Evaluation of the Dutch AIDS information helpline: an investigation of information needs and satisfaction of callers

Combining telephone and online channels: Experiences of the Dutch STI sex information helpline

INTRODUCTION

The Dutch STI Sex Information Helpline has gradually expanded its telephone services to include online services via email and online chat. In addition, a thematic broadening of AIDS and HIV-related support took place, covering almost all Sexual and Reproductive Health and Rights topics. Since 2015, the helpline collaborates closely with public sexual health clinics' nurses to provide online chat-services.

OBJECTIVES

This article explores similarities and differences among callers, emailers, and chatters, including their background characteristics, reasons for contact, characteristics of the contacts, satisfaction with the service, and channel preferences. Furthermore, it describes how nurses evaluate national cooperation in the online chat-service and the added value they perceive in relation to their work at the public sexual health clinics.

METHODS

In this mixed method cross-sectional design study registration data of the Helpline of 2018 (N = 17.585) is analysed in combination with analyses of a client satisfaction study among users of all three channels in 2018 (N = 488). In addition, an online evaluation survey was conducted among nurses who participate in the online chat-service in 2022 (N = 35).

RESULTS

This study shows that online chat is the most frequently used channel, yet there is substantial demand for email and telephone services. Channel selection depends on the background characteristics of clients, the content of the help request and personal preferences and needs. Users equally rate all channels positively. Nurses assess their participation in the chat-service as an added value to their work in the clinics and endorse the importance of national cooperation.

CONCLUSIONS

Offering sexual health information services via phone, online chat, and email allows a helpline to serve a diverse public. Despite online chat being the most popular, usage and satisfaction is high across all channels, indicating effective user choice. A mix of channels does not only extends a helpline's reach, it also enhances the accessibility of public sexual health care through its connecting role.

PRACTICAL IMPLICATIONS

While online chat is popular, it also consumes a considerable amount of professionals' time. This requires an efficient strategy for offering the three channels in a coherent manner.

Non-pharmacological interventions for the prevention of sexually transmitted infections (STIs) in older adults: A systematic review

BACKGROUND

STIs in older adults (adults aged 50 years and older) are on the rise due to variable levels of sex literacy and misperceived susceptibility to infections, among other factors. We systematically reviewed evidence on the effect of non-pharmacological interventions for the primary prevention of sexually transmitted infections (STIs) and high-risk sexual behaviour in older adults.

METHODS

We searched EMBASE, MEDLINE, PSYCINFO, Global Health and the Cochrane Library from inception until March 9th, 2022. We included RCTs, cluster-randomised trials, quasi-RCTs, interrupted time series (ITS) and controlled and uncontrolled before-and-after studies of non-pharmacological primary prevention interventions (e.g. educational and behaviour change interventions) in older adults, reporting either qualitative or quantitative findings. At least two review authors independently assessed the eligibility of articles and extracted data on main characteristics, risk of bias and study findings. Narrative synthesis was performed.

RESULTS

Ten studies (two RCTs, seven quasi-experiment studies and one qualitative study) were found to be eligible for this review. These interventions were mainly information, education and communication activities (IECs) aimed at fostering participants' knowledge on STIs and safer sex, mostly focused on HIV. Most studies used self-reported outcomes measuring knowledge and behaviour change related to HIV, STIs and safer sex. Studies generally reported an increase in STI/HIV knowledge. However, risk of bias was high or critical across all studies.

CONCLUSIONS

Literature on non-pharmacological interventions for older adults is sparse, particularly outside the US and for STIs other than HIV. There is evidence that IECs may improve short-term knowledge about STIs however, it is not clear this translates into long-term improvement or behaviour change as all studies included in this review had follow-up times of 3 months or less. More robust and higher-quality studies are needed in order to confirm the effectiveness of non-pharmacological primary prevention interventions for reducing STIs in the older adult population.

