Predictors of sexual and reproductive health knowledge and utilization of services among adolescents in Ghana's Adaklu district.

Objective: To explore factors associated with adolescents' sexual and reproductive health (SRH) knowledge and their engagement with educational and clinical services. Design: Regression analysis of secondary data collected during a community survey. Setting: Adaklu district, Volta Region, Ghana. Participants: 221 adolescent caregiver pairs. Main outcome measures: The study employed three main outcome measures: (1) adolescents' level of SRH knowledge (assessed via questionnaire), (2) membership in district-sponsored adolescent health clubs (AHCs), and (3) ever-utilization of clinical SRH services. Results: Greater SRH knowledge was significantly associated with older age, AHC membership, and relying primarily on teachers or friends for SRH information. Increased odds of AHC membership were observed among females (AOR = 2.38, 95% CI 1.14-4.95); those who had communicated with one parent about sexual issues (OR 2.70, 95% CI 1.17-6.21); and those with a history of transactional sex (OR 5.53, 95% CI 1.04-29.37). Decreased odds were observed among adolescents whose caregivers were educated to the primary level (AOR = 0.24, 95% CI = 0.07-0.79). Overall, utilization of clinical SRH services was low, but higher odds were detected among individuals reporting a history of forced sex (AOR = 117.07, 95% CI 3.82-3588.52) and those who had discussed sexual issues with both of their parents (AOR = 13.11, 95% CI 1.85-92.93). Conclusions: Awareness of the predictors of knowledge, AHC involvement, and clinical service utilization can empower adolescent SRH initiatives-both present and future-to enhance their teaching, develop targeted outreach to underserved groups, and promote engagement with key clinical resources. Funding: This work has been supported by grants from the International Development Research Centre [108936] (IDRC), Canada.

A Digital Sexual Health Education Web Application for Resource-Poor Regions in Kenya: Implementation-Oriented Case Study Using the Intercultural Research Model.

BACKGROUND: Developing a digital educational application focused on sexual health education necessitates a framework that integrates cultural considerations effectively. Drawing from previous research, we identified the problem and essential requirements to incorporate cultural insights into the development of a solution. OBJECTIVE: This study aims to explore the Solution Room of the self-established Intercultural Research Model, with a focus on creating a reusable framework for developing and implementing a widely accessible digital educational tool for sexual health. The study centers on advancing from a low-fidelity prototype (She!Masomo) to a high-fidelity prototype (We!Masomo), while evaluating its system usability through differentiation. This research contributes to the pursuit of Sustainable Development Goals 3, 4, and 5. METHODS: The research methodology is anchored in the Solution Room of the self-expanded Intercultural Research Model, which integrates cultural considerations. It uses a multimethod, user-centered design thinking approach, focusing on extensive human involvement for the open web-based application. This includes gathering self-assessed textual user feedback, conducting a System Usability Scale (SUS) analysis, and conducting 4 face-to-face semistructured expert interviews, following COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines. RESULTS: Based on the identified limitations of the low-fidelity prototype, She!Masomo (SUS score 67), which were highlighted through textual user feedback (63/77) and prototype feature comparisons, iterative development and improvement were implemented. This process led to the creation of an enhanced high-fidelity prototype (We!Masomo). The improved effectiveness of the enhanced prototype was evaluated using the qualitative SUS analysis (82/90), resulting in a favorable score of 77.3, compared with the previous SUS score of 67 for the low-fidelity prototype. Highlighting the importance of accessible digital educational tools, this study conducted 4 expert interviews (4/4) and reported e-survey results following the CHERRIES (Checklist for Reporting Results of Internet E-Surveys) guideline. The digital educational platform, We!Masomo, is specifically designed to promote universal and inclusive free access to information. Therefore, the developed high-fidelity prototype was implemented in Kenya. CONCLUSIONS: The primary outcome of this research provides a comprehensive exploration of utilizing a case study methodology to advance the development of digital educational web tools, particularly focusing on cultural sensitivity and sensitive educational subjects. It offers critical insights for effectively introducing such tools in regions with limited resources. Nonetheless, it is crucial to emphasize that the findings underscore the importance of integrating culture-specific components during the design phase. This highlights the necessity of conducting a thorough requirement engineering analysis and developing a low-fidelity prototype, followed by an SUS analysis. These measures are particularly critical when disseminating sensitive information, such as sexual health, through digital platforms. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12905-023-02839-6.

