Vulnerabilidades relacionadas a saúde sexual de mulheres atendidas em um consultório de enfermagem / Vulnerabilities related to the sexual health of women attended in a nursing office / Vulnerabilidades relacionadas con la salud sexual de mujeres atendidas en un consultorio de enfermería

Objetivo: Descrever o perfil de saúde sexual de mulheres atendidas no Consultório de Enfermagem de uma instituição de ensino superior. Métodos: Estudo descritivo com abordagem quantitativa utilizando a técnica documental retrospectiva realizado por meio da coleta de dados de prontuários das usuárias atendidas em um Consultório de Enfermagem. Resultados: Foram analisados 303 (100%) prontuários. Houve predominância de mulheres, solteiras (50,17%); pardas/pretas 80 (26,41%); heterossexuais (86,80%); cisgêneras (97,36%); cristãs (72,94%), com uma parceria sexual (65,35%) e na faixa etária entre 40 a 59 anos (42,24%). Conclusão: Identificamos que alguns determinantes sociais, sobretudo a idade, estado civil e cor, podem estar vinculados a ocorrência de infecção sexualmente transmissível, dispareunia/sinusorragia e violência psicológica. Sugere-se que políticas públicas sejam de fato instituídas, com vistas à promoção e proteção da saúde das mulheres. (AU)

Objective: To describe the sexual health profile of women attended at the Nursing Office of a higher education institution. Methods: Descriptive study with a quantitative approach using the retrospective documentary technique performed by collecting data from medical records of users attended at a Nursing Office. Results: 303 (100%) medical records were analyzed. There was a predominance of single women (50,17%); brown/black 80 (26,41%); heterosexuals (86,80%); cisgenus (97,36%); Christians (72,94%), with a sexual partner (65,35%) and aged between 40 and 59 years (42,24%). Conclusion: We identified that some social determinants, especially age, marital status and color, linked to the occurrence of sexually transmitted infection, dyspareunia/sinusorrhagia and psychological violence. It is suggested that public policies are actually instituted, with a view to promoting and protecting women's health. (AU)

Objetivo: Describir el perfil de salud sexual de las mujeres atendidas en la Oficina de Enfermería de una institución de educación superior. Métodos: Estudio descriptivo con abordaje cuantitativo utilizando la técnica documental retrospectiva realizada mediante la recolección de datos de las historias clínicas de los usuarios atendidos en un Consultorio de Enfermería. Resultados: Se analizaron 303 (100%) historias clínicas. Predominio hubo de mujeres solteras (50,17%); marrón / negro 80 (26,41%); heterosexuales (86,80%); cisgénico (97,36%); Cristianos (72,94%), como pareja sexual (65,35%) en un grupo de 40 a 59 años (42,24%). Conclusión: Identificamos que algunos determinantes sociales, principalmente la edad, el estado civil y el color, están vinculados a la ocurrencia de Infección transmitida sexualmente, dispareunia / sinitismo y violencia psicológica. Sugerir que se instituyan políticas públicas, con miras a promover y proteger la salud de la mujer. (AU)

Generative artificial intelligence and non-pharmacological bias: an experimental study on cancer patient sexual health communications.

Objectives The objective of this study was to explore the feature of generative artificial intelligence (AI) in asking sexual health among cancer survivors, which are often challenging for patients to discuss.Methods We employed the Generative Pre-trained Transformer-3.5 (GPT) as the generative AI platform and used DocsBot for citation retrieval (June 2023). A structured prompt was devised to generate 100 questions from the AI, based on epidemiological survey data regarding sexual difficulties among cancer survivors. These questions were submitted to Bot1 (standard GPT) and Bot2 (sourced from two clinical guidelines).Results No censorship of sexual expressions or medical terms occurred. Despite the lack of reflection on guideline recommendations, 'consultation' was significantly more prevalent in both bots' responses compared with pharmacological interventions, with ORs of 47.3 (p<0.001) in Bot1 and 97.2 (p<0.001) in Bot2.Discussion Generative AI can serve to provide health information on sensitive topics such as sexual health, despite the potential for policy-restricted content. Responses were biased towards non-pharmacological interventions, which is probably due to a GPT model designed with the 's prohibition policy on replying to medical topics. This shift warrants attention as it could potentially trigger patients' expectations for non-pharmacological interventions.