Ringing the changes: the role of telephone communication in a helpline and befriending service targeting loneliness in older people

The drive to deliver services addressing loneliness in older people by telephone and online makes it increasingly relevant to consider how the mode of communication affects the way people interact with services and the capacity of services to meet their needs. This paper is based on the qualitative strand of a larger mixed-methods study of a national phoneline tackling loneliness in older people in the United Kingdom. The research comprised thematic analysis of four focus groups with staff and 42 semi-structured interviews with callers. It explored the associations between telephone-delivery, how individuals used the services and how the services were able to respond. To understand these associations, it was useful to identify some constituent characteristics of telephone communication in this context: namely its availability, reach and non-visual nature. This enabled various insights and comparison with other communication media. For example, the availability of the services attracted people seeking frequent emotional support but this presented challenges to staff. More positively, the ability of the services to connect disparate individuals enabled them to form different kinds of satisfying relationships. The evolution of mixed communication forms, such as internet-based voice communication and smartphone-based visual communication, makes analysis at the level of a technology's characteristics useful. Such a cross-cutting perspective can inform both the design of interventions and assessment of their suitability for different manifestations of loneliness.

What Do Danish Youth Want to Know About Sex? Twenty Years of Telephone Counseling on Sexual and Reproductive Issues

Young people's need for sexual counseling is well documented, and both website and hotline-based services have been established as means of health promotion in this field. Such measures, however, are rarely evaluated, so this article offers data from the world's presumably oldest sexuality helpline aimed at young people. With an observation time of two decades and a total of 42,325 questions asked, the study provides a unique glance into the sexual landscapes of Danish youth. It shows an overall male predominance among callers and reveals that the counseling themes change over time and differ between both age groups and genders. The article suggests that telephone counseling-although more resource demanding than online alternatives-provides a secure, anonymous, and dialogue-based arena for discussing delicate sexual issues and therefore may constitute a viable supplement to web-based media for young people with the need to talk rather than just chat.

Sexual Problems among Japanese Women: Data from an Online Helpline

Introduction

Sexual problems have been more prevalent among East Asian women than those from other areas of the world. However, Japanese women seldom tend to consult their treating physicians as such intimate problems are socially awkward topics to share and may be considered shameful. Presently, there is little data in the literature regarding women's sexual problems in Japan.

Aims

We aimed (i) to investigate the types of sexual problems that were reported among Japanese women who had sought online consultations; and (ii) to examine whether factors such as age and family structure (marital status and presence of children) increased the likelihood of sexual problems.

Methods

An online helpline received a total of 316 messages from Japanese women related to sexual problems over a 3‐year period. We evaluated 276 respondents, who provided demographic information such as age and family structure as well as their response to an open‐ended question regarding their sexual problems.

Main Outcome Measures

Main outcome measures were the types of sexual problems reported by Japanese women.

Results

The majority of respondents were in their 30s (53.6%). Sexual aversion accounted for 42.4% of the complaints, partners' sexual issues for 18.5%, and pain during sex for 16.7%. Family structure significantly correlated with sexual problems (P < 0.001). Women with sexual aversion were more likely to be younger (P = 0.003) and have children (P < 0.001). Women whose partners had sexual issues were more likely to be married (P < 0.001) and have no children (P < 0.001). Women who reported pain during sex were more likely to have no children (P = 0.006).

Conclusion

Sexual aversion was the most common sexual problem among Japanese women who sought help via the online helpline. Family structure was related to sexual problems. More detailed assessments of family structure may be important in better identifying the triggering causes of the reported sexual problems. Ozaki Y, Nagao K, Saigo R, Tai T, Tanaka N, Kobayashi H, Nakajima K, and Takahashi Y. Sexual problems among Japanese women: Data from an online helpline. Sex Med 2015;3:289–295.

A European network of email and telephone help lines providing information and support on rare diseases: results from a 1-month activity survey

BACKGROUND

Information on rare diseases are often complex to understand, or difficult to access and additional support is often necessary. Rare diseases helplines work together across Europe to respond to calls and emails from the public at large, including patients, health care professionals, families, and students. Measuring the activity of helplines can help decision makers to allocate adequate funds when deciding to create or expand an equivalent service.

OBJECTIVE

Data presented are referred to a monthly user profile analysis, which is one of the activities that each helpline has to carry out to be part of the network. This survey aimed to explore the information requests and characteristics of users of rare diseases helplines in different European countries. Another aim was to analyze these data with respect to users' characteristics, helpline characteristics, topics of the inquiries, and technologies used to provide information. With this survey, we measure data that are key for planning information services on rare diseases in the context of the development of national plans for rare diseases.

