Efeito do tônus do corpo perineal nas disfunçõessexuais em mulheres jovens nulíparas / Effect of perineal body tone on sexual dysfunctionsin young nulliparous women

Objetivo: avaliar o tônus do corpo perineal em mulheres jovens nulíparas e correlacionar com as funções sexuais e a presença de disfunção sexual. Método: foi realizado um estudo descritivo, observacional, transversal utilizando uma amostra de conveniência incluindo mulheres adultas jovens nulíparas. A avaliação das participantes consistiu na aplicação dos questionários socioclínico, Pelvic Organ Prolaps / Urinary Incontinence Sexual Questionnaire (PISQ-12), Female Sexual Function Index (FSFI) e exame físico do tônus do corpo perineal. Os dados foram analisados pelo programa Statistical Package for the Social Sciences (SPSS®), versão 23, adotando um nível de significância de 5%. Resultados: participaram 77 mulheres jovens nulíparas (21,68 ± 2,94 anos), destas 77, 92% apresentavam vida sexual ativa e 66,03% tônus normal do corpo perineal. Dentre as alterações tônicas, o aumento do tônus predominou (33,76%). Houve alta prevalência de disfunção sexual (87,01%) pelo FSFI (23,38 ± 7,21) com maior queixa de dispareunia. Mulheres com tônus aumentado apresentaram maior disfunção sexual em relação a desejo e estímulo subjetivo (p=0,04), à excitação (p=0,01), satisfação (p=0,04) e dor ou a desconforto (p=0,03). Houve correlação inversa entre a presença de aumento do tônus e os domínios FSFI desejo e estímulo subjetivo (R= - 0,56) e excitação (R= - 0,34) e correlação direta para dor ou desconforto (R= 0,30). Conclusão: o aumento do tônus do corpo perineal piora a função sexual de mulheres jovens nulíparas.

Sexual Function Index (FSFI) and physical examination of the tone of the perineal body. The data were analyzed using the Statistical Package for the Social Sciences (SPSS®), version 23, adopting a significance level of 5%. Results: 77 young nulliparous women (21.68 ± 2.94 years) participated, of which 77, 92% had an active sexual life and 66.03% had normal tone of the perineal body. Among the tonic changes, increased tone predominated (33.76%). There was a high prevalence of sexual dysfunction (87.01%) according to the FSFI (23.38 ± 7.21) with greater complaints of dyspareunia. Women with increased tone had greater sexual dysfunction in relation to desire and subjective stimulation (p=0.04), excitement (p=0.01), satisfaction (p=0.04) and pain or discomfort (p=0.03). There was an inverse correlation between the presence of increased tone and the FSFI domains desire and subjective stimulus (R= - 0.56) and excitement (R= - 0.34) and a direct correlation for pain or discomfort (R= 0.30). Conclusion: increased perineal body tone worsens sexual function in young nulliparous women.

Acceptability of a rectal microbicide douche for HIV prevention: a mixed-methods analysis of a first-in-human formulation pilot study.

OBJECTIVES: DREAM-01 was an open label, dose-escalation and variable osmolarity study to identify a tenofovir HIV-prevention douche/enema that could achieve protective colon tissue cell concentrations and high acceptability. To assess impact on sexual enjoyment, iso-osmolar and hypo-osmolar placebo douches were provided for at-home use before receptive anal sex (RAS). METHODS: Eighteen HIV-uninfected men who have RAS were administered three tenofovir douches at the research clinic: Product A, an iso-osmolar dose; Product B, an iso-osmolar escalation dose; and Product C, a hypo-osmolar escalation dose. Following Products A and C, participants were given a saline douche of matching osmolarity to use at home before RAS. Participants reported acceptability via a computer-assisted self-interview and in-depth interview in this mixed-methods study. RESULTS: All three products were rated acceptable by 17 (95%) of the participants. A majority (94%) would be likely or very likely to use any of the three products before RAS. Of those who used the saline douches before RAS and then rated their sexual enjoyment, most reported that their sexual enjoyment was not affected. Interview data revealed that participants found the product easy to incorporate into their regular routine, but would prefer to use more liquid for cleansing. CONCLUSIONS: These findings indicate that the hypo-osmolar Product C, which also provides the most rapid delivery of tenofovir for HIV prevention, is acceptable for future safety trials and that our sample reports high likelihood of using a rectal microbicide douche for HIV prevention. Our findings support continued pursuit of a tenofovir rectal microbicide douche. TRIAL REGISTRATION NUMBER: NCT02750540.

Use of a five-category partner-type classification within a chlamydia and gonorrhoea service evaluation highlights opportunities for targeted partner notification to improve STI control.

