Social support and trauma experiences of imprisoned men in Northern Ireland.

BACKGROUND: Social Support has multiple benefits for health and mental wellbeing. Its existence, and the extent to which it can be beneficial, is dependent upon the context in which it is provided, and the recipients' view of it. Social support has long been established as a 'buffer' to the negative impact of stressful life experiences. Trauma can negatively impact upon social support, reducing the extent of social networks and ability of some trauma experienced individuals to sustain extensive social support networks. However, some trauma experiences can also strengthen social relationships. Imprisoned men are disproportionately likely to have experienced a traumatic event when compared with the general population. Past research has found that traumatic events can lead to a decrease in social support among imprisoned men but more research is needed to understand the variations in perceived social support experienced by imprisoned men and to determine how different types of trauma may be related to perceived social support. METHOD: A cross-sectional survey of 384 adult men detained in the Northern Ireland Prison Service was conducted between November 2022 and January 2023. The survey collected data on the men's demographics, mental health, substance use, and criminal history. Respondents were also asked to complete a Trauma History Questionnaire (THQ) and the Multi-dimensional Scale of Perceived Social Support (MSPSS). Regression analysis was then used to investigate the possible associations between individual characteristics, different types of trauma experiences and perceived social support. RESULTS: Most types of trauma experiences were not associated with lower levels of perceived social support. Only those who had experienced crime related trauma were more likely to report lower levels of social support. Older imprisoned men and those using substances were more likely to report lower levels of perceived social support, while those who had served a sentence of less than one year reported higher levels of perceived social support. DISCUSSION: Crime related trauma experiences were found to be associated with lower levels of perceived social support. There were no significant findings around perceived social support and any of the other trauma types i.e. physical, sexual and general disaster experiences. Trauma informed policy responses should be cognisant of this, as those with experiences of crime related victimisation are less likely to have the social support needed to buffer against future trauma experiences. The findings demonstrate that some individuals experience lower levels of perceived social support and several factors are associated with this including age, time served and substance use history. This will potentially impact upon them during release and affect their reintegration into society. Specific policies aimed at these groups should be considered to prevent them from experiencing a lack of support and any accompanying adversity upon release.

Mental Health and Black Male Graduate Students.

The purpose of this study was to understand how masculinity and race impact mental health among Black male graduate students. A qualitative study using in-depth interviews recruited Black male graduate students enrolled at a private university in the southern United States. Data were collected over zoom and recorded. Interviews were transcribed and the data were analyzed for similar themes. Twenty-nine Black male graduate students 23 to 51 were recruited. Participants reported the three main elements that impacted their mental health were (1) expectations, (2) pressure, and (3) being strong. These findings suggest that colleges need to develop programming to help Black men learn how to handle racial discrimination in positive ways. Additionally, findings also highlight the need for culturally relevant mental health services that let Black men know seeking help is ok and is what men do.

Gestational exposure to the great Chinese famine: early life undernutrition impact on prostatic hyperplasia in adulthood.

Introduction: Benign prostatic hyperplasia (BPH) is a frequent illness in aged men that impacts their quality of life; early childhood exposure to famines may have long-term effects on the chance of developing BPH. The aim of this study is to investigate the relationship between early-life famine exposure and benign prostatic hyperplasia (BPH) risk in Chinese men born during 1959-1961. Methods: We used medical records from a large, comprehensive hospital to screen people born in China during the years of famine (1959-1961). Birthplaces were identified as indicators of famine exposure status. In the time window between 2017 and 2022, people born during the famine years who had prostatic ultrasonic examinations were selected, and their medical records were retrieved from the database. Univariate and multivariate logistic regression analyses investigated the relationship between famine exposure and BPH risk. Results: A total of 3,009 subjects were included in this study. Patients with heavy famine exposure had older age, shorter height, lighter weight, lower cholesterol, lower uric acid (UA), lower aspartate aminotransferase (ALT), and a higher incidence of BPH than those with light famine exposure (all p < 0.05). Univariate logistic regression showed that BPH was positively related to famine exposure, age, height, weight, and body mass index (BMI) but negatively related to UA (all p < 0.05). Multivariate logistic regression showed that age and famine exposure were still independent risk factors (p < 0.05), while UA was an independent protective factor for BPH (p < 0.05). Heavy famine exposure increased the risk of BPH (adjusted OR = 1.214, 95% CI = 1.05-1.467, p = 0.045). Conclusions and recommendation: Famine and malnutrition exposure during early life may be independent risk factors for BPH in Chinese adults. This relationship provides additional evidence to support the fetal origins of adult diseases and offers clues for the pathological mechanisms of BPH.

