Asitava Deb Roy, Parijat Pramanik, Anirban Chatterjee, Sitanshu Barik
Background: Understanding the attitudes of medical students towards individuals from the lesbian, gay, bisexual, transgender, queer, questioning, intersex and asexual (LGBTQIA+) community is a prerequisite for informing competencies-based medical education (CBME) guidelines to make them LGBTQIA+ inclusive. The present study was conducted to assess the attitudes of medical undergraduate students from Indian medical colleges towards the LGBTQIA+ community.
Methods: An online cross-sectional survey was conducted in medical undergraduate students across India, which measured the opinions, beliefs, and acceptance of LGBTQIA+ people using a structured questionnaire uploaded on Google Forms. After data collection, the datasheet was downloaded, cleaned, and anonymised before being imported into RStudio for analysis.
Results: A total of 273 valid entries were assessed from the online survey. There was significant gender-based differences on most traditional opinions and beliefs regarding the LGBTQIA+ population (P <0.05). The female participants appeared to be more accepting of and comfortable with all denominations of LGBTQIA+. Many of the participants believed that members of the LGBTQIA+ community are more prone to sexually transmitted diseases, especially HIV/AIDS. However, a few participants also opined that the increased susceptibility to HIV/AIDS may be due to increased prevalence of intravenous drug abuse in the LGBTQIA+ community.
Conclusions: There are some misconceptions about the LGBTQIA+ community among medical students. Therefore, in order to ensure LGBTQIA+ sensitive healthcare provision, there needs to be a concerted, informed effort to incorporate necessary changes in the CBME curriculum.
{"title":"Perspective of medical undergraduates in India towards the LGBTQIA+ population: a short insight into changes in the medical curriculum.","authors":"Asitava Deb Roy, Parijat Pramanik, Anirban Chatterjee, Sitanshu Barik","doi":"10.1071/SH23155","DOIUrl":"10.1071/SH23155","url":null,"abstract":"<p><strong>Background: </strong>Understanding the attitudes of medical students towards individuals from the lesbian, gay, bisexual, transgender, queer, questioning, intersex and asexual (LGBTQIA+) community is a prerequisite for informing competencies-based medical education (CBME) guidelines to make them LGBTQIA+ inclusive. The present study was conducted to assess the attitudes of medical undergraduate students from Indian medical colleges towards the LGBTQIA+ community.</p><p><strong>Methods: </strong>An online cross-sectional survey was conducted in medical undergraduate students across India, which measured the opinions, beliefs, and acceptance of LGBTQIA+ people using a structured questionnaire uploaded on Google Forms. After data collection, the datasheet was downloaded, cleaned, and anonymised before being imported into RStudio for analysis.</p><p><strong>Results: </strong>A total of 273 valid entries were assessed from the online survey. There was significant gender-based differences on most traditional opinions and beliefs regarding the LGBTQIA+ population (P <0.05). The female participants appeared to be more accepting of and comfortable with all denominations of LGBTQIA+. Many of the participants believed that members of the LGBTQIA+ community are more prone to sexually transmitted diseases, especially HIV/AIDS. However, a few participants also opined that the increased susceptibility to HIV/AIDS may be due to increased prevalence of intravenous drug abuse in the LGBTQIA+ community.</p><p><strong>Conclusions: </strong>There are some misconceptions about the LGBTQIA+ community among medical students. Therefore, in order to ensure LGBTQIA+ sensitive healthcare provision, there needs to be a concerted, informed effort to incorporate necessary changes in the CBME curriculum.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71486351","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}
Heather McCormack, Handan Wand, Christopher Bourne, James Ward, Clare Bradley, Donna Mak, Rebecca Guy
Background: In the context of an expanding syphilis epidemic, we assessed the integration of sexually transmissible infection (STI) testing within annual health assessments for Aboriginal and Torres Strait Islander young people aged 16-29years in Aboriginal Community Controlled Health Services between 2018 and 2020.
Methods: Using routinely collected electronic medical record data from a national sentinel surveillance system (ATLAS), we performed a cross-sectional analysis to calculate the proportion of assessments that integrated any or all of the tests for chlamydia, gonorrhoea, syphilis, and HIV. We used logistic regression to identify correlates of integration of any STI test.
