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Pregnancy is a serious reproductive consequence of sexual violence, particularly among adolescents and young women. Age, repeated sexual intercourse, and physical violence during assault may increase pregnancy risk, yet evidence from forensic settings in Indonesia remains limited. This study analyzed the association of age, sexual intercourse history, and physical violence with pregnancy among sexual violence victims in Southeast Sulawesi, Indonesia. A retrospective case-control study was conducted using medicolegal (visum et repertum) and clinical records from referral hospitals in Southeast Sulawesi, Indonesia, from January 2018 to December 2025. Cases included 100 female sexual violence victims aged 10-25 years with pregnancy following sexual violence, while controls included 100 victims without pregnancy. Variables analyzed were age category, sexual intercourse history, and physical violence findings. Chi-square tests and multivariate logistic regression were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Most participants were aged below 18 years. Repeated sexual intercourse was significantly associated with pregnancy. Victims reporting more than one episode of sexual intercourse had higher odds of pregnancy than those reporting one-time intercourse (OR = 3.38; 95% CI: 1.82-6.29; p < 0.001). Physical violence findings were also significantly associated with pregnancy (OR = 2.16; 95% CI: 1.21-3.87; p = 0.009). Multivariate analysis showed that repeated sexual intercourse (AOR = 3.18; 95% CI: 1.66-6.08; p < 0.001) and physical violence (AOR = 1.98; 95% CI: 1.04-3.76; p = 0.036) remained independent predictors, while age was not significantly associated. Repeated sexual intercourse and physical violence were independently associated with pregnancy among sexual violence victims.
School nurses play a key role in responding to sexual violence in school settings. However, it remains unclear whether recent case exposure is associated with greater awareness of institutional response systems and confidence in recognizing sexually inappropriate behaviors. We conducted a cross-sectional survey of school nurses in a large Japanese municipality. The primary exposure was self-reported involvement in sexual violence-related cases within the past year (yes/no). The primary outcome was perceived awareness of institutional response procedures and interagency collaboration systems, and the secondary outcome was perceived confidence in recognizing sexually inappropriate behaviors, each measured using a 5-point Likert scale. Group differences were examined using the Mann-Whitney U test. Among 111 respondents, 50 (45.0%) reported recent exposure to a sexual violence-related case. Recent exposure was not associated with greater perceived awareness of institutional response systems (median 3 [IQR 2-4] vs. 3 [IQR 3-4], p = 0.336) or higher perceived confidence in recognizing sexually inappropriate behaviors (median 3 [IQR 3-4] in both groups, p = 0.877). In this sample of Japanese school nurses, recent exposure to sexual violence-related cases was not associated with greater perceived awareness of institutional response systems or higher perceived confidence in recognizing sexually inappropriate behaviors. Because cumulative prior experience, training history, and institutional context were not assessed, these findings should be interpreted cautiously. Future research should examine how professional experience, training opportunities, and organizational factors interact to influence preparedness and response practices related to sexual violence in school settings.
Vaginismus, classified as genito-pelvic pain/penetration disorder in DSM-5, is characterized by involuntary pelvic floor muscle contraction, fear of penetration, and anxiety. Despite its impact on sexual health, it remains underreported, particularly in conservative societies like India. Limited data exist on its prevalence and psychosocial correlates in Indian settings. This study examines the clinical and psychosocial characteristics of women diagnosed with vaginismus at a sexual health clinic in India. A retrospective descriptive study analyzed chart data from a sexual health clinic in India (May 2023-May 2024). Women aged ≥ 18 years, diagnosed with vaginismus per DSM-5 criteria, were included. Socio-demographic, clinical, psychiatric, and psychosocial data were extracted and analyzed using descriptive statistics. Of 692 women with sexual dysfunction, 313 (45.23%) had vaginismus. The mean age was 29.4 years (SD = 4.73). Most were from Tier 1 cities (72.8%) and had attempted but not succeeded in intercourse (58.8%). Anxiety and depression were common psychiatric comorbidities, while thyroid disorders and polycystic ovarian syndrome were frequent medical conditions. Partner-related sexual dysfunction occurred in 8.6% of cases. Fear of penetration (57%) and sexual myths (9.2%) were prevalent. Vaginismus has significant psychosocial and cultural implications. The findings underscore the need for multidisciplinary interventions, including psychotherapy, sexual education, and couple therapy, to improve outcomes and reduce stigma surrounding female sexual health.
