1
|
Ishungisa AM, Mmbaga EJ, Leshabari MT, Tersbøl BP, Moen K. Five different ways of reasoning: Tanzanian healthcare workers' ideas about how to improve HIV prevention among same-sex attracted men. BMC Health Serv Res 2023; 23:807. [PMID: 37501186 PMCID: PMC10375645 DOI: 10.1186/s12913-023-09771-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 06/30/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Same-sex attracted men in Tanzania and globally carry a disproportionate burden of HIV. Drawing on qualitative research, this article explores healthcare providers' ideas and recommendations regarding how to improve HIV prevention among same-sex attracted men. METHODS We carried out a qualitative study among healthcare workers in the cities of Dar es Salaam and Tanga in Tanzania between August 2018 and October 2019. Data were collected using qualitative methods of data collection, specifically in-depth interviews, focus group discussions, and participant observation. Study participants were recruited through a purposive sampling strategy that aimed to ensure variation in age, education, and work experience. Forty-eight interviews with 24 healthcare workers, six focus group discussions, and participant observation were conducted. A total of 64 persons participated in the study. RESULTS This paper describes five different "ways of reasoning" that were identified among healthcare workers regarding how to strengthen HIV prevention among same-sex attracted men. One held that punitive measures should be taken to prevent HIV transmission, another that health services needed to become more friendly towards men who have sex with men, a third that healthcare workers should reach out to provide more education to this population, a fourth called for strengthened collaboration between healthcare providers and same-sex attracted men in healthcare delivery, and the fifth proposed that activistic efforts be taken to remove structural barriers for same-sex attracted men to access healthcare. CONCLUSION When reflecting on what is needed to strengthen HIV prevention among men who have sex with men, healthcare workers described six different ideas. One was that restrictive and punitive measures ought to be taken to prevent HIV transmission through same-sex sex. The remaining five promoted understanding of and support for same-sex attracted men. They prescribed more healthcare education, measures to improve attitudes among healthcare workers, healthcare delivery with user involvement, and political action to achieve law reform. Finally, some study participants raised concerns about the implementation of the national comprehensive package for key populations.
Collapse
Affiliation(s)
- Alexander Mwijage Ishungisa
- Department of Behavioural Sciences, Muhimbili University of Health and Allied Sciences (MUHAS), Dar Es Salaam, Tanzania.
| | - Elia John Mmbaga
- Department of Behavioural Sciences, Muhimbili University of Health and Allied Sciences (MUHAS), Dar Es Salaam, Tanzania
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Melkizedeck Thomas Leshabari
- Department of Behavioural Sciences, Muhimbili University of Health and Allied Sciences (MUHAS), Dar Es Salaam, Tanzania
| | - Britt Pinkowski Tersbøl
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
| | - Kåre Moen
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| |
Collapse
|
2
|
Zhang JT, Ma L, Gong X, Luo S, Zhao S. Clinical Study on the Use of Acupuncture for the Treatment of Female Sexual Dysfunction: A Pilot Study. Sex Med 2022; 10:100541. [PMID: 35738039 PMCID: PMC9386623 DOI: 10.1016/j.esxm.2022.100541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Female sexual dysfunction (FSD) seriously affects the quality of life of women. However, most women do not have access to effective treatment. Aim This study aimed to determine the feasibility and effectiveness of the use of acupuncture in FSD treatment based on existing clear acupuncture protocol and experience-supported face-to-face therapy. Methods A retrospective analysis was performed on 24 patients with FSD who received acupuncture from October 2018 to February 2022. The Chinese version of the female sexual function index , subjective sensation, sexual desire, sexual arousal, vaginal lubrication, orgasm, sexual satisfaction, and dyspareunia scores were compared before and after the treatment in all 24 patients. Main Outcome Measure A specific female sexual function index questionnaire was used to assess changes in female sexual function before and after the acupuncture treatment. Results In this study, the overall treatment improvement rate of FSD was 100%. The Chinese version of the female sexual function index total score, sexual desire score, sexual arousal score, vaginal lubrication score, orgasm score, sexual satisfaction score, and dyspareunia score during intercourse were significantly different before and after the treatment (P < .05). Consequently, participants reported high levels of satisfaction with acupuncture. This study indicates that acupuncture could be a new and effective technique for treating FSD. The main advantages of this study are its design and efficacy in treating FSD. To the best of our knowledge, this is the first study to evaluate the efficacy of acupuncture in the treatment of FSD using the female sexual function index scale from 6 dimensions. The second advantage is that the method used (ie, the nonpharmacological method) is simple, readily available, highly safe with few side effects, and relatively inexpensive with high patient satisfaction. However, limitations include small sample size and lack of further detailed grouping, pre and post control study of patients, blank control group, and pre and post control study of sex hormones. Conclusion Acupuncture can effectively treat FSD from all dimensions with high safety, good satisfaction, and definite curative effect, and thus, it is worthy of promotion and application. Zhang JT, Ma L, Gong X, et al. Clinical Study on the Use of Acupuncture for the Treatment of Female Sexual Dysfunction: A Pilot Study. Sex Med 2022;10:100541.
