Sexual health最新文献

{"title":"Improving antimicrobial stewardship in an urban STI clinic: from syndromic management to targeted antibiotic treatment of male urethritis using point-of-care chlamydia and gonorrhea testing.","authors":"Shira Heisler, Brianna Kline, Cindy Sullins","doi":"10.1071/SH25254","DOIUrl":"10.1071/SH25254","url":null,"abstract":"<p><strong>Background: </strong>The Centers for Disease Control and Prevention (CDC) has identified drug-resistant Neisseria gonorrhoeae as an urgent public health threat, highlighting the importance of antimicrobial stewardship. This study evaluated the implementation of point-of-care (POC) nucleic acid amplification (NAA) testing for chlamydia and gonnorhea among males presenting with urethritis at an urban public sexually transmitted infections (STI) clinic.</p><p><strong>Methods: </strong>POC urine NAA testing was performed for males presenting with symptoms of urethritis and/or urethral discharge, as well as asymptomatic males reporting STI exposure. Patients with with laboratory-confirmed infections were treated according to CDC STI treatment guidelines: for chlamydia, patients were treated with doxycycline 100 mg orally twice daily for 7 days; for gonorrhea, patients were treated with a single 500-mg intramuscular dose of ceftriaxone. Patients testing negative for both infections were managed for non-gonococcal urethritis with doxycycline, or in select cases, received no empiric therapy. Reductions in antibiotic use were compared with standard syndromic management.</p><p><strong>Results: </strong>A total of 385 POC tests were analysed. Gonorrhea was detected in 40 patients (10.4%), chlamydia in 29 (7.5%), and both infections in five (1.3%), while 311 (80.8%) were negative. Forty-seven patients received ceftriaxone, representing an absolute reduction of 338 doses (87.8% relative reduction). Doxycycline was dispensed to 193 patients, representing an absolute reduction of 192 doses (49.9% relative reduction).</p><p><strong>Conclusions: </strong>Implementation of POC NAA testing for chlamydia and gonorrhea in male patients presenting with urethritis improved antimicrobial stewardship by significantly reducing unnecessary empiric use of antibiotics in an urban STI clinic setting.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"23 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164601","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":"Digital versus clinic-based sexual health services: patterns of use and equity implications from a UK-based evaluation.","authors":"Fiona Robertson, Shaun McGill","doi":"10.1071/SH26077","DOIUrl":"10.1071/SH26077","url":null,"abstract":"<p><strong>Background: </strong>Digital sexual health services have expanded rapidly in England; yet, concerns remain regarding equitable access among different population groups. We compared demographic characteristics and outcomes between online and clinic-based sexual health service users in Leicester, Leicestershire, and Rutland.</p><p><strong>Methods: </strong>A retrospective analysis of data (April 2019-June 2023) compared online contacts, via SH:24, a UK online sexual health service providing postal sexually transmitted infection (STI) testing and remote contraception, with in-clinic attendances. Demographic variables included age, gender, ethnicity and Index of Multiple Deprivation (IMD 2019) decile, where Deciles 1-2 represent the most deprived areas. Ethnicity was recoded into Office for National Statistics categories. Reasons for attendance, contraception methods, and STI test outcomes were analysed. Risk ratios with 95% confidence intervals compared proportions between modalities.</p><p><strong>Results: </strong>Online users were younger than clinic attendees (mean age, 25.1 vs 31.4 years). A slightly higher proportion of women accessed online services although gender was unrecorded in 59.1% of online attendances. White and mixed ethnicity groups were more likely to use online services than Black, Asian and 'Other' ethnic groups. Individuals living in the most deprived areas were less likely to access online services. STI testing was more frequent online (56.8% vs 43.3%), while positivity rates for infections were lower.</p><p><strong>Conclusions: </strong>Complementary to clinic-based sexual health services, online pathways provide accessible STI testing and contraception. Differences in uptake by age, ethnicity and deprivation highlight the importance of monitoring equitable access as digital provision expands. Maintaining both online and face-to-face provision is likely to remain important for equitable sexual health care.