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1.
Health Aff (Millwood) ; 41(2): 195-202, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35130060

RESUMO

Few studies have illustrated how racism influences Black women's use of reproductive health care services. This article presents findings of a collaborative study conducted by a research team and a reproductive justice organization to understand Black women's concerns with sexual and reproductive health services. The qualitative research was conducted with Black women living in Georgia and North Carolina, using a community-based participatory research approach. Themes were developed from participant accounts that highlight how racism, both structural and individual, influenced their reproductive health care access, utilization, and experience. Structural racism affected participants' finances and led some to forgo care or face barriers to obtaining care. Individual racism resulted in some women electing to receive care only from same-race medical providers. These findings suggest a need for policies and practices that address structural barriers to reproductive health care access and improve the reproductive health experience of Black women.


Assuntos
Racismo , Serviços de Saúde Reprodutiva , Feminino , Acesso aos Serviços de Saúde , Humanos , Saúde Reprodutiva , Comportamento Sexual
2.
Arch. argent. pediatr ; 120(4): 240-247, Agosto 2022. tab
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1371814

RESUMO

Introducción. La expresión del género y laidentidad sexual no siempre coinciden con el sexo asignado al nacer. Nos propusimos como objetivo explorar las percepciones de género en adolescentes que consultaron en un hospital universitario de la comunidad. Población y métodos. Se diseñó un estudio de corte transversal. Se realizó una encuesta anónima en la sala de espera a los pacientes de 13 a 20 años que se atendieron en los consultorios externos de adolescencia entre abril y diciembre del 2019. Resultados. Respondieron la encuesta 834 adolescentes y el promedio de edad de los encuestados fue de 16,3 ± 2,3 años. El 3,3 % de los adolescentes (2,9 % mujeres y 4,3 % varones) se percibieron con una identidad de género diferente a su sexo de nacimiento. El 26 % no percibió su orientación sexual en términos heteronormativos, casi el 10 % se sintió discriminado por su orientación sexual, y esto estuvo asociado a la orientación sexual no heteronormativa (p <0,0001). Las adolescentes mujeres besaron en la boca a personas del mismo sexo en mayor medida que los varones, 44,8 % versus 19 % (p <0,0001). Conclusiones. El 3,3 % de la población adolescente se percibió con una identidad de género diferente al sexo de nacimiento y el 26 % tuvo una orientación sexual no heteronormativa.


Introduction. Gender expression and sexual identity are not always the same as the sex assigned at birth. Our objective was to explore gender perceptions among adolescents who attended a teaching hospital in the Autonomous City of Buenos Aires. Population and methods. This was a cross- sectional study. An anonymous survey was administered to patients aged 13-20 years at the waiting room of the outpatient adolescent clinic between April and December 2019. Results. A total of 834 adolescents completed the survey; their average age was 16.3 ± 2.3 years. Among them, 3.3% (2.9% females and 4.3% males) perceived their gender identity as different from their sex assigned at birth; 26% perceived their sexual orientation was not heteronormative; almost 10% experienced discrimination due to their sexual orientation; and this was associated with a non-heteronormative sexual orientation (p < 0.0001). Female adolescents kissed same sex persons on the mouth more often than male adolescents: 44.8% versus 19% (p < 0.0001). Conclusions. In this population of adolescents, 3.3% perceived their gender identity was different from their sex assigned at birth and 26% had a non-heteronormative sexual orientation.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Comportamento Sexual , Identidade de Gênero , Estudos Transversais , Inquéritos e Questionários
3.
BMC Med Res Methodol ; 22(1): 213, 2022 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-35927636