Collapse
Affiliation(s)
- Jun Tan Zhang
- Maternal and Child Health Care Hospital of Zaozhuang, Zaozhuang, Shandong, China.
| | - Lin Ma
- Maternal and Child Health Care Hospital of Zaozhuang, Zaozhuang, Shandong, China
| | - Xiang Gong
- Zaozhuang Municipal Hospital, Zaozhuang, Shandong, China
| | - Sufang Luo
- Maternal and Child Health Care Hospital of Zaozhuang, Zaozhuang, Shandong, China
| | - Shuqin Zhao
- Maternal and Child Health Care Hospital of Zaozhuang, Zaozhuang, Shandong, China
| |
Collapse
|
3
|
Boucher NA, Alkazemi MH, Tejwani R, Routh JC. Parents of Children with Newly Diagnosed Disorders of Sex Development Identify Major Concerns: A Qualitative Study. Urology 2022; 164:218-223. [PMID: 35038494 DOI: 10.1016/j.urology.2022.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 12/29/2021] [Accepted: 01/02/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To develop a conceptual framework to understand and define the impact of DSD diagnosis and management from the perspective of parents of recently diagnosed children. METHODS Semi-structured interviews were conducted with parents of children diagnosed with 46 XX, 46 XY, or chromosomal DSD including complete or partial androgen insensitivity, congenital adrenal hyperplasia, or 5-alpha reductase deficiency. Analysis was completed using content analysis with an inductive approach by three coders. RESULTS Parents of six patients agreed to be interviewed, consistent with saturation points for prior similar studies; a total of 16 recurring themes were identified which were further grouped by similarity and categorized into one of three meta-themes: a) personal impact (effect of diagnosis on parents psyche, happiness, gender/sexual identity, anatomic function, mental health), b) family impact (relationships with parents/siblings, parental guilt); and c) societal impact (bullying, need for secrecy, future desirability, societal openness to DSD individuals). CONCLUSIONS Personal, family, and societal concerns amongst parents following a DSD diagnosis have significant potential psychosocial impacts for both parents as well children. The nexus between these categories provides a framework for approaching diagnosis and management of DSD and has implications for patients, families, and clinicians. Improved resource allocation, education, and clinical tools conceived through this framework may considerably alleviate potent psychosocial stressors for parents of children born with DSD.