Missed opportunities for HIV testing and sexual health-related challenges in an individual with intellectual disability: a case report.

BACKGROUND: HIV testing remains an important tool in identifying people living with HIV/AIDS (PLWHA). An early diagnosis of HIV can lead to a prolonged life expectancy if treatment is initiated promptly. Indicator conditions can be the first sign of an HIV infection and should therefore be recognised and consequently a HIV test should be carried out. Testing should occur in all individuals as sexuality can be experienced by everyone, and stigma can lead to the exclusion of vulnerable groups, leading to a gap in diagnosis and treatment [1, 2]. CASE PRESENTATION: A 63-year-old man, who identifies as bisexual and has had an intellectual disability since birth, presented at our health care centre for HIV testing. A decade ago, the patient was diagnosed with Stage III Diffuse Large B-cell Non-Hodgkin Lymphoma, an AIDS defining cancer. The patient presented at a Haematology and Oncology department 3 months prior, due to a weight loss of 10 kg over the past 5 months. Oral thrush, an HIV-indicator condition, had been diagnosed by the otolaryngologists shortly before. During this medical evaluation, pancytopenia was identified. Despite the presence of indicator conditions, the patient was never tested for HIV in the past. Staff members from the care facility for intellectually disabled suggested conducting a HIV test in our clinic through the public health department, where HIV positivity was revealed. The AIDS-defining diagnosis, along with a CD4 + cell count of 41/µl, suggests a prolonged period of HIV positivity. CONCLUSION: Due to the presence of existing indicator conditions, an earlier HIV diagnosis was possible. We contend that most of the recent illnesses could have been prevented if earlier testing had been carried out. Therefore, patients presenting with AIDS indicator conditions, including those with mental disabilities, should be given the opportunity to be tested for HIV. HIV/AIDS trainings should be made available to health care professionals as well as to personnel interacting with vulnerable groups.

The effect of psychosocial interventions for sexual health in patients with pelvic cancer: a systematic review and meta-analysis.

AIM: The aim of this systematic review and meta-analysis was to explore and evaluate the effect of psychosocial interventions in improving sexual health outcomes among post-treatment patients with pelvic cancer. METHODS: Inclusion and exclusion criteria were pelvic cancer survivors; psychosocial interventions; studies with a control group and measures of sexual health. Five databases were searched for literature along with an inspection of the included studies' reference lists to extend the search. Risk of bias was assessed with the RoB2 tool. Standardised mean difference (SMD) with a random effects model was used to determine the effect size of psychosocial interventions for sexual health in patients with pelvic cancers. RESULTS: Thirteen studies were included, with a total number of 1,541 participants. There was a large heterogeneity regarding the type of psychosocial intervention used with the source found in a leave one out analysis. Six studies showed statistically significant improvements in sexual health, while three showed positive but non-significant effects. The summary effect size estimate was small SMD = 0.24 (95% confidence interval [CI]: 0.05 to 0.42, p = 0.01). DISCUSSION: There is limited research on psychosocial interventions for sexual health in pelvic cancer patients. There are also limitations in the different pelvic cancer diagnoses examined. Commonly, the included articles examined physical function rather than the whole sexual health spectrum. The small effect sizes may in part be due to evaluation of psychosocial interventions by measuring physical dysfunction. Future research should broaden sexual health assessment tools and expand investigations to more cancer types.

Effects of pubic hair grooming on women's sexual health: a systematic review and meta-analysis.

