operating protocol of the intervention, secondary data of routine utilisation of the 12 referral hubs between January and August 2020, 21 key informant interviews and a community survey among 100 pregnant women are presented in this paper. Results The findings show an increasing trend in the referral hub utilisation and a strong recommendation of the service. Conclusion Due to a robust referral mechanism by collaborating with the community and engaging accessible and free of cost transport service, the intervention has high potential to improve access to facility care in low-resource and humanitarian contexts, especially during pandemics.
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Affiliation(s)
- Mrittika Barua
- BRAC University James P Grant School of Public
Health, Dhaka,
Bangladesh
| | - Avijit Saha
- BRAC University James P Grant School of Public
Health, Dhaka,
Bangladesh
| | - Srizan Chowdhury
- International Centre for Diarrhoeal Disease
Research, Dhaka,
Bangladesh
| | | | | | - Malabika Sarker
- BRAC University James P Grant School of Public
Health, Dhaka,
Bangladesh
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Anderson D, Kumar D, Divya D, Zepeda JL, Razzak AN, Hasoon J, Viswanath O, Kaye AD, Urits I. Mental Health in Non-Oncologic Urology Patients. Health Psychol Res 2022; 10:38352. [PMID: 36168643 PMCID: PMC9501847 DOI: 10.52965/001c.38352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
This article is a literature review of mental health concerns in non-oncologic urology patients. Pathologies represented in this review include Peyronie's Disease (PD), erectile dysfunction (ED), urinary incontinence and urinary tract infections (UTI), infertility, benign prostatic hyperplasia (BPH), kidney stones, and urinary retention. While there has been great interventional focus as of late for urogenitary malignancies (i.e. prostate cancer awareness with the Movember campaign), literature studies and intervention focused on non-oncologic urology patients has been limited. As such, we conducted a review on urology patients with non-oncologic pathologies as an effort to increase clinician awareness of mental health concerns among such patients, increase the comfort level for clinician communication on socially sensitive topics surrounding pathologies, and review ongoing interventions conducted within these pathologies. We outlined different ongoing Mental Health Illness (MHI) needs and treatments for various pathologies. Patients with non-cancerous urologic pathologies had lower quality of life and higher incidence of MHI than the general population. As such, in line with the American Urological Association recommendations, psychological and social support from peers, therapists, and healthcare providers further prove to be crucial for some subpopulations. The review also yielded pathology specific interventions such as group therapy for ED patients. Given the higher incidence of MHI in the patient population after the Covid-19 pandemic, MHI awareness in the sphere of non-oncologic urology treatment continues to be crucial when creating a collaborative treatment platform for patients.
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Affiliation(s)
| | - Devesh Kumar
- School of Medicine, Medical College of Wisconsin
| | - Divya Divya
- School of Medicine, University of Missouri- Kansas City
| | | | | | - Jamal Hasoon
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Omar Viswanath
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School; Valley Anesthesiology and Pain Consultants, Envision Physician Services; Department of Anesthesiology, University of Arizona College of Medicine Phoenix; Department of Anesthesiology, Creighton University School of Medicine
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Shreveport
| | - Ivan Urits
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School; Department of Anesthesiology, Louisiana State University Health Shreveport
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Hu J, Whyke TW, Lopez-Mugica J. Investigating Media Coverage and Public Perceptions of the HPV Vaccine in China - A Content Analysis of Weibo Posts. Sex Cult 2022; 27:363-388. [PMID: 36093363 PMCID: PMC9443650 DOI: 10.1007/s12119-022-10017-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. The HPV vaccination has been widely advocated around the world since the vaccine is beneficial in avoiding diseases, including some sexually transmitted diseases, brought on by HPV infections. For most Chinese, the HPV vaccine is still a relatively new concept, having only been made available to the general public in 2016. Despite the vaccine's increased prominence, there is still a lack of investigation about how the public is influencing the conversation about HPV vaccines and the public's perception of this vaccine. With the theoretical construct of the Health Belief Model, this study conducts both quantitative and qualitative content analysis to investigate the existing media narratives around HPV vaccines in China and the changes in public opinion by looking at users' contributions on Weibo, one of China's most popular social networking sites. It was found that different groups of Weibo users had contributed to diverse narratives surrounding HPV vaccination. Though the public awareness of HPV vaccination had been improved along with increasingly active communication practices and enhanced public health services, public knowledge about HPV remains inadequate. Therefore, to facilitate the popularisation of HPV related knowledge, more effort should be invested in tailoring and disseminating messages that communicate responsive and comprehensive HPV related information.
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Affiliation(s)
- Junyi Hu
- The School of International Communications, The University of Nottingham Ningbo China, Ningbo, Zhejiang China
| | - Thomas William Whyke
- The School of International Communications, The University of Nottingham Ningbo China, Ningbo, Zhejiang China
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Bergeron S, Bigras N, Vaillancourt-Morel MP. Child Maltreatment and Couples' Sexual Health: A Systematic Review. Sex Med Rev 2022:S2050-0521(22)00029-4. [PMID: 36028437 DOI: 10.1016/j.sxmr.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/26/2022] [Accepted: 04/30/2022] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Childhood maltreatment (CM) is an interpersonal trauma reported by 35% to 40% of individuals in population-based studies in North America. It refers to physical, sexual, and emotional abuse, as well as physical and emotional neglect. Although there is a growing body of cross-sectional work focusing on associations between CM and sexual health, most studies have ignored the broader relationship context in which sexuality is experienced. OBJECTIVES The current review sought to systematically and critically appraise all studies that reported on the association between CM and couples' sexual health, to inform clinical care and recommendations for research. METHODS The electronic literature search was conducted using PubMed, PsycNET (PsycINFO, PsychArticles), Medline, CINAHL, and Eric for peer-reviewed journal articles published before September 2021. Eligible studies had to report on the association between any form of CM and any dimension of sexual health in couples or individuals in a romantic relationship. RESULTS In total, 13 studies (18 articles) were included in this systematic review: 4 studies pertained to clinical couples and 9, to community couples; 2 studies used a longitudinal design and 11, a cross-sectional design; 3 studies examined CM as a whole, 2 studies examined multiple subtypes of CM separately, 1 study examined both CM as a whole and its subtypes separately, whereas the other 7 studies focused on childhood sexual abuse. Results indicated that studies using valid measures of sexual health outcomes found significant associations between CM and worse outcomes - including declines over time - in both clinical and community samples. Mediators and moderators of these associations were also identified. CONCLUSIONS Findings provide preliminary support for the role of CM in couples' sexual health. There is a need for future longitudinal studies involving both members of the couple, valid and multidimensional measures of sexual health, and potential mediators and moderators. Bergeron S, Bigras N, Vaillancourt-Morel M-P. Child Maltreatment and Couples' Sexual Health: A Systematic Review. Sex Med Rev 2022;XX:XXX-XXX.