RESUMO

BACKGROUND: Adolescent pregnancies and sexually-transmitted infections continue to impact 15 - 19-year-olds across the globe. The lack of sexual reproductive health information (SRH) in resource-limited settings due to cultural and societal attitudes towards adolescent SRH could be contributing to the negative outcomes. Innovative approaches, including mobile phone technologies, are needed to address the need for reliable adolescent SRH information. OBJECTIVE: The study aimed to co-design a Unstructured Supplementary Service Data (USSD) based mobile app prototype to provide confidential adolescent SRH information on-demand and evaluate the mobile app's usability and user experience. METHODS: A human-centered design methodology was applied. This practice framework allowed the perspectives and feedback of adolescent users to be included in the iterative design process. To participate, an adolescent must have been 15 to 19 years old, resided in Kibra and would be able to access a mobile phone. Adolescents were enrolled for the alpha and field testing of the app prototype at different time-points. The Mobile Application Rating Scale (MARS) a multidimensional mobile phone evaluation tool was used to access the functionality, engagement, aesthetics and quality of information in the app. Responses from the MARS were reported as mean scores for each category and a mean of the aggregate scores making the app's quality score. The MARS data was also evaluated as categorical data, A Chi square test of independence was carried out to show significance of any observed differences using cumulative and inverse cumulative distribution functions. RESULTS: During the usability test, 62/109 (54.9%) of the adolescents that were followed-up had used the app at least once, 30/62 (48.4%) of these were male participants and 32/62 (51.6%) female. On engagement, the app had a mean score of 4.3/5 (SD 0.44), 4.6/5 (SD 0.38) on functionality, 4.3/5 (SD 0.57) on aesthetics and 4.4/5 (SD 0.60) on the quality of information. The overall app quality mean score was 4.4/5 (SD 0.31). The app was described as 'very interesting' to use by 44/62 (70.9%) of the participants, 20/44 males and 24/44 females. The content was deemed to be either 'perfectly' or 'well targeted' on sexual reproductive health by 60/62 (96.7%) adolescents, and the app was rated 'best app' by 45/62 (72.6%) adolescents, 27/45 females and 18/45 males, with a p-value = 0.011. CONCLUSIONS: Adolescents need on-demand, accurate and trusted SRH information. A mobile phone app is a feasible and acceptable way to deliver adolescent SRH information in resource-limited settings. The USSD mobile phone technology shows promise in the delivery of much needed adolescent SRH information on-demand..


Assuntos
Telefone Celular , Aplicativos Móveis , Saúde Sexual , Adolescente , Adulto , Feminino , Humanos , Masculino , Gravidez , Saúde Reprodutiva , Comportamento Sexual , Adulto Jovem
4.
BMC Infect Dis ; 22(1): 679, 2022 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-35941562

RESUMO

BACKGROUND: Interventions aimed at reducing risky sexual behavior are considered an important strategy for averting Human Immunodeficiency Virus (HIV) infection among youth (15-24 years) who continue to be at risk of the disease. Enhancing intervention success requires a comprehensive understanding of the barriers and facilitators to interventions targeting youth. However, there is lack of a systematic review of both quantitative and qualitative studies to comprehensively identify and synthesize barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth worldwide. This review aimed to identify and synthesize barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth globally based on original peer-reviewed studies published in the last decade. METHODS: The Joanna Briggs Institute approach for mixed methods systematic reviews and Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used to guide this review. Nine electronic databases, Joint United Nations Programme on HIV/AIDS and World Health Organization websites, and reference lists of included studies and systematic reviews on barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth were searched for eligible articles. Studies that met the inclusion criteria underwent quality appraisal and data extraction. Findings were analyzed using thematic synthesis and underpinned by Nilsen, 2015's Determinant Framework. RESULTS: Overall 13 studies comprising of eight qualitative studies, four quantitative studies and one mixed methods study were included in the review. Several barriers and facilitators across the five Determinant Framework domains were identified. Most of the barriers fell under the characteristics of the context domain (e.g., gender-biased norms). The next important group of barriers emerged within the characteristics of the end users domain (e.g., fear of relationship breakdown). In terms of facilitators, the majority fell under the characteristics of the strategy of facilitating implementation domain (e.g., implementation of intervention with fidelity) and characteristics of the end users domain (e.g., fear of pregnancy or sexually transmitted infections). The next common set of facilitators appeared within the characteristics of the context domain (e.g., family support). CONCLUSION: This review identified several multi-level barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth. Multi-level and combination approaches are needed to address these factors and enhance intervention success.


