1
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Chedraui P, Nappi RE. The significance of obesity for women's sexuality in the life span. Gynecol Endocrinol 2024; 40:2324994. [PMID: 38439174 DOI: 10.1080/09513590.2024.2324994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 02/17/2024] [Indexed: 03/06/2024] Open
Affiliation(s)
- Peter Chedraui
- Escuela de Postgrado en Salud, Universidad Espíritu Santo, Samborondón, Ecuador
| | - Rossella E Nappi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, Obstetrics and Gynecology Unit, IRCCS San Matteo Foundation, Pavia, Italy
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2
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Erkan V, Schröder J, Briken P, Tozdan S. Factors Associated With Contact Sexual Offending Among a Non-Forensic Sample of Women With Sexual Interest in Children - Results From an Anonymous Online Survey. Sex Abuse 2024; 36:418-440. [PMID: 36913772 DOI: 10.1177/10790632231159076] [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] [Indexed: 06/18/2023]
Abstract
This study aimed at assessing the extent to which factors associated with male child sexual offending may also be applicable to women with a self-identified sexual interest in children. Participants (n = 42) took part in an anonymous online survey covering questions about general characteristics, general sexuality, sexual interest in children, and previously-perpetrated contact child sexual abuse. Group comparisons between women who reported committing contact child sexual abuse compared to those who had not were conducted in terms of sample characteristics. Furthermore, the two groups were compared regarding the factors of high sexual activity, use of child abuse material, indication of ICD-11 pedophilic disorder diagnosis, exclusivity of sexual interest in children, emotional congruence with children, and childhood maltreatment. Our results revealed that high sexual activity, indication of ICD-11 pedophilic disorder diagnosis, exclusivity of sexual interest in children, and emotional congruence with children were associated with previous contact child sexual abuse perpetration. We recommend further research on potential risk factors relating to child sexual abuse on the part of women.
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Affiliation(s)
- Viola Erkan
- Department of Psychology, University of Potsdam, Potsdam, Germany
| | - Johanna Schröder
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute for Clinical Psychology and Psychotherapy, Department of Psychology, Medical School Hamburg, Germany
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Safiye Tozdan
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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3
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Ullman J, Hobby L, Ferfolja T. Revalidating a Measure of Parents' Attitudes Toward Gender and Sexuality Diversity-Inclusive Curricula in an Australian National Sample. J Homosex 2024; 71:1536-1559. [PMID: 36883979 DOI: 10.1080/00918369.2023.2178355] [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] [Indexed: 06/18/2023]
Abstract
This paper details revalidation of a higher-order (HO) version of the Parental Attitudes Toward Inclusiveness Instrument (PATII), measuring parents' attitudes toward curricular inclusivity of gender and sexuality diversity. The 48-item scale includes two HO factors: Supports and Barriers, and one first-order factor: Parental Capability. Responses from parents of government-school students (N = 2093) provided evidence for scale reliability, validity, and measurement invariance.
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Affiliation(s)
- Jacqueline Ullman
- Centre for Educational Research, School of Education, Western Sydney University, Penrith, NSW, Australia
| | - Lucy Hobby
- Centre for Educational Research, School of Education, Western Sydney University, Penrith, NSW, Australia
| | - Tania Ferfolja
- Centre for Educational Research, School of Education, Western Sydney University, Penrith, NSW, Australia
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4
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Nobels A, De Schrijver L, Van Landuyt M, Vandeviver C, Lemmens GMD, Beaulieu M, Keygnaert I. "In the End You Keep Silent": Help-Seeking Behavior Upon Sexual Victimization in Older Adults. J Interpers Violence 2024; 39:2318-2343. [PMID: 38149594 DOI: 10.1177/08862605231220017] [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] [Indexed: 12/28/2023]
Abstract
Sexual violence is considered a prominent mental health problem. Exposure to sexual victimization during lifetime has been linked to mental health problems in old age. Research in adult victims has shown that they experience many barriers for disclosure and seeking professional help upon sexual victimization. However, information on help-seeking behavior in older victims of sexual violence is non-existent. With this study we aim for a better understanding of help-seeking behavior upon sexual violence in older adults. We used a mixed methods approach with an explanatory sequential design. Data were collected through structured face-to-face interviews with a random sample of 227 sexual violence victims of 70 years and older living in Belgium. Quantitative data were triangulated with qualitative data from 15 in-depth interviews with older victims. We found that up to 60% of older sexual violence victims never disclosed their experiences and 94% never sought professional help. Help-seeking is a complex process comprising several phases, which are affected by strong feelings of shame and self-blame, ageist premises and taboos about sexuality. In the end, most victims choose to cope on their own. Occasional disclosure only happens decades after the sexual violence took place. Older victims do not spontaneously disclose to healthcare workers but expect professionals to initiate the conversation. In conclusion, few older victims disclose or seek professional help upon sexual victimization. Healthcare professionals working with older adults need capacity building through training, screening tools, and care procedures to initiate conversation on sexual violence, and to detect signs, prevent, mitigate and respond to sexual victimization in older adults.
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Affiliation(s)
- Anne Nobels
- Department of Public Health and Primary Care, International Center for Reproductive Health, Ghent University, Ghent, Belgium
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
| | - Lotte De Schrijver
- Department of Public Health and Primary Care, International Center for Reproductive Health, Ghent University, Ghent, Belgium
- Vlaamse Vereniging van Klinisch Psychologen, Brussels, Belgium
| | - Mira Van Landuyt
- Department of Public Health and Primary Care, International Center for Reproductive Health, Ghent University, Ghent, Belgium
| | - Christophe Vandeviver
- Department of Criminology, Criminal Law, and Social Law, Ghent University, Ghent, Belgium
| | - Gilbert M D Lemmens
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
- Department of Head and Skin-Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - Marie Beaulieu
- School of Social Work, Research Chair on Mistreatment of Older Adults and Research Center on Aging, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Ines Keygnaert
- Department of Public Health and Primary Care, International Center for Reproductive Health, Ghent University, Ghent, Belgium
- Women's Clinic, Ghent University Hospital, Ghent, Belgium
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5
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Dursun M, Besiroglu H, Ortac M, Tonyali S, Kadioglu A. The effect of transobturator tape surgery on female sexual function: a systematic review and meta-analysis. Arch Gynecol Obstet 2024; 309:2211-2221. [PMID: 38315200 DOI: 10.1007/s00404-023-07361-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/21/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE We aimed to review the literature regarding the effects of trans obturator tape surgery (TOT) on sexual functions in women with stress urinary incontinence (SUI) to reveal compact data and to reach more consistent and reliable results. METHODS PRISMA statement was used in the current review. The databases of PubMed (Medline), Science Direct, and Cochrane Central Register of Controlled Trials were detected independently. We evaluated the studies comparing the preoperative and postoperative sexuality parameters related to the TOT procedure in females. Studies presenting the mean and standard deviation(SD) of global and sub-item Female Sexual Function Index(FSFI) were included in the current study. RESULTS We identified 783 studies in full publications or abstract forms using the methodology above and the search terms. Finally, eight studies were included in the meta-analysis. The pooled analysis of the mean difference demonstrated that the total sexual function scores of the patients improved after TOT surgery. CONCLUSION The data collected from the current meta-analysis suggest that TOT surgery improves female sexual function.
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Affiliation(s)
- Murat Dursun
- Faculty of Medicine, Department of Urology, Istanbul University, Istanbul, Turkey
| | - Huseyin Besiroglu
- Cerrahpasa Medical Faculty, Faculty of Medicine, Department of Urology, Istanbul University Cerrahpasa, Koca Mustafapaşa Cd. No:53, 34098, Fatih/Istanbul, Turkey.
| | - Mazhar Ortac
- Faculty of Medicine, Department of Urology, Istanbul University, Istanbul, Turkey
| | - Senol Tonyali
- Faculty of Medicine, Department of Urology, Istanbul University, Istanbul, Turkey
| | - Ates Kadioglu
- Faculty of Medicine, Department of Urology, Istanbul University, Istanbul, Turkey
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6
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Gewirtz-Meydan A. Traumatized Sexuality: Understanding and Predicting Profiles of Sexual Behaviors Using Childhood Abuse and Trauma Measures. Child Maltreat 2024; 29:350-363. [PMID: 36583251 DOI: 10.1177/10775595221148425] [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] [Indexed: 06/17/2023]
Abstract
In the current study we sought to identify sexual behavior profiles and examine the levels of childhood abuse history and trauma measures in each profile. The study was conducted among a large non-clinical sample of men and women (n = 806). Latent profile analysis was employed to identify distinct profiles of sexual behaviors and then childhood abuse, posttraumatic stress disorder (PTSD), depression, and anxiety, and motives for engaging in sex were assessed in each profile. Four distinct profiles of sexual behavior were identified: hyposexual individuals, hypersexual porn users, porn users, and within usual ranges (WURs). Hypersexual porn users had significantly more childhood trauma (emotional, physical, and sexual) than WURs, significantly greater PTSD symptom than WURs and hyposexual individuals, and significantly greater anxiety and depression as compared with all other groups. The hyposexual individuals had significantly lower scores on all motives for engaging in sex than did porn users or hypersexual porn users. Hypersexual porn users and porn users reported coping and peer-pressure as motives for engaging in sex more than did WURs or hyposexual individuals. Clinicians working with survivors of childhood abuse should consider directly targeting these different maladaptive sexual behaviors by addressing PTSD symptoms, affective disorders, and motives for engaging in sex.
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Affiliation(s)
- Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
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7
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Estruch-García V, Gil-Llario MD, Fernández-García O. Sexual experiences and knowledge of people with moderate intellectual disability. J Intellect Disabil Res 2024; 68:512-523. [PMID: 38304997 DOI: 10.1111/jir.13125] [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: 10/02/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND This study addresses the sexuality of people with moderate intellectual disabilities (PMID), a topic that has been little studied. Understanding romantic and sexual experiences is highly relevant for reducing stigma and prejudice related to their sexuality. Additionally, comprehending the level of sexual knowledge of PMID contributes to the development of preventive and sexual health education programmes tailored for this group. Our aim is to explore the sexual history (relationships, sexual behaviour, condom use and sexual abuse), sex education received and the level of sexual knowledge of PMID. METHOD The total of 142 PMID completed questionnaires about sexual knowledge and experiences, and their support staff provided additional information. Data were analysed using chi-square test (χ2) and descriptive statistical analysis. RESULTS Masturbation was the most common sexual behaviour (75.7%), especially among men (χ2 = 5.81, P < 0.05). Sexual intercourse was rare, and only 30.5% reported using condoms. Women reported a higher prevalence of self-reported sexual abuse (27.3% vs. 6% in men). The study also highlighted misconceptions about sexual intercourse risks and contraceptive methods. CONCLUSION The results suggest that PMID need sexual education to ensure healthy sexual experiences and prevent risky behaviour.