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"23 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138951","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":"Exploring menstrual poverty and its impact on adolescent mental health.","authors":"Ahmet Eren Tatar, Melis Pehlivantürk Kızılkan, Şeyma Erdem Torun, Yasemin Tulun, Aysel Hacısoy, Lala Jalilova, Zekiye Küpçü, Özlem Necipoğlu Banak, Yaşar Durmaz, Emine Demet Öztürk, Ayşe Bilge Baklacı, Ferda Evin, Yelda Kılıç, Sinem Akgül","doi":"10.1071/SH25196","DOIUrl":"10.1071/SH25196","url":null,"abstract":"<p><strong>Background: </strong>Menstrual poverty (MP) defines the lack of access to menstrual health management (MHM) due to financial barriers, and there are limited data regarding its effects on youth mental health. The purpose of this study was to assess MHM practices among adolescents, determine the prevalence of MP according to socioeconomic status and examine its association with depressive symptoms (DS).</p><p><strong>Methods: </strong>We conducted a survey on a nationally drawn sample (N = 1241) of adolescents aged 10-19 years. Data were collected from 12 provinces, which were classified into three (Tiers 5-6 having the lowest ranking) based on socioeconomic development rankings. Information regarding demographics, use and knowledge of menstrual products, menstrual hygiene, and MP was collected. The PHQ-9 scale was used to assess DS.</p><p><strong>Results: </strong>Overall, 15% of the cohort encountered challenges in obtaining MH products due to financial constraints, with a higher proportion in Tiers 5-6 (25%). Overall percentages of using improvised menstrual products (toilet paper, diapers, handmade pads, cloth etc.), MP-related school absenteeism, longer use due to an unsuitable school environment, and feeling ashamed to purchase menstrual products were 17.4%, 8.9%, 52% and 10.7%, respectively, with significantly higher proportions in Tiers 5-6. Individuals with MP were three times more likely to experience moderate-to-severe DS.</p><p><strong>Conclusions: </strong>The study indicates the significance of MP in relation to MHM across all socioeconomic levels, especially lower tiers, and its link with DS. It is imperative to establish cost-effective and sustainable health policies to improve the accessibility of MHM for menstruating individuals, starting with adolescents in poor socioeconomic conditions.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"23 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781831","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":"Sociodemographic correlates of contraceptive use among sexually active 15-year-old schoolchildren: a cross-sectional study in Albania.","authors":"Gentiana Qirjako, Anisa Subashi, Iris Mone, Enver Roshi, Elsona Agolli, Genc Burazeri","doi":"10.1071/SH26105","DOIUrl":"10.1071/SH26105","url":null,"abstract":"<p><strong>Background: </strong>Measuring contraceptive use and its sociodemographic distribution among teenagers is crucial for informing targeted sexual health education and equitable interventions. Our aim was to assess the prevalence and sociodemographic correlates of contraceptive use among sexually active adolescents.</p><p><strong>Methods: </strong>A cross-sectional study, conducted in Albania in 2022, included a nationwide representative sample of 1877 schoolchildren aged 15 years (55% girls; overall response 96%). Data on condom use, contraceptive pill use and sociodemographic characteristics were collected. Binary logistic regression was used to assess the associations of contraceptive use with sociodemographic factors.</p><p><strong>Results: </strong>Among 15-year-olds who reported engagement in sexual intercourse (N = 316), 176 (55.7%) reported condom use and 39 (12.6%) reported contraceptive pill use at last sexual intercourse. Conversely, one in five and one in 10 participants did not know whether they or their partner had used, respectively, a contraceptive pill or a condom, indicating gaps in partner communication and decision-making. Independent positive correlates of condom use at last sexual intercourse included male gender (OR 4.4, 95% CI 1.9-10.0) and a higher family affluence (OR 2.3, 95% CI 1.3-3.9). Furthermore, neither condom nor contraceptive pill use at last sexual intercourse was inversely related to male gender (OR 0.3, 95% CI 0.1-0.6) and a higher family affluence (OR 0.5, 95% CI 0.3-0.8).</p><p><strong>Conclusions: </strong>Contraceptive use among Albanian sexually active 15-year-olds is among the lowest in the European region, particularly among girls and those from low socioeconomic groups, highlighting persistent structural inequities in this transitional society. Our findings indicate an urgent need for targeted and equitable interventions to promote comprehensive contraceptive education and access in Albania.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"23 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875532","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":"Pelvic health physiotherapists' knowledge of and confidence working with the LGBTQIA+ community: a qualitative survey.","authors":"Anneka Kilroy, Rachel McKenna, Lixia Huang, Meg Harrold, Sarah Kenagy, Megan H Ross","doi":"10.1071/SH25261","DOIUrl":"10.1071/SH25261","url":null,"abstract":"<p><strong>Background: </strong>Inclusive pelvic health care for people with lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other diverse bodies, identities and/or experiences (LGBTQIA+) is essential, yet little is known about physiotherapists' preparedness to provide affirming care. This study explored the knowledge and confidence of pelvic health physiotherapists in Australia when working with LGBTQIA+ patients.