Rebecca Clarke, Gemma Heath, Jonathan Ross, Claire Farrow
Background: Black ethnic groups are disproportionately affected by sexually transmitted infections (STIs). This review aimed to identify interventions designed to increase engagement with sexual healthcare among people of Black ethnicity as determined by rates of STI testing, adherence to sexual health treatment, and attendance at sexual healthcare consultations. The behaviour change techniques (BCTs) used within identified interventions were evaluated.
Method: Four electronic databases (Web of science; ProQuest; Scopus; PubMed) were systematically searched to identify eligible articles published between 2000 and 2022. Studies were critically appraised using the Mixed Methods Appraisal Tool. Findings were narratively synthesised.
Results: Twenty one studies across two countries were included. Studies included randomised controlled trials and non-randomised designs. Behavioural interventions had the potential to increase STI/HIV testing, sexual healthcare consultation attendance and adherence to sexual health treatment. Behavioural theory underpinned 16 interventions which addressed barriers to engaging with sexual healthcare. Intervention facilitators' demographics and lived experience were frequently matched to those of recipients. The most frequently identified novel BCTs in effective interventions included information about health consequences, instruction on how to perform behaviour, information about social and environmental consequences, framing/reframing, problem solving, and review behavioural goal(s).
Discussion: Our findings highlight the importance of considering sociocultural, structural and socio-economic barriers to increasing engagement with sexual healthcare. Matching the intervention facilitators' demographics and lived experience to intervention recipients may further increase engagement. Examination of different BCT combinations would benefit future sexual health interventions in Black ethnic groups.
{"title":"Interventions supporting engagement with sexual healthcare among people of Black ethnicity: a systematic review of behaviour change techniques.","authors":"Rebecca Clarke, Gemma Heath, Jonathan Ross, Claire Farrow","doi":"10.1071/SH23074","DOIUrl":"10.1071/SH23074","url":null,"abstract":"<p><strong>Background: </strong>Black ethnic groups are disproportionately affected by sexually transmitted infections (STIs). This review aimed to identify interventions designed to increase engagement with sexual healthcare among people of Black ethnicity as determined by rates of STI testing, adherence to sexual health treatment, and attendance at sexual healthcare consultations. The behaviour change techniques (BCTs) used within identified interventions were evaluated.</p><p><strong>Method: </strong>Four electronic databases (Web of science; ProQuest; Scopus; PubMed) were systematically searched to identify eligible articles published between 2000 and 2022. Studies were critically appraised using the Mixed Methods Appraisal Tool. Findings were narratively synthesised.</p><p><strong>Results: </strong>Twenty one studies across two countries were included. Studies included randomised controlled trials and non-randomised designs. Behavioural interventions had the potential to increase STI/HIV testing, sexual healthcare consultation attendance and adherence to sexual health treatment. Behavioural theory underpinned 16 interventions which addressed barriers to engaging with sexual healthcare. Intervention facilitators' demographics and lived experience were frequently matched to those of recipients. The most frequently identified novel BCTs in effective interventions included information about health consequences, instruction on how to perform behaviour, information about social and environmental consequences, framing/reframing, problem solving, and review behavioural goal(s).</p><p><strong>Discussion: </strong>Our findings highlight the importance of considering sociocultural, structural and socio-economic barriers to increasing engagement with sexual healthcare. Matching the intervention facilitators' demographics and lived experience to intervention recipients may further increase engagement. Examination of different BCT combinations would benefit future sexual health interventions in Black ethnic groups.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Females with perinatal HIV (PHIV) infection are at elevated risk for anogenital high-risk human papillomavirus (HR-HPV) infection. Limited data are available around the effect of the HPV vaccination after initiation of sexual activity among PHIV youth. This study aims to assess the impact of a bivalent HPV vaccination on the persistence of anogenital HR-HPV among sexually active female PHIV youth and matched HIV-negative controls aged 12-24years in Thailand and Vietnam.
Methods: During a 3-year study, prevalent, incident, and persistent HR-HPV infection were assessed at annual visits. A subset of participants received a bivalent HPV vaccine. Samples were taken for HPV testing from the vagina, cervix, and anus. HR-HPV persistence was defined as the detection of the same genotype(s) at any anogenital compartment over≥two consecutive visits.
Results: Of the 93 PHIV and 99 HIV-negative female youth enrolled in this study, 25 (27%) PHIV and 22 (22%) HIV-negative youth received a HPV vaccine. Persistent infection with any HR-HPV type was significantly lower among PHIV youth who received the vaccine compared to those who did not (33%vs 61%, P =0.02); a difference was not observed among HIV-negative youth (35%vs 50%, P =0.82). PHIV infection (adjusted prevalence ratio [aPR] 2.31, 95% CI 1.45-3.67) and not receiving a HPV vaccine (aPR, 1.19, 95%CI 1.06-1.33) were associated with persistent anogenital HR-HPV infection.
