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1.
Support Care Cancer ; 28(4): 1607-1630, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31872299

RESUMO

PURPOSE: To synthesize the characteristics and effects of couple-based intervention on sexuality and the quality of life (QOL) of cancer patients and their intimate partners and its implications for future research and practice. METHODS: A systematic review and meta-analysis of randomized and non-randomized controlled studies of interventions was conducted in nine English databases and two Chinese databases, with identification of related studies published in English and Chinese. The quality of the studies was assessed using the tools of the Effective Public Health Practice Project. RESULTS: A total of 33 articles were identified for systematic review and 23 articles were identified for meta-analysis. For patients, the effect size was 0.42 (Hedges's g, 95% CI = 0.05-0.78, p = 0.03) for physical health. For partners, the effect size was 0.52 (Hedges's g, 95% CI = 0.06-0.98, p = 0.03) for sexual relationships. However, moderate to high heterogeneity was reported. Effects on sexual function, sexual self-concept, and mental health for couples were not significant. CONCLUSION: Couple-based interventions had small to medium-sized effects on physical health for cancer patients. Partners could derive medium effects for improvement in sexual relationships from couple-based intervention. Future research should pay more attention to sexual self-concept in cancer patients and target types of cancer that are more likely to compromise sexuality and QOL. PROSPERO REGISTRATION: The systematic review and meta-analysis has been registered in PROSPERO with registration number: CRD42019119047.


Assuntos
Neoplasias/psicologia , Neoplasias/terapia , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Adaptação Psicológica , Terapia Comportamental , Humanos , Relações Interpessoais , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Aconselhamento Sexual , Sexualidade
2.
Sex Reprod Health Matters ; 27(1): 1615364, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31533573

RESUMO

Female genital mutilation (FGM), also referred to as female genital cutting (FGC), has become the subject of an intense debate exposing tensions between varying cultural values about bodies and sexuality. These issues are brought to the fore in settings where professionals provide sexual counselling to young circumcised women and girls in Western, multicultural societies. This article is based on interviews and focus group discussions with professionals in social and healthcare services. The aim of this study was to examine how professionals reflect upon and talk about sexuality and the promotion of sexual wellbeing in young circumcised women and girls. Policy documents guide their obligations, yet they are also influenced by culture-specific notions about bodies and sexuality and what can be called "the FGM standard tale". The study found that professionals showed great commitment to helping the girls and young women in the best possible way. Their basic starting point, however, was characterised by a reductionist focus on the genitalia's role in sexuality, thus neglecting other important dimensions in lived sexuality. In some cases, such an attitude may negatively affect an individual's body image and sexual self-esteem. Future policy making in the field of sexual health among girls and young women with FGC would benefit from taking a broader holistic approach to sexuality. Professionals need to find ways of working that promote sexual wellbeing in girls, and must avoid messages that evoke body shame or feelings of loss of sexual capacity among those affected by FGC.


Assuntos
Atitude do Pessoal de Saúde , Circuncisão Feminina/psicologia , Pessoal de Saúde/psicologia , Saúde Sexual , Imagem Corporal , Feminino , Humanos , Entrevistas como Assunto , Autoimagem , Aconselhamento Sexual , Suécia , Saúde da Mulher
3.
Rev Bras Enferm ; 72(4): 1109-1113, 2019 Aug 19.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31432972

RESUMO

OBJECTIVE: Reporting the experience of use of the PLISSIT model as tool for the nursing care of breast cancer survivors with sexual dysfunction. METHOD: case study developed from January to August 2017, in the outpatient mastology clinic and sexuality service of a maternity in Fortaleza, Ceará, Brazil, with 15 breast cancer survivors. RESULTS: sexual counseling sessions were conducted using the PLISSIT model to address sexual issues, highlighting the particularities of women who experience survival after the treatment of breast cancer. FINAL CONSIDERATIONS: the model used in the practice of nursing care is customary and allows identifying issues experienced by women, as it has easy availability and practicality for use by nursing professionals, helping to address sexual matters with greater tranquility.