METHODS

A survey was conducted based on all calls, emails, visits, or letters received from November 1 to 30, 2012 to monitor the activity represented by 12 helplines. Data were collected by a common standardized form, using ORPHA Codes for rare diseases, when applicable. No personal data identifying the inquirer were collected. It was a descriptive approach documenting on the number and purpose of inquiries, the number of respondents, the mode of contact, the category of the inquirer in relation to the patient, the inquirer's gender, age and region of residence, the patient's age when applicable, the type and duration of response, and the satisfaction as scored by the respondents.

RESULTS

A total of 1676 calls, emails, or letters were received from November 1 to 30, 2012. Inquiries were mostly about specific diseases. An average of 23 minutes was spent for each inquiry. The inquirer was a patient in 571/1676 inquiries (ie, 34.07% of all cases; 95% CI 31.8-36.3). Other inquirers included relatives (520/1676, 31.03%; 95% CI 28.9-33.3), health care professionals (354/1676, 21.12%; 95% CI 19.2-23.1), and miscellaneous inquirers (230/1676, 13.72%; 95% CI 12.1-15.4). Telephone remained the main mode of contact (988/1676, 58.95%; 95% CI 56.6-61.3), followed by emails (609/1676, 36.34%; 95% CI 34.0-38.6). The three main reasons of inquiries were to acquire about information on the disease (682/2242, 30.42%; 95% CI 27.8-32.1), a specialized center/expert (404/2242, 18.02%; 95% CI 15.9-19.6), and social care (240/2242, 10.70%; 95% CI 9.1-12.0).

CONCLUSIONS

The helplines service responds to the demands of the public, however more inquiry-categories could be responded to. This leaves the possibility to expand the scope of the helplines, for example by providing assistance to patients when they are reporting suspected adverse drug reactions as provided by Directive 2010/84/EU or by providing information on patients' rights to cross-border care, as provided by Directive 2010/24/EU.

The relative persuasiveness of gain-framed versus loss-Framed HIV testing message: evidence from a field experiment in northwest Ethiopia

This study assessed the relative advantages of gain- versus loss-framed messages for promoting HIV testing among a sample of urban and rural residents in northwest Ethiopia. The authors randomly assigned 394 participants to read gain-framed (n = 196) or loss-framed (n = 198) HIV testing message prepared in a form of brochure. Experience with HIV testing, concern about and information needs on HIV/AIDS, and urbanity versus rurality significantly moderated the effects of framing on intention to test for HIV. A gain-frame advantage was found among urbanites, participants with high experience with HIV testing, and those with high concern about and information needs on HIV/AIDS, suggesting a more likely construal of HIV testing as a prevention behavior among these individuals. In contrast, a loss-frame advantage was found among ruralites and participants with low concern about and information needs on HIV/AIDS, suggesting a more likely construal of HIV testing as a detection behavior among such individuals. Moreover, gain- and loss-framing led to similar outcomes among individuals with low levels of experience with HIV testing, with a slight advantage for the loss-framed message. All of the framing effects obtained were of small to medium size.

Evaluation of the quality of services provided by a gambling helpline: an empirical study

This study evaluates the quality of the services provided by a helpline according to the type of caller and the type of request. One hundred and fifteen bogus calls made by simulated clients were used for the evaluation. Results showed that 87% of the calls received an adequate response from the helpline information/referral counsellors (IRCs). Referral requests made by a loved one were less frequently rated as adequate. The quality of responses was better for requests for a referral than they were for information. The simulated client method allowed for experimentation in how a caller could respond emotionally when contacting the helpline. The method revealed that answers given to a loved one could be frustrating and that some IRCs have more difficulties providing general information about gambling than providing the name of a rehabilitation centre. These results should help to improve the quality of the services offered by the helpline to respond more specifically to the callers' information and referral requests.

Telephone delivered interventions for preventing HIV infection in HIV-negative persons

BACKGROUND

This is one of the three Cochrane reviews that examine the role of the telephone in HIV/AIDS services. Although HIV infection can be prevented, still a large number of new infections occur. More effective HIV prevention interventions are needed to reduce the number of people newly infected with HIV. Phone calls can be used to potentially more effectively deliver HIV prevention interventions. They have the potential to save time, reduce costs and facilitate easier access.

