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Leonard A, Duroseau B. Overview of the Epidemiology and Clinical Care Considerations for Adolescents and Young Adults Living with or at Risk of Human Immunodeficiency Virus. Nurs Clin North Am 2024; 59:329-344. [PMID: 38670698 DOI: 10.1016/j.cnur.2024.03.002] [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] [Indexed: 04/28/2024]
Abstract
This article provides an updated examination of human immunodeficiency virus (HIV) epidemiologic trends among adolescents and young adults (AYAs) in the United States, highlighting the significant public health challenge posed by HIV within this demographic. Despite a notable decline in HIV diagnoses among AYAs, challenges remain, particularly due to 50% of AYAs living with HIV being unaware of their status. The article aims to evaluate current clinical recommendations, identify deficiencies, and propose evidence-based improvements for HIV prevention, diagnosis, and care, with the goal of enhancing health outcomes and reducing HIV prevalence among AYAs.
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Affiliation(s)
- Adam Leonard
- Center for Infectious Disease and Nursing Innovation, Johns Hopkins School of Nursing, Baltimore, MD, USA; Community Health Systems, University of California, San Francisco School of Nursing, San Francisco, CA, USA.
| | - Brenice Duroseau
- Center for Infectious Disease and Nursing Innovation, Johns Hopkins School of Nursing, Baltimore, MD, USA. https://twitter.com/thenpthatcares
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Yarger J, Gutmann-Gonzalez A, Borgen N, Romero J, Decker MJ. In the Know: A Cluster Randomized Trial of an In-person Sexual Health Education Program Integrating Digital Technologies for Adolescents. J Adolesc Health 2024; 74:1019-1025. [PMID: 38323966 DOI: 10.1016/j.jadohealth.2023.12.012] [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: 04/07/2023] [Revised: 11/03/2023] [Accepted: 12/11/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE Integrating digital technologies into sexual health education can offer advantages for connecting with adolescents, particularly populations who may be underserved through common school-based approaches. This study assessed the effectiveness of In the Know, an in-person, group-based sexual health education program integrating digital technologies, codesigned with adolescents. METHODS The study design was a cluster randomized trial with 1,263 adolescents aged 13-19 in 95 cohorts, implemented in community-based organizations and schools throughout Fresno County, California. Participants completed a baseline survey and a follow-up survey 3 months later. Two-level mixed-effects regression models with random intercepts for cohort were used to estimate the intervention's impact on unprotected sex, use of clinical health services, knowledge of local sexual health services, technology use to find or schedule services, and sexual health knowledge at the 3-month follow-up. RESULTS The average age of participants was 15.7 years, and the majority identified as Hispanic (71%). In adjusted analyses, intervention group participants were more likely to use clinical services (42.7% vs. 33.2%, p = .009) and reported greater sexual health knowledge at 3 months (57.6% of items answered correctly vs. 50.7%, p = .001). No significant differences were observed in the other outcomes by study group. DISCUSSION In the Know participants demonstrated greater use of clinical health services and sexual health knowledge at 3 months. The study findings show the potential for incorporating user-centered design and technology into sexual health education to better support adolescents who may have limited access to this important information.
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Affiliation(s)
- Jennifer Yarger
- Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, California; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California.
| | - Abigail Gutmann-Gonzalez
- Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, California; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California
| | - Natasha Borgen
- Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, California; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California
| | - Julio Romero
- Fresno Economic Opportunities Commission, Fresno, California
| | - Martha J Decker
- Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, California; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
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3
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Naert E, Van Hulle H, De Jaeghere EA, Orije MRP, Roels S, Salihi R, Traen KJ, Watty K, Kinnaer LM, Verstraelen H, Tummers P, Vandecasteele K, Denys HG. Sexual health in Belgian cervical cancer survivors: an exploratory qualitative study. Qual Life Res 2024; 33:1401-1414. [PMID: 38396183 DOI: 10.1007/s11136-024-03603-5] [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] [Accepted: 01/08/2024] [Indexed: 02/25/2024]
Abstract
PURPOSE To assess experiences of sexuality and of receiving sexual healthcare in cervical cancer (CC) survivors. METHODS A qualitative phenomenological study using semistructured one-on-one interviews was conducted with 15 Belgian CC survivors recruited in 5 hospitals from August 2021 to February 2022. The interviews were audiotaped and transcribed verbatim. Data were analyzed using inductive thematic analysis. COREQ and SRQR reporting guidelines were applied. RESULTS Most participants experienced an altered sexuality after CC treatment with often long-term loss/lack of sex drive, little/no spontaneity, limitation of positions to avoid dyspareunia, less intense orgasms, or no sexual activity at all. In some cases, emotional intimacy became more prominent. Physical (vaginal bleeding, vaginal dryness, dyspareunia, menopausal symptoms) and psychological consequences (guilt, changed self-image) were at the root of the altered sexuality. Treatment-induced menopause reduced sex drive. In premenopausal patients, treatment and/or treatment-induced menopause resulted in the sudden elimination of family planning. Most participants highlighted the need to discuss their altered sexual experience with their partner to grow together toward a new interpretation of sexuality. To facilitate this discussion, most of the participants emphasized the need for greater partner involvement by healthcare providers (HPs). The oncology nurse or sexologist was the preferred HP with whom to discuss sexual health. The preferred timing for information about the sexual consequences of treatment was at treatment completion or during early follow-up. CONCLUSION Both treatment-induced physical and psychological experiences were prominent and altered sexuality. Overall, there was a need for HPs to adopt proactive patient-tailored approaches to discuss sexual health.
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Affiliation(s)
- Eline Naert
- Department of Medical Oncology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium.
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium.
| | | | - Emiel A De Jaeghere
- Department of Medical Oncology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Marjolein R P Orije
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Sarah Roels
- Department of Radiation Oncology, AZ Sint-Jan, Brugge, Belgium
| | - Rawand Salihi
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Obstetrics & Gynaecology, Ghent University Hospital, Ghent, Belgium
- Department of Gynaecology, AZ Sint-Lucas, Ghent, Belgium
| | - Koen J Traen
- Department of Gynaecology, OLV Hospital, Aalst, Belgium
| | | | - Lise-Marie Kinnaer
- Department of Public Health and Primary Care, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Hans Verstraelen
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Obstetrics & Gynaecology, Ghent University Hospital, Ghent, Belgium
| | - Philippe Tummers
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Obstetrics & Gynaecology, Ghent University Hospital, Ghent, Belgium
| | - Katrien Vandecasteele
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Hannelore G Denys
- Department of Medical Oncology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
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Sood R, Mara KC, Vencill JA, Kling JM, Faubion SS. Association of resilience with female sexual dysfunction. Maturitas 2024; 183:107939. [PMID: 38367366 DOI: 10.1016/j.maturitas.2024.107939] [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: 10/09/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVES Female sexual dysfunction (FSD), a common concern affecting women of all ages, is often mediated by important psychological factors. Resilience has been shown to correlate with psychological well-being across different groups of people. The aim of this study was to assess if there is an association between resilience and FSD. STUDY DESIGN This cross-sectional study included 4,366 women (mean [SD] age, 51.7 [11]) seen in women's health clinics at 1 of 3 geographic Mayo Clinic locations. Participants completed the Brief Resilience Scale, the Female Sexual Function Index (FSFI), and the Female Sexual Distress Scale-Revised (FSDS-R). MAIN OUTCOME MEASURES We used univariate and multivariable logistic regression analyses to assess associations between resilience, sexual function, and sexual distress, adjusting for potential confounding variables. RESULTS FSD criteria (FSFI ≤26.55 and FSDS-R ≥ 11) were met by 55.8 % of women. Low, normal, and high levels of resilience were reported by 17.3 %, 57.1 %, and 25.6 % of participants, respectively. The univariate analysis showed that higher resilience was associated with lower sexual distress, lower odds of FSD, and better sexual function. Multivariable analysis adjusted for potential confounders showed that the association persisted and that higher resilience correlated with better sexual function and lower odds of FSD. CONCLUSIONS In this large cross-sectional study, women with higher resilience scores had better sexual function and lower odds of FSD. Additional studies with diverse women are needed to confirm this association and to determine whether women with FSD could benefit from enhancing resilience as a therapeutic strategy.
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Affiliation(s)
- Richa Sood
- Menopause and Women's Sexual Health Clinic, Mayo Clinic, Rochester, MN, United States of America.
| | - Kristin C Mara
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, United States of America
| | - Jennifer A Vencill
- Menopause and Women's Sexual Health Clinic, Mayo Clinic, Rochester, MN, United States of America; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States of America
| | - Juliana M Kling
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, United States of America
| | - Stephanie S Faubion
- Women's Health, Mayo Clinic, Jacksonville, FL, United States of America; Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, United States of America
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DeBrosse R, Mao X, Anand NS, Mullins A, Singh P, Sorcher JL, Jung J, Sanders RA, Beach MC, Pahwa AK, Golden WC, Fields EL. Evaluating the Impact of an Adolescent Sexuality Education Workshop on Medical Student Communication in an Objective Structured Clinical Examination. J Adolesc Health 2024; 74:1026-1032. [PMID: 38323963 DOI: 10.1016/j.jadohealth.2023.12.013] [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: 07/15/2023] [Revised: 10/27/2023] [Accepted: 12/12/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE Gaps still exist in medical education about the sexual health needs of sexual diverse populations, and little is known about how translatable current learning modules are to patient encounters. Efforts at an academic medical institution have been made to address this need, including a two-hour adolescent sexuality workshop during the Core Clerkship in Pediatrics. This workshop's efficacy was evaluated in an objective structured clinical examination (OSCE) given to rising fourth-year medical students, where the standardized patient case focused on an adolescent cisgender male with dysuria and in a new, same-sex relationship. METHODS Performance of students who completed the workshop prior to the OSCE (n = 48) were compared to those of students who did not participate in the workshop prior to the OSCE (n = 17). The encounters were recorded and transcribed, and the deidentified transcripts were scored on a rubric focusing on five domains: sexual identity disclosure, behavioral assessment, psychosocial history, counseling and anticipatory guidance, and relationship building. RESULTS Student's t-test comparison of the scores found significantly higher scores for the psychosocial history domain (p = .04), particularly concerning disclosure of a new boyfriend and recent sexual activity (p = .008), for students who had the workshop before the OSCE. DISCUSSION Students who took the adolescent sexuality workshop performed better in gathering psychosocial information in an OSCE encounter a sexual minority adolescent. These results affirm prior work that active learning on sexual diverse health in medical school curricula may prepare students for effective engagement with adolescents exploring their sexuality.
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Affiliation(s)
- Ren DeBrosse
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Xian Mao
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Neha S Anand
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Boston Medical Center, Boston, Massachusetts
| | - Alexa Mullins
- Deparment of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Priya Singh
- Department of Orthopedic Surgery, Montefiore Medical Center, Bronx, New York
| | - Jill L Sorcher
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Boston Medical Center, Boston, Massachusetts
| | - Julianna Jung
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Renata Arrington Sanders
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Mary Catherine Beach
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Amit K Pahwa
- Division of Hospital Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Hospital Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - W Christopher Golden
- Eudowood Neonatal Pulmonary Division, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Errol L Fields
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland.
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Graziottin A, Di Simone N, Guarano A. Postpartum care: Clinical considerations for improving genital and sexual health. Eur J Obstet Gynecol Reprod Biol 2024; 296:250-257. [PMID: 38484617 DOI: 10.1016/j.ejogrb.2024.02.037] [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: 11/08/2023] [Revised: 02/15/2024] [Accepted: 02/20/2024] [Indexed: 04/19/2024]
Abstract
The postpartum period encompasses the biological and psychoaffective transition to motherhood. However, it remains a most neglected phase in a woman's life. Furthermore, the transition to parenthood is a critical and potentially disrupting factor in a couple's relationship, which can be complicated by undiagnosed biological and psychosexual difficulties. Lack of recognition of the many biological and medical factors that can affect women's health and sexuality in the postpartum period is a common and persistent clinical omission worldwide. Communication difficulties exist between healthcare professionals and women and there are wording biases in describing female genitalia. This can further contribute to the diagnostic lack of attention and timely diagnosis and treatment of even very bothersome symptoms. Early diagnosis and treatment of common postpartum conditions is vital and quality care for new mothers should include psychological and emotional support, lactation assistance, early diagnosis and treatment of genital and sexual pain symptoms, pelvic floor rehabilitation and sexual health guidance. The inclusion of correct genital hygiene practices is a critical element of postpartum gynaecological counselling and can help improve overall genital and sexual health. In this review, we summarise the variability in global professional guidelines for postpartum care, identify common health problems faced by postpartum women and discuss appropriate postpartum care. We pay specific attention to prominent biological or medical factors that can impact the emotional and psychosexual wellbeing of women and couples. The aetiology, diagnosis and treatment of sexual dysfunction, in particular sexual pain disorders, is therefore discussed with a pragmatic approach. Finally, the role of intimate hygiene care is discussed with special attention given to cleanser ingredients with solid scientific evidence to help clinicians adopt a more tailored approach with their clinical recommendations.
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Affiliation(s)
- Alessandra Graziottin
- Centre of Gynaecology and Medical Sexology, Department of Obstetrics and Gynaecology, San Raffaele Resnati Hospital, 20122 Milan, Italy; Department of Obstetrics and Gynaecology, University of Verona, 37129 Verona, Italy; Specialty School, Endocrinology and Metabolic Diseases Department, Federico II University, 80131 Naples, Italy; Alessandra Graziottin Foundation for the Cure and Care of Pain in Women, NPO, Italy
| | - Nicoletta Di Simone
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy; IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
| | - Alice Guarano
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy.
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Wagman JA, Gresbach V, Cheney S, Kayser M, Kimball P. Protocol for designing and evaluating an undergraduate public health course on sexual and reproductive health at a public university in California. Heliyon 2024; 10:e28503. [PMID: 38644866 PMCID: PMC11033060 DOI: 10.1016/j.heliyon.2024.e28503] [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: 08/27/2023] [Revised: 02/09/2024] [Accepted: 03/20/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction Comprehensive sexuality education (CSE) is associated with positive sexual and reproductive health (SRH) outcomes, including increased contraceptive use, lower rates of unintended pregnancy and prevention of sexual violence. However, implementation of and requirements for CSE vary across the United States which can negatively impact students, both during and beyond high school, including among college students. Methods and Analysis: This paper describes the research protocol for a multi-staged approach for designing, implementing and evaluating an SRH course for up to 60 undergraduate students at a public university in California. Before the class is offered, we will conduct 20 in-depth interviews with current students, educators and course design experts to learn from their experiences and seek their guidance on course design. To evaluate the course, enrolled students will complete a pre-course and a post-course survey before and after class is taught, to assess students' attitudes and values relevant to educational concepts and the format and delivery of the course and its modules and activities. Approximately 20 students will take part in an in-depth exit interview, after completing the course, to gather perceptions about how the course impacted their knowledge and behavior. The goal is to refine materials for future in-person course offerings and develop a prototype for a fully online version of the course. Discussion This study introduces a novel university-level course to provide young adult students comprehensive, evidence-based education on sexual and reproductive health from a public health perspective. The program leverages existing CSE efforts, enhancing them with academic rigor, inclusive content and digital inclusion. This approach, inclusive of diverse sexual orientations, content on pleasure and sexual violence prevention, aims to fill existing gaps in university curricula and also set a new standard in CSE. The project's innovative and multidisciplinary design offers a model for broader impact within a large public university system and beyond.