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Cahill EP, Lerma K, Shaw KA, Blumenthal PD. Potential candidate for oral pericoital contraception: evaluating ulipristal acetate plus cyclo-oxygenase-2 inhibitor for ovulation disruption. BMJ Sex Reprod Health 2022; 48:217-221. [PMID: 35470225 DOI: 10.1136/bmjsrh-2021-201446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/28/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND There remains considerable global unmet contraceptive need, with almost 200 million women reporting desire to limit or space childbearing without contraceptive use. Researchers have documented worldwide interest in an oral, on-demand contraceptive option were it available. Candidates for use include ulipristal acetate (UA), levonorgestrel and cyclo-oxygenase-2 (COX-2) inhibitors alone or in combination. METHODS We performed an exploratory, prospective study of matched menstrual cycles: one baseline cycle and one treatment cycle of UA 30 mg plus meloxicam 30 mg just prior to ovulation. The primary outcome was ovulation disruption, defined as unruptured dominant follicle for 5 days. Secondary outcomes included comparing cycle length, endometrial stripe thickness, and side effects. RESULTS Nine participants completed all study procedures in both cycles. Ovulatory disruption occurred in 66.7% (n=6) of treatment cycles and all but one demonstrated features of ovulatory dysfunction. Cycle length (mean±SD) was longer in the treatment cycle (31.9±4.0 vs 28.6±3.5 days, p<0.01). Secondary outcomes did not differ between the two cycles. CONCLUSIONS UA plus the COX-2 inhibitor meloxicam disrupts ovulation at peak luteal surge and is a promising candidate for evaluation as a pericoital oral contraceptive. TRIAL REGISTRATION NUMBER NCT03354117.
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Affiliation(s)
- Erica P Cahill
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA
| | - Klaira Lerma
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA
| | - Kate A Shaw
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA
| | - Paul D Blumenthal
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA
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Gorman JR, Drizin JH, Smith E, Corey S, Temple M, Rendle KA. Feasibility of Mindful After Cancer: Pilot Study of a Virtual Mindfulness-Based Intervention for Sexual Health in Cancer Survivorship. J Sex Med 2022; 19:1131-1146. [PMID: 35523716 DOI: 10.1016/j.jsxm.2022.03.618] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 02/21/2022] [Accepted: 03/31/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Mindfulness-based interventions (MBIs) are increasingly recognized as an effective strategy for supporting female cancer survivors experiencing sexual health concerns. AIM To examine the feasibility of a sexual health MBI, Mindful After Cancer, which was adapted to meet the needs of breast and gynecologic cancer survivors in a community setting and for delivery via videoconference. METHODS A mixed-methods approach was used to evaluate the acceptability, feasibility, and appropriateness of the 8-week virtual MBI. Weekly sessions were 1.5-2 hours in duration and included guided meditations and group discussion about sexuality after cancer and mindfulness in daily life. Home practice activities related to both mindfulness practice and sexual health. Participants completed online surveys at baseline and 1-month post-intervention. A purposive sample of 10 participants were invited to complete a follow-up interview 2-3 months post-intervention. OUTCOMES Primary outcomes included both qualitative and quantitative assessments of acceptability, appropriateness, and feasibility of the Mindful After Cancer intervention for sexual health in cancer survivorship. RESULTS Twenty-two women completed the intervention (Mean age 53.2 years, SD = 9.4, Range= 39-73), with time since diagnosis ranging from 1 to 27 years (Mean 6.0 years, SD = 5.9). Participants completed 6.8 sessions on average (Range = 2 - 8) and 77% reported that the time commitment was manageable. Both qualitative and quantitative findings support the feasibility, acceptability, and appropriateness of the intervention. CLINICAL IMPLICATIONS Many cancer survivors experience sexual dysfunction and related distress after diagnosis and well after treatment ends, yet there are few interventions available. Improved access to effective interventions can improve the delivery of survivorship care and patient outcomes. STRENGTHS & LIMITATIONS The sample size is small for this pilot study, and a control group was not included. The intervention was offered over two time periods, one prior to COVID-19 pandemic and one during the pandemic, resulting in both limitations associated with potential differences between the experiences of participants and the opportunity to learn more about the feasibility of the intervention during times of crisis. CONCLUSION Results suggest that virtual delivery of the MBI is feasible, acceptable, and appropriate for breast and gynecologic cancer survivors. Gorman JR, Drizin JH, Smith E, et al. Feasibility of Mindful After Cancer: Pilot Study of a Virtual Mindfulness-Based Intervention for Sexual Health in Cancer Survivorship. J Sex Med 2022;19:1131-1146.
