International Journal of Sexual Health最新文献

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.

Background: Sexuality is influenced by a combination of psychological, emotional, and physiological factors, where sexual satisfaction is a key component. Progressive muscle relaxation exercises are commonly used to reduce anxiety and improve physical relaxation, but their impact on sexual satisfaction and function, particularly for individuals with low sexual satisfaction, has not been widely studied. This study aimed to investigate the effect of progressive muscle relaxation exercises applied to women with low sexual satisfaction on the sexual satisfaction and function of both the women and their partners.

Methods: This single-blind, randomized controlled study was conducted from April 2023 to January 2024. The study sample consisted of 120 couples, randomly assigned to either the intervention or control group. Women in the intervention group performed progressive muscle relaxation exercises three times a week for four weeks, while the control group did not receive any intervention. The outcomes measured were sexual satisfaction and sexual function, using the Sexual Satisfaction Scale and the Arizona Sexual Experiences Scale (ASEX), for both the women and their partners.

Results: Significant improvements were observed in the sexual satisfaction scores of both women and their partners in the intervention group, with a statistically significant difference between the groups. In the intervention group, there was a significant increase in sexual satisfaction scores (from 33.12 ± 9.22 to 73.93 ± 6.31) and a marked decrease in ASEX scores (from 14.61 ± 4.51 to 2.71 ± 1.64). In contrast, the control group showed no significant changes in either sexual satisfaction (from 30.17 ± 11.11 to 33.12 ± 9.22) or ASEX scores (from 14.88 ± 3.29 to 12.88 ± 3.11).

Conclusion: The results suggest that progressive muscle relaxation exercises can significantly improve sexual satisfaction and function in women with low sexual satisfaction and their partners, providing a potential intervention for sexual dysfunction.

Objectives: Young people in the university period, known as the transition phase from adolescence to adulthood, are at serious risk in terms of risky sexual behaviors (first sexual intercourse, use of contraceptives, sexually transmitted infections, unwanted pregnancy, maternal mortality, sexual violence). The fact that young people actively use social media and have not received adequate sexual and reproductive health education until the university period is an indication that they are a risky group in terms of sexual and reproductive health when they enter university. It is difficult to access accurate, complete and effective information through digital means, both on social media and other platforms. This study was conducted to evaluate the effectiveness of sexual and reproductive health education methods given to university students.

Method: A randomized controlled study was conducted with 165 students at a state university in Istanbul between May and July 2022. In the implementation phase of the study, the students were divided into three different groups: 55 students received QR code-supported face-to-face training (intervention group 1), 55 students received face-to-face training (intervention group 2), and 55 students received on-line training (control group).

Results: The mean age of the students was 21.6 ± 1.87 and 66.7% of them were female. When the effect of education in the groups was examined, it was determined that there was a significant difference between the pretest and post-test of the sexual health knowledge test, QR code supported face-to-face, on-line and face-to-face groups. The level of participation in the statements related to education also differed significantly according to the groups (p < .05).

Conclusions: The post-test mean of the Sexual Health Knowledge test was significantly higher than the pretest mean. There was no significant difference in the pre-training and post-training means of the Reproductive Health Scale. The level of participation of the QR code-supported face-to-face group and the face-to-face group to the statements related to education is significantly higher than the on-line group. In our study, it was concluded that students were more interactive and more comfortable in the face-to-face education model.

Objectives: The Indonesian Ministry of Health reports a significant three-fold increase in newly diagnosed HIV cases among women aged 15 and above, rising from 12,537 cases in 2015 to 35,415 in 2024. Over the past decade, the largest group of new HIV cases in Indonesia has been among women of reproductive age (15-49 years). This trend is largely driven by the widely held and fallacious belief that heterosexual, married women are not at risk of HIV. In this study we aim to challenge this misconception and investigate the complexity of HIV transmission, with a focus on HIV susceptibility among married women in Indonesia.

Methods: Feminist Participatory Action Research was conducted with 24 women living with HIV (WLWH) in Palembang, South Sumatra, Indonesia. Interviews and focus group discussions were employed to assess the impact of the actions of women and men who partake in high-risk behaviors that could result in them passing HIV onto their spouses.

Results: The study shows that among 24 women living with HIV, 14 contracted HIV from male partners who engaged in unsafe sexual behavior, and who often knowingly transmitted HIV. Those male partners may have had extra-marital affairs with women, women sex workers, or with other men or been involved in polygamous marriages. This article provides insight into the vulnerability of married women getting HIV from their spouse and highlights that healthy marital sexual relationships depend on respect, trust, and clear communication.

Conclusions: We argue that improving HIV health literacy in Indonesia, along with open discussions about sexual practices, are crucial. While these conversations may challenge deeply ingrained social, cultural and religious norms regarding sexuality, marriage and ideal gender relations, they are critical for halting the spread of HIV in Indonesia.