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Affiliation(s)
- Jennifer A. Wagman
- Jonathan and Karin Fielding School of Public Health, Department of Community Health Science, University of California Los Angeles (UCLA), Los Angeles, CA, United States
| | - Victoria Gresbach
- Jonathan and Karin Fielding School of Public Health, Department of Community Health Science, University of California Los Angeles (UCLA), Los Angeles, CA, United States
| | - Samantha Cheney
- Jonathan and Karin Fielding School of Public Health, Department of Community Health Science, University of California Los Angeles (UCLA), Los Angeles, CA, United States
| | - Mark Kayser
- UCLA Online Teaching and Learning Initiative, University of California Los Angeles, Los Angeles, CA, United States
| | - Paul Kimball
- UCLA Online Teaching and Learning Initiative, University of California Los Angeles, Los Angeles, CA, United States
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Mooney KM, Mulroy M, Park J, Pukall CF. A Prospective, Longitudinal Comparison of Sexual Distress Across Relationship Status During the COVID-19 Pandemic. Arch Sex Behav 2024:10.1007/s10508-024-02835-3. [PMID: 38652408 DOI: 10.1007/s10508-024-02835-3] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 02/11/2024] [Accepted: 02/14/2024] [Indexed: 04/25/2024]
Abstract
Numerous studies have described declines in sexual well-being during the COVID-19 pandemic, although experiences of sexual distress during this time appear to be mixed. Previous research has relied on cross-sectional methodology and focused on individuals in relationships. Furthermore, little is known about the frequency of "COVID-safe" sexual behaviors, such as online sexual activities. These gaps in the literature were addressed using a prospective, longitudinal online study examining sexual distress, predictors of sexual distress (i.e., perceived stress), and online sexual activities over time in single and partnered individuals. Participants were single (N = 64) and partnered (N = 60) individuals who completed surveys at three timepoints over a 6-month period during the COVID-19 pandemic. Mean age across the two groups was 29 years, and approximately half were women (51.6% and 50%, respectively). Results indicated that single individuals reported significantly higher sexual distress than partnered individuals at Times 1 and 2, but not at Time 3. Sexual distress significantly decreased over time for individuals in the single group but remained stable for partnered individuals. At each timepoint, there was a conditional effect of perceived stress on sexual distress depending on one's relationship status, and the nature of these conditional effects changed throughout the course of the study. Results suggested that single individuals demonstrated improvements in sexual distress over time. Perceived stress is an important predictor of sexual distress but may operate differently depending on relationship status. Results highlight the resiliency of both single and partnered individuals during the COVID-19 pandemic.
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Affiliation(s)
- Kayla M Mooney
- Department of Psychology, Queen's University, 62 Arch Street, Humphrey Hall, Kingston, ON, K7L 3N6, Canada
| | - Maeve Mulroy
- Department of Psychology, Queen's University, 62 Arch Street, Humphrey Hall, Kingston, ON, K7L 3N6, Canada
| | - Julianna Park
- Department of Psychology, Queen's University, 62 Arch Street, Humphrey Hall, Kingston, ON, K7L 3N6, Canada
| | - Caroline F Pukall
- Department of Psychology, Queen's University, 62 Arch Street, Humphrey Hall, Kingston, ON, K7L 3N6, Canada.
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Zhang X, Silva DE. "I Feel Like a Fraud Who Acts Like a Feminist": The Discussion Themes and Sexual Scripts in the Porn Free Women Online Forum. Arch Sex Behav 2024:10.1007/s10508-024-02858-w. [PMID: 38635110 DOI: 10.1007/s10508-024-02858-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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 12/04/2023] [Accepted: 03/20/2024] [Indexed: 04/19/2024]
Abstract
Research on online pornography abstinence movements has predominantly focused on men's perspectives, often within the context of the broader manosphere. This focus has overshadowed the unique experiences and viewpoints of women in these movements. Our study aimed to fill this gap by exploring women-centric perspectives in pornography abstinence forums, particularly Porn Free Women (r/pornfreewomen). Using a mixed methods approach, this study examined the sexual scripts presented in women-dominated pornography abstinence communities. Our structural topic modeling analysis delineated the interplay of therapeutic, heteronormative, and empowerment themes that were evident in women's narratives and expressions. Further, our discourse analysis elucidated three specific scripts: the addiction script, the heterosexual script, and the liberation script. These interweaving narratives show that discussions of women's pornography abstinence are multifaceted and include a variety of perspectives to negotiate. These results contribute to a nuanced understanding of the values of health and well-being, sexual liberation, and feminism within women's pornography abstinence communities.
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Affiliation(s)
- Xinyu Zhang
- School of Communication Studies, Kent State University, 300 Midway Drive, Office 201J, Kent, OH, 44242, USA
| | - David E Silva
- School of Communication Studies, Kent State University, 300 Midway Drive, Office 201J, Kent, OH, 44242, USA.
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Jaroof S, Cailhol J. Design of a bilingual (FR-UR) website on the sensitive topic of sexual and mental health with Urdu speakers in a Parisian suburb: a qualitative study. BMC Public Health 2024; 24:1075. [PMID: 38632597 PMCID: PMC11025278 DOI: 10.1186/s12889-024-18479-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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND This article is a continuation of the Musafir study published in 2020. Following the results of this study, we designed an educational website with Urdu-speaking volunteers, using a participatory approach. This type of approach aimed at bringing out situated knowledge around taboo/sensitive topics such as sexual and mental health, by considering the cultural, religious, economic, family, and social background of young Urdu-speaking men. This approach allowed us to build culturally-appropriate content matching the needs of targeted population. We report here the lessons learned from our approach. METHODS Urdu-speaking volunteers were recruited via outreach strategies, for participation in focus groups. Four focus group discussions were conducted on three distinct themes: 1/ Sexual Health Promotion, 2/Hepatitis and sexually transmitted infections, and 3/ Mental Health. The focus groups were recorded, with the written consent of the users. Thematic analysis was conducted after transcription of the focus-group discussion. RESULTS We succeeded in mobilizing 4 Pakistani users, aged between 19 and 30 years. The group dynamics was very rich and allowed us to highlight numerous social aspects related to the importance of the group belonging, the family, and others points of view on these topics. Many Urdu vocabulary had to be redefined and revealed the extent of the pre-existing taboo. CONCLUSIONS Notwithstanding the extreme difficulty of mobilizing an invisible target population on a sensitive topic such as sexual and mental health, our experience highlights the need to consider the knowledge of the people concerned. The participative approach allowed us to fit the content of our medium to, for instance: the collectivist type of society of the target population; the level of literacy in their mother tongue; and to the embodiment of some taboo in their vocabulary. Although time and energy consuming, our approach seems relevant and could be replicated to other communities.
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Affiliation(s)
- Sabah Jaroof
- Registered Nurse and Master's in Public Health at Laboratoire d'Educations et de Promotion de la Santé, Université Sorbonne Paris Nord, Bobigny, France.
| | - Johann Cailhol
- Infectious diseases department, Groupe Hospitalo-Universitaire Paris Seine Saint Denis, Bobigny, France
- Laboratoire d'Educations et de Promotion de la Santé, Université Sorbonne Paris-Nord, Bobigny, France
- French Collaborative Institute on Migration, Aubervilliers, France
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Nematzadeh S, Shahhosseini Z, Moosazadeh M, Hamzehgardeshi Z. Sexual health literacy level and its related factors among married medical sciences college students in an Iranian setting: a web‑based cross‑sectional study. Reprod Health 2024; 21:53. [PMID: 38632616 PMCID: PMC11025204 DOI: 10.1186/s12978-024-01756-7] [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: 08/13/2023] [Accepted: 02/13/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Sexual health literacy (SHL) leads to the development of personal ability, understanding, evaluation and use of information related to sexual health. The purpose of this study was to assess the sexual health literacy level and its related factors among married college students at Mazandaran University of Medical Sciences (MAZUMS). METHODS A web-based cross-sectional online study was conducted on married college students at Mazandaran University of Medical Sciences between January and November 2020. All students were included in the study by census, and the study method was explained by telephone. If they agreed to participate in the study, the online link to the questionnaire, including sociodemographic and clinical information and Sexual Health Literacy for Iranian Adults (SHELIA), was emailed. The Statistical Package for the Social Sciences (SPSS) software version 26 was used for data analysis. Univariate and multivariate logistic regression tests were used to assess factors related to sexual health literacy. RESULTS The sample consisted of 277 male and 123 female students. Sexual Health Literacy Level and all subscales are at the sufficient level (66.1-88). Among the participants, 20.5% had limited sexual health literacy. Multivariate analysis found factors related to sexual health literacy among students: economic status (OR 0.03; 95% CI 0.0-0.55) and faculty (OR 0.07; 95% CI 0.01-0.52) is related to decrease and subscription to social media for sexual health (OR 3.27; 95% CI 1.53-7.01), information source of channels and cyberspace (OR 3.23; 95% CI 1.41-7.39), educational level (OR 16.39; 95% CI 2.16-32.70), Internet search information source (OR 1.91; 95% CI 1.00-3.64) is related to increase, were statistically significant factors. CONCLUSION In Iran, medical sciences college students, who constitute a significant portion of the country's population, are responsible for sexual health education. Government agencies, with the collaboration of all stakeholders, should develop policies and programs for implementing and evaluating integrated and comprehensive sexual health literacy promotion programs for them.
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Affiliation(s)
- Samaneh Nematzadeh
- Department of Midwifery Counseling, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zohreh Shahhosseini
- Department of Midwifery, School of Nursing and Midwifery, Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Noncommunicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zeinab Hamzehgardeshi
- Department of Midwifery, School of Nursing and Midwifery, Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
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Vencill JA, Kirsch JL, McPherson K, Sprankle E, Patten CA, Campana K, Brockman T, Bronars C, Hughes C, Gastineau D, Ehlers SL. Prospective Association of Psychological Distress and Sexual Quality of Life Among Hematopoietic Stem Cell Transplant Survivors. J Clin Psychol Med Settings 2024:10.1007/s10880-024-10013-9. [PMID: 38615280 DOI: 10.1007/s10880-024-10013-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2024] [Indexed: 04/15/2024]
Abstract
Sexual health concerns are one of the most common late effects facing hematopoietic stem cell transplant (HSCT) survivors. The current study tested whether self-reported depression and anxiety symptoms before transplant were associated with embedded items assessing two specific areas of sexual health-sexual interest and sexual satisfaction-one year post-HSCT. Of the 158 study participants, 41% were diagnosed with a plasma cell disorder (n = 60) and most received autologous transplantation (n = 128; 81%). At post-HSCT, 21% of participants reported they were not at all satisfied with their sex life, and 22% were not at all interested in sex. Greater pre-HSCT depressive symptomology was significantly predictive of lower sexual interest (β = -.27, p < .001) and satisfaction (β = -.39, p < .001) at post-HSCT. Similarly, greater pre-HSCT trait anxiety was significantly predictive of lower sexual interest (β = -.19, p = .02) whereas higher levels of state and trait anxiety were both predictive of lower satisfaction (β = -.22, p = .02 and β = -.29, p = .001, respectively). Participant sex significantly moderated the relationship between state anxiety and sexual satisfaction (b = -.05, t = -2.03, p = .04). Additional research examining the factors that contribute to sexual health post-HCST is needed to inform and implement clinical interventions to address these commonly overlooked survivorship concerns.
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Affiliation(s)
- Jennifer A Vencill
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Janae L Kirsch
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | - Keagan McPherson
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
- Minnesota State University, Mankato, MN, USA
| | | | - Christi A Patten
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | | | - Tabetha Brockman
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | - Carrie Bronars
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | - Christine Hughes
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | - Dennis Gastineau
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | - Shawna L Ehlers
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA.
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Logie CH, MacKenzie F, Malama K, Lorimer N, Lad A, Zhao M, Narasimhan M, Fahme S, Turan B, Kagunda J, Konda K, Hasham A, Perez-Brumer A. Sexual and reproductive health among forcibly displaced persons in urban environments in low and middle-income countries: scoping review findings. Reprod Health 2024; 21:51. [PMID: 38609975 PMCID: PMC11010352 DOI: 10.1186/s12978-024-01780-7] [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: 06/28/2023] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Most forcibly displaced persons are hosted in low- and middle-income countries (LMIC). There is a growing urbanization of forcibly displaced persons, whereby most refugees and nearly half of internally displaced persons live in urban areas. This scoping review assesses the sexual and reproductive health (SRH) needs, outcomes, and priorities among forcibly displaced persons living in urban LMIC. METHODS Following The Joanna Briggs Institute scoping review methodology we searched eight databases for literature published between 1998 and 2023 on SRH needs among urban refugees in LMIC. SHR was operationalized as any dimension of sexual health (comprehensive sexuality education [CSE]; sexual and gender based violence [GBV]; HIV and STI prevention and control; sexual function and psychosexual counseling) and/or reproductive health (antental, intrapartum, and postnatal care; contraception; fertility care; safe abortion care). Searches included peer-reviewed and grey literature studies across quantitative, qualitative, or mixed-methods designs. FINDINGS The review included 92 studies spanning 100 countries: 55 peer-reviewed publications and 37 grey literature reports. Most peer-reviewed articles (n = 38) discussed sexual health domains including: GBV (n = 23); HIV/STI (n = 19); and CSE (n = 12). Over one-third (n = 20) discussed reproductive health, including: antenatal, intrapartum and postnatal care (n = 13); contraception (n = 13); fertility (n = 1); and safe abortion (n = 1). Eight included both reproductive and sexual health. Most grey literature (n = 29) examined GBV vulnerabilities. Themes across studies revealed social-ecological barriers to realizing optimal SRH and accessing SRH services, including factors spanning structural (e.g., livelihood loss), health institution (e.g., lack of health insurance), community (e.g., reduced social support), interpersonal (e.g., gender inequitable relationships), and intrapersonal (e.g., low literacy) levels. CONCLUSIONS This review identified displacement processes, resource insecurities, and multiple forms of stigma as factors contributing to poor SRH outcomes, as well as producing SRH access barriers for forcibly displaced individuals in urban LMIC. Findings have implications for mobilizing innovative approaches such as self-care strategies for SRH (e.g., HIV self-testing) to address these gaps. Regions such as Africa, Latin America, and the Caribbean are underrepresented in research in this review. Our findings can guide SRH providers, policymakers, and researchers to develop programming to address the diverse SRH needs of urban forcibly displaced persons in LMIC. Most forcibly displaced individuals live in low- and middle-income countries (LMICs), with a significant number residing in urban areas. This scoping review examines the sexual and reproductive health (SRH) outcomes of forcibly displaced individuals in urban LMICs. We searched eight databases for relevant literature published between 1998 and 2023. Inclusion criteria encompassed peer-reviewed articles and grey literature. SRH was defined to include various dimensions of sexual health (comprehensive sexuality education; sexual and gender-based violence; HIV/ STI prevention; sexual function, and psychosexual counseling) and reproductive health (antenatal, intrapartum, and postnatal care; contraception; fertility care; and safe abortion care). We included 90 documents (53 peer-reviewed articles, 37 grey literature reports) spanning 100 countries. Most peer-reviewed articles addressed sexual health and approximately one-third centered reproductive health. The grey literature primarily explored sexual and gender-based violence vulnerabilities. Identified SRH barriers encompassed challenges across structural (livelihood loss), health institution (lack of insurance), community (reduced social support), interpersonal (gender inequities), and individual (low literacy) levels. Findings underscore gaps in addressing SRH needs among urban refugees in LMICs specifically regarding sexual function, fertility care, and safe abortion, as well as regional knowledge gaps regarding urban refugees in Africa, Latin America, and the Caribbean. Self-care strategies for SRH (e.g., HIV self-testing, long-acting self-injectable contraception, abortion self-management) hold significant promise to address SRH barriers experienced by urban refugees and warrant further exploration with this population. Urgent research efforts are necessary to bridge these knowledge gaps and develop tailored interventions aimed at supporting urban refugees in LMICs.