Conclusions: Bivalent HPV vaccination after initiation of sexual activity was associated with reduced persistence of anogenital HR-HPV infection in Southeast Asian PHIV female youth, which may be related to vaccine cross-protection. Primary and catch-up HPV vaccinations should be prioritised for children and youth with HIV.
{"title":"The effects of bivalent human papillomavirus (HPV) vaccination on high-risk anogenital HPV infection among sexually active female adolescents with and without perinatally acquired HIV.","authors":"Pradthana Ounchanum, Pradthana Ounchanum, Jullapong Achalapong, Jullapong Achalapong, Sirinya Teeraananchai, Sirinya Teeraananchai, Sivaporn Gatechompol, Sivaporn Gatechompol, Wanatpreeya Phongsamart, Wanatpreeya Phongsamart, Kulkanya Chokephaibulkit, Kulkanya Chokephaibulkit, Dan Ngoc Hanh Tran, Dan Ngoc Hanh Tran, Hanh Le Dung Dang, Hanh Le Dung Dang, Nipat Teeratakulpisarn, Nipat Teeratakulpisarn, Amphan Chalermchockcharoenkit, Amphan Chalermchockcharoenkit, Thida Singtoroj, Thida Singtoroj, Annette H Sohn, Annette H Sohn, Nittaya Phanuphak, Nittaya Phanuphak","doi":"10.1071/SH22185","DOIUrl":"10.1071/SH22185","url":null,"abstract":"<p><strong>Background: </strong>Females with perinatal HIV (PHIV) infection are at elevated risk for anogenital high-risk human papillomavirus (HR-HPV) infection. Limited data are available around the effect of the HPV vaccination after initiation of sexual activity among PHIV youth. This study aims to assess the impact of a bivalent HPV vaccination on the persistence of anogenital HR-HPV among sexually active female PHIV youth and matched HIV-negative controls aged 12-24years in Thailand and Vietnam.</p><p><strong>Methods: </strong>During a 3-year study, prevalent, incident, and persistent HR-HPV infection were assessed at annual visits. A subset of participants received a bivalent HPV vaccine. Samples were taken for HPV testing from the vagina, cervix, and anus. HR-HPV persistence was defined as the detection of the same genotype(s) at any anogenital compartment over≥two consecutive visits.</p><p><strong>Results: </strong>Of the 93 PHIV and 99 HIV-negative female youth enrolled in this study, 25 (27%) PHIV and 22 (22%) HIV-negative youth received a HPV vaccine. Persistent infection with any HR-HPV type was significantly lower among PHIV youth who received the vaccine compared to those who did not (33%vs 61%, P =0.02); a difference was not observed among HIV-negative youth (35%vs 50%, P =0.82). PHIV infection (adjusted prevalence ratio [aPR] 2.31, 95% CI 1.45-3.67) and not receiving a HPV vaccine (aPR, 1.19, 95%CI 1.06-1.33) were associated with persistent anogenital HR-HPV infection.</p><p><strong>Conclusions: </strong>Bivalent HPV vaccination after initiation of sexual activity was associated with reduced persistence of anogenital HR-HPV infection in Southeast Asian PHIV female youth, which may be related to vaccine cross-protection. Primary and catch-up HPV vaccinations should be prioritised for children and youth with HIV.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134649820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clara Calvert, Rachel Scott, Melissa Palmer, Albert Dube, Milly Marston, Kaye Wellings, Emma Slaymaker
Background: Knowing levels and determinants of partnership acquisition will help inform interventions that try to reduce transmission of sexually transmitted infections (STIs) including HIV.
Methods: We used population-based, cross-sectional data from 47 Demographic and Health Surveys to calculate rates of partner acquisition among men and women (15-49years), and identified socio-demographic correlates for partner acquisition. Partner acquisition rates were estimated as the total number of acquisitions divided by the person-time in the period covered by the survey. For each survey and by sex, we estimated age-specific partner acquisition rates and used age-adjusted piecewise exponential survival models to explore whether there was any association between wealth, HIV status and partner status with partner acquisition rates.
Results: Across countries, the median partner acquisition rates were 30/100 person-years for men (interquartile range 21-45) and 13/100 person-years for women (interquartile range 6-18). There were substantial variations in partner acquisition rates by age. Associations between wealth and partner acquisition rates varied across countries. People with a cohabiting partner were less likely to acquire a new one, and this effect was stronger for women than men and varied substantially between countries. Women living with HIV had higher partner acquisition rates than HIV-negative women but this association was less apparent for men. At a population level, partner acquisition rates were correlated with HIV incidence.
