Journal of Mens Health最新文献

Background

Multiple studies have been done on adult men who have sex with men (MSM), but no studies have shown the rates of extragenital site sexually transmitted infections (STIs) among HIV positive young men who have sex with men (YMSM). The objective of this study was to document the rates of extragenital Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) infection among HIV positive YMSM while conducting a validity study for the use of nucleic acid amplified tests (NAATs), to detect extragenital GC and CT.

Methods

Behaviorally infected HIV positive YMSM were enrolled in this study from one urban adolescent HIV clinic, and were screened for urine and extragenital site GC and CT over a 2 year period. Samples from these sites (pharyngeal and rectal) were tested for GC and CT using both traditional culture media and NAAT technology. Urine was tested using only NAAT.

Results

Of 67 screenings, 36% (n = 24) yielded at least one positive, and 69% of participants (18/26) had at least one positive GC or CT test result during the study period. Of those with at least one positive result, 89% (16/18) had at least one extragenital site infection. Urine testing was positive in 11% (2/18) of those with a corresponding extragenital site infection. None of the extragenital CT infections detected by NAATs were detected by culture, and only 38% (5/13) of the extragenital GC infections detected by NAATs were detected by culture.

Conclusions

Use of NAATs for extragenital STI screening yielded more confirmed positive results than did traditional cultures. By use of NAATs, the majority of routinely screened HIV positive YMSM in this sample was found to have an STI at an extragenital site.

Background

conventional wisdom suggests that increased socioeconomic resources should be related to better health. Considering the body of evidence demonstrating the significant association between racial discrimination and depression, we examined whether exposure to racial discrimination could attenuate the positive effects of increased levels of socioeconomic position (SEP) among African Americans. Specifically, this paper investigated the joint interactive effects of SEP and racial discrimination on the odds of depression among African Americans.

Methods

racial discrimination was measured using two measures, major and everyday discrimination. Study objectives were achieved using data from the National Survey of American Life, which included a nationally representative sample of African Americans (n = 3570). Logistic regression models were used to estimate the effects of SEP and racial discrimination on the odds of depression.

Results

reports of racial discrimination were associated with increased risk of depression among African American men who possessed greater levels of education and income. Among African American men, significant, positive interactions were observed between education and experiences of major discrimination, which were associated with greater odds of depression (P = 0.02). Additionally, there were positive interactions between income and both measures of racial discrimination (income x everyday discrimination, P = 0.013; income x major discrimination, P = 0.02), which were associated with increased odds of depression (P = 0.02).

Conclusions

it is possible that experiences of racial discrimination could, in part, diminish the effects of increased SEP among African American men.

Background

Social determinants of health are increasingly being addressed as a causal factor for disparities in health. The purpose of this study was to assess the effects of specified social determinants of health on cardiovascular disease (CVD) clinical risk factors in Black and White men residing in rural and urban Georgia.

Methods

Self-report data were collected on a total of 548 Black and White men aged >18 years from 2004–2005. Data were derived from a random telephone survey. Separate logistic regression models were conducted to examine the effects of specified social determinants on the presence of two or more CVD clinical risk factors. In addition, differences within rural and urban men were also assessed.

Results

Lower education, unemployment, lower income, and higher general stress were all significantly related to the presence of two or more CVD clinical risk factors. As expected, the covariates of age, race, and residential location also played a significant role in cardiovascular health. Rural men were nearly twice as likely to have two or more CVD risk factors compared to urban men (P <0.01). Models examining location separately found urban Black men to be 2.6 times as likely to have more than two CVD risk factors (P <0.02).

Conclusion

Findings reveal social determinants are associated with CVD risk factor differences between Black and White men and between rural and urban residents. It is important for policymakers and the healthcare industry to address these social determinants of health as they try to improve the health of the people they serve.

Background

Prostate cancer (PCa) patients suffer from identifiable stressors that may cause them anxiety and/or depression. In a previous study, an initial exploration of the ways in which PCa patients seek to cope with those stressors was described. However, several methodological limitations prevented direct comparisons of the relative effectiveness of patients’ coping strategies. To further investigate this issue, a standardised format was used to present the most commonly-used coping strategies to a new sample of PCa patients and to compare the effectiveness of those strategies.

Methods

A total of 147 PCa patients completed a background questionnaire and the Prostate Cancer Patients’ Coping Strategies Questionnaire (which includes 16 common stressors experienced by PCa patients plus a list of Coping Strategies for each stressor item).