Results: Of the 13 892 assessments, 23.8% (95% CI 23.1, 24.6) integrated a test for any STI and 11.5% (95% CI 10.9, 12.0) included all four STIs. Of assessments that included a chlamydia/gonorrhoea test, 66.9% concurrently included a syphilis test. Integration of any STI test was associated with patients aged 20-24years (OR 1.2, 95% CI 1.1-1.4) and 25-29years (OR 1.1, 95% CI 1.0-1.2) compared to 16-19years and patients residing in very remote (OR 4.2, 95% CI 3.7-4.8), remote (OR 2.4, 95% CI 2.1-2.8), and regional areas (OR 2.5, 95% CI 2.2-2.8) compared to metropolitan areas. There was no association with patient sex.
Conclusions: Integration of STI testing into annual health assessments for Aboriginal and Torres Strait Islander young people was higher in remote areas where disease burden is greatest. Integration is similar in men and women, which contrasts with most studies that have found higher testing in women.
背景:在梅毒疫情不断扩大的背景下,我们评估了2018年至2020年间原住民社区控制健康服务机构对16至29岁原住民和托雷斯海峡岛民年轻人进行年度健康评估时将性传播感染(STI)检测纳入其中的情况:我们利用从国家定点监测系统(ATLAS)中例行收集的电子病历数据,进行了一项横断面分析,以计算纳入衣原体、淋病、梅毒和艾滋病毒的任何或所有检测的评估比例。我们使用逻辑回归法来确定整合任何性传播感染检测的相关因素:在 13 892 次评估中,23.8%(95% CI 23.1,24.6)的评估包含了任何一种性传播感染的检测,11.5%(95% CI 10.9,12.0)的评估包含了所有四种性传播感染的检测。在包含衣原体/淋病检测的评估中,66.9%同时包含梅毒检测。与16-19岁的患者相比,20-24岁(OR 1.2,95% CI 1.1-1.4)和25-29岁(OR 1.1,95% CI 1.0-1.2)的患者以及居住在非常偏远地区(OR 4.2,95% CI 3.7-4.8)、偏远地区(OR 2.4,95% CI 2.1-2.8)和地区(OR 2.5,95% CI 2.2-2.8)的患者都需要进行任何性传播感染检测。这与患者的性别无关:在疾病负担最重的偏远地区,将性传播感染检测纳入土著居民和托雷斯海峡岛民青少年年度健康评估的比例更高。男性和女性的整合情况相似,这与大多数研究发现女性的检测率较高形成鲜明对比。
{"title":"Integrating testing for sexually transmissible infections into annual health assessments for Aboriginal and Torres Strait Islander young people: a cross-sectional analysis.","authors":"Heather McCormack, Handan Wand, Christopher Bourne, James Ward, Clare Bradley, Donna Mak, Rebecca Guy","doi":"10.1071/SH23107","DOIUrl":"10.1071/SH23107","url":null,"abstract":"<p><strong>Background: </strong>In the context of an expanding syphilis epidemic, we assessed the integration of sexually transmissible infection (STI) testing within annual health assessments for Aboriginal and Torres Strait Islander young people aged 16-29years in Aboriginal Community Controlled Health Services between 2018 and 2020.</p><p><strong>Methods: </strong>Using routinely collected electronic medical record data from a national sentinel surveillance system (ATLAS), we performed a cross-sectional analysis to calculate the proportion of assessments that integrated any or all of the tests for chlamydia, gonorrhoea, syphilis, and HIV. We used logistic regression to identify correlates of integration of any STI test.</p><p><strong>Results: </strong>Of the 13 892 assessments, 23.8% (95% CI 23.1, 24.6) integrated a test for any STI and 11.5% (95% CI 10.9, 12.0) included all four STIs. Of assessments that included a chlamydia/gonorrhoea test, 66.9% concurrently included a syphilis test. Integration of any STI test was associated with patients aged 20-24years (OR 1.2, 95% CI 1.1-1.4) and 25-29years (OR 1.1, 95% CI 1.0-1.2) compared to 16-19years and patients residing in very remote (OR 4.2, 95% CI 3.7-4.8), remote (OR 2.4, 95% CI 2.1-2.8), and regional areas (OR 2.5, 95% CI 2.2-2.8) compared to metropolitan areas. There was no association with patient sex.</p><p><strong>Conclusions: </strong>Integration of STI testing into annual health assessments for Aboriginal and Torres Strait Islander young people was higher in remote areas where disease burden is greatest. Integration is similar in men and women, which contrasts with most studies that have found higher testing in women.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10202568","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: China is one of the countries that set the goal to eliminate mother-to-child transmission (EMTCT) of syphilis by a target date. Active screening for syphilis among pregnant women, followed by effective treatment of maternal syphilis, is critical for achieving the goal. The China health authority issued national implementation protocols to guide EMTCT practice in health facilities.