Assuntos
Neoplasias da Mama/complicações , Neoplasias da Mama/enfermagem , Aconselhamento Sexual/métodos , Disfunções Sexuais Fisiológicas/terapia , Sobreviventes/psicologia , Adulto , Brasil , Neoplasias da Mama/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Aconselhamento Sexual/tendências , Disfunções Sexuais Fisiológicas/psicologia , Inquéritos e Questionários , Sobreviventes/estatística & dados numéricos
4.
Acta Med Port ; 32(6): 441-447, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31292025

RESUMO

INTRODUCTION: Pre-exposure prophylaxis is defined as the use of antiretroviral drugs to prevent HIV acquisition in uninfected individuals. Recognizing the increasing use of informal pre-exposure prophylaxis in Portugal, CheckpointLX, a community clinic targeted to men who have sex with men in Lisbon, Portugal, began offering counselling and follow-up services prior to formal introduction. This study aims to characterize pre-exposure prophylaxis users attending CheckpointLX before formal pre-exposure prophylaxis introduction in Portugal, and those who were referred to pre-exposure prophylaxis in the National Health Service following formal approval of pre-exposure prophylaxis. MATERIAL AND METHODS: Data was collected by peer counsellors between May 2015 and September 2018 and inserted in a database. Medical care followed the European AIDS Clinical Society recommendations for pre-exposure prophylaxis eligibility, initiation and follow-up. For formal pre-exposure prophylaxis, the General-Directorate for Health's Pre-exposure Prophylaxis guidelines checklist was used. RESULTS: Until the end of May 2018, CheckpointLX had a total of 90 appointments for wild pre-exposure prophylaxis, of which 64 (71%) were first time visits. As for the 380 service users referred to the National Health Service, most were Portuguese (n = 318, 84%), and the mean age was 31 (8.9) years old. Condomless sex in the last six months with partners of unknown HIV status was the most common eligibility criteria (n = 59, 83%). DISCUSSION: Pre-exposure prophylaxis delivery should be complemented with effective information on the importance of immunization and education on safer practices of drug administration, in the scope of broader preventive sexual health care. CONCLUSION: Much remains to be done in Portugal to ensure that pre-exposure prophylaxis is available to those who need it the most. Offering pre-exposure prophylaxis at community clinics could be a first step.


Assuntos
Antirretrovirais/administração & dosagem , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/estatística & dados numéricos , Profilaxia Pré-Exposição/estatística & dados numéricos , Adolescente , Adulto , Brasil/etnologia , Lista de Checagem , Preservativos/estatística & dados numéricos , Hospitais Especializados/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Portugal , Guias de Prática Clínica como Assunto , Encaminhamento e Consulta/estatística & dados numéricos , Aconselhamento Sexual/estatística & dados numéricos , Espanha/etnologia , Vacinação/estatística & dados numéricos , Adulto Jovem
6.
20 Century Br Hist ; 30(3): 375-398, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-30986822

RESUMO

This article uses the audio recordings of sexual counselling sessions carried out by Dr Joan Malleson, a birth control activist and committed family planning doctor in the early 1950s, which are held at the Wellcome Library in London as a case study to explore the ways Malleson and the patients mobilised emotions for respectively managing sexual problems and expressing what they understood as constituting a 'good sexuality' in postwar Britain. The article contains two interrelated arguments. First, it argues that Malleson used a psychological framework to inform her clinical work. She resorted to an emotion-based therapy that linked sexual difficulties with unconscious, repressed feelings rooted in past events. In so doing, Malleson actively helped to produce a new form of sexual subjectivity where individuals were encouraged to express their feelings and emotions, breaking with the traditional culture of emotional control and restraint that characterized British society up until the fifties. Second, I argue that not only Malleson but also her patients relied on emotions. The performance of mainly negative emotions reveals what they perceived as the 'normal' and sexual 'ideal'. Sexual therapy sessions reflected the seemingly changing nature of the self towards a more emotionally aware and open one that adopted both the language of emotions and that of popular psychology to articulate his or her sexual difficulties.