OBJECTIVES: Partner notification (PN) is a key component of sexually transmitted infection control. British Association for Sexual Health and HIV guidelines now recommend partner-centred PN outcomes using a five-category partner classification (established, new, occasional, one-off, sex worker). We evaluated the reporting of partner-centred PN outcomes in two contrasting UK sexual health services. METHODS: Using the electronic patient records of 40 patients with a positive gonorrhoea test and 180 patients with a positive chlamydia test, we extracted PN outcomes for the five most recent sexual contacts within the appropriate lookback period. RESULTS: 180 patients with chlamydia reported 262 partners: 220 were contactable (103 established, 9 new, 43 occasional, 52 one-off, 13 unknown/unrecorded). 40 patients with gonorrhoea reported 88 partners: 53 were contactable (7 established, 1 new, 14 occasional, 10 one-off and 21 unknown/not recorded). No sex worker partners were reported. Most established partners of people with chlamydia (96/103) or gonorrhoea (7/7) were notified but fewer (60/103 and 6/7, respectively) attended for testing. Of those, 39 had a positive chlamydia test and two had a positive gonorrhoea test. For both chlamydia and gonorrhoea, most occasional and new partners were reported to be notified but there was a sharper decline in those tested. For both infections, one-off partners had the lowest rates of accessing services and testing. For chlamydia, 81% were notified (42/52), 23% accessed services (12/52) and 21% tested (11/52). However, 91% of those tested were positive (10/11). The number of contactable one-off gonorrhoea contacts was small and few attended. CONCLUSIONS: Measuring partner-centred PN outcomes was feasible. There were differences in partner engagement with PN between the different infections and partner types. If these findings are replicated in larger samples, it suggests that interventions to target one-off partners who have low rates of PN engagement yet high levels of positivity could play a key role in reducing infection at population level.

Pathways to parenthood among transgender men and gender diverse people assigned female or intersex at birth in the United States: analysis of a Cross-Sectional 2019 Survey.

Objective: To assess pathways to parenthood, pregnancy outcomes, future pregnancy desire, and fertility counseling experiences among a cross-sectional sample of transgender men and gender diverse individuals assigned female or intersex at birth in the United States. Methods: Participants were recruited from The Population Research in Identity and Disparities for Equality (PRIDE) Study and the general public. Eligible participants for this analysis were able to read and understand English, assigned female or intersex at birth, US residents, 18+ years old, and identified as transgender, nonbinary, or gender diverse. We analyzed responses to close-ended survey questions, overall and stratified by gender identity, race/ethnicity, and testosterone use. We also qualitatively assessed open-text responses on fertility counseling. Results: Among the 1694 participants, median age was 27 years (range: 18-72), 12% had ever been pregnant, and 12% were parents. Carrying a pregnancy where the individual was the egg source (36%) was the most common pathway to parenthood. Individuals with an exclusively binary gender identity (ie, transgender man or man) more often reported becoming parents through adoption than individuals with gender diverse identities (19% vs 12%). A third of individuals did not receive fertility counseling prior to initiating testosterone; individuals who exclusively reported nonbinary identities were recommended to investigate fertility preservation options less often (36%) compared to transgender men (50%). Conclusion: Transgender men and gender diverse individuals who were assigned female or intersex at birth build their families through a variety of pathways, including pregnancy, stepparenting, and adoption. Clinicians should avoid making assumptions about reproductive desires in these populations based on gender identities or testosterone use and should provide consistent fertility counseling prior to and after hormone initiation.

Exploring comprehensive sexuality education experiences and barriers among students, teachers and principals in Nepal: a qualitative study.

BACKGROUND: Comprehensive sexuality education (CSE) is essential in empowering adolescents with the knowledge and confidence to manage their sexual and reproductive health. Despite its recognized benefits, access to quality CSE remains limited, especially in low-income countries, where societal norms and structural barriers hinder effective delivery. The aim of this study is to investigate the experiences and perceptions among students, teachers, and principals in Nepal about comprehensive sexuality education. METHODS: Qualitative methods were used. 13 Semi-structured interviews and 1 focus group discussion were carried out with 15 teachers and principals working at higher secondary schools and two focus group discussions were conducted with a total of 13 adolescents. Thematic analysis was used to analyze the data. RESULTS: Four themes were developed: Resistance to Teaching and Learning, Preparation and Engagement Strategies, Taboos and Silencing and Structural Barriers. Students, teachers, principals and students reported discomfort and embarrassment when discussing sensitive topics, with gender dynamics playing a significant role. Strategies like warm-up sessions and continuous interaction with students and parents were used to create a supportive learning environment. However, socio-cultural barriers and family attitudes continued to hinder open discussions about sexuality. Structural barriers, including the lack of formal training for teachers and inadequate instructional materials, further impeded effective CSE delivery. CONCLUSION: The experiences of CSE in Nepal among students, teachers and principals highlight significant barriers including cultural taboos, gender dynamics and insufficient resources. Addressing these barriers through comprehensive teacher training, curriculum reform, and societal engagement is critical to ensure access to CSE.