Receptive Anal Intercourse: Impact on Colorectal and Urologic Diagnoses.

Purpose: We evaluated the relationship between lifetime receptive anal intercourse (RAI) and the risk of common colorectal and urologic diagnoses. Methods: We conducted an internet-based survey on sensations during RAI between July 2022 and March 2023. We used multivariable logistic regression to assess the independent impact of lifetime RAI exposure on the diagnosis of common urologic and colorectal conditions. Participants completed a main survey and were invited to complete randomly assigned patient-reported outcome measures (PROMs), which measured pelvic symptoms, mental health symptoms, and sexual satisfaction. Results: In total, 1100 participants completed the main survey and 416 completed the PROMs. Participants of the main survey ranged from 18 to 78 years old and the median age of the sample was 32 years. There was no significant association between lifetime RAI exposure and any medical diagnosis, except for anal fissures, which increased linearly with additional RAI exposure. Both sexual satisfaction and mental health symptoms improved with RAI exposure. Conclusions: RAI was not associated with most of the colorectal and urologic diagnoses tested and was associated with fewer mental symptoms and increased sexual satisfaction. Development of anal fissures may be directly related to trauma of the anal canal from penetration.

Menin signaling and therapeutic targeting in breast cancer.

To date, mounting evidence have shown that patients with multiple endocrine neoplasia type 1 (MEN1) may face an increased risk for breast carcinogenesis. The product of the MEN1 gene, menin, was also indicated to be an important regulator in breast cancer signaling network. Menin directly interacts with MLL, EZH2, JunD, NF-κB, PPARγ, VDR, Smad3, ß-catenin and ERα to modulate gene transcriptions leading to cell proliferation inhibition. Moreover, interaction of menin-FANCD2 contributes to the enhancement of BRCA1-mediated DNA repair mechanism. Ectopic expression of menin causes Bax-, Bak- and Caspase-8-dependent apoptosis. However, despite numbers of menin inhibitors were exploited in other cancers, data on the usage of menin inhibitors in breast cancer treatment remain limited. In this review, we focused on the menin associated signaling pathways and gene transcription regulations, with the aim of elucidating its molecular mechanisms and of guiding the development of novel menin targeted drugs in breast cancer therapy.

How Feminist Heterosexual Men Navigate Their Sexual Desire While Following Feminist Principles.

Feminist considerations have influenced how women and men view sex, affecting not only women's perspectives but also men's feelings about sexual desire with regard to gender equity. This might be especially the case among men who self-identify as feminist. However, how men should manage their sexual desire or communicate about it within relationships with women is not always clear in this evolving social climate. Thus, the current study aimed to explore the successes and/or struggles feminist heterosexual men experience while navigating their desires alongside feminist considerations. To explore this, we recruited feminist-identified heterosexual men in long-term relationships. We asked participants (N = 30) a series of questions regarding their sexual desire, considering the context of their long-term relationships and evolving gender norms, during a one-on-one interview via Zoom. Using thematic analysis, we identified 11 themes from the interview data. We found that, though the feminist men in this study were all aware of negative societal perceptions of heterosexual men's sexual desire, most men in this study did not feel conflicts between their feminist principles and their own sexual desires. This is because they reported already following feminist principles; those who felt ambivalent navigated this by communicating with their partners. Findings demonstrate the usefulness and positive impact men report feminism having on them, their sexuality, and their long-term relationships, by allowing them to better engage with their sexuality and partners.

The "Chemsex" Phenomenon and Its Relationship with Psychological Variables in Men Who Have Sex with Men.