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Affiliation(s)
- Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, M5S 1V4, Canada.
- Centre for Gender and Sexual Health Equity, Vancouver, Canada.
- Women's College Research Institute, Women's College Hospital, Toronto, Canada.
- United Nations University Institute for Water, Environment, and Health, Hamilton, Canada.
| | - Frannie MacKenzie
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, M5S 1V4, Canada
| | - Kalonde Malama
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, M5S 1V4, Canada
| | - Nicole Lorimer
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, M5S 1V4, Canada
| | - Anoushka Lad
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, M5S 1V4, Canada
| | - Michelle Zhao
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, M5S 1V4, Canada
| | - Manjulaa Narasimhan
- Department of Sexual and Reproductive Health and Research, including the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Sasha Fahme
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Bülent Turan
- Department of Psychology, Koc University, Istanbul, Turkey
| | - Julia Kagunda
- Elim Trust, Nairobi, Kenya
- Daystar University, Nairobi, Kenya
| | - Kelika Konda
- Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, USA
| | - Aryssa Hasham
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, M5S 1V4, Canada
| | - Amaya Perez-Brumer
- Universidad Peruana Cayetano Heredia, Lima, Peru
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Ghandour LA, Anouti S, Lotfi T, Meho L, Kashash R, Al-Akkawi A, Majed A, Akl E, Afifi RA. Parenting a High and Growing Population of Youth in the Arab Region: A Scoping Review for an Evidence-Informed Research Agenda. J Adolesc Health 2024:S1054-139X(24)00125-3. [PMID: 38597843 DOI: 10.1016/j.jadohealth.2024.02.033] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 04/11/2024]
Abstract
The Arab region is experiencing the largest youth cohort in its history. Parental influence is a clear factor in the well-being of this demographic. This scoping review serves as the first consolidated synthesis of existing research on parenting in the Arab world, aimed at identifying research gaps and informing future research agendas. Searches of 18 databases resulted in 4,758 records (1995-2018) in all languages. Using Arksey and O'Malley's methodological framework, eligible studies (n = 152) underwent duplicate data abstraction. An evidence gap map was developed using 3i.e.'s platform. Studies were mostly published in English (88%), and lead authors' affiliations were mostly from Arab institutions. Included studies were mostly cross-sectional (89%), quantitative (96%), conducted in a school/university (83%), and surveyed children and adolescents (70%). Most studies (79%) examined parenting influences on youth outcomes. Fewer examined parenting measurement (30%) or evaluated interventions (1%). Mental health and school performance were the most commonly investigated outcomes. The evidence gap map allows researchers who study youth in the Arab world to efficiently and visually delineate the gaps and strategically prioritize research needs. Future studies should employ robust mixed methods study designs, focus on evaluation and psychometric research, engage youth in the research process and explore a more diverse set of outcomes.
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Affiliation(s)
- Lilian A Ghandour
- Department of Epidemiology and Population Health, Faculty of Health Sciences, Beirut, Lebanon
| | - Sirine Anouti
- Department of Epidemiology and Population Health, Faculty of Health Sciences, Beirut, Lebanon
| | - Tamara Lotfi
- Global Evidence Synthesis Initiative (GESI) Secretariat, American University of Beirut, Beirut, Lebanon
| | - Lokman Meho
- University Libraries, American University of Beirut, Beirut, Lebanon
| | - Rima Kashash
- Global Evidence Synthesis Initiative (GESI) Secretariat, American University of Beirut, Beirut, Lebanon; Public Health Monitoring Evaluation Accountability and Learning Coordinator, Mercy Corps, Beirut, Lebanon
| | - Alaa Al-Akkawi
- Department of Epidemiology and Population Health, Faculty of Health Sciences, Beirut, Lebanon
| | - AlZahraa Majed
- Department of Epidemiology and Population Health, Faculty of Health Sciences, Beirut, Lebanon
| | - Elie Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon; Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
| | - Rima A Afifi
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa.
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15
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Haines HM, Fields EL, Alvarenga A, Yang Y, Shorrock F, Reed C, Armington G, Gaydos CA, Manabe YC, Arrington-Sanders R. Improving Access to Care Through Youth-Focused Virtual Sexual Health Navigation. J Adolesc Health 2024:S1054-139X(24)00119-8. [PMID: 38597840 DOI: 10.1016/j.jadohealth.2024.02.027] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 02/12/2024] [Accepted: 02/16/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE Gender and sexually diverse adolescents and young adults in Baltimore City, Maryland, are disproportionately impacted by HIV. The Virtual and Online Integrated Sexual Health Services for Youth program is a health navigation program which combines virtual sexual health service delivery and health navigation to link youth at risk for HIV acquisition to HIV testing/prevention and sexual healthcare services. METHODS Youth between 13 and 26 years old and residing in the Baltimore area were eligible to participate in the program. Demographic and engagement data from 238 youth (average age 21.4, SD = 2.5) who requested navigation were collected and recorded in a Health Insurance Portability and Accountability Act (HIPAA)-secure medical database and examined for associations between demographics, referral source, and the number of navigational services to which they were linked. Focused populations were defined as residents of high HIV prevalence zip codes who identify as sexual and gender diverse youth. RESULTS Receipt of navigational services was significantly associated with self-identifying as sexually diverse. A multivariate regression revealed a significant association between the count of navigational services a youth was linked to and recording one's sexual orientation, identifying as a cisgender male, and residing in a high HIV-prevalence zip code. DISCUSSION Virtual health navigation has the potential to engage priority populations, including sexual and gender diverse youth. By refining linkage and identification approaches to health navigation, future outreach attempts can be tailored to support vulnerable communities, with the potential to improve sexual healthcare access.
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Affiliation(s)
- Haley M Haines
- Division of Adolescent and Young Adult Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
| | - Errol L Fields
- Division of Adolescent and Young Adult Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Aubrey Alvarenga
- Division of Adolescent and Young Adult Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Yeng Yang
- Division of Adolescent and Young Adult Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Fiona Shorrock
- Johns Hopkins Hospital Children's Center, Baltimore, Maryland
| | - Christopher Reed
- Division of Adolescent and Young Adult Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Gretchen Armington
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Charlotte A Gaydos
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Yukari C Manabe
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Renata Arrington-Sanders
- Division of Adolescent and Young Adult Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland; Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland; Craig-Dalsimer Division of Adolescent Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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16
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Okyere J, Ayebeng C, Dickson KS. Early age at menarche and history of sexually transmitted infections significantly predict cervical cancer screening uptake among women aged 25-49 years: evidence from the 2021 Côte d'Ivoire demographic and health survey. BMC Health Serv Res 2024; 24:423. [PMID: 38570834 PMCID: PMC10993584 DOI: 10.1186/s12913-024-10881-9] [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: 01/21/2024] [Accepted: 03/19/2024] [Indexed: 04/05/2024] Open
Abstract
INTRODUCTION Cervical cancer is the second dominant type of cancer among Ivorian women with an estimated age-standardised incidence and mortality rate of 31.2 cases and 22.8 deaths per 100,000 women in 2020, respectively. The Ivorian government through its Ministry of Health implemented the National Cancer Control Programme (NCCP) in 2003 with the aim of improving the prevention, early detection and treatment of cancers in Côte d'Ivoire. Yet, there is a low uptake of CCS (1.2%). Thus, making CCS uptake an important public health concern in the country. Understanding of the extent to which reproductive factors predict CCS uptake is limited in literature. This study aimed to investigate reproductive factors as a predictor of women's uptake of CCS in Côte d'Ivoire. METHODS Data from the 2021 Côte d'Ivoire Demographic and Health Survey. A sample of 9,078 women aged 25-49 years were analyzed. The outcome variable was CCS uptake while other variables considered included age at menarche, history of STI, sexual debut, parity, age, educational level, wealth index, health insurance, place of residence, and media exposure. A multivariable logistic regression model was fitted to examine the association between the outcome of interest and predictors at 95% confidence interval. RESULTS Approximately, 7.52% of women aged 25-49 years had ever undergone testing for cervical cancer by a healthcare provider. Early menarche was associated with lower odds of CCS uptake [AOR = 0.78; CI = 0.65-0.95]. Compared to those who had no STI, women with a history of STI were more likely to screen for cervical cancer [AOR = 2.63; CI = 2.02-3.42]. Increasing age, higher educational attainment, having health insurance, and being exposed to media were significantly associated with CCS uptake. CONCLUSION In Cote d'Ivoire, age at menarche and STI history constitute reproductive factors that were significantly associated with women's uptake of CCS. It is imperative for public policy to focus on increasing CCS in these higher-risk women (i.e., women who experienced early menarche, women with early sexual debut and higher parity) through increased sensitization on cervical cancer risk factors.
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Affiliation(s)
- Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
- School of Nursing & Midwifery, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Castro Ayebeng
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
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17
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Séguin LJ, Gareau E, Bosom M. DépistaFest: The evaluation of an inclusive, positive, and playful STBBI screening campaign's effectiveness. Can J Public Health 2024; 115:250-258. [PMID: 38393551 PMCID: PMC11027723 DOI: 10.17269/s41997-024-00862-0] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/25/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVES Young adults are disproportionately affected by sexually transmitted and blood-borne infections (STBBIs), and rates of STBBI screening in this population are persistently low. The present study examined the effectiveness of Club Sexu's social marketing campaign, DépistaFest, in increasing STBBI screening, screening intentions, and general STBBI and STBBI screening knowledge among young adults in Quebec, Canada. Grounded in the health belief model, the campaign provided practical and scientifically accurate information on STBBIs and screening using an inclusive, positive, and playful approach. METHODS A sample of 686 participants (M = 28.0 years old) was recruited through Club Sexu's social media to complete an online survey assessing campaign exposure, recent STBBI screening, screening intentions, and general STBBI and screening knowledge. Logistic regressions and ANCOVAs were performed to examine group differences on outcome variables. RESULTS Compared to nonexposed participants, those who were exposed to the campaign were 2.11 times more likely to report having been tested in the past 6 months, and 2.07 times more likely to report planning to get tested in the next 6 months. Exposed participants were also more likely to correctly answer general STBBI knowledge questions and reported higher levels of self-perceived STBBI screening knowledge than nonexposed participants. CONCLUSION The findings support the effectiveness of an STBBI prevention campaign grounded in the health belief model. Future STBBI prevention campaigns aimed at young adults would benefit from destigmatizing STBBIs and normalizing STBBI screening using an inclusive, positive, and playful approach.
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Affiliation(s)
- Léa J Séguin
- Department of Sexology, Université du Québec à Montréal (UQÀM), Montreal, QC, Canada.
| | - Emmanuelle Gareau
- School of Public Health, Université de Montréal, Montreal, QC, Canada
| | - Morag Bosom
- Department of Sexology, Université du Québec à Montréal (UQÀM), Montreal, QC, Canada
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18
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Chevalier LL, Blackmon JE, Bober SL, Roman A, Chang G, Recklitis CJ. Evaluating sensitive symptoms in young adult cancer survivors: acceptability of suicidal ideation and sexual health items across administration modes. J Cancer Surviv 2024; 18:450-456. [PMID: 35904728 DOI: 10.1007/s11764-022-01237-5] [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: 05/05/2022] [Accepted: 07/15/2022] [Indexed: 10/16/2022]
Abstract
PURPOSE Patient-reported outcomes (PROs) are essential for assessing potential late effects experienced by young adult cancer survivors (YACS), but stigma and social desirability bias may limit their effectiveness for assessing sensitive topics (e.g., suicidal ideation, sexual health). This study compared two methods of item administration to determine the optimal method for obtaining sensitive information in YACS. METHODS Two hundred forty-four YACS (ages 18-40) were randomized to complete measures of suicidal ideation and sexual health (i.e., sensitive items) by paper survey or by telephone automated computer assisted structured interview (TACASI). Participants also provided information on acceptability of administration mode and sensitive items. RESULTS The proportion of participants reporting symptoms did not significantly vary between paper and TACASI administration: respectively, 10% vs. 12% reported suicidal ideation and 55% vs. 58% reported sexual health concerns. The majority (≥ 78%) of participants reported feeling comfortable answering sensitive items on paper and TACASI and there were no significant differences in acceptability based on administration mode. Although participants endorsing sensitive symptoms were significantly more likely to feel upset answering sensitive items, the majority (93%) of participants experiencing symptoms still felt they were important to ask. CONCLUSIONS Despite their potentially sensitive nature, questions about suicidal ideation and sexual health were highly acceptable to YACS across administration modes. Moreover, YACS almost universally endorse the importance of providers asking about these topics. IMPLICATIONS FOR CANCER SURVIVORS Findings should bolster provider confidence that screening for suicidal ideation and sexual health concerns can and should be integrated into clinical care for YACS using paper or technology-assisted methods.
