Sexual health最新文献

{"title":"Challenges and opportunities in the prevention of travel-related STIs.","authors":"Wondimeneh Shiferaw, Judith A Dean, Deborah Mills, Kenneth Koh, Colleen Lau, Luis Furuya-Kanamori","doi":"10.1071/SH25198","DOIUrl":"10.1071/SH25198","url":null,"abstract":"<p><p>The link between travel and acquisition of STIs is well documented. Global travel has increased to unprecedented levels, and situational disinhibition during travel contributes to less safe sexual practice, in turn heightening STI risk. Individualised advice should be provided to travellers across the travel continuum to mitigate the risk of acquisition and further spread of STIs.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"23 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345268","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 among older adults in Nigeria: a systematic review of evidence, gaps, and opportunities for intervention.","authors":"Akim Tafadzwa Lukwa, Folahanmi Tomiwa Akinsolu, Olunike Rebecca Abodunrin, Denis Okova, Aishat Adedoyin Koledowo, Salahudeen Sakina Hassan, Paidamoyo Bodzo, Priscillia Oribe Nemieboka, Dolapo Omotayo Raji, Lilian Ogochukwu Ezechi, Plaxcedes Chiwire, Oliver Chukwujekwu Ezechi","doi":"10.1071/SH25089","DOIUrl":"10.1071/SH25089","url":null,"abstract":"<p><strong>Background: </strong>Sexual health remains an understudied dimension of wellbeing among older adults in Nigeria. This review synthesised existing evidence on sexual health among Nigerians aged 60 years and over, and identified gaps in knowledge, policy, and practice. Despite global recognition of sexual health as a lifelong concern, cultural taboos, gender norms, and health system neglect continue to marginalise older adults' sexual wellbeing.</p><p><strong>Methods: </strong>A systematic review was conducted according to PRISMA 2020 guidelines (PROSPERO: CRD420251064655). Peer-reviewed empirical studies from PubMed, Web of Science, and Scopus were eligible if they reported on sexual activity, dysfunction, satisfaction, condom use, STI and HIV knowledge, or health service use among Nigerian adults aged ≥60 years. Using narrative synthesis and an aggregative from Synthesis Without Meta-analysis, data were abstracted using a structured form, and findings were narratively synthesised through thematic analysis to identify key themes and evidence gaps.</p><p><strong>Results: </strong>Seventeen studies (2003-2024) met inclusion criteria. Evidence reveals that older Nigerians remain sexually active but face significant barriers to sexual wellbeing. Gendered expectations privilege male sexuality while discouraging female expression. Misconceptions around HIV transmission persist despite widespread awareness, and condom use remains low. Cultural norms and provider discomfort inhibit uptake of sexual and reproductive health services, while traditional healers are often preferred for their perceived respectfulness. Older women, rural populations, and those with disabilities remain underrepresented in the literature.</p><p><strong>Conclusion: </strong>Sexual health in older Nigerians is shaped by a complex interplay of cultural norms, structural neglect, and limited policy attention. Integrating age-sensitive and gender-sensitive approaches into geriatric care and sexual and reproductive health programming is essential to meet the needs of this growing population.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053706","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":"An improved method for recovering clinical isolates and assessing pathogenicity of blood from secondary syphilis patients.","authors":"Xiaohui Zhang, Yinbo Jiang, Litian Zhang, Ligang Yang, Zhili Hu, Wentao Chen, Heping Zheng, Liyan Xi, Bin Yang","doi":"10.1071/SH25185","DOIUrl":"10.1071/SH25185","url":null,"abstract":"<p><strong>Background: </strong>Recovering clinical isolates of Treponema pallidum (Tp) can expedite the research on molecular epidemiology and vaccine development of syphilis. Nevertheless, obtaining numerous isolates through rabbit infectivity testing remains unsatisfactory, particularly in secondary syphilis cases. This study re-evaluates the reliability of orchitis as a phenotypic indicator for assessing Tp clinical strains during rabbit infectivity testing.</p><p><strong>Methods: </strong>Treponemal and nontreponemal tests were used to analyze the correlation between serological titers and Tp burden. An optimal titer threshold was identified and applied to verify the maximum achievable Tp burden across different initial inoculation doses. A modified recovery protocol was developed for isolating Tp clinical strains from chancre exudates or whole blood, and its success rate was subsequently evaluated.</p><p><strong>Results: </strong>We demonstrated that a Tp particle agglutination titer of 1:1280 reliably indicated the peak burden of Tp Nichols strain and clinical isolates during rabbit infectivity testing. To achieve stable recovery, the initial inoculum should be at least 105 organisms. Using this optimized protocol, we successfully recovered and maintained Tp clinical isolates from 82.69% (43/52) of syphilis patients overall. Notably, the success rate from whole blood samples of secondary syphilis cases increased markedly to 82.50% (33/40) despite many of these specimens testing negative for Tp DNA by quantitative polymerase chain reaction.