Methods: Within a cohort of infants born to mothers infected with syphilis, we obtained the data of regimens used for treatment of maternal syphilis from the National Information System of Prevention of Mother-to-Child Transmission of HIV, Syphilis and Hepatitis B, and analysed the physician's treatment behaviour and its associated factors in a public hospital in Suzhou of China.
Results: A total of 450 pregnant women who were positive for treponemal or non-treponemal antibody, or had previous infection with syphilis were included into the study for analysis. Of them, 260 (57.8%) were positive for both treponemal and non-treponemal antibodies (syphilis seropositivity), and 353 (78.4%) were treated for syphilis according to the protocol in which 123 (34.8%) were treated with two courses. Non-adherence to treatment recommended by the protocol for maternal syphilis was significantly associated with antenatal visits in the third trimester (AOR 6.65, 95% CI 2.20-20.07, P =0.001), being positive only for a treponemal test (AOR 5.34, 95% CI 3.07-9.29, P <0.001) or having a syphilis infection before the pregnancy (AOR 2.05, 95% CI 1.14-3.69, P =0.017), whereas the uptake of treatment for two treatment courses was associated with attending antenatal care in 2020 or before (AOR 3.49, 95% CI 1.89-6.42, P <0.001), being positive for treponemal and non-treponemal tests (AOR 5.28, 95% CI 2.78-10.06, P <0.001) or having non-treponemal antibody titre of ≥1:8 (AOR 3.71, 95% CI 1.77-7.78, P =0.001).
Conclusions: Implementation of the current recommendation to offer a universal treatment for syphilis among all pregnant women who are shown to be positive for a treponemal test alone is challenging in some clinical settings in China.
{"title":"Treatment of maternal syphilis for preventing congenital syphilis: an observational study of adherence to treatment recommendation in Suzhou, China, 2019-2021.","authors":"Xing-Fan Mo, Ming-Zhi Feng, Ting-Ting Jiang, Ya-Ting Xu, Min-Juan Wu, Jing-Jing Li, Min-Zhi Wu, Yue-Ping Yin, Xiang-Sheng Chen","doi":"10.1071/SH23082","DOIUrl":"10.1071/SH23082","url":null,"abstract":"<p><strong>Background: </strong>China is one of the countries that set the goal to eliminate mother-to-child transmission (EMTCT) of syphilis by a target date. Active screening for syphilis among pregnant women, followed by effective treatment of maternal syphilis, is critical for achieving the goal. The China health authority issued national implementation protocols to guide EMTCT practice in health facilities.</p><p><strong>Methods: </strong>Within a cohort of infants born to mothers infected with syphilis, we obtained the data of regimens used for treatment of maternal syphilis from the National Information System of Prevention of Mother-to-Child Transmission of HIV, Syphilis and Hepatitis B, and analysed the physician's treatment behaviour and its associated factors in a public hospital in Suzhou of China.</p><p><strong>Results: </strong>A total of 450 pregnant women who were positive for treponemal or non-treponemal antibody, or had previous infection with syphilis were included into the study for analysis. Of them, 260 (57.8%) were positive for both treponemal and non-treponemal antibodies (syphilis seropositivity), and 353 (78.4%) were treated for syphilis according to the protocol in which 123 (34.8%) were treated with two courses. Non-adherence to treatment recommended by the protocol for maternal syphilis was significantly associated with antenatal visits in the third trimester (AOR 6.65, 95% CI 2.20-20.07, P =0.001), being positive only for a treponemal test (AOR 5.34, 95% CI 3.07-9.29, P <0.001) or having a syphilis infection before the pregnancy (AOR 2.05, 95% CI 1.14-3.69, P =0.017), whereas the uptake of treatment for two treatment courses was associated with attending antenatal care in 2020 or before (AOR 3.49, 95% CI 1.89-6.42, P <0.001), being positive for treponemal and non-treponemal tests (AOR 5.28, 95% CI 2.78-10.06, P <0.001) or having non-treponemal antibody titre of ≥1:8 (AOR 3.71, 95% CI 1.77-7.78, P =0.001).</p><p><strong>Conclusions: </strong>Implementation of the current recommendation to offer a universal treatment for syphilis among all pregnant women who are shown to be positive for a treponemal test alone is challenging in some clinical settings in China.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41163568","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: HIV pre-exposure prophylaxis (PrEP) in Australia has largely been targeted at gay, bisexual and other men who have sex with men. In the context of HIV elimination, the aim of this qualitative study was to explore PrEP prescribing for Australian cisgender women from the provider's perspective.