Collapse
Affiliation(s)
- Nathan A Boucher
- Duke University, Sanford School of Public Policy, Durham, NC, USA; Duke University, School of Medicine, Durham, NC, USA; Durham VA Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health System, Durham, NC, USA; Duke-Margolis Center for Health Policy, Durham, NC, USA.
| | | | - Rohit Tejwani
- Duke University, School of Medicine, Durham, NC, USA; Division of Urologic Surgery, Duke University School of Medicine, Durham, NC
| | - Jonathan C Routh
- Duke University, School of Medicine, Durham, NC, USA; Division of Urologic Surgery, Duke University School of Medicine, Durham, NC
| |
Collapse
|
4
|
Exploration dimensionnelle des interactions sexualité/handicap psychique. Exemple d’application dans le champ de la psychose schizophrénique. SEXOLOGIES 2022. [DOI: 10.1016/j.sexol.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
5
|
Timkova V, Mikula P, Linkova M, Szilasiova J, Nagyova I. Sexual functioning in patients with multiple sclerosis and its association with social support and self-esteem. PSYCHOL HEALTH MED 2020; 26:980-990. [DOI: 10.1080/13548506.2020.1800054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Vladimira Timkova
- Department of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
| | - Pavol Mikula
- Department of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
| | - Marcela Linkova
- Department of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
| | - Jarmila Szilasiova
- Department of Neurology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
| | - Iveta Nagyova
- Department of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
| |
Collapse
|
6
|
Mollen D, Burnes T, Lee S, Abbott DM. Sexuality training in counseling psychology. COUNSELLING PSYCHOLOGY QUARTERLY 2018. [DOI: 10.1080/09515070.2018.1553146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Debra Mollen
- Department of Psychology and Philosophy, Texas Woman’s University, Denton, Texas
| | | | - Samantha Lee
- Department of Psychology and Philosophy, Texas Woman’s University, Denton, TX
| | - Dena M. Abbott
- Department of Psychology and Behavioral Sciences, Louisiana Tech University, Ruston, LA
| |
Collapse
|
7
|
Areskoug-Josefsson K, Thidell F, Rolander B, Ramstrand N. Prosthetic and orthotic students' attitudes toward addressing sexual health in their future profession. Prosthet Orthot Int 2018; 42:612-619. [PMID: 29775167 DOI: 10.1177/0309364618775444] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND: Prosthetists and orthotists have a responsibility to direct treatment toward enabling their clients to perform desired activities and to facilitate participation of their clients in all areas of life. This may include provision of assistive technologies to help clients meet goals related to participation in sexual activities. To help prosthetic and orthotic students develop competencies in dealing with the sexual health of their future clients, it is necessary to generate knowledge of their own perceived competence and capacity. OBJECTIVES: To explore prosthetic and orthotic students' attitudes and competence toward working with sexual health and to evaluate reliability and validity of the Students' Attitudes Towards Addressing Sexual Health questionnaire. STUDY DESIGN: Cross-sectional study. METHODS: Students enrolled in all three years of an undergraduate prosthetic and orthotic program were requested to complete the Students' Attitudes Towards Addressing Sexual Health questionnaire ( n = 65). Reliability and validity were evaluated using the content validity index and Cronbach's alpha. RESULTS: Students felt unprepared to talk about sexual health with future clients and thought that they would be embarrassed if they raised the issue. No differences were identified between students enrolled in each of the three years of the program and few differences were observed between male and female students. The content validity index values were low but improved as the students' level of education increased. Internal consistency of the questionnaire was acceptable ( α = 0.86). CONCLUSION: Prosthetic and orthotic students are unprepared to address sexual health issues with their future clients. There is a need to provide students with training related to sexual health issues. CLINICAL RELEVANCE This study indicates the need for additional education of prosthetic and orthotic students in issues related to sexual health and how to address sexual health issues with clients. Results can be used to develop training programs for students and will serve to improve the sexual health of individuals who receive prosthetic and orthotic services.