Assuntos
Infecções por HIV , Infecções Sexualmente Transmissíveis , Adolescente , Aconselhamento , Feminino , Infecções por HIV/prevenção & controle , Humanos , Gravidez , Assunção de Riscos , Comportamento Sexual
5.
Int J Public Health ; 67: 1604612, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35936995

RESUMO

Objectives: The objective of this study is to explore factors affecting the HIV testing behaviors among men who have sex with men (MSM) in China. Methods: A cross-sectional study was conducted in Guilin, China from April to June of 2021. Questionnaire data of 300 MSM were analyzed, and binary logistic regression models were used to examine the socio-demographic and sexual behavior characteristics associated with three HIV testing behaviors (self-testing, institutional testing, and regular testing). Results: The results showed that half of the respondents had the habit of regular HIV testing. Only 30.0% of MSM chose to do HIV testing after high-risk sexual behavior, and self-perceived luck was the main reason for not having HIV testing. Moreover, the influencing factors of three HIV testing behaviors after high-risk sexual behavior differ. Interestingly, income was not related to any of the three HIV testing behaviors among those MSM who participated. Conclusion: This research indicates insufficient health education on HIV testing behaviors among MSM in China. Health promotion practices targeting the MSM population to improve HIV-related knowledge, thus contributing to the HIV epidemic, are required.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , China/epidemiologia , Estudos Transversais , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Teste de HIV , Homossexualidade Masculina , Humanos , Masculino , Comportamento Sexual , Inquéritos e Questionários
6.
Front Endocrinol (Lausanne) ; 13: 903058, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35937791

RESUMO

Gender dysphoria (GD) is characterized by distress due to an incongruence between experienced gender and sex assigned at birth. Brain functional connectivity in adolescents who experience GD may be associated with experienced gender (vs. assigned sex) and/or brain networks implicated in own-body perception. Furthermore, sexual orientation may be related to brain functional organization given commonalities in developmental mechanisms proposed to underpin GD and same-sex attractions. Here, we applied group independent component analysis to resting-state functional magnetic resonance imaging (rs-fMRI) BOLD timeseries data to estimate inter-network (i.e., between independent components) timeseries correlations, representing functional connectivity, in 17 GD adolescents assigned female at birth (AFAB) not receiving gender-affirming hormone therapy, 17 cisgender girls, and 15 cisgender boys (ages 12-17 years). Sexual orientation was represented by degree of androphilia-gynephilia and sexual attractions strength. Multivariate partial least squares analyses found that functional connectivity differed among cisgender boys, cisgender girls, and GD AFAB, with the largest difference between cisgender boys and GD AFAB. Regarding sexual orientation and age, the brain's intrinsic functional organization of GD AFAB was both similar to and different from cisgender girls, and both differed from cisgender boys. The pattern of group differences and the networks involved aligned with the hypothesis that brain functional organization is different among GD AFAB (vs. cisgender) adolescents, and certain aspects of this organization relate to brain areas implicated in own-body perception and self-referential thinking. Overall, brain functional organization of GD AFAB was generally more similar to that of cisgender girls than cisgender boys.


Assuntos
Disforia de Gênero , Adolescente , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Criança , Feminino , Disforia de Gênero/patologia , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética/métodos , Masculino , Comportamento Sexual
7.
J Am Psychoanal Assoc ; 70(3): 511-524, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35938568

RESUMO

Psychoanalytic efforts to think sexual difference beyond the restrictions of binary notions about anatomy and gender continue to prove challenging in both clinical practice and theory building. Claims that such binary notions are no longer applicable fail to take seriously the ongoing power of binary processes as they manifest both consciously and unconsciously. Without a capacity to think sexual difference as more than two, a capacity that resists the lure of spectrum modeling, efforts to conceptualize intersexuality and other nonbinary forms of anatomy and gender falter. An exploration into the challenges faced by two parents of an intersex baby, especially regarding the dilemma of pursuing genital surgery or not, shows some of the difficulties inherent in thinking sexual difference when the profound inadequacy of binary notions cannot be ignored.


Assuntos
Transtornos do Desenvolvimento Sexual , Identidade de Gênero , Humanos , Comportamento Sexual
8.
Front Public Health ; 10: 823228, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35910931