Methods: Semi-structured interviews were held with Australian prescribers in 2022. Participants were recruited through relevant clinical services, newsletter distribution and snowball sampling. Interviews were audio-recorded, transcribed and analysed thematically.
Results: Seventeen prescribers participated, of whom 9 were sexual health physicians and 10 worked in New South Wales. All reported limited clinical experience prescribing PrEP for women. Potential enablers to PrEP prescribing to women included education for women and clinicians, easily identifiable risk factors, individualised risk assessment and expansion of existing services. Barriers were limited PrEP awareness among women and prescribers, difficulties with risk assessment and consult and service limitations. The type of service recommended for PrEP provision varied among participants.
Conclusions: Clinician experience of PrEP prescribing to Australian cisgender women is limited, with substantial barriers to access perceived by prescribers. Targeted education to PrEP prescribers, updated national PrEP guidelines to include women as a distinct group and further research regarding women's preferred model of PrEP access are required. Clarity of clinical ownership over PrEP implementation for women and, more broadly, women's sexual health, is essential in order to achieve HIV elimination in Australia.
{"title":"Provider views of pre-exposure prophylaxis (PrEP) for cisgender women - where do women fit in HIV elimination in Australia?","authors":"Caroline Lade, Catherine MacPhail, Alison Rutherford","doi":"10.1071/SH23163","DOIUrl":"10.1071/SH23163","url":null,"abstract":"<p><strong>Background: </strong>HIV pre-exposure prophylaxis (PrEP) in Australia has largely been targeted at gay, bisexual and other men who have sex with men. In the context of HIV elimination, the aim of this qualitative study was to explore PrEP prescribing for Australian cisgender women from the provider's perspective.</p><p><strong>Methods: </strong>Semi-structured interviews were held with Australian prescribers in 2022. Participants were recruited through relevant clinical services, newsletter distribution and snowball sampling. Interviews were audio-recorded, transcribed and analysed thematically.</p><p><strong>Results: </strong>Seventeen prescribers participated, of whom 9 were sexual health physicians and 10 worked in New South Wales. All reported limited clinical experience prescribing PrEP for women. Potential enablers to PrEP prescribing to women included education for women and clinicians, easily identifiable risk factors, individualised risk assessment and expansion of existing services. Barriers were limited PrEP awareness among women and prescribers, difficulties with risk assessment and consult and service limitations. The type of service recommended for PrEP provision varied among participants.</p><p><strong>Conclusions: </strong>Clinician experience of PrEP prescribing to Australian cisgender women is limited, with substantial barriers to access perceived by prescribers. Targeted education to PrEP prescribers, updated national PrEP guidelines to include women as a distinct group and further research regarding women's preferred model of PrEP access are required. Clarity of clinical ownership over PrEP implementation for women and, more broadly, women's sexual health, is essential in order to achieve HIV elimination in Australia.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71413941","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}
Anna ChuChu Schindele, Henrik Källberg, Kristina Areskoug Josefsson, Malin Lindroth
Background: School-based sexuality education is a core component of securing young people's right to attain health equity regarding sexual and reproductive health and rights. This paper aims to explore how perceived knowledge (sufficient or insufficient) of taking care of one's sexual health is associated with knowledge gained from school-based sexuality education and social determinants.
Methods: The data material is drawn from a population-based survey conducted in Sweden in 2015. The survey had 7755 respondents and a response rate of 26%. To explore the aim descriptive statistics and logistic regression models were used.
Results: Our results show that perceived insufficient knowledge from school-based sexuality education was associated with higher odds of reporting not being able to take care of one's sexual health. The highest significant excess risk for insufficient knowledge was found among young people from sexual minorities.
Conclusions: Young people in Sweden do not have equal abilities to receive knowledge needed to take care of their sexual health and thus attain sexual health literacy. There is an unequal distribution of perceived knowledge, and LGBTQI+ youth particularly face barriers in using school-based sexuality education as a resource for sexual health literacy.