The impact of COVID-19 on the male reproductive system.

OBJECTIVE: The relevance of the study is determined by the deepening understanding of the global consequences of the coronavirus pandemic, which affect not only lung health but also a wide range of other body systems. In light of new data on the long-term effects of coronavirus infection, this study is highly significant. The purpose of this study is to investigate the impact of coronavirus infection on the male reproductive system and assess its potential influence on male fertility to refine the mechanisms of damage and provide recommendations for medical care. METHODS: The study utilised a combination of methods, including a meta-analysis of medical organisation databases, analysis of clinical cases, representative sample method, and quantitative survey method. These approaches allowed for a comprehensive and multifaceted view of the problem. RESULTS: The samples of sperm showed a noticeable decrease in progressive motility, sperm concentration, and volume, especially in patients with moderate and severe symptoms of COVID-19, whereas patients with mild symptoms only experienced a decrease in progressive motility and overall sperm motility. The survey identified symptoms of male reproductive system dysfunction after recovering from COVID-19. Predominant symptoms included decreased libido (15%), impotence (13%), and infections of the genital organs (12%). Most surveyed men lacked sufficient awareness of other aspects of male reproductive health, including infections, genetic defects, chronic diseases, and available medical services. CONCLUSIONS: As a result of the study, it was concluded that coronavirus infection can have a negative impact on the male reproductive system. The practical value of this study lies in improving approaches to medical care for men who have recovered from COVID-19 and creating preventive programmes.

Treatment 'cultures', sexually transmitted infections and the rise of antimicrobial resistance.

In this article, we examine the current management of sexually transmitted infections (STIs), in the context of rising antimicrobial resistance (AMR), through the lens of 'treatment cultures'. Prevailing treatment cultures-including the prominence of syndromic care for STIs-foster certain possibilities and foreclose others, with important consequences for countering AMR. Drawing on qualitative interviews with STI professionals, experts and industry representatives, we unpack these stakeholders' accounts of STI treatment cultures, drawing out the importance of socio-historical (i.e. taboo and stigma), political-economic (i.e. perceptions of significance, profit-making and prioritisation) and subjective (i.e. patient contexts and reflexivity) dimensions therein. In developing this critical account of how treatment cultures are formed, reproduced and indeed resisted, we reveal how such discourses and practices render the reining in of AMR and shifting antibiotic use difficult, and yet, how productive engagement remains key to any proposed solutions. As such, the article contributes to our understanding of AMR as a highly diversified field, through our exploration of the bio-social dimensions of resistance as they relate to the case of STIs.

Dysorgasmia in women: Case report and preliminary assessment guide.

Dysorgasmia in women is an infrequent reason for consulting a clinician. In this article, the authors describe the case of a woman with right-sided pelvic pain immediately after orgasm. Dysorgasmia is likely to negatively impact sexual health but is rarely discussed in medical literature. Furthermore, assessment and treatment guidelines for clinicians are currently lacking. Therefore, the authors conducted a literature review and created a preliminary assessment guide, considering both medical and gray literature. A brief flowchart was developed which can facilitate the assessment of dysorgasmia in women for clinicians and improve the quality of care for patients. Further research on the etiology and pathophysiology of dysorgasmia in women is warranted, as is a more proactive attitude of clinicians to discuss sexual health. More guidance on diagnosis and treatment is needed.

Sexual health and wellbeing and the menopause: An EMAS clinical guide.

INTRODUCTION: Sexual health and wellbeing are significant aspects of quality of life. However, taking a sexual history is often avoided in medical practice, leaving a void in management and awareness. As the menopause can have a major impact on sexual health, it is imperative that healthcare providers are appropriately trained in sexual health and wellbeing and the aligned disciplines in order to achieve optimal care. AIM: To provide an evidence-based clinical guide for the assessment and management of sexual problems at the menopause and beyond. MATERIALS AND METHODS: Review of the literature and consensus of expert opinion. RESULTS AND CONCLUSION: The assessment of sexual problems includes history taking, examination and laboratory investigation (if indicated), and occasionally the use of specific validated questionnaires. Management of sexual problems requires a multidimensional approach using biopsychosocial measures. Medical management and psychosexual counselling include pharmacological and non-pharmacological interventions, and sex therapy and psychoeducation. Furthermore, perimenopausal women should be advised about the need for contraception if they wish to avoid pregnancy. Also, sexually transmitted diseases can be acquired at any age. To conclude, taking a sexual history should be incorporated into medical practice and healthcare providers should be appropriately trained to assess and manage sexual problems at the menopause and beyond.