</p><p><strong>Methods: </strong>Qualified physiotherapists practising in pelvic health in Australia were invited to complete an online survey. Qualitative data were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Sixty-three participants met eligibility criteria. The median participant age was 38 years (interquartile range 32-47 years), with a median of 9 years' (interquartile range 5-14 years) pelvic health clinical experience. Most participants identified as women (98.4%) and straight/heterosexual (87.3%), and 11.5% self-identified as LGBTQIA+. Although >75% of participants provided care for LGBTQIA+ patients, only 39% had undertaken LGBTQIA+-specific postgraduate education. One overarching theme, relationship between LGBTQIA+ exposure and knowledge and confidence, was identified, comprising two high-level themes: (1) the knowledge that shapes inclusive practice, and (2) pathways to inclusive practice. Participants with LGBTQIA+-specific pelvic health training and/or community connections demonstrated higher levels of knowledge and confidence, and most expressed a need for further training, particularly in gender-affirming language and care for people who are transgender.</p><p><strong>Conclusion: </strong>Pelvic health physiotherapists in Australia demonstrate varied knowledge and confidence when treating LGBTQIA+ individuals, shaped by exposure and education. Integrating LGBTQIA+ content into training may enhance pelvic health physiotherapists' capability to deliver inclusive, affirming care.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"23 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964729","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":"Determinants affecting the quality of sexual life among older adults in Africa: a scoping review.","authors":"Akeem Blessing Lateef, Titilola Gbaja-Biamila, Musa Sanni Ladan, Suzanne Day, Jane Okwuzu, Tomilola Musari-Martins, Agatha E Wapmuk, Oluwakorede Adedeji, Chisom Obiezu-Umeh, Juliet Iwelunmor, Joseph Tucker, Ucheoma Nwaozuru","doi":"10.1071/SH25275","DOIUrl":"10.1071/SH25275","url":null,"abstract":"<p><strong>Background: </strong>Older adults (people aged >60 years) are often stereotyped as being asexual, reflecting a broader lack of research into the sexual lives of this age group. Few studies have examined sexual well-being among older adults in low- and middle-income countries, especially in Africa. This scoping review aims to identify and synthesize the factors that affect sexual functioning and quality of sexual life among older adults in Africa.</p><p><strong>Methods: </strong>Following the approach of Arksey and O'Malley, a scoping review was conducted on determinants affecting the quality of sexual life among older adults in Africa. Seven databases were searched: PubMed, Google Scholar, CINAHL, Scopus, Web of Science, ProQuest and AJOL. Full texts were reviewed to determine the final set of papers for inclusion. Included papers were published, with publication dates between January 2010 and January 2025. Data were extracted on the study population, study design, mean age of the study participants, aims of the study and the determinants affecting the quality of sexual life, and summarized using narrative synthesis.</p><p><strong>Results: </strong>A total of 14,398 citations were identified in the database search, and seven studies were included in the review. The age of study participants averaged approximately 70 years. The research consisted of three qualitative and four quantitative articles. Four studies were conducted in Nigeria, and one each from South Africa, Morocco and Tanzania. Our review identified four categories of determinants influencing the quality of sexual life among older adults in Africa: psychological, sociocultural, physiological and health. Psychological determinants, including past trauma, performance anxiety and societal expectations, were identified across five studies. Sociocultural determinants, including sexual attitudes and culturally embedded behaviors, were examined in six studies, and found to shape the sexual functioning and behaviors of older adults. Physiological determinants, such as menopause and erectile dysfunction, were reported in four studies and associated with reduced sexual activity. Health determinants, including chronic conditions and pharmacological factors (medications), were identified in five studies as influencing older adults' sexual function and intimacy.</p><p><strong>Conclusion: </strong>Multiple, complex determinants affect the quality of sexual life among older adults in Africa. Our study findings have implications for designing sexual health services among older adults in Africa.