Assuntos
Emoções , Aconselhamento Sexual/história , Feminino , História do Século XX , Humanos , Londres , Masculino
9.
J Sex Marital Ther ; 45(3): 190-200, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30595113

RESUMO

The purpose of this study was to evaluate the effects of a relationship enhancement education and counseling (REEC) program on improving middle-aged couples' marital intimacy. The randomized controlled trial study was conducted in Tabriz, Iran, from May to December 2017. Thirty-two married couples, attending a public health center and meeting the inclusion criteria, were randomly assigned to the intervention (receiving REEC) and control (receiving routine care) groups. The outcome measures were marital intimacy, sexual motivation, and sexual function. Data were collected at three points in time. The Statistical Package for the Social Sciences was used for the purpose of data analysis. In all analyses, the interventional group outperformed the control group on all outcome measures. In the intervention group, results showed statistically significant improvement in all variables of interest after one week and 12 weeks in comparison with preintervention. Upon the completion of the experimentation, it can be concluded that a REEC program positively affects marital intimacy, sexual function, and sexual motivation in middle-aged couples.


Assuntos
Satisfação Pessoal , Aconselhamento Sexual/métodos , Comportamento Sexual/psicologia , Disfunções Sexuais Psicogênicas/prevenção & controle , Parceiros Sexuais/psicologia , Cônjuges/psicologia , Feminino , Humanos , Relações Interpessoais , Irã (Geográfico) , Masculino , Casamento , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Resultado do Tratamento
10.
AIDS Behav ; 23(7): 1812-1823, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30315429

RESUMO

Pre-exposure prophylaxis (PrEP) for the prevention of HIV infection among young men who have sex with men is a critical part of the HIV prevention landscape in the US. Given the unique challenges and resources of young MSM negotiating safer sex practices, including PrEP, counseling and supportive discussions to optimize both PrEP use and sexual health protection more generally may facilitate reaching HIV prevention goals. Within the context of a large, open-label PrEP study (ATN110/113), support for sexual health promotion and PrEP use was provided through use of integrated Next Step Counseling (iNSC) as part of study visits. We detail iNSC and, using session documentation collected throughout this study, we characterize iNSC implementation and the content generated from these discussions. We detail features of iNSC, training of counselors and the implementation of iNSC in a multi-site PrEP study with young MSM in the US. Case report forms completed by iNSC counselors at study visits at weeks 4, 8, 12, 24, 36, and 48 were evaluated. Implementation of each intervention step for each discussion is summarized at and across timepoints, as well as features of specific steps (e.g., kinds of facilitators and barriers). Implementation differences by group (e.g., race/ethnicity, age) were examined. iNSC case report forms from 1000 sessions involving 178 unique participants ages 15-22 from sessions conducted between 2013 and 2015 were reviewed. High fidelity to iNSC steps in terms of inclusion in sessions was reported; 98-100% of sessions included critical steps for sexual health protection discussions and 96-98% for PrEP use discussions. The vast majority of sessions appeared to flow in line with iNSC's emphasis on exploration and open discussion prior to considering specific needs and related strategies. Nearly three-quarters of sessions noted 'commitment to staying negative' as a motivator towards sexual health protection (more commonly reported by those identifying as White), while 'assuming partner is negative' was the most common challenge (less common for the older cohort), and 'having access' to a sexual health protection tool or strategy (besides PrEP) was the most common "need" (more common for those identifying as White or Latino). Carrying dose(s) to have them on-hand when needed was the most common PrEP adherence facilitator, drug and alcohol use was the most common challenge noted, and access to a dose when needed was the most common "need" (more common for participants self-identified as White). iNSC was implemented consistently throughout ATN110/113, and patient-centered discussions about sexual health protection and PrEP-use appeared feasible to incorporate into clinical care visits.