RESUMO

American Indian (AI) youth in the United States experience disproportionate sexual and reproductive health (SRH) disparities relative to their non-Indigenous, white counterparts, including increased rates of sexually transmitted infections (STIs), earlier sexual debut, increased rates of teen birth, and reduced access to SRH services. Past research shows that to improve SRH outcomes for AI youth in reservation communities, interventions must address complex factors and multiple levels of community that influence sexual risk behaviors. Here, we describe development of a multi-level, multi-component randomized controlled trial (RCT) to intervene upon SRH outcomes in a Northern Plains American Indian reservation community. Our intervention is rooted in a community based participatory research framework and is evaluated with a stepped wedge design that integrates 5 reservation high schools into a 5-year, cluster-randomized RCT. Ecological Systems Theory was used to design the intervention that includes (1) an individual level component of culturally specific SRH curriculum in school, (2) a parental component of education to improve parent-child communication about SRH and healthy relationships, (3) a community component of cultural mentorship, and (4) a systems-level component to improve delivery of SRH services from reservation healthcare agencies. In this article we present the rationale and details of our research design, instrumentation, data collection protocol, analytical methods, and community participation in the intervention. Our intervention builds upon existing community strengths and integrates traditional Indigenous knowledge and values with current public health knowledge to reduce SRH disparities.


Assuntos
Índios Norte-Americanos , Infecções Sexualmente Transmissíveis , Adolescente , Índios Norte-Americanos ou Nativos do Alasca , Humanos , Saúde Reprodutiva , Comportamento Sexual , Infecções Sexualmente Transmissíveis/prevenção & controle , Estados Unidos
9.
SAHARA J ; 19(1): 22-31, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35912646

RESUMO

Research suggests that HIV infections among men who have sex with men (MSM) are acquired from primary partners, yet MSM continually fail to take part in couples HIV counselling and testing (CHCT). To identify factors that inhibit MSM in universities from regularly testing for HIV with their sexual partners, this study considered the perspectives and experiences of 15 MSM students in Durban, South Africa. The findings show that despite appreciating the value of couple testing it is relatively uncommon. MSM resist doing so with their casual partners as this would presumably signal an intention to advance the relationship beyond the short-term. Other barriers included; experienced and perceived homophobia at public testing centres, trust-based assumptions that primary partners need not test for HIV and fear of discord. They also employed alternative strategies to purportedly determine their casual and primary partners' status in the absence of CHCT. Alternative strategies include; initiating sexual relationships with casual partners whose sexual history is known and making use of home-based testing kits to avoid CHCT at public testing centres. These findings emphasise the need for LGBTIQ-friendly couple-based approaches as a necessary component of HIV prevention interventions among MSM in universities.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Aconselhamento , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Masculino , Comportamento Sexual , Parceiros Sexuais , África do Sul , Estudantes , Universidades
10.
PLoS One ; 17(8): e0272271, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35913950

RESUMO

Magnetic resonance imaging (MRI) allows obtaining anatomical and functional information of the brain in the same subject at different times. Manganese-enhanced MRI (MEMRI) uses manganese ions to identify brain activity, although in high doses it might produce neurotoxic effects. Our aims were to identify a manganese dose that does not affect motivated behaviors such as sexual behavior, running wheel and the rotarod test. The second goal was to determine the optimal dose of chloride manganese (MnCl2) that will allow us to evaluate activation of brain regions after females mated controlling (pacing) the sexual interaction. To achieve that, two experiments were performed. In experiment 1 we evaluated the effects of two doses of MnCl2, 8 and 16 mg/kg. Subjects were injected with one of the doses of MnCl2 24 hours before the test on sessions 1, 5 and 10 and immediately thereafter scanned. Female sexual behavior, running wheel and the rotarod were evaluated once a week for 10 weeks. In experiment 2 we followed a similar procedure, but females paced the sexual interaction once a week for 10 weeks and were injected with one of the doses of MnCl2 24 hours before the test and immediately thereafter scanned on sessions 1, 5 and 10. The results of experiment 1 show that neither dose of MnCl2 induces alterations on sexual behavior, running wheel and rotarod. Experiment 2 demonstrated that MEMRI allow us to detect activation of different brain regions after sexual behavior, including the olfactory bulb (OB), the bed nucleus of the stria terminalis (BNST), the amygdala (AMG), the medial preoptic area (MPOA), the ventromedial hypothalamus (VMH), the nucleus accumbens (NAcc), the striatum (STR) and the hippocampus (Hipp) allowing the identification of changes in brain circuits activated by sexual behavior. The socio sexual circuit showed a higher signal intensity on session 5 than the reward circuit and the control groups indicating that even with sexual experience the activation of the reward circuit requires the activation of the socio sexual circuit. Our study demonstrates that MEMRI can be used repeatedly in the same subject to evaluate the activation of brain circuits after motivated behaviors and how can this activation change with experience.