BACKGROUND: Pubic hair grooming involves the partial or complete removal of pubic hair, and it is a common practice among men and women. Grooming is more prevalent in women, who employ various methods such as shaving, waxing and laser removal. However, it is associated with variable rates of post-grooming adverse outcomes including lacerations and sexually transmitted infections (STIs). To the best of our knowledge, this is the first systematic review and meta-analysis comparing women's sexual health outcomes between those who groom and those who don't. METHODS: We followed the MOOSE guidelines and conducted a computerized-based search using (PubMed, Web of Science, Scopus, and Ovid Medline), till June 20th, 2022, for eligible studies using the relevant keywords; (pubic hair grooming) OR (pubic hair removal OR Genital hairless OR Bikini hair removal OR pubic hair depilation). Cross-sectional studies included which compared grooming practices among women in terms of motivation and health outcomes. Women's satisfaction and incidence of STIs were pooled as standardized mean difference (SMD) and odds ratio (OR) respectively. RESULTS: Twenty-Two cross-sectional studies were included in our review with 73,091 participant.The odds of having gram-negative gonorrheal and chlamydial infection in Pubic hair groomers were found to be statistically significant (OR = 1.55, 95% CI [1.31, 1.84], P < 0.001) (OR = 1.56, 95% CI [1.32, 1.85], P < 0.001] respectively. There was no difference between groomer and non-groomer women regarding viral infections such as genital herpes (OR = 1.40, 95% CI [0.56, 3.50], P = 0.47) and Condyloma acuminata (OR = 1.75, 95% CI [0.51, 6.01], P = 0.37). The most common grooming side effect is genital itching (prevalence = 26.9%, P < 0.001). Non-electrical razor (prevalence = 69.3%, P < 0.001) is the most common grooming method. White women (prevalence = 80.2%, P < 0.001) remove pubic hair more frequently compared to black women (prevalence = 12.2%, P < 0.001). Women practice complete grooming (50.3%, P < 0.001) of the pubic hair more frequently than partial grooming (33.1%, P < 0.001). There are no differences in women's satisfaction between the two groups (SMD = 0.12, 95% CI [-0.16, 0.40], P = 0.39). CONCLUSION: This review aligns with previous observational studies regarding sexual health outcomes of pubic hair grooming. There is a need to raise awareness among women regarding the safe practice of pubic hair grooming, emphasizing the clarification of hazards and benefits.

Correlates of sexual and reproductive health service utilization among older adults in China: Findings from the sexual well-being (SWELL) study.

BACKGROUND: Sexual and reproductive health (SRH) is critical to the overall health of older adults. We assessed the utilization of SRH services and its correlates among older adults in China. METHODS: We recruited community-dwelling adults aged 50 and above in five Chinese cities between June 2020 and December 2022. In this study SRH services included reproductive health examination, cervical cancer screening, and sexual life counselling. Logistic regression was used to assess correlates of SRH services utilization. RESULTS: A total of 3001 older adults (1819 men and 1182 women) were enrolled. Among them, 11.4 % (343/3001) of participants received a reproductive health examination, 35.4 % (418/1182) of female participants received cervical cancer screening, and 30.1 % (401/1332) of sexually active participants sought help for their sexual lives. Older men with an annual income of USD 7500 or more (aOR = 3.21, 95%CI: 1.39-7.44), two or more chronic conditions (2.38, 1.39-4.08), and reproductive health problems (2.01, 1.18-3.43) were more likely to receive a urological examination. For older women, individuals who were younger (aged 50-59 years: 5.18, 2.84-9.43; aged 60-69 years: 2.67, 1.49-4.79), lived in an urban area (1.88, 1.31-2.71), were employed (1.73, 1.21-2.47), had two or more chronic conditions (2.04, 1.37-3.05), were sexually active (1.72, 1.15-2.58) and talked about sex (1.69, 1.21-2.36) were more likely to receive a gynecological examination. CONCLUSION: SRH services utilization among older adults was low, with urological examination among older men particularly low. SRH messages and services tailored for older adults are needed to enhance their utilization of SRH services.