Introduction Sexual abuse among adolescents is associated with significant psychosocial and mental health consequences. In the Democratic Republic of the Congo (DRC), data on factors associated with the severity of these abuses among vulnerable adolescents remain limited. This study aimed to identify factors associated with the severity of sexual abuse among adolescents attending reception centers in Kinshasa. Methods A cross-sectional study was conducted from April to August 2025 among 195 adolescents aged 12-18 years recruited from two reception centers in Kinshasa. Sexual abuse was assessed using the corresponding subscale of the Childhood Trauma Questionnaire-Short Form (CTQ-SF), psychological distress using the General Health Questionnaire-28 (GHQ-28), and self-esteem using the Rosenberg Self-Esteem Scale (RSES). Associations were examined using appropriate bivariate tests, followed by ordinal logistic regression. Statistical significance was set at p < 0.05. Results Overall, 56.9% of the adolescents reported experiencing sexual abuse, including 12.3% in mild form, 26.2% moderate, and 18.5% severe. In bivariate analysis, the severity of sexual abuse was associated with age, type of center, family structure, psychological distress, self-esteem, and cannabis and tobacco use. After adjustment, the factors independently associated with higher severity were female sex (adjusted odds ratio (aOR) = 1.78; 95% confidence interval (CI): 1.00-3.16), attachment to the mother (aOR = 5.12; 95% CI: 1.74-15.07), attachment to a third person (aOR = 3.34; 95% CI: 1.06-10.49), reconstituted, extended, and nuclear family structures, and cannabis use (aOR = 3.49; 95% CI: 1.56-7.81). An inverse statistical association was observed between alcohol consumption and severity of sexual abuse after adjustment. Conclusions Sexual abuse is common among adolescents attending reception centers in Kinshasa. Its severity is associated with familial, relational, and behavioral factors, highlighting the need for multisectoral interventions for prevention, screening, and psychosocial care adapted to this vulnerable population. However, all findings should be interpreted with substantial caution because the assessment instruments used in this study have not undergone formal cross-cultural validation or psychometric adaptation in the Democratic Republic of the Congo.
Early sexual debut poses significant risks to adolescent health. This study investigated the prevalence and factors associated with adolescent sexual activity among secondary school students in Addis Ketema, Addis Ababa, Ethiopia. A quantitative cross-sectional study was conducted using self-administered questionnaires from November to December 2021. Data were analyzed using frequency distributions and logistic regression. The primary outcomes were the prevalence of adolescent sexual activity and the adjusted odds ratios (AOR) for its significant associated factors. The prevalence of adolescent sexual activity was 17.3%, with a majority being male (77%). The most common reason for initiation was self-desire (36.1%). Significant predictors were having a boyfriend/girlfriend (AOR = 4.58), alcohol consumption (AOR = 5.42), school type (AOR = 3.15), and watching pornography (AOR = 21.25). A considerable prevalence of adolescent sexual activity exists in this setting, driven by identifiable relational, behavioral, and environmental factors. Key strengths include direct measurement of a sensitive public health issue. Limitations comprise potential social desirability bias in self-reported data, limited qualitative depth, and possible underreporting due to parental consent requirements for minors. Targeted interventions should address modifiable risk factors, particularly pornography consumption and substance use, to reduce early sexual activity.
