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2.
J Youth Adolesc ; 51(4): 708-723, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1739389

ABSTRACT

Media may function as sex educators for adolescents; unfortunately, media messages often glamorize risky sexual behaviors and unhealthy relationships and neglect sexual health behaviors and communication. Media Aware is a web-based comprehensive sexual health program for high school students that uses a media literacy education approach. It is designed to improve adolescents' critical thinking about media messages and provide medically-accurate information and skills building related to sexual health and communication. A randomized controlled trial was conducted in 2019-2020 with students (grades 9 and 10; n = 590) from 17 high schools across the United States. The sample was 53% female, 58% white/Caucasian; and 13% Hispanic/Latinx. One high school teacher per school and all of their 9th and 10th grade students were randomly assigned to either the intervention or delayed-intervention (control) condition. The study assessed the immediate (posttest) and short-term (3-month) effects of Media Aware on adolescents' media, sexual health, and communication outcomes. For 9 of the 17 schools, students were home from school due to the beginning of the COVID-19 pandemic during the time of their 3-month data collection, which left the short-term analyses underpowered. However, several impacts of the program were found in the immediate posttest analyses. Media Aware was found to improve sexual health knowledge and redress inaccurate normative beliefs about the frequency of risky teen sex. Media Aware also improved critical thinking about media messages with demonstrated improvements in media message deconstruction skills and decreases in the perceived realism of media messages. Moderator analyses found some differential immediate effects of the program attributable to gender. Media Aware reduced girls' normative beliefs about teen sex, generally, and increased their sexual health communication with parents as well as reduced boys' acceptance of dating violence. Students gave positive feedback about Media Aware, especially related to the online format of the program. The results from this study provide evidence that Media Aware is an effective web-based program for positively enhancing high school students' media, sexual health, and sexual health communication outcomes.


Subject(s)
COVID-19 , Sexual Health , Adolescent , COVID-19/prevention & control , Communication , Female , Humans , Literacy , Male , Pandemics , Sex Education/methods , Sexual Behavior , Sexual Health/education , United States
3.
Br J Gen Pract ; 72(714): 32, 2022 01.
Article in English | MEDLINE | ID: covidwho-1732294
4.
Arch Sex Behav ; 51(1): 169-181, 2022 01.
Article in English | MEDLINE | ID: covidwho-1702955

ABSTRACT

Recent findings suggest that the current COVID-19 pandemic has a potential negative impact in several areas of life, including sexual health. However, less is known about the psychological dimensions that may work as vulnerability/protective factors for the development of sexual problems in the current pandemic. The current study used a longitudinal design to examine the role played by personality trait factors (neuroticism, extraversion) as well as psychosexual factors (sexual beliefs) in predicting sexual functioning and sexual distress across time during the current pandemic crisis. A total of 528 individuals (337 women) completed a web survey assessing sexual health indicators and psychological factors. The first wave was conducted during the confinement period in Portugal (N = 528) between May and June 2020 and the second four months later (N = 146), when strict confinement rules were over. Generalized estimating equations (GEE) were used to examine the ability of psychological factors to predict sexual functioning and distress across time, while controlling for age and gender. Results indicated that sexual distress at time point 2 was lower than during confinement, and men had lower levels of sexual functioning post-confinement while no significant difference was observed for women. Moreover, higher levels of neuroticism and age-related beliefs significantly predicted lower sexual functioning as well as higher sexual distress, whereas lower levels of extraversion predicted lower sexual functioning after controlling for age and gender effects. Findings support the role of psychological vulnerability factors to predict sexual problems across time and may have important implications in the prevention and treatment of sexual dysfunctions.


Subject(s)
COVID-19 , Sexual Health , Female , Humans , Male , Pandemics , Portugal/epidemiology , Protective Factors , SARS-CoV-2 , Surveys and Questionnaires
5.
PLoS One ; 17(2): e0261034, 2022.
Article in English | MEDLINE | ID: covidwho-1686093

ABSTRACT

Despite billions of dollars invested into Sexual and Reproductive Health and Rights (SRHR) efforts, the effect of incorporating sexual pleasure, a key driver of why people have sex, in sexual health interventions is currently unclear. We carried out a systematic review and meta-analysis following PRISMA guidelines across 7 databases for relevant articles published between 1 January 2005-1 June, 2020. We included 33 unique interventions in our systematic review. Eight interventions reporting condom use outcomes were meta-analyzed together with a method random effects model. Quality appraisal was carried out through the Cochrane Collaborations' RoB2 tool. This study was pre-registered on Prospero (ID: CRD42020201822). We identified 33 unique interventions (18886 participants at baseline) that incorporate pleasure. All included interventions targeted HIV/STI risk reduction, none occurred in the context of pregnancy prevention or family planning. We find that the majority of interventions targeted populations that authors classified as high-risk. We were able to meta-analyze 8 studies (6634 participants at baseline) reporting condom use as an outcome and found an overall moderate, positive, and significant effect of Cohen's d = 0·37 (95% CI 0·20-0·54, p < 0·001; I2 = 48%; τ2 = 0·043, p = 0·06). Incorporating sexual pleasure within SRHR interventions can improve sexual health outcomes. Our meta-analysis provides evidence about the positive impact of pleasure-incorporating interventions on condom use which has direct implications for reductions in HIV and STIs. Qualitatively, we find evidence that pleasure can have positive effects across different informational and knowledge-based attitudes as well. Future work is needed to further elucidate the impacts of pleasure within SRHR and across different outcomes and populations. Taking all the available evidence into account, we recommend that agencies responsible for sexual and reproductive health consider incorporating sexual pleasure considerations within their programming.


