Sexual health最新文献

Background: Anal cancer (AC) can cause symptoms such as anal bleeding, pain or lumps. While high-grade squamous intraepithelial lesions (HSIL) are the precursors of AC, scarce information exists regarding its association with anal symptomatology. This study aims to assess anal symptoms and their association with anal squamous intraepithelial lesions (SIL) and HSIL in a Hispanic high-risk population, as well as predictors of anal symptoms.

Methods: Data from the baseline visit of patients attending the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Cancer Center (September 2016-December 2023) was analyzed. AC screening was performed and the presence of seven self-reported anal symptoms were assessed at the clinical visit. Logistic regression analyses were performed to evaluate the association of anal symptoms with HSIL by HIV status, as well as predictors of anal symptoms.

Results: From 872 patients, 69.0% were people living with HIV (PLWH). HSIL prevalence was 41.7%. Prevalence of self-reported anal symptoms was 19.5%; most common symptoms were bleeding (6.6%), pain or discomfort (5.3%) and lump (4.2%). On multivariable adjusted analysis, HSIL was not associated with having anal symptoms. However, current smoking (OR:1.12, 95% CI:1.04-1.20), having hemorrhoids (OR: 1.10, 95% CI: 1.03-1.16) and anal warts (OR: 1.16 (1.18, 95% CI: 1.08-1.24) were associated with higher odds of anal symptoms.

Conclusion: Our results suggest that anal symptoms are not good predictors for HSIL, and that smokers and those with benign anal conditions have increased anal symptomatology. These results highlight the importance of systematic AC screening for prevention and early detection.

Introduction: Neisseria gonorrhoeae (NG) is one of the World Health Organization's high-priority bacterial pathogens due to the emergence of multidrug-resistant strains. The culture of NG remains important for providing antimicrobial resistance surveillance data.

Objective: To determine the NG culture yield following a positive NG nucleic acid amplification test (NAAT) within 30 days, stratified by culture specimen collection sites, the time interval between NAAT and culture, and gender.

Methods: A retrospective data analysis of positive NG NAAT specimens of individuals attending the Melbourne Sexual Health Centre between April 2015 and March 2023. We calculated the NG culture yield within 30 days and stratified by culture specimen collection sites.

Results: The NG culture yield was lowest in pharynx (37.9%, 95% confidence interval [CI] 36.6% to 39.2%, 1,964/5,185) followed by vagina (41.6%, 95% CI 37.0% to 46.3%, 186/447), cervix (60.1%, 95% CI 52.2% to 67.7%, 98/163) and rectum (68.0%, 95% CI 66.6% to 69.3%, 3,223/4,742) and urethra (97.0%, 95% CI 96.4 to 97.6, 3,282/3,382). The overall NG culture yield was 77.8% (95% CI: 76.8% to 78.8%, 5,254/6,754) when the culture was performed on the same date as the NAAT test, and it decreased significantly to 53.6% (95% CI: 51.5% to 55.7%, 1,193/2,224) 1 to 3 days, then to 37.1% (95% CI: 30.7% to 43.7, 83/224) 15 to 30 days after the NAAT positive specimens (ptrend<0.001).

Conclusion: The culture specimen collection sites and time to culture collection influenced the culture yield. NG culture should be performed as close as possible to NAAT testing to improve NG culture yield. In addition, combining molecular resistance testing with culture-based techniques may be necessary to ensure adequate antimicrobial resistance detection.

Background: Secondary distribution of HIV self-testing can expand testing among men who have sex with men. A parent quasi-experimental trial found that sexual health influencers (SHIs) identified by a machine-learning model achieved greater peer uptake than those identified by an empirical scale, but the factors driving distribution effectiveness remain unclear.

Methods: We conducted a secondary analysis of the parent trial (ChiCTR2000039632) in five provinces in southern China. Participants were randomized to either the empirical scale or machine-learning identification arm, and SHIs were then selected within each arm. The current analysis included 196 SHIs with complete follow up. Effective distribution was defined as motivating at least one peer to test. Predictor variables captured sociodemographic, behavioral and network characteristics. Multivariable Poisson LASSO models with multiple imputation and cross-validation estimated adjusted incidence rate ratios (aIRRs).

Results: Among 196 SHIs (mean age 28 years), 46.9% achieved effective distribution. A total of 286 unique peers returned verified HIV self-testing results, of whom 118 (41.3%) were first-time testers. Peer HIV testing was associated with stronger awareness of peers' HIV status (aIRR 1.31; 95% CI 1.16-1.48) and more active sharing of HIV information (aIRR 1.28; 95% CI 1.10-1.50). SHIs who had been accompanied during their own HIV test recruited more newly tested peers (aIRR 1.94; 95% CI 1.12-3.37).

