Article Feed - This Week in Sexual Health

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Abstract

Sexual function after hysterectomy can be a concern for patients, and research remains inconclusive about changes in sexual function associated with hysterectomy.

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Article Details

Title:
Hysterectomy and sexual function: a systematic review and meta-analysis.

Author(s):
Dedden SJ; Werner MA; Steinweg J; Lissenberg-Witte BI; Huirne JAF; Geomini PMAJ; Maas JWM

Summary:
Many people worry about their sex life after having a hysterectomy, but scientists still haven't figured out exactly how it might change. The research doesn't have clear answers yet.

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pubmed id: 36857309 Indexed on February 9th, 2025

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Abstract

Few evidence-based interventions exist to improve person-centred maternity care in low-resource settings. This study aimed to understand whether a quality improvement (QI) intervention could improve person-centred maternity care (PCMC) experiences for women delivering in public health facilities in Kenya. A pre-post design was used to examine changes in PCMC scores across three intervention and matched control facilities at baseline ( = 491) and endline ( = 677). A QI intervention, using the Model for Improvement, was implemented in three public health facilities in Nairobi and Kiambu Counties in Kenya. Difference-in-difference analyses using models that included main effects of both treatment group and survey round was conducted to understand the impact of the intervention on PCMC scores. Findings suggest that intervention facilities' average total PCMC score decreased by 5.3 points post-intervention compared to baseline (95% CI: -8.8, -1.9) and relative to control facilities, holding socio-demographic and facility variables constant. Additionally, the intervention was significantly associated with a 1.8-point decrease in clinical quality index pre-post-intervention (95% CI: -2.9, -0.7), decreased odds of provider visits, and less likelihood to plan to use postpartum family planning. While improving the quality of women's experiences during childbirth is a critical component to ensure comprehensive, high-quality maternity care experiences and outcomes, further research is required to understand which intervention methods may be most appropriate to improve PCMC in resource-constrained settings.

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Title:
Can a quality improvement intervention improve person-centred maternity care in Kenya?

Author(s):
Sudhinaraset M; Giessler KM; Nakphong MK; Munson MM; Golub GM; Diamond-Smith NG; Opot J; Green CE

Summary:
This study looked at ways to make maternity care better for women in Kenya. A special program was tried in some hospitals, but it didn't lead to better care. More research is needed to find the best ways to help women during childbirth in places with fewer resources.

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pubmed id: 36857118 Indexed on February 9th, 2025

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Abstract

As governments impose restrictive policies to contain infectious disease outbreaks, pre-existing gender-based inequalities are often exacerbated, increasing the risk of gender-based violence (GBV). Despite international guidance on the need for continued provision of GBV services during emergencies, governments often de-prioritise GBV services and programmes. We conducted a rapid assessment in South Africa, Kenya, Uganda, and Nigeria to examine the impact of COVID-19 policies on the availability of GBV prevention and response services. The study team interviewed 80 stakeholders representing different GBV services in the four countries. The interviews revealed strikingly similar government mis-steps that disrupted the availability of comprehensive GBV services. In all four countries, the government's failure to exempt the provision of multi-sectoral GBV services from initial lockdown restrictions led to confusion and disrupted the provision of critical GBV services such as clinical management of rape, legal and judicial services, psychosocial services, availability of shelters, and community-based prevention activities. The government's imposition of curfews, stay-at-home orders, and transportation restrictions further diminished access to services. Governments must strengthen currently available GBV prevention and response services and be better prepared for future pandemics. Following international guidelines, governments should deem GBV services as essential from the beginning with clear implementation plans. Governments must invest in community-based solutions and the expansion of digital tools to ensure everyone, especially those likely to be structurally excluded, have access to critical services during an emergency.

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Title:
Government responses to COVID-19 and impact on GBV services and programmes: comparative analysis of the situation in South Africa, Kenya, Uganda, and Nigeria.

Author(s):
John NA; Bukuluki P; Casey SE; Chauhan DB; Jagun MO; Mabhena N; Mwangi M; McGovern T

Summary:
Governments tried to stop the spread of COVID-19 with strict rules, which made it harder for people to get help with gender-based violence. In South Africa, Kenya, Uganda, and Nigeria, important services for victims were harder to access because they weren't treated as essential. Governments should make sure these services are always available during emergencies by planning better and using digital tools.

