Sexual health最新文献

Background Telehealth adoption for HIV care continuum accelerated during the COVID-19 pandemic. This study explored telehealth usage, motivators and barriers to telehealth adoption, and implementation challenges during the pandemic among people living with HIV, individuals at risk and community-based organisations (CBOs) in Asia. Methods This cross-sectional study was conducted in June to December 2022 using an online quantitative survey among people living with HIV (n =787) and individuals at risk (n =744), and semi-structured qualitative interviews with CBOs across nine countries/territories in Asia. Responses from the survey were reported descriptively, and narratives from the interviews were used to identify the main themes associated with engagement configurations by CBOs. Results Regionally, HIV-related telehealth services were used by 56.8% of people living with HIV and 66.5% of individuals at risk, with 53.6-55.9% increasing their usage in 2021. Phone consultations, HIV-related health information sharing and video communications were the most commonly accessed services by telehealth users. Telehealth users most trusted mobile applications or software provided by clinics/healthcare providers/local CBOs. Telehealth uptake motivators included saving travelling time, improved access to HIV prevention care services and information outside of medical appointments; barriers included data privacy concerns and lack of technology accessibility, which were similarly acknowledged by local CBOs. Lack of resources to support telehealth services, and local policies on HIV prevention and treatment impeded CBOs from adequately delivering HIV care through telehealth. Conclusions This study highlights the potential of telehealth in HIV care while identifying critical challenges for its sustained integration. Addressing these issues (e.g. data privacy, telehealth infrastructure) would be essential to optimise telehealth services and improve HIV outcomes in the region.

Background The impact of receiving HIV serostatus disclosure from partners before sex on number of sexual partners and condomless anal intercourse (CAI) among men who have sex with men (MSM) remains unclear. We aimed to determine the association between receiving this disclosure and engaging in risky sexual behaviors and its impact on HIV incidence rates. Methods HIV-negative MSM were followed with questionnaires every 3months for 12months. Generalized estimation equations models were used to assessed the factors associated with receiving serostatus disclosure and its impact on multiple sexual partners and CAI. Results Of the 363 participants, those tested for HIV in the past 3months were more likely to receive serostatus disclosure than those who had not (adjusted odds ratio (aOR)=3.145, 95% confidence interval (CI): 2.109-4.691, P P P =0.351). Subgroup analysis revealed that MSM with casual partners who received serostatus disclosure were more likely to engage in CAI (aOR=1.646, 95% CI: 1.06-2.556, P =0.027). Conclusions HIV testing promotes serostatus disclosure and disclosure of HIV serostatus correlated with fewer sexual partners. However, among MSM with casual partners, disclosure was associated with a higher likelihood of CAI. These findings encourage regular HIV testing and HIV serostatus disclosure.

Background Sexual intercourse frequency (SIF) is widely known to be associated with fertility, but little is known about what predicts SIF among infertile couples trying to conceive. In this study, we examine the demographic and lifestyle risk factors associated with less frequent coitus among infertile couples. Methods This cross-sectional study examined infertile couples actively trying to conceive, selecting them from patients seeking fertility treatment. Demographic data and lifestyle factors such as age, occupation, smoking status, and body mass index were recorded. Participants self-reported the frequency of vaginal-penile intercourse per week and month. Descriptive statistics and binary logistic regression analyses were used to analyze the data and identify predictors of SIF. Results Our study included a final sample size of 790 couples. In univariate binary logistic regression, women's age (OR: 0.948; 95% CI 0.928-0.969), men's age (OR: 0.957; 95% CI 0.937-0.977), duration of marriage (OR: 0.927; 95% CI 0.903-0.952), and duration of infertility (OR: 0.928; 95% CI 0.898-0.960) were found to be significant factors. Additionally, men's smoking was negatively associated with SIF, with an odds ratio of 0.732 (95% CI: 0.578-0.928, P =0.010). Conclusions We observed that younger female partner age and shorter duration of marriage independently emerged as significant predictors associated with higher SIF. Our study highlights the need for tailored counseling and education based on age and marital stage. Older couples may benefit from specialized support such as sexual therapy and stress management. The negative impact of men's smoking on sexual intercourse frequency underscores the importance of effective smoking cessation programs. Comprehensive infertility treatment should address medical, psychological, and sexual health factors.