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Affiliation(s)
- V Estruch-García
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - M D Gil-Llario
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - O Fernández-García
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
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8
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Tozzi M, Jannello LMI, Silvaggi M, Michetti PM. Anxiety, depression, urinary continence, and sexuality in patients undergoing radical prostatectomy: preliminary findings. Support Care Cancer 2024; 32:294. [PMID: 38635029 DOI: 10.1007/s00520-024-08503-5] [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: 11/25/2023] [Accepted: 04/13/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVES Evaluate the relationship between psychological distress, namely anxiety and depression, with urinary continence and recovery of erectile function in patients undergoing radical prostatectomy (RP). METHODS We retrospectively analyzed data from 33 consecutive patients who underwent RP in a single tertiary-referral academy between 01/2018 to 01/2019. We used the International Index of Erectile Function (IIEF-15), the Sexual Complaints Screener for Men (SCS-M), and the Hospital Anxiety and Depression Scale (HADS), validated questionnaires for the assessment of sexual function, anxiety, and depression experiences, respectively. These questionnaires were administered at the pre-surgical visit, after surgery, and at intermediate follow-ups (three, six, and twelve months). RESULTS The analysis of the questionnaires completed during follow-up shows that erectile function is the most affected, with 90% erectile dysfunction (ED) at three months after surgery. In terms of emotional states, anxiety prevails in the first months following surgery and is statistically significantly associated with incontinence (p = 0.02). Depressive symptoms, on the other hand, appear later and prevail over anxiety at six months after surgery, although not statistically significant. CONCLUSIONS In the early post-surgical phase anxiety and ED are the most frequently detected components, while depressive experiences and decreased desire, typical of later stages, have not yet fully emerged.
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Affiliation(s)
- Marco Tozzi
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, Milan, Italy
- Università Degli Studi Di Milano, Milan, Italy
| | - Letizia Maria Ippolita Jannello
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, Milan, Italy.
- Università Degli Studi Di Milano, Milan, Italy.
| | - Marco Silvaggi
- Institute of Clinical Sexology (ISC), Via Savoia 78, 00198, Rome, Italy
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Acevedo Ayala J, Solari Del Sol A, Arroyo Concha M, Tirreau Román D. Literature review on sexuality in the elderly: What is being taught and with what technologies. Medwave 2024; 24:e2710. [PMID: 38621376 DOI: 10.5867/medwave.2024.03.2710] [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: 04/17/2024] Open
Abstract
Chile is facing an increasingly aging population and, with it, changes in its demographic, epidemiological, and healthcare structure. As a result, the sexual health of the elderly is an emerging area at the social level and in healthcare systems. This research aims to identify general aspects of sexuality in the elderly and learn about educational content delivered to this group using digital technologies. To do this, we proposed a review of scientific literature on the subject between January 1st, 2018, and December 31st, 2022, in the databases Web of Science, MEDLINE/PubMed, LILACS, Cochrane, Scopus, and Google Scholar. The articles found, and the emerging information was analyzed. A total of 1573 articles were found, of which 21 papers were finally included, 11 with qualitative methodology, six quantitative, and four mixed. In addition, nine addressed the area of sexuality, and 12 focused on technological innovations for the elderly. Sexuality is a growing topic worldwide, carrying with it sociocultural beliefs associated with dogmatic opinions and myths, with discrimination against this age group, especially if they belong to sexual minorities. This group also has better access to new digital technologies that facilitate access to training, social integration, and timely healthcare. Scientific evidence shows that the sexuality of the elderly is a topic of global interest, invisibilized, with low education and training of healthcare workers. The latter are neither informed nor able to solve the reasons for consultation in the traditional way or with new digital health technologies.
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Affiliation(s)
- Jhonny Acevedo Ayala
- Departamento de Atención Primaria y Salud Familiar, Universidad de Chile, Facultad de Medicina, Santiago, Chile
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10
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Baumann SE, Leeson L, Raonivololona M, Burke JG. Exploring the multi-level impacts of a youth-led comprehensive sexuality education model in Madagascar using Human-centered Design methods. PLoS One 2024; 19:e0297106. [PMID: 38598416 PMCID: PMC11006148 DOI: 10.1371/journal.pone.0297106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/24/2023] [Indexed: 04/12/2024] Open
Abstract
Comprehensive sexuality education (CSE) is recognized as a critical tool for addressing sexuality and reproductive health challenges among adolescents. However, little is known about the broader impacts of CSE on populations beyond adolescents, such as schools, families, and communities. This study explores multi-level impacts of an innovative CSE program in Madagascar, which employs young adult CSE educators to teach a three-year curriculum in government middle schools across the country. The two-phased study embraced a participatory approach and qualitative Human-centered Design (HCD) methods. In phase 1, 90 school principals and administrators representing 45 schools participated in HCD workshops, which were held in six regional cities. Phase 2 took place one year later, which included 50 principals from partner schools, and focused on expanding and validating findings from phase 1. From the perspective of school principals and administrators, the results indicate several areas in which CSE programming is having spill-over effects, beyond direct adolescent student sexuality knowledge and behaviors. In the case of this youth-led model in Madagascar, the program has impacted the lives of students (e.g., increased academic motivation and confidence), their parents (e.g., strengthened family relationships and increased parental involvement in schools), their schools (e.g., increased perceived value of schools and teacher effectiveness), their communities (e.g., increased community connections), and impacted broader structural issues (e.g., improved equity and access to resources such as menstrual pads). While not all impacts of the CSE program were perceived as positive, the findings uncovered opportunities for targeting investments and refining CSE programming to maximize positive impacts at family, school, and community levels.
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Affiliation(s)
- Sara E. Baumann
- University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA, United States of America
| | | | | | - Jessica G. Burke
- University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA, United States of America
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11
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Caiada M, Felix S, Guionnet S, Valery KM, Bonilla-Guerrero J, Destaillats JM, Prouteau A. Promoting Intimate Relationships in Mental Illness: A Systematic Review of Interventions. Community Ment Health J 2024; 60:536-551. [PMID: 38015269 DOI: 10.1007/s10597-023-01204-z] [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: 06/01/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023]
Abstract
Although persons with Serious Mental Illness (SMI) express a need for intimate relations with others, they still suffer from a severe lack of social participation in this domain. However, these unmet needs have received little attention until recently. This study reviews interventions that aim to facilitate the development and the maintenance of intimate relationships (IR) of persons with schizophrenia, bipolar disorder and major depression. A systematic review following PRISMA guidelines was conducted. Studies published in Scopus, PubMed, EBSCO (Psych INFO, Psych ARTICLES, Psychology and Behavioral Sciences Collection) from January 1, 2000, to December, 2021, were screened. The search using terms referring to "schizophrenia", "bipolar disorder", "major depression", "IR" and "interventions" revealed 11 studies. Among them, 10 reported interventions for persons with depression, including 9 for couple therapy. Most interventions targeted satisfaction with couple relationships as the main therapeutic objective. Heterogeneity in study design precludes any firm conclusions about their efficacy. Interestingly, only one intervention focused on single persons interested in developing IR. The results highlight the lack of interventions: (i) aimed at promoting IR, (ii) designed for single persons, and (iii) targeting persons with psychotic disorders. This result may reflect the persisting stigmatization of persons with psychotic disorders, and the taboo associated with the IR and sexuality of persons with mental illness. Further studies are needed to develop inclusive interventions promoting the development of IR in persons with mental illness.
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Affiliation(s)
- Meryl Caiada
- Laboratory of Psychology, LabPsy, UR 4139, University of Bordeaux, 33000, Bordeaux, France.
| | - Simon Felix
- Laboratory of Psychology, LabPsy, UR 4139, University of Bordeaux, 33000, Bordeaux, France
- Department of Adult Psychiatry, Jonzac Hospital, Jonzac, France
| | - Sarah Guionnet
- Laboratory of Psychology, LabPsy, UR 4139, University of Bordeaux, 33000, Bordeaux, France
| | - Kevin-Marc Valery
- Laboratory of Psychology, LabPsy, UR 4139, University of Bordeaux, 33000, Bordeaux, France
| | | | | | - Antoinette Prouteau
- Laboratory of Psychology, LabPsy, UR 4139, University of Bordeaux, 33000, Bordeaux, France
- Department of Adult Psychiatry, Jonzac Hospital, Jonzac, France
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12
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Moore M, Balascio P, Bonner-Johnson T, Garth J, Brinkman B, Hill AV. Implementing Comprehensive Sex and Sexuality Education in Kindergarten-Grade 12 Schools: Guiding Practices and Examples. J Sch Health 2024; 94:374-379. [PMID: 38351584 DOI: 10.1111/josh.13431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 12/08/2023] [Accepted: 12/20/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND Comprehensive sex and sexuality education (CSE) is an evidence-based intervention associated with improved sexual and reproductive health outcomes. Currently, there are no standardized requirements for sex and sexuality education in the United States, despite expert recommendations. CONTRIBUTIONS TO THEORY In the United States, a Whole School, Whole Community, Whole Child theoretical model proposed by the Centers for Disease Control, and current examples of school sex education policy is used to make recommendations for the standardization of comprehensive sexual health education in K-12 schools. This article describes the necessary components to adopt CSE equitably, and provides an example of the process implemented to improve CSE in 1 school district in Pittsburgh, PA. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Understanding the key components of legislation that align with recommended standards, and the process of advocating for school policy change, allows local advocacy groups and education policymakers to create and pass feasible legislation that will ensure appropriate instruction. There is additional room for improvement in states and local districts that have current CSE legislation, to adopt approaches grounded in frameworks that critically evaluate social determinants of health and amend legislation to further improve health equity. CONCLUSIONS Several states and local districts have passed CSE regulations, and are implementing and evaluating their efficacy, providing support and examples for other regions interested in adopting similar policies and processes. Pittsburgh Public Schools can be used as an example adapting current legislation and adopting more comprehensive language.
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Affiliation(s)
- Mikaela Moore
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Phoebe Balascio
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Tausha Bonner-Johnson
- Health & Wellness Workgroup, Black Girls Equity Alliance, New Voices for Reproductive Heath, Pittsburgh, PA
| | - José Garth
- Health & Wellness Workgroup, Black Girls Equity Alliance, Gwen's Girls, Pittsburgh, PA
| | - Britney Brinkman
- Black Girls Equity Alliance, Gwen's Girls, Pittsburgh, Pennsylvania; Department of Psychology, Point Park University, Pittsburgh, PA
| | - Ashley V Hill
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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Cunningham E, Benítez ME. From pathology to pleasure: Reframing mechanistic studies on same-sex sexual behavior in primates. Horm Behav 2024; 160:105476. [PMID: 38278061 DOI: 10.1016/j.yhbeh.2024.105476] [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: 09/05/2023] [Revised: 12/11/2023] [Accepted: 01/07/2024] [Indexed: 01/28/2024]
Abstract
Same-sex sexual behaviors (SSB) in primates have historically been studied as sexual perversions, evolutionary paradoxes, and hormone-driven pathologies. Researchers in recent decades have challenged these perspectives, yet some of the original biases still linger. In this paper, we examine how the study of endocrinological mechanisms in SSB has been influenced by the historical framework of pathology. Societal attitudes and cultural conceptions of human sexuality have led researchers to study SSB in primates as the outcome of "abnormal" processes of "feminization" or "masculinization" of sexual behavior. Here, we argue for a renewed attention to other areas of inquiry regarding the relationship between hormones and SSB, such as the role of pleasure. We briefly review how current knowledge on the neuroendocrinology of pleasure in nonhuman primates may relate to the expression of SSB and highlight oxytocin and dopamine as potentially fruitful areas for future research. We argue that future studies on SSB in primates would benefit from 1) acknowledging how the historical study of SSB as a pathology has shaped mechanistic studies and 2) studying SSB with the same holistic approach as is taken with different-sex sexual behavior (DSB).