"I think my vagina is still there?": Women's perspectives on sexual function and dysfunction following radical cystectomy for bladder cancer, a qualitative study.

BACKGROUND: Women's sexual health after radical cystectomy is an important but poorly understood aspect of bladder cancer survivorship. Dedicated investigation is needed to elucidate patient perceptions on sexual function and dysfunction in this setting. AIMS: In this study we sought to qualitatively examine women's perceptions and experiences of sexual health following radical cystectomy for bladder cancer. METHODS: We conducted one-on-one qualitative telephone interviews with 40 women who underwent radical cystectomy in the past 6 months to 5 years and signed a research consent form to be contacted for future studies. We examined women's experiences of engaging in sexual activity after surgery and their attitudes toward sex and body image. We audio recorded, transcribed, and coded the interviews using ATLAS.ti software and applied grounded theory methods for analysis. OUTCOMES: For data that emerged during the qualitative interviews that was related to lack of knowledge about how physical and psychological sexual health would be affected after surgery, we reviewed and discussed transcripts that enabled coding of the data into emerging topic areas. RESULTS: Our analysis yielded 4 main themes. (1) Women reported receiving little to no information from providers about female sexual dysfunction prior to or after radical cystectomy. Women wished they had been provided more information about female sexual dysfunction from their clinicians, including strategies for postoperative self-pleasure and nonintercourse methods of sexual pleasure with partners. (2) Women shared that they were not sexually active following surgery due to physical and mental barriers. (3) When women did try to engage in sex, they described feeling disappointed that it did not feel the same as prior to surgery. (4) Some women found that physical therapy helped them to physically and mentally recover their strength to engage in sexual activity again. CLINICAL IMPLICATIONS: Clinicians must directly address sexual health concerns with patients who undergo radical cystectomy. STRENGTHS AND LIMITATIONS: This study has several key strengths. Investigation into women's sexual function and dysfunction addresses a gap in understanding of this component of women's health-related quality of life after radical cystectomy, which represents an unmet need. The large number of interviews conducted as well as the in-depth information obtained through one-on-one interviews are additional strengths. This study also has limitations, including possible shortcomings of telephone interviews compared with in-person interviews. However, telephone interviews were beneficial because the interviews took place during the COVID-19 pandemic and spared patients from extra visits or from having to travel long distances to the respective medical centers. Other possible limitations were that patients may have been reluctant to share all of their experiences and that patients who underwent urostomies, also termed ileal conduits, were overrepresented in this study compared with women who underwent continent urine diversions, which allow greater control over urine output. CONCLUSION: Broadening the understanding of sexual health beyond sexual intercourse to encompass sexuality and self-pleasure can provide clinicians, patients, and their families with more effective preparation and strategies to care for an essential aspect of their wellbeing.

Investigating sexual health after breast cancer by longitudinal assessment of patient-reported outcomes.

