Sexual health in cancer: the results of a survey exploring practices, attitudes, knowledge, communication, and professional interactions in oncology healthcare providers.

PURPOSE: To assess, focusing on population of healthcare professionals providing oncosexology care to men with cancer, clinical practice, attitudes, knowledge, communication, and professional interaction. METHODS: We performed a descriptive cross-sectional study with an online self-administered e-questionnaire addressed to all medical, paramedical, or administrative professionals attending the 4th "Cancer, Sexuality and Fertility" Meeting in Toulouse, France. Their participation was voluntary and totally anonymous. RESULTS: The 165 respondents comprised 44% of physicians, 47% of paramedics, and 9% of other health professionals in oncology, from all French regions. Paramedics were significantly younger than physicians (p = .006). One third of respondents were degreed in sexology, but 75.8% were in demand of oncosexology-specific trainings, particularly paramedics (p = .029). Regarding the oncosexology network, respondents declared being linked to organ specialists (56.8%), psychologists (49.5%), oncologists (47.4%), nurses (31.5%), radiation therapists (27.4%), and general practitioners (25.3%). Compared to paramedics, physicians were more likely to be engaged in oncosexology care (p = .039) and couple counseling (p = .005), but the proportions of counseled patients or couple were identical (p = .430 and p = .252, respectively). Overall, 90% of respondents reported discussing sexuality issues with patients. Regarding the time for discussion, physicians reported communicating more at cancer announcement (p = .004) or after treatments (p = .015), while more paramedics reported discussing at another time (p = .005). Regarding the place for discussion, paramedics more frequently reported talking about sexuality in the hospital room (p = .001) or during a specific consult (p = .007). CONCLUSIONS: Results emphasize various levels for improving existing oncosexology care, such as developing oncosexology-specific educational and practical training programs, particularly for paramedics; consolidating information, counseling, and therapeutic education with formal procedures like implementing medical and paramedical "oncosexology moments," or strengthening the community-hospital networks, from diagnosis to survivorship.

Identifying MSM-competent physicians in China: a national online cross-sectional survey among physicians who see male HIV/STI patients.

BACKGROUND: Men who have sex with men (MSM) are at high risk of human immunodeficiency virus (HIV) infection and sexually transmitted infection (STI) in China. Inadequate clinical services and poor clinical competency among physicians are major barriers to improving the sexual health of MSM. This study aims to understand physician clinical competency in providing MSM health services in China. METHODS: We conducted an online cross-sectional survey among Chinese physicians who have seen male patients for STI complaints in the past year. We obtained information on individual demographics, clinical practice, attitudes toward MSM, and interest in contributing to MSM clinical services. We defined an MSM-competent physician as one who asked male patients about sexual orientation, sexual practices, and recommended HIV/ STI testing during a clinic visit. We conducted multivariable logistic regression to identify factors associated with MSM competency. RESULTS: In total, 501 physicians completed the survey. The most common subspecialties were dermatovenereology (33.1%), urology (30.1%), and general medicine (14.4%). Roughly half (n = 267, 53.3%) reported seeing MSM in the past 12 months. Among physicians who saw MSM in the past 12 months, 60.3% (n = 161) met criteria as MSM-competent physicians, and most (n = 234, 87.6%) MSM-competent physicians reported positive or neutral attitudes towards MSM. Over 60% of all physicians were willing to participate in activities for improving MSM services, such as training and being on a list of physicians willing to serve MSM. MSM-competent physicians showed no sociodemographic differences compared with non MSM-competent physicians. MSM-competent physicians were more willing to have their medical institution named on a public clinic list capable of serving MSM (aOR: 1.70, 95%CI: 1.01-2.86) and being on a public physician list capable of serving MSM (aOR: 1.77, 95%CI: 1.03-3.03). CONCLUSIONS: MSM-competent physicians included a broad range of individuals that practiced in diverse clinical settings. Most physicians were interested in improving and expanding MSM clinical services, despite having neutral attitudes toward same-sex behavior. Future interventions should focus on developing MSM clinical competency and expanding services that meet the needs of MSM.

Randomized controlled trials in the journal of sexual medicine: a quality assessment and relevant clinical impact.