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Affiliation(s)
- Evan Cunningham
- Department of Anthropology, Emory University, Atlanta, GA, United States of America
| | - Marcela E Benítez
- Department of Anthropology, Emory University, Atlanta, GA, United States of America.
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14
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Colombo A, Carbajal M, Milani R. Social Representations and Experiences of Sexual Transactions Among Swiss Youth. Arch Sex Behav 2024; 53:1431-1447. [PMID: 38413533 PMCID: PMC10954841 DOI: 10.1007/s10508-024-02814-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 02/29/2024]
Abstract
This article relies on quantitative data collected in Switzerland as part of a research study on sexual transactions among youth. Building on an analytical framework that defines sexual transactions in terms of negotiated exchanges rooted in social representations, we explored how they were perceived by the Swiss young people included in our sample at a cognitive, ethical, and political level. We found that research participants who reported having experienced sexual transactions viewed them much more positively than those who reported never having engaged in such exchanges. While this was especially true among young women, we also found that the tendency of respondents to perceive sexual transactions negatively increased with age. When analyzed in light of the qualitative results of our study, these quantitative findings suggest that negative representations of sexual transactions are less likely to be based on lived experience than on an ideal-type of sexual behavior. In other words, our research highlights how young people interpret sexuality according to norms developed within a heteronormative matrix.
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Affiliation(s)
- Annamaria Colombo
- School of Social Work, HES-SO, University of Applied Sciences and Arts Western Switzerland, Fribourg, 1700, Switzerland.
| | - Myrian Carbajal
- School of Social Work, HES-SO, University of Applied Sciences and Arts Western Switzerland, Fribourg, 1700, Switzerland
| | - Riccardo Milani
- School of Social Work, HES-SO, University of Applied Sciences and Arts Western Switzerland, Fribourg, 1700, Switzerland
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15
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Kürne HG, Akbayrak T. The validity and reliability of the Turkish version of the Postmenopause Sexuality Questionnaire. Int J Gynaecol Obstet 2024; 165:188-193. [PMID: 38084782 DOI: 10.1002/ijgo.15293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 11/13/2023] [Accepted: 11/28/2023] [Indexed: 03/17/2024]
Abstract
OBJECTIVE To translate and to validate the Postmenopause Sexuality Questionnaire (PMSQ) for Turkish women in the climacteric. METHODS The study included 356 menopausal women with a mean age of 60.2 ± 7.6 years. First, the demographic characteristics and obstetric information of the women were recorded. Then, the PMSQ was adapted into Turkish. In order to determine the sexual activity and menopause-specific quality of life, the Female Sexual Function Index (FSFI), The Menopause Specific Quality of Life Questionnaire (MENQOL), and the PMSQ were administered. The reliability and validity of the PMSQ were assessed with internal consistency, test-retest, and criterion validity analyses. RESULTS According to the results of the study, the internal consistency (Cronbach's α = 0.97) and test-retest reliability (r = 0.95) of the PMSQ were found to be high (P < 0.001). Criterion validity was established based on the relationship of PMSQ scores with FSFI (r = 0.76; P < 0.001) and MENQOL (r = -0.47, P < 0.001) scores. CONCLUSION According to this study, it was determined that the Turkish version of the PMSQ can be a valid and reliable scale to evaluate sexual activity in Turkish menopausal women.
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Affiliation(s)
- Hatice Gülşah Kürne
- Division of Physiotherapy and Rehabilitation, Institute of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Türkan Akbayrak
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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16
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Scotto L, Pizzoli SFM, Marzorati C, Mazzocco K, Pravettoni G. The impact of prophylactic mastectomy on sexual well-being: a systematic review. Sex Med Rev 2024; 12:164-177. [PMID: 38185919 DOI: 10.1093/sxmrev/qead054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION Considering the increasing women's awareness of health promotion and disease prevention programs, mutation carriers are inevitably asked to face important decisions concerning the possibility of undergoing prophylactic mastectomy. Risk-reducing mastectomy (RRM) has become increasingly more common, although it has a significant impact on women's quality of life and sexual well-being. OBJECTIVES The systematic review aims to evaluate the impact of RRM on the sexuality of women with breast cancer. METHODS According to Cochrane Collaboration guidelines and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, the study quantified the effects of frontline work on the mental health of healthcare workers. This review followed the PRISMA guidelines. Three databases were systematically searched from inception to December 2022. The expression ("sexuality" OR "sexual" OR "sex") AND ("prophylactic mastectomy" OR "risk-reducing mastectomy") was searched in PubMed, Ovid Medline, and Embase. Twenty-two articles published in English until 2022 were selected. RESULTS Two studies investigated sexual experience after risk-reducing surgeries as a single outcome, while other studies analyzed the relationship between sexuality and psychosocial outcomes, risk perception, and satisfaction. In all of the included studies, significant findings in sexual dysfunction were found. The most reported problems were related to sexual satisfaction and attractiveness, body image, and loss of femininity. Last, women reported changes in the relationship with their partners. CONCLUSION RRM has a major impact on body image that affects sexual functioning and quality of life. These implications must be considered during treatment selection.
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Affiliation(s)
- Ludovica Scotto
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy
| | - Silvia Francesca Maria Pizzoli
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
- Facoltà di Psicologia, Università Cattolica del Sacro Cuore, Largo A. Gemelli 1, 20123 Milan, Italy
| | - Chiara Marzorati
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy
| | - Ketti Mazzocco
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
| | - Grabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
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17
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Ramírez-Santos J, Cristóbal-Cañadas D, Parron-Carreño T, Lozano-Paniagua D, Nievas-Soriano BJ. The problem of calculating the prevalence of sexual dysfunction: a meta-analysis attending gender. Sex Med Rev 2024; 12:116-126. [PMID: 38336366 DOI: 10.1093/sxmrev/qead058] [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: 09/06/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 02/12/2024]
Abstract
INTRODUCTION Sexuality is an integral part of human health, and sexual dysfunctions are prevalent issues that affect men and women. While reviews on sexual dysfunctions in various diseases have been conducted, overall data are scarce. OBJECTIVES To update the overall prevalence of sexual dysfunctions from available prevalence studies on both sexes. METHODS We used a 2-phase selection process to include cross-sectional studies that were conducted on the adult population and published between 2017 and 2022. The extracted data were prevalence, methodology, sample size, and location. Sensitivity and subgroup analyses were conducted to assess heterogeneity. RESULTS This review analyzed 4407 studies. Twenty-three met the established criteria: 9 on the male population and 14 on the female population. The meta-analysis included 7 articles on males and 13 on females. The prevalence of sexual dysfunction was 31% in men and 41% in women, with significant heterogeneity among the studies. Sociocultural differences and use of varying measurement methods were identified as the main factors contributing to heterogeneity. Subgroup analysis revealed decreased heterogeneity among studies that used the Female Sexual Function Index as a diagnostic tool for females. CONCLUSIONS The review highlights the notable variability in results due to methodological and geographic variations. Therefore, enhancing the training of professionals and standardizing the recording of patient data-through the Female Sexual Function Index and Male Sexual Health Questionnaire or by developing new ones for this purpose-could improve the consistency of research on sexual health.
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Affiliation(s)
| | | | - Tesifón Parron-Carreño
- Department of Nursing, Physiotherapy, and Medicine, University of Almería, Almería, 04120, Spain
| | - David Lozano-Paniagua
- Department of Nursing, Physiotherapy, and Medicine, University of Almería, Almería, 04120, Spain
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18
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Mills-Finnerty C, Staggs H, Bittoni C, Wise N. Affective neuroscience: applications for sexual medicine research and clinical practice. Sex Med Rev 2024; 12:127-141. [PMID: 38281754 DOI: 10.1093/sxmrev/qead048] [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: 11/02/2022] [Revised: 10/03/2023] [Accepted: 10/26/2023] [Indexed: 01/30/2024]
Abstract
INTRODUCTION Affective neuroscience is the study of the brain substrates of emotional, embodied experiences. Affective neuroscience theory (ANT) is based on experimental evidence that all mammals are hardwired with 7 primary subcortical emotional operating systems, or "core emotions," that have overlapping but distinct circuits buried in the deep, ancient parts of the brain. Imbalances in the 7 core emotions can affect multiple aspects of the individual's psychosocial well-being (eg, depression, anxiety, substance abuse). Here, we propose that core emotions can also influence sexual function and, specifically, that imbalances in core emotions are the bridge connecting psychiatric symptoms (eg, anhedonia) to sexual dysfunction (eg, anorgasmia). OBJECTIVES In this targeted review and commentary, we outline potential connections between ANT and sexual medicine research and clinical practice. We summarize ANT by defining the 3-level BrainMind and core emotions; examining how they relate to personality, behavior, and mental health; and determining the implications for sexual health research and clinical practice. METHODS A targeted literature review was conducted. Case studies were adapted from client files and clinician interviews and then anonymized. RESULTS We propose a novel organizational schema for implementing affective balance therapies for sexual dysfunction, which integrate psychoeducational, somatic, and cognitive therapeutic approaches under the ANT framework. We provide 3 patient case studies (anorgasmia, hypersexuality, spinal cord injury) outlining the implementation of this approach and patient outcomes. CONCLUSION ANT has practical translational applications in sexual health research and clinical practice. By integrating our understanding of the role of core emotions in human sexuality, clinicians can better tailor treatments to address sexual dysfunction.
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Affiliation(s)
- Colleen Mills-Finnerty
- Mental Illness Research, Education, and Clinical Care, Palo Alto Veterans Health Care System, Palo Alto, CA 94304, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA 94304, United States
| | - Halee Staggs
- Mental Illness Research, Education, and Clinical Care, Palo Alto Veterans Health Care System, Palo Alto, CA 94304, United States
| | - Celeste Bittoni
- Department of Psychology, University of Padova, Padova 2 35122, Italy
| | - Nan Wise
- Department of Psychology, Rutgers University, Newark, NJ 07102, United States
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19
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Wittrock J. A human right to pleasure? Sexuality, autonomy and egalitarian strategies. J Med Ethics 2024; 50:263-267. [PMID: 37277174 PMCID: PMC10958316 DOI: 10.1136/jme-2023-109011] [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: 02/16/2023] [Accepted: 05/19/2023] [Indexed: 06/07/2023]
Abstract
A growing focus on pleasure in human rights discourse has been used to address patterns of sexual exclusion, often when addressing the problems of people with disabilities (PWD). As convincingly argued by Liberman, however, not all PWD suffer from sexual exclusion, and not all who suffer from sexual exclusion are PWD. Danaher and Liberman have thus argued in various ways for a broader range of measures, addressing sexual exclusion. This article builds on previous research and offers a conceptual framework for addressing sexual pleasure and exclusion in terms of human rights. It argues that human rights aim to safeguard autonomy, which is interpreted as multidimensional. It, thus, divides autonomy into the four dimensions of liberty (freedom from threat and coercion), opportunity (options to choose between), capacity (what an agent is capable of doing) and authenticity (the extent to which choices are genuine). Furthermore, it distinguishes between distinct egalitarian strategies, which offer different problems and possibilities, and may be combined. Thus, there is direct egalitarian distribution, indirect egalitarian distribution, baseline or threshold strategies and general promotion strategies. By way of conclusion, the importance of sexual authenticity as the ultimate aim of sexual rights is emphasised.