Conclusions: Partner acquisition rates are variable and are associated with important correlates of STIs and thus could be used to identify groups at high risk of STIs.
{"title":"Rates of sexual partner acquisition from nationally representative surveys: variation between countries and by age, sex, wealth, partner and HIV status.","authors":"Clara Calvert, Rachel Scott, Melissa Palmer, Albert Dube, Milly Marston, Kaye Wellings, Emma Slaymaker","doi":"10.1071/SH23134","DOIUrl":"10.1071/SH23134","url":null,"abstract":"<p><strong>Background: </strong>Knowing levels and determinants of partnership acquisition will help inform interventions that try to reduce transmission of sexually transmitted infections (STIs) including HIV.</p><p><strong>Methods: </strong>We used population-based, cross-sectional data from 47 Demographic and Health Surveys to calculate rates of partner acquisition among men and women (15-49years), and identified socio-demographic correlates for partner acquisition. Partner acquisition rates were estimated as the total number of acquisitions divided by the person-time in the period covered by the survey. For each survey and by sex, we estimated age-specific partner acquisition rates and used age-adjusted piecewise exponential survival models to explore whether there was any association between wealth, HIV status and partner status with partner acquisition rates.</p><p><strong>Results: </strong>Across countries, the median partner acquisition rates were 30/100 person-years for men (interquartile range 21-45) and 13/100 person-years for women (interquartile range 6-18). There were substantial variations in partner acquisition rates by age. Associations between wealth and partner acquisition rates varied across countries. People with a cohabiting partner were less likely to acquire a new one, and this effect was stronger for women than men and varied substantially between countries. Women living with HIV had higher partner acquisition rates than HIV-negative women but this association was less apparent for men. At a population level, partner acquisition rates were correlated with HIV incidence.</p><p><strong>Conclusions: </strong>Partner acquisition rates are variable and are associated with important correlates of STIs and thus could be used to identify groups at high risk of STIs.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bernard Saliba, Melissa Kang, Nathanael Wells, Limin Mao, Garrett Prestage, Mohamed A Hammoud
Background: Strategies pertaining to HIV and sexual health for gay, bisexual, and other men who have sex with men (GBMSM) have shifted focus towards underrepresented subgroups within some developed Western countries. Although emerging research exists on some subgroups, limited attention has been given to the needs of Arab GBMSM in these contexts. Considering they are part of a large diaspora, understanding their access to services is crucial. This paper focuses on Arab GBMSM as a case study within a scoping review, highlighting their hidden status within the broader landscape of HIV and sexual health research for GBMSM in the West.
Methods: A multi-method search strategy was employed, including searching four electronic databases using several terms within each of the following search topics: Arab, GBMSM, HIV and other sexual health services, and developed Western countries.
Results: Of the 384 articles found, only one addressed the research question and met the inclusion criteria, revealing a stark scarcity of research on access to HIV and sexual health services for this population.
Conclusions: This review highlights a paucity of research on access to HIV and sexual health services for underrepresented GBMSM populations in developed Western countries. The literature indicates that, for Arab men, this may be due to a difficulty in participant recruitment and poor data collection efforts. By focusing on one hidden population, we aim to advocate for inclusive policies and interventions that promote equitable sexual health access for all. Addressing this research gap aligns with broader local and global HIV strategies to reduce disparities among underrepresented GBMSM populations.