OBJECTIVES

To assess the effectiveness of voice landline and mobile telephone delivered HIV prevention interventions in HIV-negative persons.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials, MEDLINE, PubMed Central, EMBASE, PsycINFO, Web of Science, Cumulative Index to Nursing & Allied Health, the World Health Organization's Global Health Library and Current Controlled Trials from 1980 to June 2011. We searched the following grey literature sources: Dissertation Abstracts International and the Centre for Agricultural Bioscience International Direct Global Health database, the System for Information on Grey Literature Europe, The Healthcare Management Information Consortium, Google Scholar, Conference on Retroviruses and Opportunistic Infections database, International AIDS Society conference database, AIDS Education Global Information System and reference lists of articles.

SELECTION CRITERIA

Randomised controlled trials (RCTs), quasi-randomised controlled trials, controlled before and after studies, and interrupted time series studies comparing the effectiveness of delivering HIV prevention by phone calls to usual care in HIV-negative people regardless of their demographic characteristics and in all settings.

DATA COLLECTION AND ANALYSIS

Two reviewers independently searched databases, screened citations, assessed study quality and extracted data. A third reviewer resolved any disagreement. Primary outcomes were knowledge about the causes and consequences of HIV/AIDS, change in behaviour, healthcare uptake and clinical outcomes. Secondary outcomes were users' and providers' views on the intervention, economic outcomes and adverse outcomes.

MAIN RESULTS

Out of 14,717 citations, only one study met the inclusion criteria. The included RCT recruited women and girl children who received post-exposure prophylaxis (PEP) after rape from sexual assault services in South Africa between August 2007 and May 2008.Participants (n (number) =274) were randomised into a telephone support (n=136) and control (n=138) group. Control group participants received usual care (an interactive information session) from the sexual assault service during the 28 days in which they had to take PEP, with no further contact from the study staff. Telephone support group participants received standard care and phone calls from a counsellor throughout the 28 days when they had to take PEP.Overall, adherence to PEP was not significantly (P=0.13) different between the intervention (38.2%) and control (31.9 %) groups. Also, the proportion of participants who read a pamphlet, did not return to collect medication or with a depression were not significantly different between the intervention and control groups (P=0.006, P=0.42, P=0.72 respectively). The proportion of participants who used a diary was significantly (P=0.001) higher in the intervention group (78.8%) versus the control group (69.9%). The study authors reported that there were no recorded adverse events. The RCT did not provide information about participants' and providers' evaluation outcomes, or economic outcomes. The study had a moderate risk of bias.

AUTHORS' CONCLUSIONS

We found only one RCT, with a moderate risk of bias, which showed that providing PEP support by phone calls did not result in higher adherence to PEP. However, the RCT was conducted in an upper-middle-income country with high HIV prevalence, on a high-risk population and the applicability of its results on other settings and contexts is unclear. There is a need for robust evidence from various settings on the effectiveness of using phone calls for providing PEP support and for other HIV prevention interventions.

Determinants of HIV/AIDS-related information needs and media use: beyond individual-level factors

Despite the centrality of information and communication in the fight against HIV/AIDS, little research has investigated the factors associated with HIV/AIDS-related information needs and media use in hard-hit Sub-Saharan Africa. This study explored individual-level and socioecological determinants among urban and rural residents in northwest Ethiopia. Urbanity versus rurality, education, direct experience with HIV/AIDS, perceived salience of HIV/AIDS-related information, and personal health concern were tested as predictors. Regression analyses showed that urbanity versus rurality and education are the major determinants of HIV/AIDS-related information needs and media use. Being urbanite and educated were associated with high concern about and information needs on HIV/AIDS and HIV/AIDS-related mass media use. Moreover, urbanity versus rurality and education significantly predicted preferences for specific types of HIV/AIDS-related information. While rurality and low education were associated with a preference for basic HIV transmission and prevention information, urbanity was associated with a preference for information on HIV/AIDS-related care and support. In most cases, urbanity versus rurality emerged as a substantial predictor and also significantly moderated the effects of other variables. Given the evolving nature of the pandemic and its expansion to rural areas, ruralites' low information needs and media use deserve due attention. Equally, communication interventions targeting urban contexts need to move beyond providing only the ABCs of HIV transmission and prevention and should attend to urbanites' progressive information needs, which seem to have now become more on care and support so as to live and deal with the pandemic.

Evaluation of the Dutch AIDS STI information helpline: differential outcomes of telephone versus online counseling

OBJECTIVE

Health information helplines have an important function in health education, prevention and counseling. Information and help services are increasingly provided online. This study focuses on the differences and similarities between online help services and telephone services.