Knowledge and Attitudes About HIV Pre-Exposure Prophylaxis Among Sexually Active Black and Latina Cisgender Women: Findings from the 2017 and 2018 New York City Sexual Health Survey.

Pre-exposure prophylaxis (PrEP) is a highly effective tool to prevent HIV, yet it is underutilized among women. The current study aims to evaluate the awareness, attitudes, and perceptions of PrEP among a large survey sample of Black and Latina women in New York City (NYC). Interviewer-administered surveys were conducted in high HIV incidence neighborhoods in NYC among Black, Latina, and Afro-Latina women who reported recent sex with a man in 2017 (n = 398) and 2018 (n = 405). About 40% of participants were aware of PrEP, whereas 30.4% indicated interest in using it. The top reason for not utilizing it was low HIV risk perception. However, most participants supported the idea that using PrEP meant asserting control over their health (94.1%). Primary care providers and obstetricians/gynecologists were participants' preferred sources for PrEP (91.6%). Across survey cycles, compared to non-Black Latina participants, Black participants had significantly higher PrEP awareness (44.4% vs. 29.1%). PrEP awareness was also significantly higher among survey participants in 2018 (45.2%) than in 2017 (34.3%). Less than half of the participants were aware of PrEP, but those who were aware expressed largely positive attitudes toward the medication. Our findings may inform future PrEP implementation strategies to optimize awareness and access to PrEP among women disproportionately affected by HIV, like focusing on personal empowerment instead of risk-based messaging and training women's sexual health care providers in PrEP provision.

Two-Year Outcomes of Prostatic Artery Embolization for Symptomatic Benign Prostatic Hyperplasia: An International, Multicenter, Prospective Study.

PURPOSE: To describe clinical outcomes among patients with benign prostatic hyperplasia (BPH) 24 months following prostatic artery embolization (PAE). MATERIALS AND METHODS: This was an international, multicenter, prospective trial of males with BPH with lower urinary tract symptoms (LUTS) or acute urinary retention (AUR) treated with PAE. The primary outcome was the 12 month change in the International Prostate Symptom Score (IPSS) for patients referred for bothersome LUTS, or urinary catheter independence for patients treated for AUR. Secondary outcome measures included changes in IPSS at 3 and 24 months, changes in quality of life (QoL), changes in the Sexual Health Inventory for Men (SHIM) questionnaire, technical success rate, and adverse events (AEs). Data were summarized using descriptive statistics. RESULTS: Four hundred seventy-eight consecutive patients underwent PAE (bothersome LUTS: N = 405; AUR: N = 73), mean age was 70 years. For patients treated for bothersome LUTS, mean total IPSS at baseline was 21.8 and decreased to 9.3, 10.6, and 11.2 at 3, 12, and 24 months following PAE, respectively (all p < 0.001); QoL at baseline was 4.7 and decreased to 2.0, 2.1, and 2.3 at 3, 12, and 24 months, respectively (all p < 0.001). The mean SHIM score at baseline and 12 months following PAE was 13.8 and 13.9, respectively. Of the 73 patients treated for AUR, 48 (65.8%) had their indwelling catheter removed within 3 months of PAE and remained catheter free at 24 months. Fifty-five patients (11.5%) experienced ≥ 1 AE and 10 (2.1%) experienced a serious AE. CONCLUSION: PAE is a safe and effective treatment for symptomatic BPH and LUTS. Level of Evidence Level 3 Trial registration ClinicalTrials.gov NCT03527589.

Communicating sexual health to the incarcerated population: information dissemination in a US sample of inmate handbooks.

Incarcerated individuals frequently enter prison with a history of high-risk lifestyle behaviours likely to contribute to the transmission of infectious disease. Prisons offer a unique setting in which to advance health equity to an underserved population by disseminating information and education. Sexual health education has the potential to mitigate negative health consequences in the incarcerated population and improve sexual health practices upon community re-entry, benefiting both incarcerated individuals and communities. Limited empirical research examines sexual health information and education in US correctional facilities. Handbooks, given to all people upon incarceration, have the potential to provide vital information and education to promote safe sexual practice and prevent disease transmission. This work, guided by 22 critical sexual health education recommendations from the US Centers for Disease Control and Prevention, examines the presence (or absence) of recommended sexual health information and guidance in prison handbooks. Handbooks (n = 74) from 49 of 50 US states were qualitatively analysed with results revealing limited information, education or guidance about sexual health/safe sexual practice during incarceration or afterwards. Utilising handbooks for comprehensive sexual education could be a critical step towards reaching members of an already at-risk underserved population.