背景:针对男同性恋、双性恋和其他男男性行为者(GBMSM)的艾滋病和性健康战略已将重点转向一些西方发达国家中代表性不足的亚群体。虽然针对某些亚群体的研究正在兴起,但在这些情况下,对阿拉伯男同性恋、双性恋和其他男男性行为者(GBMSM)需求的关注还很有限。考虑到他们是大量散居国外者的一部分,了解他们获得服务的情况至关重要。本文以阿拉伯 GBMSM 为案例,进行了一次范围界定研究,强调了他们在针对西方 GBMSM 的 HIV 和性健康研究中的隐蔽地位:本文采用了多种方法的检索策略,包括使用以下检索主题中的多个术语检索四个电子数据库:阿拉伯、GBMSM、HIV 和其他性健康服务以及西方发达国家:结果:在找到的 384 篇文章中,仅有一篇涉及研究问题并符合纳入标准,这表明有关该人群获得 HIV 和性健康服务的研究十分匮乏:本综述强调了西方发达国家对代表性不足的 GBMSM 群体获得 HIV 和性健康服务的研究极少。文献表明,对于阿拉伯男性而言,这可能是由于参与者招募困难和数据收集工作不力造成的。通过关注一个隐性人群,我们旨在倡导包容性政策和干预措施,促进所有人公平地获得性健康服务。解决这一研究缺口与更广泛的地方和全球艾滋病战略相一致,以减少代表性不足的 GBMSM 群体中的差异。
{"title":"Hiding in plain sight: highlighting the research gap on access to HIV and other sexual health services for underrepresented gay men in developed Western countries - insights from a scoping review with a focus on Arab men.","authors":"Bernard Saliba, Melissa Kang, Nathanael Wells, Limin Mao, Garrett Prestage, Mohamed A Hammoud","doi":"10.1071/SH23131","DOIUrl":"10.1071/SH23131","url":null,"abstract":"<p><strong>Background: </strong>Strategies pertaining to HIV and sexual health for gay, bisexual, and other men who have sex with men (GBMSM) have shifted focus towards underrepresented subgroups within some developed Western countries. Although emerging research exists on some subgroups, limited attention has been given to the needs of Arab GBMSM in these contexts. Considering they are part of a large diaspora, understanding their access to services is crucial. This paper focuses on Arab GBMSM as a case study within a scoping review, highlighting their hidden status within the broader landscape of HIV and sexual health research for GBMSM in the West.</p><p><strong>Methods: </strong>A multi-method search strategy was employed, including searching four electronic databases using several terms within each of the following search topics: Arab, GBMSM, HIV and other sexual health services, and developed Western countries.</p><p><strong>Results: </strong>Of the 384 articles found, only one addressed the research question and met the inclusion criteria, revealing a stark scarcity of research on access to HIV and sexual health services for this population.</p><p><strong>Conclusions: </strong>This review highlights a paucity of research on access to HIV and sexual health services for underrepresented GBMSM populations in developed Western countries. The literature indicates that, for Arab men, this may be due to a difficulty in participant recruitment and poor data collection efforts. By focusing on one hidden population, we aim to advocate for inclusive policies and interventions that promote equitable sexual health access for all. Addressing this research gap aligns with broader local and global HIV strategies to reduce disparities among underrepresented GBMSM populations.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lily Moor, Joel R Anderson, Jennifer Power, Alexandra James, Andrea Waling, Nicole Shackleton
Background: Technologies such as the Internet, smartphones, and sex toys have demonstrated the capacity to facilitate and enhance sexual and intimate practice by offering new ways to meet sexual partners, maintain and establish intimate connections, and providing access to sexual education and exposure to new ways of engaging in sex. They have also afforded novel risks to safety, privacy, and sexual autonomy. Understanding how people perceive and experience both the risks and benefits of using technology to facilitate sex and intimacy is important to understanding contemporary sexual practice, health, and pleasure. However, research in this space is currently hampered by a lack of quantitative measures to accurately and holistically assess both the risks and benefits in the context of technologised sexual practices.
Methods: To facilitate a nuanced quantitative exploration of these concepts, we present the psychometric properties of the newly developed Risks and Benefits of Technologised Sexual Practice Scale .
Results: Using an exploratory (Study 1, n =445) and confirmatory factor analysis (Study 2, n =500), this paper presents evidence for a 6-factor scale (Benefits (3): 'sexual gratification', 'connection', and 'access to information and culture'; Risks (3): 'concerns', 'worries', and 'knowledge of rights and ownership').
Conclusion: This scale may be used to contribute to research areas including sexual health, sexual behaviour, sexual education, online connection, online safety, and digital literacy with the aim to contribute to a sex- and technology-positive framework for understanding sexual health and pleasure.