Collapse
Affiliation(s)
| | - Fredrik Thidell
- 2 Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Bo Rolander
- 3 Futurum, Academy for Health and Care, Jönköping County Council, Jönköping, Sweden
| | - Nerrolyn Ramstrand
- 2 Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| |
Collapse
|
8
|
Hendriks B, Vandenberghe AMJA, Peeters L, Roelens K, Keygnaert I. Towards a more integrated and gender-sensitive care delivery for victims of sexual assault: key findings and recommendations from the Belgian sexual assault care centre feasibility study. Int J Equity Health 2018; 17:152. [PMID: 30249254 PMCID: PMC6154874 DOI: 10.1186/s12939-018-0864-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/13/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Sexual assault remains a major threat to public health, affecting every gender, gender identity and sexual orientation. Following the Belgian ratification of the Istanbul Convention in 2016, the feasibility of a Belgian sexual assault centre model was investigated, aiming to provide more integrated and patient-centred health and judiciary services to victims of sexual assault. By actively involving health professionals, police and judiciary system representatives, as well as victims themselves, this feasibility study eventually fed into the Belgian Sexual Assault Care Centre model. In this process, this paper assessed current Belgian health services and the degree to which the implementation of this model could contribute to both a more integrated and gender-sensitive care delivery. Findings from this study and the subsequent recommendations aim to contribute to similar reforms in other countries that have already taken or are about to take steps towards an integrated, multi-agency support framework for victims of sexual assault. METHODS A qualitative, descriptive analysis of the survey response of 60 key health professionals (N = 60) representing 15 major Belgian hospitals was first conducted. Comparing their approach with the international guidelines and standards, a Strengths Weaknesses Opportunities and Threats analysis of the current sexual assault health services and their potential transition to the Sexual Assault Care Centre model was then executed. RESULTS Despite adequate equipment, the clear fragmentation of health services and limited follow-up hamper an integrated care delivery in most hospitals. Only three hospitals differentiated their sexual assault care protocol based on the victim's gender, gender identity and sexual orientation. A striking unawareness among health professionals of sexual assault in male victims, as well as in gender and sexual minorities further hampers a gender-sensitive care delivery. CONCLUSIONS The Sexual Assault Care Centre model aims to counter most of the current sexual assault health services' weaknesses and threats hampering an integrated care for victims of sexual assault. Further research and training of health professionals are however required in order to tune this integrated form of care to sexuality and gender-based differences in victims' already multi-faceted healthcare needs.
Collapse
Affiliation(s)
- Bavo Hendriks
- International Centre for Reproductive Health (ICRH), Department of Uro-Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, UZP114, B-9000 Ghent, Belgium
| | - Anke Marie-Josée Aimé Vandenberghe
- International Centre for Reproductive Health (ICRH), Department of Uro-Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, UZP114, B-9000 Ghent, Belgium
| | - Laura Peeters
- International Centre for Reproductive Health (ICRH), Department of Uro-Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, UZP114, B-9000 Ghent, Belgium
| | - Kristien Roelens
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, Ghent University Hospital, Corneel Heymanslaan 10, UZP3, B-9000 Ghent, Belgium
| | - Ines Keygnaert
- International Centre for Reproductive Health (ICRH), Department of Uro-Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, UZP114, B-9000 Ghent, Belgium
| |
Collapse
|
9
|
Damghanian M. Sexual function and related factors in the women with urinary incontinence treated by pelvic floor exercise. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2018. [DOI: 10.29252/pcnm.8.2.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
|
10
|
Tejwani R, Jiang R, Wolf S, Adkins DW, Young BJ, Alkazemi M, Wiener JS, Pomann GM, Purves JT, Routh JC. Contemporary Demographic, Treatment, and Geographic Distribution Patterns for Disorders of Sex Development. Clin Pediatr (Phila) 2018; 57:311-318. [PMID: 28758411 PMCID: PMC5891214 DOI: 10.1177/0009922817722013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to describe the demographic characteristics, hospital utilizations, patterns of inpatient surgical management, and the overall state/regional variation in surgery rate among patients with disorders of sex development (DSD). We analyzed the Nationwide Inpatient Sample from 2001 to 2012 for patients younger than 21 years. DSD-related diagnoses and procedures were identified via International Classification of Diseases, Ninth Revision (ICD-9) codes. We identified a total of 43,968 DSD-related admissions. Of these, 73.4% of the admissions were designated as female and 642 (1.9%) were inpatient surgical admissions. Among neonates, less than 1% underwent any type of genital surgery. Nonsurgical admissions were associated with longer length of stay and higher cost. There was no significant regional variation in the rate of DSD surgeries, but we observed higher concentrations of DSD surgeries in states associated with tertiary referral centers.