Parental Sexual Socialization, Sexual Subjectivity, and Emotional Responses to Sexual Experiences among Adolescent Girls.

This study explored girls' sexual subjectivity as a pathway through which parental socialization influenced their emotions about past sexual experiences. A national online survey of 397 adolescent girls (Mage = 16.8 years) from diverse racial/ethnic backgrounds (33.0% Black, 25.7% Latina, 28.0% non-Hispanic White) assessed (1) parental messaging emphasizing relational, sex-positive, gendered sex role, abstinence-only, and sex-is-taboo discourses; (2) girls' sexual subjectivity including sexual body esteem, entitlement to sexual pleasure, and perceived sexual control; and (3) positive and negative emotional reactions to sexual experiences. Sexual subjectivity fully mediated the positive effect of relational messaging on positive emotional reactions and the negative effect on negative emotional reactions. Additionally, sexual subjectivity partially mediated the positive effect of gendered sex role messaging on negative emotional reactions. This study draws critical attention to placing the psychological aspects of girls' sense of their own sexuality and the emotional components of their sexual experience at the forefront of understanding the influence of parental sexual socialization on the sexual experiences of adolescent girls.

Gynecologic cancer survivor preferences for provider communication regarding sexual health after treatment: a qualitative study.

PURPOSE: Survivorship from gynecologic cancers is becoming increasingly prevalent. There are significant sexual side effects that influence quality of life that would be reduced with proper intervention; however, existing literature highlights the lack of understanding of the sexual health needs within this population. Furthermore, multiple studies show that one contributing factor to sexual well-being in survivorship is provider-patient communication. The aim of this study is to explore experiences of sexual distress and survivor experiences of sexual health communication. METHODS: Adult participants who had been out of active treatment for 3 months were recruited to participate in focus groups. Six focus groups (n = 32) were conducted with survivors of gynecologic cancers via Zoom. Research team members analyzed content using thematic analysis. RESULTS: Two broad themes were identified: Experiences of provider communication and Preferences for provider communication, with subthemes nested under both. Subthemes from the Experiences theme included absent/lacking communication, negative experiences, emotional reaction to lack of communication, and feeling like sexuality was not valued. Subthemes from the Preferences theme included more conversation and open communication about sexuality, more resources/referrals, and more provider training on sexuality. CONCLUSION: Survivor experiences of subjective sexual health are often dependent on the type and quality of information they receive from their healthcare team during treatment. Unfortunately, the majority of participants endorsed negative or absent communication related to their sexual health needs, leading to additional distress.

Factorial Trial to Optimize an Internet-Delivered Intervention for Sexual Health After Breast Cancer: Protocol for the WF-2202 Sexual Health and Intimacy Enhancement (SHINE) Trial.

BACKGROUND: Although most survivors of breast cancer report substantial sexual concerns following treatment, few receive support for these concerns. Delivering sexual health care to survivors of breast cancer via the internet could overcome many of the barriers to in-person treatment. Even when delivered remotely, survivor time constraints remain a leading barrier to sexual health intervention uptake. OBJECTIVE: Guided by the multiphase optimization strategy methodological framework, the primary objective of this study is to identify the most efficient internet-delivered sexual health intervention package that is expected to provide survivors of breast cancer the greatest benefit with the fewest (and least-intensive) intervention components. This study aims to determine how intervention components work (mediators) and for whom they work best (moderators). METHODS: Partnered, posttreatment adult female survivors of breast cancer (N=320) experiencing at least 1 bothersome sexual symptom (ie, pain with sex, vaginal dryness, low sexual desire, and difficulty with orgasm) related to their breast cancer treatment will be enrolled. Clinic-based recruitment will be conducted via the Wake Forest National Cancer Institute Community Oncology Research Program (NCORP) Research Base. Participants will be randomly assigned to 1 of 16 combinations of four intervention components with two levels each in this factorial trial: (1) psychoeducation about cancer-related sexual morbidity (receive either enhanced vs standard versions); (2) communication skills training for discussing concerns with health care providers (received vs not received); (3) communication skills training for discussing concerns with a partner (received vs not received); and (4) intimacy promotion skills training (received vs not received). Cores will be fully automated and implemented using a robust internet intervention platform with highly engaging elements such as animation, video, and automated email prompts. Survivors will complete web-based assessments at baseline (prerandomization time point) and again at 12 and 24 weeks later. The primary study aim will be achieved through a decision-making process based on systematically evaluating the main and interaction effects of components on sexual distress (Female Sexual Distress Scale-Desire, Arousal, Orgasm) and sexual functioning (Female Sexual Function Index) using a generalized linear model approach to ANOVA with effect coding. Mediation analyses will be conducted through a structural equation modeling approach, and moderation analyses will be conducted by extending the generalized linear model to include interaction effects. RESULTS: This protocol has been reviewed and approved by the National Cancer Institute Central Institutional Review Board. Data collection is planned to begin in March 2024 and conclude in 2027. CONCLUSIONS: By identifying the combination of the fewest and least-intensive intervention components likely to provide survivors of breast cancer the greatest sexual health benefit, this study will result in the first internet intervention that is optimized for maximum impact on the undertreated, prevalent, and distressing problem of breast cancer-related sexual morbidity. TRIAL REGISTRATION: ClinicalTrials.gov NCT06216574; https://clinicaltrials.gov/study/NCT06216574. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/57781.