Assuntos
Imageamento por Ressonância Magnética , Manganês , Animais , Encéfalo/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Manganês/farmacologia , Área Pré-Óptica , Comportamento Sexual , Comportamento Sexual Animal/fisiologia
11.
J Med Internet Res ; 24(8): e39094, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35916700

RESUMO

BACKGROUND: Efficacious mental health interventions for sexual and gender minority youth have had limited reach, given their delivery as time-intensive, in-person sessions. Internet-based interventions may facilitate reach to sexual and gender minority youth; however, there is little research examining their efficacy. OBJECTIVE: This study aims to describe the results of a pilot randomized controlled trial of imi, a web application designed to improve mental health by supporting lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority identity affirmation, coping self-efficacy, and coping skill practice. METHODS: Sexual and gender minority youth (N=270) aged 13 to 19 (mean 16.5, SD 1.5) years and living in the United States were recruited through Instagram advertisements. Approximately 78% (210/270) of the sample identified as racial or ethnic minorities. Participants were randomized in a 1:1 fashion to the full imi intervention web application (treatment; 135/270, 50%) or a resource page-only version of the imi site (control; 135/270, 50%). The imi application covered four topical areas: gender identity; lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority identity; stress and coping; and internalized homophobia and transphobia. Participants explored these areas by engaging with informational resources, exercises, and peer stories at a self-guided pace. Both arms were assessed via web-based surveys at baseline and 4-week follow-up for intervention satisfaction, stress appraisals (ie, challenge, threat, and resource), coping skills (ie, instrumental support, positive reframing, and planning), and mental health symptoms among other outcomes. Main intent-to-treat analyses compared the arms at week 4, controlling for baseline values on each outcome. RESULTS: Survey retention was 90.4% (244/270) at week 4. Participants in the treatment arm reported greater satisfaction with the intervention than participants in the control arm (t241=-2.98; P=.003). The treatment arm showed significantly greater improvement in challenge appraisals (ie, belief in one's coping abilities) than the control (Cohen d=0.26; P=.008). There were no differences between the arms for threat (d=0.10; P=.37) or resource (d=0.15; P=.14) appraisals. The treatment arm showed greater increases in coping skills than the control arm (instrumental support: d=0.24, P=.005; positive reframing: d=0.27, P=.02; planning: d=0.26, P=.02). Mental health symptoms improved across both the treatment and control arms; however, there were no differences between arms. Within the treatment arm, higher engagement with imi (≥5 sessions, >10 minutes, or >10 pages) predicted greater improvement in stress appraisals (all P values <.05). CONCLUSIONS: The results provide initial evidence that asynchronous psychosocial interventions delivered via a web application to sexual and gender minority youth can support their ability to cope with minority stress. Further research is needed to examine the long-term effects of the imi application. TRIAL REGISTRATION: ClinicalTrials.gov NCT05061966; https://clinicaltrials.gov/ct2/show/NCT05061966.


Assuntos
Identidade de Gênero , Minorias Sexuais e de Gênero , Adaptação Psicológica , Adolescente , Feminino , Humanos , Masculino , Projetos Piloto , Comportamento Sexual/psicologia , Estados Unidos
12.
Span J Psychol ; 25: e21, 2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-35920340

RESUMO

Many governments invest public funds in communication interventions and campaigns against prostitution and sexual exploitation in an attempt to change attitudes toward prostitution and eventually decrease its consumption. Despite the considerable investment that public institutions have made in campaigns against prostitution and sexual slavery, no known empirical studies have evaluated the effectiveness of such campaigns on attitudes and behavioral change. The messages of these campaigns usually center on one of two thematic focuses: Prostituted women who suffer exploitation and male consumers of prostitution. The present study examines the impact of different anti-prostitution advertisements on attitudes among male participants (N = 155 male participants). Specifically, the experiment aims to test the differential effect of these two focuses, compared to a no-advertisement control condition, on social support for prostitution, negative and incorrect beliefs about prostitutes, and family values related to prostitution. The results show that compared with the no-advertisement control condition, advertisements focused on men who use prostitutes have a significant effect on social support toward prostitution and incorrect beliefs about prostitutes, whereas advertisements focused on female prostitutes have no effect. The results have practical implications for governments and councils regarding the efficacy of this kind of public communication campaign against prostitution consumption.