Background In the healthcare setting, transgender patients are often marginalized, face discrimination and have limited access to high-quality gender-affirming care, such as gender-affirming surgery (GAS). As a result, the available data pertaining to GAS are often based on convenience samples, and the majority of published studies in the US are cross-sectional. Transgender people may undergo GAS to align their bodies with their gender identities. There has been little emphasis on the GAS self-evaluated experience. GAS may be associated with improved quality of life in transgender people. This study aimed to analyze the functionality of transgender patients' genitals following vaginoplasty. Methods A total of 306 transgender patients responded to a validated survey for patient-reported feminizing GAS outcomes. Surveys were given to patients prior to GAS, and then 2weeks, 6months and 12months postoperatively. Pre- and post-GAS responses were compared using McNemar and Wilcoxon signed-rank tests. Self-identified race/ethnicity was available for all survey participants. All participants voluntarily took the same survey by using the same survey platform to eliminate bias. Results Five questions showed significant improvement between the 2-week and 6-month responses. These questions assessed if respondents had sensation in their clitoris (P =0.031), the frequency that clitoral stimulation was pleasurable (P =0.018), the presence of sexual activity in the past 3months (P P =0.031) and if labial irritation while walking or exercising decreased (P =0.051). Significant differences were not detected between the 6-month and 12-month responses for any of the survey questions. Conclusions The results of five different metrics regarding sexual activity and vaginal functioning showed a significant improvement for transgender people following GAS. Findings also similarly demonstrate a high success rate of sexual activity after GAS. These are significant patient-reported outcomes using tools validated for the transgender population. Respondent outcomes significantly improved between the 2-week and 6-month time period, but did not differ between the 6-month and 12-month period, suggesting the ideal time to assess the above-described patient-perceived outcomes with vaginoplasty is 6months postoperatively.

Background Gonorrhoea notification rates in Australia have more than doubled between 2014 and 2019. We explored gonorrhoea testing patterns and management of gonorrhoea infection in general practice. Methods We analysed de-identified electronic medical record data for individuals who attended 73 Australian general practices (72 in the state of Victoria) between January 2018 and December 2020. The 'care cascade' model was utilised to explore gonorrhoea detection and management. Descriptive analysis and logistic regression were used to investigate factors associated with gonorrhoea testing, treatment and retesting. Results During the study period, there were a total of 1,027,337 clinical episodes. Of these, 5.6% (n =57,847, 95% confidence interval [CI] 4.5-6.7) involved a gonorrhoea test and 1.1% (n =637, 95% CI 0.8-1.4) tested positive. Of the 637 gonorrhoea cases, 48.4% (n =308, 95% CI 29.8-67.0) had an Australian guideline-recommended dual antibiotic prescription (ceftriaxone and azithromycin) recorded. Of 329 cases without a dual antibiotic prescription, 84.2% (n =277, 95% CI 77.5-90.9) had reattended the clinic. Among the 206 gonorrhoea cases with dual antibiotic prescription recorded in 2018 and 2019, 32.0% (n =66, 95% CI 25.3-38.8) were retested from 6weeks to 6months post-treatment. Of the 140 gonorrhoea cases that were not retested, 54.3% (n =76, 95% CI 46.8-61.8) reattended the clinic within 6months of treatment. Conclusion The low proportion of gonorrhoea cases prescribed recommended antibiotics and retested within recommended timeframes suggests opportunities for integrating Australian STI guidelines into primary care. Further exploration of care pathways is warranted to determine if care was provided but not recorded, provided elsewhere or not provided.

Background Human papillomavirus (HPV)-associated cancers are a global concern, particularly for sexual minority men (SMM). Understanding awareness and the determinants of these beliefs is crucial for developing educational programs to reduce HPV-associated cancers. This study explored awareness and determinants of beliefs about HPV's carcinogenicity among SMM living with and without HIV in Nigeria. Methods Participants were recruited through secure social media platforms in Abuja, Nigeria. REDCap surveys captured demographics, sexual practices and participants' beliefs regarding HPV's role in cancer. Multivariable logistic regression modeling was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the relationships between individual characteristics and belief levels stratified by those living with and without HIV. Results Of 982 participants, the median age was 29years (interquartile range: 26-34); 64.1% were living with HIV, and 9.7% believed HPV causes cancer. Awareness was highest for anal (82.1%) and penile cancers (15.8%) and less so for oropharyngeal and female HPV-associated cancers (range: 3-7%). Anogenital warts increased the odds of awareness for SMM living with HIV (aOR: 6.4, CI: 3.0-13.6) and for individuals without HIV (aOR: 4.8, CI: 1.6-14.2). Living with HIV for over 6years was independently associated with a two-fold increased knowledge about HPV's carcinogenicity (aOR: 2.1, CI: 1.1-4.1). Conclusions Awareness of HPV's carcinogenicity was low; however, those who were aware were more likely to identify male HPV-associated cancers relevant to their own cancer risk. Formalizing targeted education in HIV care settings may promote knowledge and advocacy for prevention strategies.