Experiencias y conocimientos, sobre salud sexual y reproductiva en personas con discapacidad en Ecuador / Experiences and knowledge about sexual and reproductive health of people with disabilities in Ecuador / Experiências e conhecimento sobre saúde sexual e reprodutiva entre pessoas com deficiência no Equador

La discapacidad es una afección (deficiencia) que dificulta el desarrollo de las actividades cotidianas y la interacción del individuo con el entorno que lo rodea, se divide en: discapacidad física, motora, orgánica, mental, intelectual y sensorial. Objetivo: Documentar las percepciones y emociones en salud sexual y reproductiva de las personas con discapacidad del Centro diurno del Cantón Biblián. Metodología: Se trata de un estudio observacional cualitativo en el que se recopila las vivencias de 34 personas de la población con discapacidad que forman parte del Proyecto Centro diurno "San José" de Biblián, siendo seleccionados cinco participantes mediante muestreo simple no probabilístico. Hallazgos: A partir del análisis de los relatos se determina que las personas con discapacidad mantienen relaciones satisfactorias aún con las inseguridades que los rodean. Sin embargo, la exclusión dentro de sus propios hogares, la escasa información segura y la difusión mediática masiva sobre la sexualidad han condicionado percepciones que los expone a un nivel elevado de vulnerabilidad. A manera de Conclusión: En varias ocasiones existen prejuicios y tabúes al hablar de sexualidad con personas con discapacidad en los diferentes hogares, los familiares optan por no responder interrogantes relacionadas, por eso el personal de salud cumple un rol muy importante al brindar la educación necesaria para generar personas independientes que vivan plenamente en la sociedad sin importar su condición

Disability is a condition (impairment) that hinders the development of daily activities and the interaction of the individual with the surrounding environment, it is divided into: physical, motor, organic, mental, intellectual and sensory disability. Objective: To document the perceptions and emotions on sexual and reproductive health of people with disabilities in the Biblián Canton Day Center. Methodology: This is a qualitative observational study in which the experiences of 34 people from the population with disabilities who are part of the Project Day Center "San José" of Biblián are collected, with five participants being selected through simple non-probabilistic sampling. Findings: From the analysis of the narratives, it is determined that people with disabilities maintain satisfactory relationships even with the insecurities that surround them. However, exclusion within their own homes, scarce safe information and mass media dissemination about sexuality have conditioned perceptions that expose them to a high level of vulnerability. By way of conclusion: On several occasions there are prejudices and taboos when talking about sexuality with people with disabilities in different homes, family members choose not to answer related questions, so health personnel play a very important role in providing the necessary education to generate independent people who live fully in society regardless of their condition

A deficiência é uma condição (impedimento) que dificulta o desenvolvimento das atividades cotidianas e a interação do indivíduo com o ambiente que o cerca. Ela se divide em: deficiência física, motora, orgânica, mental, intelectual e sensorial. Objetivo: documentar as percepções e emoções sobre saúde sexual e reprodutiva de pessoas com deficiência no Centro de Dia do Cantão de Biblián. Metodologia: trata-se de um estudo observacional qualitativo no qual são compiladas as experiências de 34 pessoas da população com deficiência que fazem parte do Projeto Centro de Dia "San José" em Biblián, sendo que cinco participantes foram selecionados por meio de amostragem simples não probabilística. Achados: A partir da análise das histórias, constatou-se que as pessoas com deficiência mantêm relacionamentos satisfatórios mesmo com as inseguranças que as cercam. Entretanto, a exclusão dentro de suas próprias casas, a escassez de informações seguras e a cobertura da sexualidade pela mídia de massa condicionaram percepções que as expõem a um alto nível de vulnerabilidade. Conclusão: Em várias ocasiões, há preconceitos e tabus ao falar sobre sexualidade com pessoas com deficiência em diferentes lares, e os membros da família optam por não responder às perguntas relacionadas, razão pela qual a equipe de saúde desempenha um papel muito importante ao fornecer a educação necessária para gerar pessoas independentes que vivem plenamente na sociedade, independentemente de sua condição