Chemsex is described as the use of psychoactive substances during sexual activity to sustain, enhance, disinhibit, or facilitate the sexual experience. It preferentially concerns men who have sex with men. The main objective of this study was to examine the relationship between participation in chemsex and the psychological variables impulsivity, sexual assertiveness, and hypersexuality. The sample was composed of 137 Spanish men. A total of 104 participants reported that they had engaged in chemsex, with ages ranging from 19 to 42 years (M = 31.41, SD = 4.83). A total of 33 participants reported that they had never participated in chemsex sessions. The participants were contacted and recruited at social centers, LGBT associations, and key informants. Results showed that men who participated in chemsex reported higher impulsivity, higher hypersexuality, and lower sexual assertiveness than those who have never participated in it. The frequency of participation in chemsex, as well as the number of substances consumed, was positively and significantly correlated with dimensions of impulsivity and hypersexuality. This frequency and this consumption were negatively and significantly correlated with sexual assertiveness. Findings showed significant differences in the psychological variables based on the number of consumed substances (polydrug use/consumption of one substance) and the time of consumption (before, during or before and during sex). In conclusion, the study demonstrates the existence of a clear relationship between the experience of chemsex and psychological factors such as being an impulsive person, presenting hypersexual behavior, and/or having low sexual assertiveness.

Sexually transmitted diseases and HIV co-infection among adult male patients in the 2022 monkeypox outbreak: a systematic review and meta-analysis.

This meta-analysis estimates sexually transmitted disease (STI) and HIV rates in male monkeypox patients during the 2022 outbreak. The study examines contextual factors that increase monkeypox risk. A systematic review of PubMed/Medline, Scopus, and Google Scholar was conducted to find observational studies on monkeypox patients' demographics and medical characteristics from the 2022 outbreak. This review's meta-analysis followed the System for the Unified Management, Assessment, and Review of Information - Joanna Briggs Institute (SUMARI JBI) guidelines. All HIV and STI prevalence data for male monkeypox patients was exported into the SUMARI JBI. For point prevalence of HIV and STIs, we used the Freeman-Tukey-type arcsine square root transformation to stabilize raw proportion variances. A fixed-effects model weighted and pooled all estimates by inverse variance. We then used a random model to account for sampling variation and reported fixed-effect model effect size heterogeneity across studies. Study heterogeneity was measured using the I2 test statistic and P-values. I2 test results were interpreted as low (25%), moderate (50%), and high (75%). Six Spanish and English studies qualified. These studies included 541 male monkeypox patients, 214 of whom had HIV and 255 with other STIs. HIV prevalence was estimated at 40% (95% CI = 0.31%, 0.50%; ᵡ2=15) and STIs at 43% (95% CI = 25%, 61%; ᵡ2=118). Overall, analyses showed moderate to high heterogeneity. Four in ten male monkeypox patients in 2022 had HIV or other STIs. To prevent HIV and other STIs, public health measures should target male and female monkeypox patients.

Recommendations from Black and Latinx sexual minority males to include pharmacists to increase greater accessibility and OnlyFans stars to promote uptake of injectable PrEP.

BACKGROUND: Pre-exposure Prophylaxis (PrEP) medication is the keystone of preventative measures to curtail the spread of HIV. However, oral PrEP, the pill intended to prevent HIV, has been slow to proliferate among men who have sex with men (MSM). This is of major concern as MSM account for the largest number of new HIV diagnoses in the U.S. More recently, the newest generation of PrEP in the form of a long-acting injectable (LAI) is to be administered every two months as an intramuscular injection and many MSM indicate preferring LAI-PrEP to the oral form of PrEP. However, uptake of PrEP, in all forms, remains low. Research is sparse that focuses on LAI-PrEP uptake among Black/African American and Latinx men who have sex with men (BLMSM). OBJECTIVE: To address this concern, this study explored the willingness to uptake LAI-PrEP, and recommendations for increasing awareness and encouraging uptake of LAI-PrEP among BLMSM. METHODS: Qualitative data were collected between February 2022 to December 2022 through focus groups via Zoom with BLMSM (N=30; Black=14, Latinx=16) aged 18 to 29 (Mean = 23, SD = 3) in Los Angeles County. RESULTS: Findings revealed that while 90% of BLMSM were aware of PrEP in oral form, only 10% were aware of LAI-PrEP. Findings from the qualitative analysis suggested to consider self-administration of LAI-PrEP, allow local community pharmacists to assess and administer it, and promote uptake of LAI-PrEP using high-profile male content creators and stars on OnlyFans social media platform. CONCLUSION: Increasing PrEP uptake, in all forms available, such as promoting awareness through popular social media stars, and engaging community pharmacists in feasible ways, is critical for addressing the disproportionate impact of HIV among the BLMSM community.