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Affiliation(s)
- Lydia L Chevalier
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
- Harvard Medical School, Boston, MA, USA
| | - Jaime E Blackmon
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Sharon L Bober
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
- Harvard Medical School, Boston, MA, USA
| | - Anthony Roman
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
- University of Massachusetts, Boston, MA, USA
| | - Grace Chang
- Harvard Medical School, Boston, MA, USA
- VA Boston Healthcare System, Brockton, MA, USA
| | - Christopher J Recklitis
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA.
- Harvard Medical School, Boston, MA, USA.
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Roberts NA, Esler R, Pearce A, Wyld D, Smith M, Woollett K, Mazariego C, Roberts MJ. Exploring Unmet Needs in Prostate Cancer Care: A Cross-sectional Descriptive Study. EUR UROL SUPPL 2024; 62:36-42. [PMID: 38585211 PMCID: PMC10998272 DOI: 10.1016/j.euros.2024.01.018] [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] [Accepted: 01/31/2024] [Indexed: 04/09/2024] Open
Abstract
Background and objective Prostate cancer, the most common cancer among men worldwide, has significant impact on quality of life. Supportive care needs for those affected by prostate cancer are not well understood. This study aims to describe patient-reported unmet needs and explore supportive care priorities of men treated for prostate cancer. Methods A cross-sectional survey was distributed to all men who had accessed prostate cancer services (including surgical, radiation, and medical oncology treatment modalities) at a tertiary hospital. The survey included qualitative questions exploring patient experience and a validated patient-reported outcome measure (Supportive Care Needs Survey Short Form 34). Clinical information was collected. Analyses included, descriptive statistics, multivariate logistic regression models and qualitative analyses using a framework method. Key findings and limitations A total of 162 participants provided survey data. Domains about information, self-management, and sexual function were the highest ranked items with unmet needs. A qualitative analysis also identified "relationships", "information", and "the value of hindsight" constructs. Participants who identified three or more unmet needs expressed treatment regret (odds ratio 5.92, 1.98-22.23, p = 0.01). Conclusions and clinical implications Understanding the unmet needs of patients may better inform supportive care interventions that address what is important to patients. Importantly, participants valued relationships. There may be opportunities to better meet the needs of patients by improving access to information and self-management resources, particularly around sexuality. Further research is warranted. Patient summary Prostate cancer and its treatment impacts are not well understood. Prioritisation of relationships and improving access to information and self-management resources are important. Further attention to prostate cancer supportive care in clinical practice is needed.
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Affiliation(s)
- Natasha A. Roberts
- Centre for Clinical Research, Clinical School, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Herston, QLD, Australia
| | - Rachel Esler
- Department of Urology, Cancer Care Services, Surgery and Peri-operative Services, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia
| | - Adam Pearce
- Department of Urology, Cancer Care Services, Surgery and Peri-operative Services, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia
| | - David Wyld
- Centre for Clinical Research, Clinical School, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Department of Urology, Cancer Care Services, Surgery and Peri-operative Services, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia
| | - Michael Smith
- Department of Urology, Cancer Care Services, Surgery and Peri-operative Services, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia
- School of Nursing, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Kaylene Woollett
- Department of Urology, Cancer Care Services, Surgery and Peri-operative Services, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia
| | - Carolyn Mazariego
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Kings Cross, NSW, Australia
| | - Matthew J. Roberts
- Centre for Clinical Research, Clinical School, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Department of Urology, Cancer Care Services, Surgery and Peri-operative Services, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia
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20
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Pignedoli C, Rivest P. The gender of PrEP: Transgender men negotiating legitimacy in France. Soc Sci Med 2024; 348:116842. [PMID: 38593613 DOI: 10.1016/j.socscimed.2024.116842] [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: 08/31/2023] [Revised: 01/05/2024] [Accepted: 03/26/2024] [Indexed: 04/11/2024]
Abstract
Transmasculine people (TM) constitute an invisibilized group within the transgender population. Little is known about their relationship to sexuality in transgender medicine. Their presence and needs are still unacknowledged within HIV prevention research and services. Pre-exposure prophylaxis (or PrEP) is an oral medication that prevents HIV in HIV-negative individuals at risk of infection with the virus. This paper proposes to bring TM back into the focus of PrEP research by questioning how they navigate and situate themselves in relation to existing PrEP categorization and services, and how they think about and (re)shape the meanings of PrEP. It is based on the "interpretative descriptive" method and a transfeminist theoretical framework applied to the analysis of ten semi-structured interviews with TM conducted in France between 2019 and 2023. Findings show that PrEP is gendered. We identify specific barriers to getting PrEP as well as to access healthcare and we show that a cisnormative and homonormative approach to prevention generates them. PrEP use and PrEP disclosure are embedded in structural and symbolic power relations between cisgender and transgender MSM that are reflected in the intimate sphere. TM use PrEP to prevent sexual assault and to alleviate the difficulty of condom negotiation. PrEP comes into play following major changes in TM's sexualities and is integrated post-exposure.
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Affiliation(s)
- Clark Pignedoli
- Université d'Aix-Marseille, SESSTIM - SanteRCom, Faculté de Médecine, 27 Bd Jean Moulin, 13385, Marseille, Cedex 5, France.
| | - Paul Rivest
- Université d'Aix-Marseille, Ideas, 5 rue du Château de l'Horloge, 13090, Aix-en-Provence, France.
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21
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Mwakawanga DL, Massae AF, Kohli N, Lukumay GG, Rohloff CT, Mushy SE, Mgopa LR, Mkoka DA, Mkonyi E, Trent M, Ross MW, Rosser BRS, Connor J. The need for and acceptability of a curriculum to train nursing and medical students in the sexual healthcare of clients with female genital mutilation/cutting in Tanzania. BMC Womens Health 2024; 24:198. [PMID: 38532377 DOI: 10.1186/s12905-024-03034-x] [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: 07/18/2023] [Accepted: 03/18/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Female genital mutilation/cutting (FGM/C) is tied to one of the most conservative cultures in the Mediterranean and Sub-Saharan Africa. More than 200 million girls and women in 30 African, Asian and the middle Eastern countries have undergone FGM/C. However, healthcare professionals are not adequately trained to prevent and manage FGM/C-related complications including sexual health problems. This study aimed to assess the need and acceptability of a curriculum to train nursing and medical students in the sexual healthcare of clients with FGM/C in Tanzania. METHODS We used a descriptive and cross sectional study design to collect and analyse information from 271 medical and 137 nursing students in Tanzania. A Qualtrics online survey was used to obtain quantitative data on training interest, previous training received, and the curriculum delivery method. Open-ended questions were used to explore their insights on significance to obtain the necessary competencies to treat and prevent FGM/C. Descriptive statistics were used to analyze quantitative data while qualitative data were analyzed using a thematic approach. RESULTS Almost half of the participants reported they had little to no training in sexual healthcare for women with FGM/C (47%). In all, 82.4% reported the training to be acceptable. Following thematic analysis of open-ended questions, participants expressed a desire to improve their competencies to meet the current and future sexual and psychological health needs of women and girls who have undergone FGM/C. CONCLUSION It is a necessary and acceptable to develop a curriculum to train healthcare students to diagnose, treat and prevent sexual health complications related to FGM/C. In our study, designing a culturally sensitive curriculum and its delivery method, that includes practical sessions with simulated patients, was considered the most beneficial and favorable.
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Affiliation(s)
- Dorkasi L Mwakawanga
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - Agnes F Massae
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - Nidhi Kohli
- University of Minnesota, #300, 1300 S. 2nd St., Minneapolis, MN, 55454, USA
| | - Gift Gadiel Lukumay
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - Corissa T Rohloff
- University of Minnesota, #300, 1300 S. 2nd St., Minneapolis, MN, 55454, USA
| | - Stella Emmanuel Mushy
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - Lucy R Mgopa
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - Dickson Ally Mkoka
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - Ever Mkonyi
- University of Minnesota, #300, 1300 S. 2nd St., Minneapolis, MN, 55454, USA
| | - Maria Trent
- Johns Hopkins University, 200 N. Wolfe Street, Baltimore, MD, 21287, USA
| | - Michael W Ross
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - B R Simon Rosser
- University of Minnesota, #300, 1300 S. 2nd St., Minneapolis, MN, 55454, USA.
| | - Jennifer Connor
- University of Minnesota, #300, 1300 S. 2nd St., Minneapolis, MN, 55454, USA
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22
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Brisson J, Ravitsky V, Williams-Jones B. A Mixed-Methods Study Exploring Colombian Adolescents' Access to Sexual and Reproductive Health Services: The Need for a Relational Autonomy Approach. J Bioeth Inq 2024:10.1007/s11673-024-10356-w. [PMID: 38532187 DOI: 10.1007/s11673-024-10356-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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/10/2024] [Indexed: 03/28/2024]
Abstract
This study's objective was to understand Colombian adolescents' experiences and preferences regarding access to sexual and reproductive health services (SRHS), either alone or accompanied. A mixed-method approach was used, involving a survey of 812 participants aged eleven to twenty-four years old and forty-five semi-structured interviews with participants aged fourteen to twenty-three. Previous research shows that adolescents prefer privacy when accessing SRHS and often do not want their parents involved. Such findings align with the longstanding tendency to frame the ethical principle of autonomy as based on independence in decision-making. However, the present study shows that such a conceptualization and application of autonomy does not adequately explain Colombian adolescent participants' preferences regarding access to SRHS. Participants shared a variety of preferences to access SRHS, with the majority of participants attaching great importance to having their parents involved, to varying degrees. What emerges is a more complex and non-homogenous conceptualization of autonomy that is not inherently grounded in independence from parental involvement in access to care. We thus argue that when developing policies involving adolescents, policymakers and health professionals should adopt a nuanced "relational autonomy" approach to better respect the myriad of preferences that Colombian (and other) adolescents may have regarding their access to SRHS.
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Affiliation(s)
- J Brisson
- Department of Social & Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada.
| | - V Ravitsky
- Department of Social & Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada
| | - B Williams-Jones
- Department of Social & Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada
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23
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Wood SM, Bauermeister J, Fiks AG, Phillips AW, Richardson HM, Garcia SM, Maleki P, Beidas RS, Young JF, Gross R, Dowshen N. Adolescent Preferences for a Pediatric Primary Care-based Sexually Transmitted Infection and HIV Prevention Intervention. J Adolesc Health 2024:S1054-139X(24)00069-7. [PMID: 38520429 DOI: 10.1016/j.jadohealth.2024.01.033] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/16/2023] [Accepted: 01/22/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE We sought to elicit perspectives on HIV and sexually transmitted infection (STI) prevention among adolescents with recent STIs in primary care to optimize acceptability and effectiveness in designing a novel HIV/STI prevention intervention. METHODS We enrolled 13-19 year-olds with recent gonorrhea, chlamydia, trichomonas, and/or syphilis in a multimethods cross-sectional study at two primary care clinics. Participants completed surveys and interviews. We used an integrated analytic approach deductively coding data using the Integrated Behavioral Model, then inductively coding to identify themes not represented in the Integrated Behavioral Model. RESULTS Participants (n = 35) were 85% cisgender female, 14% cisgender male, 1% transgender female; 25% identified as lesbian, bisexual, or queer. Most (97%) identified as non-Latinx Black. None used condoms consistently, 26% were aware of pre-exposure prophylaxis (PrEP), and 31% were never HIV tested. Five key themes emerged. 1) Mental health was central to HIV prevention behavior uptake and coping with STI diagnosis. 2) Youth desired prevention counseling that allowed decisional autonomy and individualized goal setting. 3) Negative social norms around condoms and absent norms around HIV testing and PrEP limited method uptake. 4) Both confidence and concrete skills were needed to initiate prevention methods. 5) Youth desired education at the time of STI diagnosis to improve subsequent prevention decision making. DISCUSSION Key intervention design considerations included 1) integrating mental health assessment and referral to services, 2) promoting individualized goal setting, 4) building communication skills, 4) providing navigation and material support for PrEP uptake and HIV testing, and 5) augmenting comprehensive STI and HIV prevention education.
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Affiliation(s)
- Sarah M Wood
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - José Bauermeister
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - Alexander G Fiks
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alexis W Phillips
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Haley M Richardson
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Stephanie M Garcia
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Pegah Maleki
- Division of Hematology and Oncology, Department of Medicine, University Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Rinad S Beidas
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Psychiatry, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Robert Gross
- Division of Infectious Diseases, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Nadia Dowshen
- Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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24
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Pakpahan C, Agustinus A, Sa'adi A, Nguyen TTA, Liamputtong P, Effendy C, Hinting A. Lay understanding and experience of sexual intercourse among couples with infertility undergoing an assisted reproduction technology program: A qualitative study. Heliyon 2024; 10:e26879. [PMID: 38434274 PMCID: PMC10907792 DOI: 10.1016/j.heliyon.2024.e26879] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/09/2024] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
Aim To explore the perception and lay understanding of sexual intercourse and sexual life experiences among infertile couples before, during, and after undergoing an assisted reproduction technology (ART) program. Method The participants of this descriptive qualitative study were Indonesian couples with infertility who underwent an ART program. Semi-structured interviews were conducted between September and December 2022, and the participants' responses were recorded. Data were analyzed using a step-by-step analysis based on Braun's qualitative analysis. The study was reported based on the Consolidated Criteria for Reporting a Qualitative Research (COREQ) Checklist. Results Fifty participants were included, and five themes were developed before and two themes during or after the ART program. The couples' knowledge varied as they experienced sexual intercourse at different periods, such as before, during, and after the ART program. Many participants reported that ART affected their emotions and mood, leading to decreased desire to engage in sexual intercourse. However, some used sexual intercourse as a basis for creating optimism and confidence in having offspring. Furthermore, couples perceived that the purpose of sexual intercourse is not only to have offspring but also to improve communication, promote intimacy, and express affection. In contrast, some perceived the ART program as time consuming, preventing them from engaging in sexual activities. However, not all couples considered sexual activity solely as a means of procreation. They concluded that sexual behavior is not only determined by genetics. Conclusion Couples who underwent the ART program regardless of its effectiveness were aware that sexual interaction is not only for having children but also for preserving harmony and familial connection.
