RESUMEN
BACKGROUND: Stigmatization of sexually transmitted infections (STIs) threatens provider-patient relationships and contributes to the underutilization of STI services. Media can shape public attitudes toward healthcare topics by perpetuating or reducing stigma. Given the high prevalence of STIs and the widespread consumption of media, it is essential for healthcare providers to be cognizant of factors influencing societal perceptions of STI symptoms, transmission, diagnosis, and treatment. METHODS: This study is a scoping review of popular films depicting STIs. Full-length English-language narrative films featuring characters with confirmed or suspected STIs were included. Descriptive statistics were used to determine the proportion of characters accurately portrayed with STI symptoms, transmission, diagnosis, and treatment. RESULTS: The final analysis comprised 128 characters from 77 films, with human immunodeficiency virus (HIV) being the most frequently featured STI (42 films, 54.5%). The overall accuracy across all four clinical variables of symptoms, transmission, diagnosis, and treatment was 87.4%. Transmission was the most depicted clinical variable, represented in 74 characters (57.8%). All four clinical variables were simultaneously depicted in only four (3.1%) characters, with two characters portraying all four clinical variables accurately. Death occurred in 39 characters (30.5%), with HIV accounting for the majority (82.1%). CONCLUSIONS: Most films accurately portrayed STI clinical variables, including symptoms, transmission, diagnosis, and treatment. Rates of individual variable depiction were inconsistent, while death secondary to STIs was common. Understanding the portrayal of STIs in popular films can provide valuable insights for clinicians, enabling them to effectively address patient misconceptions and knowledge gaps.
RESUMEN
BACKGROUND: Extended-release, intramuscular (IM) naltrexone can be an effective and convenient medication option for alcohol use disorder. We sought to assess the clinical impact of an alternate, if inadvertent, administration of IM naltrexone in the deltoid muscle instead of the recommended gluteal muscle. CASE SUMMARY: IM naltrexone was prescribed to a hospitalized 28-year-old man with severe alcohol use disorder as part of an inpatient clinical trial. A nurse unfamiliar with naltrexone administration mistakenly administered the drug to the deltoid instead of the gluteal muscle recommended by the manufacturer. Despite concerns that injection of the large-volume suspension to the smaller muscle would potentially contribute to increased pain and higher chance of adverse events owing to faster medication absorption, the patient experienced only mild discomfort to the deltoid region, without other adverse events on immediate physical and laboratory examinations. The patient later denied additional adverse events in the period after hospitalization, but he did not endorse any anti-craving effect of the medication, resuming drinking alcohol quickly following initial discharge. PRACTICE IMPLICATIONS: This case represents a unique procedural challenge of administering a medication in the inpatient setting that is typically given in the outpatient setting. Inpatient staff members frequently rotate and may be relatively unfamiliar with IM naltrexone, so handling should be limited to personnel who have received focused training on its administration. Fortunately, in this case deltoid administration of naltrexone was well-tolerated and even deemed quite "acceptable" to the patient. Clinically, the medication was insufficiently effective, but biopsychosocial context may have made his AUD especially refractory. More research is needed to fully establish whether naltrexone given via deltoid muscle injection has comparable safety and efficacy to gluteal muscle administration.