The impact of hidradenitis suppurativa (HS) on sexual health, pregnancy, and breastfeeding in female patients is understudied. To characterize the impact of HS on sexual health, barriers to breastfeeding, and barriers to accessing care for HS during breastfeeding and pregnancy. A cross-sectional survey of self-identified adult women with HS from June 13, 2021 to June 30, 2021 was performed to assess associations between demographic and clinical factors, including age, gender, race, and ethnicity, disease severity (patient global assessment), and difficulty accessing dermatologic care with the outcomes of sexual health-related quality of life, breastfeeding practices, and barriers to care. Eight hundred eight eligible female respondents resided in 5 countries. Seventy-four point three percent self-identified as White, 8.3% Black, 2.4% Asian, 5.3% Hispanic, 7.1% Mixed race, and 1.4% Native Hawaiian or other Pacific Islander. Moderate to extreme difficulties with sexual activity and desire were associated with more difficulty accessing dermatologic care and higher patient global assessment scores (P < .01 for all). Depression and anxiety were associated with moderate to extreme difficulties with sexual activity (P < .01). Of the participants who were previously pregnant, 15% (n = 79/526) reported that HS interfered with breastfeeding ability. The top barrier to care was believing nothing could be done for HS during pregnancy and breastfeeding. Diagnosis and disease severity were self-reported and could not be verified. Impaired sexual health was associated with access to care limitations, increased disease activity, and comorbid depression and anxiety. Our findings underscore the need for guidance on safe HS therapies during pregnancy and breastfeeding.
Female sexual dysfunction (FSD) is frequently observed in women with urinary incontinence (UI) and pelvic organ prolapse (POP). Although surgical management of POP and SUI is widely performed, evidence regarding postoperative changes in female sexual function remains inconsistent and sometimes contradictory. To compare the postoperative effect of POP and UI surgeries on female sexual function and to explore the differential responsiveness of validated assessment tools. A literature search was conducted in PubMed, Web of Science, the Cochrane Library, and EMbase from database inception to 2025. The studies assessing sexual function using Female Sexual Function Index (FSFI) and PISQ-12, or reporting dyspareunia outcomes were included. Meta-analysis was analyzed by RevMan 5.4. No statistically change was observed between preoperative and postoperative FSFI scores in women undergoing surgery for POP (P = .19), whereas patients treated surgically for SUI demonstrated statistically significant improvement in FSFI scores (P = .02). Among POP procedures, Laparoscopic repair was associated with higher postoperative FSFI scores compared with vaginal surgery (P < .00001). In contrast, no difference in FSFI outcomes was identified between traditional and minimally invasive sling procedures for SUI (P = .11). Assessment using the PISQ-12 revealed significant postoperative improvement in POP and SUI patients (POP:P < .00001; SUI:P = .002), with no difference between surgical approaches or combined procedures. Postoperative dyspareunia rates differed among SUI techniques (P = .04), but not among POP surgeries (P = .29); however, dyspareunia occurred more frequently after POP surgery compared with baseline (P = .002). Surgical management of POP and UI shows a general correlation with improved sexual function scores, the extreme heterogeneity suggests that these pooled estimates should be viewed as broad trends rather than precise clinical benchmarks. The observed differences in FSFI and PISQ-12 scores may reflect differential patterns in detecting functional changes in specific patient groups, though the high variability precludes a definitive hierarchy of instrument sensitivity.
Fibromyalgia syndrome (FMS) is a chronic rheumatic disorder characterised by body pain, decreased pain threshold and psychological distress. Our aim is to investigate the effects of breathing exercises on sexual function, sleep, and mood in FMS. This is a cross-sectional study comparing psychological assessments conducted prior to and following breathing exercises. Participants completed the Fibromyalgia Impact Questionnaire (FIQ), Hospital Anxiety and Depression Scale (HADS), and Jenkins Sleep Rating Scale (JSS) and Female Sexual Function Index (FSFI). Scores were analysed for comparison to controls. A total of 56 women were enrolled to the study (30 intervention group, 26 controls). The mean age was 50.79 ± 9.06 years in intervention group. There were no statistical difference between groups occupational status (p > 0.05). The FIQ, HADS-depression, HADS anxiety, JSS and FSFI scores were similar between groups before breathing exercises (p > 0.05). FIQ, HADS depression- HADS anxiety, JSS scores after breathing exercises were better comparing to controls, p<0.001, p<0.001, p=0.002 and p=0.001, respectively. Although all symptoms were alleviated, the FSFI scores were not higher than FSD (Female sexual dysfunction) cut off value in intervention group after breathing exercises (p=0.033). The total FSFI score less than 26.55 was the cut-off for FSD. All of the participants had FSD. Breathing exercises can positively influence quality of sleep, anxiety, depression, and sexual life in patients with FMS. Incorporating breathing exercises into the curriculum may be considered to balance the quality of life for women with FMS.