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Affiliation(s)
- Cennikon Pakpahan
- Andrology Study Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Ferina Mother and Child Hospital, Surabaya, Indonesia
| | - Agustinus Agustinus
- Andrology Study Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Ferina Mother and Child Hospital, Surabaya, Indonesia
| | - Ashon Sa'adi
- Ferina Mother and Child Hospital, Surabaya, Indonesia
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Pranee Liamputtong
- College of Health Sciences, VinUniversity, Gia Lam District, Hanoi, Viet Nam
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, USA
| | - Christantie Effendy
- Medical Surgical Nursing Department, Faculty of Medicine, Public Health and Nursing. Universitas Gadjah Mada, Indonesia
| | - Aucky Hinting
- Andrology Study Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Ferina Mother and Child Hospital, Surabaya, Indonesia
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25
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Bentsen L, Aagesen M, Bidstrup P, Hjerming M, Pappot H. Sexuality, intimacy, and body image among adolescents and young adults with cancer: a qualitative, explorative study. Support Care Cancer 2024; 32:219. [PMID: 38460054 PMCID: PMC10924731 DOI: 10.1007/s00520-024-08405-6] [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: 10/13/2023] [Accepted: 02/24/2024] [Indexed: 03/11/2024]
Abstract
AIM The aim of this study was threefold: (1) to explore Danish adolescents and young adults' (AYAs) thoughts concerning sexual health particularly focusing on sexuality, intimacy, and body image throughout a cancer trajectory, (2) to investigate how AYAs experience healthcare professionals address of- and respond to sexual health issues, and (3) to identify AYAs' suggestions on how to support conversation about sexual health. METHODS A qualitative, single-center study was conducted, including AYAs (18-29 years) diagnosed with cancer recruited at the University Hospital of Copenhagen, Rigshospitalet. Individual semi-structured interviews were conducted from January-February 2023, recorded, transcribed verbatim, and analyzed using thematic analysis. RESULTS Twelve participants were interviewed, aged 20-29; five were diagnosed with hematological- and seven with oncological cancer. Our analyses yielded three themes: (1) sexuality and body image as part of the identity, (2) excluding relatives in conversations about sexual health, and (3) uncertainty how to discuss sexual health with healthcare professionals. Finally, the AYAs' suggestions to support conversations about sexual health were organized into six thematic categories. CONCLUSION In this study, participants experienced altered sexual subsequent impacts on body image and self-esteem during their cancer trajectory. While some adapted to these changes, discussing them with healthcare providers was difficult, especially in the presence of relatives, as the AYAs wanted to shield them from additional concerns. To enhance support, AYAs suggest regular discussions on sexual health and the use of a dialog tool by healthcare professionals.
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Affiliation(s)
- Line Bentsen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Maria Aagesen
- Occupational Science, User Perspectives and Community-Based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Pernille Bidstrup
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Strandboulevarden 49 2100, Copenhagen, Denmark
| | - Maiken Hjerming
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Helle Pappot
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
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26
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Elsayed R, Zembe-Mkabile W. Women's access to sexual and reproductive health services and information in Ismailia, Egypt. BMC Womens Health 2024; 24:163. [PMID: 38448850 PMCID: PMC10918981 DOI: 10.1186/s12905-024-02986-4] [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: 08/16/2022] [Accepted: 02/19/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Sexual and reproductive health (SRH) is a right that should be guaranteed to every woman worldwide in order to have a healthy and safe sex life. In most Arab countries, including Egypt, there are different cultural, political, and religious factors that have contributed significantly to how society views and treats women's bodies and sexuality. As a result, it is difficult to provide solid data and information to guide policymakers, policies, and to implement awareness and preventive programmes. This study sought to address this gap by looking at the intersectionality of women's access to SRH services and information in Ismailia, Egypt. METHODS The study utilised qualitative research methods. Semi-structured interviews were conducted with twelve married women and two key informant interviews with health professionals (a gynecologist and a pharmacist) in the study area. RESULTS The study revealed that married women suffer from scarcity of understanding and knowledge of their SRH and lack of access to adequate SRH services and information. Married women's experiences of accessing SRH services and information were influenced by intersecting factors located at the micro and macro levels. These intersected factors (e.g., power dynamics, socioeconomic factors, cultural norms, and religious misconception) shaped oppression and privilege structures which created unequal access to SRH information and services. CONCLUSION There is a need for building quality parental relationships for women before and after marriage in order to promote positive SRH attitudes and behavior. There is an urgent need to empower women before and after marriage with accurate, safe, and affordable SRH services and information that could have life-long benefits to protect them. There is a need to conduct educational programmes, and initiate media awareness campaigns, to equip women with information and knowledge about their SRH services and information.
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Affiliation(s)
- Reem Elsayed
- Researcher and Technical Officer, Egypt Healthcare Authority, 7th Al Nasr Road, Elforsan Building, Nasr City, Cairo, Egypt.
| | - Wanga Zembe-Mkabile
- Senior Specialist Scientist, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
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Nkulu Kalengayi FK, Baroudi M, Hurtig AK. Prevalence of perceived discrimination, determinants and associations with self-rated general and sexual health, healthcare utilization and self-perceived integration: a cross-sectional survey of migrants in Sweden. BMC Public Health 2024; 24:699. [PMID: 38443834 PMCID: PMC10913465 DOI: 10.1186/s12889-024-18160-2] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/20/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Sweden has welcomed migrants, but attitudes have shifted, becoming hostile due to populism and the growing number of migrants. This has left migrants feeling unwelcome and marginalized. Few studies have examined the extent to which migrants perceive discrimination, who, why, where and its relationships with different outcomes. This study has two aims: to assess the prevalence, reasons, and determinants of perceived discrimination among migrants (1) and its associations with self-rated health, sexual health, healthcare use, and integration (2). METHODS We analysed data from a 2018 survey on migrants' sexual and reproductive health and rights. The survey included 1740 migrants aged 16 or older. We used descriptive and log-binomial regression analyses to estimate prevalence, crude and adjusted prevalence ratios (APR) with 95% confidence interval (CI). RESULTS About 36% of participants perceived discrimination in Sweden, with ethnic origin (62%) and religion (35%) as main reasons. Perceived discrimination occurred in public spaces (47%), schools (33%), internet (20%), work (19%), public services (18%), residential areas (16%), and healthcare settings (10%). Migrant men (APR: 1.26, CI:1.07-1.49), born in Middle East and North Africa (APR: 1.57, CI:1.26-1.95) and South Asia (APR: 1.61, CI:1.27-2.04) regions, with more than 12 years of education (APR: 1.33, CI:1.10-1.60), a non-heterosexual orientation (APR: 1.21, CI: 1.02-1.43), a non-Christian religion (APR: 1.41, CI: 1.10-1.80), economic stress (APR:1.67, CI: 1.44-1.93) or Swedish language skills (APR: 1.24, CI:1.07-1.43) perceived discrimination more than their counterparts. In contrast, the oldest participants (46 years or more) perceived less discrimination (APR:0.55, CI: 0.37-0.80) than the youngest ones (16-25 years). Moreover, perceived discrimination was associated with poor self-rated general (APR:1.72, CI: 1.45-2.04) and sexual health (APR:1.40, CI:1.2-1.64), integration (APR:1.25, CI:1.14-1.37), and healthcare access (APR: 1.48, 1.16-1.89). CONCLUSIONS This study shows that migrants in Sweden face widespread perceived discrimination based on ethnicity and religion. This can affect their health, healthcare use, and social integration. The study calls for policies and interventions that tackle systemic perceived discrimination, foster inclusion, and guarantee equal opportunities in accessing healthcare and resources for migrants. It also urges support for vulnerable groups who perceive more discrimination, such as migrants from certain regions or under economic stress.
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Affiliation(s)
| | - Mazen Baroudi
- Department of Epidemiology and Global Health, Umeå University, Umeå, SE-901 87, Sweden
| | - Anna-Karin Hurtig
- Department of Epidemiology and Global Health, Umeå University, Umeå, SE-901 87, Sweden
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28
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Vargas SE, Thornton K, Norris C, Gist G, Clark MF, Ramirez L, Guillen M, Guthrie KM, Landoll RR. Sexual and reproductive health in military settings: A qualitative study. Mil Psychol 2024:1-10. [PMID: 38436987 DOI: 10.1080/08995605.2024.2324644] [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: 09/01/2023] [Accepted: 02/22/2024] [Indexed: 03/05/2024]
Abstract
Mission readiness is critical to the operational success of the United States (US) military and includes having a healthy and fit fighting force. Service members and their dependents have access to a wide range of sexual and reproductive health services with no out-of-pocket costs. Despite this access, negative outcomes such as sexually transmitted infections (STIs) and unintended pregnancy persist. Semi-structured, in-depth interviews were conducted with service members and stakeholders (e.g. medical providers). Interviews explored the individual, interpersonal, organizational, and institutional factors that inform sexual norms, behaviors, and healthcare experiences in the US military. Interview transcripts were coded manually; data were summarized for themes related to unique aspects of military culture and healthcare affecting sexual and reproductive health. Twenty-five (25) service members and 15 stakeholders completed interviews. Four themes emerged: 1) despite free access, both general and military-specific barriers to sexual and reproductive healthcare persist; 2) general and military-specific cultural norms apply to sexual behavior and care seeking; 3) sexual and reproductive health-related norms can be perceived as confusing and contradictory within the military; and 4) resources addressing sexual assault are ubiquitous in military settings, but resources addressing prevention of STIs and unintended pregnancy are limited. Both general and military-specific norms, behavior, and healthcare experiences need to be considered in clinical care, public health campaigns, and other efforts to promote sexual and reproductive health in military settings.
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Affiliation(s)
- Sara E Vargas
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Kade Thornton
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences School of Medicine, Bethesda, Maryland
| | - Colby Norris
- Department of Family Medicine, Uniformed Services University of the Health Sciences School of Medicine, Bethesda, Maryland
| | - Galen Gist
- Department of Family Medicine, Uniformed Services University of the Health Sciences School of Medicine, Bethesda, Maryland
| | - Madison F Clark
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland
| | - Leslie Ramirez
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
| | - Melissa Guillen
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
| | - Kate M Guthrie
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island
| | - Ryan R Landoll
- Department of Family Medicine, Uniformed Services University of the Health Sciences School of Medicine, Bethesda, Maryland
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Nolan H, O'Donoghue B, Simmons M, Zbukvic I, Ratcliff S, Milton A, Hughes E, Thompson A, Brown E. The development of a novel sexual health promotion intervention for young people with mental ill-health: the PROSPEct project. BMC Health Serv Res 2024; 24:262. [PMID: 38429748 PMCID: PMC10905889 DOI: 10.1186/s12913-024-10734-5] [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: 05/19/2023] [Accepted: 02/15/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Young people with mental ill-health experience higher rates of high-risk sexual behaviour, have poorer sexual health outcomes, and lower satisfaction with their sexual wellbeing compared to their peers. Ensuring good sexual health in this cohort is a public health concern, but best practice intervention in the area remains under-researched. This study aimed to co-design a novel intervention to address the sexual health needs of young people with mental ill-health to test its effectiveness in a future trial undertaken in youth mental health services in Melbourne, Australia. METHODS We followed the 2022 Medical Research Council (MRC) guidelines for developing and evaluating complex interventions. This involved synthesising evidence from the 'top down' (published evidence) and 'bottom up' (stakeholder views). We combined systematic review findings with data elicited from qualitative interviews and focus groups with young people, carers, and clinicians and identified critical cultural issues to inform the development of our intervention. RESULTS Existing evidence in the field of sexual health in youth mental health was limited but suggested the need to address sexual wellbeing as a concept broader than an absence of negative health outcomes. The Information-Motivation-Belief (IMB) model was chosen as the theoretical Framework on which to base the intervention. Interviews/focus groups were conducted with 29 stakeholders (18 clinicians, three carers, and eight young people). Synthesis of the evidence gathered resulted in the co-design of a novel intervention consisting of an initial consultation and four 60-90-minute sessions delivered individually by a young 'sex-positive' clinician with additional training in sexual health. Barriers and supports to intervention success were also identified. CONCLUSIONS Using the MRC Framework has guided the co-design of a potentially promising intervention that addresses the sexual health needs of young people with mental ill-health. The next step is to test the intervention in a one-arm feasibility trial.
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Affiliation(s)
- Hayley Nolan
- Orygen, 35 Poplar Road, 3052, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia
| | - Brian O'Donoghue
- Orygen, 35 Poplar Road, 3052, Parkville, Melbourne, Australia
- University College Dublin, Dublin, Ireland
- Department of Psychiatry, Royal College of Surgeons, Ireland, Ireland
| | - Magenta Simmons
- Orygen, 35 Poplar Road, 3052, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia
| | - Isabel Zbukvic
- Orygen, 35 Poplar Road, 3052, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia
| | - Sophia Ratcliff
- Orygen, 35 Poplar Road, 3052, Parkville, Melbourne, Australia
| | - Alyssa Milton
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, Sydney, Australia
| | - Elizabeth Hughes
- Research Centre for Applied Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Andrew Thompson
- Orygen, 35 Poplar Road, 3052, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Warwick, United Kingdom
| | - Ellie Brown
- Orygen, 35 Poplar Road, 3052, Parkville, Melbourne, Australia.
- Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.
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Kurt A, Kürtüncü M. The effectiveness of sexual health and development education given to children with intellectual disabilities: A randomized controlled study. J Pediatr Nurs 2024; 75:e49-e57. [PMID: 38199932 DOI: 10.1016/j.pedn.2023.12.027] [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: 09/09/2023] [Revised: 12/27/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE The purpose of this study is to determine the effectiveness of an educational program implemented to support the sexual health and development of children with intellectual disabilities, using the Mastery Learning Model, on their knowledge of sexual health and development, as well as on their mothers' awareness of their children's sexual development. METHOD This study was conducted as a randomized controlled trial with 48 children who have intellectual disabilities, divided into two groups: an education group (n = 24) and a control group (n = 24). The program implemented was a sexual health and development education program based on the Mastery Learning Model. The data collection tools used were 'The Sexual Development Characteristics of Children with Adolescent Intellectual Disability Scale' for mothers and 'The Sexual Development Knowledge Assessment Scale for Children with Intellectual Disabilities' for children. RESULTS Following the educational program, the children in the education group demonstrated an increase in knowledge regarding their sexual development and health. Additionally, the mothers in the education group showed an increased awareness of their children's sexual health and development. One month after implementing the education program, which utilized mastery learning, the children in the education group exhibited a greater level of knowledge compared to the control group. CONCLUSION This study utilized the Mastery Learning Model to achieve effective and comprehensive sexual health and development education for children with intellectual disabilities. PRACTICE IMPLICATIONS Pediatric and school nurses are recommended to use the Mastery Learning Model for sexual health education in clinics and school health practices.