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.

Awareness of chronic hepatitis B and C in men who have sex with men in Belgium: epidemiological survey and on-site screening.

OBJECTIVES: To eliminate hepatitis B and C virus (HBV/HCV) as a public health threat by 2030, the WHO focuses on screening key populations, including men who have sex with men (MSM).This study aims to assess HBV and HCV knowledge and awareness and HCV prevalence in MSM in Belgium. METHODS: First, a questionnaire was designed to assess MSM's knowledge of HBV and HCV infection (disease process, vaccination, treatment and transmission routes). This questionnaire was conducted online, and by means of a tablet-based face-to-face questionnaire at the Antwerp and Belgian Pride. Second, HCV and HIV prevalence data were collected during outreach projects and office screening for sexually transmitted infections (STIs) organised by Sensoa and Exaequo, a Flemish and Walloon sexual health organisation. RESULTS: 300 MSM completed the questionnaire (median age 36 years; 7.7% HIV+). Mean overall survey scores were low (HBV: 41.1%; HCV: 39.8%). Few participants identified all transmission routes correctly (HBV: 15%; HCV 1%).The degree of education was significantly correlated with HBV knowledge and showed a trend towards correlation with HCV knowledge. HCV knowledge was significantly correlated with high-risk sexual behaviour.The prevalence of HCV and HIV was 0.3% and 1.0%, respectively, in MSM attending commercial gay venues and 0% and 1.9% in MSM attending office STI screening. CONCLUSIONS: Knowledge of HBV and HCV infection in MSM is poor. More awareness campaigns are needed, focusing on frequent HCV risk factors (group sex, chemsex, receptive fisting, and sharing of anal toys and anal douching devices), especially targeting low-educated MSM. HBV vaccination of MSM requires continued attention.The prevalence of HCV and HIV was remarkably low in commercial gay venues and may be higher in older MSM or in subcultures where risk factors coexist (eg, chemsex). The cost-effectiveness of internet-based approaches with subsequent at-home testing needs to be evaluated in the future.

Improving young patient - practitioner communication about sexual health during medical visits.

OBJECTIVES: Young people face barriers that lead to gaps in sexual and reproductive health care communications. Issues such as discomfort discussing sexual health lead to inadequate delivery of services resulting in unintended pregnancies and STIs. Closing this communication gap between patients and health care practitioners would improve communication and health outcomes. The objective of this study was to gain feedback from focus groups about: (a) barriers and facilitators to communication surrounding sexual health and (b) the feasibility and acceptability of a question prompt list (QPL) and informational video emphasizing asking questions about sexual health during medical visits as tools young people could use to be more involved during visits. METHODS: Three focus groups were conducted: two with young adults (n=14) and one with practitioners (n=5) of sexual/reproductive health care services. Practitioners were recruited from healthcare clinics. RESULTS: Young adults were aged 18-22 years old. Participants identified barriers to communication such as embarrassment over sexual health topics and practitioner assumptions about patients' base of knowledge. A facilitator to communication was patient-friendly language. Focus group participants offered suggestions on how to improve the QPL as well as themes that should be covered in an educational video. Participants viewed the QPL and educational video as useful for encouraging conversations between patient and practitioner. CONCLUSIONS: Many barriers obstruct communication between young adults and practitioners on topics relating to sexual health. Both the QPL and an educational video could be used to enhance patient-practitioner communication.

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.

Determinants of Sexual Health and Sexual Quality of Life after Cardiovascular Surgeries: An Integrative Review.