Collapse
|
11
|
Pluchino N, Wenger JM, Petignat P, Tal R, Bolmont M, Taylor HS, Bianchi-Demicheli F. Sexual function in endometriosis patients and their partners: effect of the disease and consequences of treatment. Hum Reprod Update 2016; 22:762-774. [PMID: 27591248 DOI: 10.1093/humupd/dmw031] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 08/11/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Sexual function is an important aspect of health and quality of life and is influenced by both medical conditions and health-care interventions, especially when gynecologic disorders are involved. Coital pain is among the main factors that affect sexual functioning, and this symptom is reported by almost half of women suffering from endometriosis. However, sexuality is a complex phenomenon driven by social, psychological and biological/hormonal factors and the presence of endometriosis might further affect domains of sexual function and the quality of a sexual relationship. OBJECTIVE AND RATIONALE The objective of this report is to review the current state of knowledge on the impact that endometriosis and its treatments have on the sexual function of women and their sexual partners. SEARCH METHODS A systematic literature search was performed to identify studies evaluating sexual function in endometriosis patients, and a narrative analysis of results is presented. The review discusses relevant quantitative and qualitative studies analyzing the effect of endometriosis and its hormonal and surgical treatments on measures of sexual function and quality of sexual relationship. OUTCOMES Endometriosis negatively affects different domains of sexual function, and the presence of dyspareunia is not the only determinant of sexual health in these women. Chronic pelvic pain, advanced stages of disease and the presence of physical and mental comorbidities affect sexual function, as well as personality traits and women's expectations. Although a number of studies have evaluated the effect of surgery and hormonal treatment on deep dyspareunia, overall sexual function and quality of the relationship with the partner are often under-investigated. WIDER IMPLICATIONS Multiple clinical and personal determinants affect sexual function in women with endometriosis, with potentially negative consequences on the sexual function of partners and quality of the relationship. Additional prospective and longitudinal investigations are warranted using specific instruments to analyze biopsychosocial variables of sexual pain in endometriosis patients and the effects that actual treatments have on measures of quality of sexual function and relationship.
Collapse
Affiliation(s)
- Nicola Pluchino
- Department of Obstetrics and Gynecology, University Hospital of Geneva, 30, Boulevard de la Cluse, 1211 Geneva, Switzerland .,Department of Gynecology, Obstetrics and Reproductive Sciences, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510 New Haven, USA
| | - Jean-Marie Wenger
- Department of Obstetrics and Gynecology, University Hospital of Geneva, 30, Boulevard de la Cluse, 1211 Geneva, Switzerland
| | - Patrick Petignat
- Department of Obstetrics and Gynecology, University Hospital of Geneva, 30, Boulevard de la Cluse, 1211 Geneva, Switzerland
| | - Reshef Tal
- Department of Gynecology, Obstetrics and Reproductive Sciences, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510 New Haven, USA
| | - Mylene Bolmont
- Department of Obstetrics and Gynecology, University Hospital of Geneva, 30, Boulevard de la Cluse, 1211 Geneva, Switzerland
| | - Hugh S Taylor
- Department of Gynecology, Obstetrics and Reproductive Sciences, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510 New Haven, USA
| | - Francesco Bianchi-Demicheli
- Department of Obstetrics and Gynecology, University Hospital of Geneva, 30, Boulevard de la Cluse, 1211 Geneva, Switzerland
| |
Collapse
|
12
|
Affiliation(s)
- Shirin Heidari
- Director and Editor, Reproductive Health Matters, London, UK / Geneva, Switzerland.
| |
Collapse
|
13
|
Chou D, Cottler S, Khosla R, Reed GM, Say L. Sexual health in the International Classification of Diseases (ICD): implications for measurement and beyond*. REPRODUCTIVE HEALTH MATTERS 2015; 23:185-92. [DOI: 10.1016/j.rhm.2015.11.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 11/18/2015] [Accepted: 11/23/2015] [Indexed: 11/28/2022] Open
|