{"title":"The risks and benefits of technologised sexual practice scale: a quantitative measure of technology facilitated sex and intimacy.","authors":"Lily Moor, Joel R Anderson, Jennifer Power, Alexandra James, Andrea Waling, Nicole Shackleton","doi":"10.1071/SH23034","DOIUrl":"10.1071/SH23034","url":null,"abstract":"<p><strong>Background: </strong>Technologies such as the Internet, smartphones, and sex toys have demonstrated the capacity to facilitate and enhance sexual and intimate practice by offering new ways to meet sexual partners, maintain and establish intimate connections, and providing access to sexual education and exposure to new ways of engaging in sex. They have also afforded novel risks to safety, privacy, and sexual autonomy. Understanding how people perceive and experience both the risks and benefits of using technology to facilitate sex and intimacy is important to understanding contemporary sexual practice, health, and pleasure. However, research in this space is currently hampered by a lack of quantitative measures to accurately and holistically assess both the risks and benefits in the context of technologised sexual practices.</p><p><strong>Methods: </strong>To facilitate a nuanced quantitative exploration of these concepts, we present the psychometric properties of the newly developed Risks and Benefits of Technologised Sexual Practice Scale .</p><p><strong>Results: </strong>Using an exploratory (Study 1, n =445) and confirmatory factor analysis (Study 2, n =500), this paper presents evidence for a 6-factor scale (Benefits (3): 'sexual gratification', 'connection', and 'access to information and culture'; Risks (3): 'concerns', 'worries', and 'knowledge of rights and ownership').</p><p><strong>Conclusion: </strong>This scale may be used to contribute to research areas including sexual health, sexual behaviour, sexual education, online connection, online safety, and digital literacy with the aim to contribute to a sex- and technology-positive framework for understanding sexual health and pleasure.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134649821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: When demand for counselling in community-based clinics exceeds capacity, waiting lists are typically formed. Determining allocation priority solely on wait time can overlook client risk factors that can elevate priority. We undertook to rigorously adapt the only existing validated counselling triage tool, to better fit the sexual health setting.
Methods: Sexual health counsellors were surveyed about aspects of client presentations that flagged increased priority. The revised Client Priority Rating Scale (CPRS-R) was created through systematic analysis and decision making, informed by survey results and literature review. Four expert sexual health counsellors independently rated the priority of 14 hypothetical clinical vignettes using the CPRS and CPRS-R.
Results: Criterion (concurrent), content and face validity are evidenced in the revised scale. Average interrater agreement was higher on the CPRS-R (28%) than the CPRS (11%); however, this difference was marginal (P =0.06). According to Gwet's Agreement Coefficient (AC) and Krippendorff's Alpha, both the CPRS and the CPRS-R demonstrate comparable interrater reliability, substantial and moderate, respectively. Kendall's W indicates the CPRS yielded higher reliability. However, the difference is not substantial.
Conclusions: The CPRS-R is a triage tool designed for the sexual health counselling setting. This tool has demonstrated criterion, content and face validity, as well as moderate to substantial inter-rater reliability. It can be used in sexual health settings to inform assessments about client priority, along with clinical judgement and peer consultation.
{"title":"Adapting the Client Priority Rating Scale to better fit the sexual health counselling setting: a quality improvement study.","authors":"Katherine Coote, Fiona O'Neill, Eve Slavich","doi":"10.1071/SH23171","DOIUrl":"10.1071/SH23171","url":null,"abstract":"<p><strong>Background: </strong>When demand for counselling in community-based clinics exceeds capacity, waiting lists are typically formed. Determining allocation priority solely on wait time can overlook client risk factors that can elevate priority. We undertook to rigorously adapt the only existing validated counselling triage tool, to better fit the sexual health setting.</p><p><strong>Methods: </strong>Sexual health counsellors were surveyed about aspects of client presentations that flagged increased priority. The revised Client Priority Rating Scale (CPRS-R) was created through systematic analysis and decision making, informed by survey results and literature review. Four expert sexual health counsellors independently rated the priority of 14 hypothetical clinical vignettes using the CPRS and CPRS-R.</p><p><strong>Results: </strong>Criterion (concurrent), content and face validity are evidenced in the revised scale. Average interrater agreement was higher on the CPRS-R (28%) than the CPRS (11%); however, this difference was marginal (P =0.06). According to Gwet's Agreement Coefficient (AC) and Krippendorff's Alpha, both the CPRS and the CPRS-R demonstrate comparable interrater reliability, substantial and moderate, respectively. Kendall's W indicates the CPRS yielded higher reliability. However, the difference is not substantial.</p><p><strong>Conclusions: </strong>The CPRS-R is a triage tool designed for the sexual health counselling setting. This tool has demonstrated criterion, content and face validity, as well as moderate to substantial inter-rater reliability. It can be used in sexual health settings to inform assessments about client priority, along with clinical judgement and peer consultation.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca L Fix, Colleen S Walsh, Ashli J Sheidow, Michael R McCart, Jason E Chapman, Tess K Drazdowski
Background: Risky sexual behaviour (RSB) is a serious public health problem for adolescents. We examined whether a contingency management intervention implemented by juvenile probation officers (JPOs) targeting substance use also impacted RSB.
Methods: A total of 218 adolescents on probation were randomly assigned to contingency management or to probation as usual.
Results: The substance use intervention delivered by JPOs reduced rates of RSB over time (β =-0.32, P =0.041 at 6months; β =-0.32, P =0.036 at 9months).