BACKGROUND AND AIM: Sexual health and sexual quality of life are key components of psychosocial adjustment after cardiac surgeries and are often linked with improving the general quality of life. Reviews have been conducted to highlight the associations between cardiovascular diseases and sexual dysfunctions, but no review reported determinants of sexual health and sexual quality of life in patients after cardiovascular surgeries. We aimed to comprehensively examine the determinants of sexual health and sexual quality of life among individuals with cardiovascular surgeries. METHODS: Literature was searched within PubMed, CINAHL, Scopus, Web of Science, and OVID databases. In total, 816 records were identified from database searches, 279 records were screened, and 11 empirical studies were included for review. Relevant data were extracted using literature summary tables and synthesised using an inductive approach. RESULTS: The core determinants of sexual health and sexual quality of life were type of surgery and comorbidities, fears and uncertainties regarding sexual activity, sexual health education and counselling, spousal relationship and communication, and demographic factors such as advanced age and literacy levels. Major surgeries performed were coronary artery bypass grafting (CABG) and heart valve surgeries. The data collection tools used to collect data for sexual health and sexual quality of life were the International Erectile Function Questionnaire (IEFQ), International Index of Erectile Function (IIEF), Female Sexual Function Index (FSFI), Sexual Knowledge CABG Scale (SKS-CABG), Sexual Quality of Life Questionnaire (SQOL), SKS-Myocardial Infarction Scale (SKS-MI), and Couple Communication Scale (CCS). CONCLUSIONS: Despite their importance, sexual health and quality of life are frequently overlooked during patient rehabilitation after cardiovascular surgeries. The lack of adequate education and counselling from healthcare professionals frequently leads to increased fear and uncertainties among individuals and their partners. Therefore, more person-centred educational and counselling approaches should be developed to address the sexual concerns of individuals and their partners.

Nursing practices on sexual health for people with neurological disorders: A narrative review.

AIMS: To identify and describe nursing practices on the sexual health of people with neurological disorders. DESIGN: Narrative review. METHODS: Data were extracted from 1 January 2002, to 20 May 2021. Inclusion criteria were nursing practices, sexual health and people with neurological disorders. The main outcome measures were: context of nursing practice implementation (assumptions, knowledge, strategies and skills), facilitators of and barriers to addressing and treating the sexual health of people with neurological disorders, and benefits of nursing practices in sexual health. PRISMA reporting guidelines were used. DATA SOURCES: PubMed, Embase, ScienceDirect and CINAHL. RESULTS: In total, 926 articles were identified and nine were included. The involvement of nurses was recommended in most studies. Assumptions about the impact of neurology on sexuality and nurse's role in sexual healthcare, biopsychosocial knowledge, and skills (ethical, interpersonal, and technical) were highlighted. We found that the modes of knowledge proposed by Carper were mobilized in an unequal way. Sexual difficulties were the key focus and eroticization concerns were not addressed in any of the articles. CONCLUSION: Several studies advocate nursing intervention; however, few accurately present, detail and evaluate sexual health nursing practices of patients with neurological pathologies. Literature describes practices structured around disorders rather than the potentials, fails to address the brake of eroticism and provides little information on the results of interventions. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Developing teaching programs on sexual health in nursing programs may be necessary if nurses are to support a diverse range of patients in an inclusive and positive manner. These programs should highlight the domain-specific knowledge that is mobilized. IMPACT: Sexual health is a fundamental human right. Alterations in the nervous system have shown to affect sexual health, however, it is not often discussed among patients with neurological disorders, who are rarely provided with sexual health counselling. Our findings may impact healthcare professionals engaged in care with these patients. REPORTING METHOD: PRISMA. No patient or public contribution.

Understanding Practical, Robust Implementation and Sustainability of Home-based Comprehensive Sexual Health Care: A Realist Review.

