Sexual health最新文献

Background: This study aimed to systematically review and synthesize evidence on Chlamydia trachomatis prevalence in Canada, describe epidemiological patterns across populations and anatomical sites, and assess associations with prevalence.

Methods: A systematic review of Chlamydia trachomatis prevalence studies was conducted and reported according to PRISMA guidelines. Random-effects meta-analyses generated pooled mean prevalence estimates, and meta-regression analyses explored epidemiological and methodological predictors of prevalence variation.

Results: A total of 169 publications were included, contributing 437 prevalence measures spanning 1981-2025. The pooled mean prevalence in the general population was 4.4% (95% CI: 3.6-5.2%) for current urogenital infection and 50.3% (95% CI: 44.5-56.1%) for ever infection. Among men who have sex with men and transgender people, prevalence estimates were 1.8% (95% CI: 0.6-3.5%) for urogenital infection, 6.6% (95% CI: 3.7-10.1%) for anorectal infection and 0.7% (95% CI: 0.0-2.1%) for oropharyngeal infection. Prevalence was substantially higher among symptomatic populations, reaching 18.6% (95% CI: 9.3-30.2%) in women and 24.3% (95% CI: 13.7-36.7%) in men. Meta-regression analyses explained >40% of the observed variation in prevalence, indicating that prevalence was approximately 30% lower among individuals aged ≥25 years compared with those aged <25 years, with no significant sex differences. Prevalence declined over time at a relative rate of 3% per year.

Conclusions: Chlamydia trachomatis prevalence in Canada is comparable to global levels. The ongoing persistence of infection underscores the need to enhance public health responses and expand investment in vaccine development as a cornerstone of long-term prevention and control.

Background: Orgasm can be an important component of sexual wellbeing broadly and specifically in the preconception period, yet epidemiologic research on orgasm is limited.

Methods: We used cross-sectional data from Pregnancy Study Online (PRESTO), a cohort study of females attempting conception with one male partner (N = 6022; 2020-2025), to descriptively evaluate orgasm frequency, its correlates and its relationship to orgasm intensity. We used self-reported data to assess orgasm frequency (Likert scale: never/rarely to always/almost always) and intensity (0-10). Across correlates (e.g. encompassing sociodemographic, medical, behavioral factors), we calculated the absolute difference and 95% confidence interval (CI) in the percentage of participants reporting the highest versus lowest orgasm frequency within levels of each correlate, standardized relative to the difference in the full sample.

Results: Over half of the sample reported orgasming 'always', 'almost always' or 'most times' during sexual activity. Partner support was a strong correlate; participants whose partner 'rarely' provided love/affection and emotional support reported less frequent orgasms (standardized percentage-point differences of -11.0, 95% CI -36.7, 14.7 and -27.5, 95% CI -44.4, -10.6, respectively). Irritable bladder syndrome (standardized percentage point difference -15.4, 95% CI -25.5, -5.3), diabetes (standardized percentage point difference -5.8, 95% CI -18.2, 6.7) and depressive symptoms (highest category standardized percentage point difference -11.6, 95% CI -19.3, -4.0) were strong correlates of less frequent orgasms. Participants with lower function on other domains of sexual function reported fewer orgasms.

Conclusions: Important correlates of preconception orgasm frequency spanned relational, clinical and sexual function factors. We discuss implications for conducting etiologic orgasm research.