Assuntos
Publicidade , Trabalho Sexual , Feminino , Humanos , Masculino , Comportamento Sexual
13.
Rev Bras Enferm ; 75(6): e20210712, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35920496

RESUMO

OBJECTIVE: to understand higher education students' perceptions of sexual and reproductive health risk behaviours. METHODS: a descriptive study following a qualitative approach was conducted, using Pender's Health Promotion Model as a theoretical and methodological framework. A thematic analysis of the data obtained from different focus groups was performed. RESULTS: participants consider that factors such as communication with their sexual partner, the ability to negotiate and a positive attitude regarding condoms are positive aspects that will encourage consistent use of condom. The embarrassment felt at the time of purchase, the reduction of sexual pleasure and the growing stability of the relationship are usually seen as barriers. FINAL CONSIDERATIONS: the study was crucial to identify some strategies that will be considered in further health promotion programmes, namely peer education, and will help promote personal and social skills and the (re)organisation of healthcare services.


Assuntos
Comportamentos de Risco à Saúde , Comportamento Sexual , Preservativos , Grupos Focais , Humanos , Estudantes
14.
Sex Reprod Health Matters ; 30(1): 2083809, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35929964

RESUMO

Young people, particularly adolescent girls and young women, represent a growing proportion of those living with HIV. Edutainment programmes have been widely used throughout the world to "educate" and "entertain" audiences and tackle serious social issues in bold and engaging ways. This paper examines the extent to which an edutainment programme, MTV-Shuga, was reported to influence young people's engagement with sexual and reproductive health (SRH) information in rural KwaZulu-Natal, South Africa. In 2019 we conducted eight community-based screenings of MTV-Shuga episodes followed by 25 individual in-depth interviews and 13 focus group discussions with young people aged between 15 and 30. Interviews were audio recorded and transcribed verbatim. Data analysis was thematic and complemented by constant comparison and deviant case analysis techniques. In this rural and poor setting with a high burden of HIV, young people exhibited high levels of awareness of SRH and HIV but had constrained access to services, and limited ability to engage with parents or guardians on SRH matters. MTV Shuga provided an entertaining guide of ways to navigate the risks that they faced in a way that resonated with them. The findings highlight the importance of enabling young people in rural areas to watch MTV Shuga with peers in a safe space in which discussion of the content is facilitated. There is also value in encouraging parents to watch MTV Shuga as a means of enabling discussions between children and adults in their lives about SRH matters.


Assuntos
Infecções por HIV , Saúde Sexual , Adolescente , Adulto , Criança , Feminino , Infecções por HIV/prevenção & controle , Humanos , Saúde Reprodutiva , Comportamento Sexual , África do Sul , Adulto Jovem
15.
Pediatr Clin North Am ; 69(4): 759-777, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35934498

RESUMO

HIV is now a chronic condition that can be managed. Adolescents and emerging adults represent a large proportion of new diagnoses, but struggle with many aspects of HIV-related self-management. Self-management of HIV is critical to maintaining health and involves retention in HIV care, medication adherence to achieve viral suppression, managing substance use, and sexual and general health-related behaviors. This article describes theoretic frameworks for HIV self-management as adapted for youth and reviews self-management interventions developed to improve health outcomes in youth living with HIV identified from a recent systematic review.


Assuntos
Infecções por HIV , Autogestão , Adolescente , Adulto , HIV , Infecções por HIV/tratamento farmacológico , Humanos , Adesão à Medicação , Comportamento Sexual
16.
Soins Gerontol ; 27(156): 13-22, 2022.
Artigo em Francês | MEDLINE | ID: mdl-35926968

RESUMO

The sexual life of elderly people living in residential institutions for the dependent elderly (Ehpad) is a sensitive subject that is rarely discussed. Particular difficulties sometimes arise when they have cognitive problems. Affectivity and sexuality in old people's homes must be approached with tact and maturity by the carers. Sexuality belongs to private life, but its excesses are difficult to reconcile with collective life. Some proposals can be made on ethical issues and on the relationship with residents and their families.