This review identifies which elements of home-based comprehensive sexual health care (home-based CSH) impacted which key populations, under which circumstances. A realist review of studies focused on home-based CSH with at least self-sampling or self-testing HIV and additional sexual health care (e.g., treatment, counseling). Peer-reviewed quantitative and qualitative literature from PubMed, Embase, Cochrane Register of Controlled Trials, and PsycINFO published between February 2012 and February 2023 was examined. The PRISM framework was used to systematically assess the reach of key populations, effectiveness of the intervention, and effects on the adoption, implementation, and maintenance within routine sexual health care. Of 730 uniquely identified records, 93 were selected for extraction. Of these studies, 60% reported actual interventions and 40% described the acceptability and feasibility. Studies were mainly based in Europe or North America and were mostly targeted to MSM (59%; 55/93) (R). Overall, self-sampling or self-testing was highly acceptable across key populations. The effectiveness of most studies was (expected) increased HIV testing. Adoption of the home-based CSH was acceptable for care providers if linkage to care was available, even though a minority of studies reported adoption by care providers and implementation fidelity of the intervention. Most studies suggested maintenance of home-based CSH complementary to clinic-based care. Context and mechanisms were identified which may enhance implementation and maintenance of home-based CSH. When providing the individual with a choice of testing, clear instructions, and tailored dissemination successful uptake of STI and HIV testing may increase. For implementers perceived care and treatment benefits for clients may increase their willingness to implement home-based CSH. Therefore, home-based CSH may determine more accessible sexual health care and increased uptake of STI and HIV testing among key populations.

Social media use, knowledge, attitudes, and risky sexual behavior of HIV transmission: A survey among boarding school adolescent students in Indonesia.

Background: Social media has many positive and negative influences on individuals, especially for adolescents related to HIV. However, little is known about how social media impacts HIV-related outcomes among adolescents in boarding schools. Objective: This study aims to investigate the social media use, knowledge, attitudes, and sexual behavior at risk of HIV transmission and their relationship with the demographic characteristics of adolescent students at boarding schools. Methods: This study was school-based and used a cross-sectional design. The questionnaires were used to assess social network site usage, knowledge, attitudes, and risky behavior. Cluster random sampling involved students (n = 214) from three boarding schools in Cirebon City, West Java, Indonesia, in 2022. Chi-square tests and Cramer's V were used to explore correlations between social and demographic factors. Results: A considerable number of adolescent students exhibited high social media addiction (58.4%), with the majority possessing limited knowledge of HIV transmission (54.7%). Additionally, nearly half displayed a negative attitude towards preventing HIV transmission (47.2%), while only a small fraction engaged in risky behavior (2.8%). Bivariate analysis revealed that social media use was moderately associated with the type of social media application (φc = 0.246, p <0.05). Knowledge of HIV transmission exhibited a moderate correlation with age (φc = 0.331, p <0.05), education level (φc = 0.240, p <0.001), and exposure to information (φc = 0.269, p <0.001). Similarly, attitudes toward HIV prevention demonstrated moderate associations with age (φc = 0.341, p = 0.001), education level (φc = 0.317, p <0.001), and exposure to information (φc = 0.266, p <0.001). Furthermore, risky sexual behavior exhibited a strong association with exposure to pornographic content (φc = 0.730, p <0.001). Conclusion: The study found a high prevalence of social media usage among adolescents, coupled with low knowledge about HIV, negative attitudes, and risky behavior. Significant relationships were observed between social media use, knowledge, attitudes, and risky sexual behavior related to HIV transmission and demographic characteristics. This study emphasizes the vital role of nurses and healthcare professionals in implementing targeted educational interventions in boarding schools to address gaps in HIV risk knowledge influenced by social media, ultimately improving strategies for adolescents' sexual health.

Research trends of Moringa oleifera Lam as Remedy toward Cattle's embryo according to the frequently used words in content of papers and citations.

Moringa oleifera is an herb that has the potential to reduce the mortality rate of an embryo. Research about Moringa oleifera treatment toward an embryo of livestock was quite a number. However, there were still very few previous studies that explain the trend of research related to that topic in this decade, 2010-2023. This study tried to observe the research trend related to Moringa oleifera treatment to embryos of livestock in terms of frequently used words inside papers along with their citations. This study gathered 132 data samples from Scopus and 41 data from PubMed and processed them using the bibliometric method. The bibliometric software used was Vosviewer to produce the image of the author's keyword connection and trend and biblioshiny for depicting frequently words used as a title and inside content and mean of total citation/year. This study also used R Studio to complement Vosviewer in conducting the bibliometric method. The result showed that there was no author's keyword that depicted ruminant-type animals instead of cow, and no name of the animal as livestock that was being used as a title of the sample papers. There were also no papers that observed Moringa oleifera to treat sick embryos of livestock and the previous studies used as samples also had a low mean of total citation/year.