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Affiliation(s)
- Aylin Kurt
- Bartın University, Faculty of Health Sciences, Nursing Department, Pediatric Nursing, Bartın, Turkey.
| | - Meltem Kürtüncü
- Zonguldak Bülent Ecevit University, Faculty of Health Sciences, Nursing Department, Pediatric Nursing, Zonguldak, Turkey.
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Hong D, Cherabie J, Reno HE. Taking a Sexual History: Best Practices. Med Clin North Am 2024; 108:257-266. [PMID: 38331478 DOI: 10.1016/j.mcna.2023.09.004] [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] [Indexed: 02/10/2024]
Abstract
Recognizing the holistic definitions of sexual health, health-care providers must approach sexual health history taking with sensitivity, inclusivity, and a trauma-informed perspective. Many versions of what a sexual history should look like exist but certain principles are commonly found. Education of health-care providers on sexual history taking can involve reviewing the components of the sexual history but should also include the importance of using nonstigmatizing language, having a patient-centered approach, and practicing trauma-informed and culturally sensitive care.
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Affiliation(s)
- Donald Hong
- Department of Medicine, Division of Infectious Diseases, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
| | - Joseph Cherabie
- Department of Medicine, Division of Infectious Diseases, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Hilary E Reno
- Department of Medicine, Division of Infectious Diseases, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
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Safshekan S, Khalesi ZB. Factors affecting sexual-self-esteem among Iranian women. Eur J Obstet Gynecol Reprod Biol X 2024; 21:100284. [PMID: 38323102 PMCID: PMC10845242 DOI: 10.1016/j.eurox.2024.100284] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 02/08/2024] Open
Abstract
Introduction The quality of marital relationships is positively impacted by women's sexual self-esteem. This study aims to determine the factors that affect sexual self-esteem among Iranian women. Methods A total of 1176 eligible women who have been referred to comprehensive healthcare centers of Rasht, participated in this analytical cross-sectional study. A stratified two-stage cluster sampling methodology was applied to achieve samples. Data were collected using a validated Persian version of the Sexual Self-Esteem Inventory in Women-Short Form and related factors checklist. Results The mean sexual self-esteem score of the respondents was 103.97(SD =5.29) in this study. Education level of the woman (B = 2.622, P < 0.032), employment status of the woman (B= 9.24, P < 0.01), duration of the marriage (B = 11.47, P < 0.01), body image (B = 3.446, P < 0.01), childhood sexual abuse experiences (B = -0.363, P < 0.01), was related with sexual self-esteem. The sexual self-esteem score increased with an increase in higher levels of education, employment of women, an increase in the duration of the marriage, and a positive body image. However, there was an inverse relationship between the experience of childhood sexual abuse and sexual self-esteem. Conclusions The findings revealed that sexual self-esteem in women is influenced by background, intrapersonal, and interpersonal factors that should be approached in education, counseling, and therapy.
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Affiliation(s)
- Sahar Safshekan
- School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
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Eidelberg A, Axelrad J, Chedid V, Ballou S, Cheifetz A, Rabinowitz LG. Sexual Health in Sexual and Gender Minority Patients with Inflammatory Bowel Disease. Dig Dis Sci 2024; 69:743-748. [PMID: 38267727 DOI: 10.1007/s10620-023-08253-0] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/14/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND In recent years, legislation targeting the sexual and gender minority (SGM) community has been passed at an increasingly alarming rate, affecting access to safe and effective gender-affirming care and forcing many SGM patients, including those with inflammatory bowel disease (IBD), to withhold their identities and health concerns. Additionally, SGM patients with IBD may have unique health considerations that have not yet been well-studied OBJECTIVE: This article aims to explore the intersection of IBD and sexual health in patients who identify as SGM and to identify limitations for gastroenterologists in caring for SGM patients. The article also aims to provide suggestions for improvement in SGM-competent care within gastroenterology METHODS: A thorough literature review was conducted regarding sexual health and the SGM community with IBD. This included a review of surgical considerations in SGM patients, sexually transmitted infections (STIs) and prevention, and sexual dysfunction RESULTS: Overall, little is known about the impact of IBD on patients who identify as sexual and gender minorities. Surgery, medications, and STIs continue to be a concern in the SGM community with IBD and these areas represent opportunities to improve SGM-competent IBD care. Additionally, implementation of an SGM-focused curriculum is urgently needed in medical education to improve provider knowledge and care for this unique group of patients CONCLUSIONS: Patients with IBD who identify as SGM experience challenges that are not well described in prior literature. More research is needed and is actively being pursued to guide provider awareness and improve sexual health for this patient population.
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Affiliation(s)
- Andrew Eidelberg
- Department of Medicine and Division of Gastroenterology, Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Rabb 4, Boston, MA, 02215, USA.
| | | | | | - Sarah Ballou
- Department of Medicine and Division of Gastroenterology, Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Rabb 4, Boston, MA, 02215, USA
| | - Adam Cheifetz
- Department of Medicine and Division of Gastroenterology, Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Rabb 4, Boston, MA, 02215, USA
| | - Loren G Rabinowitz
- Department of Medicine and Division of Gastroenterology, Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Rabb 4, Boston, MA, 02215, USA
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Ard KL, Mayer KH. A Practical Approach to Sexually Transmitted Infection Screening for the Primary Care Clinician. Med Clin North Am 2024; 108:267-278. [PMID: 38331479 DOI: 10.1016/j.mcna.2023.08.014] [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] [Indexed: 02/10/2024]
Abstract
Sexually transmitted infections (STIs) are commonly encountered in primary care. The Centers for Disease Control and Prevention and the US Preventive Services Task Force have both issued guidelines about screening for chlamydia, gonorrhea, syphilis, and HIV. By eliciting a sexual history, understanding their patients' anatomy, and considering factors which may increase the likelihood of STIs and their sequelae, clinicians can implement a practical, evidence-based approach to STI screening.
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Affiliation(s)
- Kevin L Ard
- Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
| | - Kenneth H Mayer
- Division of Infectious Diseases, The Fenway Institute, Fenway Health, Harvard Medical School, Beth Israel Deaconess Medical Center, 1340 Boylston Street, Boston, MA 02215, USA
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Goudman L, van Schaik D, Jager T, Moens M, Scheerlinck T. Discussing sexual health with patients eligible for spine surgery: An online survey in spine surgeon and pain physicians. Brain Spine 2024; 4:102776. [PMID: 38465281 PMCID: PMC10924173 DOI: 10.1016/j.bas.2024.102776] [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: 12/19/2023] [Revised: 02/03/2024] [Accepted: 02/19/2024] [Indexed: 03/12/2024]
Abstract
Introduction Spinal pain syndromes have a severe impact on the patient's sex life, contributing to a decrease in sexual function and sexual satisfaction. Despite the importance of sexual health on mental and physical wellbeing, sexual health is rarely discussed during consultations. Research question The aim of this study is to explore to what extent influencing factors can alter the discussion about sexual health during consultations. More specifically, we will evaluate the influence of healthcare profession, sex of the patient and the surgical approach that is proposed. Material and methods An online survey was sent to neurosurgeons, pain physicians and orthopedists in Belgium and The Netherlands in April 2019. Participants were asked about; counseling routine, knowledge, and opinion on sexual health. Answers were scored on a 5-point Likert scale. Independence between the response levels and type of surgery as well as profession were tested. Results In total, 350 respondents were approached of whom 57 completed the survey. The majority of respondents (61.4%) indicated that they rarely or never discussed sexual disturbances. Profession and type of surgery had an influence on discussing erectile dysfunction, retrograde ejaculation, and alterations in orgasms. Thirty-five percent of healthcare providers considered it the patient's responsibility to bring up the subject of sexual health. Discussion and conclusion Sexual health is rarely addressed by healthcare providers during spinal care. Profession as well as type of surgery seems to play a role on whether sexual health is discussed during consultations.
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Affiliation(s)
- Lisa Goudman
- STIMULUS Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Research Foundation—Flanders (FWO), 1090, Brussels, Belgium
| | - David van Schaik
- Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Tjeerd Jager
- Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Maarten Moens
- STIMULUS Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Thierry Scheerlinck
- Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
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Letessier M, Mignot D, Mejri I, Hitoto H. A rural interprofessional primary care team develops a school-based sex education program. Sante Publique 2024; 35:87-127. [PMID: 38388405 DOI: 10.3917/spub.236.0087] [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] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Introduction In French rural areas, getting information about sexual health and identifying health actors on the topic is difficult for teenagers. Despite national and international guidelines, school-based sex education programs remain insufficient in France. The aim of this project was to develop a school-based psycho-affective and sexual health program (PASHP) for teenagers, led by an interprofessional primary care team (IPCT) in Montval-sur-Loir (Sarthe) and to coordinate local stakeholders. Method The IPCT developed the PASHP using a community-based participatory research method. The first step identified the target population and its needs for sex education. The second step was to create a steering group to tailor PASHP interventions in a participatory way and to define the PASHP’s aims and execution arrangements. The third step aimed at carrying out the PASHP and getting stakeholders’ and the target population’s feedback. Results The PASHP, carried out in the 2020–2021 and 2021–2022 school years, included an intervention about contraception and sexually transmitted infections, artistic workshops on consent or gender stereotypes, group discussions, and an intervention about pornography to assist parents. Conclusion The PASHP developed and coordinated by the Montval-sur-Loir IPCT is innovative because of its organization. It coordinates local stakeholders, teenagers, and their parents in a disadvantaged rural area, respecting national guidelines on sex education.
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Affiliation(s)
| | | | - Ilyess Mejri
- Maison de santé pluridisciplinaire de Montval-sur-Loir, France
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Garolla A, Kiesswetter M, Angelini S, Cavalieri F, Foresta C, Panzeri M, Ferlin A. Communication of the diagnosis to Klinefelter subjects: an observational study on a key moment of the patient's life. J Endocrinol Invest 2024:10.1007/s40618-024-02302-9. [PMID: 38376732 DOI: 10.1007/s40618-024-02302-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/30/2023] [Indexed: 02/21/2024]
Abstract
PURPOSE Klinefelter syndrome (KS) is the most prevalent sex chromosome disorder among males. The communication of the KS diagnosis holds significant implications for the diagnosis's acceptance. Recently, the increased use of prenatal diagnostic procedures has raised the question of whether, when, and by whom information, once provided to parents, should be communicated to their children/adolescents. Currently, there is limited information on this topic. This study aims to investigate the most suitable timing, content, and healthcare professionals (HCPs) according to KS patients' suggestions for conveying the diagnosis, analyzing the impact of communicating the KS diagnosis on patients and their reception of the communication in real-life situations. Furthermore, research entails a comparison of the actual communication and the patients' preferred mode of communication. METHODS Self-reported interview data was collected from 196 adults diagnosed with KS. The interview was structured, consisting of 32 multiple-choice questions covering various areas related to diagnosis communication. RESULTS Most patients with Klinefelter syndrome reported that earlier communication would have been beneficial. Communication before the age of 18 and by parents increased the likelihood of overcoming negative consequences and relying on psychological support. CONCLUSION To mitigate the adverse effects of poorly timed and inadequately delivered communication, typically by a single person, it is advisable that such communication be carried out at the onset of adolescence by an interdisciplinary team of HCPs (including psychologists, geneticists, endocrinologists) and parents. The information provided should not solely concentrate on hormonal and fertility aspects, but also consider other factors such as psychological variables.
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Affiliation(s)
- A Garolla
- Andrology and Reproductive Medicine & Centre for Klinefelter Syndrome, Department of Medicine, University of Padova, Padua, Italy
| | - M Kiesswetter
- Institute of Psychology, UMIT TIROL, University of Health Sciences and Technology, Hall in Tirol, Austria
| | - S Angelini
- Andrology and Reproductive Medicine & Centre for Klinefelter Syndrome, Department of Medicine, University of Padova, Padua, Italy
| | - F Cavalieri
- Andrology and Reproductive Medicine & Centre for Klinefelter Syndrome, Department of Medicine, University of Padova, Padua, Italy
| | - C Foresta
- Andrology and Reproductive Medicine & Centre for Klinefelter Syndrome, Department of Medicine, University of Padova, Padua, Italy
| | - M Panzeri
- Department of Developmental Psychology and Socialisation, Padua University, Padua, Italy.
| | - A Ferlin
- Andrology and Reproductive Medicine & Centre for Klinefelter Syndrome, Department of Medicine, University of Padova, Padua, Italy
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Van Damme L, Chatrou L, de la Peña E, Kibungu P, Bolya CS, Van Damme P, Vanhove W, Ceuterick M, De Meyer E. Plant use and perceptions in the context of sexual health among people of Congolese descent in Belgium. J Ethnobiol Ethnomed 2024; 20:20. [PMID: 38373968 PMCID: PMC10877895 DOI: 10.1186/s13002-024-00662-3] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/13/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND The use of medicinal plants is integral to global healthcare systems, with Sub-Saharan Africa maintaining a robust tradition of herbal medicine alongside Western-oriented healthcare. As migrant communities tend to continue traditional herbal practices after migration, documenting this use is vital to develop culturally sensitive healthcare. This study investigates plant usage and perspectives in the context of sexual and reproductive health among the Congolese community in Belgium, particularly in the Matongé quarter of Brussels. Our research questions were: (1) What is the current knowledge of medicinal plants among the Congolese community in Belgium in the context of sexual health, and what are the applications and commonly employed administration methods of these plants? (2) What role does herbal medicine play in the context of sexual health for people of Congolese descent in Belgium and how this is influenced by perceptions of sexuality? and (3) Is there a gender bias in the use of medicinal plants, and if so, can this be related to perceived gender norms? METHODS We conducted 22 semi-structured interviews with people of Congolese descent currently living in Belgium. Participants were selected using both snowball sampling and purposive sampling. Plant use in the context of sexual health was recorded through freelisting. Data on narratives, ideas, and perceptions of this plant use in the context of sexual health were collected. Interview transcripts were analyzed using thematic analysis. RESULTS We identified 17 plant species used for sexual health. Three overarching themes emerged from our data. Plants were used with a notable gender bias favoring male sexual potency enhancement. Men used these plants for both remedying potency issues and enhancing sexual prowess. In contrast, knowledge about plants for female sexual health was limited. Gender norms reinforced the importance of male sexual potency, while stigmatizing open discussions of female sexuality. CONCLUSIONS The use of medicinal plants for sexual health raises health, social, and conservation concerns, underscoring the need for further research in this area. This study contributes to understanding medicinal plant use within the Congolese community in Belgium and highlights the necessity for future research on herbal practices for female sexual health in this context.
