Sexual health最新文献

{"title":"Characteristics and determinants of quality non-directive pregnancy options counselling: a scoping review.","authors":"Kari Dee Vallury, Amanda Asher, Olivia Sarri, Nicola Sheeran","doi":"10.1071/SH24170","DOIUrl":"https://doi.org/10.1071/SH24170","url":null,"abstract":"<p><p>Non-directive pregnancy options counselling (POC) is a core component of comprehensive reproductive health care for pregnant people wanting support in making a pregnancy outcome decision. Approximately one quarter of people with unintended pregnancies and people seeking abortion care seek POC. This study synthesises global evidence on access to and characteristics of quality non-directive POC. We searched five health databases in line with PRISMA guidelines. Primary research articles (published in English, 2011-2023) were included if they addressed provision, experiences, or characteristics of non-directive POC. Data were synthesised and organised thematically. Twelve of the 4021 unique citations identified were included in the review. Four themes were generated: (1) characteristics of quality non-directive POC; (2) provider-level determinants of care quality and provision; (3) patient level factors impacting the desire for and receipt of care; and (4) organisational setting and legal determinants of provision and quality of care. Abortion-related values and policies at the provider, organisational and legislative levels were the most common and salient determinants of POC access and quality. Quality POC includes non-directive, empathetic, compassionate discussions about all pregnancy options that convey non-judgement and respect. However, we identified provider, organisational setting, and legal level determinants that disproportionately impact access to POC for marginalised pregnant people. Research regarding POC access and quality outside of the USA is needed. Upskilling primary care and other health professionals in POC and embedding referral pathways to non-directive POC and abortion care will support Australia to achieve its commitment to universal access to reproductive health care by 2030.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"22 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the impact of sexualised drug use with and without chemsex on sexual behaviours among men who have sex with men in China: a national multi-site cross-sectional study.","authors":"Jiajun Sun, Bingyang She, Phyu M Latt, Jason J Ong, Xianglong Xu, Yining Bao, Christopher K Fairley, Lin Zhang, Weiming Tang, Lei Zhang","doi":"10.1071/SH24173","DOIUrl":"10.1071/SH24173","url":null,"abstract":"<p><p>Background Sexualised drug use (SDU) is common in men who have sex with men (MSM). Chemsex, a form of psychoactive SDU, is a strong risk factor for sexually transmitted infections (STIs). We investigated the associations of SDU and chemsex with the sexual behaviours in Chinese MSM. Methods From 23 March 2022 to 22 April 2022, we recruited participants (male, >18 years old) via WeChat across five Chinese cities to an online cross-sectional survey on sexual behaviour preferences, pre-exposure prophylaxis, SDU, and chemsex. One-way ANOVA and chi-squared tests were used to compare sexual behaviour patterns across the groups. Results We included the responses from 796 eligible participants, who were aged 18-70 years, and mostly single. Three groups of participants were identified, the largest was the 'non-SDU group' (71.7%), followed by the 'SDU without chemsex' group (19.7%), and the 'chemsex' group (8.5%). Poppers (8.4%) were the most used drugs in the 'chemsex' group. The 'chemsex' group also had the highest number of sexual partners, and reported the highest frequency of self-masturbation (38.2%). The'chemsex' group also exhibited the highest Shannon diversity index value of 2.32 (P =0.03), indicating a greater diversity of sexual acts. For sequential sex act pairs, the 'chemsex' group was more likely to self-masturbate than perform receptive oral sex, perform receptive oral sex than self-masturbate, being masturbated or perform receptive oral sex than being rimmed by another man. Conclusion Our findings identify the urgent need for targeted HIV/STI interventions for MSM who practice chemsex.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"21 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between antimicrobial resistance mutations and treatment outcomes for <i>Mycoplasma genitalium</i> infections from 2018 to 2022: a cross-sectional study from Auckland, New Zealand.","authors":"Shivani Fox-Lewis, Rose Forster, Indira Basu, Matthew Blakiston, Gary McAuliffe","doi":"10.1071/SH24166","DOIUrl":"https://doi.org/10.1071/SH24166","url":null,"abstract":"<p><p>Background New Zealand has among the highest rates of antimicrobial resistance in Mycoplasma genitalium in the world. The aim of this study was to correlate treatment outcomes with 23S rRNA and parC mutations associated with macrolide and fluroquinolone resistance, respectively, in a cohort of sexual health clinic patients. Methods Laboratory and clinical data were collected for patients with M. genitalium infections attending Auckland Sexual Health Service