High risks of unintended pregnancies and abortion have been reported among Chinese university students; however, their contraceptive use remains poorly understood. This study synthesised Chinese university students' contraceptive usage to inform the development of context-specific contraceptive investigations and interventions. We searched six databases from 1 January 2014 to 31 December 2024. Studies with clear definitions and comprehensive data reporting the usage of any contraceptive among Chinese university students either in China or attending universities abroad were included. Eligible studies were independently appraised by two authors. Random-effects meta-analyses were used to estimate pooled proportions of any contraceptive use. Of 6476 records identified, 34 studies were included. The proportions of any contraceptive use were reported across three important dimensions, namely, frequency of use, duration of use and at a specific time point (first/last sex). Accordingly, using any contraceptive, using any contraceptive every time and using any contraceptive at first sex among sexually experienced Chinese university students were commonly reported measurements, with pooled proportions of 74.5% (95% confidence interval (CI): 55.0-87.4%, I2 = 98.6%), 43.4% (95% CI: 33.6-53.8%, I2 = 97.5%) and 60.8% (95% CI: 51.4-69.4%, I2 = 96.8%), respectively. Subgroup analyses were performed; however, careful interpretation is required given the wide CIs, significant and unexplained heterogeneity, and the risk of bias. Findings revealed varied measurements of any contraceptive use substantiate the methodological challenges in assessing contraceptive behaviour among university populations. Future studies should adopt transparent, standardised and contextually justified measurement approaches in both global and local contexts.

Significant disparities in the sexual and reproductive health of young people persist globally. Although previous systematic reviews and meta-analyses have largely focused on the effects of parenting practices, such as parent-child communication and parental monitoring, on sexual behaviors among young people, the effect size of parent-child connectedness (PCC) remains underexplored. The objective of this study was to explore the associations between PCC and sexual intercourse, unprotected sex, multiple sexual partners, and unintended pregnancy among young people. We searched and screened relevant literature published between January 2000 and May 2025 from six databases: PubMed/Medline, Web of Science, Ovid Embase, Cumulative Index to Nursing and Allied Health Literature, Education Resources Information Center, and APA PsycArticles. Eligible studies underwent quality assessment and data extraction. The meta-analysis used a multilevel mixed-effects model to calculate pooled odds ratios (OR). A total of 18 studies involving 78,284 participants were included. Meta-analysis indicated that a higher level of PCC was significantly associated with a lower risk of sexual intercourse (OR 0.72; 95% CI: 0.61-0.84), unprotected sex (OR 0.84; 95% CI: 0.74-0.96) and unintended pregnancy (OR 0.62; 95% CI: 0.43-0.91) among young people. However, its association with multiple sexual partners was not statistically significant. Higher levels of PCC are associated with lower risks of sexual-related behaviors and outcomes. However, findings should be interpreted cautiously given the high heterogeneity and limited number of included studies. Further research should explore its effects in broader populations, and incorporate prospective designs.

Background: Point-of-care (POC) testing for chlamydia and gonorrhea has seen significant advancements, with nucleic acid amplification tests yielding results within 30 min. The aims of this study were to: (1) describe implementation of POC nucleic acid amplification testing in urban non-clinical outreach settings, and (2) explore demographic and symptom correlates of test positivity to inform testing strategies.

Methods: A program evaluation and retrospective data review was conducted of individuals undergoing POC sexually transmitted infection (STI) testing in non-clinical testing sites in Dallas, Texas, USA. Chi-squared and Fisher's exact tests were used to investigate the association between positive test results with demographic characteristics and presence of symptoms.

Results: Ninety-eight individuals were tested using the binx io CT/NG Assay. There were 12 cases of chlamydia and 5 cases of gonorrhea diagnosed within 30 min of testing, and all were referred for treatment within 1 day of testing. No statistically significant associations were detected between test positivity and demographics or symptoms; however, analyses were limited by small sample size.

Conclusions: POC nucleic acid amplification testing enabled rapid diagnosis and referral in this urban outreach setting. Further evaluation of scalability, cost and treatment completion is warranted.

Background: Zimbabwe has ratified international agreements and developed national policies, such as the National Disability Policy (2021), promoting the rights of people with disabilities (PWD). However, a significant gap persists between policy and the lived reality of PWD accessing sexual and reproductive health (SRH) services. Therefore, this study aimed to explore the lived experiences of people with sensory and physical disabilities in accessing SRH services in Bulawayo, Zimbabwe.

Methods: A qualitative study was conducted in Bulawayo Metropolitan Province of Zimbabwe. Twenty participants with sensory and physical disabilities were recruited to represent diversity in gender, age, and disability type. In-depth, semi-structured phone or text message interviews depending on participant need and preference, until data saturation was reached. Data were analysed using reflexive thematic analysis, following a six-step process to ensure analytical rigour.