Assuntos
Síndrome de Imunodeficiência Adquirida/prevenção & controle , Homossexualidade Masculina/psicologia , Profilaxia Pré-Exposição , Sexo Seguro/psicologia , Aconselhamento Sexual/métodos , Adolescente , Afro-Americanos , Ensaios Clínicos como Assunto , Grupo com Ancestrais do Continente Europeu , Hispano-Americanos , Humanos , Masculino , Motivação , Saúde Sexual , Parceiros Sexuais , Adulto Jovem
11.
J Sex Marital Ther ; 45(1): 21-30, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29757100

RESUMO

The aim of the study was to determine the effect of sexual counseling based on the BETTER model of female sexual health in infertile women with sexual dysfunction. This is an experimental, prospective study carried out in an infertility clinic. The study included 70 women with primary infertility, of whom 35 were in the experimental group and 35 were in the control group. The Female Sexual Function Scale and the Golombok-Rust Sexual Satisfaction Scale were administered at the initial assessment and the final assessment. Two sessions of sexual counseling were given to the experimental group based on the BETTER model. A routine follow-up of the control group was performed. After the counseling, there was a statistically significant improvement in the mean scores for Female Sexual Function Scale and the total scores for the Golombok-Rust Sexual Satisfaction Scale and its subscales in the experimental group compared to the control group. The women who had been infertile for six years and more had less improvement in sexual dysfunction and sexual dissatisfaction. The sexual counseling given in accordance with the BETTER model was found to be effective in improvement of sexual function and sexual satisfaction in the women with one to two years of infertility.


Assuntos
Infertilidade Feminina/psicologia , Aconselhamento Sexual/métodos , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Psicogênicas/psicologia , Adaptação Psicológica , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Estudos Prospectivos , Fatores de Risco , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia
12.
Menopause ; 26(5): 520-530, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30531440

RESUMO

OBJECTIVE: The present study was conducted to investigate the effect of a midwife-based counseling education program on sexual function in postmenopausal women. METHODS: A randomized clinical trial was conducted on 52 eligible postmenopausal women. Participants' sexual function was assessed using the Female Sexual Function Index (FSFI). The women were randomly allocated into two groups: (1) the intervention group, in which the participants received a midwife-based counseling education program in 4 sessions held at 10-day intervals, with each session lasting for 70 minutes; (2) the control group, in which the participants only received routine care. Data were collected 1 week before the start of the sessions, 2 weeks after the end of the sessions, and 2 months after the last follow-up. RESULTS: No statistically significant differences were reported between the groups in terms of personal and sociodemographic characteristics and sexual function before the intervention; the total FSFI score was 17.05 (±4.54) in the intervention group and 16.66 (±3.62) in the control group. After the program, in the first and second follow-ups, the scores reached 27.18 (±4.61) and 28.20 (±4.43) in the intervention group and 16.06 (±3.94) and 16.32 (±2.98) in the control group. Significant improvements were observed in the total score of sexual function and all the FSFI domains in the intervention group, but not in the control group (P < 0.001). CONCLUSION: Midwife-based counseling education can be an appropriate approach to improving sexual function in postmenopausal women.


Assuntos
Tocologia/métodos , Pós-Menopausa , Aconselhamento Sexual/métodos , Educação Sexual/métodos , Disfunções Sexuais Fisiológicas/psicologia , Feminino , Seguimentos , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Comportamento Sexual/psicologia , Inquéritos e Questionários
13.
Rev Bras Epidemiol ; 21(suppl 1): e180013, 2018 Nov 29.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30517464

RESUMO

OBJECTIVE: To analyze sexual and reproductive health indicators of adolescents based on data from the National School-based Health Survey (PeNSE) in 2015, comparing them to the data from 2009 and 2012. METHODS: Cross-sectional study that has analyzed data from 9th grade students from PeNSE 2015, 2012 and 2009. We estimated prevalence and 95% confidence intervals for the following indicators: sexual initiation, condom use in the last sexual intercourse, counseling for pregnancy, sexually transmitted infections and free condoms in the three rounds of the survey. Prevalence of all indicators accessed in 2015 was estimated according to sex, type of school and region. Pearson's χ2 test was used. RESULTS: The prevalence of sexual initiation reported by adolescents has decreased from 30.5%, in 2009, to 27.5%, in 2015, as well as the use of condom in the last intercourse, from 75.9 to 66.2%, respectively. In respect to counseling, there was a reduction regarding pregnancy prevention in public schools, from 81.1 to 79.3% and in relation to free condom in private schools, from 65.4 to 57.3%. About 30% reported using both condom and another contraceptive method, and 19.5% did not use any method. Boys presented greater prevalence of sexual initiation, higher number of partners and reduced prevalence of condom use. Adolescents living in North, Northeast and Central-West regions presented worse indicators. CONCLUSION: There was a reduction in sexual initiation and condom use among Brazilian adolescents, boys were more vulnerable to sexually transmitted infections, and girls from public schools were more vulnerable to pregnancy.


