Sexual health最新文献

Background Data on persistent use of HIV pre-exposure prophylaxis (PrEP) is limited among Chinese men who have sex with men (MSM). This study aimed to explore factors associated with the re-initiation of PrEP among Chinese MSM from a longitudinal PrEP demonstration trial. Methods A multi-center cohort study was conducted in Guangzhou and Wuhan, China (September 2021-2024), providing 1134 MSM participants with a 12-month dosage of tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) as oral PrEP. Following the trial, a subgroup of participants were invited to complete a 3-month post-trial follow-up survey. These participants were categorized on the basis of self-reported PrEP use patterns into (1) continued PrEP use, (2) discontinued without re-initiation, and (3) re-initiated after discontinuation. Log-binomial regression models were used to assess factors associated with PrEP re-initiation. Results Out of 408 participants who completed the 3-month post-trial follow-up survey, 70.1% (n =286/408) reported discontinuing PrEP, and 50.7% (n =145/286) of those who discontinued subsequently re-initiated PrEP. Participants who had concurrent sexual partnerships (adjusted risk ratio [aRR]=1.47, 95% CI: 1.11-1.96), used drugs during sex (aRR=1.34, 95% CI: 1.09-1.65), or lived alone (aRR=1.29, 95% CI: 1.03-1.61) were more likely to re-initiate PrEP. The Likert scale analysis indicated that perceived partner influence, specifically the expectation of condomless sex, played a significant role in re-initiation decisions (P =0.03). Conclusion Individuals engaging in higher-risk behaviors are more likely to re-initiate PrEP, highlighting the dynamic nature of risk perception. Future interventions should focus on promoting both re-initiation and consistent condom use, emphasizing partner-related dynamics and substance use as key factors in PrEP decisions among MSM.

Background Sexually transmitted infections (STIs) other than HIV are a major public health concern globally. The goal of this study is to analyse the trends of the five most common STIs; chlamydia, gonococcal infection, trichomoniasis, genital herpes and syphilis in India and its states from 1990 to 2019. Methods We extracted data pertaining to STIs from the Global Burden of Disease study, 2019 (GBD 2019), and analysed the burden of disease based on individual STI, for both sexes, across multiple age groups, and for each state and union territory of India. Results Incidence of STIs increased by 82.79% from 54.64million in 1990 to 99.88million in 2019, and disability-adjusted life years decreased by 48.66% from 1.51million to 0.77million, which is primarily attributed to a decline in disability-adjusted life years for syphilis. The incidence was higher in men compared to women. The incidence rate for chlamydia, trichomoniasis and genital herpes increased, the incidence rate for syphilis declined, whereas the incidence rate for gonococcal infection did not show any substantial change. Most of the disability-adjusted life years and deaths in 2019 were contributed by syphilis. Conclusion The burden of STIs in India is substantial and calls for comprehensive efforts to stem the tide of increasing incidence of STIs. Enhancing surveillance, increasing awareness and targeted control programs are recommended for the affected populations.

Background China implemented extensive non-pharmaceutical interventions (NPIs) to contain COVID-19. Methods National and provincial data on monthly reported HIV and AIDS cases from January 2017 to December 2020 were collected from the National Health Commission of the People's Republic of China. We used interrupted time series analysis to assess whether COVID-19-related NPIs had an impact on reported HIV and AIDS cases in 31 provinces in China, and estimated underreported numbers of HIV and AIDS cases in the first month of the COVID-19 pandemic. Results A total of 393,357 HIV cases and 254,735 AIDS cases were recorded in China from January 2017 to December 2020. Nationally, the number of reported HIV cases decreased by 25.1% in the first month of the NPIs period (January 2020) compared with the counterfactual (incidence rate ratio (IRR) 0.749; 95% confidence interval (CI) 0.664-0.845), whereas the number of reported AIDS cases decreased by 36.5% (IRR 0.635, 95% CI 0.543-0.741). An estimated 2208 HIV cases (95% CI 1209-3335) and 1525 AIDS cases (95% CI 927-2233) were underdiagnosed and underreported in the first month of the NPIs in China. The highest numbers of underdiagnosed and underreported HIV cases in the first month of NPIs were estimated in Sichuan (IRR 577, 95% CI 239-978), Guangdong (IRR 185, 95% CI 170-200) and Henan (IRR 170, 95% CI 77-286). Conclusions There was substantial underdiagnosis and underreporting of HIV and AIDS cases during the first month of the COVID-19 pandemic in China and certain provinces. Health departments should consider the specific barriers encountered during the pandemic, such as disrupted healthcare access and resource limitations, and implement targeted strategies to strengthen HIV surveillance and report systems.