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pubmed id: 36857089 Indexed on February 9th, 2025

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Abstract

Recent reviews of the pornography literature have called for the development of valid and reliable measures that assess multiple facets of pornography use. Moreover, despite pornography use having important implications for romantic relationships, there are currently no self-report assessments of pornography use specifically within the context of romantic relationships. To address these limitations, the current paper reports on two studies regarding the development and psychometric evaluation of a 38-item multidimensional measure of pornography use within the context of romantic relationships: the Pornography Use in Romantic Relationships Scale (PURRS). Study 1 (n = 739) reports on an Exploratory and Confirmatory Factor Analytic approach to determine the factor structure of the PURRS. Study 2 (n = 765) reports on the cross-validation of the factor structure of the PURRS, before assessing the criterion validity of the measure. The PURRS exhibited good internal consistency, construct validity, and criterion validity. The findings suggest that the PURRS is best modeled by 13 first-order factors, though a higher-order factor structure comprising four broad factors may also be used. The PURRS significantly extends on past assessments of pornography use, and in particular, advances the assessment and study of pornography use within the context of romantic relationships.

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Article Details

Title:
The Development and Validation of the Pornography Use in Romantic Relationships Scale.

Author(s):
Lawless NJ; Karantzas GC; Knox L

Summary:
This paper talks about a new tool called the PURRS, which helps to understand how people use pornography in their romantic relationships. The tool was tested in two studies with lots of people to make sure it works well and gives good information. The results showed that the PURRS is a good way to study pornography use in relationships.

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pubmed id: 36853349 Indexed on February 9th, 2025

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Abstract

In the last decade, research on "sexting" has undergone an exponential increase, giving rise to the publication of numerous studies clarifying its meaning, offering information of educational value, and favoring a good use of technology to prevent problems caused by this exchange of sexual information. The aim of this article was to analyze the production, performance, impact, and content of scientific articles evaluating the "sexting" thesaurus (title, abstract, and/or keywords) between 2009 and September 2019. Articles were sourced from two internationally recognized databases: Scopus and Web of Science. A scientometric study was then carried out on a sample of 641 articles that met the established inclusion criteria. The main findings indicate that "sexting" is a very recent research focus, but one in full growth phase, with scientific production related to the topic likely to double over the next few years. Although "sexting" has been researched worldwide, the scientific production of the US and American authors is the most notable. There were also some differences between the Scopus and Web of Science databases, mainly in the volume of production and the trend. However, the studies do show a common research line, "cyberbullying," and a common target population: adolescents. Therefore, the content analysis reveals that research on "sexting" is mostly carried out with adolescents and takes into consideration other themes such as cyberbullying, dating violence, and sexuality.

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Title:
Retrospective and Prospective Analysis on "Sexting": Indicators of Productivity, Dispersion, and Content (2009-2019).

Author(s):
Rodríguez-García AM; Moreno-Guerrero AJ; García-Carmona M

Summary:
Scientists are studying "sexting," which is when people send sexual messages or pictures using technology. They looked at many articles from 2009 to 2019 and found that this topic is growing fast, especially in the United States. Most of the research is about teens and also talks about problems like cyberbullying and dating violence.

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pubmed id: 36849675 Indexed on February 9th, 2025

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Abstract

Prior studies found that sexting was associated with risky sexual activities and that men who have sex with men (MSM) engaged in more frequent sexting than their heterosexual counterparts. Therefore, it is pertinent to understand what factors are associated with sexting among MSM. This study explored the relationships between sensation-seeking, gay identity confusion, and muscularity ideal with sexting behaviors. An online survey was administered to 355 and 448 18-34-year-old MSM in Hong Kong and Taiwan, respectively. While the number of sexting partners and the frequency of sexting were similar across the two regions, they had different associations with psychological factors. In Hong Kong, sensation-seeking was positively related to the number of sexting partners, while in Taiwan, it was positively related to the frequency of sending sexts. In Hong Kong, MSM who were more confused about their sexual orientation had fewer sexting partners. In both regions, MSM holding a stronger muscularity ideal also had more sexting partners. Gay identity confusion and muscularity ideal were associated with sexting under pressure in Taiwan; all three psychological factors concerned were associated with sexting under pressure in Hong Kong. Overall, these results showed that some MSM found sexting to be a sensation-fulfilling activity, but some were vulnerable to sexting under pressure. Counseling services to MSM about their sexual identity and concern for muscularity are needed to prevent them from becoming victims of forced sexting. Finally, the inconsistent results for the Hong Kong and Taiwanese samples indicated the importance of considering regional specificity in sexting research.

