International Journal of Sexual Health最新文献

Background: Sexually transmitted infections (STIs) remain a critical public health challenge globally, with Africa facing the highest incidence and mortality rates. The Dapivirine Vaginal Ring (DVR) is a discreet HIV prevention tool for women but does not protect against other non-HIV STIs. Like any other HIV biomedical prevention tool, DVR might lead to increased STI prevalence. Thus, this scoping review assessed the prevalence of STIs and the sociocultural, economic, and demographic factors influencing STI risk among African women using DVR in Africa. The review also examined current policies and interventions to reduce STI risk.

Method: We searched electronic databases such as the Ovid platform, MEDLINE, Embase, Global Health, CINAHL, Web of Science, Cochrane Library databases, Social Sciences Citation Index, and Gray literature from January 2014 to July 2024. The Rayyan tool was used to screen the title and abstract, whereas DistillerSR Version 2 was used for the full text screening. The qualitative data were analyzed for themes using QDA Miner Lite, while the numeric data was analyzed using the Microsoft Excel Package. This scoping review followed the PRISMA-ScR guidelines.

Result: Out of 1,247 papers, 11 were selected. The overall end-point prevalence of any STI was 33.42%, with specific rates for chlamydia (18.34%), Neisseria gonorrhoeae (8.56%), Trichomonas vaginalis (9.38%), and syphilis (0.90%). Sociocultural, economic, and demographic factors, including poverty, patriarchy, location, knowledge, and age, were found to influence STI risk among women using DVR. Suggested policies include routine STI screening, education, targeted interventions, and partner treatment frameworks to effectively control STIs.

Conclusion: Our findings reveal no evidence of risk compensation with DVR use. Holistic sexual health services are needed to support the use of DVR and prevent other STIs. Further research on biomedical tools that prevent both HIV and other STIs is crucial to address this gap.

Objectives: This study aimed to explore the psychosocial phenotype and its association with risky sexual behavior to deepen the understanding of the mechanisms of risky sexual behavior (RSB) among people living with HIV.

Methods: Data were collected between October and December 2021 in a cross-sectional study. Participants were 727 people living with HIV from an HIV clinic in a comprehensive hospital and completed a battery of questionnaires. A latent profile approach was utilized to identify the psychosocial phenotype based on depression, stigma, and social support. Multinomial logistic regression was used to investigate the relationship between sexual behaviors and the psychosocial phenotype.

Results: Three distinct phenotypes were identified: a low-risk profile (52.68%), a middle-risk profile (37.96%), and a high-risk profile (9.35%). These profiles exhibited a gradually increasing level of depression and stigma but a decreased level of social support. Participants in the middle-risk profile were twice as likely to engage in risky sexual behavior than those in low-risk profile (OR = 1.924, p = .008).

Conclusions: This study implies the synergistic impact of depression, stigma, and social support on the occurrence of risky sexual behavior among people living with HIV, which may be useful to the early intervention of risky sexual behavior.

Objectives: Faking orgasm is a common yet psychologically complex behavior among women, shaped by both emotional vulnerabilities and sexual motivations. This study examined the psychological correlates of faking orgasm in two sexual contexts-vaginal intercourse and oral sex-focusing on difficulties in emotion regulation and sexual motivation.

Method: A sample of 425 Hungarian women completed self-report measures assessing six facets of emotion regulation (Difficulties in Emotion Regulation Scale), three types of sexual motivation (Hungarian Short Form of the Reasons for Having Sex Questionnaire), and four motives for faking orgasm in each context (Faking Orgasm Scale). We used a dual analytic approach combining network analysis and multiple linear regressions to explore and predict context-specific patterns.

Results: Faking orgasm was associated with emotion regulation difficulties-especially non-acceptance of emotions, impulse control problems, and lack of emotional clarity-and with sexual motivations related to coping, personal goals, and partner-focused concerns. These associations were stronger and more interconnected in vaginal intercourse than in oral sex. Network centrality analyses identified coping-related motivation and emotion regulation deficits as key variables.

Conclusions: Faking orgasm may serve as a strategic emotion regulation behavior embedded in relational dynamics and sociocultural scripts. The findings highlight the importance of addressing emotional literacy, sexual communication, and relational expectations in clinical and educational contexts. Future research should investigate real-time affective processes and cultural norms that shape women's sexual behavior.

Objectives: To identify trajectories of chemsex engagement and their evolution across time among men who have sex with men (MSM) and the associated factors.

Methods: Among 2518 PrEP-using MSM in the French ANRS- Prévenir cohort, a group-based trajectory model was used to identify trajectories of chemsex engagement. A multivariable model was then used to estimate time-constant factors associated with trajectory membership, and time-varying factors associated with the shape of each trajectory. Data were collected quarterly from self-administered online questionnaires and electronic case record forms. The median follow-up time was 21 months [interquartile range: 9-27 months].