Assuntos
Comportamento Sexual , Sexualidade , Idoso , Emoções , Humanos , Sexualidade/psicologia
17.
West Afr J Med ; 39(7): 685-790, 2022 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-35924874

RESUMO

BACKGROUND: Parents play a significant role in the sexual orientation and behaviours of their children. Lack of communication between parents and their children about sexual matters may contribute to engagement of young people in risky sexual behaviours. OBJECTIVES: To assess the pattern of parent-youth sexual discussions and its association with sexual activity among unmarried undergraduates in a Nigerian university. METHODS: A descriptive cross-sectional study was conducted among 400 undergraduates aged 15-24 years in a tertiary institution in Ogun state, Nigeria. A structured selfadministered questionnaire was used for data collection. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) version 21.0. The level of significance was set at p <0.05. RESULTS: Parent-youth discussions on sexual issues had occurred in 225 (56.2%) of the respondents, with mothers being more involved than fathers; onset was at secondary school level in nearly three-fifths. There was no statistically significant relationship between parent-youth sexual discussions and engagement in sexual intercourse (p = 0.666); however, parental visit(s) on campus was associated with a significant reduction in sexual intercourse (p = 0.006). CONCLUSION: Engagement of youths in sexual discussions by their parents is still low and such discussions are often not impactful in preventing pre-marital sex. Parental supervisory visits for undergraduates on campus may be helpful in consolidating the desired effect of such sexual discussions, and should be encouraged.


CONTEXTE: Les parents jouent un rôle important dans l'orientation et les comportements sexuels de leurs enfants. Le manque de communication entre les parents et leurs enfants sur les questions sexuelles peut contribuer à l'engagement des jeunes dans des comportements sexuels à risque. OBJECTIFS: Évaluer le modèle de discussions sexuelles entre parents et enfants et son association avec l'activité sexuelle chez les étudiants célibataires de premier cycle d'une université nigériane. MÉTHODES: Une étude descriptive transversale a été menée auprès de 400 étudiants de premier cycle âgés de 15 à 24 ans dans un établissement d'enseignement supérieur de l'État d'Ogun, au Nigeria. Un questionnaire structuré auto-administré a été utilisé pour la collecte des données. Les données ont été analysées à l'aide du logiciel SPSS (Statistical Package for the Social Sciences) version 21.0. Le niveau de signification a été fixé à p <0,05. RÉSULTATS: Des discussions entre parents et jeunes sur les questions sexuelles ont eu lieu chez 225 (56,2%) des répondants, les mères étant plus impliquées que les pères ; elles ont eu lieu au niveau de l'école secondaire chez près de trois cinquièmes des répondants. Il n'y avait pas de relation statistiquement significative entre les discussions sexuelles entre parents et jeunes et l'engagement dans des rapports sexuels (p = 0,666) ; cependant, la visite des parents sur le campus était associée à une réduction significative des rapports sexuels (p = 0,006). CONCLUSION: L'engagement des jeunes dans des discussions sexuelles avec leurs parents reste faible et ces discussions n'ont souvent pas d'impact sur la prévention des rapports sexuels avant le mariage. Les visites de supervision parentale pour les étudiants de premier cycle sur le campus peuvent être utiles pour consolider l'effet désiré de ces discussions sexuelles, et devraient être encouragées. Mots clés: Discussion sexuelle entre parents et jeunes, rapports sexuels, étudiants de premier cycle, jeunes.


Assuntos
Relações Pais-Filho , Comportamento Sexual , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Nigéria , Pais , Universidades
18.
BMC Pregnancy Childbirth ; 22(1): 616, 2022 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-35927705

RESUMO

BACKGROUND & AIM: Pregnancy is associated with numerous physical and psychological changes and affects the sexual function of couples. Since the root of many marital problems lies in the quality of the relationship and sexual function, the present study investigates the effect of virtual cognitive-behavioral sexual counseling on pregnant women's sexual function and intimacy. METHODS & MATERIALS: This study is a randomized clinical trial, and 80 pregnant women aged 18 to 35 years and in 16-24 weeks of pregnancy were assigned to two intervention and control groups based on randomized blocks from June 2021 to July 2021. The control group received routine prenatal care, but the intervention group, in addition to routine prenatal care, underwent virtual counseling with a cognitive-behavioral approach during eight sessions of 90 minutes. Data were collected using the Female Sexual Function Index (FSFI) and sexual intimacy questionnaire. SPSS software was used for statistical analysis. RESULTS: The comparison of mean scores of sexual function and intimacy in the two groups before the intervention was not statistically significant with each other. However, after the intervention, the mean scores of sexual function and intimacy in the intervention group were significantly increased compared to the control group (p < 0.001). The effect size of the intervention was 0.52 for sexual function and 0.272 for sexual intimacy. CONCLUSION: Virtual cognitive-behavioral counseling can be used as an effective treatment to promote sexual function and intimacy of women during pregnancy. TRIAL REGISTRATION: IRCT20161230031662N10. Registry date: 21/06/2021.