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Affiliation(s)
- Jessica R Gorman
- Oregon State University, College of Public Health and Human Sciences, Corvallis, OR, USA.
| | - Julia H Drizin
- Oregon State University, College of Public Health and Human Sciences, Corvallis, OR, USA
| | - Ellie Smith
- Oregon State University, College of Public Health and Human Sciences, Corvallis, OR, USA
| | - Stephanie Corey
- Oregon State University, College of Public Health and Human Sciences, Corvallis, OR, USA
| | - Madison Temple
- Oregon State University, College of Public Health and Human Sciences, Corvallis, OR, USA
| | - Katharine A Rendle
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Penn Center for Cancer Care Innovation, Philadelphia, PA, USA
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Grabski B, Kasparek K, Koziara K, Mijas M. Professional Help-Seeking in Men Experiencing Sexual Problems - The Role of Sexual Identity and Minority Stress. J Sex Med 2022; 19:1090-1097. [PMID: 35654717 DOI: 10.1016/j.jsxm.2022.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/31/2022] [Accepted: 04/28/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Only a minority of men experiencing sexual problems will seek professional help and the proportion of gay or bisexual men can be even lower. AIM To investigate if sexual identity and minority stress are related to professional help-seeking in Polish gay and bisexual men. METHODS Sexual identity was measured with the standard question: "Do you consider yourself to be heterosexual, gay, or bisexual?" Men who provided a complete set of answers to the study tools and replied "yes" to the question: "Have you ever had a problem with sexual functioning that lasted at least several months?" were included (Ntotal =644, Nstraight = 203, Ngay = 324, Nbi = 117). A simple question on help-seeking was: "Did you seek professional assistance then?" Other data were gathered with the use of a self-constructed questionnaire. Minority stress processes, that is, internalized homophobia, expectations of rejection, and identity concealment, were measured with the subscales of the Sexual Minority Stress Scale. Bivariate analyses and multivariate logistic regressions were performed to test the statistical significance of sexual identity and minority stress processes as predictors of professional help-seeking. OUTCOMES Contacting a specialist when experiencing a sexual problem. RESULTS A total of 84.5% of all men did not seek professional help. Gay identity (OR = 0.58, P = .045), as opposed to bisexual identity, was significantly related to reduced odds of consulting a specialist. Age (OR = 1.03, P = .005), number of doctor's visits per year (OR = 1.51, P < .001), and a psychiatric diagnosis (OR = 1.65, P = .043) were positively related to help-seeking behaviors. Identity concealment significantly decreased the likelihood of consulting a specialist (OR = 0.94, P = .017). CLINICAL TRANSLATION Specialists need to be aware that gay identity and identity concealment may prevent a proportion of men from seeking their help and thus should be publicly explicit about their inclusive and nonpathologizing approach to sexual diversity. STRENGTHS AND LIMITATIONS The major strengths of the study include the use of a relatively large sample size and data from the little recognized Polish context characterized by a predominantly hostile anti-LGBT social climate, and exploration of a neglected topic of substantial significance at the public and individual levels. The major limitations are the use of nonprobability sampling, cross-sectional self-report design, and a single question to capture the presence of sexual problems with no measurement of associated distress. CONCLUSION Gay men are at risk of avoiding help-seeking when experiencing sexual problems because of identity concealment. Grabski B., Kasparek K., Koziara K., et al. Professional Help-Seeking in Men Experiencing Sexual Problems - The Role of Sexual Identity and Minority Stress. J Sex Med 2022;19:1090-1097.
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Affiliation(s)
- Bartosz Grabski
- Jagiellonian University Medical College, Faculty of Medicine, Department of Psychiatry, Sexology Lab, Krakow, Poland.
| | - Krzysztof Kasparek
- Jagiellonian University, Faculty of Philosophy, Institute of Sociology, Centre for Evaluation and Analysis of Public Policies, Krakow, Poland
| | - Karolina Koziara
- Jagiellonian University Medical College, Faculty of Health Sciences, Institute of Public Health, Department of Epidemiology and Population Studies, Krakow, Poland
| | - Magdalena Mijas
- Jagiellonian University Medical College, Faculty of Health Sciences, Institute of Public Health, Department of Environmental Health, Krakow, Poland
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Rahmani A, Afsharnia E, Fedotova J, Shahbazi S, Fallahi A, Allahqoli L, Ghanei-Gheshlagh R, Abboud S, Alkatout I. Sexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review. J Sex Med 2022; 19:1098-1115. [PMID: 35752457 DOI: 10.1016/j.jsxm.2022.03.614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Changes in sex hormones during menopause may have detrimental effects on a woman's sexual function and cause mood disorders. The treatment of both conditions is a challenge in gynecology. AIM To review the published literature on sexual function and mood disorders among peri- and postmenopausal women. METHODS The review is based on the methodological framework of scoping reviews. We searched electronic databases including Medline (PubMed), Scopus, Embase, and Web of Science (WoS). Publications that reported data about the relationship between sexual function and mood disorders among menopausal women were included in the review. The search was not subject to any limitation in terms of time or method. OUTCOMES The main outcome measures used for the review were sexual dysfunction and mood disorders. RESULTS We found 106 total records. After a full-text screening we included 19 studies from 1986 to 2020 based on various methodologies; the majority of the studies16 were cross-sectional. Investigations that addressed the symptoms of mood disorders and some domains of sexual function showed a close relationship between sexual dysfunction and mood disorders among menopausal women. CLINICAL IMPLICATIONS In clinical practice, it would be appropriate to screen women for at least one mood disorder or sexual dysfunction. If a woman suffers from either, it will be necessary to assess for a further disorder as well. STRENGTHS & LIMITATIONS The review was based on a detailed search of the published literature concerning mood disorders and sexual dysfunction among menopausal women compared to women of reproductive age. Despite the clinical importance of the subject, the number of studies eligible for inclusion in the review are rather small. Further investigation of the topic is clearly warranted. CONCLUSIONS While the association between sexual dysfunction and mood disorders appears to be bidirectional, future studies will have to investigate the specific mechanisms by which sexual dysfunction could lead to mood disorders (or vice versa). Future studies should specifically address sexual dysfunctions and attitudes of partners, BMI, family support, sleep, and multiparity. Azam Rahmani, Elahe Afsharnia, Julia Fedotova, Shirin Shahbazi, Arezoo Fallahi, Leila Allahqoli, Reza GhaneipoklGheshlagh, Sarah Abboud, Ibrahim Alkatout. Sexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review. J Sex Med 2022;19:1098-1115.