Background In the United States, many residents and fellows lack confidence in their ability to confidentially counsel adolescents regarding sexual health topics. Little is known about how personal and professional experiences may affect medical residents' and fellows' confidence in counselling adolescents about sexual health services. Methods We invited 361 residents and fellows (trainees) from paediatric, obstetrics and gynaecology, as well as family medicine programs at an academic medical centre in Texas to complete a survey about confidence in counselling about sexual health services. We describe respondents' demographics, medical training, personal sexual healthcare experiences, and confidence in confidential care and STI management measured on a four-point Likert scale. We calculated average confidence scores, dichotomised responses into confident (≥3 points) and not-so-confident ( Results Among 228 trainees (63% response rate), 54% were confident in confidential care and 81% were confident in STI management. Those who received training in aspects of confidential care and STI management reported significantly greater confidence in many of these areas. Respondents who recalled private discussions with their personal healthcare provider as an adolescent reported confidence in STI management (P =0.02) compared to those who did not have that experience. Conclusions Medical training should focus on communication training to address gaps in confidence, particularly regarding adolescent confidentiality. Clinicians' personal experiences may impact aspects of confidence, highlighting the importance of encouraging trainees to reflect on how their background might influence their clinical practice.

Background Despite its integral role in preventing and controlling infectious diseases, there is limited research that evaluates the impact of disease investigation (DI) services. The County of Santa Clara Public Health Department activated its emergency response operations, which included designated DI services, to respond to its local Mpox outbreak. The aim of this evaluation was to understand the range of outcomes achieved through Mpox DI services. Methods Mpox investigations completed between June and December 2022 were included in an evaluation that employed a composite measure to calculate the number of investigations needed to achieve the following outcomes: (1) treatment completion, (2) monitoring completion, (3) partial vaccine dose completion, (4) full vaccination series completion, and (5) STI and HIV testing. Results The overall composite score of 0.53 indicated that each investigation led to 1.90 outcomes achieved. Among cases eligible for treatment, 2.16 investigations yielded one treatment completion; 1.19 case and contact investigations yielded one monitoring completion; 2.21 and 3.53 contact investigations yielded one partial vaccine dose completion and one full vaccination series completion, respectively; and 2.25 case and contact investigations yielded one STI or HIV test. Conclusion Recognizing the multiple steps involved in DI can inform holistic evaluations that illuminate intervention impact.

Background Sexual health and functioning outcomes have been shown to be poor among veterans due to factors associated with military service, as well as barriers to healthcare access. However, there is currently limited research attempting to assess the scope and extent of these issues in the Australian context. Methods Ten qualitative, semi-structured interviews were conducted with Australian professionals working within or adjacent to veteran sexual health and were analysed using inductive thematic analysis. Results Sexual health and functioning issues commonly develop among Australian veterans due to a variety of physical, psychological and social factors. Factors include mental ill-health, physical illness and injury, use of medication, and relationship strain. These contribute to physiological dysfunctions, poor sexual behaviours and difficulties in forming healthy, meaningful intimate relationships. Barriers, such as lack of awareness and understanding, stigma, and structural barriers, were suggested to interfere with healthcare access and worsen outcomes. Key informants recommended increasing provider training, research and military support, as well as de-stigmatising sexual health issues. Conclusions Veteran sexual health is not often on the radar of Australian health and research professionals. Our study is one of few studies in the Australian context, highlighting the need to conduct more research to better manage veteran sexual health and functioning needs.

Background There is a co-occurrence of adolescents' substance use and sexual practices, with an important impact on their health and health behaviours; however, limited research is conducted with adolescents. The aim of this study was to estimate the prevalence of substance use (alcohol and/or other substances) in sexual contexts and to identify its associated factors among adolescents, comparing boys and girls. Methods Cross-sectional study with data from 6352 adolescents aged 14----18years from the DESKcohort project. Prevalence of alcohol and/or other substance use in sexual contexts (OSUSC) stratified by sex were calculated, according to axes of inequality, psychosocial factors, and sexual health and health variables. Poisson regression models with robust variance were calculated to analyse potential associations with independent variables. Results Girls (51.4% of the sample) reported a higher prevalence of alcohol use in sexual contexts than boys (43.9% vs 33.9%, P Conclusions These findings suggest that substance use in sexual contexts reflects a broader pattern of co-occurring risky behaviours rather than intentional sexualised substance use. Some vulnerable groups include girls, adolescents with a minority sexual orientation, and students with disadvantaged SEPs. These findings underscore the need for holistic interventions targeting adolescents' health, addressing substance use and sexual risk behaviours simultaneously to reduce potential consequences such as unplanned pregnancies and sexually transmitted infections.