Conclusions: Our data have implications for secondary distribution of HIV self-test kits and suggest the need for capacity strengthening related to peer engagement in HIV self-testing.

Purpose: Traditionally, there has been little emphasis regarding the self-evaluated experience following gender affirmation surgery (GAS). As such, this study aimed to evaluate patient-reported outcomes following vaginoplasty in transgender individuals using a novel and validated Affirming Surgery Form and Function Individual Reporting Measure (AFFIRM-A).

Methods: 279 transgender patients completed the AFFIRM-A survey, reporting on their experiences with feminizing GAS outcomes. Surveys were given to patients via email prior to GAS, at 2 weeks, 6 months, and 12 months postoperatively. Pre and post GAS responses were compared using Wilcoxon signed rank tests. All participants voluntarily completed the same survey using the Vision Tree Platform to eliminate bias.

Results: Prior to GAS, ~3% of respondents reported positive feelings about their genitals, ~18% reported comfort with a sexual partner seeing their genitals, ~1% reported the absence of embarrassment regarding their genitals, and ~1% reported that their genitals matched their gender identity. Six months after surgery, the percentages rose to ~85% (p<0.001), ~77% (p<0.001), 66% (p<0.001), and ~85% (p<0.001) respectively. Prior to GAS, ~78% of respondents reported they could not dress as desired because of the appearance of their genitals and 83% reported the appearance of their genitals prevented them from doing some enjoyable activities. Six months after surgery, the percentages fell to ~3% (p<0.001), and ~7% respectively (p<0.001).

Conclusion: Gender affirming surgeries like vaginoplasty are associated with dramatic quality of life improvement in transgender people. All six gender identity metrics measured by the validated AFFIRM-A survey showed unequivocal benefits following vaginoplasty.

Background: research on pornography use and casual sex has lacked a comprehensive understanding of university women's engagement with such content. To address this gap, we examined pornography use, sexual motives, and hookup behavior among university women in China from a sexual scripting perspective.

Methods: Participants (N = 1242) provided self-reported data on their frequency of pornography viewing, motives for and against sex, and hookup behavior.

Results: The findings showed that pornography consumption was positively associated with hookup behaviors. Pornography use was also positively correlated with all motives for sex and negatively correlated with not ready motives. In turn, hookup behaviors were positively associated with enhancement and coping motives but negatively associated with value and not ready motives. Moreover, some of these motives (e.g., enhancement and not ready) partly explained the link between pornography use and hookup.

Conclusion: These findings underscore the association between pornography use and casual sex engagement among Chinese university women, with specific motives for and against sex playing a relevant role. These insights may help inform targeted sexual health promotion strategies that support autonomy and sexual well-being among Chinese college women.

Background: Intimate partner violence (IPV) remains a critical yet understudied issue among young sexual minority men (YSMM) who use substances, who experience heightened vulnerability due to intersecting forms of stigma, discrimination, and structural marginalization. While previous research has begun to explore the prevalence of IPV among YSMM, most studies have narrowly focused on victimization, often excluding the experiences of perpetration or bidirectional IPV. Moreover, limited attention has been paid to understanding IPV across intersecting racial, ethnic, and sexual identity groups, or to exploring multiple forms of IPV including emotional, physical/sexual, controlling, monitoring, and HIV-related abuse.

Methods: Data were drawn from a racially and ethnically diverse online sample of cisgender YSMM (N = 277) recruited between 2022 and 2024. Participants reported lifetime and past-year experiences of IPV victimization, perpetration, and bidirectional IPV across multiple IPV domains. Sociodemographic characteristics and substance use patterns, including alcohol, tobacco, marijuana, and methamphetamine use, were examined in relation to IPV experiences.

Results: Rates of lifetime IPV were alarmingly high: 69.7% reported victimization, 47.7% reported perpetration, and 44.4% experienced bidirectional IPV. In the past year, 65.0% reported IPV victimization, 43.3% reported perpetration, and 39.4% experienced bidirectional IPV. Emotional and physical/sexual IPV were the most common types. Nearly 40% of participants reported frequent IPV victimization in the past year, with emotional IPV (30.0%) being the most prevalent. Participants identifying as Black, Latino/Hispanic, mixed-race, or bisexual, as well as those with lower educational attainment, reported higher rates of IPV experiences. Alcohol, tobacco, and other drug use including methamphetamine and marijuana use were significantly linked to higher rates of multiple forms of IPV, especially frequent and bidirectional IPV.