Prevention of sexual transmission of mpox: a systematic review and qualitative evidence synthesis of approaches.

BACKGROUND: The ongoing multi-country mpox outbreak in previously unaffected countries is primarily affecting sexual networks of men who have sex with men. Evidence is needed on the effectiveness of recommended preventive interventions. To inform WHO guidelines, a systematic review and qualitative evidence synthesis were conducted on mpox preventive behavioural interventions to reduce: (i) sexual acquisition; (ii) onward sexual transmission from confirmed/probable cases; and (iii) utility of asymptomatic testing. METHODS: Medline, EMBASE, PubMed, Cochrane and WHO trial databases, grey literature and conferences were searched for English-language primary research published since 1 January 2022. A reviewer team performed screening, data extraction and bias assessment. A qualitative thematic synthesis explored views and experiences of engagement in prevention in individuals at increased risk. RESULTS: There were 16 studies: 1 on contact-tracing, 2 on sexual behaviour, and 13 on asymptomatic testing. Although MPXV was detected in varying proportions of samples (0.17%-6.5%), the testing studies provide insufficient evidence to fully evaluate this strategy. For the qualitative evidence synthesis, four studies evaluated the experiences of most affected communities. Preferences about preventive interventions were shaped by: mpox information; the diversity of sexual practices; accessibility and quality of mpox testing and care; and perceived cost to wellbeing. CONCLUSIONS: Evidence on the effectiveness of interventions to prevent the sexual transmission of mpox remains scarce. Limited qualitative evidence on values and preferences provides insight into factors influencing intervention acceptability. Given global and local inequities in access to vaccines and treatment, further research is needed to establish the effectiveness of additional interventions.

Clinical characteristics, viral dynamics, and antibody response of monkeypox virus infections among men with and without HIV infection in Guangzhou, China.

Background: Monkeypox virus (MPXV) is spreading globally and nearly half of the infected people were human immunodeficiency virus (HIV) positive. Therefore, an in-depth understanding of the effects of HIV infection on the outcomes of MPXV infection is urgently needed. This study aimed to explore the clinical features, viral dynamics, and antibody response to MPXV infections in men who had sex with men (MSM) with and without HIV co-infection. Design or methods: MPXV-infected patients diagnosed by PCR were recruited in this study and were divided into MPXV and MPXV + HIV groups based on whether they were co-infected with HIV. Clinical data and samples were collected during of the hospital stay and follow up interviews. The symptoms and signs, laboratory examinations, viral shedding in various body fluids or swabs, antibody dynamics were tracked and compared between the two groups. Results: A total of 41 MPXV patients were recruited through June 2023 to September 2023 in Guangzhou. The MPXV group and MPXV + HIV group comprised 20 and 21 MSM, respectively. Patients in the two groups exhibited similar clinical characteristics except for pruritus and eschar, both were significantly fewer in MPXV + HIV group than in MPXV only group. Among the 355 clinical samples collected, MPXV DNA was detected in 100% of scabs, 97.4% of skin swabs, and 92.3% of exudate swabs from lesions, while the positive rate was 87.5% from oropharyngeal swabs, 59% from saliva, 51.3% from anal swabs, 50% from feces, 30.6% from urine samples, 37.5% of semen, and 28.2% from sera. Dynamics analysis revealed that viral DNA was undetectable in most patients 20 days after symptom onset. IgM and IgG antibodies to MPXV were detected in all patients with 3-5 days earlier in the MPXV group than in the MPXV + HIV group. Conclusion: This cohort analysis based on a large outbreak among MSM in Guangzhou indicated no obvious differences in clinical symptoms, viral DNA data, but antibody responses were 3-5 days later in mpox patients with HIV infection.

Vesical Endometriosis in a male patient on treatment for papillary urothelial carcinoma.