Experiencias y conocimientos, sobre salud sexual y reproductiva en personas con discapacidad en Ecuador

La discapacidad es una afección (deficiencia) que dificulta el desarrollo de las actividades cotidianas y la interacción del individuo con el entorno que lo rodea, se divide en: discapacidad física, motora, orgánica, mental, intelectual y sensorial. Objetivo: Documentar las percepciones y emociones en salud sexual y reproductiva de las personas con discapacidad del Centro diurno del Cantón Biblián. Metodología: Se trata de un estudio observacional cualitativo en el que se recopila las vivencias de 34 personas de la población con discapacidad que forman parte del Proyecto Centro diurno "San José" de Biblián, siendo seleccionados cinco participantes mediante muestreo simple no probabilístico. Hallazgos: A partir del análisis de los relatos se determina que las personas con discapacidad mantienen relaciones satisfactorias aún con las inseguridades que los rodean. Sin embargo, la exclusión dentro de sus propios hogares, la escasa información segura y la difusión mediática masiva sobre la sexualidad han condicionado percepciones que los expone a un nivel elevado de vulnerabilidad. A manera de Conclusión: En varias ocasiones existen prejuicios y tabúes al hablar de sexualidad con personas con discapacidad en los diferentes hogares, los familiares optan por no responder interrogantes relacionadas, por eso el personal de salud cumple un rol muy importante al brindar la educación necesaria para generar personas independientes que vivan plenamente en la sociedad sin importar su condición.

Disability is a condition (impairment) that hinders the development of daily activities and the interaction of the individual with the surrounding environment, it is divided into: physical, motor, organic, mental, intellectual and sensory disability. Objective: To document the perceptions and emotions on sexual and reproductive health of people with disabilities in the Biblián Canton Day Center. Methodology: This is a qualitative observational study in which the experiences of 34 people from the population with disabilities who are part of the Project Day Center "San José" of Biblián are collected, with five participants being selected through simple non-probabilistic sampling. Findings: From the analysis of the narratives, it is determined that people with disabilities maintain satisfactory relationships even with the insecurities that surround them. However, exclusion within their own homes, scarce safe information and mass media dissemination about sexuality have conditioned perceptions that expose them to a high level of vulnerability. By way of conclusion: On several occasions there are prejudices and taboos when talking about sexuality with people with disabilities in different homes, family members choose not to answer related questions, so health personnel play a very important role in providing the necessary education to generate independent people who live fully in society regardless of their condition.

A deficiência é uma condição (impedimento) que dificulta o desenvolvimento das atividades cotidianas e a interação do indivíduo com o ambiente que o cerca. Ela se divide em: deficiência física, motora, orgânica, mental, intelectual e sensorial. Objetivo: documentar as percepções e emoções sobre saúde sexual e reprodutiva de pessoas com deficiência no Centro de Dia do Cantão de Biblián. Metodologia: trata-se de um estudo observacional qualitativo no qual são compiladas as experiências de 34 pessoas da população com deficiência que fazem parte do Projeto Centro de Dia "San José" em Biblián, sendo que cinco participantes foram selecionados por meio de amostragem simples não probabilística. Achados: A partir da análise das histórias, constatou-se que as pessoas com deficiência mantêm relacionamentos satisfatórios mesmo com as inseguranças que as cercam. Entretanto, a exclusão dentro de suas próprias casas, a escassez de informações seguras e a cobertura da sexualidade pela mídia de massa condicionaram percepções que as expõem a um alto nível de vulnerabilidade. Conclusão: Em várias ocasiões, há preconceitos e tabus ao falar sobre sexualidade com pessoas com deficiência em diferentes lares, e os membros da família optam por não responder às perguntas relacionadas, razão pela qual a equipe de saúde desempenha um papel muito importante ao fornecer a educação necessária para gerar pessoas independentes que vivem plenamente na sociedade, independentemente de sua condição.

The population-level impact of introducing rapid diagnostic tests on syphilis transmission in Canadian arctic communities - a mathematical modeling study.