INTRODUCTION: Quality assessment of randomized clinical trials (RCTs) is important to prevent the adoption of findings of low-quality trials into clinical practice. AIM: The aim if this study was to analyze the quality of studies reporting RCTs in the Journal of Sexual Medicine (JSM) and to find relevant clinical impact. METHODS: A quality assessment was conducted in all studies identified as RCTs published in the JSM from 2004 to 2012. The review period was divided into three periods: early (2004-2006), mid (2007-2009), and late (2010-2012). MAIN OUTCOME MEASURES: The Jadad scale, van Tulder scale, and the Cochrane Collaboration Risk of Bias Tool (CCRBT) quality scoring instruments were used. The RCTs were also categorized by country of origin, topic, the inclusion of institutional review board (IRB) approval, funding, citation rate, and impact factor. RESULTS: A total of 2,418 original articles were published in the JSM during the review period, and 188 were reports of RCTs. There were 39 (14.89%), 70 (7.77%), and 76 (6.29%) RCTs published during the early, mid, and late terms, respectively (P < 0.001). No significant increases in Jadad or van Tulder scale scores were found over time nor were there any significant changes in the number of low-risk articles as assessed by the CCRBT. However, significant differences in quality analysis were found in funding and IRB approval. Citation rates and impact factor were not correlated with RCT quality using any of the tools. CONCLUSIONS: The number of original articles and RCTs published in the JSM increased over time. However, the ratio of RCTs to original articles did not increase significantly. Adequate randomization and blinding methods, IRB review, and financial support are required for the conduct of high-quality RCTs.

Sexual health discussions with older adult patients during periodic health exams.

INTRODUCTION: Sexual health is an integral part of overall health across the lifespan. In order to address sexual health issues, such as sexually transmitted infections (STIs) and sexual functioning, the sexual history of adult patients should be incorporated as a routine part of the medical history throughout life. Physicians and health-care professionals cite many barriers to attending to and assessing the sexual health needs of older adult patients, underscoring the importance of additional research to improve sexual history taking among older patients. AIM: The purpose of this article is to explore the content and context of physician-patient sexual health discussions during periodic health exams (PHEs) with adults aged 50-80 years. METHODS: Patients completed a pre-visit telephone survey and attended a scheduled PHE with their permission to audio-record the exam. Transcribed audio recordings of 483 PHEs were analyzed according to the principles of qualitative content analysis. MAIN OUTCOME MEASURES: Frequency of sexual history taking components as observed in transcripts of PHEs. Physician characteristics were obtained from health system records and patient characteristics were obtained from the pre-visit survey. RESULTS: Analyses revealed that approximately one-half of the PHEs included some discussion about sexual health, with the majority of those conversations initiated by physicians. A two-level logistic regression model revealed that patient-physician gender concordance, race discordance, and increasing physician age were significantly associated with sexual health discussions. CONCLUSION: Interventions should focus on increasing physician self-efficacy for assessing sexual health in gender discordant and race/ethnicity concordant patient interactions. Interventions for older adults should increase education about sexual health and sexual risk behaviors, as well as empower individuals to seek information from their health-care providers.

Factors predicting publication of sexual medicine abstracts presented at the annual meeting of the American Urological Association.

INTRODUCTION: At sexual medicine meetings throughout the world, hundreds of scientific abstracts are presented each year. To our knowledge, no previous studies have looked at the rate of publication of these studies in a peer-reviewed journal. AIM: To define the fate of abstracts presented at sexual medicine sessions at the annual meeting of the American Urological Association (AUA) and to describe the factors predicting ultimate publication in scientific journals. METHODS: All abstracts presented at the 2006 and 2007 AUA annual meeting were surveyed to find sexual medicine abstracts. Publication status as of October 2009 was assessed using the Medline database. Abstract parameters were recorded including number of authors, country of origin, clinical or basic research, and area of sexual research. Predictors of publication were analyzed using a multivariable model. MAIN OUTCOME MEASURE: Publication status of all sexual medicine abstracts presented at the 2006 and 2007 AUA annual meetings. RESULTS: A total of 208 sexual medicine abstracts were presented in 2006 and 2007. Fifty-one percent of these were published by October 2009. On univariate analysis, the predictors of publication in a peer-reviewed journal included the number of authors (r=0.22, P<0.01), studies pertaining to erectile dysfunction (RR 1.3, CI 1-1.8, P=0.05), and studies originating from academic centers (RR 2.7, CI 1.7-4.3, P<0.01). On multivariate analysis, the predictors of publication included the number of authors (OR 1.3, CI 1-1.4, P<0.01) and having a study originate from an academic center (OR 5.9, CI 2.8-12.7, P<0.01). CONCLUSIONS: Fifty-one percent of the sexual medicine abstracts presented at the 2006 and 2007 annual AUA meetings have been published within 2 to 3 years of the date of presentation. Studies originating from academic centers were six times more likely to be published in a peer-reviewed journal.