Background This study describes chlamydia and gonorrhoea testing, positivity, treatment, and retesting among individuals aged ≥15years attending an urban Aboriginal Community Controlled Health Service during the period 2016-2021. Method Utilising routinely collected clinical data from the ATLAS program (a national sentinel surveillance network), a retrospective time series analysis was performed. The study assessed testing rates, positivity, treatment efficacy, retesting and trends over time within an urban Aboriginal Community Controlled Health Service. Results Testing rates for chlamydia and gonorrhoea varied between 10 and 30% over the study period, and were higher among clients aged 15-29years and among females. Positivity rates for both infections varied by age, with clients aged 15-24years having higher positivity than older clients. Gonorrhoea positivity rates decreased after 2016. Treatment and retesting practices also showed sex disparities, with men having a slightly higher treatment rate within 7days, whereas females had significantly higher retesting rates within 2-4months, indicating differences in follow-up care between sexes. Conclusion The study emphasises the need for clinical and public health interventions within urban Aboriginal and Torres Strait Islander populations to further reduce chlamydia and gonorrhoea. Prioritising improved access to testing, timely treatment and consistent retesting can significantly contribute to lowering STI prevalence and enhancing sexual health outcomes in these communities.

Background The high prevalence of non-consensual sex, including physical force, verbal threats, intimidation, and/or verbal coercion and rape among university students, has prompted urgent calls for action from governments, statutory, and university bodies. This research aims to identify key factors students see as contributing to non-consensual sex with a view to developing effective strategies to address these issues. Methods An online cross-sectional survey was administered to 4291 university students attending universities in south-east Queensland, Australia. Participants were recruited via email, print media, and face-to-face invitations. The survey contained closed and open-ended questions on a range of sexual health knowledge, attitudes, and behaviours, including non-consensual sexual experiences. A subset of students (n =199) who responded 'yes' to engaging in sexual acts against their consent were the primary participants for this paper. Descriptive statistical analysis and thematic analysis, employing the theory of planned behaviour, were conducted using the quantitative and qualitative data regarding non-consensual sex, respectively. Results Immediate and longer-term fear and partner eagerness were the most commonly identified influences on non-consensual sex. An inability to give consent due to lack of consciousness or intoxication were also frequently cited factors contributing to non-consensual sex. Conclusions Interventions acknowledging and addressing sociocultural factors are needed. Sexuality and relationship education encompassing effective communication, relationship boundaries, and safe use of alcohol and drugs could substantially reduce the incidence of non-consensual sex. Importantly, such education should be non-judgmental and place greater responsibility on perpetrators than victim-survivors.

Background To gain an understanding of chlamydia (CT) and gonorrhoea (NG) testing conducted within an annual health check (AHC) and in standard clinical consultations for clients aged 15-29years attending an urban Aboriginal Community Controlled Health Service in the period 2016-2021. Methods De-identified electronic medical record data were extracted and analysed on CT and NG testing by sex, age, Indigenous status and the context of testing (conducted within an AHC or not). An access, testing, and diagnosis cascade for CT and NG, inclusive of an AHC, was constructed. Results Combined testing within an AHC and outside an AHC for CT and NG ranged between 30 and 50%, except for the year 2021. Males were twice as likely to receive a CT and NG test within an AHC consultation as females. Females were almost equally likely to have a CT and NG test, both as part of an AHC consult and during other clinical consultations. Females had the highest CT positivity in 2018 (11%) and 2019 (11%), with a dip in 2020 (5%), whereas NG diagnoses remained stable at 2%. Conclusion The study demonstrates the potential of the AHC to facilitate greater coverage of CT and NG testing in an urban Aboriginal Community Controlled Health Service. Screening conducted within an AHC alongside screening in clinical consultations might be enough to reduce CT prevalence over a sustained period.

Background Partner notification is an important step in the control of sexually transmissible infections (STIs). STIs remain at high rates among young people and can have serious reproductive consequences if left untreated. This study aimed to determine the preferences and motivations for partner notification among young people in Australia. Methods Quantitative and free-text qualitative data were collected through the 2024 Sex, Drugs and Rock 'n' Roll survey, an annual cross-sectional survey conducted among people aged 15-29years old in Victoria, Australia. Respondents were recruited using convenience sampling through social media advertisements. Counts and proportions were calculated for the preferences and motivations for partner notification by regular and casual sexual partners as well as methods of communication. Inductive content analysis was used to analyse free-text responses. Results The partner notification module of the survey was completed by 1163 people (60.3% identified as women, 40.2% as heterosexual) who provided a total of 1720 free-text responses. The majority, 1056 (90.8%) stated that they would notify their sexual partners and 1142 (98.2%) would want to be notified by a sexual partner of an STI risk. Qualitative analysis highlighted that respondents felt that partner notification is the responsible thing to do to look after their own and their partner's health and protect others by reducing transmission. Few stated that embarrassment and fear of repercussions may make them less likely to notify their partners or that it would depend on the type of relationship. Most preferred to notify regular partners face-to-face (941, 80.9%) and casual partners via text message (785, 67.5%). Conclusion Almost all young people want to notify and be notified by partners of an STI risk regardless of age, gender or sexual identity. Tailoring resources by communication method and partner type is one way in which practitioners and public health authorities can support young people in undertaking this important step in STI control.