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Affiliation(s)
- Jon Wittrock
- Global Political Studies, Malmö Universitet, Malmö, Sweden
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20
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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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21
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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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22
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Anantapong K, Burapakiat B, Ananchaisarp T. Sex and concepts of sexuality influence sexual problems and help-seeking behaviours of older people. J Women Aging 2024; 36:139-151. [PMID: 37922193 DOI: 10.1080/08952841.2023.2276636] [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: 04/26/2023] [Accepted: 10/15/2023] [Indexed: 11/05/2023]
Abstract
In this study, we aimed to examine the prevalence, associated factors, and management of sexual problems in older people at a primary care unit. We recruited people aged 60 years old and over, who visited the Primary Care Unit of Songklanagarind Hospital, a tertiary-care and referral centre in Southern Thailand, between June and August 2021, and used a self-administered questionnaire on sexuality, sexual problems, help-seeking behaviours, and clinical consultations for sexual problems in older people. There were 190 participants in this study (120 women, 70 men, mean age = 68.3). One hundred and five (55.3%) participants reported having sexual problems. Compared to their female counterparts, males were more likely to have sexual problems (adjusted OR = 3.11; 95% CI = 1.52,6.34; p-value = 0.001). The majority (77.3%) considered non-penetrative sexual activities (outercourse) when discussing sexuality in later life, and they had lower odds of having sexual problems compared to those who relied purely on sexual intercourse (adjusted OR = 0.27 for only outercourse and 0.30 for both intercourse and outercourse; p-value = 0.016). Only 2.1% (4/190) of participants reported that a physician had asked them about sexual problems. Participants reporting sexual problems (N = 105) often consulted their partners (25.7%) and friends (10.5%) or searched information from the internet (18.1%). According to this study, sexual problems in older people are common in primary care settings, but they tend to be poorly managed. Clinical discussions and interventions that are sensitive to gender differences and acknowledge the broadened concepts of sexuality in later life, e.g., encouragement to practice outercourse, may help improve sexual problems and well-being among older people.
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Affiliation(s)
- Kanthee Anantapong
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Bongkot Burapakiat
- Division of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Thareerat Ananchaisarp
- Division of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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23
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Kulis SS, Tsethlikai M, Ayers SL, Gresenz KE. Parenting in 2 Worlds: Testing improved parent-adolescent communication about sexuality in Urban American Indian families. J Res Adolesc 2024; 34:56-68. [PMID: 37957746 PMCID: PMC10926230 DOI: 10.1111/jora.12900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 10/10/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023]
Abstract
Urban American Indian (AI) adolescents are more likely than non-Natives to have early sexual debut, teen pregnancies, sexually transmitted infections, and inadequate sexual health information. A RCT in three Arizona cities, with 585 parents of urban AI adolescents, tested whether a culturally tailored parenting intervention for urban AI families, Parenting in 2 Worlds (P2W), increased parent-adolescent communication about sexuality, compared to an informational family health intervention that was not culturally tailored. P2W produced significantly larger increases on two measures: communication about general sexual health and about sexual decision-making. The desired effects of P2W on the first measure were stronger short-term for cross-gender dyads, while for the second measure, they were stronger long-term for both mothers and fathers of adolescent sons.
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Affiliation(s)
- Stephen S. Kulis
- School of Social and Family Dynamics, Arizona State
University
- Global Center for Applied Health Research, Arizona State
University
| | | | | | - Kyle E. Gresenz
- School of Social and Family Dynamics, Arizona State
University
- Global Center for Applied Health Research, Arizona State
University
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24
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Byer L, Orozco-Poore C, Rosendale N. Limitations and Future Directions in Sex, Sexuality, and Gender Diverse Research in Neurology. Ann Neurol 2024; 95:421-431. [PMID: 38112171 DOI: 10.1002/ana.26863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/16/2023] [Accepted: 12/09/2023] [Indexed: 12/20/2023]
Abstract
Sex, sexuality, and gender diversity is understudied and underserved in neurology. Neurology research inclusive of LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual) people is limited. Existing research struggles with a paucity of neurology studies collecting sex, sexuality, and gender diverse (SSGD) data, conflation of sex and gender, lack of precision in measures, neglect of younger and older populations, nebulous benefit to community, and absent intersectionality. Future directions in SSGD neurology research include precise and community-based measurements, respect for LGBTQIA+ colleagues, and the application of minority stress models. All patients stand to benefit from research that elucidates how SSGD variables influence neurological health. ANN NEUROL 2024;95:421-431.
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Affiliation(s)
- Lennox Byer
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Casey Orozco-Poore
- Department of Child Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Nicole Rosendale
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
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25
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Martínez-Galiano JM, Peinado-Molina RA, Martínez-Vazquez S, Hita-Contreras F, Delgado-Rodríguez M, Hernández-Martínez A. Influence of pelvic floor disorders on sexuality in women. Int J Gynaecol Obstet 2024; 164:1141-1150. [PMID: 37830235 DOI: 10.1002/ijgo.15189] [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: 02/15/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVE To determine the association between different pelvic floor disorders and the presence of sexual dysfunction in women. METHOD An observational study of non-pregnant women was carried out in Spain in 2021 and 2022. To assess the presence of pelvic floor problems, the Pelvic Floor Distress Inventory (PFDI-20) was used, consisting of the subscales Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6; prolapse symptoms), Colorectal-Anal Distress Inventory (CRADI-8; colorectal symptoms), and Urinary Distress Inventory-6 (UDI-6; urinary symptoms). The validated tool, Female Sexual Function (FSF), was used to evaluate female sexual function. RESULTS In total, 1008 women participated. Of these, 288 (28.6%) had some type of sexual dysfunction. Regarding symptoms, 52 (5.2%) stated that they do not reach orgasm and 172 (17.1%) said they had never or occasionally felt sexual desire in the last month. Women with sexual dysfunctions had higher mean scores on the POPDI-6, CRADI-8, and UDI-6 subscales than those who did not have sexual dysfunction (P ≤ 0.005). Risk factors identified included being postmenopausal, with an adjusted odds ratio (aOR) of 2.98 (95% confidence interval [CI] 2.12-4.18), and a greater impact of the symptoms of pelvic floor problems as assessed by the PFDI-20 scale, in such a way that for each point increase the probability of sexual dysfunction increases with an aOR of 1.008 (95% CI 1.005-1.011). CONCLUSION Women with pelvic floor disorders and postmenopausal women present sexual dysfunction more frequently.
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Affiliation(s)
- Juan Miguel Martínez-Galiano
- Department of Nursing, University of Jaen, Jaen, Spain
- Consortium for Biomedical Research in the Epidemiology and Public Health Network (CIBERESP), Madrid, Spain
| | | | | | | | - Miguel Delgado-Rodríguez
- Consortium for Biomedical Research in the Epidemiology and Public Health Network (CIBERESP), Madrid, Spain
- Department of Health Sciences, University of Jaen, Jaen, Spain
| | - Antonio Hernández-Martínez
- Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real Faculty of Nursing, University of Castilla-La Mancha, Ciudad Real, Spain
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Dewinter J, Onaiwu MG, Massolo ML, Caplan R, Van Beneden E, Brörmann N, Crehan ET, Croen LA, Faja S, Gassner DL, Graham Holmes L, Hughes C, Hunter M, Huysamen M, Jelonche P, Lai MC, Noens I, Pukki H, Stokes MA, Strang JF, van der Miesen AIR. Short report: Recommendations for education, clinical practice, research, and policy on promoting well-being in autistic youth and adults through a positive focus on sexuality and gender diversity. Autism 2024; 28:770-779. [PMID: 37530121 PMCID: PMC10913304 DOI: 10.1177/13623613231188349] [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] [Indexed: 08/03/2023]
Abstract
LAY ABSTRACT In this article, we propose recommendations on what we can do to promote that autistic people can enjoy their sexuality and gender identity, because that contributes to overall well-being.First, we briefly summarize the existing research on sexuality and gender diversity in autistic individuals.Next, we propose recommendations for how to promote sexual and gender diversity-related health and well-being. Based on what is known about sexuality, gender diversity, and relationships in autistic adolescents and adults, we convened an international group of autistic and non-autistic researchers, advocates, parents, and professionals to develop recommendations to promote sexual and gender health in autistic people.The resulting recommendations were checked through an online survey distributed to autistic people across the world. The online participants endorsed the importance of eight final recommendations related to:1. Providing education and information on sexuality, relationships, and gender diversity to autistic individuals and their families;2. Improving expertise in and accessibility to healthcare for sexuality, relationships, and gender-related questions, with specific attention to prevention of and support after sexual victimization; and3. Meaningfully including the autism community in future research that addresses well-being relating to sexuality, relationships, and gender diversity.These community-driven recommendations aim to promote sexual health and well-being in autistic individuals internationally.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Susan Faja
- Boston Children’s Hospital/Harvard Medical School, USA
| | | | | | | | | | | | | | | | | | - Heta Pukki
- European Council of Autistic People, Finland
| | | | - John F Strang
- George Washington University School of Medicine, USA
| | - Anna IR van der Miesen
- Centre for Addiction and Mental Health, Canada
- Amsterdam University Medical Centers, Location Vrije Universiteit, The Netherlands
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Rodrigues DL. A Narrative Review of the Dichotomy Between the Social Views of Non-Monogamy and the Experiences of Consensual Non-Monogamous People. Arch Sex Behav 2024; 53:931-940. [PMID: 38177608 PMCID: PMC10920412 DOI: 10.1007/s10508-023-02786-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 12/06/2023] [Accepted: 12/12/2023] [Indexed: 01/06/2024]
Abstract
Monogamy is deeply rooted in most Western societies, shaping how people construe and behave in romantic relationships. These normative views facilitate the emergence of negative perceptions and evaluations when people choose not to adhere to mononormativity. Even though people in consensual non-monogamous (CNM) relationships are targets of stigmatization, research shows a dichotomy between these negative views and the relational experiences of CNM people. Indeed, people in CNM and monogamous relationships have comparable relationship functioning and quality and struggle with similar relationship problems. One of the differences is that CNM relationships afford people to explore their sexuality and fulfill their needs with multiple partners, without agreed-upon extradyadic behavior being perceived as infidelity or having deleterious consequences to relationship maintenance. These positive experiences notwithstanding, CNM people are continuously pressured by mononormativity and stigmatization, increasing the risk of internalized CNM negativity and worse personal and relational outcomes. One possible way to counteract CNM stigmatization and improve the lives of CNM people is by changing discourses surrounding non-monogamy and improving acceptance, not only in professional settings but also in the general population. Another strategy is to understand how the relationship beliefs and scripts of younger generations can help promote more inclusive and diverse societies.