Subject(s)
Sexual Health , Databases, Factual , HIV Infections/prevention & control , Humans , Reproductive Health , Right to Health , Sexually Transmitted Diseases/prevention & control
6.
Int J Environ Res Public Health ; 19(3)2022 Jan 27.
Article in English | MEDLINE | ID: covidwho-1667134

ABSTRACT

The accumulated evidence maps the COVID-19 pandemic's diverse impacts on sexual and reproductive health (SRH); however, the precise changes in sexual behaviours and the underlying causes producing these changes are rarely considered. This study is aimed at assessing the changes in sexual behaviours during the COVID-19 pandemic in Germany, using quantitative methods, and it is also aimed at identifying the underlying reasons, using qualitative methods. It is a part of the broader I-SHARE project, which administered a cross-sectional online survey in 33 countries to describe the effects of the COVID-19 restrictions on different aspects of SRH. In the current study, a total of 611 adults from Germany are included. The findings demonstrate a decline in sexual satisfaction, as well as increases in sexual problems and partnership conflicts. Furthermore, the findings indicate an increase in pornography consumption and masturbation. Psychological stress, due to the pandemic, seemed to be the main reason for the changes in the participants' sexual behaviours, followed by a decrease in social contacts, and an increase in time resources. Thus, it is important to provide accessible clinical and psychosocial (online) interventions and services in order to maintain good sexual health in times of pandemic.


Subject(s)
COVID-19 , Sexual Health , Adult , Cross-Sectional Studies , Germany/epidemiology , Humans , Pandemics , Reproductive Health , SARS-CoV-2
8.
Sex Health ; 18(5): 385-393, 2021 11.
Article in English | MEDLINE | ID: covidwho-1596308

ABSTRACT

Background The emergence of artificial intelligence (AI) provides opportunities for demand management of sexual and reproductive health services. Conversational agents/chatbots are increasingly common, although little is known about how this technology could aid services. This study aimed to identify barriers and facilitators for engagement with sexual health chatbots to advise service developers and related health professionals. Methods In January-June 2020, we conducted face-to-face, semi-structured and online interviews to explore views on sexual health chatbots. Participants were asked to interact with a chatbot, offering advice on sexually transmitted infections (STIs) and relevant services. Participants were UK-based and recruited via social media. Data were recorded, transcribed verbatim and analysed thematically. Results Forty participants (aged 18-50 years; 64% women, 77% heterosexual, 58% white) took part. Many thought chatbots could aid sex education, providing useful information about STIs and sign-posting to sexual health services in a convenient, anonymous and non-judgemental way. Some compared chatbots to health professionals or Internet search engines and perceived this technology as inferior, offering constrained content and interactivity, limiting disclosure of personal information, trust and perceived accuracy of chatbot responses. Conclusions Despite mixed attitudes towards chatbots, this technology was seen as useful for anonymous sex education but less suitable for matters requiring empathy. Chatbots may increase access to clinical services but their effectiveness and safety need to be established. Future research should identify which chatbots designs and functions lead to optimal engagement with this innovation.


Subject(s)
Reproductive Health Services , Sexual Health , Adolescent , Adult , Artificial Intelligence , Female , Humans , Male , Middle Aged , Reproductive Health , Sex Education , Young Adult
9.
Ann Agric Environ Med ; 28(4): 667-675, 2021 Dec 29.
Article in English | MEDLINE | ID: covidwho-1591762

ABSTRACT

INTRODUCTION AND OBJECTIVE: A change in the body mass may be one of the health consequence of the COVID-19 pandemic, and may affect the health condition measured in many dimensions. The paper aims at assessment of the level and determinants of the body mass changes and stress level in the initial months of the COVID-19 pandemic, and the interrelation of these two factors. MATERIAL AND METHODS: Data were collected in June 2020, as a cross-sectional on-line survey. The representative sample of 2,535 Poles aged 18-65 was analysed. The main outcome is the Cohen's stress index PSS-4. Among thirteen independent variables, five were related to the change observed during the pandemic (including the body mass change and satisfaction with sexual life). RESULTS: Increase of the body mass within the period of the pandemic was declared by 33.9% of the respondents, including 36.1% in urban and 30.9% in rural areas (p=0.026). The average increase of body mass was 5.11 kg. The increase of body mass was related to the existing overweight and obesity, occurrence of chronic diseases, episodes of physical and mental crisis, and decrease of interest in sexual activity. The average index of stress in the initial months of the pandemic was 6.38±2.94. Multivariate regression analysis showed eight independent predictors of stress in the whole group, seven in towns and five in rural areas. The significance of the relationship with the body mass increase was proved only among residents of rural areas. CONCLUSIONS: The initial months of the COVID-19 pandemic were reflected, to a different extent, among residents of urban and rural areas. Body mass change and sexual health indicators remained significant predictors of stress level, even after analyses were corrected for other covariates.