between 1 January 2018 and 31 December 2022, who had a test-of-cure performed within 21-90days of a treatment episode. Treatment outcomes were correlated with the presence or absence of resistance mutations and treatment regimen utilised. Results A total of 95 infections from 93 patients met the study inclusion criteria. Eighty of 93 (86%) infections with available data were macrolide resistant, with 20 of 74 (27%) having both macrolide resistance and parC mutations. Sixteen of 20 (80%) of parC mutations were G248T (S83I), three of 20 (15%) G259T (D87Y) and one of 20 (5%) A247C (S83R). All macrolide-susceptible infections treated with doxycycline and azithromycin were cured (12/12), as were all macrolide-resistant infections without parC mutations treated with doxycycline and moxifloxacin (37/37). Cure rates for macrolide-resistant infections with parC mutations were lower, with variable and often multiple treatment courses; eight of 16 (50%) were cured using one course of sequential doxycycline and moxifloxacin, seven of nine (78%) with one course of minocycline, zero of two (0%) with pristinamycin and one of one (100%) with doxycycline and sitafloxacin. Conclusions Our findings highlight the differing treatment outcomes for infections with and without parC mutations, offering opportunities to refine management of M. genitalium infections.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"21 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual dissatisfaction and its association with health status among older adults in China: a nationwide study.","authors":"Yiwen Diao, Yan Sun, Joseph D Tucker, Fan Yang","doi":"10.1071/SH24016","DOIUrl":"https://doi.org/10.1071/SH24016","url":null,"abstract":"<p><p>Background Most population-based sexual health research in China excludes older adults. To fill the gap, this study aims to characterise sexual dissatisfaction among people aged 50years or older from a nationwide, population-representative sample and to explore its association with physical, mental, and self-reported overall health indicators. Methods Data were collected as part of the China Family Panel Studies in 2020, led by the Institute of Social Science Survey of Peking University. Multivariable logistic regressions with robust estimators were used to investigate the association between sexual dissatisfaction and health indicators and potential demographic confounders. Results Among the 8222 partnered Chinese adults aged 50years or older (median age: 59, IQR: 54-66, 47% identified as women), 78% (6380/8222) reported being satisfied or very satisfied in their sex life. After adjusting for demographic variables, poor self-rated health status (aOR: 1.59, 95% CI: 1.42-1.77), experiencing depression symptoms (aOR: 2.02, 95% CI: 1.80-2.26), and having chronic diseases (aOR: 1.20, 95% CI: 1.07-1.36) were positively associated with sexual dissatisfaction in multivariable analyses. Among sociodemographic factors, younger age, female gender, and education level at senior high school or above were more likely to experience sexual dissatisfaction (all P Conclusion Based on our sample, more than one in five Chinese adults aged 50years or older might face sexual dissatisfaction. Comorbidities common in older age likely exacerbate sexual dissatisfaction. Greater attention to sexual satisfaction research and sexual health programs among older adults is needed with respect to gender differences and chronic disease comorbidities.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"21 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of IgG serum antibodies, electronic health records and self-report in estimating past infection with <i>Chlamydia trachomatis</i> in a cohort of men who have sex with men.","authors":"Mary Bridget Waters, Lindley A Barbee, Kevin Hybiske, Katherine Newman, Ren Ikeda, Angela LeClair, Matthew R Golden, Olusegun O Soge, Lisa E Manhart, Christine M Khosropour","doi":"10.1071/SH24101","DOIUrl":"https://doi.org/10.1071/SH24101","url":null,"abstract":"<p><p>Background The best method for measuring a history of Chlamydia trachomatis (CT) infections is unknown. We examined the reliability of three methods as markers of past CT infections: IgG serum antibodies, the electronic health record (EHR) and self-report. Methods This cross-sectional study used data from a cohort study of 122 MSM in King County, Washington, United States. Sera were tested for IgG using the mixed CT peptide enzyme-linked immunosorbent assay (ELISA). Participant data for past CT diagnoses were extracted from the EHR. Self-report of past CT was collected via survey. We calculated positive and negative percent agreements of CT history using total IgG serum antibodies to CT, past EHR diagnosis and self-report of past CT as reference measures when they were compared with one another. Results Of those who were IgG seropositive, only 41.5% had a past diagnosis of CT in their EHRs, but 74.4% self-reported a history of CT. The majority (92.7%) of participants who had a diagnosis of CT in their EHRs reported a past CT infection. Conclusions Self-report in combination with IgG serum antibodies to CT may be a more reliable indicator of past CT than EHRs in settings without comprehensive EHRs.