Sexual health最新文献

{"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}

{"title":"Rising incidence of gonorrhea in Taiwan amid the COVID-19 pandemic: a nationwide surveillance study.","authors":"Hsing-Yuan Chen, Yi-Hsiang Sung, Chung-Chu Chen, Shun-Long Weng, Bo-Huang Liou, Chun-Yan Yeung, Chi-Hone Lien, Chao-Hsu Lin, Hsin Chi, Liang-Yen Lin, Nan-Chang Chiu, Chien-Yu Lin","doi":"10.1071/SH23188","DOIUrl":"https://doi.org/10.1071/SH23188","url":null,"abstract":"<p><p>Background The protracted battle against coronavirus disease 2019 (COVID-19) has had a profound impact on various facets of society. The epidemiology of several diseases underwent alterations following the implementation of social restrictive strategies and non-pharmaceutical interventions (NPI). Methods In response to these changes, we conducted a retrospective nationwide surveillance study to investigate the prevalence of sexually transmitted infections during the pandemic. Weekly incidences of gonorrhea, syphilis, human immunodeficiency virus (HIV), and enterovirus were extracted from the national surveillance database. Results Over the period from 2015 to 2022, a sustained increase in gonorrhea notifications was evident (linear trend with a rising slope of 0.24 and an R-squared value of 0.62). When comparing the pre-pandemic period (2017-2019) with the pandemic period (2020-2022), a significant surge in gonorrhea notifications was observed (85 notifications per week pre-pandemic vs 143 notifications during the pandemic, representing a 68% increase, P Conclusions Our study highlights a significant rise in gonorrhea notifications during the pandemic. Despite disruptions to gonorrhea testing and medical services, and the implementation of NPI, there was no significant decrease in the incidence of gonorrhea in Taiwan. Gonorrhea emerged as a critical public health concern during the pandemic.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"21 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606541","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":"Community-engaged strategies to improve sexual health services for adults aged 45 and above in the United Kingdom: a qualitative data analysis.","authors":"Michel Nunez, Yoshiko Sakuma, Hayley Conyers, Suzanne Day, Fern Terris-Prestholt, Jason J Ong, Stephen W Pan, Tom Shakespeare, Joseph D Tucker, Eneyi E Kpokiri, Dan Wu","doi":"10.1071/SH24143","DOIUrl":"https://doi.org/10.1071/SH24143","url":null,"abstract":"<p><p>Background Sexual health is an essential component of health and well-being across the life course. However, sexual health research often focuses on young adults and excludes those aged 45years and older. We organized a national crowdsourcing open call and co-creation events to identify recommendations to improve sexual health service provision for middle-aged and older adults in the United Kingdom (UK). Methods We conducted a crowdsourcing open call and seven co-creation events consisting of workshop-style meetings and one-to-one in-depth interviews. Open call submissions and qualitative data from the co-creation events were analyzed using a thematic approach. A social-ecological framework was used to code deductively, but new codes were allowed to emerge. Thematic categories were organized to describe factors influencing the accessibility and inclusivity of sexual health services for middle-aged and older adults. Results We received 22 submissions in total; of those, 35% of participants reported a disability, 40% of individuals were aged 45-65years, and 6% of submissions came from individuals that identified as gay/lesbian. Five key themes highlighted that improving sexual health services for adults aged 45years and over requires a multi-leveled approach: increase sexual health education, enhance patient and provider relationships, utilize community-led sexual health promotion efforts and delivery of reliable sexual health information, improve inclusive sexual health services, and break down sexual health taboos against adults aged 45+ years. Conclusions Our data suggest that middle-aged and older adults can co-create compelling strategies to enhance sexual health services for middle-aged and older adults in the UK. Further implementation research is needed to pilot these strategies.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"21 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688902","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 health in an aging world: a global call to action for more resilient services for older and disabled adults.","authors":"Sophia Randazzo, Suzanne Day, Isabella Kritzer, Huachun Zou, Hayley Conyers, Yoshiko Sakuma, Dan Wu, Eneyi E Kpokiri, Lianne Gonsalves, Joseph D Tucker","doi":"10.1071/SH24137","DOIUrl":"10.1071/SH24137","url":null,"abstract":"<p><p>Sexual health and well-being are critical for people across all age groups. However, older adults are neglected in sexual health research, programs, and policies. This editorial is a call to action for greater attention to the sexual health of older adults. We welcome all related research on this topic, but are particularly interested in manuscripts related to sexual functioning and co-morbidities, menopause and related topics, sexual health service utilization, research that links sexual activity and health, perspectives from low and middle-income countries, and community-engaged research on sexual health among older adults.