Conclusions: Adolescents receiving a substance use intervention from JPOs demonstrated reduced/prevented RSB. Interventions targeting single risk behaviours in juvenile probation populations should measure changes in other risk behaviours . Under-resourced communities lacking clinicians might consider JPOs delivering interventions.
{"title":"Juvenile probation officers delivering an intervention for substance use significantly reduces adolescents' risky sexual behaviours.","authors":"Rebecca L Fix, Colleen S Walsh, Ashli J Sheidow, Michael R McCart, Jason E Chapman, Tess K Drazdowski","doi":"10.1071/SH23181","DOIUrl":"10.1071/SH23181","url":null,"abstract":"<p><strong>Background: </strong>Risky sexual behaviour (RSB) is a serious public health problem for adolescents. We examined whether a contingency management intervention implemented by juvenile probation officers (JPOs) targeting substance use also impacted RSB.</p><p><strong>Methods: </strong>A total of 218 adolescents on probation were randomly assigned to contingency management or to probation as usual.</p><p><strong>Results: </strong>The substance use intervention delivered by JPOs reduced rates of RSB over time (β =-0.32, P =0.041 at 6months; β =-0.32, P =0.036 at 9months).</p><p><strong>Conclusions: </strong>Adolescents receiving a substance use intervention from JPOs demonstrated reduced/prevented RSB. Interventions targeting single risk behaviours in juvenile probation populations should measure changes in other risk behaviours . Under-resourced communities lacking clinicians might consider JPOs delivering interventions.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11162195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mina Saadat, Afsaneh Keramat, Ali Mohammad Nazari, Hadi Ranjbar, Shayesteh Jahanfar, Zahra Motaghi
Background: This study aimed to examine the experiences of transgender women who work in the sex industry regarding their access to health care facilities for sexual health. Transgender women sex workers are recognised worldwide as a high-risk group for HIV and sexually transmitted infections (STIs).
Methods: In Iran, between January and May 2022, we employed a snowball sampling technique to recruit a diverse group of 22 transgender women sex workers aged 19-42 years. Semi-structured interviews were conducted with these participants to provide insights into their experiences with accessing sexual health care.
Results: The data was analysed using thematic analysis, revealing four overarching themes: experiences of violence, contextual barriers to health, socioeconomic challenges and HIV/STI risk practices, and 11 sub-themes. The results demonstrate that many participants experienced difficulties in accessing sexual health services due to violence, discrimination, financial difficulties and lack of awareness about STIs.
Conclusion: Sex workers face extraordinarily challenging occupational risks, including sexual and physical abuse, mental health issues, and HIV and STIs. Targeted public intervention programs and research for this group are urgently needed. Outreach programs engaging with underserved transgender women sex workers have the potential to enhance access to healthcare services, and contribute to the reduction of HIV transmission rates.
{"title":"Transgender women sex workers' experiences accessing sexual health care in Iran: a qualitative study.","authors":"Mina Saadat, Afsaneh Keramat, Ali Mohammad Nazari, Hadi Ranjbar, Shayesteh Jahanfar, Zahra Motaghi","doi":"10.1071/SH23113","DOIUrl":"10.1071/SH23113","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to examine the experiences of transgender women who work in the sex industry regarding their access to health care facilities for sexual health. Transgender women sex workers are recognised worldwide as a high-risk group for HIV and sexually transmitted infections (STIs).</p><p><strong>Methods: </strong>In Iran, between January and May 2022, we employed a snowball sampling technique to recruit a diverse group of 22 transgender women sex workers aged 19-42 years. Semi-structured interviews were conducted with these participants to provide insights into their experiences with accessing sexual health care.</p><p><strong>Results: </strong>The data was analysed using thematic analysis, revealing four overarching themes: experiences of violence, contextual barriers to health, socioeconomic challenges and HIV/STI risk practices, and 11 sub-themes. The results demonstrate that many participants experienced difficulties in accessing sexual health services due to violence, discrimination, financial difficulties and lack of awareness about STIs.</p><p><strong>Conclusion: </strong>Sex workers face extraordinarily challenging occupational risks, including sexual and physical abuse, mental health issues, and HIV and STIs. Targeted public intervention programs and research for this group are urgently needed. Outreach programs engaging with underserved transgender women sex workers have the potential to enhance access to healthcare services, and contribute to the reduction of HIV transmission rates.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephanie C Munari, Anna L Wilkinson, Jason Asselin, Louise Owen, Phillip Read, Robert Finlayson, Sarah Martin, Charlotte Bell, Catherine C O'Connor, Allison Carter, Rebecca Guy, Anna McNulty, Rick Varma, Eric P F Chow, Christopher K Fairley, Basil Donovan, Mark Stoove, Jane L Goller, Jane Hocking, Margaret E Hellard
Background: Chlamydia remains the most notified bacterial sexually transmissible infection in Australia with guidelines recommending testing for re-infection at 3months post treatment. This paper aimed to determine chlamydia retesting and repeat positivity rates within 2-4months among young women in Australia, and to evaluate what factors increase or decrease the likelihood of retesting.