BACKGROUND: Sexual concerns are a major unaddressed need among survivors of breast cancer (BC) with significant negative effects on quality of life. We longitudinally analyzed sexual health over time, using patient-reported outcomes. METHODS: Patients with stage I-III BC prospectively included from the CANcer TOxicity cohort (CANTO) provided data at diagnosis, then 1, 2, and 4 years afterward. Sexual concerns outcomes included poor body image (score ≤91/100), poor sexual functioning (≤16/100), poor sexual enjoyment (≤66/100), and sexual inactivity (EORTC QLQ-B23). Multivariate generalized estimating equation models assessed associations with sexual concerns after diagnosis, adjusting for age, sociodemographic, tumor, treatment, and clinical characteristics. RESULTS: Nearly 78.1% among 7895 patients reported at least one sexual concern between diagnosis and 4 years' follow-up. Over time, the proportion of patients reporting sexual concerns either increased or remained constant with diagnosis. Less than half (46%, range 11.4-57) of the patients with sexual concerns reported the use of supportive care strategies, including gynecological or psychological consultations (range 11.4-57.4). Factors consistently associated with sexual concerns up to 4 years after diagnosis included already reporting the same concern at diagnosis [odds ratio (OR)poor body image 3.48 [95% confidence interval (CI) 3.11-3.89]; ORsexual inactivity 9.94 (95% CI 8.84-11.18), ORpoor sexual function 9.75 (95% CI 8.67-10.95), ORpoorsexual enjoyment 3.96 (95% CI 3.34-4.69)], endocrine therapy use [ORpoor body image 1.15 (95% CI 1.01-1.31); ORsexual inactivity 1.19 (95% CI 1.02-1.39), ORpoor sexual function 1.17 (95% CI 1.01-1.37), ORpoor sexual enjoyment 1.23 (95% CI 1.00-1.53)], and depression [ORpoor body image 2.00 (95% CI 1.72-2.34); ORsexual inactivity 1.66 (95% CI 1.40-1.97), ORpoor sexual function 1.69 (95% CI 1.43-2.00), ORpoor sexual enjoyment 1.94 (95% CI 1.50-2.51)]. Outcome-specific associations were also identified. CONCLUSIONS: Sexual concerns seem frequent, persistent, and insufficiently addressed. Pretreatment concerns, endocrine therapy, and emotional distress are commonly associated factors. A proactive evaluation of sexual health across the care continuum is needed, to promptly identify patients suitable for multidisciplinary counseling, referral, and supportive interventions.

Inequities in PrEP use according to Medicare status in a publicly funded sexual health clinic; a retrospective analysis.

New HIV diagnoses continue to disproportionately affect overseas-born men who have sex with men (MSM). A retrospective study of all pre-exposure prophylaxis (PrEP)-eligible MSM attending Sydney Sexual Health Centre for the first time in 2021 analysed self-reported PrEP-use, PrEP prescribed at the initial consult, and PrEP taken during 2021 using binomial logistic regression models. A total of 1367 clients were included in the analysis, 716 (52.4%) were born overseas and 414 (57.8%) were Medicare-ineligible. Medicare-ineligible clients were less likely to be on PrEP at initial visit (OR 0.45, 95% CI 0.26-0.77). This study suggests inequities in PrEP access and/or awareness in Medicare-ineligible MSM in Australia.

Improving awareness and uptake of pre-exposure HIV prophylaxis amongst service users accessing Sexual Health London, a regional online postal sexually transmitted infection testing health service.

BACKGROUND: The UK pledged commitment to the global strategy of zero new HIV infections and HIV-related deaths by 2030. PrEP was commissioned in England in 2020 and is fundamental to achieving these targets, yet awareness and uptake are suboptimal in certain populations. METHOD: Sexual Health London (SHL) incorporated questions on its e-triage questionnaire estimating need for PrEP amongst online service users. Two types of signposting messaging were shown to users directing them to more detailed online content: PrEP-discussion (potential need) and PrEP-eligible (assumed need). The effectiveness of this signposting was evaluated by reviewing demographics and triage responses in returning users. RESULTS: 426,149 SHL users requested STI screening between 1.7.21-31.10.22. 16% (69,867/426,149) and 32.2% (137,489/426,149) of individuals received PrEP-eligible and PrEP-discussion signposting. The PrEP-eligible cohort were: 41.0% gay/bisexual or other men who have sex with men (GBMSM), 16.3% heterosexual males, 33.1% heterosexual females, and 60.6% were of white ethnicity. The PrEP-discussion cohort were: 9.3% GBMSM, 34.3%% heterosexual males, 45.5% heterosexual females and 63.7% of white ethnicity. 50.4% (35,190/69,867) and 41.3% (56,808/137,489) of the PrEP-eligible and PrEP discussion cohorts ordered a subsequent SHL STI testing kit, during which 10.0% (3510/35,190) and 5.9% (3364/56,808) reported taking PrEP. Of those who denied taking PrEP, 59% (18,702/31,680) and 61.0% (32,559/53,444) triggered PrEP signposting again. 95.4% of PrEP starters were GBMSM (6562/6874) and 1.4% (97/6874) heterosexual males/females. CONCLUSION: The e-service demonstrated feasibility in estimating PrEP need and signposting service users. Up to 16% of returning users subsequently commenced PrEP. This highlights significant missed opportunities for the remaining online users, who continue to report HIV acquisition risk(s). Further efforts regionally/nationally to optimise uptake of PrEP, particularly among under-represented groups are warranted.