Results: Four themes were identified: (1) structural and infrastructural barriers; (2) financial exclusion due to multiplied costs; (3) systemic communication failures; and (4) pervasive stigma and discrimination from healthcare providers. These barriers intersect to limit SRH access and result in unmet sexual and reproductive needs, unwanted pregnancies, and avoidance of healthcare facilities.

Conclusion: Despite a progressive policy environment, the implementation of disability-inclusive SRH services in Bulawayo is critically weak. Urgent action is required, including mandatory disability sensitivity training for all healthcare workers, investment in accessible infrastructure and assistive communication devices, enforcement of accessibility standards through regular audits, and engagement with disability advocacy groups to monitor policy compliance. These measures are essential to bridge the gap between law and practice and uphold the SRH rights of PWD.

Background: Mycoplasma genitalium (MG) is an important sexually transmitted pathogen associated with cervicitis, pelvic inflammatory disease and adverse reproductive outcomes. Female sex workers (FSWs) are at elevated risk; however, data on MG epidemiology and antimicrobial resistance in this population in China remain limited. This study assessed the prevalence of MG infection, associated risk factors and resistance-related mutations among FSWs.

Methods: This cross-sectional study was conducted from April to August 2022 in four cities in Guangdong Province. FSWs were recruited through venue-based outreach. Participants completed structured questionnaires covering sociodemographic characteristics and sexual behaviors. Urine and blood samples were collected for laboratory confirmation of MG, Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and HIV. MG-positive specimens were subjected to Sanger sequencing to detect macrolide resistance mutations in the 23S rRNA gene, and fluoroquinolone resistance mutations in the gyrA and parC genes. Logistic regression analyses were used to identify factors associated with MG infection.

Results: Among 955 FSWs, the prevalence of MG was 6.6%, whereas the prevalences of C. trachomatis, N. gonorrhoeae, T. pallidum and HIV were 14.0%, 1.7%, 1.4% and 0.1%, respectively. Multivariate logistic regression analysis revealed higher odds of MG infection among women with monthly income ≤3000 RMB (aOR 2.61, 95% CI: 1.08-6.31), primary school education or below (aOR 2.87, 95% CI: 1.12-7.37), work in mid-level venues (aOR 2.64, 95% CI: 1.37-5.09) and C. trachomatis co-infection (aOR 3.30, 95% CI: 1.81-6.01). Among MG-positive samples with successful amplification, macrolide resistance-associated mutations in the 23S rRNA gene were detected in 70.27% (26/37). Fluoroquinolone resistance-associated mutations were identified in 78.95% (30/38) of amplifiable parC samples and in only one amplifiable gyrA sample. The S83I substitution in parC was the most prevalent, accounting for 66.67% (20/30) of parC mutations. Dual resistance-conferring mutations in both macrolide (23S rRNA) and fluoroquinolone (parC) targets were observed in 51.35% (19/37) of samples.

Conclusion: MG infection persists at a relatively high level among FSWs, accompanied by alarmingly high rates of macrolide and fluoroquinolone resistance mutations. These findings highlight the urgent need for strengthened surveillance, improved access to molecular diagnostics, and tailored prevention and treatment strategies to curb MG transmission and preserve antimicrobial efficacy in this high-risk population.

Background: Sexual health in the postpartum period contributes to a patient's overall well-being, highlighting the importance of addressing concerns that may arise related to sexual dysfunction. The comprehensive postpartum visit should include providing guidance on sexuality, management of dyspareunia, and resumption of intercourse. There is little literature examining the incidence of such counseling.

Methods: Patients who attended their postpartum visit at a large, urban academic medical center were invited to complete a web-based survey at their postpartum visit as part of a quality initiative. The survey consisted of a total of 34 questions evaluating frequency and quality of sexual health counseling, as well as sexual experience after delivery. Descriptive statistics, chi-squared tests, and multivariable logistic regression were used to analyze our findings.