Endometriosis denotes the abnormal growth of tissue resembling endometrium in ectopic sites and has largely been studied in women of reproductive age. It is an extremely rare phenomenon in men. We came across an exceptional clinical scenario of histologically proven bladder endometriosis in a 66-year-old man in relook bladder biopsy following completion of adjuvant intravesical Bacillus Calmette-Guerin induction course for G3pTa bladder cancer. We have pencilled down pathophysiology and commonly seen predisposing factors for "endometriosis in male patients" from available case reports and applied those findings to hypothesise the disease profile of our patient in this case report.

Quantifying the effects of five rehabilitation training methods on the ability of elderly men to control bowel movements: a finite element analysis study.

Purpose: The study aims to develop a finite element model of the pelvic floor and thighs of elderly men to quantitatively assess the impact of different pelvic floor muscle trainings and the urinary and defecation control ability. Methods: A finite element model of the pelvic floor and thighs of elderly men was constructed based on MRI and CT. Material properties of pelvic floor tissues were assigned through literature review, and the relative changes in waistline, retrovesical angle (RVA) and anorectad angulation (ARA) to quantitatively verify the effectiveness of the model. By changing the material properties of muscles, the study analyzed the muscle strengthening or impairment effects of the five types of rehabilitation training for four types of urination and defecation dysfunction. The changes in four outcome indicators, including the retrovesical angle, anorectad angulation, stress, and strain, were compared. Results: This study indicates that ARA and RVA approached their normal ranges as material properties changed, indicating an enhancement in the urinary and defecation control ability, particularly through targeted exercises for the levator ani muscle, external anal sphincter, and pelvic floor muscles. This study also emphasizes the effectiveness of personalized rehabilitation programs including biofeedback, exercise training, electrical stimulation, magnetic stimulation, and vibration training and advocates for providing optimized rehabilitation training methods for elderly patients. Discussion: Based on the results of computational biomechanics, this study provides foundational scientific insights and practical recommendations for rehabilitation training of the elderly's urinary and defecation control ability, thereby improving their quality of life. In addition, this study also provides new perspectives and potential applications of finite element analysis in elderly men, particularly in evaluating and designing targeted rehabilitation training.

Bone mineral density is not associated with incident high-intensity back pain: a 10-year cohort study in men.

Although patients believe that osteoporosis is a painful condition, health professionals assume it is painless unless a fracture occurs. The association between BMD and back pain has not been examined longitudinally in community-based adults in an unbiased population using gold-standard measures. This study aimed to examine the association between BMD and incident high-intensity back pain and/or high disability over 10 years in Australian men without high-intensity symptoms at baseline. Men with no high-intensity back pain and/or high disability attending the Geelong Osteoporosis Study at the 5-year visit (occurring between 2006-2010) (considered the baseline for the current study) were followed for 10 years (reassessed between 2016-2021). Back pain and disability were assessed using the Graded Chronic Pain Scale at both time points. At baseline, DXA was used to measure lumbar spine and total hip BMD and spinal artefacts. The relationships between BMD and incident high-intensity pain and/or high disability at follow-up were examined using binary logistic regression, adjusted for age, body mass index, depression, education, smoking, mobility, and spinal artefacts. A total of 679 participants had no to low-intensity pain and/or no to low disability at baseline. A total of 441 attended follow-up, providing back pain and disability data. Thirty-seven men developed high-intensity pain and/or high disability. No association of BMD at any site was seen with incident high-intensity pain and/or high disability. BMD was not associated with incident high-intensity pain or disability in community-based men. These data provide evidence to dispel the erroneous community-held belief that low BMD is related to back pain and disability.

Advancing Black Men's Type 2 Diabetes Healthcare Through Addressing Gender-centered Social Norms, Cognitive Scripts, and Manhood: An Integrated Public Health Approach for Reducing T2D Disparities.

In the United States, the burden of type 2 diabetes (T2D) health complications and outcomes is higher in Black men, and the diabetes disparities are escalating. Previous evidence-based research underscored the need to explore gender-specific experiences of chronic illness in social-cultural, historical, and clinical contexts. Our community-engaged qualitative study focused on learning from the live experiences of Black men (n = 15) in the Arkansas Delta area. Applying a narrative approach, we explored and learned from the participants about their perception of the consequences of T2D on manhood and the usefulness of T2D management instructions. Findings indicate that an integrated public health approach contextualizes social-cultural norms, cognitive scripts, and gender-centered expressions of manhood, a promising direction in T2D healthcare; social support is essential for emotional and physical help in continued T2D management; and connecting with Black men and their insights are vital to develop relevant and appropriate guidelines for T2D management care.