Enhancing sexual health in primary care: Guidance for practitioners.

Sexual health is an integral aspect of overall health and well-being and is fundamental to the sustainable development of societies worldwide. The World Health Organization (WHO) defines sexual health as 'a state of physical, emotional, mental, and social well-being in relation to sexuality'. However, addressing sexual health has been afforded low priority in primary healthcare systems. Primary care practitioners (PCPs), who play a crucial role in providing comprehensive care to communities, receive little training on screening and managing individuals with sexual health problems. The scope of services ranges from education, prevention and screening, to management of sexual health matters. Patients with noncommunicable diseases (NCDs), such as stroke, cancer, heart disease and diabetes, are at increased risk for sexual dysfunction, possibly because of common pathogenetic mechanisms, such as inflammation. This is of considerable importance in the sub-Saharan African context where there is a rapidly increasing prevalence of NCDs, as well as a high burden of HIV. Strategies to improve the quality of sexual health services in primary care include creating a safe and non-judgemental practice environment for history-taking among gender-diverse populations, utilising effective screening tools aligned with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for sexual dysfunctions. In particular, the International Consultation on Sexual Medicine (ICSM -5) diagnostic and treatment algorithm can empower primary care providers to effectively address sexual dysfunctions among patients and improve the quality of care provided to communities regarding sexual and reproductive health.

Sexual health in Belgian cervical cancer survivors: an exploratory qualitative study.

PURPOSE: To assess experiences of sexuality and of receiving sexual healthcare in cervical cancer (CC) survivors. METHODS: A qualitative phenomenological study using semistructured one-on-one interviews was conducted with 15 Belgian CC survivors recruited in 5 hospitals from August 2021 to February 2022. The interviews were audiotaped and transcribed verbatim. Data were analyzed using inductive thematic analysis. COREQ and SRQR reporting guidelines were applied. RESULTS: Most participants experienced an altered sexuality after CC treatment with often long-term loss/lack of sex drive, little/no spontaneity, limitation of positions to avoid dyspareunia, less intense orgasms, or no sexual activity at all. In some cases, emotional intimacy became more prominent. Physical (vaginal bleeding, vaginal dryness, dyspareunia, menopausal symptoms) and psychological consequences (guilt, changed self-image) were at the root of the altered sexuality. Treatment-induced menopause reduced sex drive. In premenopausal patients, treatment and/or treatment-induced menopause resulted in the sudden elimination of family planning. Most participants highlighted the need to discuss their altered sexual experience with their partner to grow together toward a new interpretation of sexuality. To facilitate this discussion, most of the participants emphasized the need for greater partner involvement by healthcare providers (HPs). The oncology nurse or sexologist was the preferred HP with whom to discuss sexual health. The preferred timing for information about the sexual consequences of treatment was at treatment completion or during early follow-up. CONCLUSION: Both treatment-induced physical and psychological experiences were prominent and altered sexuality. Overall, there was a need for HPs to adopt proactive patient-tailored approaches to discuss sexual health.

A guide for addressing sexual health in breast cancer patients.