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Article Details

Title:
Sexting Among Men Who Have Sex with Men in Hong Kong and Taiwan: Roles of Sensation-Seeking, Gay Identity, and Muscularity Ideal.

Author(s):
Chan LS; Wu-Ouyang B

Summary:
This study looked at why some men who like other men send more text messages about sex. It found that in Hong Kong and Taiwan, men who sought excitement or wanted to look strong were more likely to send these messages. Some also felt pressure to send them, so helping these men with their feelings and body image is important.

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pubmed id: 36849674 Indexed on February 9th, 2025

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Abstract

This study assessed the effectiveness of a school-based stigma-reduction intervention focusing on stigmatising attitudes towards girls associated with abortion and contraceptive use. In February 2017, two gender-mixed secondary schools ( = 1368) in peri-urban areas of Kisumu County, Kenya, were assigned to receive either an 8-hour stigma-reduction intervention over four sessions (intervention school: IS) or standard comprehensive sexuality education (control school: CS). A classroom survey entailing two five-point Likert scales - the 18-item Adolescents Stigmatizing Attitudes, Beliefs and Actions (ASABA) scale, which measures abortion stigma, and the seven-item Contraceptive Use Stigma (CUS) scale - was conducted to collect data at baseline, 1-month and 12-months after the intervention. The intervention was to be considered effective if a mean score reduction of 25% was achieved for both the ASABA (primary outcome) and the CUS (secondary outcome) at the IS between baseline and 12-month follow-up. 1207 (IS = 574; CS = 633) students were included in analyses at 1-month follow-up, and 693 (IS = 323; CS = 370) at 12-months (the final-year students had left school). A decrease in mean score on both scales was observed at 1-month at both schools. At 12-months, the score decrease was 30.1% at the IS and 9.0% at the CS for ASABA, and 27.3% at the IS and 7.9% at the CS for CUS. At the IS, the score decrease for ASABA between baseline and 12-months was 23.3% among girls and 31.2% among boys; for CUS, the decrease was 27.3% and 24.3%, respectively. ASABA and CUS were positively correlated ( = 0.543; < 0.001), implying a broader perspective on reproductive stigma. A four-session, school-based stigma-reduction intervention could lead to transformed values and attitudes towards gender norms among adolescents regarding abortion and contraceptive use. Stigma associated with abortion and contraception should become a priority for high-quality CSE programmes.

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Article Details

Title:
A stigma-reduction intervention targeting abortion and contraceptive use among adolescents in Kisumu County, Kenya: a quasi-experimental study.

Author(s):
Makenzius M; Rehnström Loi U; Otieno B; Oguttu M

Summary:
The study looked at a special program in schools to help change how kids think about girls and topics like abortion and using contraception. After a year, the schools that had the program showed a bigger drop in negative attitudes compared to the schools that didn't get the program. This suggests that schools can help change how students feel about these topics.

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pubmed id: 36846933 Indexed on February 9th, 2025

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Abstract

The stressful nature of the early months of the COVID-19 pandemic severely impacted the quality of maternity care. The purpose of this study was to understand and explore the labour and delivery experiences for women who were diagnosed with COVID-19 in Brazil during this time. Between July and October 2020, we conducted 28 semi-structured interviews with postpartum women who tested positive for COVID-19 prior to delivering at a tertiary hospital in Fortaleza, Brazil. Interview transcripts were coded, and we carried out a thematic analysis using three domains of the World Health Organization's model of intrapartum care for a positive childbirth experience as a framework. During labour and delivery, women experienced varying levels of respect, with many women reporting feeling mistreated by their healthcare team because of their COVID-19 diagnosis. Due to COVID-19 hospital protocols that denied companions or visitors, women reported feeling unsupported and isolated, especially during the mandatory quarantine. Women also experienced varying levels of effective communication, with some women citing they felt the staff were often fearful, and either avoidant or disrespectful. A minority of women reported that the staff appeared to be respectful and receptive to their needs. Our findings provide preliminary evidence that the strain of the COVID-19 pandemic on health professionals potentially results in ineffective communication and mistreatment during labour and delivery. Embedding respectful and humanised childbirth principles into emergency maternal healthcare protocols may improve the childbirth experience for women with COVID-19, as well as for women during future public health emergencies.