Results: Four distinct trajectories were identified: the Null/low (probability of engagement) (N-CX, n = 1881, 75%), the Increasing (I-CX, n = 158, 6%), the Decreasing (D-CX, n = 195, 8%), and the High (H-CX, n = 284, 11%). Compared to N-CX: MSM in the I-CX and D-CX were younger (OR [95%CI]: 0.95[0.93-0.98], p < 0.001 & 0.94[0.91-0.96] p < 0.001 per additional year or point (p/y), respectively), while MSM in the H-CX were older (1.03[1.01-1.05] p/y, p = 0.016); depression score was higher among the D-CX (1.02[1.00-1.04] p/y, p = 0.026) and lower among the I-CX (0.97[0.94-0.99] p/y, p = 0.028). Use of daily PrEP regimen (compared to 'on-demand') was associated with increased and decreased likelihood of chemsex engagement for the H-CX (Coeff.(SE): 0.75(0.33), p = 0.027) and D-CX (-0.41(0.20), p = 0.043), respectively. The likelihood of chemsex engagement increased for the D-CX (0.02(0.01), p = 0.006), H-CX (0.04(0.01), p = 0.004), and N-CX (0.008(0.003), p = 0.011) as their number of casual sex partners increased. Participants in the N-CX and D-CX were more likely to engage in chemsex if they engaged in condomless anal sex during their last sexual encounter [0.86 (0.34), p = 0.011 and 1.63 (0.21), p < 0.001, respectively].

Conclusion: Four different patterns of engagement in chemsex were identified, with specific sexual behaviors and HIV prevention strategies. Differentiated healthcare and prevention approaches could be offered to MSM based on their patterns of chemsex engagement.

Introduction: Despite the importance of school-based sexual health education (SHE) for enhancing sexual health outcomes, little is known about the SHE youth receive in Spain.

Objective: The goal of this research was to shed light on the experience of SHE of Spanish adults.

Method: Participants were 524 Spaniards (73% women, 27% men) between 18 to 70 years of age (M = 35.29, SD = 11.68) who completed an on-line survey. This survey collected information on whether and during which courses they had received SHE in high school. In addition, participants indicated the extent to which each of 10 important sexual health topics had been covered in their school-based SHE.

Results: On average, participants indicated that these 10 important SHE topics were covered between not at all and poorly. Biological topics were most likely to be covered at least to a small extent. Participants who received SHE on average received it in two different grades, most often around 14-16 years old. These participants, on average, rated the quality of the SHE as poor. There were no differences in perceptions of the extent or quality of SHE based on age-group or sexual orientation. However, women reported receiving significantly less SHE than did men; there were no gender differences in perceptions of the quality of SHE. Participants who had received SHE in more grades reported more extensive and higher quality SHE.

Conclusions: Results reflect that SHE in high schools in Spain is still very limited, which could be related to poorer sexual health. To improve sexual health, it would be necessary to enhance the SHE provided in Spanish schools.

Introduction: Reproductive coercion refers to attempts to control reproductive choices, often exerted by an intimate partner or a family member. Introduced by Miller et al. (2010), this concept highlights the link between reproductive coercion and unintended pregnancies, as well as its impact on sexual and reproductive autonomy. Although frequently associated with intimate partner violence, some research emphasizes its occurrence outside of this context.

Objectives: Reproductive coercion, defined as acts that directly interfere with contraception and compromise women's reproductive autonomy, was first formally described in 2010. Since then, numerous studies have examined its prevalence, forms, and consequences for reproductive health, primarily it to intimate partner violence and domestic violence. This study aims to update the current understanding of CR, including its occurrence beyond the context of intimate partner violence.

Method: A strategic literature search was conducted using ScienceDirect, PsycINFO, Scopus and PubMed to identify published articles that used reproductive coercion and related terms as keywords. A total of 68 articles met the inclusion criteria, addressing the prevalence, forms, contexts, risk factors, and existing intervention strategies related to reproductive coercion.

Results: The findings reveal that while reproductive coercion often occurs within intimate partner relationships, it can also involve family members or structural factors. Common tactics include contraception sabotage, pressure to pursue unwanted pregnancies, and coercion in pregnancy-related decision-making, often accompanied by violence or psychological manipulation. Prevalence rates vary widely and are often imprecise, with higher rates observed in the presence of intimate partner violence. Identified risk factors include gender inequality, socio-economic disadvantage, and minority status. However, protective factors remain underexplored. Current prevention strategies focus on healthcare-based screening and public awareness campaigns, although their effectiveness remains limited.

Conclusions: This review highlights the need for further research into reproductive coercion across diverse populations, the role of perpetrators, and cases occurring outside of intimate partner violence contexts, to better inform prevention and intervention efforts.

Introduction: The perceptions of judges regarding sexual violence perpetrated by women against men (SVWM) have not been approached widely in previous empirical research. This exploratory qualitative study aimed to provide a preliminary understanding of the perceptions of Portuguese judges regarding SVWM.

Method: Eight Portuguese judges (men and women) were interviewed in 2020. Data was analyzed using framework analysis.

Results: Gender and alcohol had central roles in judges' accounts, as non-consent, motivations, risk, the impact of violence, and sexual scripts were mostly discussed with these two factors in mind. Narratives oscillated between gender-neutral reflections and depictions of gender stereotypes and male rape myths. Challenges and opportunities of the Justice System were discussed considering the stigma associated with SVWM, while judges' accounts were shaped by their lack of direct experience with such cases.