Evidence-based Prostate Cancer Screening Interventions for Black Men: A Systematic Review.

Prostate cancer is the second leading cause of death for men in the U.S. and Black men are twice as likely to die from the disease. However, prostate cancer, if diagnosed at an earlier stage, is curable. The purpose of this review is to identify prostate cancer screening clinical trials that evaluate screening decision-making processes of Black men. METHODS: The databases PubMed, Ovid MEDLINE, CINAHL Plus, and PsychInfo were utilized to examine peer-reviewed publications between 2017 and 2023. Data extracted included implementation plans, outcome measures, intervention details, and results of the study. The Critical Appraisal Skills Programme was used to assess the quality of the evidence presented. RESULTS: Of the 206 full-text articles assessed, three were included in this review. Educational interventions about prostate cancer knowledge with shared and informed decision-making (IDM) features, as well as counseling, treatment options, and healthcare navigation information, may increase prostate cancer screening participation among Black men. Additionally, health partner educational interventions may not improve IDM related to screening participation. The quality of the evidence presented in each article was valid and potentially impactful to the community. DISCUSSION: Black men face various social determinants of health barriers related to racism, discrimination, cost of health services, time away from work, and lack of trust in the healthcare system when making health-related decisions, including prostate cancer screening participation. A multifactorial intervention approach is required to address these inequities faced by Black men especially as prostate cancer is curable when diagnosed at an earlier stage.

Educational and professional experiences of men in nursing: An interpretive description study to guide change and foster inclusive environments for men in nursing.

BACKGROUND: Nursing shortages are occurring due to decreased student enrollment, nurse burnout, staffing deficits, nurse retirements, and increasingly low numbers of nursing faculty. Men are an untapped resource that can offset these crises. However, men's presence in nursing remains underwhelming. Changes aimed at improving diversity and inclusivity related to men's presence is needed in the nursing workforce. PURPOSE: Explore men's experiences in modern nursing environments to identify barriers to men's presence in nursing faculty and clinical workforce roles. METHOD: This study used interpretive description design. Data were collected through individual and group interviews. Interviews were video recorded. Interview questions were semi-structured and open ended. Data were analyzed using thematic analysis. RESULTS: Two themes were identified and reflected men's experiences in nursing: educational and professional change. Subthemes for educational change included increasing numbers of men in student and faculty roles; instructional change; admission, retention, and advising. Subthemes for professional change included inclusive hiring practices; healthy working environments; and leadership outcomes. CONCLUSION: Findings constitute calls for action. Change implementation should address barriers to diversity and inclusivity related to men's presence in nursing. Recommendations and strategies presented can guide change implementation. Change implementation is expected to strengthen the nursing profession.

Prevalence and associated risk factors for men being paid for sex in Ethiopia: a multilevel analysis of 2016 Ethiopian demographic health survey data.

Paying for sex is considered a high-risk sexual behavior, especially among men. Men who pay for sex are perceived to be a bridge group for sexually transmitted illnesses. In sub-Saharan Africa, the prevalence of paid sex among men is approximately 4.3%. Men paid for sex are not studied in Ethiopia. Therefore, the objective of this study was to identify factors associated with men paying for sex in Ethiopia. We analyzed data from the 2016 Ethiopian Demographic Health Survey. In the analysis, 9070 men were included. To identify factors associated with paid-for sex among men, we used a multilevel logistic regression model. A p value less than 0.05 was considered to indicate statistical significance at the 95% confidence interval (CI). In this study, 509 (5.6%) men were ever paid for sex. Men who paid for sex were significantly more likely to be rich [Adjusted Odds Ratio (AOR) = 1.70; 95% CI 1.287, 2.246], widowed or separated (AOR = 1.97; 95% CI 1.142, 3.396), had more sexual partners [AOR = 1.03; 95% CI 1.005, 1.063], had ever been tested for human immunodeficiency virus (HIV) (AOR = 1.50; 95% CI 1.173, 1.916), drank alcohol (AOR = 4.15; 95% CI 3.086, 5.576), and chewing khat (AOR = 2.28; 95% CI 1.822, 2.85); men who had ever paid for sex were significantly less likely to have higher education (AOR = .63; 95% CI .438, .898) and the lowest age at first sex (AOR = .90; 95% CI .870, .924). In conclusion, educational level, wealth status, province, marital status, age at first sexual intercourse, number of sexual partners, HIV status, alcohol consumption status, and chewing khat were significantly associated with men's paid-for sex. From a public and sexual health perspective, more education is needed for illiterate, widowed, separated, and rich men. Additionally, preventive measures should be taken against men's behavior through the use of alcohol or khat, having many sexual partners, and having young men.