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Article Details

Title:
COVID-19 threatens the progress of humanised childbirth: a qualitative study of giving birth during the pandemic in Brazil.

Author(s):
Ross T; de Maria de Albuquerque C; Chaves J; Carneiro Rolim KM; Albuquerque Frota M; Surkan PJ

Summary:
The study looked at what it was like for women in Brazil to have babies during the COVID-19 pandemic. Many women felt sad and alone because they couldn't have visitors, and some said doctors and nurses weren't nice to them. The study suggests treating moms kindly during emergencies could make things better.

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pubmed id: 36825627 Indexed on February 9th, 2025

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Abstract

The love and companionship provided from romantic relationships is a right for all adults, yet many adults with intellectual and developmental disabilities (IDD) have been unable to experience these forms of relationship. This study investigates the experiences and perspectives on romantic relationships regarding adults with IDD involved in an inclusive supported living program. We asked residents with IDD, their parents, graduate student residents (without disabilities), and organization staff for their insights into the romantic relationships of adults with IDD and how the organization could better support those relationships. The residents with IDD described romantic relationships in various ways, but all emphasized their importance. Participants discussed an array of challenges in this area, including difficulty meeting people to date, challenges with social skills, and a lack of comprehensive sexual education. Likewise, the study noted a number of tensions that arise when supporting adults with IDD to pursue romantic relationships, including their comfort addressing this area, navigating dignity of risk, and acceptance from family members. The residents, parents, and staff members also provided helpful recommendations for how supported living organizations can most effectively support individuals with IDD in romantic relationships.

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Article Details

Title:
Romantic Relationships and Adults with IDD in Inclusive Supported Living: Considerations, Complexities, and Opportunities.

Author(s):
Charpentier K; Carter EW

Summary:
The study is about adults with intellectual and developmental disabilities (IDD) and their experiences with romantic relationships. It talks about how important these relationships are and the challenges they face, like meeting people and learning social skills. The study also shares ideas on how organizations can better support people with IDD in having romantic relationships.

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pubmed id: 36819486 Indexed on February 9th, 2025

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Abstract

Men's adherence to constraining male gender norms can lead them to resist contraceptive use. Very few interventions have attempted to transform masculine norms to encourage greater contraceptive acceptance and gender equality. We designed and evaluated a small-scale community-based intervention targeting the masculine norms tied to contraceptive resistance among partnered men ( = 150) in two western Kenya communities (intervention vs. control). Pre-post survey data fit to linear and logistic regression models evaluated differences in post-intervention outcomes, accounting for pre-intervention differences. Intervention participation was associated with increases in contraceptive acceptance scores (adjusted coefficient (aβ) 1.04; 95% confidence interval (CI) 0.16, 1.91; = 0.02) and contraceptive knowledge scores (aβ 0.22; 95% CI 0.13, 0.31; < 0.001) and with contraceptive discussions with one's partner (adjusted Odds Ratio (aOR) 3.96; 95% CI 1.21, 12.94; = 0.02) and with others (aOR 6.13; 95% CI 2.39, 15.73; < 0.001). The intervention was not associated with contraceptive behavioural intention or use. Our findings demonstrate the promise of a masculinity-driven intervention on increasing men's contraceptive acceptance and positive contraceptive involvement. A larger randomised trial is needed to test the effectiveness of the intervention among men as well as among couples.

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Article Details

Title:
Transforming masculine norms to improve men's contraceptive acceptance: results from a pilot intervention with men in western Kenya.

Author(s):
Newmann SJ; Zakaras JM; Rocca CH; Gorrindo P; Ndunyu L; Gitome S; Withers M; Bukusi EA; Dworkin SL

Summary:
Researchers studied a program in two communities in Kenya to help men accept and talk about using birth control. The program helped men know more and have more talks about birth control, but didn't change if they planned to use or did use it. More research with more people is needed to see if this program works well.