Background: Canadian Arctic communities have experienced sustained syphilis transmission, with diagnoses rates 18-times higher than the national average. Remoteness from laboratory facilities leads to delays between syphilis screening and treatment, contributing to onward transmission. Rapid diagnostic tests can eliminate treatment delays via testing at the point-of-care. This study aims to describe syphilis diagnostic gaps and to estimate the impact of introducing rapid diagnostic tests at the point-of-care on syphilis transmission. Methods: To assess the population-level impact of deploying rapid diagnostic tests, an individual-based model was developed using detailed surveillance data, population surveys, and a prospective diagnostic accuracy field study. The model was calibrated to syphilis diagnoses (2017-2022) from a community of approximately 1,050 sexually active individuals. The impacts of implementing rapid diagnostic tests using whole blood (sensitivity: 92% for infectious and 81% for non-infectious syphilis; specificity: 99%) from 2023 onward was calculated using the annual median fraction of cumulative new syphilis infections averted over 2023-2032. Findings: The median modeled syphilis incidence among sexually active individuals was 44 per 1,000 in 2023. Males aged 16-30 years exhibited a 51% lower testing rate than that of their female counterparts. Maintaining all interventions constant at their 2022 levels, implementing rapid diagnostic tests could avert a cumulative 33% (90% credible intervals: 18-43%) and 37% (21-46%) of new syphilis infections over 5 and 10 years, respectively. Increasing testing rates and contact tracing may enhance the effect of rapid diagnostic tests. Interpretation: Implementing rapid diagnostic tests for syphilis in Arctic communities could reduce infections and enhance control of epidemics. Such effective diagnostic tools could enable rapid outbreak responses by providing same-day testing and treatment at the point-of-care. Funding: Canadian Institutes of Health Research.

Improving the sexual health of women with disabilities in sub-Saharan Africa: a scoping review of published studies.

BACKGROUND: An essential aspect of human well-being is positive sexual health outcomes. However, the issue of adverse sexual health outcomes continues to be a major public health concern, particularly for women with disabilities in sub-Saharan Africa (SSA). Therefore, this current scoping review mapped studies conducted in the last twenty-nine years on the sexual health of women with disabilities from these five dimensions: sexual activity, contraceptive use, sexual autonomy, sexual violence and risky sexual behaviour, whilst seeking to identify the current state of knowledge and address the study gaps in SSA. METHODS: This current scoping review was informed by the methodological framework proposed by Arksey and O'Malley. Exploratory searches were conducted in PubMed, Web of Science, African Journals Online, etc., to identify studies conducted in SSA that focus on sexual activity, contraceptive use, sexual autonomy, sexual violence and risky sexual behaviour among women with disabilities in SSA since the inception of the International Conference on Population and Development in 1994 to 30th of March 2024. This process resulted in the inclusion of seventeen (17) studies. RESULTS: Of the 1362 identified through various databases, 34 studies were included for the full-text retrieval and screening; only 17 studies met the inclusion criteria. The eligible studies were conducted across six countries in SSA and published between 2008 and 2023. Eight studies used quantitative study type, six utilised qualitative approach, and three employed mixed-methods analysis. Two studies were conducted on sexual activity, ten were conducted on contraceptive use, four were conducted on sexual violence, and one study was conducted on risky sexual behaviour, whilst no study on sexual autonomy met the inclusion criteria. CONCLUSION: This review showed that there were few or scarce studies on sexual activity, contraceptive use, sexual autonomy, sexual violence and risky sexual behaviour among women with disabilities in SSA and even where the studies were substantial (contraceptive use), the majority of the studies were conducted in a country. Future studies should consider examining dimensions of sexual health, such as sexual autonomy, sexual activity and risky sexual behaviour of women with disabilities that were not available or were scarce in the literature.

Sexual health is really important for people's overall well-being, and it includes aspects like how we feel socially, mentally, emotionally, and physically. In sub-Saharan Africa, especially for women with disabilities, sexual health is a big concern. So, this review looked at studies done over the last 29 years about the sexual health of women with disabilities in sub-Saharan Africa. It focused on five areas: sexual activity, contraceptive use, sexual autonomy, sexual violence, and risky sexual behaviour. Databases were searched for relevant studies and found 17 that fit the set criteria. These studies were from six countries in sub-Saharan Africa and were published between 2008 and 2023. Most of the studies were about contraceptive use, with fewer focusing on sexual activity, sexual violence, and risky behaviour. There weren't any eligible studies on sexual autonomy. The review concluded that there's not enough research on these sexual health dimensions among women with disabilities in sub-Saharan Africa, especially on sexual autonomy, and future studies should explore this further.