METHODS

The telephone service of the Dutch AIDS STI helpline was compared to its e-mail equivalent. After consulting the helpline service, both callers and e-mailers (N(tot) = 455) were asked to participate in a survey that evaluated their background characteristics, contacting reasons, and satisfaction with the specific service and information received. The survey also included questions regarding the advice received from the helpline. A follow-up measure 4 weeks after the baseline survey evaluated to what extent clients acted upon the advice.

RESULTS

The study shows that both services are positively evaluated and are equally persuasive in their counseling. Differences between callers and e-mailers were found regarding background characteristics, content of the consultation, satisfaction, and the advice received.

CONCLUSION

It can be concluded that online health information services are an important addition to, but not a replacement for, the traditional telephone helplines.

PRACTICE IMPLICATIONS

In order to provide an optimal health service to a wide public, both online and telephone counseling should be offered.

Telephone consultation for improving health of people living with or at risk of HIV: a systematic review

BACKGROUND

Low cost, effective interventions are needed to deal with the major global burden of HIV/AIDS. Telephone consultation offers the potential to improve health of people living with HIV/AIDS cost-effectively and to reduce the burden on affected people and health systems. The aim of this systematic review was to assess the effectiveness of telephone consultation for HIV/AIDS care.

METHODS

We undertook a comprehensive search of peer-reviewed and grey literature. Two authors independently screened citations, extracted data and assessed the quality of randomized controlled trials which compared telephone interventions with control groups for HIV/AIDS care. Telephone interventions were voice calls with landlines or mobile phones. We present a narrative overview of the results as the obtained trials were highly heterogeneous in design and therefore the data could not be pooled for statistical analysis.

RESULTS

The search yielded 3321 citations. Of these, nine studies involving 1162 participants met the inclusion criteria. The telephone was used for giving HIV test results (one trial) and for delivering behavioural interventions aimed at improving mental health (four trials), reducing sexual transmission risk (one trial), improving medication adherence (two trials) and smoking cessation (one trial). Limited effectiveness of the intervention was found in the trial giving HIV test results, in one trial supporting medication adherence and in one trial for smoking cessation by telephone.

CONCLUSIONS

We found some evidence of the benefits of interventions delivered by telephone for the health of people living with HIV or at risk of HIV. However, only limited conclusions can be drawn as we only found nine studies for five different interventions and they mainly took place in the United States. Nevertheless, given the high penetration of low-cost mobile phones in countries with high HIV endemicity, more evidence is needed on how telephone consultation can aid in the delivery of HIV prevention, treatment and care.

An e-mail and telephone helpline for sexual problems - results of a 2-year survey of men's sexual concerns

INTRODUCTION

Sexual problems are relatively common in the community. The under-reporting of such problems calls for alternative ways of getting a true perspective of the prevalence of sexual dysfunction.

AIM

To assess and investigate the concerns, ages and nationality of male users of a electronic helpline using it over 2 years (2009-2010).

METHODS

Detailed records were kept of all emails and telephone calls to the helpline which included administrative and clinical queries. The clinical calls and some of the emails were answered by the administrator, while the majority of the emails were answered by a physician. This presentation will deal with the users who emailed for assistance with male sexual dysfunction. (n = 673).

RESULTS

The helpline received a total of 6142 calls over the period of investigation, including administrative and press calls. Men accounted for 88% of the callers about sexual dysfunction. Erectile dysfunction accounted for 68% of the complaints by men who used the e-mail service. Premature ejaculation, loss of sex drive, genital problems and masturbation worries were other concerns that were received. A large number of men from the Middle East and the Indian sub-continent used the email service, mostly for premature ejaculation and masturbation worries, related to their arranged marriage.

CONCLUSIONS

We found confirmation that the commonest sexual complaints in men were of erectile dysfunction and loss of sex drive. Significant correlations were identified between the types of sexual dysfunction and the age and ethnicity of the men who presented with them.

[Evaluation of a child health prevention and promotion telephone service before its introduction]

OBJECTIVES

To evaluate a telephone-information service on health issues for children before its implementation. To determine the overall assessment of the service and quality of the information available from the perspective of a potential user population.

DESIGN

Simulation of a telephone call to the telephone service and further evaluation using qualitative techniques.

SETTING

Primary and special care in the city of Granada.