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"23 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164580","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":"Female sexual function and satisfaction in the postpartum period: structural equation modelling analysis.","authors":"Farzaneh Ashrafinia, Hui Chen, Omolbanin Heydari","doi":"10.1071/SH25158","DOIUrl":"10.1071/SH25158","url":null,"abstract":"<p><strong>Background: </strong>After childbirth, many couples experience a decline in sexual function and satisfaction. This study aimed to investigate the relationship between the domains of the Female Sexual Function Index and sexual satisfaction during the postpartum period.</p><p><strong>Methods: </strong>A cross-sectional study of 500 postpartum women aged 18-42 years was conducted between 1 January and 30 June 2024 in 20 health centres in Kerman, Iran. All participants had resumed sexual activity after childbirth. The data was collected using self-assessment questionnaires, including the Female Sexual Function Index and the Larson Sexual Satisfaction Questionnaire. Structural equation modelling was used for data analysis.</p><p><strong>Results: </strong>The average age of participants was 30.9 ± 5.8 years. Sexual activity resumed at 9.1 weeks postpartum, with an average frequency of 6.0 times per month. The results showed a positive association between Female Sexual Function Index scores and sexual satisfaction (β = 1.231, P < 0.001). Inadequate income (P = 0.001) and moderately adequate income (P = 0.004) were negatively associated with sexual function, whereas earlier resumption of sexual activity was positively associated with sexual function (P < 0.001). Additionally, a higher number of children was significantly and negatively associated with sexual satisfaction (P = 0.028).</p><p><strong>Conclusion: </strong>Women's sexual satisfaction after childbirth was related to their sexual function, particularly in the areas of desire, arousal, orgasm and pain. Women who reported higher relationship satisfaction also tended to be more sexually active and had better sexual function.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"23 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780895","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 attitudes and conversations among heterosexual older adults in China: findings from the sexual well-being (SWELL) study.","authors":"Xin Peng, Bingyi Wang, Xinyi Li, Ying Wang, Shihao Wang, Yong Lu, Bingyu Liang, Lin Ouyang, Guohui Wu, Maohe Yu, Jiewei Liu, Yoshiko Sakuma, Hayley Conyers, Xiaopei Shen, Xiaojun Meng, Joseph D Tucker, Dan Wu, Yong Cai, Huachun Zou","doi":"10.1071/SH25234","DOIUrl":"10.1071/SH25234","url":null,"abstract":"<p><strong>Background: </strong>Sexuality is a key component of psycho-physical well-being among older adults. We aimed to understand sexual attitudes and conversations, and their correlates among older adults.</p><p><strong>Methods: </strong>This study was based on a cross-sectional survey conducted from June 2020 to December 2022 in China. Community-dwelling heterosexual older adults aged ≥50 were recruited. Sexual attitudes included believing that sex is harmful to health and supporting sex education. The conversation was defined as talking about sex with a partner. Logistic regressions were used to assess the correlates of sexual attitude and conversation.</p><p><strong>Results: </strong>A total of 3001 older adults (60.6% men, 39.4% women) were included. Of these, 13.3% believed sex is harmful to health, 53.2% supported sex education and 34.6% reported conversation. For men, age (60-69 years: aOR 0.57, 95% CI: 0.39-0.82), living in urban areas (aOR 2.78, 95% CI: 1.90-4.05), being employed (aOR 0.44, 95% CI: 0.29-0.66), higher annual incomes (aOR 0.42, 95% CI: 0.22-0.78) and being sexually active (aOR 0.54, 95% CI: 0.36-0.79) were associated with believing that sex is harmful. For women, higher educational levels (aOR 0.48, 95% CI: 0.29-0.79) and sexual knowledge acquisition (aOR 1.95, 95% CI: 1.24-3.05) were significantly associated with this negative belief. Notably, older adults who reported life satisfaction (men: aOR 1.70, 95% CI: 1.32-2.18; women: aOR 2.66, 95% CI: 1.90-3.72) and sexual knowledge acquisition (men: aOR 2.00, 95% CI: 1.53-2.43; women: aOR 1.56, 95% CI: 1.13-2.17) were more likely to talk about sex.</p><p><strong>Conclusion: </strong>A minority of older adults believed that sex was harmful to health, whereas over half supported sex education, and approximately one-third reported conversations with their partner about sex. Targeted interventions are needed to adjust sexual attitudes and facilitate sex-related conversations.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"23 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975761","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":"Adolescent and young adult participation in HIV self-testing: secondary analysis of cross-sectional data from Nigeria.","authors":"Susan Nkengasong, Lauren Fidelak, Weiming Tang, Kadija M Tahlil, David Oladele, Titilola Gbaja-Biamila, Akeem Blessing Lateef, Adesola Zaidat Musa, Folahanmi Tomiwa Akinsolu, Tomilola Musari-Martins, Jane Okwuzu, Aisha Adedoyin Koledowo, Suzanne Day, Temitope Ojo, Olufunto Olusanya, Donaldson Conserve, Oluwaseun Adebayo Bamodu, Nora Rosenberg, Ucheoma Nwaozuru, Chisom Obiezu-Umeh, Hong Xian, Collins Airhihenbuwa, Kathryn E Muessig, Oliver Ezechi, Juliet Iwelunmor, Joseph D Tucker","doi":"10.1071/SH25101","DOIUrl":"10.1071/SH25101","url":null,"abstract":"<p><strong>Background: </strong>Youth participation is critical to improving HIV prevention outcomes, yet evidence on the quality of adolescent and young adult (AYA) participation in HIV self-testing programs in low- and middle-income countries remains limited. This study assessed levels and correlates of AYA participation in HIV self-testing interventions implemented in Nigeria.