Classroom Voices: Youth Perspectives to Direct School-based Sexual Health Education.

Sexual health education is a well-known, evidence-based intervention that can improve adolescent health outcomes, increase protective health behaviours, and decrease risky health behaviours. Providing sexual health education in school settings offers opportunities for discussion of critical health topics and can improve the school environment for all students. However, not all sexual health education is taught equitably across classroom environments. As part of a mixed-methods study to describe school-based sexual health education, we conducted focus groups and interviews with recently graduated high school students in New Mexico, a geographically and ethnically diverse state in the US Southwest. Thirty-one young people shared their experiences, explored the sexual health education content they had been taught, and offered recommendations to improve sexual health education. Three key themes were developed: young people wanted and needed sexual health education taught in school settings; the sexual health education currently taught in school is not helpful and sometimes harmful; and the individuals who teach sexual health education are critically important. These findings can inform and support school staff and administrators addressing barriers to school-based sexual health education delivery, particularly in schools within marginalised communities with limited resources. The results support including youth as stakeholders in the planning, delivery and evaluation of school-based sexual health education; and the development of sexual health education training for teachers, with the goal of improving health outcomes for all youth populations.

Sexualized drug use and chemsex: A bibliometric and content analysis of published literature.

Sexualized drug use (SDU) describes drug-facilitated sexual enhancement, and chemsex is an SDU subculture involving the use of specific drugs by men who have sex with men (MSM). This study aimed to identify research trends, foci, and themes within the SDU and chemsex-specific literature. The Web of Science Core Collection was searched with a list of SDU synonyms. All SDU-related articles were analyzed using the R package, bibliometrix. Full text review identified chemsex-specific records, and text was extracted verbatim for content analysis in Leximancer. The search returned 1,866 unique records. A total of 521 addressed SDU, and 301 papers specifically addressed chemsex. The small but growing SDU literature primarily addressed consensual encounters between MSM, and drug-facilitated assault experienced by women, in Western settings. Little attention was given to transgender communities or consensual SDU in cisgender heterosexual individuals. The literature primarily viewed SDU through a public health lens, specifically focusing on the risk conferred to sexual health.The SDU and chemsex-specific literature are potentially limited in scope and may inadequately capture the geographical, demographic, and cultural diversity of these phenomena. Future research should address the myriad social and health implications of SDU and chemsex participation across all relevant communities and settings.

'I just LOVE data': perceptions and practices of data sharing and privacy among users of the Lioness.

High profile data breaches and the proliferation of self-tracking technologies generating bio-feedback data have raised concerns about data privacy and data sharing practices among users of these devices. However, our understanding of how self-trackers in sexual health populations, where the data may be sensitive, personal, and stigmatising, perceive data privacy and sharing is limited. This study combined industry consultation with a survey of users of the world's first biofeedback smart vibrator, the Lioness, that enables users to monitor and analyse their sexual response intensity and orgasm duration over time. We found users of the Lioness are motivated to self-track by both individual and altruistic goals: to learn more about their bodies, and to contribute to research that leads to better sexual health outcomes. Perceptions of data privacy and data sharing were shaped by an eagerness to collaborate with sexual health researchers to challenge traditional male-centric perspectives in biomedical research on women's sexual health, where gender plays a crucial role in defining healthcare systems and outcomes. This study extends our understanding of the non-digital aspects of self-tracking by emphasising the role of gender and inclusive healthcare advocacy in shaping perceptions of data privacy and sharing within sexual health populations.

French Validation of the oMtFSFI Questionnaire for Assessing the Sexual Function of Transgender Women After Vulvo-vaginoplasty.