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Affiliation(s)
- David L Rodrigues
- Iscte-Instituto Universitário de Lisboa, CIS-Iscte, Av. das Forças Armadas, 1649-026, Lisbon, Portugal.
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Krebill C, Crozier J, Kalliainen LK. Patient-Provider Communication on Concerns Related to Sexuality Following Upper Extremity Surgery. Hand (N Y) 2024; 19:300-305. [PMID: 35815655 PMCID: PMC10953517 DOI: 10.1177/15589447221107698] [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] [Indexed: 02/10/2023]
Abstract
BACKGROUND Sexuality and sexual health are important components of overall quality of life that can be affected by injuries, operations, and disease processes. Much of the research into health-related sexuality has been devoted to patients with spinal cord injuries and urogenital disease processes. There is very little research on the relationship of upper extremity injuries and their impact on a patient's sex life. The purposes of this study are to assess the proportion of patients who experience sexual limitation following upper extremity surgery and to assess the frequency of discussions regarding their sexual function with their surgeons. METHODS This was a prospective study of a cohort of patients who had hand, shoulder, or arm surgery more than 6 weeks prior to study recruitment. Patients were approached during a follow-up visit with their hand surgeon and were provided with an deidentified survey that focused on upper extremity function, impact of upper extremity injury or surgery on sexual satisfaction, and patient-physician communication surrounding the topic. RESULTS Of the patients surveyed, 11 (39%) reported that their upper extremity injury frequently negatively affected their sexual satisfaction. In addition, 9 patients (35%) reported that they wanted their surgeon to initiate discussion about recovery from surgery and its impact on sexual activity. CONCLUSIONS Upper extremity injuries may negatively affect sexual well-being. Many people want their physician to discuss this with them. Additional research is necessary to qualitatively assess what interventions may be useful for this population as well as how to integrate these discussions into hand surgery clinic visits.
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Affiliation(s)
- Cicely Krebill
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Joseph Crozier
- Department of Plastic and Reconstructive Surgery, Rhode Island Hospital, Providence, USA
| | - Loree K. Kalliainen
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Plastic and Reconstructive Surgery, Rhode Island Hospital, Providence, USA
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Hasson R, Ginzburg K. The Development and Psychometric Evaluation of the Sexual Fantasy Experience Scale. Arch Sex Behav 2024; 53:1015-1030. [PMID: 38263538 DOI: 10.1007/s10508-023-02794-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 12/18/2023] [Accepted: 12/18/2023] [Indexed: 01/25/2024]
Abstract
Clinicians and researchers consider sexual fantasies to be a central aspect of human sexuality. Although these are subjective experiences, most studies have assessed only their frequency and content. A measure that assesses individuals' subjective experience of sexual fantasies is therefore needed. The aim of this study was to evaluate the psychometric properties of a new measure, the Sexual Fantasy Experience Scale (SFES). In Study 1, the SFES was administered to 391 participants (240 defined themselves as women, 149 as men, and 2 as other). In Study 2, the SFES was administered to 426 participants (255 defined themselves as women, 167 as men, and 4 as other), along with a battery of questionnaires including the New Sexual Satisfaction Scale Short Form and the Global Measure of Sexual Satisfaction, both of which measure sexual satisfaction, as well as the Sexual Fantasy Checklist, which evaluates the content of sexual fantasies and their frequency. Five reliable SFES subscales emerged from Study 1: playfulness, limitlessness, functionality, intrusiveness, and shame. In Study 2, a confirmatory factor analysis confirmed the scale's underlying factor structure, which was obtained in Study 1. The subscales of the SFES contributed to the explained variance of the assessments of sexual satisfaction, beyond the contribution of the fantasies' content and frequency, demonstrating the incremental validity of the subscales. The results of the present analyses suggest that the SFES has good psychometric properties, making it useful as an assessment tool for future research, clinical practice, and sex education.
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Affiliation(s)
- Rachel Hasson
- Tel Aviv University Gershon H Gordon Faculty of Social Sciences, Tel Aviv, 6997801, Israel.
| | - Karni Ginzburg
- Tel Aviv University Gershon H Gordon Faculty of Social Sciences, Tel Aviv, 6997801, Israel
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30
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Bond KT, Radix AE. Sexual Health and Well-Being: A Framework to Guide Care. Med Clin North Am 2024; 108:241-255. [PMID: 38331477 DOI: 10.1016/j.mcna.2023.10.001] [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
Although the acceptance of sex positivity centering pleasure and justice has grown, clinical and public health strategies for sexually transmitted infection management have remained focused on risk and adverse outcomes. To promote sex-positive health care practice in clinical settings and beyond, health care practitioners should use an integrated, patient-centered approach to sexual health. These strategies include initiating discussions, continued sexual health education, providing informative material for patients, and knowledge of different communication strategies. Patient-provider interactions might be enhanced by using such methods.
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Affiliation(s)
- Keosha T Bond
- Department of Community Health and Social Medicine, CUNY School of Medicine, 160 Convent Avenue, Harris Hall, New York, NY 10031, USA; Center for Interdisciplinary Research on AIDS at Yale University, Yale University School of Public Health, 135 College Street, Suite 200, New Haven, CT 06510-2483, USA.
| | - Asa E Radix
- Center for Interdisciplinary Research on AIDS at Yale University, Yale University School of Public Health, 135 College Street, Suite 200, New Haven, CT 06510-2483, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, USA
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31
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Breistig S, Thorkildsen KM, Werner HMJ, Nordgreen T, Sekse RJT. Redefining sexual health after gynaecological cancer: Lived experiences from Gynea, a digital rehabilitation programme. J Clin Nurs 2024; 33:1110-1121. [PMID: 37984464 DOI: 10.1111/jocn.16923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Gynaecological cancer illness and treatment have a significant impact on women's sexual health and concerns regarding sexual health are known to be an unmet need in survivors. The digital support programme Gynea was designed to enhance women's health, including sexual health, after gynaecological cancer treatment. This study aimed to explore how cancer survivors experienced participation in Gynea. METHODOLOGY This is a phenomenological hermeneutic study. Individual, in-depth semi-structured interviews were conducted to explore lived experiences. Twenty women were interviewed after completing the Gynea programme. The transcripts were analysed using Lindseth and Norberg's phenomenological hermeneutic method. FINDINGS Three main themes (with subthemes) emerged from the analysis: (1) A silent existential trauma; (2) Redefining sexual health; (3) Communicating with a partner about sexuality. The women redefined sexual health rather than just being sexual intercourse, being a rediscovery of the body. The women's increased awareness and understanding of their own sexual health empowered their communication about their sexuality with their partners. This was important for regaining sexual health and intimacy in their relationships. CONCLUSION Participation in Gynea helped to strengthen the women's sexual integrity. Knowledge and support empowered them to take care of their sexual needs and communicate these with their partners. IMPLICATIONS FOR PATIENT CARE Healthcare services and nurses need to be aware that sexual health is an existential state of being, in which good sexual health does not necessarily equate to sexual function, but rather to sexual empowerment. Digital support with nurse guidance can support women in caring for their sexual health after cancer illness by thematizing sexual health with a holistic approach and should be part of the medical treatment. PATIENT OR PUBLIC CONTRIBUTION Twenty gynaecological cancer survivors contributed by sharing their experiences from the sexual health module in Gynea.
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Affiliation(s)
- Sigrund Breistig
- Centre of Diaconia and Professional Practice, VID Specialized University, Bergen, Norway
| | - Kari Marie Thorkildsen
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Henrica Maria Johanna Werner
- Department of Obstetrics and Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands
- GROW - School for Oncology and Reproduction, University of Maastricht, Maastricht, The Netherlands
| | - Tine Nordgreen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Ragnhild Johanne Tveit Sekse
- Faculty of Health Sciences, VID Specialized University, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
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32
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Fretz KM, Hunker KE, Tripp DA. The Impact of Inflammatory Bowel Disease on Intimacy: A Multimethod Examination of Patients' Sexual Lives and Associated Healthcare Experiences. Inflamm Bowel Dis 2024; 30:382-394. [PMID: 38206426 PMCID: PMC10906359 DOI: 10.1093/ibd/izad106] [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: 02/06/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) can negatively impact sexual well-being, and some patients desire healthcare for these issues. Research capturing the lived experiences of patients in these areas is lacking. The present study investigated the sexual well-being impacts of IBD (objective 1) and patients' experiences accessing support for these concerns in the healthcare system (objective 2) through multimethod analyses. METHODS A total of 480 adults with IBD were recruited for an online survey study. Reflexive thematic analysis was used to analyze responses to 2 open-ended questions (ie, qualitative data; question 1, n = 326, question 2, n = 309). Frequency analyses and contingency tables were used to analyze quantitative data (n = 436). RESULTS Thematic analysis (objective 1) generated 8 themes highlighting the negative impacts of IBD on patients' sexual/intimate lives (eg, sexual activity, intimate relationships) and the influence of broader psychosocial experiences (eg, self-perception, mental health) on patients' sexual well-being. Quantitative analyses (objective 2) indicated that 39.2% of participants wanted sexual health information from a healthcare provider, but only 5.7% of our sample reported both wanting and receiving this information. Thematic analysis generated 5 themes highlighting the lack of support and information available for sexuality concerns in IBD healthcare and detailed patients' perceived barriers to obtaining support in this area. CONCLUSIONS IBD has myriad impacts on patients' sexual lives. However, patients who want healthcare in this area rarely receive satisfactory support.
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Affiliation(s)
| | | | - Dean A Tripp
- Department of Psychology, Queen’s University, Kingston, ON, Canada
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Mazursky N, Nadan Y. Unveiling the shadows: Exploring the reality of commercial sexual exploitation among LGBTQ+ youth in out-of-home care. Child Abuse Negl 2024; 149:106691. [PMID: 38359778 DOI: 10.1016/j.chiabu.2024.106691] [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: 10/05/2023] [Revised: 01/30/2024] [Accepted: 02/05/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND LGBTQ+ youth frequently encounter familial rejection based on their sexuality and gender identity and are at greater risk of being maltreated by their family, often prompting them to leave or run away from their parents' home. Such youth may find themselves living independently and, once they leave home, tend to be vulnerable to all kinds of abuse and sexual victimization, sometimes leading to different types of commercial sexual exploitation. OBJECTIVE This study aimed to comprehensively explore the subjective perspectives and understandings of commercial sexual exploitation among LGBTQ+ youth in out-of-home care in Israel. METHODS The study employed a critical constructivist grounded theory approach. Thirty-one in-depth semi-structured interviews were conducted with LGBTQ+ youth aged 16 to 32 (average 21.6), who aged out of one or more of the out-of-home care services for LGBTQ+ youth in Israel. RESULTS Our analysis indicates four main constructions of commercial sexual exploitation that depict the experiences of the participants: (1) survival sex; (2) gray prostitution; (3) sugar daddy; and (4) sex work. CONCLUSIONS Our findings highlight the diverse manifestations of commercial sexual exploitation among LGBTQ+ youth, shedding light on its pervasive nature and significant scale. Several of these manifestations are characterized by ambivalence and are placed in the gray areas of commercial sexual exploitation, making it challenging to identify.