</p><p><strong>Conclusions: </strong>This study shows that the pathogenicity of secondary syphilis blood is greater than previously recognized. Thus, monitoring Tp particle agglutination titers enables the recovery of Tp clinical isolates, even from specimens with extremely low bacterial burdens.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935064","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":"Implementation of a Hospital in the Home model for delivery of long-acting injectable antiretroviral therapy to people living with HIV: development, integration and early experience.","authors":"Connie Lam, Madeleine Bangham, Morgan Rose, Shanti Narayanasamy, Angela Sullivan, Ray Dowling, Janine Trevillyan","doi":"10.1071/SH25237","DOIUrl":"10.1071/SH25237","url":null,"abstract":"<p><strong>Background: </strong>Long-acting injectable cabotegravir/rilpivirine provides an alternative to daily oral antiretroviral therapy for people living with HIV, but is limited by its clinic-based delivery model. The aim of this study was to describe the implementation and early outcomes of a Hospital in the Home (HITH) program delivering long-acting injectable antiretroviral therapy within an Australian tertiary health service.</p><p><strong>Methods: </strong>A structured protocol for HITH-based delivery of cabotegravir/rilpivirine was developed at a single tertiary centre in Melbourne, Australia. The program was established through collaboration between infectious diseases clinicians, HITH physicians, nursing leadership and pharmacy. Processes were designed for patient selection, induction dosing, medication storage, cold-chain transport, clinical documentation and escalation of care. HITH staff received targeted training in HIV care, injection technique and stigma-sensitive communication. Following the first dose in clinic, subsequent injections were administered at home every 8 weeks, with pre-visit telephone assessments, post-dose telehealth reviews and routine pathology monitoring.</p><p><strong>Results: </strong>The program was integrated into existing HITH infrastructure without additional resources. One patient has completed five treatment doses, all delivered safely within dosing timeframes. Laboratory monitoring confirmed continued viral suppression. Nursing staff reported high satisfaction, describing the model as patient-centred and professionally rewarding. Operationally, coordination between HITH pharmacy, nursing and infectious diseases teams was efficient and sustainable.</p><p><strong>Conclusion: </strong>HITH delivery of cabotegravir/rilpivirine is feasible, safe and well accepted, providing a scalable, decentralised model for HIV treatment in Australia.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"23 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202484","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":"What are the facilitators and barriers for Asian-born gay and bisexual men to access sexual health services in Australia: an integrative review.","authors":"Thi Thuy Linh Nguyen, Amanda Müller, Georgia Geller","doi":"10.1071/SH25051","DOIUrl":"10.1071/SH25051","url":null,"abstract":"<p><p>This integrative qualitative review examines barriers and facilitators affecting sexual health service access among Asian-born men who are gay, bisexual, or who have sex with men in Australia. Despite advancements in HIV prevention, this group remains under-represented in research and health care, contributing to health disparities. The analysis identified a 'socioecological cascade' where external, structural-level forces such as pervasive stigma and perceived threat of health-related visa requirements are progressively internalised, culminating in individual-level barriers to care. On the positive side, a supportive attitude from the clinic's staff and the connection to the gay community improve access. Findings highlight the need for culturally sensitive outreach, clinician training, and policy reforms.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030933","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":"Resilience of STI service delivery in community-based organizations during the 2024 armed conflict: insights from Lebanon.","authors":"M Assi, N Badran, F Mallat, I Maatouk","doi":"10.1071/SH25086","DOIUrl":"10.1071/SH25086","url":null,"abstract":"<p><p>This study explores the potential impact of war on STI services in Lebanon. Programmatic STI service data from Lebanon were analyzed, alongside a targeted review of the literature on conflict-affected settings, using public health databases covering the period 2014-2024. Evidence-based STI service packages for conflict settings remain limited. Drawing insights from the COVID-19 crisis, periods of emergencies are