Marginalized populations experience increased eating disorder (ED) risk and encounter significant barriers to treatment. Intersectionality provides a framework for understanding how systemic oppression contributes to inequities in EDs; however, intersectional approaches have yet to be applied to a clinical ED sample. The current study examined inequities in ED severity and treatment outcome across the intersections of race/ethnicity, sexual orientation, and socioeconomic status (SES). Adult women (N=3016; M = 27.2 years) with transdiagnostic EDs presenting to affiliated treatment sites across the United States completed the Eating Disorder Examination-Questionnaire (EDE-Q) at admission and discharge. Race/ethnicity and sexual orientation were self-reported; SES was measured using the area deprivation index of participants' neighborhoods. Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) was used to estimate baseline EDE-Q global score; change in EDE-Q global score and binge eating, self-induced vomiting, laxative use, and driven exercise frequency from admission to discharge; and reason for discharge (routine or non-routine) across intersectional subgroups. In this sample of women with access to treatment, MAIHDA models predicted higher baseline levels of overall ED pathology among sexual minorities (predicted M = 4.10). Few differences in ED symptom improvement were observed across intersectional subgroups, with some small yet potentially meaningful inequities. Racially/ethnically minoritized subgroups appeared slightly less likely to complete treatment (predicted percent non-routine discharge = 41.50%). Future research should build on these findings by analyzing other dimensions of inequity (e.g., gender, weight status, disability status) to further characterize and address intersecting systems of oppression that disparately influence ED outcomes.
To describe the prevalence of common sexual and reproductive health (SRH) indicators and healthcare access among women of reproductive age residing in Closed Controlled Access Centre (CCAC) Mavrovouni on Lesbos, Greece. A household survey comprising 119 questions across eight SRH domains was completed by 247 refugee women of reproductive age residing in CCAC Mavrovouni. Nine refugee coresearchers were engaged in a participatory action research process, contributing to question development, recruitment, data collection and analysis in June and July 2023. Most women reported adequate antenatal care (25/28, 89%) and healthcare-assisted births (14/14, 100%), but postpartum care was suboptimal with 47% (7/15) not accessing any services despite 63% (10/16) reporting complications. About half (56/120, 47%) of women with children were single mothers. Two women had a child die at sea. Family planning showed considerable unmet need, with only 24% (42/178) of women using modern contraception and over 25% (17/66) desiring fertility treatment but none accessing it. Despite 84% (173/207) reporting adequate access to menstrual materials, only 14% (29/207) were able to consistently alleviate pain. Of 247 women, 151 (61%) experienced gynaecological symptoms yet 68 (45%) did not access healthcare. Low screening for sexually transmitted infections (43/240, 18%) and cervical cancer (1/246, 0.4%) was reported. Of 244 women, 74% (180/244) experienced verbal, 52% (127/244) physical and 36% (87/244) sexual abuse in their lifetime. Gender-based violence was most reported in home countries, during travel and during pushbacks. 54% (133/247) of women experienced at least one pushback and 23% (57/247) reported denial of medical care. Across all domains except breastfeeding, most women (67%-91%) had not received healthcare information. In refugee camp Mavrovouni, there is an urgent need for comprehensive SRH services that address diverse unmet health and information needs. Strengthening responses require cocreated, tailored interventions that are both data-driven and community-informed. Simultaneously, action must be taken to eliminate pushbacks and ensure equitable healthcare access irrespective of legal status.