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pubmed id: 36811906 Indexed on February 9th, 2025

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Abstract

Involvement as peer researchers provides young people with an opportunity to exercise their right to participation and can facilitate unique insights into young people's lives, social contexts, choices and negotiations. However, evidence on the approach has to date included little in-depth discussion on the complexities presented by sexuality research. Here, engaging young people as researchers is influenced by intersecting cultural discourses, particularly regarding youth agency and sexual freedom. This article provides practice-based insights from involving young people as peer researchers within two rights-based sexuality-focused research projects in Indonesia and the Netherlands. Drawing on two contrasting cultural contexts, it explores benefits and challenges regarding youth-adult power dynamics, the taboo nature of sexuality, research quality and dissemination. Recommendations for future studies include ongoing training and capacity strengthening for peer researchers which recognise cultural and educational backgrounds, strong youth-adult partnerships creating an enabling environment for the engagement of peer researchers, careful consideration of how young people are involved and critical reflection on adult-centric views of what constitutes "academic" research.

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Article Details

Title:
Working with young peer researchers in sexuality studies: benefits, challenges and lessons learnt.

Author(s):
Page A; Cense M; van Reeuwijk M

Summary:
Young people worked as researchers in projects about sexuality in Indonesia and the Netherlands. The study talks about how this helps them learn and share their ideas but also shows the challenges they face because of different cultures and adult ideas. It suggests training and partnerships to make future projects better.

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pubmed id: 36811895 Indexed on February 9th, 2025

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Abstract

Infertility is a reproductive health concern that deserves attention, as reconfirmed by the 2018 report of the Guttmacher- Commission on Sexual and Reproductive Health and Rights (SRHR). However, governments and SRHR organisations tend to neglect infertility. We conducted a scoping review of existing interventions aiming to decrease the stigmatisation of infertility in low- and middle-income countries (LMICs). The review consisted of a combination of research methods: academic database (Embase, Socological abstracts, google scholar; resulting in 15 articles), Google and social media searches, and primary data collection (18 key informant interviews and 3 focus group discussions). The results distinguish between infertility stigma interventions targeted at intrapersonal, interpersonal and structural levels of stigma. The review shows that published studies on interventions tackling infertility stigmatisation in LMICs are rare. Nevertheless, we found several interventions at intra- and interpersonal levels aiming to support women and men to cope with and mitigate infertility stigmatisation (e.g. counselling, telephone hotlines, and support groups). A limited number of interventions addressed stigmatisation at a structural level (e.g. empowering infertile women to become financially independent). The review suggests that infertility destigmatisation interventions need to be implemented across all levels. Interventions geared to individuals experiencing infertility should include women and men and also be offered beyond the clinical setting; and interventions should also aim to combat stigmatising attitudes of family or community members. At the structural level, interventions could aim to empower women, reshape masculinities and improve access to and quality of comprehensive fertility care. Interventions should be undertaken by policymakers, professionals, activists, and others working on infertility in LMICs, and accompanied with evaluation research to assess their effectiveness.

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Article Details

Title:
Breaking the silence around infertility: a scoping review of interventions addressing infertility-related gendered stigmatisation in low- and middle-income countries.

Author(s):
Gerrits T; Kroes H; Russell S; van Rooij F

Summary:
Infertility is an important health issue that many people overlook, especially in lower-income countries. Researchers looked at different ways to help reduce the shame people feel about not being able to have children. They found some ideas that help people personally, like counseling, and suggested changes in communities and attitudes to better support those affected.

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pubmed id: 36811853 Indexed on February 9th, 2025

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Abstract

This study examined how gender shapes sexual interactions and pleasure outcomes. We highlight varying expectations people have in regard to sex by combining questions about orgasm frequency and sexual pleasure. Our analysis was driven from a sample of 907 survey responses from cis women, cis men, trans women, trans men, non-binary, and intersex millennial respondents, 324 of which had gender-diverse sexual histories. The findings built upon previous literature about the orgasm gap by including those with underrepresented gender identities and expanding our conceptualization of gender's role in the gap beyond gender identity. Qualitative results indicated that individuals change their behavior based on their partner's gender and follow strong gendered scripts. Participants also relied upon heteronormative scripts and cis normative roles to set their interactions for the sexual encounter. Our findings support previous research on how gender identity impacts pleasure outcomes and has implications for how we might make gender progress in the arena of sexuality.