Methods: Chlamydia retesting rates among 16-29-year-old women were analysed from Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of sexually transmissible infection and bloodborne virus (ACCESS) sentinel surveillance data (n =62 sites). Among women with at least one positive test between 1 January 2018 and 31 August 2022, retesting counts and proportions within 2-4months were calculated. Logistic regression was performed to assess factors associated with retesting within 2-4months.
Results: Among 8758 women who were positive before 31 August 2022 to allow time for follow up, 1423 (16.2%) were retested within 2-4months, of whom 179 (12.6%) tested positive. The odds of retesting within 2-4months were 25% lower if tested in a coronavirus disease 2019 (COVID-9) pandemic year (2020-2022) (aOR=0.75; 95% CI 0.59-0.95). Among 9140 women with a positive test before 30 November 2022, 397 (4.3%) were retested too early (within 7days to 1month) and 81 (20.4%) of those were positive.
Conclusions: Chlamydia retesting rates remain low with around a sixth of women retested within 2-4months in line with guidelines. Re-infection is common with around one in eight retesting positive. An increase in retesting is required to reduce the risk of reproductive complications and onward transmission.
{"title":"Chlamydia retesting remains low among young women in Australia: an observational study using sentinel surveillance data, 2018-2022.","authors":"Stephanie C Munari, Anna L Wilkinson, Jason Asselin, Louise Owen, Phillip Read, Robert Finlayson, Sarah Martin, Charlotte Bell, Catherine C O'Connor, Allison Carter, Rebecca Guy, Anna McNulty, Rick Varma, Eric P F Chow, Christopher K Fairley, Basil Donovan, Mark Stoove, Jane L Goller, Jane Hocking, Margaret E Hellard","doi":"10.1071/SH23178","DOIUrl":"10.1071/SH23178","url":null,"abstract":"<p><strong>Background: </strong>Chlamydia remains the most notified bacterial sexually transmissible infection in Australia with guidelines recommending testing for re-infection at 3months post treatment. This paper aimed to determine chlamydia retesting and repeat positivity rates within 2-4months among young women in Australia, and to evaluate what factors increase or decrease the likelihood of retesting.</p><p><strong>Methods: </strong>Chlamydia retesting rates among 16-29-year-old women were analysed from Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of sexually transmissible infection and bloodborne virus (ACCESS) sentinel surveillance data (n =62 sites). Among women with at least one positive test between 1 January 2018 and 31 August 2022, retesting counts and proportions within 2-4months were calculated. Logistic regression was performed to assess factors associated with retesting within 2-4months.</p><p><strong>Results: </strong>Among 8758 women who were positive before 31 August 2022 to allow time for follow up, 1423 (16.2%) were retested within 2-4months, of whom 179 (12.6%) tested positive. The odds of retesting within 2-4months were 25% lower if tested in a coronavirus disease 2019 (COVID-9) pandemic year (2020-2022) (aOR=0.75; 95% CI 0.59-0.95). Among 9140 women with a positive test before 30 November 2022, 397 (4.3%) were retested too early (within 7days to 1month) and 81 (20.4%) of those were positive.</p><p><strong>Conclusions: </strong>Chlamydia retesting rates remain low with around a sixth of women retested within 2-4months in line with guidelines. Re-infection is common with around one in eight retesting positive. An increase in retesting is required to reduce the risk of reproductive complications and onward transmission.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joanne Peel, Joshua Brousse de Gersigny, Richard Teague, Jayne Howard, Catriona Bradshaw, Marcus Chen, Melanie Bissessor
Background: Women living with HIV are a minority population with unique care needs. Rates of unintended pregnancy are higher among women living with HIV versus HIV negative women. However, uptake of contraception among women living with HIV including long-acting-reversible contraceptives (LARCs) remains low. This quality improvement project aimed to identify gaps in reproductive healthcare for women living with HIV attending Melbourne Sexual Health Centre (MSHC).
Methods: We performed a retrospective review of women living with HIV attending MSHC for HIV care February 2019-February 2020. Women aged over 45years were excluded. Primary outcomes included proportion using contraception, methods used and whether a sexual or reproductive health history had been taken in the past year.