Background Untreated sexually transmissible infections (STIs) such as Chlamydia trachomatis and Neisseria gonorrhoeae can lead to serious health issues, including pelvic inflammatory disease, infertility in women, increased HIV risk, and emotional distress. Timely testing and treatment are crucial for reducing transmission. Australia's STI Management Guidelines recommend regular STI testing every 6-12months for sexually active individuals aged 15-35 years in high-prevalence, remote areas. However, testing uptake remains low among young Aboriginal and Torres Strait Islander peoples. This analysis explores how healthcare providers engage Aboriginal and Torres Strait Islander peoples in STI testing using point-of-care (POC) diagnostics. Methods Semi-structured interviews were conducted with trained STI POC testing operators within the Test Treat ANd GO (TTANGO2) project. Seven clinics involved in TTANGO2 were selected for their 'high' and 'low' implementation of STI POC testing. Purposive sampling was used to recruit similar personnel from each of the selected clinics. Coding was informed by a patient communication protocol lens. Results Twenty healthcare personnel, including Aboriginal Health Workers/Practitioners (n =8), Registered Nurses (n =7), Coordinators (n =2), and Clinical/Practice Managers (n =3) participated. Key themes related to implementing STI POC testing focused on different stages of identified patient communication protocols, such as offering tests, providing follow-up results, and contact tracing. Concerns about shame and confidentiality were significant factors affecting patient communication protocols throughout the process. Conclusions Normalising sexual health discussions in healthcare settings helps reduce feelings of shame and stigma, further encouraging patient participation in sexual health services. Ensuring patient safety and offering culturally appropriate explanations of STI POC testing are essential to reduce barriers, such as shame and stigma. Culturally safe practices can increase patient engagement and provide opportunities for health education. Integrating STI POC testing into routine health care can help normalise testing and boost uptake. However, same-day results may still require patient follow-up to maintain confidentiality. Addressing external factors, such as accessibility, confidentiality, stigma reduction, and community engagement, is crucial for improving STI testing services.

Background To explore the characteristics, influencing factors, and associations between sexting and high-risk sexual behaviors among college students in Jiangxi Province, China, providing a basis for promoting sexual health education and preventing high-risk sexual behaviors among college students. Methods A convenient sampling method was used to conduct an anonymous survey on 13,976 students from 15 universities in Jiangxi Province from November to December 2023. Chi-squared tests and binary logistic regression analyses were employed to investigate the influencing factors and associations between sexting and high-risk sexual behaviors. Results The reported rates of sexting and high-risk sexual behaviors among college students were 12.7% and 11.0%, respectively. Regression results indicated that the influencing factors for both behaviors included sex, grade, major, sexual orientation, knowledge of HIV/AIDS and family upbringing methods (P -values all Conclusion The prevalence of sexting and high-risk sexual behaviors among college students in Jiangxi Province should not be overlooked, and those with sexting experiences are more likely to engage in high-risk sexual behaviors. Educators should enhance sexual health education and safety control of sexual behaviors among college students.

Background Individuals aged 15-24years are disproportionately affected by sexually transmitted infections (STIs) in the United States, and young women can face severe health consequences if STIs are left undiagnosed. Yet STI testing rates in this priority population remain low. Few studies incorporate health behavior theory to examine factors associated with STI testing among young women in the United States, which is vital for intervention development. This study therefore sought to identify the determinants of college-enrolled late adolescent women's intentions to be tested for common STIs in the next 12months using a theory-based approach. Methods Students who identified as female at a large Midwestern university completed an online survey about STIs (n =171). Hierarchical multiple regression was used to assess the relationship between STI testing intention and the Reasoned Action Approach (RAA) global constructs of attitude, perceived norm, and perceived behavioral control, supplemented by STI knowledge, STI stigma, and STI shame. Results Findings indicate that the RAA global constructs predicted STI testing intention (P Conclusions Future interventions aimed at increasing STI testing among young women should focus on beliefs underlying the RAA global constructs and especially young women's beliefs regarding other people's support for getting tested for STIs.