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Article Details

Title:
The Relational Nature of Gender, the Pervasiveness of Heteronormative Sexual Scripts, and the Impact on Sexual Pleasure.

Author(s):
Harvey P; Jones E; Copulsky D

Summary:
This study looked at how gender affects people's experiences during sex, including how often they have orgasms and how much pleasure they feel. The researchers found that people change their behavior based on their partner's gender, and they often follow traditional gender roles during sexual encounters. This work helps us understand more about how gender identity and expectations impact sexual pleasure.

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pubmed id: 36810636 Indexed on February 9th, 2025

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Abstract

A person convicted of sex offences (PCSO) is confronted with several challenges upon re-entry to the community, often facing difficulties accessing housing and employment, and experiencing stigmatisation, hostility and harassment from community members. Given the importance of community support for successful reintegration, we examined differences in public ( = 117) attitudes toward a PCSO against a child (PCSO-C) with mental illness or intellectual disability compared to a neurotypical PCSO-C in an online survey. At present, differences in attitudes towards these groups has not been explored. Results indicated the PCSO-Cs with intellectual disability or mental illness were seen to pose less risk of sexual reoffending and prompted higher levels of reintegration comfort than the neurotypical PCSO-C. Participants' prior personal exposure to mental illness or intellectual disability was unrelated to attitudes, but those who believed that PCSOs in general have a low capacity for change attributed greater risk of sexual reoffending, greater risk of future harm to children, higher levels of blame and lower reintegration comfort, regardless of MI and ID information. Female participants also perceived greater risk of future harm to adults, and older participants estimated higher risk of sexual reoffending than younger participants. Findings have implications for community acceptance of PCSO-Cs and jury decision-making processes and highlight the importance of public education regarding neurodiverse PCSO-Cs and PCSO capacity for change to encourage knowledge-based judgements.

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Article Details

Title:
The Impact of Mental Illness and Intellectual Disability Information on General Public Perceptions of a Person Convicted of a Child Sex Offence.

Author(s):
Brodie ZP; Shirlaw K; Hand CJ

Summary:
People who have done bad things like sex offenses have a hard time when they return to live in the community. They found that if the person had mental illness or an intellectual disability, people thought they were less likely to do bad things again and were a bit more comfortable having them back in the community than those without such conditions. The study shows how important it is to teach people about these differences.

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pubmed id: 36809111 Indexed on February 9th, 2025

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Abstract

Recent findings suggest that the rate of certain cancers can be reduced by increasing human papillomavirus (HPV) vaccination coverage, resulting in considerable research interest on the antecedents of HPV vaccine receipt to identify avenues to promote vaccination. The current article continues this stream of research by (1) studying the three HPV vaccination outcomes of willingness, receipt, and word-of-mouth, (2) investigating the antecedent effects of sociodemographic characteristics, health insurance status, provider conversation, and political orientation, and (3) testing the mediating role of vaccine hesitancy dimensions using a recently developed conceptualization. We achieve these goals by conducting a cross-sectional study with 404 participants (Age = 37.64; Age = 14.91; 57% female; 72% white; 100% located in U.S.). Our results show that provider conversations and political orientation had the most consistent and strong effects of the personal characteristics, whereas perceptions that vaccines pose health risks and perceptions that vaccines are not needed for healthy individuals produced the most consistent and strong effects of the vaccine hesitancy dimensions. Other personal characteristics and vaccine hesitancy dimensions also produced intermittent significant effects, including age, education, and race. Together, these results support that personal characteristics and vaccine hesitancy dimensions relate to a broader range of outcomes associated with HPV vaccination than previously known, and these results also support that the recently developed conceptualization of vaccine hesitancy is apt for understanding HPV vaccine perceptions. Our discussion concludes with highlighting avenues for future research and practice that can leverage our discovered relations to improve HPV vaccination outcomes.

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Article Details

Title:
Relation of Personal Characteristics with Human Papillomavirus Vaccination Outcomes: Assessing the Mediating Role of Vaccine Hesitancy Dimensions.

Author(s):
Howard MC

Summary:
Some research suggests that getting more people to take the HPV vaccine can lower cancer rates. The study found that talking with healthcare providers and political beliefs strongly affect if people are willing to get the vaccine. Also, some people think vaccines aren't safe or necessary, which can cause them to hesitate.