associated with an elevated risk of STI surges among key populations. Programmatic data from the conflict further demonstrated this increased risk, reflected in reductions in prevention and early detection activities compared with pre- and post-conflict periods. Self-care and outreach service packages could be critical in these contexts. Community-based organizations (CBOs) should adapt STI services to the wartime environment and evaluate the effectiveness of these interventions post-conflict. CBOs are encouraged to prioritize the implementation of self-care modalities for STI prevention and early detection, expand the availability of telehealth services, and deploy mobile clinics to maximize service continuity. This editorial analyzes STI service delivery within the specific context of the Lebanese war.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107369","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 rates of intimate partner violence among diverse young sexual minority men who use substances.","authors":"Chenglin Hong","doi":"10.1071/SH25201","DOIUrl":"10.1071/SH25201","url":null,"abstract":"<p><strong>Background: </strong>Intimate partner violence (IPV) is a critical yet understudied issue among young sexual minority men (YSMM) who use substances, who experience heightened vulnerability due to intersecting forms of stigma, discrimination, and structural marginalisation. Most studies have narrowly focused on victimisation, often excluding the experiences of perpetration or bidirectional IPV. There is limited understanding on IPV intersecting racial, ethnic, and sexual identity groups, or to exploring multiple forms of IPV including emotional, physical/sexual, controlling, monitoring, and HIV-related abuse.</p><p><strong>Methods: </strong>Data were drawn from a racially and ethnically diverse online sample of cisgender YSMM (N = 277) in 2022-2024. Participants reported lifetime and past-year experiences of IPV victimisation, perpetration, and bidirectional IPV across multiple IPV domains. Socio-demographic characteristics and substance use patterns, were examined in relation to IPV experiences.</p><p><strong>Results: </strong>Rates of lifetime IPV were high: 69.7% reported victimisation; 47.7% reported perpetration; and 44.4% experienced bidirectional IPV. In the past year, 65.0% reported IPV victimisation, 43.3% reported perpetration, and 39.4% experienced bidirectional IPV. Emotional and physical/sexual IPV were the most common types. Nearly 40% of participants reported frequent IPV victimisation in the past year, with emotional IPV (30.0%) being the most prevalent. Participants identifying as Black, Latino/Hispanic, mixed-race, or bisexual, and those with lower educational attainment reported higher rates of IPV experiences. Substance use was significantly linked to higher rates of multiple forms of IPV, especially frequent and bidirectional IPV.</p><p><strong>Conclusion: </strong>The syndemic interplay between substance use and IPV among YSMM means that public health responses need to culturally responsive and trauma-informed for the developmental and intersectional contexts of this population.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107417","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":"Culture yield of Neisseria gonorrhoeae: culture yield varies by anatomical site and time to culture collection.","authors":"Jun Jung, Marcus Y Chen, Norelle L Sherry, Vesna De Petra, Christopher K Fairley, Eric P F Chow","doi":"10.1071/SH25242","DOIUrl":"10.1071/SH25242","url":null,"abstract":"<p><strong>Background: </strong>Neisseria gonorrhoeae (NG) is one of the World Health Organization's high-priority bacterial pathogens due to the emergence of multidrug-resistant strains. The culture of NG remains important for providing antimicrobial resistance surveillance data.</p><p><strong>Objective: </strong>To determine the NG culture yield following a positive NG nucleic acid amplification test (NAAT) within 30 days, stratified by culture specimen collection sites, the time interval between NAAT and culture, and gender.</p><p><strong>Methods: </strong>A retrospective data analysis of positive NG NAAT specimens of individuals attending the Melbourne Sexual Health Centre between April 2015 and March 2023. We calculated the NG culture yield within 30 days and stratified by culture specimen collection sites.</p><p><strong>Results: </strong>The NG culture yield was lowest in the pharynx (37.9%, 95% confidence interval (CI) 36.6-39.2, 1964/5185) followed by the vagina (41.6%, 95% CI 37.0-46.3, 186/447), cervix (60.1%, 95% CI 52.2-67.7, 98/163), rectum (68.0%, 95% CI 66.6-69.3, 3223/4742) and urethra (97.0%, 95% CI 96.4-97.6, 3282/3382). The overall NG culture yield was 77.8% (95% CI 76.8-78.8, 5254/6754) when the culture was performed on the same date as the NAAT test, and it decreased significantly to 53.6% (95% CI 51.5-55.7, 1193/2224) 1-3 days after the NAAT-positive specimens were collected, then to 37.1% (95% CI 30.7-43.7, 83/224) 15-30 days after the NAAT-positive specimens were collected (Ptrend <0.001).