Diferenças de gênero no campo da sexologia: novos contextos e velhas definições / Gender differences in the field of sexology: new contexts and old definitions / Diferencias de género en el campo de la sexología: nuevos contextos y viejas definiciones

OBJETIVO: Analisar concepções de gênero e sexualidade presentes no campo de intervenções terapêuticas em torno do sexo. PROCEDIMENTOS METODOLÓGICOS: Observação etnográfica, complementada por análise documental de material impresso referente ao X Congresso Brasileiro de Sexualidade Humana, promovido pela Sociedade Brasileira de Estudos em Sexualidade Humana, e ao VIII Congresso Brasileiro sobre Inadequações Sexuais, promovido pela Associação Brasileira para o Estudo das Inadequações Sexuais, realizados em 2005. A análise privilegiou a interação entre a perspectiva quantitativa no processamento das variáveis profissão e gênero dos participantes e temas das palestras, e perspectiva qualitativa na análise e interpretação do conjunto mais geral de dados. RESULTADOS: Os temas das sessões e o enfoque das apresentações sugerem que o campo é definido pelo contraste entre duas especialidades médicas: a ginecologia e a urologia, a primeira voltada para disfunções femininas e do casal e a segunda para as disfunções masculinas. CONCLUSÕES: A sexualidade masculina é abordada por perspectiva predominantemente biomédica, centrada na fisiologia da ereção e na prescrição de medicamentos, enquanto a sexualidade feminina é apresentada como condicionada por problemas relacionais, mais adequados à intervenção psicológica.

OBJECTIVE: To analyze concepts of gender and sexuality present in the field of sex therapeutic interventions. METHODOLOGICAL PROCEDURES: An ethnographic observation was conducted, and it was completed with the analysis of printed material originated from the X Congresso Brasileiro de Sexualidade Humana (10th Brazilian Congress on Human Sexuality), promoted by the Sociedade Brasileira de Estudos em Sexualidade Humana (Brazilian Society of Human Sexuality Studies), and the VIII Congresso Brasileiro sobre Inadequações Sexuais (8th Brazilian Congress on Sexual Inadequacies), promoted by the Associação Brasileira para o Estudo das Inadequações Sexuais (Brazilian Association of Sexual Inadequacy Studies), both held in 2005. The analysis emphasized the interaction between the quantitative perspective in the processing of the variables (participants' gender and profession and lecture topics) and the qualitative perspective in the analysis and interpretation of the more general set of data. RESULTS: The topics of sessions and focus of presentations suggest that the field is divided by the contrast between two medical specialties: gynecology and urology, the former is aimed at female and couple dysfunctions, while the latter is aimed at male dysfunctions. CONCLUSIONS: Male sexuality is approached from the predominantly biomedical perspective, centered on the physiology of erection and drug prescription, whereas female sexuality is considered to be conditioned by relationship problems, when psychological intervention is more adequate.