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pubmed id: 38596759 Indexed on February 9th, 2025

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Abstract

Adolescence and young adulthood are important periods of transition and therefore for action and intervention to ensure future sexual and reproductive health (SRH). Caregiver-adolescent communication about sex and sexuality is a protective factor for SRH, but there are often barriers to this. Adults' perspectives are limited within the literature but important as they should lead this process. This paper uses exploratory qualitative data from in-depth interviews with 40 purposively sampled community stakeholders and key informants to explore their insights into the perceived, experienced or expected challenges adults' experience when having these conversations within a high HIV prevalence, South African context. Findings suggest that respondents recognised the value of communication and were generally willing to try it. However, they identified barriers such as fear, discomfort and limited knowledge and perceived capacity to do so. They show that in high prevalence contexts adults grapple with their own personal risks, behaviours and fears that may affect their ability to have these conversations. This demonstrates the need to equip caregivers with the confidence and ability to communicate about sex and HIV, alongside managing their own complex risks and situations to overcome barriers. It is also necessary to shift the negative framing of adolescents and sex.

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Article Details

Title:
'A difficult conversation': community stakeholders' and key informants' perceptions of the barriers to talking about sex and HIV with adolescents and young people in KwaZulu-Natal, South Africa.

Author(s):
Knight L; Humphries H; Van der Pol N; Ncgobo N; Essack Z; Rochat T; van Rooyen H

Summary:
Talking with kids about sex and keeping them safe is important but can be hard for adults. This study talks to people in South Africa about the challenges they face in doing this. It says that adults need help to feel more comfortable and prepared to have these talks.

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pubmed id: 36803644 Indexed on February 9th, 2025

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Abstract

Mate choice in humans is specific by the involvement of kin both in partner choice and in the functioning of the relationship. The influence of relatives ranges from providing advice all the way to arranged marriages. Existing research so far tended to map neither the actual parental interventions and further reactions (counteractions) nor the independently pursued behavior (actions) by which the offspring or their partners assert their interests. This study identified such sets of behaviors through semi-structured individual interviews with members of 20 dyads of adult offspring and their biological parents (five son-mother, five son-father, five daughter-mother, and five daughter-father dyads). Thematic analysis revealed sets of parental actions aimed at the offspring, their partners, and the couple as a whole, as well as further counteractions (reactions to parental interference) and independently pursued behavior (actions) of the offspring and their partners aimed at the parents in the context of the offspring's previous or current relationship. Our findings showed that parental interference differed depending on the recipient: toward the couple were applied mainly indirect and supportive parental actions, whereas when facing their offspring or offspring's partner, parents' actions were more direct and disruptive. Our results thus indicate the importance of reporting about actual interactions which differ from the hypothetical settings used in prior studies by lower intensity. Moreover, by interviewing both members of dyads, we expanded the sets of actions and counteractions identified by prior studies and managed to limit self-reporting bias.

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Article Details

Title:
Parental Interference in Offspring's Mate Choice: Sets of Actions and Counteractions Based on Both Perspectives.

Author(s):
Fišerová A; Havlíček J; Urban M; Urban K; Štěrbová Z

Summary:
This study looked at how parents get involved in their kids' relationships and how the kids and their partners react. Parents try to help or sometimes interfere, but the kids and their partners have their own ways to handle it. The research showed that parents act differently depending on if they're dealing with the couple together or just one person, and interviewing both sides helped get a clearer picture.

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pubmed id: 36800066 Indexed on February 9th, 2025

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Abstract

This literature review synthesises existing evidence and offers a thematic analysis of primary care and emergency department experiences of lesbian, gay, bisexual, transgender, queer and/or any other sexual or gender minority (LGBTQ+) individuals in Canada. Articles detailing first-person primary or emergency care experiences of LGBTQ + patients were included from EMBASE, MEDLINE, PsycINFO and CINHAL. Studies published before 2011, focused on the COVID-19 pandemic, unavailable in English, non-Canadian, specific to other healthcare settings, and/or only discussing healthcare provider experiences were excluded. Critical appraisal was performed following title/abstract screening and full-text review by three reviewers. Of sixteen articles, half were classified as general LGBTQ + experiences and half as trans-specific experiences. Three overarching themes were identified: discomfort/disclosure concerns, lack of positive space signalling, and lack of healthcare provider knowledge. Heteronormative assumptions were a key theme among general LGBTQ + experiences. Trans-specific themes included barriers to accessing care, the need for self-advocacy, care avoidance, and disrespectful communication. Only one study reported positive interactions. LGBTQ + patients continue to have negative experiences within Canadian primary and emergency care - at the provider level and due to system constraints. Increasing culturally competent care, healthcare provider knowledge, positive space signals, and decreasing barriers to care can improve LGBTQ + experiences.