To investigate female sexual function and its association with sociodemographic factors and comorbidities among Hispanic women in Puerto Rico (PR). The study consisted of 2 phases. Phase 1 validated a Spanish version of the Female Sexual Function Index (FSFI) questionnaire with added sections that elicited sociodemographic information and medical history. Phase 2 involved a cross-sectional study in which the validated questionnaire was distributed at multiple gynecology clinics. The domains assessed included Desire, Arousal, Lubrication, Orgasm, Satisfaction, and Pain and were scored using the FSFI. Descriptive statistics characterized participant profiles, and we analyzed relationships with total FSFI scores using Wilcoxon-Mann-Whitney, Kruskal-Wallis, and Spearman correlation tests. Among 311 participants who completed the questionnaire, the prevalence of female sexual dysfunction (FSD) was 45.34% (n = 141), similar to estimates reported in the US(not including PR). Most of the participants were younger than 40 years (56%, 173) and reported having partners (63%, 195). Desire was the most affected domain. Correlations were observed between FSD and both medical history (particularly ovarian insufficiency) and medication use (particularly beta-blocker use). The high FSD prevalence in PR highlights the need for screening to improve characterization and treatment, ultimately enhancing patients' quality of life.
Problem gambling among sexual and gender diversity (SGD) populations has received increasing attention in research. While the literature shows that these populations are more likely than others to experience addiction and mental health issues, little is known about gambling among them. In our online survey (n=1519), a group of SGD participants reported problematic gambling practices. The present study, conducted as part of a broader mixed-methods study on gambling among SGD populations, aimed to gather qualitative data to gain insight into why problem gambling seemed high in our online survey. This qualitative descriptive study was conducted via semi-structured individual interviews with voluntary participants who gamble and were from sexually diverse populations across Canada (n=23). A primarily inductive approach with a deductive component was employed to conduct a thematic analysis of the collected data. Participants shared their thoughts on specific difficulties faced by SGD populations and gambling. These included themes such as gambling as a coping mechanism for SGD-related struggles, a lack of visibility and awareness of gambling issues and help resources, seeking a sense of community and belonging through gambling and other addictive behaviours and a minor theme regarding perspectives on risk-taking. Other contextual influences included the COVID-19 pandemic, online gambling and financial needs. This study adds to the existing knowledge of problem gambling among SGD populations by providing a qualitative perspective of sexually diverse participants on the issue. It also provides support for the minority stress framework as a potential reason why people from SGD populations might be at a higher risk of problem gambling.
This scoping review aims to identify, map, and synthesize evidence on the sexual and reproductive health (SRH) information needs of youth 15-24 years living with epilepsy, congenital heart disease (CHD), or systemic lupus erythematosus (SLE) in the USA and Canada, and identify barriers and facilitators to access to SRH information and services. Youth and young adults with chronic health conditions face elevated and condition-specific reproductive risks. Among youth with epilepsy, interactions between seizures, antiseizure medications, hormones, and hormonal contraceptives increase the risk of unintended pregnancy. For youth with congenital heart disease, a substantial proportion of pregnancies are associated with cardiac complications, and contraceptive counseling is often delayed or inconsistently delivered. In systemic lupus erythematosus, limited contraceptive options and teratogenic therapies further heighten reproductive risk, with active disease associated with significantly increased risks of preterm birth and pre-eclampsia. Despite these well-documented risks, youth with chronic conditions frequently report unmet SRH information needs related to contraception, medication safety, fertility, and pregnancy planning. Evidence remains fragmented across specialties and largely focused on pregnancy outcomes rather than youth-centered informational needs and access to services. Our preliminary search did not identify a comprehensive scoping review that maps sexual and reproductive health (SRH) information needs, barriers, and facilitators across these three chronic conditions among young people in North America. Given the anticipated heterogeneity in study designs, populations, and outcomes, a scoping review is appropriate for characterizing the breadth and nature of the evidence base. Eligible sources will include empirical studies from the USA and Canada involving youth aged 15-24 years diagnosed with epilepsy, CHD, or SLE. Studies must address SRH information needs and/or barriers and facilitators to accessing SRH information or services. Youth-reported needs will be distinguished from caregiver or provider perspectives, which will be included only when directly relevant to youth experiences. All primary qualitative, quantitative, and mixed-methods designs, as well as empirical grey literature, will be considered. This review will follow Joanna Briggs Institute (JBI) methodology for scoping reviews and will be reported in accordance with the PRISMA-ScR guidelines. A three-step search strategy will be implemented across MEDLINE, Embase, CINAHL, PsycINFO, Scopus, Web of Science, CENTRAL, and targeted grey literature sources from the inception of each database to the final search date. Two reviewers will independently screen records and extract data using a piloted standardized tool. Results will be synthesized descriptively and analyzed using manifest-level content analysis to categorize SRH information needs, barriers, and facilitators. Findings will be mapped across socio-ecological levels and developmental stages (15-19 and 20-24 years), where data permit. This protocol is registered with the Open Science Framework (https://doi.org/10.17605/OSF.IO/5SWTY).