</p><p><strong>Methods: </strong>We conducted a secondary analysis of data from the Innovative Tools to Expand Youth-friendly HIV Self-Testing study, which recruited AYA aged 14-24 years from four Nigerian sites (September 2019-March 2020). Participation was measured using an adapted 12-item Tiffany-Eckenrode Program Participation Scale across four domains: ownership, voice/influence, support and community participation. Scores ranged from 0 (strongly disagree) to 4 (strongly agree) and were categorized as minimal (<3.5), moderate (3.5-4.0) or substantial (>4.0). Chi-squared tests examined associations between participation levels and sociodemographic variables, with Cramér's V summarizing effect sizes.</p><p><strong>Results: </strong>Among 388 AYA (mean age 21 ± 2 years; 58% male), overall participation was high (M = 4.04 ± 0.24). Domain-specific analyses showed substantial participation in support (M = 4.08 ± 0.23), community participation (M = 4.04 ± 0.24) and ownership (M = 3.94 ± 0.27), whereas voice/influence was moderate (M = 3.87 ± 0.32). Education (χ2 = 43.23, P < 0.001; V = 0.33), employment (χ2 = 122.70, P < 0.001; V = 0.56) and income (χ2 = 119.68, P < 0.001; V = 0.55) were significantly associated with participation, whereas age, sex and marital status were not.</p><p><strong>Conclusion: </strong>These findings highlight generally high AYA participation in HIV self-testing interventions, but underscore socioeconomic disparities that may shape participation quality. Programs should prioritize equitable engagement strategies for youth with fewer resources.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"23 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138953","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":"Factors associated with post-pornography masturbation among university students: a machine-learning study.","authors":"Mohammed A Mamun, Mahmudul Hasan, Md Muktarul, Md Emran Hasan, Johurul Islam, Nitai Roy, Moneerah Mohammad ALmerab, Firoj Al-Mamun, Mohammad Muhit","doi":"10.1071/SH25097","DOIUrl":"10.1071/SH25097","url":null,"abstract":"<p><strong>Background: </strong>Pornography consumption is common among university students, yet little research has examined behavioral responses occurring immediately after exposure. Such behaviors may have implications for sexual health, behavioral conditioning and psychosocial well-being. This study investigated the prevalence and correlates of post-pornography masturbation among university students in Bangladesh, and evaluated predictive performance using supervised machine-learning approaches.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 1179 university students who reported prior pornography use. Sociodemographic, behavioral, psychological and contextual variables were assessed using self-administered questionnaires. Multivariable logistic regression examined associations with post-pornography masturbation. Supervised machine-learning models were trained and evaluated using a training-hold-out design. Model performance was assessed using accuracy, F1-score, log loss and area under the receiver operating characteristic curve.</p><p><strong>Results: </strong>Overall, 19.8% of participants reported masturbation following pornography use, with a higher prevalence among males than females (25.2% vs 7.1%). Pornography-use frequency showed a graded association with the outcome. Residence in university halls and cigarette smoking were independently associated with higher odds, whereas psychological distress variables were not significant after adjustment. Ensemble models outperformed distance- and margin-based classifiers. Random forest achieved the highest area under the receiver operating characteristic curve, whereas extreme gradient boosting showed strong classification performance at the default probability threshold. Pornography-use frequency emerged as the most influential predictor across models.</p><p><strong>Conclusions: </strong>Post-pornography masturbation was associated primarily with behavioral engagement patterns and selected contextual factors within this sample. Predictive modeling indicated that a limited set of routinely collected characteristics contains meaningful associative structure, although estimates remain probabilistic rather than causal. Longitudinal and externally validated research is needed to clarify temporal relationships and improve generalizability.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"23 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780906","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}