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Affiliation(s)
- Azam Rahmani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Elahe Afsharnia
- Department of Gerontology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Julia Fedotova
- International Research Centre "Biotechnologies of the Third Millennium", St. Petersburg, Russian Federation. Laboratory of Neuroendocrinology, ITMO University, I.P. Pavlov Institute of Physiology RASci., St. Petersburg, Russia
| | - Shirin Shahbazi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran; Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran; Breastfeeding Research Center-Family Health Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezoo Fallahi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Leila Allahqoli
- School of Public Health, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Reza Ghanei-Gheshlagh
- Social Determinants of Health Research Center, Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Kurdistan University of Medical, Sciences, Sanandaj, Iran
| | - Sarah Abboud
- Department of Women, Children, and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Kiel, Germany
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Tabaac AR, Johns MM, Zubizarreta D, Haneuse S, Tan AS, Austin SB, Potter J, Lindberg L, Charlton BM. Associations between sexual orientation, sex education curriculum, and exposure to affirming/disaffirming LGB content in two US-based cohorts of adolescents. Sex Educ 2022; 23:506-523. [PMID: 37771517 PMCID: PMC10530727 DOI: 10.1080/14681811.2022.2072286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 04/27/2022] [Indexed: 09/30/2023]
Abstract
Sexual health education experienced by lesbian, gay, and bisexual (LGB) youth varies widely in relevancy and representation. However, associations among sexual orientation, type of sex education, and exposure to affirming or disaffirming content have yet to be examined. Understanding these patterns can help to address gaps in LGB-sensitive sex education. Our goal in this study was to examine the prevalence and associations among abstinence-only until marriage (AOUM) and comprehensive sex education with LGB-affirming and -disaffirming content sought/received before age 18 (from 1999-2014) by sexual orientation (completely heterosexual with same-sex contact, completely heterosexual with no same-sex contact, mostly heterosexual, bisexual, gay/lesbian) in a sample of 12,876 US young adults from the Growing Up Today Study. Compared to completely heterosexual referents, LGB participants who received AOUM sex education were more likely to encounter LGB-disaffirming content, and this effect was largest among sexual minority participants. Conversely, exposure to comprehensive sex education was associated with receipt of LGB-affirming information. Overall, participants commonly reported receiving AOUM sex education, which may lead to deficits and potential harm to sexual minorities.
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Affiliation(s)
- Ariella R. Tabaac
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Michelle M. Johns
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dougie Zubizarreta
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Andy S.L. Tan
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - S. Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Jennifer Potter
- Beth Israel Deaconess Medical Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Fenway Institute, Boston, MA, USA
| | | | - Brittany M. Charlton
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Healthcare Institute, Boston, MA, USA
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Vedovo F, Capogrosso P, Di Blas L, Cai T, Arcaniolo D, Privitera S, Palumbo F, Palmieri A, Trombetta C. Longitudinal Impact of Social Restrictions on Sexual Health in the Italian Population. J Sex Med 2022; 19:923-932. [PMID: 35513999 PMCID: PMC9060260 DOI: 10.1016/j.jsxm.2022.03.607] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 02/21/2022] [Accepted: 03/17/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Several trials have reported on the impact of social restrictions due to SARS-CoV-2 (COVID-19) pandemic on sexual function and psycho-physical well-being. However, data showing modifications of these outcomes over time and at the end of lock-down are scant. AIM We investigated the longitudinal changes in sexual function during social restrictions for COVID-19 pandemic in Italy. METHODS A web-based survey was administered to Italian citizens of legal age via social networks. The Beck Depression Inventory Primary Care, the General Health Survey, Female Sexual Function Index, International Index of Erectile Function, UCLA Loneliness Scale-version 3 questionnaires were used to test mental, physical and sexual well-being. The questionnaires were administered at the beginning of the lockdown (T0), 15 days from the first assessment (T1) and 1 month after the end of the restrictions in 2020 (T2). OUTCOMES Descriptive statistics and multiple regression analysis were applied to investigate changes in sexual function over and at the end of social restrictions. RESULTS Data were available for 2543 people (47.2% of men; 43.4% women; 9.4% undefined). Mean age was 48.3 ± 15.1 years for males and 43.9 ± 13.4 for females. Overall, 2.6% reported depressive symptoms according to Beck Depression Inventory Primary Care, 7.4% reported a high level of UCLA loneliness and 19.4% low levels of general mental health. Mild to severe erectile dysfunction was reported by 59.1% of men at T0, while 68.4% of women reported sexual dysfunction. Sexual function levels remain generally unchanged at further follow-up over the social restriction time period (T1), although those who were sexually active at baseline showed a decrease in sexual function scores. At T2, there was an overall improvement in sexual function scores with a rate of severe erectile dysfunction decreasing from 37.1% to 24.1% from T0 to T2 among males and a significant decrease of female sexual dysfunction from 68.4% to 51.2%. CLINICAL IMPLICATIONS Young individuals and those with good mental and physical health were more likely to improve sexual function at the end of social restrictions. STRENGTHS & LIMITATIONS Valid and reliable questionnaires and longitudinal approach design represent strengths; a large but convenient sample and lack of pre-pandemic baseline data represent limits. CONCLUSION Social restrictions due to COVID-19 pandemic led to an increase in sexual dysfunctions in both genders. However, these conditions appeared temporary since an overall improvement was observed at the end of lockdown and especially in younger individuals with higher psycho-physical well-being. Vedovo F, Capogrosso P, Di Blas L, et al. Longitudinal Impact of Social Restrictions on Sexual Health in the Italian Population. J Sex Med 2022;19:923-932.