Assuntos
Gestantes , Comportamento Sexual , Cognição , Aconselhamento , Feminino , Humanos , Gravidez , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia
19.
BMC Womens Health ; 22(1): 330, 2022 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-35927719

RESUMO

BACKGROUND: Nurses and midwives role in sexual healthcare is essential to help patients, particularly women, ensure a satisfactory sexual wellbeing. Yet, these professionals often overlook this aspect of patients' health. Little is known regarding nurses and midwives' attitudes, views and experiences concerning sexual healthcare. Using a naturalistic inquiry approach, this qualitative study was conducted to overcome this limitation and gain insights into nurses and midwives' role in the delivery of sexual healthcare. METHODS: A purposive sample of nurses and midwives was chosen from different clinical sites. Data generated by focus group discussions were were analysed using the Framework Analysis while adopting different strategies to ensure rigour. The study aligns with the consolidated criteria for reporting qualitative research checklist. RESULTS: Five themes illustrated the participants' views and experiences. These are: 'Perceptions of sexuality', 'Appreciating the discussion around the individuals' sexual issues', 'Muting the discussion around the individuals' sexual issues, 'Coping with embarrassment', and 'Promoting nurses' and midwives' roles sexual healthcare'. Nurses and midwives discussed the importance of sexuality in the couple's life. They reported controversial views and highlighted many challenges that make them reluctant in playing an efficient role in sexual healthcare. They discussed many suggestions, mainly getting a solid sexual health education to become better equipped to meet patients' sexual health needs. CONCLUSION: Findings are critical to empower nurses and midwives, break the barriers in discussing sexual healthcare and integrate this aspects of care more actively and confidently in daily practice.


Assuntos
Tocologia , Enfermeiras Obstétricas , Atenção à Saúde , Feminino , Humanos , Gravidez , Pesquisa Qualitativa , Comportamento Sexual
20.
BMJ Open Qual ; 11(3)2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35914817

RESUMO

INTRODUCTION: Testosterone replacement therapy (TRT) is the treatment of choice for male hypogonadism. British Society for Sexual Medicine (BSSM) guidelines on adult testosterone deficiency recommend that TRT patients undergo annual monitoring of their testosterone levels and potential complications of treatment; though evidence suggests that substantial numbers of men on TRT are not monitored adequately. METHODS: Review of the electronic patient record from a single general practice in southwest Scotland revealed that only 1 of 26 (4%) TRT patients had been monitored as per BSSM guidelines in the previous 12 months. Additionally, when monitoring was undertaken there was inconsistency in the blood tests requested. The use of quality improvement (QI) tools including process mapping and cause-and-effect diagram identified staff and patient knowledge of monitoring requirements and the lack of an effective recall system as areas for improvement. We tested three change ideas: the utilisation of an existing recall system for long-term therapies; a TRT Ordercomms blood group template (OBGT) to standardise monitoring; and a patient information leaflet (PIL) to improve patient education. The aim of this project was to achieve 60% annual monitoring rate. RESULTS: The percentage of patients monitored for testosterone levels and potential TRT complications increased from 4% (1/26) to 65% (17/26) over a 7-week test period. The utilisation of the existing recall system was a particularly effective intervention, leading to an increase from 4% (1/26) to 31% (8/26) in the first 2 weeks. CONCLUSION: The use of QI tools was associated with over 60% of male TRT patients receiving comprehensive annual monitoring, as per BSSM guidelines. Our findings support the hypothesis that a patient recall system, combined with an OBGT and a PIL led to this increase.


Assuntos
Hipogonadismo , Adulto , Terapia de Reposição Hormonal , Humanos , Hipogonadismo/complicações , Hipogonadismo/tratamento farmacológico , Masculino , Atenção Primária à Saúde , Comportamento Sexual , Testosterona/efeitos adversos
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