{"title":"Perceived knowledge gained from school-based sexuality education - results from a national population-based survey among young people in Sweden.","authors":"Anna ChuChu Schindele, Henrik Källberg, Kristina Areskoug Josefsson, Malin Lindroth","doi":"10.1071/SH23093","DOIUrl":"10.1071/SH23093","url":null,"abstract":"<p><strong>Background: </strong>School-based sexuality education is a core component of securing young people's right to attain health equity regarding sexual and reproductive health and rights. This paper aims to explore how perceived knowledge (sufficient or insufficient) of taking care of one's sexual health is associated with knowledge gained from school-based sexuality education and social determinants.</p><p><strong>Methods: </strong>The data material is drawn from a population-based survey conducted in Sweden in 2015. The survey had 7755 respondents and a response rate of 26%. To explore the aim descriptive statistics and logistic regression models were used.</p><p><strong>Results: </strong>Our results show that perceived insufficient knowledge from school-based sexuality education was associated with higher odds of reporting not being able to take care of one's sexual health. The highest significant excess risk for insufficient knowledge was found among young people from sexual minorities.</p><p><strong>Conclusions: </strong>Young people in Sweden do not have equal abilities to receive knowledge needed to take care of their sexual health and thus attain sexual health literacy. There is an unequal distribution of perceived knowledge, and LGBTQI+ youth particularly face barriers in using school-based sexuality education as a resource for sexual health literacy.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71486350","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}
Julia Keegan, Spring Chenoa Cooper, Andrew Porter, Courtney Ciervo, Rafia Khalid
Background: Traditional school-based sexuality education has a myriad of problems with its successful delivery, including access to comprehensive sexuality curricula, access to trained facilitators, and community and parental fears. As an alternative form of sexuality education, The Sex Wrap podcast is released in weekly episodes of about 20-45min, providing listeners with diverse, evidence-based sexual health information.
Methods: Participants in a larger mixed-methods study evaluating The Sex Wrap were invited to participate in qualitative in-depth interviews to explore their experiences with sexuality education, including The Sex Wrap , and how they relate to information received through the podcast. Seventeen interviews were conducted with listeners of The Sex Wrap , aged 20-25years old.
Results: One core category and three axial codes were identified in the interview data. The core category is: sexuality education is an ongoing process that includes learning and unlearning. The three temporally related axial codes are: (1) experiences with formal and informal sexuality education (mostly negative) drove participants to seek more information about sex, (2) participants use The Sex Wrap as a way of exploring and personalising information about sexuality, and (3) participants equipped with comprehensive sexuality education are empowered to educate their peers.
Conclusions: This study suggests that podcast-based interventions, such as The Sex Wrap , can play a key role in young people's process of sexuality education and should be considered for incorporation into other forms of sex education.
背景:传统的以学校为基础的性教育在成功实施方面存在许多问题,包括获得全面的性教育课程、获得受过培训的辅导员以及社区和家长的恐惧。作为性教育的另一种形式,The Sex Wrap播客每周发布约20-45分钟,为听众提供多样化的循证性健康信息。方法:在一项评估《性包裹》的大型混合方法研究中,参与者被邀请参加定性的深入访谈,探讨他们在性教育方面的经历,包括“性包裹”,以及他们如何与通过播客收到的信息联系起来。《性包装》对20-25岁的听众进行了17次采访。结果:在访谈数据中识别出一个核心类别和三个轴向代码。核心类别是:性教育是一个持续的过程,包括学习和遗忘。三个时间相关的轴向代码是:(1)接受正式和非正式性教育的经历(大多是负面的)促使参与者寻求更多关于性的信息,(2)参与者使用性包装作为探索和个性化关于性信息的一种方式,以及(3)配备了全面性教育的参与者有权教育他们的同龄人。结论:这项研究表明,基于播客的干预措施,如性包装,可以在年轻人的性教育过程中发挥关键作用,应该考虑将其纳入其他形式的性教育中。
{"title":"Unlearning and relearning sexuality: a qualitative exploration of <i>The Sex Wrap</i>, a sex education podcast.","authors":"Julia Keegan, Spring Chenoa Cooper, Andrew Porter, Courtney Ciervo, Rafia Khalid","doi":"10.1071/SH23109","DOIUrl":"10.1071/SH23109","url":null,"abstract":"<p><strong>Background: </strong>Traditional school-based sexuality education has a myriad of problems with its successful delivery, including access to comprehensive sexuality curricula, access to trained facilitators, and community and parental fears. As an alternative form of sexuality education, The Sex Wrap podcast is released in weekly episodes of about 20-45min, providing listeners with diverse, evidence-based sexual health information.</p><p><strong>Methods: </strong>Participants in a larger mixed-methods study evaluating The Sex Wrap were invited to participate in qualitative in-depth interviews to explore their experiences with sexuality education, including The Sex Wrap , and how they relate to information received through the podcast. Seventeen interviews were conducted with listeners of The Sex Wrap , aged 20-25years old.