Tooth loss is an indicator of oral health and may be affected by cannabis use. The authors aimed to examine whether cannabis use and frequency of past-month cannabis use (in days) were associated with tooth loss, especially among racial and/or sexual orientation/gender identity groups, in a cross-sectional, nationally representative sample of Americans. The number of missing teeth was assessed in the 2016, 2018, 2020, and 2022 Behavioral Risk Factor Surveillance System surveys. Past-month cannabis use was assessed as both a binary and continuous variable (days of cannabis use) in 2024. Backwards selection selected covariates for 2 multivariate models. Final models were stratified by race/ethnicity and sexual orientation/gender identity if the interaction with cannabis use was significant. After adjusting for covariates, current cannabis use was associated with 1.157 times higher odds of tooth loss (95% CI=1.065, 1.257), although this relationship was found to differ by racial/ethnic subgroups. Among non-Hispanic Whites, cannabis use was associated with higher odds of tooth loss (OR=1.223, 95% CI=1.119, 1.336), although no significant associations were found among other subgroups. Among those who used cannabis, each 1-day increase in the frequency of past-month cannabis use was associated with 1.009 times higher odds of tooth loss (95% CI=1.003, 1.015). Cannabis use was significantly associated with tooth loss overall and among non-Hispanic Whites specifically. Frequency of cannabis use was significantly associated with tooth loss among those using cannabis. More research may be needed to fully understand the relationship among minority subgroups.
Mpox has particularly adverse effects among people with HIV (PWH). We examined mpox vaccine utilization and hesitancy among men who have sex with men (MSM), and transgender women (TW) in HIV care in a multisite U.S. cohort. We queried MSM/TW reporting past 3-month sexual activity at 7 Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) sites regarding mpox vaccination status, and willingness and hesitancy to vaccinate via questionnaires self-administered at routine HIV care visits between 1/2023 and 4/2024. We measured bivariate cross-sectional associations between vaccination status and demographic characteristics; among those reporting no vaccination, we measured associations between hesitancy and demographic characteristics. Among MSM/TW (n = 1146, mean age 46; 97% cisgender MSM, 3% TW; 46% white, 39% Black, 11% Hispanic), 52% (n = 597) reported not being vaccinated against mpox. Of these, 33% (n = 195) indicated they were not likely to be vaccinated despite provider recommendation. A higher proportion of Black respondents indicated they would not get vaccinated compared with white or Hispanic (42% vs. 23% and 33%, respectively; p ≤ 0.001). Key reasons were health concerns (57%, highest among Black participants, p ≤ 0.001), particularly concerns that 'not enough is known' about the vaccine (47%), side effects (25%), and low perceived acquisition risk (33%). Among sexually active MSM/TW in HIV care, mpox vaccine hesitancy was highest among persons of Black race. Common reasons were concerns about negative health effects, the belief that not enough is known about the vaccine, and low perceived risk. Education efforts should highlight mpox vaccine safety as well as mpox transmission risk.