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Affiliation(s)
- Nofar Mazursky
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel.
| | - Yochay Nadan
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel
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Stefanczyk MM. People Declare Lowered Levels of Sociosexual Desire in the Presence of an Attractive Audience. Arch Sex Behav 2024; 53:879-887. [PMID: 38102509 DOI: 10.1007/s10508-023-02753-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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 12/17/2023]
Abstract
Due to social desirability bias, people tend to self-present themselves in the presence of others in a favorable light, which sometimes may lead to deviations from reality. This phenomenon is particularly pronounced when controversial or strictly norm-bounded matters are considered. Here, we tested how a presence of an attractive model-either male or female-influences people's declarations on their sociosexual orientation-the degree of their sexual permissiveness in terms of their past behavior, attitudes toward uncommitted sex, and desire for sexual intercourse with individuals they are not in a relationship with. The participants (N = 244, 52% men) answered questions about their sociosexuality in solitude, or out loud with an attractive model present. The results show that both men and women declare lowered levels of their desire, but not behavior or attitude, in the presence of both male and female attractive models. A follow-up study (N = 188, 51% men) showed that this effect was not due to the differing conditions of responding (out loud vs written down). The research points out to an area of human sexuality that is prone to being falsified in research and which serves as an important factor in self-presentation.
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35
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Nikolaidis I, Karakasi MV, Artemiadis A, Nteli E, Bakirtzis C, Boziki MK, Foley FW, Grigoriadis N. Translation, cross-cultural adaptation, and validation of the Greek version of the Multiple Sclerosis Intimacy and Sexuality Questionnaire-19. Somatosens Mot Res 2024; 41:1-10. [PMID: 36538411 DOI: 10.1080/08990220.2022.2158801] [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: 09/12/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) explores optimally impact of MS on sexual activity/satisfaction/intimacy. AIM The present study aims to provide the only validation of the Greek Version of MSISQ-19, and compare results to validation studies in other languages. METHODS The original/English version of the MSISQ-19 was translated into Greek according to standardized guidelines, while validity/reliability, correlations with other scales and sexual dysfunction prevalence were tested. Subjects were requested to complete all questionnaires and MSISQ-19, being re-tested three weeks later. Construct-validity of the Greek version of the MSISQ-19 was confirmed with principal-component-analysis. Bartlett's test assessed correlation-adequacy between items. Pearson's correlation explored internal-construct-validity between subscales and overall score, and external-construct-validity with disease-status variables, cognitive testing and patient-reported outcomes regarding fatigue, depression/anxiety, MS impact, and quality of life. RESULTS 201 PwMS (130 female). Mean age was 39.3 ± 11.8 years with median disease-duration 11.7 ± 7.9 years. 79.1% RRMS, PPMS (10.4%) and SPMS (10.4%). Cronbach's alpha coefficient was 0.949. MSISQ-19 correlations between items were large. Significant associations of sexual dysfunction were identified with age (rho = 0.392, p < 0.01), years of education (rho=-0.199, p = 0.006), the Expanded Disability Status Scale (rho = 0.518, p < 0.01) and MS duration (rho = 0.354, p < 0.01). Correlations were disclosed with the Brief International Cognitive Assessment for MS (rho=-0.247, p < 0.05), Modified Fatigue Impact Scale (rho = 0.374, p < 0.05), Depression Anxiety Stress Scale (rho = 0.375, p < 0.05), Multiple Sclerosis Impact Scale (rho = 0.442, p < 0.05), and EuroQoL-five-dimensional instrument (rho = 0.375, p < 0.05). Internal consistency of the Greek version of the MSISQ-19 was confirmed with Cronbach's alpha. Test-retest reliability (31 PwMS) was excellent with intraclass-correlation-coefficients > 0.90. CONCLUSION Besides Greek MSISQ-19 satisfactory validity/reliability/reproducibility and being first to include cognitive-testing, authors estimated sexual-dysfunction prevalence affecting half PwMS.HIGHLIGHTSThis study provides the only validation of the Greek Version of the MSISQ-19.The latter was found with satisfactory validity, reliability and reproducibility.50% of the Greek PwMS sample was found to be afflicted with sexual dysfunction.This is also the first validation study to examine associations with cognitive testing.Sexual function is still an underestimated functionality parameter upon examination.
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Affiliation(s)
- Ioannis Nikolaidis
- 2nd Department of Neurology, Multiple Sclerosis Center, Aristotle University of Thessaloniki - School of Medicine, Thessaloniki, GR, Greece
| | - Maria-Valeria Karakasi
- 3rd Department of Psychiatry, Aristotle University of Thessaloniki - School of Medicine, Thessaloniki, GR, Greece
| | - Artemios Artemiadis
- Department of Neurology, University of Cyprus - Medical School, Nicosia, CY, Cyprus
| | - Elli Nteli
- 2nd Department of Neurology, Multiple Sclerosis Center, Aristotle University of Thessaloniki - School of Medicine, Thessaloniki, GR, Greece
| | - Christos Bakirtzis
- 2nd Department of Neurology, Multiple Sclerosis Center, Aristotle University of Thessaloniki - School of Medicine, Thessaloniki, GR, Greece
| | - Marina-Kleopatra Boziki
- 2nd Department of Neurology, Multiple Sclerosis Center, Aristotle University of Thessaloniki - School of Medicine, Thessaloniki, GR, Greece
| | - Frederick W Foley
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Multiple Sclerosis Center, Holy Name Medical Center, Teaneck, NJ, USA
| | - Nikolaos Grigoriadis
- 2nd Department of Neurology, Multiple Sclerosis Center, Aristotle University of Thessaloniki - School of Medicine, Thessaloniki, GR, Greece
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Dumont H. [Sex therapy and support for women and couples]. Rev Infirm 2024; 73:34-35. [PMID: 38485400 DOI: 10.1016/j.revinf.2024.01.013] [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] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Sexuality is shaped by experience and by what has been passed down. Body image and sex influence desire and pleasure. In the case of endometriosis, suffering and pain can lead to shame and guilt. Encouraging people to talk to each other helps to create a free eroticism that resembles the couple.
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Affiliation(s)
- Hélène Dumont
- c/o La Revue de l'infirmière, 65 rue Camille-Desmoulins, 92442 Issy-les-Moulineaux cedex, France.
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Ozdemir Isik O, Temiz Karadag D, Tekeoglu S, Yazici A, Cefle A. Gynecological symptoms in primary and secondary Sjögren's syndrome and the effect of the disease on sexuality. J Sex Med 2024; 21:248-254. [PMID: 38366657 DOI: 10.1093/jsxmed/qdae004] [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: 07/21/2023] [Revised: 11/29/2023] [Accepted: 12/22/2023] [Indexed: 02/18/2024]
Abstract
BACKGROUND Sjögren's syndrome (SS) is an autoimmune systemic disease affecting many organs and systems, such as genital system. AIM This study aimed to present the gynecological symptoms of patients who were followed up in an outpatient clinic because of primary Sjögren's syndrome (pSS) and secondary Sjögren's syndrome (sSS) and to show how the disease affected sexuality. METHODS This study is a cross-sectional study conducted between 2019 and 2020. The study sample consisted of 60 pSS patients, 42 sSS patients, and 52 healthy control subjects. OUTCOMES All the participants were questioned about sexuality, and completed the 36-item Short Form Survey, Hospital Anxiety and Depression Scale, Health Assessment Questionnaire, and Modified Hill questionnaire. RESULTS The patients had a mean age of 55.6 ± 11.85 years in pSS, 59.39 ± 11.18 years in sSS, and 56.1 ± 10.46 years in healthy control subjects. Vaginal and vulvar dryness and dyspareunia were present at a significantly higher rate in SS, especially in pSS, compared with the control subjects. The Health Assessment Questionnaire score was significantly lower in the pSS group than in the sSS group. Arthralgia, myalgia, and fatigue were prominent in all SS patients. CLINICAL IMPLICATIONS Gynecological symptoms, sexual ability, and the effects of the disease on sexuality should be questioned in all SS patients. STRENGTHS AND LIMITATIONS It is very important that we evaluate the gynecological symptoms of both pSS and sSS patients and the effect of the disease on these symptoms. The small number of patients and healthy control subjects is a limitation. CONCLUSION The gynecological and musculoskeletal symptoms negatively affected sexuality in patients with pSS and sSS, and the negative effect of the disease on sexuality was more pronounced in the pSS group.
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Affiliation(s)
- Ozlem Ozdemir Isik
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Kocaeli University, Kocaeli 41001, Turkey
| | - Duygu Temiz Karadag
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Kocaeli University, Kocaeli 41001, Turkey
| | - Senem Tekeoglu
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Kocaeli University, Kocaeli 41001, Turkey
| | - Ayten Yazici
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Kocaeli University, Kocaeli 41001, Turkey
| | - Ayse Cefle
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Kocaeli University, Kocaeli 41001, Turkey
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Fairlamb S, Cheso D, Giddens EK, Akhter ZJ. Death and Sexuality: Mortality Salience Increases Heteronormative Preferences and Stereotyping Among Those with High Need for Closure. J Homosex 2024; 71:758-774. [PMID: 36228166 DOI: 10.1080/00918369.2022.2132575] [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] [Indexed: 06/16/2023]
Abstract
Terror Management Theory has shown that mortality salience can increase outgroup stereotyping and dislike of people who are different. We examined heterosexual participant reactions to profiles of homosexual and heterosexual men after mortality salience utilizing need for closure (NFC) as a moderating variable. We also examined the role of death-thought accessibility (DTA) in these effects. Among those with high NFC, mortality salience increased stereotyping and preference for the heterosexual individual. This effect only occurred when participants examined the profiles before completing the DTA measure. Control participants showed parallel reactions to the mortality salience condition when completing the DTA measure first. We found no reliable effects of mortality salience increasing DTA, and defensiveness decreasing DTA. The current findings demonstrate how two different death reminders can affect reactions to homosexual men among those in high NFC. Potential reasons for the lack of support for DTA in these effects are discussed.