INTRODUCTION: The Operated Male-to-Female Sexual Function Index (oMtFSFI) questionnaire is the first scoring system developed to assess sexual function after gender-affirming vulvo-vaginoplasty, and was initially developed and validated in Italian. The aim of this study was to provide linguistic validation of the questionnaire in French through several steps including use of the questionnaires across a series of patients who had undergone gender-affirming vulvo-vaginoplasty between 2020 and 2022 at two French academic centers. METHOD: The French version of the oMtFSFI questionnaire was obtained through a double translation (Italian to French) and a back-translation (French to Italian), validated by a scientific committee, and cognitively assessed by a panel of expert patients. The questionnaire was then distributed to transgender male to female patients who had undergone genital gender affirming surgery at two French academic centers. RESULTS: The oMtFSFI score consists of 18 questions exploring 7 domains (genital self-image, desire, arousal, lubrication, orgasm, satisfaction, sexual pain). Among the sixty-four patients who responded to the questionnaire, 16 patients (25%) reported abstaining from sexual activity involving vaginal penetration at the time of the study were excluded. The mean total score was 37, corresponding to mild to moderate sexual dysfunction and 60.4% of the patients reported normal overall sexual function. The level of sexual satisfaction was normal for 68.8% of the patients and the genital self-image was normal for 52.1%. Most of the patients (79.2%) reported at least mild dyspareunia and 10.4% had critical sexual dysfunction. Surgery improved gender dysphoria in 96.7% of patients. There was a strong correlation between the overall oMtFSFI score and the happiness Visual Analog Scale (VAS) (p<0.001) as well as with the quality of life VAS (p<0.001). CONCLUSION: The French version of the oMtFSFI questionnaire is the only scoring system specifically developed to assess sexual function after vulvo-vaginoplasty in transgender women linguistically validated in French. Its validation in French language makes it an interesting tool for research and clinical practice.

Barriers and Facilitators to Accessing PrEP and Other Sexual Health Services Among Immigrant Latino Men Who Have Sex with Men in Los Angeles County.

In the United States, immigrant Latino men who have sex with men (ILMSM) are, compared to white MSM, disproportionately burdened by HIV and lack access to highly effective HIV prevention strategies, such as pre-exposure prophylaxis (PrEP). Qualitative research centered on exploring barriers that ILMSM experience in accessing PrEP and other sexual services is extremely limited, despite a high prevalence of HIV in this population. In this study, a purposive sample of ILMSM (n = 25) was recruited to participate in a semi-structured in-depth interview to identify the distinct barriers and facilitators ILMSM experience in accessing sexual health services given their complex intersectional identities of being an immigrant, Latino, and a sexual minority man. Using a thematic analysis approach, nine themes were generated from the data representing barriers and facilitators. Barriers included: (1) cost and a lack of health insurance, (2) complexity of PrEP assistance programs; (3) challenges related to the immigrant experience; (4) impact of gay stigma; and (5) communication challenges. Facilitators included: (1) improving affordability and accessibility of PrEP services; (2) receiving services from LGBT- or Latine LGBT-centered clinics; (3) receiving services from medical providers who are gay and/or Latino; and (4) providing targeted community outreach, education, and promotion of PrEP to ILMSM. While many of the barriers illuminated in the study were structural (e.g., cost and lack of health insurance), and not easy to overcome, the findings highlight a range of facilitators that can support access to PrEP and other sexual health services for ILMSM. Considering these findings, we suggest strategies that may enhance access to needed sexual health services among ILMSM.

Testosterone concentrations and associated predictors in men with cystic fibrosis: a retrospective, single-center study.

BACKGROUND: Men with cystic fibrosis (CF) have sexual health concerns such as delayed puberty, infertility, and hypogonadism. The causes and prevalence of hypogonadism have not been well studied. The purpose of this study was to determine the prevalence of a low testosterone concentration in men with CF. METHODS: This retrospective study was approved by the Emory University Institutional Review Board (IRB). Data were extracted from the electronic medical records of adult men with CF receiving care at the Emory Cystic Fibrosis Center. A total of 129 men with CF were followed at our center from 2016 to 2023. Of these individuals, 76 men with CF (58.9%) had at least one serum total testosterone measurement. Seven individuals were excluded from this study since they were currently receiving testosterone therapy, leaving a final sample size of 69 individuals for the analysis. Demographic data, serum testosterone concentrations, and other factors associated with low testosterone concentrations were collected. Low testosterone was defined as a value below 300 ng/dL. Regression analyses were used to determine factors associated with low testosterone levels. RESULTS: The mean (± SD) age of the 69 eligible participants was 33.34 ± 10.98 years. The mean testosterone concentration was 421 ± 158.5 ng/dL with 27.54 percent of men with a testosterone value below 300 ng/dL. The mean hemoglobin level was 14.23 ± 2.18 g/dL. Testosterone levels were positively related to hemoglobin levels. Time of day of measurement and age were not associated with testosterone levels. CONCLUSION: Roughly a quarter of men with CF demonstrated low testosterone in our sample. Low hemoglobin was associated with low testosterone levels in men with CF. Neither time of day nor age influenced testosterone concentrations in this sample.