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Affiliation(s)
- Francesca Vedovo
- Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy.
| | - Paolo Capogrosso
- Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation, Varese, Italy
| | - Lisa Di Blas
- Department of Life Sciences, University of Trieste, Italy
| | - Tommaso Cai
- Department of Urology, Santa Chiara Regional Hospital, Trento, Italy
| | - Davide Arcaniolo
- Unit of Urology, Luigi Vanvitelli University of Campania, Naples, Italy
| | | | | | | | - Carlo Trombetta
- Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
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Aupomerol M, Chaltiel D, Pautier P, Wehrer D, Véron L, Degousée L, Fasse L, Guéroult-Accolas L, Di Meglio A, Scotté F, De-Jesus A, Vaz-Luis I, Delaloge S, Lambertini M, Pistilli B. Breast cancer patients' experience and wishes regarding communication on sexual health: the BEROSE study. Cancer Invest 2022; 40:483-493. [PMID: 35468006 DOI: 10.1080/07357907.2022.2066112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BEROSE is a single-center observational study, which aimed to determine the proportion of women with breast cancer who received information on sexual health from health professionals throughout their whole care pathway. A total of 318 women with all stages of breast cancer (30% metastatic) and at different time interval from diagnosis (up to 7 years) participated to the survey. Sixty-five percent of women reported that they had not received any information about sexual health over the whole care. Increased awareness among the healthcare professionals and particularly the oncology community is needed to discuss sexual health in women with breast cancer.
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Affiliation(s)
- M Aupomerol
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France
| | - D Chaltiel
- Department of Biostatistics and Epidemiology, Gustave Roussy Cancer Center, University Paris-Saclay, Villejuif, France.,Oncostat U1018, Inserm, University Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif, France
| | - P Pautier
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France
| | - D Wehrer
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France
| | - L Véron
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France
| | - L Degousée
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France
| | - L Fasse
- Department of Interdisciplinary Cancer Course and supportive care (DIOPP), psychology Unit, Gustave Roussy Cancer Center, Villejuif, France
| | | | - A Di Meglio
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France.,INSERM unit 981, Gustave Roussy Cancer Center, Villejuif, France
| | - F Scotté
- Department of Interdisciplinary Cancer Course and Supportive care (DIOPP), Gustave Roussy Cancer Center, Villejuif, France
| | - A De-Jesus
- Coordinator of Patient Group, Gustave Roussy Cancer Center, Villejuif, France
| | - I Vaz-Luis
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France.,INSERM unit 981, Gustave Roussy Cancer Center, Villejuif, France
| | - S Delaloge
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France
| | - M Lambertini
- Department of Medical Oncology, Breast Unit, IRCCS Ospedale Policlinico San Martino, Genova,Italy.,Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - B Pistilli
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France
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Warwick RM, Araya AC, Shumer DE, Selkie EM. Transgender Youths' Sexual Health and Education: A Qualitative Analysis. J Pediatr Adolesc Gynecol 2022; 35:138-146. [PMID: 34619356 DOI: 10.1016/j.jpag.2021.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/21/2021] [Accepted: 09/29/2021] [Indexed: 02/02/2023]
Abstract
STUDY OBJECTIVE To characterize transgender adolescents' sexual behaviors, identities, and their perceived experiences with sex education. DESIGN Semi-structured interviews were conducted and addressed sexual experiences and perceptions of sex education received from family, school educators, and healthcare providers. Interviews were audio recorded, transcribed, and analyzed utilizing NVivo 12 software for thematic analysis. SETTING Child and adolescent gender services clinic at a Midwestern university-based medical center in the United States. PARTICIPANTS 30 transgender adolescents between the ages of 15 to 20. INTERVENTIONS AND MAIN OUTCOME MEASURES Themes generated during semi-structured interviews. RESULTS Sexual orientations were inclusive of attractions to a spectrum of gender identities. Libido was perceived to be impacted by gender-affirming hormone therapy, which was unanticipated for some adolescents. Family and school-based sex education was perceived to be relevant only for heterosexual and cisgender adolescents. Inclusive education for transgender adolescents was desired. Counseling provided by gender-affirming providers on sexual health was trusted and other healthcare providers were perceived to lack training on gender-inclusive care. CONCLUSION This study demonstrated that families and school educators did not provide sex education perceived to be applicable to transgender adolescents. Similarly, healthcare providers of transgender adolescents were perceived to not provide inclusive or comprehensive medical care in comparison to physicians who routinely provide gender-affirming care. Gaps in education and healthcare could be improved with sex education outreach or training for families and school educators as well as the development and implementation of professional competencies for pediatricians on transgender adolescent healthcare.
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Affiliation(s)
| | - Adrian C Araya
- Division of Pediatric Endocrinology, Michigan Medicine, Ann Arbor, MI
| | - Daniel E Shumer
- Division of Pediatric Endocrinology, Michigan Medicine, Ann Arbor, MI
| | - Ellen M Selkie
- Division of Adolescent Medicine, Michigan Medicine, Ann Arbor, MI
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Bhatia S, Acharya V, Jalaeian H, Kumar J, Bryant E, Richardson A, Malkova K, Harward S, Sinha V, Kably I, Kava BR. Effect of Prostate Artery Embolization on Erectile Function - A Single Center Experience of 167 Patients. J Sex Med 2022; 19:594-602. [PMID: 35184995 DOI: 10.1016/j.jsxm.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/03/2022] [Accepted: 01/10/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Prostate artery embolization (PAE) is an emerging therapy for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). AIM This retrospective study was conducted to assess the effect of prostate artery embolization (PAE) on erectile function in a cohort of patients with LUTS attributable to BPH at 3-months after the procedure. METHODS A retrospective review was performed on 167 patients who underwent PAE. Data collected included Sexual Health Inventory in Men (SHIM) scores at 3, 6, and 12 months post-PAE, in conjunction with the International Prostate Symptom Scores (IPSS), Quality of Life (QoL) scores, and prostate volumes. Primary outcome was erectile function as assessed by SHIM scores at 3 months after PAE. An analysis was performed to identify patients with a ±5-point SHIM change to group them according to this minimum clinically significant difference in erectile function. Adverse events were recorded using the Clavien-Dindo (CD) classification. OUTCOMES At 3 months following PAE, median IPSS decreased by 16.0 [IQR, 9.0-22.0] points, median QOL decreased by 4.0 [IQR, 2.0-5.0] points, and median prostate volume decreased by 33 g [IQR, 14-55]. RESULTS Median SHIM score was 17.0 [IQR, 12.0-22.0] at baseline, 18.0 [IQR, 14.0-23.0] at 3 months [P = .031], 19.0 [IQR, 14.5-21.5] at 6 months [P = .106] and 20 [IQR, 16.0-24.0] at 12 months [P = .010] following PAE. In patients with no erectile dysfunction (ED) at baseline, 21% (n = 9) reported some degree of decline in erectile function post-PAE. However, 38% (n = 40) of patients who presented with mild-to-moderate ED reported improvement in their erectile function 3 months following PAE. Overall, the changes in baseline SHIM score were relatively small; 82% (n = 137) of patients did not have more than 5 points of change in their SHIM scores at 3 months following PAE. CLINICAL IMPLICATIONS Our findings suggest PAE has no adverse impact on erectile function for most patients. STRENGTHS & LIMITATIONS The study was performed at a single center with 1 operator's experience, and is retrospective with no control group. CONCLUSION Findings suggest that prostate artery embolization has no adverse effect on erectile function in the majority of patients with LUTS attributable to BPH at 3 months after the procedure. Bhatia S, Acharya V, Jalaeian H, et al., Effect of Prostate Artery Embolization on Erectile Function - A Single Center Experience of 167 Patients. J Sex Med 2022;19:594-602.