Results: Our survey study had a 41.5% response rate (277/668). A total of 91% of participants reported receiving some sexual health counseling at their postpartum visit but only half of participants reported the counseling as helpful. Providers were statistically more likely to discuss sexual health with primiparous over multiparous participants (94.9% vs 87.9%; P = 0.037) and patients who had not yet resumed intercourse (93.5% vs 85.7%; P = 0.039). Providers had longer conversations with patients who delivered vaginally versus via cesarean (P = 0.039).

Conclusions: Providers at this institution are almost universally offering some sexual health counseling to patients. However, we found that parity, delivery mode, and resumption of intercourse may impact providers' likelihood of discussing sexual health with postpartum patients.

Background: Biomedical prevention technologies, such as pre-exposure prophylaxis, treatment as prevention and the principle of Undetectable = Untransmittable, have transformed HIV care and opened new possibilities for enhancing the sexual wellbeing of people living with HIV. Yet, the psychosocial and relational benefits of these tools, particularly their impact on sexual wellbeing, remain underexplored, especially across diverse subpopulations.

Methods: Using data from 669 people living with HIV participating in a large-scale survey of people living with HIV in Australia, this study developed the Sexual Wellbeing through Biomedical Prevention scale, a five-item measure assessing sexual wellbeing (e.g. confidence, enjoyment) in the context of biomedical HIV prevention (score range 0-20; higher scores = greater wellbeing). ANOVA tests examined differences in Sexual Wellbeing through Biomedical Prevention scores across demographic, relational, psychosocial and health-related variables.

Results: Exploratory factor analysis supported a single-factor structure. The mean Sexual Wellbeing through Biomedical Prevention score was moderate overall (M = 13.0), but varied significantly by gender, sexuality, relationship status, partner pre-exposure prophylaxis use, stigma and quality of life. Gay/queer men reported markedly higher scores than women and heterosexual participants. Higher scores were associated with partner pre-exposure prophylaxis use, reduced fear of transmission, and better self-reported health and quality of life. Participants who reported 'always' experiencing HIV-related stigma had significantly lower mean scores.

Discussion: Biomedical advances have improved virological outcomes, but their sexual wellbeing benefits appear unevenly distributed. Targeted interventions that address stigma, strengthen HIV literacy and support sexual confidence, particularly among women and heterosexual people living with HIV, are essential to realising the full potential of biomedical prevention and advancing equity in wellbeing.

Background: This study aimed to investigate the prevalence and temporal patterns of five major sexually transmitted infections (STIs) among individuals with HIV in Jiading, Shanghai, China, from 2009 to 2024.

Methods: Data on HIV and the five targeted STIs, including Treponema pallidum, Neisseria gonorrhoeae, condyloma acuminatum (HPV), genital herpes (HSV) and genital Chlamydia trachomatis infection, were extracted from the China Information System for Disease Control and Prevention. Descriptive analyses and logistic regression models were used to describe temporal patterns and identify associated factors.

Results: Among 1337 individuals with HIV, 24.8% (n = 367) had at least one STI diagnosis. T. pallidum was the most prevalent (63.5%), followed by HPV (20.4%), N. gonorrhoeae (9.3%), C. trachomatis (4.9%) and HSV (1.9%). Simultaneous HIV and STI diagnoses accounted for 41.1% of cases, and STI before HIV accounted for 39.8%. In multivariable analysis, homosexual transmission was associated with higher odds of STI diagnosis compared with heterosexual transmission (aOR 1.55; 95% CI: 1.11-2.17). Individuals diagnosed in hospitals also had higher odds of STI detection than those diagnosed in voluntary counseling and testing clinics (aOR 2.00; 95% CI: 1.49-2.68).

Conclusions: Syphilis and HPV are highly prevalent among individuals with HIV, and frequently occur before or concurrently with HIV diagnosis. Low detection rates of N. gonorrhoeae, C. trachomatis and HSV likely reflect asymptomatic infections and underscreening. These findings underscore the need for routine and integrated HIV and STI screening, as well as targeted prevention strategies to reduce the syndemic burden of HIV and STIs.