</p><p><strong>Results: </strong>One core category and three axial codes were identified in the interview data. The core category is: sexuality education is an ongoing process that includes learning and unlearning. The three temporally related axial codes are: (1) experiences with formal and informal sexuality education (mostly negative) drove participants to seek more information about sex, (2) participants use The Sex Wrap as a way of exploring and personalising information about sexuality, and (3) participants equipped with comprehensive sexuality education are empowered to educate their peers.</p><p><strong>Conclusions: </strong>This study suggests that podcast-based interventions, such as The Sex Wrap , can play a key role in young people's process of sexuality education and should be considered for incorporation into other forms of sex education.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41171075","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}
Andrew P Gador-Whyte, Christine Roder, Rochelle Hamilton, Helen Fay, Emily Huning, Emma Nicholson, Kathryn Mackie, Eugene Athan, Amanda J Wade
Women living with HIV in regional Victoria face barriers accessing care. We evaluated the care cascade and outreach nurse support required for women attending our service between 2005 and 2020. A total of 33 women attended; 97% (32/33) were on antiretroviral therapy; 67% (22/33) retained in care, 27% (9/33) transferred and 6% (2/33) lost to follow up. Of women retained in care, 95% (21/22) were on antiretroviral therapy and 91% (20/22) had virological suppression. A total of 91% (30/33) required outreach nurse care (median care episodes 100/woman; IQR 44-179) - most frequently (87%; 26/30) liaising with pharmacies and prescribers. Outreach nurses are critical in achieving UNAIDS targets for women in western Victoria.
{"title":"Outreach nurses critical for delivery of HIV care to women in western Victoria.","authors":"Andrew P Gador-Whyte, Christine Roder, Rochelle Hamilton, Helen Fay, Emily Huning, Emma Nicholson, Kathryn Mackie, Eugene Athan, Amanda J Wade","doi":"10.1071/SH23153","DOIUrl":"10.1071/SH23153","url":null,"abstract":"<p><p>Women living with HIV in regional Victoria face barriers accessing care. We evaluated the care cascade and outreach nurse support required for women attending our service between 2005 and 2020. A total of 33 women attended; 97% (32/33) were on antiretroviral therapy; 67% (22/33) retained in care, 27% (9/33) transferred and 6% (2/33) lost to follow up. Of women retained in care, 95% (21/22) were on antiretroviral therapy and 91% (20/22) had virological suppression. A total of 91% (30/33) required outreach nurse care (median care episodes 100/woman; IQR 44-179) - most frequently (87%; 26/30) liaising with pharmacies and prescribers. Outreach nurses are critical in achieving UNAIDS targets for women in western Victoria.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71522580","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}
Definate Nhamo, Collin Mangenah, Gwendoline Chapwanya, Takudzwa Mamvuto, Imelda Mahaka, Clarisse Sri-Pathmanathan, Rashida A Ferrand, Katharina Kranzer, Fern Terris-Prestholt, Michael Marks, Joseph D Tucker
Background: Access to syphilis testing and treatment is frequently limited for men who have sex with men (MSM). A two-armed randomised controlled trial compared feasibility and costs of facility-based syphilis testing with self-testing among MSM in Zimbabwe.
Methods: This randomised controlled trial was conducted in Harare, with participants randomised 1:1. Syphilis self-testing was offered in community-based settings. The primary outcome was the relative proportion of individuals taking up testing. Total incremental economic provider and user costs, and cost per client tested, diagnosed and treated were assessed using ingredients-based costing in 2020US$.
Results: A total of 100 men were enrolled. The two groups were similar in demographics. The mean age was 26years. Overall, 58% (29/50) and 74% (37/50) of facility- and self-testing arm participants, respectively, completed syphilis testing. A total of 28% of facility arm participants had a reactive test, with 50% of them returning for confirmatory testing yielding 28% reactivity. In the self-testing arm, 67% returned for confirmatory testing, with a reactivity of 16%. Total provider costs were US$859 and US$736, and cost per test US$30 and US$15 for respective arms. Cost per reactive test was US$107 and US$123, and per client treated US$215 and US$184, respectively. The syphilis test kit was the largest cost component. Total user cost per client per visit was US$9.
Conclusion: Syphilis self-testing may increase test uptake among MSM in Zimbabwe. However, some barriers limit uptake including lack of self-testing and poor service access. Bringing syphilis testing services to communities, simplifying service delivery and increasing self-testing access through community-based organisations are useful strategies to promote health-seeking behaviours among MSM.