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Affiliation(s)
- Shivank Bhatia
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Vedant Acharya
- University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Hamed Jalaeian
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Jessica Kumar
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA.
| | - Evan Bryant
- University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Andrew Richardson
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Kseniia Malkova
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Sardis Harward
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Vishal Sinha
- Weill Cornell Department of Radiology, New York, NY, USA
| | - Issam Kably
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Bruce R Kava
- Department of Urology, University of Miami, Miller School of Medicine, Miami, FL, USA
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Bungener SL, Post L, Berends I, Steensma TD, de Vries ALC, Popma A. Talking About Sexuality With Youth: A Taboo in Psychiatry? J Sex Med 2022; 19:421-429. [PMID: 35105513 DOI: 10.1016/j.jsxm.2022.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 12/28/2021] [Accepted: 01/01/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Young people who have psychiatric problems are more likely than their peers to endure difficulties during their sexual and gender identity development. AIM This study aims to examine the communication between mental health care providers and their patients about the topics of relations, sexuality and gender identity, including a description of professionals' attitudes toward these topics and the factors that contribute to and inhibit communication. METHODS Study participants (n = 242, response rate = 31%) were a representative sample of a large multicenter cohort of 768 mental health care professionals (eg, medical doctors, psychiatrists, psychologists, group counselors, parent counselors) of 7 institutions and 5 solo practices in the Netherlands, who completed a survey on communication about sexuality and gender identity with their young patients (age 12-21 years). OUTCOMES Sexuality and gender identity are infrequently discussed by mental health care providers with their young patients or their patients' parents. RESULTS Of the study sample, 99.5 % valued sexuality as an important topic to discuss with their patients. However, only 17.1% of the professionals reported that they discussed sexuality-related issues with the majority (>75%) of their patients (adolescents: 19.9%, parents: 14.4%) Additionally, only 2.3 % of the participants discussed gender nonconformity regularly with patients. Information about sexual side effects of prescribed medication was infrequently (20.3%) provided: antidepressants (40.0%), antipsychotics (34.0%), benzodiazepines (5.1%) and stimulants (2.4%). The most frequently cited reasons for not discussing these topics were a lack of awareness, own feelings of discomfort, and the patients' supposed feelings of shame. There was no gender differences observed. CLINICAL IMPLICATIONS Recommendations for professionals include to be aware of these topics, initiating age-appropriate conversation and use inclusive language. STRENGTHS AND LIMITATIONS The present study included a diverse and representative group of mental health care professionals. Frequency of sexual communication was based on self-report, which brings a risk of bias. CONCLUSION Despite a recognized need to engage in age-appropriate communication about sexuality and gender identity in youth mental health care, mental health providers seem to remain hesitant to discuss such topics. Bungener SL, Post L, Berends I, et al. Talking About Sexuality With Youth: A Taboo in Psychiatry?. J Sex Med 2022;19:421-429.