Assuntos
Comportamento do Adolescente/psicologia , Inquéritos Epidemiológicos/estatística & dados numéricos , Comportamento Reprodutivo/estatística & dados numéricos , Comportamento Sexual/psicologia , Adolescente , Brasil , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Masculino , Comportamento Reprodutivo/psicologia , Instituições Acadêmicas/estatística & dados numéricos , Aconselhamento Sexual/estatística & dados numéricos , Parceiros Sexuais , Doenças Sexualmente Transmissíveis/prevenção & controle , Fatores Socioeconômicos
15.
Curr Probl Pediatr Adolesc Health Care ; 48(12): 345-357, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30466839

RESUMO

Both the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have developed, published, and updated evidence-based guidelines to support medical providers in the provision of contraceptives to patients with specific medical conditions or characteristics. The goal of these guidelines is to provide recommendations on the safe use of contraceptives with the goal of removing unnecessary medical barriers to access and use of contraceptives, thus decreasing the number of unintended pregnancies. Many medical conditions increase a patient's risk of venous thromboembolism; a risk that may also be increased with specific contraceptives. Specific conditions that require more enhanced contraceptive counseling due to their frequency in adolescence and their association either with adverse events during pregnancy or with increased risk for specific contraceptives are detailed by the WHO and CDC and are summarized herein. Adolescents with morbid obesity, migraine headache, cardiac conditions, hypertension, diabetes mellitus, hyperlipidemia, systemic lupus erythematosus, sickle cell anemia, cystic fibrosis, inflammatory bowel disease, or seizure disorders would benefit from greater attention to the urgency of exploring highly effective contraceptive methods. Details of the considerations that should be used in providing contraceptive care to adolescents with each of these medical conditions, as per WHO and CDC guidelines, are provided in this review. The ultimate goal in contraceptive counseling is the balancing of risk and benefit to arrive at the best therapeutic option, maintaining patient preference as a priority, as that will enhance adherence and comfort with the contraceptive method. Each patient must be assessed for pregnancy risk and be allowed full risk reduction and education regarding contraceptive options.


Assuntos
Comportamento do Adolescente , Doença Crônica , Anticoncepcionais/administração & dosagem , Preparações de Ação Retardada/administração & dosagem , Gravidez na Adolescência/prevenção & controle , Aconselhamento Sexual/organização & administração , Adolescente , Comportamento Contraceptivo , Feminino , Guias como Assunto , Humanos , Dispositivos Intrauterinos , Masculino , Seleção de Pacientes , Gravidez
16.
J Cardiovasc Nurs ; 33(6): E24-E30, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30289767

RESUMO

BACKGROUND: Although sex lives of patients with cardiovascular disease (CVD) are affected in various ways and degrees, nurses working with these patients refrain from talking about sexual matters with their patients or encounter barriers trying to do so. OBJECTIVE: The purpose of this descriptive study was to identify attitudes and beliefs of cardiovascular nurses regarding talking to their patients about sexual problems, perceived barriers, and proposed solutions. METHODS: The sample included 170 nurses working for the cardiology and cardiac surgery departments of 1 university hospital, 2 ministry of health hospitals, and 2 private hospitals in Turkey. Data were collected between April and August 2015 through a 4-section questionnaire including the Sexual Attitude and Beliefs Scale. Descriptive, parametric, and nonparametric statistics were used to analyze the data. RESULTS: Most (73.5%) reported not talking to their patients about sexual issues, and only 35.9% stated that they had been educated on how to do so. The major reason for nurses avoiding discussions about sex with their patients was not considering sexuality as a patient care priority (86.4%). Establishing privacy for the patient (91.2%) was the solution proposed by most nurses. The average score of the nurses on the Sexual Attitude and Beliefs Scale was only medium. CONCLUSION: Most of the nurses were untrained about how to talk about sexual problems with their patients and therefore were unable to talk about it freely.