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"21 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High interest for long-acting injectable PrEP among men who have sex with men at most risk for HIV in San Francisco, 2021.","authors":"Christopher J Hernandez, Caitlin M Turner, Dillon Trujillo, Moranda Tate, Jerry Quintana, Glenda Baguso, Katherine C McNaughton, Sean Arayasirikul, Willi McFarland, Erin C Wilson","doi":"10.1071/SH23085","DOIUrl":"https://doi.org/10.1071/SH23085","url":null,"abstract":"<p><p>Background Men who have sex with men (MSM) represent a disproportionate total of incident HIV cases. Oral pre-exposure prophylaxis (PrEP) has contributed to significant declines in total HIV incidence. Barriers to PrEP include individual and structural factors that can prevent PrEP adherence and persistence. Long-acting injectable PrEP (LA-IP) can be leveraged to address high incident rates of HIV. Methods This study was a secondary analysis of the National HIV Behavioral Surveillance (NHBS) survey. We measured interest in LA-IP and associated factors among MSM in San Francisco from June 2021 to December 2021. Results Of the 505 MSM who were recruited, 409 reported not living with HIV. Interest in LA-IP among MSM in San Francisco was high (78.0%). Interest was associated with the use of on-demand PrEP (adjusted prevalence ratio [aPR] 3.68, 95% confidence interval [CI] 1.24-10.9), having two or more sexual partners (aPR 3.65, 95% CI 1.89-7.03), and having condomless insertive anal intercourse (aPR 2.15, 95% CI 1.19-3.87). LA-IP was inversely associated with having a high school education or lower (aPR 0.23, 95% CI 0.08-0.70) and being aged 50 years or more (aPR 0.32, 95% CI 0.19-0.56). Strikingly, we found that five of the six participants who were found to have incident HIV infections in this study were interested in LA-IP. Further, they had used oral PrEP in the past 30days with suboptimal adherence. Conclusions These findings suggest that a population with elevated risk for HIV and barriers to daily oral PrEP adherence may find LA-IP a preferable alternative to daily oral PrEP in meeting their HIV prevention needs.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"21 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher identity resilience - self-efficacy is associated with sexual risk behaviours in gay men.","authors":"Rusi Jaspal, Asrin Yenihayat","doi":"10.1071/SH24211","DOIUrl":"https://doi.org/10.1071/SH24211","url":null,"abstract":"<p><p>Cross-sectional survey data from 226 heterosexual and 201 gay men in the UK and Germany, analysed using moderation analyses, showed a positive relationship between identity resilience -self-efficacy and engaging in condomless sex and drug use in sexualised settings in gay men only. It is proposed that higher self-efficacy may lead to increased feelings of invincibility in gay men, which in turn is associated with sexual risk-taking.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"21 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual satisfaction among people living with HIV in the era of biomedical prevention: enduring impacts of HIV-related stigma?","authors":"Thomas Norman, Adam Bourne, Jack Thepsourinthone, Dean Murphy, John Rule, G J Melendez-Torres, Jennifer Power","doi":"10.1071/SH24103","DOIUrl":"https://doi.org/10.1071/SH24103","url":null,"abstract":"<p><p>Background People living with HIV (PLHIV) have historically faced a range of challenges negotiating satisfying sex lives in the context of virus transmission risks and HIV-related stigma. We examine the experience of sexual satisfaction among PLHIV in an era of pre-exposure prophylaxis (PrEP) and undetectable=untransmissible (U=U)/treatment as prevention. Methods Data are derived from HIV Futures 9, a cross-sectional survey of PLHIV in Australia conducted between December 2018 and May 2019. Logistic regression was used to identify factors associated with sexual satisfaction, including awareness of/engagement with U=U and PrEP as well as experiences that denote HIV-related stigma. Results Over half (56.5%) of the total sample (n =715) reported they were not satisfied with their sex lives. Those who avoided sex because of their HIV status (44.4%) were more likely to report sexual dissatisfaction, as were those who were aged 50 years or over and those with worse self-reported health. Participants who expressed a concern about their drug use were more likely to report sexual dissatisfaction when compared with those who expressed no such concern. Conclusions Concerns about HIV continue to be present in the lives of PLHIV and can interrupt or undermine intimate and sexual relationships. Although biomedical prevention technologies such as PrEP and antiretroviral therapy may alleviate anxiety relating to onward transmission of HIV, these findings indicate that concerns about HIV status, which may be related to experiences of stigma, are still adversely associated with enjoyment of sex for those living with HIV.