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"21 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628493","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":"Perceptions, experiences and concerns with sexually transmitted infections among current and former PrEP users: a longitudinal qualitative study of gay, bisexual and queer men in Canada.","authors":"Emerich Daroya, Alex Wells, Mark Gaspar, Jad Sinno, Mark Hull, Nathan J Lachowsky, Darrell H S Tan, Daniel Grace","doi":"10.1071/SH23195","DOIUrl":"https://doi.org/10.1071/SH23195","url":null,"abstract":"<p><p>Background Pre-exposure prophylaxis (PrEP) use has been attributed to heightened rates of sexually transmitted infections (STIs), ostensibly due to increased condomless anal sex (CAS) and greater frequency of STI testing. Few qualitative studies have assessed how gay, bisexual and queer men (GBQM) who use PrEP perceive STIs and how these attitudes have evolved post-PrEP uptake. We investigated the perspectives of current and former PrEP users on STIs. Methods Annual, in-depth longitudinal interviews were conducted with 38 current and former PrEP users in Ontario (n =18) and British Columbia (n =20), Canada, as part of a mixed-methods implementation science study (2020-2022). Over 3years, 109 interviews were conducted. Data analysis included reflexive thematic coding and longitudinal recurrent cross-sectional analysis using NVivo 12. Results Four STI-related themes emerged: (1) lack of STI-related concerns due to treatment and prevention optimism, (2) stigma-related concerns, (3) perceived risk among other PrEP users due to increased CAS, and (4) inconsistent testing concerns among non-PrEP users. Over time, some STI-related anxieties decreased with increased knowledge and reduced stigma. However, concerns persisted for other participants due to perceived risky sexual behaviours among other PrEP users and non-PrEP users. Both current and former PrEP users who expressed STI-related apprehensions consistently indicated adopting risk-reduction strategies, including condom use and having fewer sexual partners throughout the study. Conclusions Findings show how varied STI perceptions and experiences among current and former PrEP users shaped sexual decision-making over time. Providers, public health experts, and policymakers should develop a more comprehensive strategy to address STI concerns among GBQM.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"21 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628208","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":"Prescribing pre-exposure prophylaxis for HIV prevention: a cross-sectional survey of general practitioners in Australia.","authors":"Jason Wu, Christopher K Fairley, Daniel Grace, Benjamin R Bavinton, Doug Fraser, Curtis Chan, Eric P F Chow, Jason J Ong","doi":"10.1071/SH24018","DOIUrl":"https://doi.org/10.1071/SH24018","url":null,"abstract":"<p><p>Background Pre-exposure prophylaxis (PrEP) is a safe and effective medication for preventing HIV acquisition. We examined Australian general practitioners' (GP) knowledge of PrEP efficacy, characteristics associated with ever prescribing PrEP and barriers to prescribing. Methods We conducted an online cross-sectional survey of GPs working in Australia between April and October 2022. We performed univariable and multivariable logistic regression analyses to identify factors associated with: (1) the belief that PrEP was at least 80% efficacious; and (2) ever prescribed PrEP. We asked participants to rate the extent to which barriers affected their prescribing of PrEP. Results A total of 407 participants with a median age of 38years (interquartile range 33-44) were included in the study. Half of the participants (50%, 205/407) identified how to correctly take PrEP, 63% (258/407) had ever prescribed PrEP and 45% (184/407) felt confident with prescribing PrEP. Ever prescribing PrEP was associated with younger age (AOR 0.97, 95% CI: 0.94-0.99), extra training in sexual health (AOR 2.57, 95% CI: 1.54-4.29) and being a S100 Prescriber (OR 2.95, 95% CI: 1.47-5.90). The main barriers to prescribing PrEP included: 'Difficulty identifying clients who require PrEP/relying on clients to ask for PrEP' (76%, 310/407), 'Lack of knowledge about PrEP' (70%, 286/407) and 'Lack of time' (69%, 281/407). Conclusion Less than half of our GP respondents were confident in prescribing PrEP, and most had difficulty identifying who would require PrEP. Specific training on PrEP, which focuses on PrEP knowledge, identifying suitable clients and making it time efficient, is recommended, with GPs being remunerated for their time.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"21 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628221","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":"Telehealth for HIV care and management among people living with HIV in Australia: results from an online survey.","authors":"Juan Martinez-Andres, Christopher K Fairley, Timothy Krulic, Jason J Ong, Louise Owen, Anna McNulty, Melanie Bissessor, Caroline Thng, Charlotte Bell, Mahesh Ratnayake, Dean Murphy, Eric P F Chow, Tiffany R Phillips","doi":"10.1071/SH24067","DOIUrl":"https://doi.org/10.1071/SH24067","url":null,"abstract":"<p><p>Background The aims of this study were to evaluate the experiences of telehealth for routine HIV care and identify preferred models of HIV routine care for the future. Methods Anonymous, online questionnaire among people living with HIV aged 18years or older. This survey was advertised via posters with a QR code in six sexual health clinics and one community organisation as well as on social media from November 2021 to December 2022. Results Of 89 participants, the majority were males (80/89, 