{"title":"Feasibility and economic costs of syphilis self-testing to expand test uptake among gay, bisexual and transgender men: results from a randomised controlled trial in Zimbabwe.","authors":"Definate Nhamo, Collin Mangenah, Gwendoline Chapwanya, Takudzwa Mamvuto, Imelda Mahaka, Clarisse Sri-Pathmanathan, Rashida A Ferrand, Katharina Kranzer, Fern Terris-Prestholt, Michael Marks, Joseph D Tucker","doi":"10.1071/SH23038","DOIUrl":"10.1071/SH23038","url":null,"abstract":"<p><strong>Background: </strong>Access to syphilis testing and treatment is frequently limited for men who have sex with men (MSM). A two-armed randomised controlled trial compared feasibility and costs of facility-based syphilis testing with self-testing among MSM in Zimbabwe.</p><p><strong>Methods: </strong>This randomised controlled trial was conducted in Harare, with participants randomised 1:1. Syphilis self-testing was offered in community-based settings. The primary outcome was the relative proportion of individuals taking up testing. Total incremental economic provider and user costs, and cost per client tested, diagnosed and treated were assessed using ingredients-based costing in 2020US$.</p><p><strong>Results: </strong>A total of 100 men were enrolled. The two groups were similar in demographics. The mean age was 26years. Overall, 58% (29/50) and 74% (37/50) of facility- and self-testing arm participants, respectively, completed syphilis testing. A total of 28% of facility arm participants had a reactive test, with 50% of them returning for confirmatory testing yielding 28% reactivity. In the self-testing arm, 67% returned for confirmatory testing, with a reactivity of 16%. Total provider costs were US$859 and US$736, and cost per test US$30 and US$15 for respective arms. Cost per reactive test was US$107 and US$123, and per client treated US$215 and US$184, respectively. The syphilis test kit was the largest cost component. Total user cost per client per visit was US$9.</p><p><strong>Conclusion: </strong>Syphilis self-testing may increase test uptake among MSM in Zimbabwe. However, some barriers limit uptake including lack of self-testing and poor service access. Bringing syphilis testing services to communities, simplifying service delivery and increasing self-testing access through community-based organisations are useful strategies to promote health-seeking behaviours among MSM.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10153443","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}
Kyle T Ganson, Nelson Pang, Alexander Testa, Rachel F Rodgers, Jori Jones, Jason M Nagata
Background: The aim of this study was to investigate the association between lifetime sex work involvement and muscle dysmorphia symptomatology.
Methods: Data from the Canadian Study of Adolescent Health Behaviours (N =912) were analysed. Multiple adjusted linear regression models were estimated with lifetime sex work involvement as the independent variable and muscle dysmorphia symptomatology, measured using the Muscle Dysmorphic Disorder Inventory, as the dependent variable.
Results: Among the sample, 3.7% of participants reported engaging in lifetime sex work. Significant associations were found between self-reported lifetime sex work and greater total muscle dysmorphia symptomatology (B =5.03, 95% CI 1.80, 8.26), greater Drive for Size symptomatology (B =2.36, 95% CI 0.74-3.97), and greater Functional Impairment symptomatology (B =2.11, 95% CI 0.54, 3.67), while adjusting for relevant sociodemographic variables.
Conclusions: Findings from this study expand prior research that has documented poor mental health among individuals involved in sex work. Clinical and community health professionals should consider screening for muscle dysmorphia symptomatology among young people who have been involved in sex work.
{"title":"Involvement in sex work is associated with muscle dysmorphia symptomatology among a sample of Canadian adolescents and young adults.","authors":"Kyle T Ganson, Nelson Pang, Alexander Testa, Rachel F Rodgers, Jori Jones, Jason M Nagata","doi":"10.1071/SH23157","DOIUrl":"10.1071/SH23157","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to investigate the association between lifetime sex work involvement and muscle dysmorphia symptomatology.</p><p><strong>Methods: </strong>Data from the Canadian Study of Adolescent Health Behaviours (N =912) were analysed. Multiple adjusted linear regression models were estimated with lifetime sex work involvement as the independent variable and muscle dysmorphia symptomatology, measured using the Muscle Dysmorphic Disorder Inventory, as the dependent variable.</p><p><strong>Results: </strong>Among the sample, 3.7% of participants reported engaging in lifetime sex work. Significant associations were found between self-reported lifetime sex work and greater total muscle dysmorphia symptomatology (B =5.03, 95% CI 1.80, 8.26), greater Drive for Size symptomatology (B =2.36, 95% CI 0.74-3.97), and greater Functional Impairment symptomatology (B =2.11, 95% CI 0.54, 3.67), while adjusting for relevant sociodemographic variables.</p><p><strong>Conclusions: </strong>Findings from this study expand prior research that has documented poor mental health among individuals involved in sex work. Clinical and community health professionals should consider screening for muscle dysmorphia symptomatology among young people who have been involved in sex work.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71522579","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: The longer ongoing benefits of coronavirus disease 2019 (COVID-19) non-pharmaceutical interventions (NPIs) for sexually transmitted diseases (STDs) in China are still unclear. We aimed to explore the changes in five STDs (AIDS, hepatitis B, hepatitis C, gonorrhoea, and syphilis) before, during, and after the COVID-19 pandemic in mainland China, from 2010 to 2021.