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Affiliation(s)
- Sara L Bungener
- Center of Expertise on Gender Dysphoria, Department of Child and Adolescent Psychiatry, Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
| | - Laura Post
- Center of Expertise on Gender Dysphoria, Department of Child and Adolescent Psychiatry, Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Inez Berends
- Center of Expertise on Gender Dysphoria, Department of Child and Adolescent Psychiatry, Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Thomas D Steensma
- Center of Expertise on Gender Dysphoria, Department of Child and Adolescent Psychiatry, Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Annelou L C de Vries
- Center of Expertise on Gender Dysphoria, Department of Child and Adolescent Psychiatry, Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Arne Popma
- Center of Expertise on Gender Dysphoria, Department of Child and Adolescent Psychiatry, Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
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Kutner BA, Perry NS, Stout C, Norcini Pala A, Paredes CD, Nelson KM. The Inventory of Anal Sex Knowledge (iASK): A New Measure of Sexual Health Knowledge Among Adolescent Sexual Minority Males. J Sex Med 2022; 19:521-528. [PMID: 35090838 PMCID: PMC9115869 DOI: 10.1016/j.jsxm.2021.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/16/2021] [Accepted: 12/16/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Knowledge about sexual health is a key determinant of sexual behavior among adolescent sexual minority males (ASMM). No measures exist to assess anal sex knowledge, even though anal sex is the primary route by which ASMM acquire sexually transmitted infections (STIs), including a disproportionate burden of human immunodeficiency virus (HIV). AIM We developed a new measure as a first step toward assessing the prevalence and correlates of anal sex knowledge and potential effects of interventions to improve knowledge. METHODS Two coders independently outlined domains of knowledge within 2 sex education videos designed to address anal sex knowledge among ASMM. An initial set of 56 items, some duplicative, encompassed all domains. A larger team, including a psychometrician, then iteratively revised and reduced the set of items, and assessed construct validity via cognitive testing among ASMM (N = 4, aged 16-17 years old, 75% identifying as racial/ethnic minorities). For the final set of 10 items, factor structure and convergent and divergent validity were assessed using baseline responses to an online survey within a randomized controlled pilot trial among 154 ASMM. Open-ended questions assessed their comprehension and the acceptability of items. OUTCOMES We examined correlates that we anticipated would be theoretically related (ie, the HIV Knowledge Questionnaire [HIV-KQ-18] and the STD-Knowledge Questionnaire [STD-KQ]) and theoretically distinct (ie, the Patient Health Questionnaire [PHQ-2], Generalized Anxiety Disorder scale [GAD-2], and employment status). RESULTS The one-factor model explained 42% of the items' common variance and demonstrated acceptable internal reliability (Cronbach's alpha = 0.72). The measure withstood tests of convergent and divergent validity when compared to current measures (HIV knowledge, r = 0.35 and STI knowledge, r = 0.24, both P < .05; internalizing mental health symptoms, r = -0.07 and employment status, r = 0.13, both P > .05). Few respondents found words unfamiliar or uncomfortable. CLINICAL IMPLICATIONS A method for assessing anal sex knowledge may offer opportunities to intervene to lessen harmful sequelae of a lack of knowledge. STRENGTH & LIMITATIONS We developed a brief, psychometrically valid measure of anal sex knowledge. The measure may neither generalize to all anal health knowledge nor to more sexually experienced, older SMM. CONCLUSION The resulting 10-item, single-factor measure, the Inventory of Anal Sex Knowledge (iASK), is psychometrically sound and addresses the lack of anal sex knowledge measures among ASMM. The iASK can function to assess the prevalence and sequelae of anal sex knowledge among ASMM as well as the impact of interventions targeting anal sex knowledge. Kutner BA, Perry N, Stout C, et al. The Inventory of Anal Sex Knowledge (iASK): A New Measure of Sexual Health Knowledge Among Adolescent Sexual Minority Males. J Sex Med 2022;19:521-528.
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Affiliation(s)
- Bryan A Kutner
- HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, NY, USA.
| | | | - Claire Stout
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Andrea Norcini Pala
- Social Intervention Group (SIG), Columbia School of Social Work, New York, NY, USA
| | - Christian D Paredes
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Kimberly M Nelson
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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Scull TM, Dodson CV, Geller JG, Reeder LC, Stump KN. A Media Literacy Education Approach to High School Sexual Health Education: Immediate Effects of Media Aware on Adolescents' Media, Sexual Health, and Communication Outcomes. J Youth Adolesc 2022; 51:708-723. [PMID: 35113295 PMCID: PMC8811737 DOI: 10.1007/s10964-021-01567-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/20/2021] [Indexed: 12/03/2022]
Abstract
Media may function as sex educators for adolescents; unfortunately, media messages often glamorize risky sexual behaviors and unhealthy relationships and neglect sexual health behaviors and communication. Media Aware is a web-based comprehensive sexual health program for high school students that uses a media literacy education approach. It is designed to improve adolescents’ critical thinking about media messages and provide medically-accurate information and skills building related to sexual health and communication. A randomized controlled trial was conducted in 2019-2020 with students (grades 9 and 10; n = 590) from 17 high schools across the United States. The sample was 53% female, 58% white/Caucasian; and 13% Hispanic/Latinx. One high school teacher per school and all of their 9th and 10th grade students were randomly assigned to either the intervention or delayed-intervention (control) condition. The study assessed the immediate (posttest) and short-term (3-month) effects of Media Aware on adolescents’ media, sexual health, and communication outcomes. For 9 of the 17 schools, students were home from school due to the beginning of the COVID-19 pandemic during the time of their 3-month data collection, which left the short-term analyses underpowered. However, several impacts of the program were found in the immediate posttest analyses. Media Aware was found to improve sexual health knowledge and redress inaccurate normative beliefs about the frequency of risky teen sex. Media Aware also improved critical thinking about media messages with demonstrated improvements in media message deconstruction skills and decreases in the perceived realism of media messages. Moderator analyses found some differential immediate effects of the program attributable to gender. Media Aware reduced girls’ normative beliefs about teen sex, generally, and increased their sexual health communication with parents as well as reduced boys’ acceptance of dating violence. Students gave positive feedback about Media Aware, especially related to the online format of the program. The results from this study provide evidence that Media Aware is an effective web-based program for positively enhancing high school students’ media, sexual health, and sexual health communication outcomes.
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Affiliation(s)
- Tracy M Scull
- Innovation Research & Training, 5316 Highgate Drive, Suite 125, Durham, NC, 27713, USA.