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Affiliation(s)
- Laura Van Damme
- Department of Biology, Ghent University, K.L. Ledeganckstraat 35, 9000, Ghent, Belgium
| | - Lars Chatrou
- Department of Biology, Ghent University, K.L. Ledeganckstraat 35, 9000, Ghent, Belgium
| | - Eduardo de la Peña
- Department of Plants and Crops, Ghent University, Coupure Links 653, 9000, Ghent, Belgium
- Spanish National Research Council (CSIC), Institute for Subtropical and Mediterranean Horticultural Research (IHSM-UMA-CSIC), Malaga, Spain
| | - Pathy Kibungu
- Department of Plants and Crops, Ghent University, Coupure Links 653, 9000, Ghent, Belgium
- Natural Products & Food Research and Analysis (NatuRA), Department of Pharmaceutical Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
- Department of Environmental Sciences, Kinshasa University (UNIKIN), BP 127, Kinshasa XI, Democratic Republic of the Congo
| | | | - Patrick Van Damme
- Faculty of Tropical AgriSciences (FTA), Czech University of Life Sciences Prague, 165 00, Prague, Czech Republic
| | - Wouter Vanhove
- Lignaverda Belgium, Duwijckstraat 17, 2500, Lier, Belgium
| | - Melissa Ceuterick
- Department of Sociology, Health & Demographic Research, Ghent University, Sint-Pietersnieuwstraat 41, 9000, Ghent, Belgium
| | - Emiel De Meyer
- Department of Plants and Crops, Ghent University, Coupure Links 653, 9000, Ghent, Belgium.
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Velasco-Gijón IM, Polo-Oliver A, Gutiérrez-Ramírez L, Arias-Arias Á, Tejera-Muñoz A. [Survey to know the perception of sexual education in adolescents]. Rev Esp Salud Publica 2024; 98:e202402005. [PMID: 38333924] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/29/2023] [Indexed: 02/10/2024] Open
Abstract
OBJECTIVE Sex education is essential for an accurate approach of sexuality in adolescents, being more effective when it is carried out at early ages. This study aimed to estimate the sexual health knowledge and the information in this regard perceived by adolescents, as well as where it came from. METHODS A cross-sectional observational study was performed in students from two public high schools in Castilla-La Mancha who were surveyed about sexual knowledge. Comparisons were made by using the Student's t test or Mann Whitney U test, the Chi-square test (or Fisher's exact test) depending on the variables. RESULTS 248 students were included (68.1% from Madridejos and 31.9% from Herencia) with a mean age of 14.67±1.1 years. The 47.2% were women. Only 4.8% of the participants affirm to talk about sexuality with their parents. The 56% declared had consumed pornographic content, with a mean first access age of 12.8±1 years. Significant statistically differences were found between the information received in schools and in the familiar surroundings, being alcohol and drug intake, sexually transmitted infections (STI), and contraceptive methods more frequently treated at the educational centers. A 25% of the surveyed students who reported having performed sexual relations stated not having used condom. Approximately, half of the participants did not perceive a high risk of getting STIs (HIV, herpes and chlamydia) in the case of having sex without condom. CONCLUSIONS There is a lack of sexual knowledge in adolescents, perceiving a noteworthy heterogeneity in the offered information depending on it is received in high school or in familiar surroundings.
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Affiliation(s)
- Isabel M Velasco-Gijón
- Centro de Salud de Madridejos; GAI Alcázar de San Juan. Alcázar de San Juan (Ciudad Real). España
| | - Ana Polo-Oliver
- Centro de Salud Alcázar I; GAI Alcázar de San Juan. Alcázar de San Juan (Ciudad Real). España
| | - Lucía Gutiérrez-Ramírez
- Unidad de Apoyo a la Investigación; Hospital Mancha Centro. Alcázar de San Juan (Ciudad Real). España
- Instituto de Investigación de Castilla-La Mancha (IDISCAM). Toledo. España
- Fundación del Hospital Nacional de Parapléjicos para la Investigación y la Integración. Toledo. España
| | - Ángel Arias-Arias
- Unidad de Apoyo a la Investigación; Hospital Mancha Centro. Alcázar de San Juan (Ciudad Real). España
- Instituto de Investigación de Castilla-La Mancha (IDISCAM). Toledo. España
| | - Antonio Tejera-Muñoz
- Unidad de Apoyo a la Investigación; Hospital Mancha Centro. Alcázar de San Juan (Ciudad Real). España
- Instituto de Investigación de Castilla-La Mancha (IDISCAM). Toledo. España
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Obach A, Blukacz A, Sadler M, Carreño Calderón A, Cabieses B, Díaz C. Barriers and facilitators to access sexual and reproductive health services among young migrants in Tarapacá, Chile: a qualitative study. BMC Public Health 2024; 24:386. [PMID: 38317103 PMCID: PMC10845769 DOI: 10.1186/s12889-024-17884-5] [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: 09/29/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Chile has become a destination country for immigrants from Latin America, including youth. Guaranteeing access and use of sexual and reproductive health services for young migrants is crucial because of their overlapping experiences of transitioning to a new country and to adulthood. However, the existing evidence shows barriers to accessing sexual and reproductive healthcare among young migrant populations. In this context, the main objective of this article is to identify the barriers and facilitators that young migrants experience to access sexual and reproductive healthcare in the Tarapacá region of Chile. METHODS A qualitative study was conducted in the Tarapacá region of Chile. Semi-structured interviews with 25 young migrants from Venezuela, Colombia, and Ecuador, as well as 10 health workers, were carried out. The interviews were transcribed and thematically analysed. The study was approved by the Ethics Committee of the Universidad del Desarrollo (#2019-22). RESULTS Young migrants face barriers linked to structural shortcomings within the healthcare system, which may be similar to those faced by the local population. Barriers are also derived from reductionist sexual and reproductive health approaches, which prioritise the prevention of pregnancy, sexually transmitted infections, and HIV, with a predominantly heteronormative focus. The prevailing narratives from the health system are those of risk and lack of control and self-care among young people, and they are exacerbated in the case of migrants. Young migrants, especially from the Caribbean, are stereotyped as over-sexualised and liberal in comparison to the local population and believed to be engaging in riskier sexual behaviours that should be kept under check. This may translate into experiences of discrimination and mistreatment when receiving care. Facilitators include good-quality information and community-level interventions. CONCLUSIONS This study shows a limited approach to the sexual and reproductive health of young migrants in Chile, severely hampering their reproductive and sexual rights. Policies and initiatives must work towards removing structural barriers, changing narratives, and empowering young migrants regarding their sexual and reproductive health.
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Affiliation(s)
- Alexandra Obach
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, y Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | - Alice Blukacz
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, y Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile.
| | - Michelle Sadler
- Departamento de Historia y Ciencias Sociales, Facultad de Artes Liberales, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Alejandra Carreño Calderón
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, y Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | - Báltica Cabieses
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, y Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | - Carolina Díaz
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, y Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
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Mrad H, Chouinard A, Pichette R, Piché L, Bilodeau K. Feasibility and Impact of an Online Simulation Focusing on Nursing Communication About Sexual Health in Gynecologic Oncology. J Cancer Educ 2024; 39:3-11. [PMID: 37698822 DOI: 10.1007/s13187-023-02366-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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/26/2023] [Indexed: 09/13/2023]
Abstract
Nurses' communication regarding the sexual health of women with gynecologic cancer is suboptimal and may be attributed to their lack of sexual health training and knowledge. Our study aims to document the learning experience, impacts, and feasibility of an online educational intervention activity between oncology nurses and a simulated participant on communication with patients regarding oncological sexual health. Using a qualitative approach, we conducted a feasibility study, which included 11 oncology nurses, and performed semi-structured individual interviews after our simulation exercise. We then conducted an iterative thematic data analysis. The participating nurses found the learning experience positive and satisfactory, despite issues with discussions between learners via Zoom™. Study nurse participants reported positive outcomes in knowledge, beliefs, attitudes, communication skills, and nursing practices. Finally, the educational intervention was found to be feasible. The online educational intervention involving a simulated participant appears to be a satisfactory, feasible, and promising module to improve communication regarding the sexual health of gynecologic cancer patients among oncology nurses. However, further studies are needed to verify this type of intervention's effectiveness and optimize oncology nurses' continuing education in sexual health.
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Affiliation(s)
- Hazar Mrad
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada.
- Center for Innovation in Nursing Education, Faculty of Nursing, University of Montreal, Montreal, QC, Canada.
| | - Audrey Chouinard
- Research Center of the Montreal University Hospital Center (CHUM), Montreal, QC, Canada
| | - Renée Pichette
- Montreal University Hospital Center (CHUM), Montreal, QC, Canada
| | - Lynda Piché
- Montreal University Hospital Center (CHUM), Montreal, QC, Canada
| | - Karine Bilodeau
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
- Center for Innovation in Nursing Education, Faculty of Nursing, University of Montreal, Montreal, QC, Canada
- Research Center of the Montreal University Hospital Center (CHUM), Montreal, QC, Canada
- Research Center of the Centre Intégré Universitaire de Santé Et de Services Sociaux de L'Est-de-L'Île-de-Montréal, Montreal, QC, Canada
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Wetzel GM, Sanchez DT. "What's Something You've Heard About Sex, But Are Unsure If It's True?": Assessing Middle and High School Students' Sex Education Questions. J Adolesc Health 2024; 74:327-339. [PMID: 37804300 DOI: 10.1016/j.jadohealth.2023.08.028] [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: 03/02/2023] [Revised: 07/25/2023] [Accepted: 08/16/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE Comprehensive sex education (CSE) encourages safer sex behavior for teens and young adults. However, young people recognize a gap between sex education as taught in the classroom and the reality of their sexual experiences. Thus, CSE should take into account the perspectives of its target population. METHODS The current project assesses young people's sexual uncertainties by analyzing open-ended responses that were anonymously submitted during in-person sex education sessions. These education programs were administered in middle and high schools in New York State by facilitators from Planned Parenthood Hudson Peconic, Inc. The authors analyzed 1,335 responses from a racially diverse sample of students between the ages of 10 and 21, with 75% of participants between 15 and 17 years old. RESULTS Using content analysis, the authors identified 49 recurring content codes in participants' responses, which were organized into 16 categories. Most responses centered around pregnancy, sexually transmitted infections, and how to prevent these outcomes. However, responses also highlighted topics that are not always covered with nuance and transparency, if at all, in sex education (e.g., withdrawal, effectiveness of condoms and other contraception, anal and oral sex). Additionally, gender analyses indicated that girls made greater reference to pain, while boys made greater reference to pleasure, which has implications for girls' development of a positive sexuality. DISCUSSION These results should be interpreted with a social equity lens to inform the development of needs-driven, target-based CSE programming.
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Affiliation(s)
- Grace M Wetzel
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey.
| | - Diana T Sanchez
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey
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King AJ, Bilardi JE, Maddaford K, Fairley CK, Chow EP, Phillips TR. Sexual health clinic attendees' views on antibiotic post-exposure prophylaxis and vaccinations for sexually transmitted infections prevention: A qualitative study. Prev Med Rep 2024; 38:102628. [PMID: 38375181 PMCID: PMC10874840 DOI: 10.1016/j.pmedr.2024.102628] [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: 10/02/2023] [Revised: 12/19/2023] [Accepted: 01/20/2024] [Indexed: 02/21/2024] Open
Abstract
Background The rising prevalence of bacterial sexually transmitted infections (STIs) is cause for concern in the context of antimicrobial resistance and the potential health outcomes of untreated infections. Objective The Community Awareness and Surveillance of Transmission (CAST) study sought sexual health service users' views on reducing the prevalence of STIs. Methods Semi-structured interviews were conducted with sexual health clinic attendees who had received a diagnosis of chlamydia, gonorrhea or syphilis in the previous six months. Participant comments relating to antibiotic post-exposure prophylaxis (APEP) and vaccination were inductively coded, then compared using comparative qualitative data analysis methods described by Miles and Huberman. Findings Twenty-one participants with differing genders, ages, nationalities and sexual orientations, were interviewed. Participants across informant groups expressed concerns about APEP for STI prevention because of potential antimicrobial resistance and personal health impacts. Vaccination against bacterial STIs was more acceptable. Common factors mentioned in relation to both interventions included perception of individual STI risk over time, safety, effectiveness and accessibility. Conclusions The views of sexual health service users support efforts to find alternatives to more frequent use of antibiotics, such as vaccinations against bacterial STIs, to reduce STI incidence and support antimicrobial stewardship.
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Affiliation(s)
- Alicia J. King
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
| | - Jade E. Bilardi
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kate Maddaford
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
| | - Christopher K. Fairley
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
| | - Eric P.F. Chow
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Tiffany R. Phillips
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
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Adrian Parra C, Stuardo Ávila V, Contreras Hernández P, Quirland Lazo C, Bustos Ibarra C, Carrasco-Portiño M, Belmar Prieto J, Barrientos J, Lisboa Donoso C, Low Andrade K. Structural and intermediary determinants in sexual health care access in migrant populations: a scoping review. Public Health 2024; 227:54-62. [PMID: 38118243 DOI: 10.1016/j.puhe.2023.11.031] [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: 07/14/2023] [Revised: 10/27/2023] [Accepted: 11/15/2023] [Indexed: 12/22/2023]
Abstract
OBJECTIVES Addressing migrant population's sexual health needs is essential, given the high vulnerability of this population, especially during migratory trajectories and when accessing health care in destination countries. The aim of this scoping review is to identify and describe the structural and intermediary determinants and their dimensions, which negatively influence sexual healthcare access in migrant population in the world in the last 20 years. STUDY DESIGN Scoping review. METHODS The search strategy was carried out in the databases PubMed/MEDLINE, Web of Science, EMBASE, and CINAHL. The inclusion criteria were primary studies published in English or Spanish from 2000 to 2022, describing determinants or barriers to access to sexual health for international migrants, refugees, and asylum seekers. The construction of the results was based on the social determinants of health framework. RESULTS A total of 44 studies were included. Thirteen categories that negatively affect access to sexual health in migrants were identified-structural determinants: language and communication barriers, religious and cultural values, VIH stigma and discrimination, irregular migration status, financial constraints, racism and discrimination, gender inequalities, and lack of knowledge and awareness about sexuality and sexual health; and intermediary determinants: financial health coverage, privacy and confidentiality, health system navigation; health system and facilities, and psychosocial factors. CONCLUSION The most relevant dimensions identified as barriers to access to health services were "culture and societal values" and "health system". Identifying the determinants that affect migrants' access to sexual health is relevant for the formulation of public policies with sociocultural relevance and an intersectional and human rights approach.