A web-based video messaging intervention for suicide prevention in men: study protocol for a five-armed randomised controlled trial.

BACKGROUND: More than 50% of people who die by suicide have not been in contact with formal mental health services. The rate of people who fly 'under the radar' of mental health services is higher among men than women, indicating a need to improve engagement strategies targeted towards men who experience suicidal thoughts and/or behaviours. In Australia, a range of mental health support services exist, designed specifically for men, yet, a substantial proportion of men do not use these services. The aim of this study is to evaluate whether a brief online video-based messaging intervention is an effective approach for encouraging men with suicidal thoughts and/or behaviours to engage with existing support services. METHODS: Informed by a literature review, surveys, and consultation with men with a lived experience of suicidal thoughts and/or behaviours, we designed five video-based messages that will be used in this five-arm randomised controlled trial. A total of 380 (76 per arm) men aged 18 years or older with suicidal thoughts who are not currently accessing formal mental health services will be recruited online and randomly assigned to watch one of the five web-based video messages. After viewing the video, men will be presented with information about four existing Australian support services, along with links to these services. The primary outcome will be help-seeking, operationalised as a click on any one of the four support service links, immediately after viewing the video. Secondary outcomes include immediate self-reported help-seeking intentions in addition to self-reported use of the support services during a 1-week follow-up period. We will also use the Discrete Choice Experiment methodology to determine what aspects of support services (e.g. low cost, short appointment wait times) are most valued by this group of men. DISCUSSION: This study is the first to evaluate the effectiveness of a brief web-based video messaging intervention for promoting engagement with existing support services among men with suicidal thoughts who are not currently receiving formal help. If found to be effective, this would represent a scalable, cost-effective approach to promote help-seeking for this at-risk population. Limitations and strengths of this study design are discussed.

A Mixed Methods Investigation Examining the PrEP Cascade Among 13-18-Year-Old Latino Adolescent Sexual Minority Men.

Latino adolescent sexual minority men (ASMM) are at high risk of HIV. Limited research has explored the impact of parent-adolescent communication and beliefs on PrEP adoption among Latino ASMM. Our objective was to examine how parental support and beliefs influence decisions regarding PrEP use. We analyzed PrEP-related attitudes and behaviors within a national cohort of 524 Latino ASMM aged 13-18. Out of the participants, 60.5% were suitable for PrEP. Among them, 59.7% were in the precontemplation stage (stage 1), indicating a lack of willingness or belief of unsuitability. However, 86.4% moved to reach the contemplation stage (stage 2), demonstrating willingness and suitability for PrEP. Only 16.8% moved on to the PrEParation stage (stage 3), indicating their intention to start using PrEP. Furthermore, 4.3% progressed to the PrEP action stage and initiation (stage 4), signifying they had received a prescription, and all reported high adherence (stage 5). Factors associated with reaching later stages included older age, parental support of sexual orientation, and previous HIV/STI testing. The qualitative findings revealed diverse attitudes towards parental involvement in PrEP care among Latino ASMM, including positive, negative, and ambivalent perspectives. Notably, Spanish-speaking participants expressed specific barriers to PrEP communication between ASMM and their parents. Given that parental support and attitudes emerged as significant factors in both our quantitative and qualitative findings, it is evident that public health approaches aiming to disseminate education and awareness about PrEP to parents and families could alleviate the burden on adolescents to educate their parents and enhance support.