| | - Christina V Dodson
- Innovation Research & Training, 5316 Highgate Drive, Suite 125, Durham, NC, 27713, USA
| | - Jacob G Geller
- Innovation Research & Training, 5316 Highgate Drive, Suite 125, Durham, NC, 27713, USA
| | - Liz C Reeder
- Innovation Research & Training, 5316 Highgate Drive, Suite 125, Durham, NC, 27713, USA
| | - Kathryn N Stump
- Innovation Research & Training, 5316 Highgate Drive, Suite 125, Durham, NC, 27713, USA
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Rodrigues Â, Valentim B, Tavares D, Augusto MJ, Campelo J, Loureiro M, Raposo A, Alves I, Almeida MC, Santos Silva I. Knowledge and Patterns of Use of Emergency Oral Contraception among Portuguese Female Users of Healthcare Services. ACTA MEDICA PORT 2022; 35:30-35. [PMID: 34454638 DOI: 10.20344/amp.14043] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/23/2020] [Accepted: 07/02/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The lack of knowledge about the existence, effectiveness, and supply of emergency contraception as well as access to it, its effective duration and the lack of recognition of the need for its use can prevent women from using it. The aim of this study was to ascertain the attitudes, experience, level of knowledge and information sources about emergency contraception of Portuguese female users of healthcare services. MATERIAL AND METHODS We conducted a multicentre, cross-sectional, observational study among 280 Portuguese women users of health care services through an original and anonymous questionnaire composed of 30 questions. RESULTS The mean age of the women who replied to the questionnaire was 33.83 ± 8.76 years. Of the observed sample, 27.7% used EC, 50% of whom with no counselling. Despite 92.1% of women claiming knowledge about emergency contraception, only 31.2% of these answered 8 - 10 questions correctly (14 in total). The media were the most frequent source of information (63.4%). Most participants (67.5%) considered that emergency contraception is associated with severe adverse reactions. Furthermore, 76% did not know the time range of effectiveness after unprotected sexual intercourse. Youngest age (p = 0.038), higher education level (p < 0.001), increasing parity (p = 0.051) and previous use of emergency contraception (p = 0.011) were identified as the determinant sociodemographic factors for a higher level of knowledge about emergency contraception. DISCUSSION The use of emergency contraception after counselling by healthcare professionals was lower than reported in the literature. CONCLUSION This study showed that female users of healthcare services were aware of the existence of emergency contraception, but they demonstrated a low level of knowledge about it, especially regarding the correct period of use, place of acquisition and safety issues.
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Affiliation(s)
- Ângela Rodrigues
- Departamento de Obstetrícia. Centro Hospitalar Universitário de Coimbra. Coimbra. Faculdade de Medicina. Universidade de Coimbra. Centro Académico Clínico de Coimbra. Coimbra. Portugal
| | - Bruno Valentim
- Unidade de Saúde Familiar de Condeixa. Coimbra. Portugal
| | - Daniel Tavares
- Unidade de Cuidados de Saúde Primários de Penalva do Castelo. Viseu. Portugal
| | - Maria João Augusto
- Unidade de Cuidados de Saúde Primários de São Miguel. Castelo Branco. Portugal
| | - Jorge Campelo
- Unidade de Saúde Familiar de Celas. Coimbra. Portugal
| | | | - Ana Raposo
- Unidade de Saúde Familiar Cândido Figueiredo. Viseu. Portugal
| | - Isabel Alves
- Departamento de Obstetrícia. Centro Hospitalar Universitário de Coimbra. Coimbra. Portugal
| | - Maria Céu Almeida
- Departamento de Obstetrícia. Centro Hospitalar Universitário de Coimbra. Coimbra. Portugal
| | - Isabel Santos Silva
- Departamento de Obstetrícia. Centro Hospitalar Universitário de Coimbra. Coimbra. Faculdade de Medicina. Universidade de Coimbra. Centro Académico Clínico de Coimbra. Coimbra. Portugal
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Kim JI, Zhu D, Davila J, Lee J, Chubak BM, Melamed ML, Abraham N. Female Sexual Dysfunction as Measured by Low Sexual Frequency is Associated with Lower Socioeconomic Status: An Analysis of the National Health and Nutrition Examination Survey (NHANES), 2007-2016. J Sex Med 2022; 19:90-97. [PMID: 34696997 DOI: 10.1016/j.jsxm.2021.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/04/2021] [Accepted: 09/24/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND Female sexual dysfunction (FSD) is a complex disorder of biopsychosocial etiology, and FSD symptoms affect more than 40% of adult women worldwide. AIM In this cross-sectional study, we sought to investigate the association between FSD and socioeconomic status (SES) in a nationally representative female adult population. METHODS Economic and sexual data for women aged 20-59 from the 2007-2016 National Health and Nutrition Examination Survey, a United States nationwide representative database, was analyzed. Poverty income ratio (PIR), a ratio of family income to poverty threshold, was used as a measure of SES, and low sexual frequency was used as a measure of FSD. The association between FSD and SES was analyzed using survey-weighted logistic regression after adjusting for relevant social and gynecologic covariates, such as marital status and history of pregnancy, as well as significant medical comorbidities. OUTCOMES We found that FSD, as measured by low sexual frequency, was associated with lower SES. RESULTS Among the 7,348 women of mean age 38.4 (IQR 29-47) included in the final analysis, 26.3% of participants reported sexual frequency of 0-11 times/year and 73.7% participants reported sexual frequency >11 times/year. Participants of PIR <2 were 92% more likely to report sexual frequency ≤11 times/year than those of PIR ≥2 after adjusting for demographics, social history, gynecologic history and significant medical conditions (OR = 1.92; 95% CI = 1.21-3.05; P < .006). CLINICAL IMPLICATIONS The evaluation and treatment of FSD may benefit from a comprehensive approach that takes SES into account. STRENGTHS & LIMITATIONS This study is limited by its cross-sectional design, but it is strengthened by a large, nationally representative sample with extensive, standardized data ascertainment. CONCLUSION Lower SES and lower sexual frequency are directly correlated among female adults in the United States; future studies should focus on social determinants of health as risk factors for FSD.
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Affiliation(s)
- Joseph I Kim
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Denzel Zhu
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jonathan Davila
- Department of Urology, Montefiore Medical Center, Bronx, NY, USA
| | - Justin Lee
- Department of Urology, Columbia University Medical Center, New York, NY, USA
| | - Barbara M Chubak
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michal L Melamed
- Albert Einstein College of Medicine, Bronx, NY, USA
- Division of Nephrology, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nitya Abraham
- Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Urology, Montefiore Medical Center, Bronx, NY, USA
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Malebranche D, Watriss A, Dangerfield DT. Implementing a National PrEP Program: How Can We Make It Happen? J Law Med Ethics 2022; 50:51-54. [PMID: 35902086 PMCID: PMC9341202 DOI: 10.1017/jme.2022.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Inequities in HIV pre-exposure prophylaxis (PrEP) use persist in the United States. Although scientific advancement in delivery options and social acceptance of PrEP has occurred in the past decade, gaps remain in ensuring that this sexual health program is available to all. Components of what a national PrEP program for all would look like are discussed.
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