PARTICIPANTS

Parents, who were not health professionals, of children between 0 and 14 years old, resident in Andalusia and recruited from both primary care and hospitals throughout the city of Granada. A comprehensive assessment of service and quality of information offered through interviews and focus groups. The number of participants was established on two criteria: evaluation of the whole range of information provided by the telephone service; response saturation.

RESULTS

The overall service assessment was positive, emphasising the quick and easy access to information, time saving and confidence building. The information received was described as clear, easily understood and expressed in a respectful tone. To improve the service it has been suggested that the calls be free and that the range of information topics available should be extended.

CONCLUSIONS

The methodology used is novel, as most telephone services are evaluated after they have been put in place and without the participation of the future users.

Health information seeking: a review of measures and methods

OBJECTIVE

Outlines the methods and measures commonly used to study active health information seeking and prescribes important considerations in advancing the study of patient information seeking.

METHODS

A systematic review of the literature from 1978 to 2010. A single bibliometric database, PsychInfo, identified 648 articles of health information seeking. The 129 articles included in the review were coded by type of sample, measures (n=12) utilized to study health information seeking, and types of study methods (n=5).

RESULTS

A majority of studies used non-clinical samples and measured general health information seeking (i.e., whether the participant engaged in a search for health information) through cross-sectional study designs.

CONCLUSIONS

There are varying samples, measures, and designs used to identify those who do or do not seek health information. Future research should look into how health information seeking influences health management and should uncover the social and relational functions of health information seeking using more advanced (and less routinely applied) measures and methods of studying health information seeking.

PRACTICE IMPLICATIONS

More people are actively searching for health information and health providers should address this in their discussions with patients.

How much do they know about sexual health?: Knowledge and information-seeking behaviors of Spanish-speaking immigrant adolescents in Curacao, Netherlands Antilles

Scant HIV/AIDS prevalence data from Curacao suggest that 65.9% of the HIV/AIDS cases in the Netherlands Antilles are currently being documented in this country. The present cross-sectional qualitative study evaluated levels of knowledge of sexual health and information-seeking behavior of Spanish-speaking immigrant adolescents in Curacao. Findings point to a greater need for channels of sexual health information targeting adolescents that focus on the interpersonal aspects of sexuality, to encourage greater parental involvement in their adolescents' lives, and to improve communications between adolescents and their parents. Study findings also suggest the need for a more thoughtful and systematic exploration of the indications by participants that force/coercion specifically by older men including stepfathers was a reason for sexual initiation of many young Latina girls in Curacao.

An evaluation of the use of a website and telephonic information service as public education about forgetfulness

There is increasing interest in telehealth as a potential new approach for healthcare delivery. To investigate whether telehealth is suitable to inform the older population about forgetfulness, we designed and compared two types of telehealth: Memory Website and the Memory Phone. The aim of this study was to analyze characteristics of the individuals who are interested in the Memory Phone and the Memory Website, to investigate the nature of the information in which the users were interested, and to evaluate the usefulness of the services. Participants were asked to answer several questions before and after visiting the main information menu of the telehealth facilities. Characteristics are given for all participants who used the facilities. In the evaluation period of 3 months, more individuals used the Memory Website (n = 2,631) than the Memory Phone (n = 228). The two services were used by different populations. Phone users were significantly older, more often female, and perceived themselves more often as forgetful. In the specific group of nonprofessional older individuals, general information about memory was more requested by Phone users compared with Website users (67% vs. 41%). Website users more often requested strategies and tips than Phone users (66% vs. 34%). The Phone and the Website were both considered useful. Overall, the Memory Website and the Memory Phone are two different types of evidence-based telehealth interventions, which are relevant for different populations, and are useful in informing the older population about forgetfulness and aging.

A typology of men's sexual attitudes, erectile dysfunction treatment expectations and barriers

In total, 1122 men completed non-validated structured interviews on sexual attitudes and on erectile dysfunction treatment expectations and barriers. Dimensions of sexual attitudes and treatment expectations and barriers were extracted by factor analysis and subjects were grouped into types by cluster analysis. Five types emerged: the sensation seeker, the sensuous, the anxious, the confident and the abstinent. The majority of men agreed on the importance of sex for the partnership. For the majority of anxious, sensuous and sensation-seeking men, sex was important for self-esteem. Expecting quality of life, enjoyment, self-esteem and hard reliable erections from treatment with phosphodiesterase-5 inhibitors, anxieties for side effects and loss of control, sexual abstinence and desire for an intensive sex life had the strongest impact on the likelihood of use. Men's sexual attitudes vary considerably and impact reactions to erection difficulties. A typology of five groups was developed, which will contribute to research on and understanding of men's sexual and treatment-seeking behaviors.