Assuntos
Atitude do Pessoal de Saúde , Enfermagem Cardiovascular , Conhecimentos, Atitudes e Prática em Saúde , Aconselhamento Sexual , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato , Adulto Jovem
17.
Sex Transm Dis ; 45(11): 747-753, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30303948

RESUMO

BACKGROUND: Some human immunodeficiency virus (HIV) serodiscordant couples are faced with the dual challenge of preventing HIV transmission to the uninfected partner and avoiding unintended pregnancy. Therefore, we hypothesized that serodiscordance is associated with dual method use at last sex. METHODS: We analyzed data from a cross-sectional survey of HIV-infected men and women attending 2 ante-retroviral therapy clinics in Lilongwe, Malawi. We used Fisher exact test and Wilcoxon rank sum to assess for associations between serodiscordance, covariates, and dual method use. Multivariable logistic regression was used to estimate the adjusted odds ratio (aOR) and 95% confidence intervals (CI) of dual method use at last sex, comparing serodiscordant to seroconcordant relationships. Separate analyses were conducted for men and women. RESULTS: We surveyed 253 HIV-infected men, of which 44 (17.4%) were in a known serodiscordant relationship and 63 (24.9%) were using dual methods at last sex. Likewise, among 302 HIV-infected women surveyed, 57 (18.9%) were in a known serodiscordant relationship, and 80 (26.5%) were using dual method at last sex. Serodiscordance was not significantly associated with dual method use at last sex for among HIV-infected men (aOR, 0.62; 95% CI, 0.27-1.44) or women (aOR, 1.21; 95% CI, 0.59-2.47). CONCLUSION: Dual method use was low among all HIV-infected individuals, irrespective of their partner's HIV status. Given these findings, we recommend greater efforts to encourage HIV providers to counsel their patients about the importance of dual method use to prevent both unintended pregnancy and sexually transmitted infections.


Assuntos
Anticoncepção/estatística & dados numéricos , Infecções por HIV/imunologia , Infecções por HIV/prevenção & controle , Soropositividade para HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Estudos Transversais , Feminino , HIV/imunologia , Humanos , Modelos Logísticos , Malaui/epidemiologia , Masculino , Razão de Chances , Aconselhamento Sexual , Comportamento Sexual , Parceiros Sexuais , Inquéritos e Questionários
18.
BMC Public Health ; 18(1): 914, 2018 07 25.
Artigo em Inglês | MEDLINE | ID: mdl-30045702

RESUMO

BACKGROUND: In the United States, problematic stimulant use is a prevalent and difficult to treat problem among men who have sex with men (MSM), as well as a major driver of HIV transmission through the large number of sexual partners and concomitant condomless anal sex (CAS). Evidence-based behavioral studies that address problematic stimulant use in MSM at risk for HIV infection are also lacking. In this paper, we describe the design of a behavioral intervention trial to reduce sexual risk behavior and stimulant use in HIV-uninfected MSM. METHODS: This study, funded by the National Institute on Drug Abuse (NIDA), is a randomized controlled trial (RCT) testing an integrated HIV risk reduction and behavioral activation counseling intervention (IMPACT) for HIV-uninfected, stimulant using MSM in Boston, MA, and Miami, FL. Participants are randomized (2:2:1) to either (1) the IMPACT intervention; (2) a relaxation condition, an active therapy time- and intensity-matched control; or (3) a standard of care risk reduction counseling comparison. At enrollment, all participants receive an HIV test and pre- and post-test counseling. The primary outcome is the difference in the rate of change in the number of self-reported condomless anal sex acts without the protection of consistent Pre-Exposure Prophylaxis (PrEP) use, as well as reductions in stimulant use during the prior 4-months. Major assessments are conducted at baseline, 4-, 8-, and 12-month follow-up visits. DISCUSSION: Effective and sustainable behavioral interventions are sorely needed to reduce HIV acquisition in stimulant using MSM at risk for HIV infection. In this study, we will evaluate the evidence of efficacy of the IMPACT intervention to reduce HIV acquisition in HIV-uninfected, stimulant-using MSM. If found effective, the intervention tested here holds promise for being readily integrated into real-world clinical settings. TRIAL REGISTRATION: ClinicalTrials.gov number NCT03175159 , registered June 5, 2017.