OBJETIVO: Analizar concepciones de género y sexualidad presentes en el campo de intervenciones terapéuticas en torno al sexo. PROCEDIMIENTOS METODOLÓGICOS: Observación etnográfica, complementada por análisis documental de material impreso referentes al X Congreso Brasileño de Sexualidad Humana, promovido por la Sociedad Brasileña de Estudios en Sexualidad Humana y el VIII Congreso Brasileño sobre Inadecuaciones Sexuales, promovido por la Asociación Brasileña para el Estudio de las Inadecuaciones Sexuales, realizados en 2005. El análisis privilegió la interacción entre la perspectiva cuantitativa en el procesamiento de las variables profesión y género de los participantes y temas de las palestras y cualitativa en el análisis e interpretación del conjunto más general de datos. RESULTADOS: Los temas de las sesiones y el enfoque de las presentaciones sugieren que el campo es definido por el contraste entre dos especialidades médicas: la ginecología y la urología, la primera dirigida a disfunciones femeninas y de la pareja y la segunda a las disfunciones masculinas. CONCLUSIONES: La sexualidad masculina es abordada por perspectiva predominantemente biomédica, centrada en la fisiología de la erección y en la prescripción de medicamentos, mientras que la sexualidad femenina es presentada como condicionada por problemas de relación, más adecuados a la intervención psicológica.

Gender differences in the field of sexology: new contexts and old definitions.

OBJECTIVE: To analyze concepts of gender and sexuality present in the field of sex therapeutic interventions. METHODOLOGICAL PROCEDURES: An ethnographic observation was conducted, and it was completed with the analysis of printed material originated from the X Congresso Brasileiro de Sexualidade Humana (10th Brazilian Congress on Human Sexuality), promoted by the Sociedade Brasileira de Estudos em Sexualidade Humana (Brazilian Society of Human Sexuality Studies), and the VIII Congresso Brasileiro sobre Inadequações Sexuais (8th Brazilian Congress on Sexual Inadequacies), promoted by the Associação Brasileira para o Estudo das Inadequações Sexuais (Brazilian Association of Sexual Inadequacy Studies), both held in 2005. The analysis emphasized the interaction between the quantitative perspective in the processing of the variables (participants' gender and profession and lecture topics) and the qualitative perspective in the analysis and interpretation of the more general set of data. RESULTS: The topics of sessions and focus of presentations suggest that the field is divided by the contrast between two medical specialties: gynecology and urology, the former is aimed at female and couple dysfunctions, while the latter is aimed at male dysfunctions. CONCLUSIONS: Male sexuality is approached from the predominantly biomedical perspective, centered on the physiology of erection and drug prescription, whereas female sexuality is considered to be conditioned by relationship problems, when psychological intervention is more adequate.

[Training of primary health care nurses on sexuality: a study of associated factors]. / Formação sobre sexualidade dos enfermeiros dos cuidados de saúde primários: estudo de factores a ela associados.

The present work presents a mixed study that evaluates the factors related to the basic formation in sexuality for Portuguese nurses of primary health care. 1735 nurses working in the 18 Health Sub-Regions of the Continent and the 2 Health Regional Secretaries of the Autonomous Regions of Madeira and Azores, corresponding to 226 Health Centers, were studied between March 2004 and July 2005. The profile of the Portuguese primary health care nurse with basic training on sexuality is between 22/30 years of age, 1/7 years of professional exercise, single, resident in Madeira or Azores, with bachelor degree and from a private nursing school. The nurses with special training in sexuality are essentially nurses with more than 38 years of age, with more than 13 years of professional exercise, seaside or Azores resident, specialists in one nursing branch, a masters degree and from public nursing schools. It was found that the 31-37 age group shows a deficit either in basic or specific training about sexuality.

Sexology as a profession in the United Kingdom.

To identify clinicians working within the field of sexual and psychosexual medicine and to identify and quantify the diversity of problems seen by specialist physicians, nurses and therapists working in the UK and compare these with French clinicians, a prospective 89 item questionnaire was sent to 2352 practitioners in the UK. Eight hundred and fourteen completed questionnaires were returned detailing clinician practice and training and the presenting problems of patients in their clinical practice. The commonest presenting problem amongst men was erectile dysfunction (562/814) followed by emotional and relational problems. The commonest problem for women was loss or absence of sexual desire and was of a similar magnitude to that of erectile dysfunction in men. The substantial majority of clinicians working with patients and clients with sexual problems are non-physicians from a diverse professional training background which contrasts with a high number of physicians in France. The high incidence of emotional and relational problems in both men and women would suggest that clinical services require considerable psychotherapeutic consultation space within the service provision.