PURPOSE: Sexual health concerns are common in breast cancer surgery but often overlooked. Yet, breast cancer patients want more sexual health information from their providers. We aimed to share ways for providers to address sexual health concerns with their breast cancer patients at different stages of the treatment process. METHODS: Experts in breast cancer treatments, surgeries, and sexual health at Memorial Sloan Kettering Cancer Center assembled to review the literature and to develop the recommendations. RESULTS: Providers should provide sexual health information for their breast cancer patients throughout the continuum of care. Conversations should be initiated by the providers and can be brief and informative. Whenever appropriate, patients should be referred to Sexual Medicine experts and/or psychosocial support. There are various recommendations and tools that can be utilized at diagnosis, endocrine and chemotherapy, and breast surgery to identify patients with sexual health concerns and to improve their sexual functioning. CONCLUSION: In this paper, we sought to provide providers with some insights, suggestions, and tools to address sexual health concerns. We encourage healthcare providers to initiate the conversation throughout the continuum of care beginning as early as diagnosis and refer patients to additional services if available.

Differences in STI/HIV Burden and Sexual Health Care-Seeking Behavior Among First- and Second-Generation Migrant and Western-Born Male Sex Workers Who Have Sex With Men in the Netherlands: A Retrospective Cohort Study.

BACKGROUND: Globally, migrant sex workers have a higher burden of sexually transmitted infections (STI)/human immunodeficiency virus (HIV). This large study aimed to assess demographics, STI/HIV burden, and sexual health care-seeking behavior of first-generation migrant and second-generation migrant male sex workers who have sex with men (MSW-MSM) versus Western-born MSW-MSM. METHODS: Coded STI clinic consultations (n = 6970) from 3116 individual MSW-MSM attending any Dutch STI clinic between 2016 and 2021 were included. First-generation migrant: born outside of northern/central/southern/western Europe/North America/Oceania. Second-generation migrant: ≥1parent born outside of northern/central/southern/western Europe/North America/Oceania. Multivariable logistic regression analysis assessed associations between MSW-MSM groups and STI in first consultation in the data. A Cox proportional hazard regression compared the incidence of a first repeat consultation between migration groups, stratified by STI in first consultation. All analyses were adjusted for age and urbanity of STI clinic region. RESULTS: First-generation migrant MSW-MSM (n = 1085) were mostly born in Latin America (50%), whereas second-generation migrant MSW-MSM (n = 368) mostly originated from North Africa (30.4%). The proportion of STI diagnoses differed (33.2%, 29.3%, 23.3%; P < 0.001) between the first-generation migrant, second-generation migrant, and Western-born MSW-MSM. First-generation migrant MSW-MSM versus Western-born had an adjusted odds ratio of 1.6 (95% confidence interval, 1.3-1.9) of STI diagnosis in the first consultation. First-generation migrant MSW-MSM versus Western-born had an adjusted hazard ratio of 1.5 (95% confidence interval, 1.3-1.8) of having a first repeat consultation at any time, when stratified for no STI in the first consultation. CONCLUSIONS: The STI/HIV burden is high among all 3 MSW-MSM groups. First-generation migrants have higher odds of STI, but retention in care seems similar. Results highlight the importance of low-threshold STI testing and care for (migrant) MSW-MSM.

How Can Gaps in Oncology Sexual Health Care Be Addressed With the Independent Practice of Nurses?

Over the years, I have embraced various roles ascending the ladder of healthcare leadership, shouldering immense responsibilities and persistently seeking opportunities for professional development. This drive for continuous.

Obesity and sexual health: focus on postmenopausal women.

Menopause is a cardiometabolic transition with many women experiencing weight gain and redistribution of body fat. Hormonal changes may affect also several dimensions of well-being, including sexual function, with a high rate of female sexual dysfunction (FSD), which displays a multifactorial etiology. The most important biological factors range from chronic low-grade inflammation, associated with hypertrophic adipocytes that may translate into endothelial dysfunction and compromised blood flow through the genitourinary system, to insulin resistance and other neuroendocrine mechanisms targeting the sexual response. Psychosocial factors include poor body image, mood disorders, low self-esteem and life satisfaction, as well as partner's health and quality of relationship, and social stigma. Even unhealthy lifestyle, chronic conditions and putative weight-promoting medications may play a role. The aim of the present narrative review is to update and summarize the state of the art on the link between obesity and FSD in postmenopausal women, pointing to the paucity of high-quality studies and the need for further research with validated end points to assess both biomarkers of obesity and FSD. In addition, we provide general information on the diagnosis and treatment of FSD at menopause with a focus on dietary interventions, physical activity, anti-obesity drugs and bariatric surgery.