Sexual support and education for adults with mild intellectual disabilities: a Delphi study on multiple perspectives.

BACKGROUND: Providing appropriate sexual support and education for adults with mild intellectual disabilities (IDs) is a source of considerable debate, resulting in diverse, non-funded and potentially adverse practices. This study aims to identify a consensus among experts regarding what conditions are conducive to successful sexual support and education for adults with mild IDs. METHODS: A Delphi study was conducted with 13 experts, including experts-by-experience, relatives, support staff, psychologists and sexologists. Qualitative data on the conditions for sexual support and education were gathered in the first round and thematically analysed. In the following three quantitative rounds, consensus was achieved using Likert-type response scales and participants' feedback. RESULTS: Round 1 resulted in 82 conditions on six themes: 'the necessary attitude', 'requirements', 'approach to delivering sexual support and education', 'appropriate providers', 'settings and timing' and 'effective collaboration with the network'. In the following three quantitative rounds, the experts reached consensus on 68 conditions distributed across the six themes. CONCLUSIONS: The six themes highlight conducive conditions for successful sexual support and education for adults with mild IDs, emphasising the significance of a safe and supportive environment, comprehensive educational programmes, and the promotion of autonomy and protection. The consensus-based findings have distinct implications for practice and future research.

Psychosocial and sexual health among men with and without HIV who have sex with men: A cross-sectional nationwide study in Denmark.

OBJECTIVES: The HIV/AIDS epidemic has disproportionately affected men who have sex with men (MSM) since its onset. Despite important medical advancements in treatment, the enduring effects of living with HIV continue to adversely impact the health and well-being of this population. This cross-sectional nationwide study examined psychosocial and sexual health among MSM in Denmark, comparing those living with and without HIV. METHODS: Data from MSM living with HIV were collected from the SHARE study, a Danish nationwide survey that investigated psychosocial, sexual and reproductive health among people with HIV, and compared with data from MSM without HIV, retrieved from the nationally representative cohort study, Project SEXUS. Associations between HIV status and psychosocial and sexual health outcomes were examined using logistic regression models while controlling for potentially confounding variables. RESULTS: Among 369 MSM with HIV and 1002 MSM without HIV, logistic regression analyses revealed that living with HIV was significantly associated with having current symptoms of anxiety and depression and greater dissatisfaction with one's body. Additionally, MSM with HIV significantly more often than MSM without HIV reported low sexual desire, sexual inactivity, a lack of sexual needs in the last year and erectile dysfunction. Having received payment for sex was more frequently reported by MSM with HIV, as was sexualised drug use, including chemsex drugs. CONCLUSION: Compared with MSM without HIV, MSM with HIV in Denmark report a higher burden of mental health and sex life challenges.

Sexual health and testosterone concentration in male lymphoma survivors: A systematic review.

Advancements in lymphoma treatment have increased the number of long-term survivors who may experience late effects such as impaired sexual function and testosterone deficiency. The aim of this review was to determine the prevalence of testosterone deficiency and sexual dysfunction among male lymphoma survivors; and associations between the two. A systematic search identified 20 articles for inclusion. The prevalence of low total testosterone was 0%-50 %, with mean values within reference levels, and for luteinizing hormone above reference levels in 0%-80 %. Four studies included SHBG and free testosterone, with mixed results. Compromised sexual health was found in 23%-61 %. Overall, total testosterone and sexual health were associated. The risk of bias (ROBINS-E and RoB 2) was high/very high, leading to low/very low overall confidence in the bulk of evidence (GRADE). Longitudinal studies evaluating biologically active testosterone and sexual health are needed, to develop evidence based standard procedures for follow-up of sexual health.