In remote Australian First Nations communities, the burden of curable sexually transmitted infections (STIs) is highest for young women and men aged 16-29 years and for women is associated with two-fold higher rates of hospitalisations for pelvic inflammatory disease (PID) than for non-First Nations women. Following a randomised trial, decentralised community-led molecular point-of-care (POC) testing for STIs has operated in remote primary care across Australia for more than 7 years, improving uptake and timeliness of treatment for chlamydia, gonorrhoea and trichomonas infections. However, cost-effectiveness remains unknown. A decision analytic model was devised to compare costs and outcomes associated with a POC testing programme for chlamydia, gonorrhoea and trichomonas infections in women and men aged 16-29 years seeking care, compared with standard care (laboratory-based testing). The analysis used a government payer perspective and 10-year time horizon. The primary outcome was the cost ($A) per quality-adjusted life year (QALY) gained. Sensitivity analyses examined uncertainty around the results. Based on a combined testing positivity rate of 36% and 29% for chlamydia, gonorrhoea and trichomonas for women and men, respectively, the POC testing programme, compared with laboratory testing, produced an estimated incremental cost per QALY ratio (ICER) of $A19 714 (95% CIs $A19 608 to $A19 821) over 10 years. Among those with an STI, the POC testing programme was predicted to reduce diagnosed PID by 30% and preterm/low birth weight babies by 17%. Sensitivity analyses indicated that the ICER was most sensitive to the probability of infection and receiving treatment within 2 days, based on a willingness-to-pay threshold of $A50 000. This health economic evaluation indicates that a scaled molecular POC testing programme for the management of STIs in remote primary care settings is cost-effective compared with standard care. Sustained POC testing in this setting is likely to improve reproductive health outcomes.
Gender-nonconforming acoustic speech features, such as fundamental frequency, spectral moments of the fricative /s/, and vowel formants produced at higher frequencies, relative to straight men, have been examined as markers of gay identities in multiple varieties of English. Production of these features is not observed consistently, as some gay men exhibit some gender-nonconforming features without producing globally gender-nonconforming speech. Variation in speech features is further increased by accent differences and linguistic diversity in the gay community. This study investigated acoustic characteristics of gay speech in Australian English (AusE), a variety with limited experimental research on gay speech. Acoustic characteristics of fundamental frequency, /s/, and vowel production were compared between 35 gay and 25 straight AusE-speaking men. Speech variation among gay men was examined in relation to gender-nonconformity, masculinity, self-identified straight-acting behavior, outness, and internalized homophobia. AusE-speaking gay men produced fundamental frequency with gender-nonconforming larger variation and /s/ with gender-nonconforming higher center of gravity than straight men. Vowel production with gender-nonconforming, higher formants indexed both gay identity and gay men who identified as less masculine and less straight-acting.
HIV pre-exposure prophylaxis (PrEP) is not widely available in India. We explored the needs and perspectives of men who have sex with men (MSM) and transgender persons about PrEP in Delhi, India. We accessed these key populations through targeted intervention (TI) projects for HIV prevention in Delhi. We conducted three focus group discussions (FGD) with community members, and four in-depth interviews (IDI) with key informants. We coded them using deductive and inductive reasoning, including constructs from the information-motivation-behavioural skills model for HIV prevention. Eleven MSM and 16 transgender persons (median age 24 years) participated in FGDs. Participants were mostly unaware of PrEP and considered condoms the mainstay of HIV prevention. Upon explaining PrEP, they considered adopting it as additional protection. Participants stressed the need to disseminate information about it through social media and dating apps. Motivation to adopt PrEP could be influenced by long-term partners, side effects, privacy and stigma. Adherence and concomitant condom use would be behavioural challenges. Affordability could be a barrier for access. For PrEP scale-up in India, the health system would need to communicate risks and benefits to key populations, integrate PrEP with HIV preventive services, consider product preferences, and ensure financial support and confidentiality.
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Nocturnal emissions are a normal biologic function of sexual arousal and ejaculation during sleep, often beginning in puberty. Historically, views on nocturnal emissions have varied, but they are an important aspect of sexual culture, as they may represent one of a person's earliest encounters with sexuality, often beginning during puberty. We sought to characterize the sexual culture views on nocturnal seminal emissions in the early 1900s and compare and contrast that to the views of the modern era as it relates to destigmatization of sexual health. A non-systematic review was performed to characterize historical views on nocturnal emissions, including cultural and religious perspectives. Modern perspectives on social media platform TikTok were also reviewed and compared to historical viewpoints. Throughout history, views on nocturnal emissions have varied, from accepting as a biological function to deeply stigmatized with sinful connotations. There remain medically unfounded claims about nocturnal emissions today highlighting an opportunity for sexual medical care providers to clarify and destigmatize the topic particularly for adolescents who may be most impressionable as they experience nocturnal emissions for the first time.