Results: A total of 100 women were included, predominantly born overseas (Asia, 38%; sub-Saharan Africa, 34%). Of these, 5% were pregnant, 16% were trying to conceive and 1% were undergoing elective oocyte preservation. Of the remaining 74 women, 48.6% were using any form of contraception, including 17.6% women using less-effective methods (withdrawal and condoms), 6.8% using the combined oral contraceptive pill, 18.9% using LARCs and 5.4% using permanent methods. Sexual activity status was documented for 61% women, 1% declined to answer and not documented for 38% women.
Conclusions: Rate of contraceptive use in this study was lower than previously reported among women living with HIV in Australia; however, our findings suggest contraceptive methods may be changing in light of undetectable equals untransmittable and increased fertility desires. Discussions regarding sexual activity and reproductive health were limited. Mechanisms to increase clinician-patient discourse regarding these important issues should be explored.
背景:感染艾滋病毒的妇女是少数群体,有独特的护理需求。与 HIV 阴性女性相比,感染 HIV 的女性意外怀孕率更高。然而,感染艾滋病病毒的妇女对包括长效可逆避孕药在内的避孕措施的接受程度仍然很低。本质量改进项目旨在找出墨尔本性健康中心(MSHC)为女性艾滋病感染者提供的生殖健康保健服务中存在的不足:我们对 2019 年 2 月至 2020 年 2 月在 MSHC 接受 HIV 护理的女性 HIV 感染者进行了回顾性审查。年龄超过 45 岁的女性被排除在外。主要结果包括使用避孕药具的比例、使用的方法以及过去一年中是否有性健康或生殖健康史:共纳入 100 名妇女,她们主要出生在海外(亚洲 38%;撒哈拉以南非洲 34%)。其中,5%已经怀孕,16%正在尝试怀孕,1%正在进行选择性卵细胞保存。在剩余的 74 名妇女中,48.6% 的妇女使用任何形式的避孕方法,其中 17.6%的妇女使用效果较差的方法(体外射精和避孕套),6.8% 的妇女使用复方口服避孕药,18.9% 的妇女使用 LARCs,5.4% 的妇女使用永久性方法。61%的妇女记录了性活动情况,1%的妇女拒绝回答,38%的妇女没有记录:本研究中,澳大利亚感染艾滋病毒的妇女使用避孕药具的比例低于之前的报告;然而,我们的研究结果表明,鉴于检测不到等同于不会传播以及生育愿望的增加,避孕方法可能会发生变化。有关性活动和生殖健康的讨论非常有限。应探索增加临床医生与患者就这些重要问题进行讨论的机制。
{"title":"Reproductive health among women living with HIV attending Melbourne Sexual Health Centre for HIV care from February 2019 to February 2020.","authors":"Joanne Peel, Joshua Brousse de Gersigny, Richard Teague, Jayne Howard, Catriona Bradshaw, Marcus Chen, Melanie Bissessor","doi":"10.1071/SH23122","DOIUrl":"10.1071/SH23122","url":null,"abstract":"<p><strong>Background: </strong>Women living with HIV are a minority population with unique care needs. Rates of unintended pregnancy are higher among women living with HIV versus HIV negative women. However, uptake of contraception among women living with HIV including long-acting-reversible contraceptives (LARCs) remains low. This quality improvement project aimed to identify gaps in reproductive healthcare for women living with HIV attending Melbourne Sexual Health Centre (MSHC).</p><p><strong>Methods: </strong>We performed a retrospective review of women living with HIV attending MSHC for HIV care February 2019-February 2020. Women aged over 45years were excluded. Primary outcomes included proportion using contraception, methods used and whether a sexual or reproductive health history had been taken in the past year.</p><p><strong>Results: </strong>A total of 100 women were included, predominantly born overseas (Asia, 38%; sub-Saharan Africa, 34%). Of these, 5% were pregnant, 16% were trying to conceive and 1% were undergoing elective oocyte preservation. Of the remaining 74 women, 48.6% were using any form of contraception, including 17.6% women using less-effective methods (withdrawal and condoms), 6.8% using the combined oral contraceptive pill, 18.9% using LARCs and 5.4% using permanent methods. Sexual activity status was documented for 61% women, 1% declined to answer and not documented for 38% women.</p><p><strong>Conclusions: </strong>Rate of contraceptive use in this study was lower than previously reported among women living with HIV in Australia; however, our findings suggest contraceptive methods may be changing in light of undetectable equals untransmittable and increased fertility desires. Discussions regarding sexual activity and reproductive health were limited. Mechanisms to increase clinician-patient discourse regarding these important issues should be explored.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}