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Affiliation(s)
- Samuel Fairlamb
- Psychology Department, Royal Holloway, University of London, Egham, UK
| | - Diana Cheso
- Psychology Department, Royal Holloway, University of London, Egham, UK
| | - Eloise K Giddens
- Psychology Department, Royal Holloway, University of London, Egham, UK
| | - Zaida J Akhter
- Psychology Department, Royal Holloway, University of London, Egham, UK
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Naroji S, Tomlin K. NASPAG Position Statement: Comprehensive Sexuality Education for Adolescents. J Pediatr Adolesc Gynecol 2024; 37:7-8. [PMID: 37820852 DOI: 10.1016/j.jpag.2023.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023]
Affiliation(s)
- Swetha Naroji
- Pediatric and Adolescent Gynecology, Children's National Medical Center, Washington, DC.
| | - Kristl Tomlin
- Pediatric and Adolescent Gynecology, Prisma Health-Midlands/University of South Carolina School of Medicine, Columbia, South Carolina
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Tatum AK, Flicker SM, Peralta I, Kubicki RJ. Initial Motivations for Engaging in Polyamorous Relationships. Arch Sex Behav 2024; 53:629-644. [PMID: 38097872 DOI: 10.1007/s10508-023-02750-z] [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: 08/12/2022] [Revised: 10/11/2023] [Accepted: 11/08/2023] [Indexed: 02/07/2024]
Abstract
Polyamory is a relationship style in which partners consensually agree to engage in sexual and/or emotional relationships with concurrent partners. Compared with other forms of consensual non-monogamy (CNM), polyamory practitioners tend to report greater relationship satisfaction and less jealousy. However, the unique motivations leading people to engage with polyamory are less understood. Previous research has examined motivations for engaging in CNM relationship styles, in general, but no research has focused exclusively on the motivations of polyamory practitioners. The present study draws on the open-ended responses of 63 U.S. American adults who reported previous or current engagement in at least one consensually polyamorous relationship. Thematic analyses revealed four themes guiding participants' initial motivations for polyamory engagement: values alignment, relationship factors, external triggers, and sexuality. The study's themes are discussed in the context of self-determination theory and situated in the existing body of CNM and polyamory research. Directions for future research provide next steps for examining outcomes associated with specific polyamory motivations.
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Affiliation(s)
- Alexander K Tatum
- Department of Counseling Psychology, Social Psychology, and Counseling, Ball State University, 1613 W Riverside Ave., Muncie, IN, 47303, USA.
| | - Sharon M Flicker
- Department of Psychology, Sacramento State University, Sacramento, CA, USA
| | | | - R J Kubicki
- Department of Psychology, University of South Florida, Tampa, FL, USA
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Schilstra CE, Sansom-Daly UM, Ellis SJ, Trahair TN, Anazodo AC, Amiruddin A, Lindsay T, Maguire F, Wakefield CE, Lah S, Bland E, Lenthen K, Rifkin A, Awan A, Kittos T, Hanbury N, Tsalidis S, Patterson P, McDonald F, Fardell JE. Guidelines for Caring for the Social Well-Being of Adolescents and Young Adults with Cancer in Australia. J Adolesc Young Adult Oncol 2024; 13:8-29. [PMID: 37367208 DOI: 10.1089/jayao.2023.0027] [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: 06/28/2023] Open
Abstract
More than 1000 Australian adolescents and young adults (AYAs) are diagnosed with cancer annually. Many report unmet social well-being needs, which impact their mental health. Australian AYA cancer care providers lack guidance to address these needs well. We aimed to develop guidelines for caring for the social well-being of AYAs with cancer in Australia. Following the Australian National Health and Medical Research Council guidance, we formed a multidisciplinary working group (n = 4 psychosocial researchers, n = 4 psychologists, n = 4 AYA cancer survivors, n = 2 oncologists, n = 2 nurses, and n = 2 social workers), defined the scope of the guidelines, gathered evidence via a systematic review, graded the evidence, and surveyed AYA cancer care providers about the feasibility and acceptability of the guidelines. The guidelines recommend which AYAs should have their social well-being assessed, who should lead that assessment, when assessment should occur with which tools/measures, and how clinicians can address AYAs' social well-being concerns. A key clinician, who is knowledgeable about AYAs' developmental needs, should lead the assessment of social well-being during and after cancer treatment. The AYA Psycho-Oncology Screening Tool is recommended to screen for social well-being needs. The HEADSSS Assessment (Home, Education/Employment, Eating/Exercise, Activities/Peer Relationships, Drug use, Sexuality, Suicidality/Depression, Safety/Spirituality Assessment) can be used for in-depth assessment of social well-being, while the Social Phobia Inventory can be used to assess social anxiety. AYA cancer care providers rated the guidelines as highly acceptable, but discussed many feasibility barriers. These guidelines provide an optimal care pathway for the social well-being of AYAs with cancer. Future research addressing implementation is critical to meet AYAs' social well-being needs.
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Affiliation(s)
- Clarissa E Schilstra
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Ursula M Sansom-Daly
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
- Sydney Youth Cancer Service, Prince of Wales Hospital, Sydney, Australia
| | - Sarah J Ellis
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Toby N Trahair
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Antoinette C Anazodo
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Azhani Amiruddin
- Western Sydney Youth Cancer Service, Westmead Hospital, Wentworthville, Australia
| | | | - Fiona Maguire
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
- Sydney Youth Cancer Service, Prince of Wales Hospital, Sydney, Australia
| | - Claire E Wakefield
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Suncica Lah
- School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia
| | - Elizabeth Bland
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | | | - Allison Rifkin
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Adry Awan
- Cancer Survivor and Advisor, Sydney, Australia
| | | | | | | | - Pandora Patterson
- Canteen, Sydney, Australia
- Faculty of Medicine, University of Sydney, Sydney, Australia
| | - Fiona McDonald
- Canteen, Sydney, Australia
- Faculty of Medicine, University of Sydney, Sydney, Australia
| | - Joanna E Fardell
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
- Western Sydney Youth Cancer Service, Westmead Hospital, Wentworthville, Australia
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Koch M, Tyson N, Bhuinneain GMN, Kasliwal A, Conry J, Sridhar A. FIGO position statement on comprehensive sexuality education. Int J Gynaecol Obstet 2024; 164:531-535. [PMID: 38219018 DOI: 10.1002/ijgo.15319] [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: 01/15/2024]
Abstract
Now is a pivotal moment in the fight for reproductive health and justice internationally. Well-established research has recognized the benefits of comprehensive sexuality education for youth and adolescents-including vast reproductive health benefits, decreased interpersonal violence, and improvements on measures of academic success and well-being. Despite these established benefits, challenges to the implementation of culturally sensitive and holistically framed sexuality education are intensifying across the globe. The International Federation of Gynecology and Obstetrics (FIGO) stands firmly in its support of comprehensive sexuality education and re-emphasizes the importance of the implementation of scientifically accurate, age-appropriate, culturally relevant, and inclusive education. Successful implementation relies on active youth leadership, physician involvement, and a renewed focus on high-quality monitoring mechanisms to assess impact and accountability at all levels. Most importantly, future efforts to improve and scale comprehensive sexuality education must emphasize the importance of an inclusive curriculum that addresses previously marginalized youth, such as LGTBQ+ and disabled individuals, through a reproductive justice lens. FIGO commits, and encourages the international healthcare community, to provide continued advocacy for the rights to health, education, and equality, in order to achieve improvement in health outcomes for young people across the globe.
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Affiliation(s)
- Mikaela Koch
- David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA
| | - Nichole Tyson
- Stanford University School of Medicine, Stanford, California, USA
- FIGO Committee on Contraception, London, UK
| | - G Meabh Ni Bhuinneain
- Royal College of Physicians of Ireland (RCPI), Dublin, Ireland
- FIGO Committee on Well Woman Health Care, London, UK
| | - Asha Kasliwal
- FIGO Committee on Contraception, London, UK
- Manchester Foundation Trust, Manchester, UK
| | | | - Aparna Sridhar
- David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA
- FIGO Committee on Contraception, London, UK
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43
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Simms-Cendan J. Guest Editorial: The Urgent Need for Advocacy for Comprehensive Sexuality Education. J Pediatr Adolesc Gynecol 2024; 37:3-4. [PMID: 38245193 DOI: 10.1016/j.jpag.2023.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 01/22/2024]
Affiliation(s)
- Judith Simms-Cendan
- President, North American Society of Pediatric Adolescent Gynecology (NASPAG), Co-Chair Advocacy, Treasurer International Federation Pediatric Adolescent Gynecology (FIGIJ), Division Director Pediatric Adolescent Gynecology, Department of Obstetrics, Gynecology and Reproductive Health, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136.
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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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45
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Ramlachan P, Naidoo K. Enhancing sexual health in primary care: Guidance for practitioners. S Afr Fam Pract (2004) 2024; 66:e1-e5. [PMID: 38299528 PMCID: PMC10839213 DOI: 10.4102/safp.v66i1.5822] [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: 08/24/2023] [Revised: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 02/02/2024] Open
Abstract
Sexual health is an integral aspect of overall health and well-being and is fundamental to the sustainable development of societies worldwide. The World Health Organization (WHO) defines sexual health as 'a state of physical, emotional, mental, and social well-being in relation to sexuality'. However, addressing sexual health has been afforded low priority in primary healthcare systems. Primary care practitioners (PCPs), who play a crucial role in providing comprehensive care to communities, receive little training on screening and managing individuals with sexual health problems. The scope of services ranges from education, prevention and screening, to management of sexual health matters. Patients with noncommunicable diseases (NCDs), such as stroke, cancer, heart disease and diabetes, are at increased risk for sexual dysfunction, possibly because of common pathogenetic mechanisms, such as inflammation. This is of considerable importance in the sub-Saharan African context where there is a rapidly increasing prevalence of NCDs, as well as a high burden of HIV. Strategies to improve the quality of sexual health services in primary care include creating a safe and non-judgemental practice environment for history-taking among gender-diverse populations, utilising effective screening tools aligned with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for sexual dysfunctions. In particular, the International Consultation on Sexual Medicine (ICSM -5) diagnostic and treatment algorithm can empower primary care providers to effectively address sexual dysfunctions among patients and improve the quality of care provided to communities regarding sexual and reproductive health.
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Affiliation(s)
- Padaruth Ramlachan
- International Society for Sexual Medicine (ISSM), Durban; and, African Society for Sexual Medicine (ASSM), Durban.
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46
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Ross M, Roijer P, Mullender M, Grift TCVD. Trans, gender non-conforming and non-binary individuals' perspectives on experienced sexuality during medical transition. J Sex Marital Ther 2024; 50:379-394. [PMID: 38238978 DOI: 10.1080/0092623x.2023.2300828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
How gender-affirming treatments (GAT) influence the experienced sexuality of transgender, gender non-conforming, and non-binary (TGNB) individuals remains understudied. The aim of this research was to discern factors contributing to a satisfying sexual experience for TGNB individuals, explore the influence of GAT on this process, and identify potential areas for improvement in transition-related care. We conducted interviews with 21 participants at various stages of GAT. Participants identified as (trans)men (12), (trans)women (7), transgender (1), and genderqueer/gender non-conforming/non-binary (1). Thematic analysis was conducted and involved multiple researchers. Three themes emerged from the data: (i) the role sexuality plays in understanding and affirming one's gender, (ii) satisfaction with one's physical sexual function, (iii) positive communication about sex and its subsequent influence on relationships. Many participants associated satisfaction with physical sexual function with positive sexual experiences, often describing GAT-induced changes in sexual arousal, drive, and orgasm as gender-affirming. Emotional connection and affirmation from sexual partners also contributed to positive experiences. The ability to (re-)define what sex meant individually increased satisfaction levels. Moreover, understanding and affirming one's gender identity were closely related to a satisfactory sex life. This study offers valuable insights for healthcare providers working with TGNB individuals during GAT, particularly concerning their sexuality.