Methods: The number of the monthly reported cases of the five STDs were extracted from the website to construct the Joinpoint regression and autoregressive integrated moving average (ARIMA) models. Eight indicators reflecting NPIs were chosen from the COVID-19 Government Response Tracker system. The STDs and eight indicators were used to establish the Multivariable generalised linear model (GLM) to calculate the incidence rate ratios (IRRs).
Results: With the exception of hepatitis B, the other four STDs (AIDS, hepatitis C, gonorrhoea, and syphilis) had a positive average annual percent change over the past 12years. All the ARIMA models had passed the Ljung-Box test, and the predicted data fit well with the data from 2010 to 2019. All five STDs were significantly reduced in 2020 compared with 2019, with significant estimated IRRs ranging from 0.88 to 0.92. In the GLM, using data for the years 2020 (February-December) and 2021, the IRRs were not significant after adjusting for the eight indicators in multivariate analysis.
Conclusion: Our study demonstrated that the incidence of the five STDs decreased rapidly during the COVID-19 pandemic in 2020. A recovery of STDs in 2021 was found to occur compared with that in 2020, but the rising trend disappeared after adjusting for the NPIs. Our study demonstrated that NPIs have an effect on STDs, but the relaxation of NPI usage might lead to a resurgence.
{"title":"A long trend of sexually transmitted diseases before and after the COVID-19 pandemic in China (2010-21).","authors":"Aifang Xu, Zhongbao Zuo, Chunli Yang, Fei Ye, Miaochan Wang, Jing Wu, Chengjing Tao, Yunhao Xun, Zhaoyi Li, Shourong Liu, Jinsong Huang","doi":"10.1071/SH22172","DOIUrl":"10.1071/SH22172","url":null,"abstract":"<p><strong>Background: </strong>The longer ongoing benefits of coronavirus disease 2019 (COVID-19) non-pharmaceutical interventions (NPIs) for sexually transmitted diseases (STDs) in China are still unclear. We aimed to explore the changes in five STDs (AIDS, hepatitis B, hepatitis C, gonorrhoea, and syphilis) before, during, and after the COVID-19 pandemic in mainland China, from 2010 to 2021.</p><p><strong>Methods: </strong>The number of the monthly reported cases of the five STDs were extracted from the website to construct the Joinpoint regression and autoregressive integrated moving average (ARIMA) models. Eight indicators reflecting NPIs were chosen from the COVID-19 Government Response Tracker system. The STDs and eight indicators were used to establish the Multivariable generalised linear model (GLM) to calculate the incidence rate ratios (IRRs).</p><p><strong>Results: </strong>With the exception of hepatitis B, the other four STDs (AIDS, hepatitis C, gonorrhoea, and syphilis) had a positive average annual percent change over the past 12years. All the ARIMA models had passed the Ljung-Box test, and the predicted data fit well with the data from 2010 to 2019. All five STDs were significantly reduced in 2020 compared with 2019, with significant estimated IRRs ranging from 0.88 to 0.92. In the GLM, using data for the years 2020 (February-December) and 2021, the IRRs were not significant after adjusting for the eight indicators in multivariate analysis.</p><p><strong>Conclusion: </strong>Our study demonstrated that the incidence of the five STDs decreased rapidly during the COVID-19 pandemic in 2020. A recovery of STDs in 2021 was found to occur compared with that in 2020, but the rising trend disappeared after adjusting for the NPIs. Our study demonstrated that NPIs have an effect on STDs, but the relaxation of NPI usage might lead to a resurgence.</p>","PeriodicalId":22165,"journal":{"name":"Sexual health","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10113031","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}