Conclusion: These findings highlight the syndemic interplay between substance use and IPV among YSMM. Public health responses must prioritize culturally responsive, trauma-informed interventions that account for the unique developmental and intersectional contexts of this population.

Background Contraception enables reproductive choices, yet little is known about its use by Aboriginal and Torres Strait Islander youth. This study describes contraceptive awareness and use among Aboriginal and Torres Strait Islander youth. Methods We conducted a cross-sectional analysis of baseline data from the 'Next Generation Youth Wellbeing Study' participants aged 16-24 years from Central Australia, Western Australia, and New South Wales. They reported their awareness of contraceptive methods, contraceptive use, and reasons for not using condoms. Results Among the 375 participants, awareness was particularly high for condoms (83%), the oral contraceptive pill (OCP) (78%), and Implanon (77%). Females, older participants, and sexually active participants demonstrated higher awareness. Among 219 participants who were sexually active, 27% reported no contraception at last sex, while 44% used condoms. The most common reasons for not using condoms were using another contraception method (28%), being in a long-term relationship (24%), and not having or liking condoms (22%). After condoms, long-acting reversible contraception was most frequently used, then the OCP. Conclusions Participants had a good awareness of contraceptive options. Understanding how females and sexually active participants became aware may guide initiatives to increase awareness in other groups. Not using contraception was common. Strategies to normalise discussions about contraception, increase health service visits, influence school sex education, and address power imbalances in relationships may increase use. Higher uptake of long-acting reversible contraception over the OCP suggests that Aboriginal and Torres Strait Islander youth may have adopted these more effective contraceptives earlier in time than non-Indigenous youth.

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Background: Sexual health remains an important yet understudied dimension of wellbeing among older adults in Nigeria. This review aimed to synthesize existing evidence on sexual health among Nigerians aged 60 years and above, and to identify gaps in knowledge, policy, and practice. As the country undergoes demographic ageing, addressing the sexual and reproductive health (SRH) needs of this growing population is increasingly urgent. Despite global recognition of sexual health as a lifelong concern, cultural taboos, gender norms, and health system neglect continue to marginalize older adults' sexual wellbeing.

Methods: A systematic review was conducted according to PRISMA 2020 guidelines (PROSPERO: CRD420251064655). Searches were run across PubMed, Web of Science, and Scopus. Peer-reviewed empirical studies were eligible if they reported on sexual activity, dysfunction, satisfaction, condom use, STI and HIV knowledge, or health service use among Nigerian adults aged ≥60 years. Data on these dimensions were abstracted using a structured form, and findings were narratively synthesized through thematic analysis to identify key themes and evidence gaps.

Results: Seventeen studies (2003-2024) met inclusion criteria. Evidence reveals that older Nigerians remain sexually active but face significant barriers to sexual wellbeing. Gendered expectations privilege male sexuality while discouraging female expression. Misconceptions around HIV transmission persist despite widespread awareness, and condom use remains low. Cultural norms and provider discomfort inhibit SRH service uptake, while traditional healers are often preferred for their perceived respectfulness. Older women, rural populations, and those with disabilities remain underrepresented in the literature.

Conclusion: Sexual health in later life in Nigeria is shaped by a complex interplay of cultural norms, structural neglect, and limited policy attention. Integrating age- and gender-sensitive approaches into geriatric care and SRH programming is essential to meet the needs of this growing population.

Purpose - This study explores the potential impact of war on STI services in Lebanon. Design/methodology/approach - Programmatic STI service data from Lebanon were analyzed, alongside a targeted review of the literature on conflict-affected settings, using public health databases covering the period 2014-2024. Findings - Evidence-based STI service packages for conflict settings remain limited. Drawing insights from the COVID-19 crisis, periods of emergencies are associated with an elevated risk of STI surges among key populations. Programmatic data from the conflict further demonstrated this increased risk, reflected in reductions in prevention and early detection activities compared with pre- and post- conflict periods. Self-care and outreach service packages could be critical in these contexts. Practical implications - Community-based organizations (CBOs) should adapt STI services to the wartime environment and evaluate the effectiveness of these interventions post-conflict. CBOs are encouraged to prioritize the implementation of self-care modalities for STI prevention and early detection, expand the availability of telehealth services, and deploy mobile clinics to maximize service continuity. Originality/value - This paper analyzes STI service delivery within the specific context of the Lebanese war. Keywords Lebanon, Sexual health, War, Armed conflict, Community-based organizations Paper type Editorial Conflict of interest The authors declare that there are no conflicts of interest relevant to the content of this editorial.