Erectile dysfunction and premature ejaculation are the most frequently self-reported sexual concerns: profiles of 9,536 men calling a helpline

OBJECTIVES

To describe the range of sexual problems, as reported by men calling a help-line and to investigate factors associated with help seeking behaviour.

METHODS

The study included all calls between 1999 and 2004. The information used for analysis comprised caller's demographic characteristics, the sexual problem reported, previous doctor contacts, coexisting physical and mental health problems.

RESULTS

Erectile dysfunction (ED) and premature ejaculation (PE) were the most frequently reported problems (57 and 19.2% respectively). ED-reporting callers were older (OR 0.63 for the ages of 50-59 yrs), with co-morbidities (OR 1.75) and in stable relationship (OR 0.46), while PE-reporting callers were younger (OR 5.83 for the ages of 20-29 yrs), relatively healthy and more likely single (OR 2.62 and OR 2.92 respectively). Type and duration of sexual concern, age, coexisting health problems and marital status relate significantly (p<0.01) with willingness to seek medical help.

CONCLUSIONS

The study demonstrates that ED and PE are men's major sexual concerns with personal and interpersonal factors influencing their help-seeking behaviour. Help-lines can serve as a link between health services and callers, while provide useful information for policy formation and improvement of support services.

Women's Sexual Concerns: Data Analysis from a Help‐Line

PURPOSE

To report female sexual problems and concerns, as presented by women calling a help-line, and to evaluate women's help-seeking behavior regarding sexual matters.

MATERIALS AND METHODS

The study included all telephone calls from women who called for sexual concerns to a help-line dedicated to sexual problems during a 5-year period. During the call, the counselor addresses demographic characteristics of the caller, the sexual problem reported, their sexual function, any previous doctor contacts, coexisting physical and mental health problems, couple's relationship, and lifestyle factors that may influence sexual function. Data processing employed descriptive statistics and logistic regression analysis in order to detect possible associations between categorical variables.

RESULTS

Of a total of 3,523 calls made by women, 2,287 full forms were analyzed, reflecting a response rate of 64.9%. Most women (46.6%) called for problems encountered by their partners, 45.1% called for their own sexual problems, while 5.9% were calling for their children. Only 34.3% of them had already consulted a doctor. The most frequently reported difficulties were achieving orgasm (25.6%), reduced sexual desire (16.9%), and pain during intercourse (6.1%). Women in the 40-49 age group had the higher odds ratios for the sexual problems reported (reduced sexual desire: odds ratio [OR] 5.0; difficulties achieving orgasm: OR 6.3; pain during intercourse: OR 5.8). Both married and single women had high risk of experiencing low levels of sexual desire (40% and 30%, respectively).

CONCLUSIONS

Women's sexual concerns are not devoted to their sexual problems, but also their partner's and children's problems. Most frequently reported sexual problems are difficulties in reaching orgasm and reduced sexual desire. However, women are reluctant to seek medical advice on their sexual concerns. There is a need for general practitioners and family doctors to become aware of the possibility of a sexual problem and to be trained on how to manage this at a primary care level.

AIDS knowledge and attitudes in Iran: results from a population-based survey in Tehran

A population-based study was conducted to investigate about AIDS knowledge and attitudes among the general public in Tehran, Iran. Using a short questionnaire a random sample of 1172 individuals aged between 15 and 65 years were interviewed. The mean age of the respondents was 34.8 (S.D. = 12.9) years, 52% were male and mostly married (70%), and had received secondary education or above (84%). The findings indicated that the respondents had a fairly good to excellent knowledge about AIDS. The correct answers ranged from 53% to about 99%. Also the results showed that the majority of the respondents were strongly agree or agree with the statement that people with AIDS should have social right to study or work (84%) or with the statement that AIDS is a public health problem (98.7%). The majority of the respondents (87%) said that the mass media including radio, television and newspapers were the main source of their information about HIV/AIDS. The findings from this study indicate that although misconception exist among Iranian about AIDS, in general they have fairly good knowledge and have positive attitudes towards AIDS and people with AIDS. Such findings suggest that prevention programs should be encouraged and these might have the potential role to limit the emergence of Iran's HIV/AIDS epidemic.