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Affiliation(s)
- Maeghan Ross
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centers, Amsterdam, the Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands
| | - Pip Roijer
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centers, Amsterdam, the Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands
| | - Margriet Mullender
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centers, Amsterdam, the Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands
| | - Tim C van de Grift
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centers, Amsterdam, the Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands
- Department of Medical Psychology and Psychiatry, Zaans Medisch Centrum, Zaandam, The Netherlands
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Arends SAM, van Rossum CE, Eeltink CM, Robertus JE, Schoonmade LJ, Francke AL, Jongerden IP. Feasibility and effectiveness of communication tools for addressing intimacy and sexuality in patients with cancer: a systematic review. Support Care Cancer 2024; 32:109. [PMID: 38231322 PMCID: PMC10794301 DOI: 10.1007/s00520-024-08308-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/05/2024] [Indexed: 01/18/2024]
Abstract
PURPOSE Patients diagnosed with cancer might experience changes in intimacy and sexuality due to the illness itself, treatment, or psychological and social factors. Healthcare professionals (HCPs) often feel reluctant to discuss these changes. This study aimed to provide an overview of the feasibility and effectiveness of communication tools that support communication regarding changes in intimacy or sexuality among patients with cancer. METHODS This is a systematic review. Databases are PubMed, Embase, CINAHL, PsycInfo, Web of Science and Cochrane Library from inception to June 2023. The Mixed Methods Appraisal Tool was used to assess included studies. Data were summarized in data charting forms. RESULTS In total 35 studies were included, published between 2001 and 2023. Most had a quantitative design and moderate methodological quality. In 11 studies, the PLISSIT model (Permission, Limited Information, Specific Suggestions, Intensive Therapy) was used. Tools were integrated in counselling sessions or training programmes for individual patients, couples, groups of patients, or HCPs. All tools were considered feasible by patients or HCPs. Twenty studies reported significant improvement in sexual functioning, quality of life, quality of care or combined outcomes. CONCLUSION Tools to support communication about changes in intimacy and sexuality among patients with cancer seem feasible and effective. The most commonly used tool, the PLISSIT model, proved to be feasible for HCPs and to have a positive effect on patients' and partners' sexual functioning and quality of life. Giving attention to changes in intimacy and sexuality seems to be important in itself, regardless of the communication tool or approach used.
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Affiliation(s)
- Susanne A M Arends
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands.
- Amsterdam Public Health Research Institute, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands.
- Center of Expertise in Palliative Care, VU University Medical Center, Amsterdam, the Netherlands.
| | - Carlijn E van Rossum
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
| | - Corien M Eeltink
- Oncology Daycare Center, Dijklander Hospital, Hoorn, the Netherlands
| | - Jantien E Robertus
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
| | | | - Anneke L Francke
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
- Center of Expertise in Palliative Care, VU University Medical Center, Amsterdam, the Netherlands
- NIVEL. Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Irene P Jongerden
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
- Center of Expertise in Palliative Care, VU University Medical Center, Amsterdam, the Netherlands
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Bilge C, Kaydirak M, Saçan U, Demir F. Determination of risky sexual behaviors and associated factors of Turkish young women. Women Health 2024; 64:41-50. [PMID: 38014446 DOI: 10.1080/03630242.2023.2286267] [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: 12/22/2022] [Accepted: 11/13/2023] [Indexed: 11/29/2023]
Abstract
Risky sexual behaviors of young women cause significant reproductive health problems. Therefore, it is vital to evaluate the sexual attitude and behavior characteristics of young women, their changes over the years, and the effects of information sources such as family, media, and friends, which play an effective role in bringing about changes in sexual behavior of young women. This study was planned to evaluate young women's premarital sexual behaviors and related factors in Turkiye between 01.11.2021 and 01.05.2022. It is designed as a descriptive correlation study conducted with 1.430 young women studying at universities in 30 metropolitan cities in Turkiye. The study data were collected using the "Participant Information Form" and the "Premarital Risky Sexual Behavior Assessment Scale for Young Women." This study showed that parents' educational status and geographical region was related to the young women's mean score and the subdimension score of the Premarital Sexual Behavior Assessment Scale for Young Women (PSAS-YW) (p < .001). Furthermore, young women's top source of information about sexuality was internet media (80 percent, n = 1144), and the least source was their fathers (2.9 percent, n = 41). There is a relationship between where young women spend most of their lives, the geographical region where their families live, and the risk of sexual behavior. The study observed that the geographical region where young women's parents live was effective in risky sexual behavior. While less risky sexual behavior was observed, primarily in the country's east, this rate increased in the western parts. Furthermore, while it was determined that young people mainly acquire sexual information through the media-internet or friends, it was observed that the participants in this group had the highest rate of risky sexual behavior. The age variable explained only 2 percent of the change in risky sexual behavior, and there was a linear increase between the mother's education level and the risky sexual behavior score of young women.
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Affiliation(s)
- Ciğdem Bilge
- Faculty of Health Sciences, Department of Obstetric and Women's Health Nursing, Mugla Sitki Kocman University, Muğla, Turkey
| | - Meltem Kaydirak
- Faculty of Nursing, Department of Women's Health and Diseases Nursing, Istanbul University-Cerrahpasa Florence Nightingale, Istanbul, Turkey
| | | | - Fatmanur Demir
- Department of Medical Nursing, Aydin Nazilli State Hospital, Aydın, Turkey
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Barbonetti A, Rastrelli G, Sparano C, Castellini C, Vignozzi L, Maggi M, Corona G. Is marijuana a foe of male sexuality? Data from a large cohort of men with sexual dysfunction. Andrology 2024; 12:9-19. [PMID: 36617843 DOI: 10.1111/andr.13382] [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: 11/01/2022] [Revised: 12/29/2022] [Accepted: 01/06/2023] [Indexed: 01/10/2023]
Abstract
BACKGROUND Although it has been assumed that chronic cannabis use may have an unfavorable impact on male sexual function and its metabolic correlates, evidence from clinical studies remains inconclusive. OBJECTIVE To investigate the relationship between cannabis use and sexual behavior, anthropometrics and metabolic/vascular profiles in a large series of men evaluated for sexual dysfunction. METHODS A total of 4800 men (mean age 50.8 years) attending an andrology outpatient clinic for sexual dysfunction were studied. Sexual symptoms, hormonal, metabolic, and instrumental (penile color Doppler ultrasound, PCDU) parameters were evaluated according to the reported habitual use of recreational substances (no use, 1-2 joints/week, >2 joints/week, and use of illicit drugs other than cannabis). RESULTS When compared with non-users, cannabis users were younger and exhibited a lower prevalence of comorbidities as well as better PCDU parameters, despite reporting higher alcohol and tobacco consumption. After adjustment for confounders, cannabis use was associated with a greater instability in the couple's relationship and a higher frequency of masturbation. In addition, the group smoking >2 joints/week showed a significantly lower body mass index than both controls and users of substances other than cannabis. Men who reported using recreational drugs (either cannabis or other) exhibited significantly lower levels of both total and low-density lipoprotein cholesterol than non-users. At the PCDU, smoking 1-2 joints/week was associated with significantly higher dynamic peak systolic velocity than both non-drug use and use of >2 joints/week. Prolactin levels were significantly higher in individuals smoking 1-2 joints/week and in those who used substances other than cannabis when compared with controls, whereas no difference in total testosterone levels was observed. DISCUSSION In men with sexual dysfunction, mild cannabis consumption may be associated with a more favorable anthropometric and lipid profile and with a better penile arterial vascular response to intracavernous prostaglandin injection.
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Affiliation(s)
- Arcangelo Barbonetti
- Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences, University of L'Aquila, Coppito, L'Aquila, Italy
| | - Giulia Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, - Careggi Teaching Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Clotilde Sparano
- Andrology, Women's Endocrinology and Gender Incongruence Unit, - Careggi Teaching Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Chiara Castellini
- Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences, University of L'Aquila, Coppito, L'Aquila, Italy
| | - Linda Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, - Careggi Teaching Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
- Istituto Nazionale Biostrutture e Biosistemi, Rome, Italy
| | - Mario Maggi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, - Careggi Teaching Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
- Istituto Nazionale Biostrutture e Biosistemi, Rome, Italy
- Endocrinology Unit, Careggi Teaching Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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Hwang JHA, Downing MG, Specht RAG, Ponsford JL. Co-designing for behavioural change: understanding barriers and enablers to addressing sexuality after traumatic brain injury and mapping intervention strategies in a multi-disciplinary rehabilitation unit. BRAIN IMPAIR 2024; 25:IB23068. [PMID: 38566291 DOI: 10.1071/ib23068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/24/2023] [Indexed: 04/04/2024]
Abstract
Background Persistent changes in sexuality often follow traumatic brain injury (TBI). However, health professionals remain reticent about discussing sexuality and have reported barriers including uncertainties around whose role it is and limited educational and institutional support. This study employed a co-design and implementation process, aiming to promote team-wide behavioural change, whereby health professionals at a TBI rehabilitation unit would attempt to address sexuality with patients routinely. Methods Focus group sessions with multidisciplinary health professionals were conducted to identify barriers and enablers to behavioural change, identify areas for development, and co-design intervention options. Implementation deliverables were then finalised and provided to the team. The Theoretical Domains Framework was used to map factors influencing behaviours and the Behaviour Change Wheel was used to map interventions. Thematic analysis was used to further analyse barrier themes. Results Thirty-five barriers and eight enablers falling within 12 theoretical domains to behavioural change were identified. Thematic analysis revealed highly correlated barriers in initiating and sustaining change. Nine co-designed intervention options aligned with five intervention functions of the Behaviour Change Wheel, resulting in six final implementation deliverables. Conclusions Barriers were highly interrelated, influencing the approach to implementation deliverables. Simultaneously addressing multiple barriers could potentially alleviate discomfort associated with discussing sexuality. Concerns around initiating change were related to confidence in achieving sustainable changes. Achieving change requires organisational and team-level environmental restructuring and enablement. The next step involves evaluating the effectiveness of the co-design and implementation process in driving behavioural change and potential impacts on patient satisfaction and sexuality outcomes.
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Affiliation(s)
- Jill H A Hwang
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Vic. 3121, Australia; and Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, Vic. 3121 Australia
| | - Marina G Downing
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Vic. 3121, Australia; and Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, Vic. 3121 Australia
| | - Riccarda A G Specht
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jennie L Ponsford
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Vic. 3121, Australia; and Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, Vic. 3121 Australia
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