Results

The most common stressors included physical, emotional, cognitive and relationship aspects of PCa. Although the coping strategies most used were “Just accepted it” and “Exercise/Activity”, these were not the most effective strategies. Data indicated that the strategies that received higher ratings of Overall Clinical Efficacy were either specific to particular stressors, which were clearly defined, or more general to less well-defined stressors. The strategies that were rated as “Very successful” by participants who used them were also a mixture of specific and general responses.

Conclusion

PCa patients’ ability to respond effectively to the kinds of stressors they encounter appears to be dependent upon the specificity of the stressor itself, with more general responses being made to stressors that were less specific in their effects upon patients. Implications for assessment of PCa patients’ ability to cope with the stress they experience, and methods of developing individualised coping strategies, are discussed.

Men's lives and health are rooted in opportunity structures that are shaped by race, ethnicity and other characteristics that have important social, political, economic and cultural meaning. Within men's health, there is a need to consider how structural factors and men's socially-defined characteristics affect the relationship between sex, gender and health. The goal of an intersectional approach is to simultaneously examine the social and health effects of several key aspects of identity and context in ways that create a new understanding of these factors and that are a more accurate reflection of the lived experiences of the populations of interest. Despite their promise, intersectional approaches have been criticized for being difficult to operationalize and study systematically. This paper, however, presents a framework for studying the intersection of gender and other identities and characteristics that are relevant for men's health, and explicitly identifies key pathways and stratification variables to guide future research.

This framework highlights pathways and ways to think about why race, gender, age and ethnicity affect men's health, and offers a tool for studying the relationship between socially-defined characteristics and men's health. Future research on men's health should begin by recognizing that comparing how men experience and embody masculinities may be most useful when researchers are explicit about their assumptions and theories about what and how socially-defined characteristics intersect with gender in a given national and local context. Research employing an intersectional approach also may elucidate how men of specific population groups create new normative masculinities for themselves.

Background

Testicular cancer (TC) is the most common malignancy among men aged 15–35 years and although Africa has one of the lowest prevalence rates, TC is often diagnosed late. The aim of this study was to describe TC knowledge, perceived risk and barriers to testicular self-examination (TSE) among young males in Uganda.

Method

Self-administered questionnaires and a systematic random sampling technique were used to collect data from 323 male students in a Ugandan University.

Results

The participants were mostly in the 18–22 years age range (59%) (mean age = 22 ± 2.5 years). The majority of participants (87%) did not know what age group was most at risk for TC, when to perform TSE (71%) or whether testicular lumps are a sign of TC (77%). Participants mostly perceived their risk for TC as being either low (32%) or moderate (58%). The mean perceived risk for TC was 1.8 ± 0.61 and few participants (14%) were performing TSE regularly. Most participants (80%) reported a lack of skill for performing TSE as well as perceiving TSE as embarrassing (87%) and time consuming (79%). Self-reported practice of TSE was found to be associated with different aspects of TC knowledge (P = 0.01).

Conclusion

Young male Ugandans have little knowledge about TC and perceive their risk for this disease to be low. Findings show that having good knowledge about TC is associated with performing TSE. Implications for practice are that health care providers should scale-up health education about TC to empower young males with the knowledge and skills required for cancer preventive practices and behaviors.

Background

The objectives of this study were to determine if men realize the importance of optimizing their health prior to a pregnancy, whether the pregnancy is planned or not; and to evaluate their knowledge level and beliefs about preconception healthcare. Additionally, we sought to understand how and when men wanted to receive information on preconception health.

Methods

A survey study was performed using consecutive patients presenting to two primary care practices for care. Patients were recruited based on willingness to complete the survey at the time of their appointment, but prior to being seen by the physician.

Results

A total of 132 men completed the survey. Nearly all men (93.2%) realized the importance of optimizing their health prior to a pregnancy, and realized the best time to receive information about preconception health was before conception. The majority of patients surveyed (75.0%) preferred to receive information about preconception health from their primary care physician. Only 8.3% of men could recall their physician ever discussing this topic. The population studied revealed some significant knowledge deficiencies about factors that may threaten their health or the health of their partner's fetus.

Conclusions

A majority of men do understand the importance of optimizing their health prior to conception, and look to their primary care physician as their preferred source for such information. Study participants demonstrated deficiencies in their knowledge of risk factors that impact paternal and fetal health suggesting that physicians are not addressing preconception healthcare during routine care.