89.9%), between 36 and 55years old (49/89, 55.1%), spoke English at home (74/89, 84.1%), had been living with HIV for >5years (68/89, 76.4%) and reported having a telehealth consultation since the COVID-19 pandemic began (69/89, 77.5%). The top three liked aspects of telehealth were: the convenience of not leaving home or work (50/69, 72.5%); less travel time (48/69, 69.6%); and avoiding contact with other people (30/69, 43.5%). The top three dislikes of telehealth were: they could not be screened for sexually transmitted infections (STIs) or have a physical examination at the same time (29/69, 42.0%); it was an impersonal experience (20/69, 29.0%); and it was more difficult to discuss health concerns (18/69, 26.1%). Among all participants, the preference for future consultations was to have a mix between in-person and telehealth (40/89, 44.9%); however, nearly one-quarter prefer in-person consultations only (20/89, 22.5%). Conclusions Use of telehealth during COVID-19 has been evaluated positively among people living with HIV that participated in this survey. Participants support the use of telehealth for routine care in conjunction with in-person consultations.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"21 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576133","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":"Relationship status and sexual health service engagement among young people in the United Kingdom: a cross-sectional survey study.","authors":"Jack Large, Selma Vieira, Cora Sargeant, Clare Scholfield, Heather L Armstrong","doi":"10.1071/SH24094","DOIUrl":"https://doi.org/10.1071/SH24094","url":null,"abstract":"<p><p>Background Sexual health service engagement is important for the healthy sexual development of young people. Further, as later adolescence and early adulthood are critical periods for relationship development, sexual health needs may vary across this period and be associated with relationship status. Methods A total of 468 participants, aged 16-25years (mean age: 19.7years) and living in the United Kingdom, completed an anonymous, online survey about their sexual health service use. To explore how relationship status is associated with engagement for five different sexual health services, we conducted chi-squared and multivariable logistic regression analyses. Results In general, engagement with sexual health services was low: 28.2% reported accessing free condoms, 21.4% reported STI testing, and 9.4% had used relationship advice services. Among women only, 57.2% had accessed services to start the pill and 19.6% had done so for pregnancy testing. Among all participants, those in relationships were more likely to have accessed sexual health services for free condoms (aOR: 1.71, 95% CI: 1.13, 2.59). Among female participants, those in relationships were more likely to have accessed sexual health services to start the pill (aOR: 2.21, 95% CI: 1.45, 3.36) and for pregnancy testing (aOR: 3.86, 95% CI: 2.20, 6.78). There were no differences by relationship status for accessing sexual health services for STI testing or relationship advice. Conclusions Health care providers and relationship and sexual education providers should encourage all young people to engage with sexual health services, while also recognising that sexual health needs are likely to vary depending on relationship status.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"21 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688915","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":"Trends in high-risk human papillomavirus infection and cervical cytology of women in Karamay City, 2012-2021.","authors":"Xiaoping Jia, Min Jiang, Jing Zhou, Cailing Ma","doi":"10.1071/SH24057","DOIUrl":"https://doi.org/10.1071/SH24057","url":null,"abstract":"<p><p>Background To describe the changes in cervical lesions prevalence and high-risk human papillomavirus (HR-HPV) infections from 2012 to 2021, which have never been reported before, to provide direction for the effective implementation of cervical cancer prevention measures. Methods This retrospective study included women aged >25years who received either organised or opportunistic cervical HR-HPV screening from January 2012 to December 2021 in Karamay Central Hospital, Karamay, China. The patients were split into four groups according to age 25-35, 36-45, 46-55 and >55years, respectively. The Joinpoint Regression Program was used to analyse the trends of HR-HPV infection and the detection of cervical lesions. Results Data from 85,429 women revealed a decline in HR-HPV infection rates across all age groups from 2012 to 2021. Although HR-HPV infection rates decreased, cervical lesion detection rates increased, although the proportion of cervical cancer in these lesions declined, likely due to enhanced awareness and HPV vaccination in Karamay. From 2012 to 2021, the prevalence of low-grade squamous intraepithelial lesions was 9.70%, and high-grade squamous intraepithelial lesions was 5.85%. HR-HPV infections were highest in the ≥55years age group, with HPV52 (20.96%) being the most prevalent type. Conclusions In the past 10years, the prevalence of HR-HPV infection has shown a decreasing trend, whereas the detection prevalence of cervical lesions has shown an upward trend among women in Karamay City. Importantly, particular emphasis should be placed on cervical cancer screening in women aged >55years.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"21 ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508457","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}