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Article Details

Title:
Lesbian, gay, bisexual, transgender and or queer patient experiences in Canadian primary care and emergency departments: a literature review.

Author(s):
Campbell J; Nathoo A; Chard S; Messenger D; Walker M; Bartels SA

Summary:
This research paper looked at how LGBTQ+ people in Canada feel about going to the doctor or emergency room. Most experiences were not good, with people feeling uncomfortable and thinking doctors didn't understand them well. The paper suggests making healthcare more welcoming and understanding for LGBTQ+ people.

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pubmed id: 36794329 Indexed on February 9th, 2025

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Abstract

Good quality patient care requires health care providers to respect the humanity and autonomy of their patients. However, this is not achieved in all settings. This study used cross-sectional survey data including open-ended text responses to explore negative experiences with health care providers among women in Appalachia. We used the Heath Stigma & Discrimination Framework (HSDF) to identify how stigma is created and perpetuated through interactions with health care providers. Survey data from 628 women collected through purposive sampling identified that two out of three participants had had a bad encounter with a provider that made them not want to return for care. One in six participants had a negative experience specifically while seeking contraception. Using the domains of the HSDF framework, qualitative answers to open-ended questions illuminated how health care providers, influenced by social and cultural norms related to religiosity, patriarchal views, poverty, poor health infrastructure, and the opioid crisis, created and perpetuated stigma through dehumanising treatment, low-quality care, and health care misogyny. Because stigma is a driver of health inequity, these findings highlight the important and sometimes problematic role that health care providers can play when they create a barrier to future care through poor treatment of patients.

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Article Details

Title:
Mistreatment in health care among women in Appalachia.

Author(s):
Alspaugh A; Swan LET; Auerbach SL; Bartmess M; Agbemenu K; Ely GE

Summary:
Many women in Appalachia had bad experiences with doctors that made them not want to go back. The study found that these experiences often happened because of the way doctors treated them, affected by things like poverty and cultural beliefs. This can keep people from getting the care they need.

Meta:
pubmed id: 36780368 Indexed on February 9th, 2025

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Abstract

Suicide is a major public health concern, patterned by systematic inequalities, with lesbian, gay, bisexual and trans (LGBT+) people being one example of a minoritised group that is more likely to think about and attempt suicide worldwide. To address this, UK national suicide prevention policies have suggested that LGBT+ people should be prioritised in prevention activities. However, there is little research seeking to understand how LGBT+ suicide is re/presented in political and policy spheres. In this article, we critically analyse all mentions of LGBT+ suicide in UK parliamentary debates between 2009 and 2019 and in the eight suicide prevention policies in use during this period. We argue that LGBT+ suicide is understood in two contrasting ways: firstly, as a pathological 'problem', positioning LGBT+ people either as or as and in need of mental health support. Alternatively, suicide can be seen as externally attributable to perpetrators of homophobic, biphobic and transphobic hate, requiring anti-hate activities as part of suicide prevention. In response, we argue that although these explanations may appear oppositional; they both draw on reductive explanations of LGBT+ suicide, failing to consider the complexity of suicidal distress, thus constraining understandings of suicide and suicide prevention.

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Article Details

Title:
The politics of LGBT+ suicide and suicide prevention in the UK: risk, responsibility and rhetoric.

Author(s):
Marzetti H; Chandler A; Jordan A; Oaten A

Summary:
This paper looks at how people talk about LGBT+ suicide in UK government debates and policies from 2009 to 2019. It finds two main views: one sees LGBT+ people as needing mental health help, while the other blames hate against them, but both ideas oversimplify the issue.

Meta:
pubmed id: 36780346 Indexed on February 9th, 2025

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February 9th, 2025

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