Conclusions: Participants' narratives reflected important contradictions between their adherence to some male rape myths and gender stereotypes and their endorsement of the ideal of a gender-neutral rape Law.

Policy implications: The results of this study implicate that the impact of gender-based perceptions and rape myths on rape-related attrition rates and sentencing in SVWM cases should be further explored in empirical research. Additionally, public policy efforts should be invested in evidence-based professional training for judges focused on challenging gender stereotypes and male-rape myths.

Objectives: This 4-year follow-up study examined whether individual factors and environmental factors at baseline predict problematic internet use (PIU) four years later among young adult lesbian, gay, and bisexual (LGB) individuals and the mediating effect of PIU at baseline.

Method: Data on PIU, demographics, sexual stigma (e.g., perceived sexual stigma from family members, internalized sexual stigma, and sexual microaggression), self-identity confusion (e.g., disturbed identity, unconsolidated identity, and lack of identity), affective symptoms (e.g., anxiety and depression), and family support were collected from 1,000 LGB individuals. The participants' PIU was surveyed again after 4 years. The predictions of individual and environmental factors with PIU at follow-up were analyzed through mediation analysis.

Results: In total, 673 (67.3%) participants completed the follow-up assessment. Higher affective symptoms and self-identity confusion directly predicted higher PIU at follow-up and indirectly through PIU at baseline. Higher sexual stigma indirectly predicted higher PIU at follow-up through PIU at baseline, whereas the direct effect was not significant. Higher family support indirectly predicted lower PIU at follow-up through PIU at baseline, whereas the direct effect was not significant. Being transgender directly predicted higher PIU at follow-up, whereas the indirect effect was not significant.

Conclusions: Interventions aimed at reducing the severity of PIU among LGB individuals should be designed considering the predictors identified in our study.

Background: Menstruating individuals have the right to access proper menstrual health education and hygiene practices. However, many of these individuals experience period poverty, which is defined as the lack of access to safe and hygienic menstrual products, basic sanitation services, adequate waste disposal systems, and menstrual hygiene education. Although the negative effects of period poverty on the physical, social, and mental well-being of menstruating adolescents have been emphasized and reported as a major public health issue, there remains a gap in research exploring the impact of evidence-based digital menstrual health educational tools on improving overall health outcomes and mental well-being of menstruating individuals. This scoping review aims to address this gap in period poverty and menstrual health research by exploring the availability of online educational intervention and digital platforms on menstrual health.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) was utilized as a reference checklist for this study. The Arksey and O'Malley Framework was used to guide the methodology for this review. The Joanna Briggs Institute recommendations were used for the extraction, analysis, and presentation of results for the review.

Results: After a full study review, seven studies were retained for analysis. The majority of the barriers were classified into the "Study design and methodological issues" (n = 10) theme category, which encompassed lack of validated tools for compliance, limited power, loss to follow-up, and inability to build evidence for causation among others. The second most cited barrier theme category was "Generalizability and selection bias" (n = 8). Lessons learned across included studies were identified regarding the use of social media, interventions, and period-tracking apps. Future interventions should consider individual preference for receiving materials (i.e., through web pages vs apps), cost-effectiveness, research methods to improve user engagement, and involve families and community members in improving attitudes and knowledge.

Conclusion: Findings from this review will provide recommendations and inform future implementation and broader dissemination of such platforms for further improvement of menstrual health outcomes.

Objectives: This study uses a decolonized research approach to identify the sexual and reproductive health (SRH) priorities of adolescent women living in Freedom Park, Cape Town, South Africa. The history of colonialism and apartheid has a significant ongoing impact on the SRH of women in the community. The objectives of the research were for adolescent women to create a shared definition of SRH and identify SRH needs and priorities.

Methods: A qualitative, participatory action design guided by decolonized methodologies was employed. Community members co-developed a modified body mapping exercise, ensuring cultural appropriateness and participant privacy. This participatory tool was used to explore SRH issues, leveraging its ability to foster dialogue and self-expression in a safe and collaborative environment. Seven workshops were conducted, engaging 54 adolescent girls and young women (AGYW) aged 16-25. Participant body maps and narratives were analyzed with the community through thematic coding and visual interpretation.

Results: Participants defined SRH, and illustrated SRH body parts, outcomes, and priorities on their body maps. Five themes were identified when discussing priority SRH issues: reproductive health and sexual wellness, abuse and violence, mental health, support and knowledge, and social pressures. Participants identified the two SRH issues they most wanted to address in their community as gender-based violence (GBV) and adolescent pregnancy. The body mapping methodology fostered open discussion and provided insight into personal lived experiences.

Conclusions: This study highlights socio-economic factors, cultural context, and historical influences as intersecting root causes of SRH outcomes in Freedom Park. The participatory body mapping approach empowered AGYW to express their SRH needs and identify community-driven priorities. Findings underscore the importance of contextualized, culturally sensitive research methods in addressing complex health challenges. Future interventions should address GBV and adolescent pregnancy through community-led strategies to foster sustainable change.