Self-reported intimate partner violence among men who have sex with men at an urban Australian sexual health clinic.

BACKGROUND: In Australia, 17% of women and 6% of men have experienced intimate partner violence (IPV). Although most IPV research has focused on heterosexual partnerships, studies suggest that men who have sex with men (MSM) may experience IPV at similar or higher rates than those documented among women. IPV may also take different forms among MSM and have different health and social impacts. This study aims to assess the utility of a screening tool for identifying and responding to IPV among MSM attending a sexual health clinic in Sydney, Australia. METHODS: Between 1 June 2020 and 30 June 2022, MSM clients were screened using standardised questions to identify IPV experienced within the preceding 12months. Answers to the screening questions were correlated with data collected routinely at the initial clinic visit, including age, employment, country of birth, drug and alcohol use, sexual partner numbers, and any history of sex work, pre-exposure prophylaxis use and HIV status, as well as any bacterial STI diagnosed at the initial visit. RESULTS: There were 2410 eligible clients and of these, 2167 (89.9%) were screened during the study period. A total of 64 men (3.0%) (95% CI 2.3-3.8%) reported experiencing physical violence or intimidation in the past 12months. Controlling for age, men who were born in Australia were 2.03 (95% CI: 1.04-3.01) times more likely to report IPV, and men who had Medicare were 2.43 (95% CI: 0.95-3.90) times more likely to report IPV than those who did not. Those who had ever injected drugs were 5.8 (95% CI: 1.87-9.73) times more likely to report IPV, and men with sexualised drug use were 4.11 (95% CI: 2.03-6.19) times more likely. Those that were employed or studying were 72% (95%CI: 0.13-0.42) less likely to report IPV. CONCLUSIONS: The prevalence of reported IPV in our study was lower than that reported by others, which may be due to differences in recruitment methods and questions asked. Associations between IPV in MSM and injecting drug use and sexualised drug use highlight that clinicians should be aware of the impact and potential for IPV particularly in those with risk factors.

Sexual Health in Sexual and Gender Minority Patients with Inflammatory Bowel Disease.

BACKGROUND: In recent years, legislation targeting the sexual and gender minority (SGM) community has been passed at an increasingly alarming rate, affecting access to safe and effective gender-affirming care and forcing many SGM patients, including those with inflammatory bowel disease (IBD), to withhold their identities and health concerns. Additionally, SGM patients with IBD may have unique health considerations that have not yet been well-studied OBJECTIVE: This article aims to explore the intersection of IBD and sexual health in patients who identify as SGM and to identify limitations for gastroenterologists in caring for SGM patients. The article also aims to provide suggestions for improvement in SGM-competent care within gastroenterology METHODS: A thorough literature review was conducted regarding sexual health and the SGM community with IBD. This included a review of surgical considerations in SGM patients, sexually transmitted infections (STIs) and prevention, and sexual dysfunction RESULTS: Overall, little is known about the impact of IBD on patients who identify as sexual and gender minorities. Surgery, medications, and STIs continue to be a concern in the SGM community with IBD and these areas represent opportunities to improve SGM-competent IBD care. Additionally, implementation of an SGM-focused curriculum is urgently needed in medical education to improve provider knowledge and care for this unique group of patients CONCLUSIONS: Patients with IBD who identify as SGM experience challenges that are not well described in prior literature. More research is needed and is actively being pursued to guide provider awareness and improve sexual health for this patient population.