Assuntos
Terapia Comportamental/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Aconselhamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto , Terapia Comportamental/métodos , Boston , Estimulantes do Sistema Nervoso Central , Florida , HIV , Infecções por HIV/psicologia , Homossexualidade Masculina/psicologia , Humanos , Masculino , Profilaxia Pré-Exposição/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto , Comportamento de Redução do Risco , Assunção de Riscos , Sexo Seguro/psicologia , Aconselhamento Sexual/métodos , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Transtornos Relacionados ao Uso de Substâncias/virologia , Resultado do Tratamento
19.
Support Care Cancer ; 26(12): 4169-4176, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29876833

RESUMO

PURPOSE: To determine which health care provider and what timing is considered most suitable to discuss sexual and relational changes after prostate cancer treatment according to the point of view of men and their partners. METHODS: A cross-sectional survey was conducted among men diagnosed with prostate cancer or treated after active surveillance, who received laparoscopic radical prostatectomy, brachytherapy, intensity-modulated radiotherapy, and/or hormonal therapy. If applicable, partners were included as well. RESULTS: In this survey, 253 men and 174 partners participated. Mean age of participating men was 69.3 years (SD 6.9, range 45-89). The majority (77.8%) was married and average length of relationship was 40.3 years (SD 14.1, range 2-64). Out of 250 men, 80.5% suffered from moderate to severe erectile dysfunction. Half of them (50.2%, n = 101) was treated for erectile dysfunction and great part was partially (30.7%, n = 31) up to not satisfied (25.7%, n = 26). Half of the partners (50.6%, n = 81) found it difficult to cope with sexual changes. A standard consultation with a urologist-sexologist to discuss altered sexuality is considered preferable by 74.7% (n = 183). Three months after treatment was the most suitable timing according to 47.6% (n = 49). CONCLUSIONS: During follow-up consultations, little attention is paid to the impact of treatment-induced sexual dysfunction on the relationship of men with prostate cancer and their partners. A standard consultation with a urologist-sexologist 3 months after treatment to discuss sexual and relational issues is considered as most preferable.


Assuntos
Disfunção Erétil/psicologia , Prostatectomia/efeitos adversos , Neoplasias da Próstata/terapia , Qualidade de Vida/psicologia , Aconselhamento Sexual/métodos , Parceiros Sexuais/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Braquiterapia/efeitos adversos , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Radioterapia de Intensidade Modulada/efeitos adversos , Comportamento Sexual/psicologia , Saúde Sexual , Inquéritos e Questionários
20.
AIDS Behav ; 22(8): 2480-2490, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29808258

RESUMO

The number of HIV cases in Taiwan exceeded 30,000 in 2016. Per the UNAIDS 90-90-90 target, 81% of people living with HIV should receive medication. However, numerous previous studies focused on adherence rather than the initial healthcare seeking intention if diagnosed with HIV (HIV HSI). Based on the Theory of Planned Behavior (TPB), anonymous online survey data were collected from December 2016 through February 2017 from 2709 young MSM (YMSM) ages 15-39. Multivariate logistic regression found the significant factors and strengths of associations with HIV HSI varied by their HIV voluntary counseling and testing (VCT) experience. YMSM without VCT experience perceiving high support from salient others (AOR = 1.28) and high control under facilitating conditions (AOR = 2.73) had higher HIV HSI. YMSM with VCT experience perceiving high control under facilitating (AOR = 1.79) and constraining (AOR = 1.54) conditions had higher HIV HSI. Regardless of VCT experience, YMSM with positive attitudes toward positive healthcare seeking outcomes (AOR = 3.72-3.95) had highest HIV HSI, highlighting the importance of increasing positive outcome expectations in YMSM.


Assuntos
Sorodiagnóstico da AIDS , Infecções por HIV/diagnóstico , Homossexualidade Masculina/psicologia , Intenção , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aconselhamento Sexual , Adolescente , Adulto , Infecções por HIV/psicologia , Infecções por HIV/terapia , Humanos , Masculino , Taiwan , Adulto Jovem
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