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"21 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-creation and community engagement in implementation research with vulnerable populations: a co-creation process in China.","authors":"Liyuan Zhang, Katherine T Li, Tong Wang, Danyang Luo, Rayner K J Tan, Gifty Marley, Weiming Tang, Rohit Ramaswamy, Joseph D Tucker, Dan Wu","doi":"10.1071/SH23149","DOIUrl":"https://doi.org/10.1071/SH23149","url":null,"abstract":"<p><p>Background Top-down implementation strategies led by researchers often generate limited or tokenistic community engagement. Co-creation, a community engagement methodology, aims to create a shared leadership role of program beneficiaries in the development and implementation of programs, and encourages early and deep involvement of community members. We describe our experience using a four-stage co-creation approach to adapt and implement a sexually transmitted diseases (STD) testing intervention among men who have sex with men (MSM) in China. Methods We adapted a four-stage approach to co-creation. First, we conducted a needs assessment based on our prior work and discussions with community members. Second, we planned for co-creation by establishing co-creator roles and recruiting co-creators using both stratified convenience and opportunistic sampling. Third, we conducted co-creation via hybrid online/in-person focus groups (four multistakeholder groups and four MSM-only groups). Finally, we evaluated validity of the co-creation process through qualitative observations by research staff, analyzed using rapid qualitative analysis, and evaluated co-creator experience through post-discussion survey Likert scales and open-ended feedback. Results Needs assessment identified the needs to adapt our STD intervention to be independently run at community-based and public clinics, and to develop explanations and principles of co-creation for our potential co-creators. In total, there were 17 co-creation members: one co-creation lead (researcher), two co-chairs (one gay influencer and one research assistant), eight MSM community members, four health workers (two health professionals and two lay health workers) and two research implementers and observers. Co-created contents for the trial included strategies to decrease stigma and tailor interventions to MSM at public STD clinics, strategies to integrate STD testing services into existing community-led clinics, and intervention components to enhance acceptability and community engagement. Our evaluation of validity identified three main themes: challenges with representation, inclusivity versus power dynamics and importance of leadership. Surveys and free responses suggested that the majority of co-creators had a positive experience and desired more ownership. Conclusion We successfully adapted a structured co-creation approach to adapt and implement an STD testing intervention for a vulnerable population. This approach may be useful for implementation, and further research is needed in other contexts and populations.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"21 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preferences for the delivery of early abortion services in Australia: a discrete choice experiment.","authors":"Jody Church, Marion Haas, Deborah J Street, Deborah Bateson, Danielle Mazza","doi":"10.1071/SH24112","DOIUrl":"https://doi.org/10.1071/SH24112","url":null,"abstract":"<p><p>Background Abortion is a common procedure in Australia; it is estimated that the rate is between 15 and 17 per 1000 women. Surgical and medical abortion options are available; however, the use of medical abortion is not as common as in other similar countries. The aim of this study is to understand preferences for the provision of early abortion services in Australia. Methods We conducted a survey of 821 members of an online panel representative of the Australian adult general population. The survey consisted of a discrete choice experiment including 16 choice tasks and a number of follow-up questions. A mixed logit model was used to analyse the responses to the discrete choice experiment. Results Respondents preferred services that provided surgical abortion compared with early medical abortion (EMA). They preferred consultations with a specialist gynaecologist compared with a general practitioner (GP); consultations with a GP were preferred to those with a nurse practitioner. Face-to-face consultations were preferred to telehealth. For EMA, respondents preferred to collect medication from the doctor's surgery rather than from a pharmacy or to receive it by post. Overall, respondents preferred lower-cost services. There were no differences in preferences between respondents with or without experience of abortion or between genders. Conclusions Respondents prefer abortion services with low out-of-pocket costs. Their reluctance to use a nurse-led service may reflect the general public's lack of understanding of and familiarity with the training and expertise of nurse practitioners. Similarly, the safety and benefits of EMA relative to surgery, including EMA delivered by telehealth, need to be emphasised.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"21 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}