</p><p><strong>Conclusions: </strong>The culture specimen collection sites and time to culture collection influenced the culture yield. NG culture should be performed as close as possible to NAAT testing to improve NG culture yield. In addition, combining molecular resistance testing with culture-based techniques may be necessary to ensure adequate antimicrobial resistance detection.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143334","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":"Development of a survey to assess sexual health knowledge, behaviour and help-seeking of Australian-born men travelling to Southeast Asia: findings from the NEXUS2 study.","authors":"Gemma Crawford, Corie Gray, Nang Nge Nge Phoo, Roanna Lobo","doi":"10.1071/SH25145","DOIUrl":"10.1071/SH25145","url":null,"abstract":"<p><strong>Background: </strong>Australian men travelling overseas to Southeast Asia for work or leisure are reflected in new HIV and STI notifications. However, behavioural, social and environmental data are limited. This study developed a survey to assess sexual health knowledge, attitudes and practices among Australian-born men traveling to Southeast Asia, and presents findings.</p><p><strong>Methods: </strong>A 62-item instrument was developed to assess demographics, travel characteristics, sexual health knowledge, behaviour and attitudes. Validity testing involved face (n = 8) and content (n = 3) testing. Reliability was assessed via a test-retest (n = 35) using intraclass correlation coefficients. A convenience sample of Australian-born adult men who had travelled to Southeast Asia in the past 5 years completed the online, panel-driven survey.</p><p><strong>Results: </strong>Overall, reliability results indicated considerable to high agreement in initial and repeat tests. Participants (n = 136) were predominantly heterosexual (n = 116, 85.9%), more than half were tertiary educated (n = 77, 57%) and employed full-time (n = 85, 63%). Nearly half (n = 65/133, 48.9%) reported sex during their most recent trip, with less than half always using condoms (n = 27/65, 41.5%). One-quarter (n = 32, 23.5%) purchased sexual services overseas. Most were unaware of post- (n = 77/131, 58.8%) and pre-exposure prophylaxis (n = 87/131, 64%). Just over one in 10 (n = 19/131, 14.5%) tested for STIs before travel.</p><p><strong>Conclusions: </strong>Participants demonstrated sexual health knowledge gaps, inconsistent protective behaviours and low awareness of prevention strategies. Findings warrant broader survey implementation to generate national data to support targeted interventions.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":"23 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469492","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":"Identifying predictors for counties that have exceptionally low STI case rates in the US (2019): a positive deviant model.","authors":"Sungwon Lim, Betty Bekemeier, Jillian Pintye, David Grembowski","doi":"10.1071/SH25164","DOIUrl":"10.1071/SH25164","url":null,"abstract":"<p><strong>Background: </strong>The US is experiencing an unprecedented sexually transmitted infections (STIs) epidemic. Although recent provisional data show some stabilization or minor declines in case rates for chlamydia, gonorrhea and syphilis, overall rates remain significantly higher than a decade ago. Local health departments (LHDs) play a crucial role in preventing and treating STIs, but some LHDs are demonstrably more effective than others. This study utilized a positive deviance (PD) approach to identify and analyze US counties with unexpectedly low STI rates.</p><p><strong>Methods: </strong>We used a cross-sectional study design, analyzing data from 981 counties across the US, using a two-step approach: (1) multivariate linear regression to identify PD counties, and (2) multivariate logistic regression to examine predictors of PD status.</p><p><strong>Results: </strong>We identified 187 (19.06%) high-performing counties, considering internal and external factors, and investigated predictors that affect the identification of these high-performing counties. These counties were more likely to have the smallest population category (<25,000), which had 6.47 times odds of being identified as PD counties compared with counties of ≥1 million, counties with high social vulnerability in specific subcategories (racial and ethnic subgroup, housing, and transportation), and counties with LHDs that provided STI-related treatment services directly and through community partnerships.</p><p><strong>Conclusions: </strong>Our findings demonstrate the potential of using a PD approach for identifying and learning from high-performing LHDs. The identification of high-performing counties provides a foundation for future research to explore the nuanced interventions contributing to their success, ultimately informing targeted public health strategies and resource allocation.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678688","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}