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Affiliation(s)
- C Adrian Parra
- PhD in Biomedical Research Methodology and Public Health, Department of Pediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public Health, Universitat Autònoma de Barcelona, Spain
| | - V Stuardo Ávila
- Institute of Public Health, Universidad Andrés Bello, Santiago de Chile, Chile.
| | | | - C Quirland Lazo
- PhD in Biomedical Research Methodology and Public Health, Department of Pediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public Health, Universitat Autònoma de Barcelona, Spain; Health Technology Assessment Unit, Arturo López Pérez Foundation, Chile
| | - C Bustos Ibarra
- Department of Social Work, Faculty of Social Sciences, Universidad de Concepción, Concepción, Chile
| | - M Carrasco-Portiño
- Department of Obstetrics and of Childcare, Faculty of Medicine, Universidad de Concepción, Concepción, Chile
| | - J Belmar Prieto
- School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile
| | - J Barrientos
- Faculty of Psychology, Universidad Alberto Hurtado, Chile
| | - C Lisboa Donoso
- School of Dentistry, Faculty of Health Sciences, Universidad Autonoma de Chile, Chile
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Cihan E, Vural F. Effect of a telephone-based perioperative nurse-led counselling programme on unmet needs, quality of life and sexual function in colorectal cancer patients: A non-randomised quasi-experimental study. Eur J Oncol Nurs 2024; 68:102504. [PMID: 38310665 DOI: 10.1016/j.ejon.2024.102504] [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: 09/07/2023] [Revised: 12/13/2023] [Accepted: 01/04/2024] [Indexed: 02/06/2024]
Abstract
PURPOSE To investigate the effect of perioperative nurse-led counselling intervention on unmet needs, sexual function and quality of life in colorectal cancer patients. METHOD This quasi-experimental study included 82 patients who underwent colorectal cancer surgery (control n = 45, intervention n = 37). The telephone-based perioperative nurse-led counselling intervention, which contained implementation, follow-up, and assessment, was applied to start from pre-surgery to post-surgery 3rd month. Data were collected with the Unmet Needs of Cancer Survivors Scale, European Organisation for Treatment and Research of Cancer Quality of Life Scale-30, Colorectal-29, Female Sexual Function Index, and International Index of Erectile Function pre- and post-surgery 3rd-6th months. The control data was collected before the pandemic, and the intervention group throughout the pandemic. The Mann-Whitney-U, Wilcoxon rank test was used. RESULTS Compared to the control group, intervention group patients reported lower unmet and total needs scores (p = 0.000); higher quality of life (p = 0.000), physical, emotional (p = 0.000), role (p = 0.001), and social functioning scores (p = 0.002); lower fatigue (p = 0.000), constipation (p = 0.034), pain (p = 0.018), nausea-vomiting (p = 0.004), and insomnia scores (p = 0.003); and higher body image, anxiety (p = 0.000) and weight scores (p = 0.003), lower urinary frequency buttock pain (p = 0.000), dysuria (p = 0.001), abdominal pain (p = 0.001), fluctuance (p = 0.000), stool frequency (p = 0.002), and faecal incontinence (p = 0.006) scores at the sixth month (p < 0.05). There were no statistically significant differences between male and female sexual function scores (p > 0.05). CONCLUSIONS Perioperative nurse-led counselling reduced unmet needs and increased the overall quality of life by decreasing symptom levels but did not affect sexual health outcomes in patients with colorectal cancer surgery.
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Affiliation(s)
- Emel Cihan
- Department of Surgical Nursing, Faculty of Health Sciences, Kutahya Health Sciences University, 43100, Kutahya, Turkey.
| | - Fatma Vural
- Department of Surgical Nursing, Faculty of Nursing, Dokuz Eylul University, 35100, Izmir, Turkey.
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Nehmé L, Agostini A, Piclet H, Bargier J. [The place of sexual health in general medicine]. Gynecol Obstet Fertil Senol 2024; 52:86-94. [PMID: 38070675 DOI: 10.1016/j.gofs.2023.11.009] [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: 08/12/2023] [Revised: 11/15/2023] [Accepted: 11/28/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE Assessment of the practices and knowledge of general practitioners in Bouches-du-Rhône and Vaucluse regarding their patients's sexual health. METHOD A descriptive cross-sectional study was conducted among general practitioners in Bouches-du-Rhône and Vaucluse from January 12, 2023 to February 9, 2023. A questionnaire was developed and sent to general practitioners practicing in Bouches-du-Rhône and Vaucluse. It was distributed by personal and professional emails and numbers, and Bouches-du-Rhône and Vaucluse's medical order. The questionnaire was divided into three parts: the first collected demographic and epidemiological data, the second assessed knowledge and practices of general practitioners regarding the sexual health, and the last evaluated practitioner's obstacles to talking about sexual health. RESULTS Ninety-nine general practitioners responded to the questionnaire (99/276, 35.9%). In all, 30.3% obtained a rate of correct answers>60%. The general practitioners with the best response rates had training in sexology or a degree in gynecology (P=0.0109). In their practices, some topics such as contraception for adolescents, the reassessment of contraception, the search for vulvuvaginal disorders in postmenopausal patients are more addressed by doctors and in particular those of the female sex. Other topics such as sexual violence, male sexual dysfunction and sexual health in patients over 70 are less discussed in consultation. CONCLUSION The care of sexual health is an important part of global health, specific to the profession of general practitioner. The results of our study suggest that the knowledge and practices of general practitioners in Bouches-du-Rhône and Vaucluse, are perfectible. The establishment of professional training, consultation dedicated to prevention, or even better awareness of sexual health professionals would promote a better screening.
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Affiliation(s)
- Laurie Nehmé
- Faculté de médecine d'Aix-Marseille, Marseille, France.
| | - Aubert Agostini
- Department of Gynecology and Obstetrics, Assistance publique-Hôpitaux de Marseille, AP-HM, Marseille, France
| | - Hélène Piclet
- Department of Gynecology and Obstetrics, Assistance publique-Hôpitaux de Marseille, AP-HM, Marseille, France
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Douglas CM, Ahrens K, Dombrowski JC, Rodean J, Coker TR. Racial and Ethnic Differences in Chlamydia and Gonorrhea Testing Locations Among Medicaid-Insured Youth. J Adolesc Health 2024; 74:381-384. [PMID: 37804298 PMCID: PMC10841468 DOI: 10.1016/j.jadohealth.2023.08.032] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE Chlamydia trachomatis (CT) and Neisseria gonorrhea (GC) infections are common among 15- to 24-year-olds, with Black and Hispanic youth disproportionately affected. Understanding where youth receive CT/GC testing is necessary to address disparities in CT/GC care. Our objective was to identify if differences exist in CT/GC testing locations by race and ethnicity. METHODS We used 2019 MarketScan Medicaid data to examine CT/GC testing location by youth race and ethnicity. RESULTS There were 418,623 CT/GC tests during the study period. Tests were most frequently ordered at medical offices for all races and ethnicities, although less frequently for Black (37.6%) and Hispanic (37.3%) than for White youth (49.3%). Black youth were frequently tested in emergency departments (19.6%), while Hispanic youth were frequently tested in Federally Qualified Health Centers (19.0%). DISCUSSION We found significant racial and ethnic disparities in the location of CT/GC testing among Medicaid-insured-youth; these findings should be used to guide strategies that address inequities in CT/GC care.
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Affiliation(s)
| | - Kym Ahrens
- University of Washington School of Medicine, Seattle Children's Research Institute, Seattle, Washington
| | | | | | - Tumaini R Coker
- University of Washington School of Medicine, Seattle Children's Research Institute, Seattle, Washington
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Wirtz MR, Ahmad ZN, Ford JS. "What if I die and no one had ever romantically loved me?": sexual well-being in a sample of YA cancer survivors. J Cancer Surviv 2024; 18:186-195. [PMID: 36930436 PMCID: PMC10022557 DOI: 10.1007/s11764-023-01360-x] [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: 12/22/2022] [Accepted: 03/06/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE Among young adult (YA) cancer survivors, sexual health is often exclusively focused on sexual functioning, or the completion of sexual tasks. However, it has become clear that there is another element of sexual health, sexual well-being-one's subjective experience of sex (e.g., body image or sexual/romantic relationship satisfaction)-that may be just as impaired as sexual functioning. In this study, we sought to elucidate potential themes that YA cancer survivors experience that cross both sexual functioning and well-being, thus encouraging more comprehensive sexual health education among those diagnosed with cancer. METHODS Semi-structured interviews were conducted as part of a larger qualitative study. Three codes developed by a team of coders-Social Isolation: Dating and Sex, Self-Evaluative Emotion: Shame in Dating and Relationships, and Self-Evaluative Emotion: Shame in Body Image/Physical Ability Concerns-included both sexual functioning and sexual well-being, and therefore guided this analysis. RESULTS Our sample consisted of thirty-five YA cancer survivors who were predominately female (86%) and non-Latino White (77%). Four themes emerged: missing out/aging out, inability to please (potential) partners, body image concerns, and unmet needs for social support. CONCLUSION While current research has identified sexual functioning as making up most of the sexual health education that cancer survivors receive, there is an interrelationship between sexual functioning and sexual well-being. IMPLICATIONS FOR CANCER SURVIVORS The clinical ramifications of the data are clear: more work must be done to address sexuality within both the couple and the individual survivor, and that work cannot be exclusively devoted to sexual functioning.
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Affiliation(s)
- Megan R Wirtz
- Program in Psychology, The Graduate Center, City University of New York, 365 5th Avenue, New York, NY, 10016, USA.
- Department of Psychology, Hunter College, City University of New York, 695 Park Avenue, New York, NY, 10065, USA.
| | - Zeba N Ahmad
- Program in Psychology, The Graduate Center, City University of New York, 365 5th Avenue, New York, NY, 10016, USA
- Department of Psychology, Hunter College, City University of New York, 695 Park Avenue, New York, NY, 10065, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA
| | - Jennifer S Ford
- Program in Psychology, The Graduate Center, City University of New York, 365 5th Avenue, New York, NY, 10016, USA
- Department of Psychology, Hunter College, City University of New York, 695 Park Avenue, New York, NY, 10065, USA
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Bagherinia M, Dolatian M, Mahmoodi Z, Ozgoli G, Alavi Majd H. Predictors of social intermediate factors associated with sexual quality of life of women: systematic review and meta-analysis. BMC Womens Health 2024; 24:64. [PMID: 38267989 PMCID: PMC10809577 DOI: 10.1186/s12905-024-02899-2] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 01/11/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Sexual problems and diminished sexual quality of life can adversely affect the physical, psychological, and emotional health of women. The present study was done to determine the social intermediate factors of health associated with sexual quality of life in women of reproductive age. DESIGN Systematic review and Meta-analysis. DATA SOURCES Embase, Web of Science, PubMed/Medline (NLM), ProQuest, and CENTRAL. ELIGIBILITY CRITERIA Observational studies (cross-sectional, case-control, cohort) from 2010 to 2022 with no language constraints were included. The sexual quality of life, as the main variable of the study, has been evaluated using Symonds women's sexual quality of life scale (SQOL-F). The health social determinants intermediate factors based on WHO model were considered as exposure variables. DATA EXTRACTION AND SYNTHESIS The data of included studies were extracted by two independent persons through a researcher-made checklist according to the study aims. Quality assessment of studies was done using Newcastle-Ottawa instrument. R software (Version R-4.2.1) were used for meta-analysis. Publication bias was evaluated by Egger & Begg tests. Sensitivity analysis was done through one-out remove approach. RESULTS Eventually, 15 studies were eligible to be included in this systematic review and meta-analysis. Variables of depression, quality of marital relation, body image, self-esteem, physical activity, and sexual function were among the health social intermediate factors associated with sexual quality of life. Publication bias had no effect on the obtained results; no study affecting the results was found through sensitivity analysis. CONCLUSION Considering the relationship between modifiable factors and sexual quality of life, it seems that identification of these factors can be an important step towards designing interventional studies to help women experience enhanced sexual quality of life.
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Affiliation(s)
- Marzieh Bagherinia
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahrokh Dolatian
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- , Tehran, Iran.
| | - Zoherh Mahmoodi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Giti Ozgoli
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Carvalho AOD, Andrade LBD, Ruano FFLO, Wigg CMD, Marinheiro LPF. Knowledge, practices and barriers to access sexual health of women in the menopausal stages: a cross-sectional study with Brazilian gynecologists. BMC Womens Health 2024; 24:52. [PMID: 38238746 PMCID: PMC10795360 DOI: 10.1186/s12905-024-02901-x] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 01/11/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Sexual health access and care for women in the menopausal stages face significant barriers, presenting deficits in relation to diagnosis and treatment. Although epidemiological data indicate high prevalence of problems related to sexual health in this population, traditionally, the theme is not discussed in health care settings. This study aimed to analyze knowledge, practices and barriers to access sexual health of women in the menopausal stages in the context of women's health care in Brazil. METHODS With a cross-sectional design, a questionnaire was distributed electronically, encompassing variables related to knowledge; practices; and barriers to access sexual health of women in the menopausal stages. The data obtained were subjected to analysis using both descriptive and inferential statistics. Specifically, we employed multivariate analysis, employing multiple linear regression models, to discern potential factors associated with outcomes concerning the level of knowledge and the frequency of addressing the topic in professional practice. RESULTS The sample included 70 physicians with specialization in obstetrician/gynecologists who work in health care with women in the menopausal transition or postmenopausal women. A high level of self-reported knowledge about sexual health was identified. Regarding the practices, most of them reported directly proposing the subject and not using instruments. Although they reported frequently addressing the topic in general, topics related to vaginal lubrication, dyspareunia, and sexual dysfunction have been more present in the clinic compared to sexual orientation and women's relationship with themselves. The main barriers were time limitation and patient discomfort with the topic. The multivariate models indicated that female gynecologists and professionals with higher levels of knowledge on the subject had a higher frequency of addressing sexual health in clinical practice with women in menopausal stages. CONCLUSIONS Sexual health access and care for brazilian women in the menopausal stages presents discrepancies in the frequency of approach between the various topics, in addition to the predictive character of technical knowledge in the practices of professionals. To ensure universal access to sexual health services for this population, an active approach through specific instruments is important, as well as the reinforcement of strategies to improve the level of knowledge of professionals.
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Affiliation(s)
- Amanda Oliveira de Carvalho
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira - Fundação Oswaldo Cruz (IFF/Fiocruz), Avenida Rui Barbosa, 716, Flamengo, Rio de Janeiro, RJ, CEP 22250-020, Brazil.
| | | | - Flávia Fairbanks L O Ruano
- Universidade de São Paulo, São Paulo, SP, Brasil
- Miller School of Medicine - University of Miami, Miami, FL, USA
| | | | - Lizanka Paola Figueiredo Marinheiro
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira - Fundação Oswaldo Cruz (IFF/Fiocruz), Avenida Rui Barbosa, 716, Flamengo, Rio de Janeiro, RJ, CEP 22250-020, Brazil
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