Subject(s)
Body Mass Index , COVID-19 , Health Status , Mental Health , Sexual Health , Adult , Cross-Sectional Studies , Humans , Pandemics , Poland , Rural Population , Urban Population
10.
BMJ Open ; 11(12): e049010, 2021 12 08.
Article in English | MEDLINE | ID: covidwho-1559314

ABSTRACT

INTRODUCTION: More research and policy action are needed to improve migrant health in areas such as sexual health and blood-borne viruses (SHBBV). While Knowledge, Attitudes and Practice Surveys (KAPS) can inform planning, there are no SHBBV KAPS suitable for use across culturally and linguistically diverse contexts. This study pretests one instrument among people born in Sub-Saharan Africa, South-East and North-East Asia living in Australia. METHODS: Employees of multicultural organisations were trained to collect data over three rounds using a hybrid qualitative pretesting method. Two researchers independently coded data. Researchers made revisions to survey items after each round. Responses to feedback questions in the final survey were analysed. RESULTS: Sixty-two participants pretested the survey. Issues were identified in all three rounds of pretesting. Of the 77 final survey respondents who responded to a survey experience question, 21% agreed and 3% strongly agreed with the statement 'I found it hard to understand some questions/words'. CONCLUSION: It is essential to pretest SHBBV surveys in migrant contexts. We offer the following pretesting guidance: (1) large samples are needed in heterogeneous populations; (2) intersectionality must be considered; (3) it may be necessary to pretest English language surveys in the participants' first language; (4) bilingual/bicultural workers must be adequately trained to collect data; (5) results need to be interpreted in the context of other factors, including ethics and research aims; and (6) pretesting should occur over multiple rounds.


Subject(s)
Sexual Health , Transients and Migrants , Australia , Health Surveys , Humans , Surveys and Questionnaires
12.
Int J Impot Res ; 34(2): 138-144, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1493095

ABSTRACT

Since severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first discovered, there have been questions surrounding the effects of coronavirus disease 2019 (COVID-19), and more recently the COVID-19 vaccine, on men's health and fertility. Significant research has been conducted to study viral tropism, potential causes for gender susceptibility, the impact of COVID-19 on male sexual function in the acute and recovery phases, and the effects of the virus on male reproductive organs and hormones. This review provides a recent assessment of the literature regarding the impact of COVID-19 and its vaccine on male sexual health and reproduction.


Subject(s)
COVID-19 , Sexual Health , Vaccines , COVID-19/prevention & control , COVID-19 Vaccines , Female , Humans , Male , Pregnancy , Reproduction , SARS-CoV-2
13.
Sex Health ; 18(4): 294-302, 2021 09.
Article in English | MEDLINE | ID: covidwho-1434217

ABSTRACT

International students within Australia are disproportionately affected by adverse sexual and reproductive health (SRH) outcomes. Chinese international students represent the majority of international students in Australia, and a large proportion of students in other high-income countries such as the United States and the United Kingdom, making them an important priority group. However, the SRH issues of this priority group have received little attention from international researchers. This review provides an overview of global studies surrounding the SRH knowledge, attitudes and behaviours of Chinese international students studying abroad. Ten articles were deemed relevant and findings from both the qualitative and quantitative data synthesis were categorised into six codes: (1) knowledge; (2) sources of information; (3) attitudes; (4) behaviours; (5) barriers; and (6) recommendations. The findings provide valuable understanding to inform the development of targeted, culturally sensitive and inclusive health promotion initiatives and policies. It is recommended that further research is conducted in this field to reduce evident health disparities.


Subject(s)
Reproductive Health , Sexual Health , China , Health Knowledge, Attitudes, Practice , Humans , Students
14.
BMC Public Health ; 20(1): 1771, 2020 Nov 23.
Article in English | MEDLINE | ID: covidwho-1388748

ABSTRACT

BACKGROUND: Guaranteeing the sexual and reproductive health and rights (SRHR) of populations living in fragile and humanitarian settings is essential and constitutes a basic human right. Compounded by the inherent vulnerabilities of women in crises, substantial complications are directly associated with increased risks of poor SRHR outcomes for displaced populations. The migration of Venezuelans, displaced due to current economic circumstances, is one of the largest in Latin America's history. This study aims to provide an overview of the sexual and reproductive health (SRH) issues affecting migrant Venezuelan women in the state of Roraima, Brazil. METHODS: Face-to-face interviews were conducted from 24 to 30 November 2019. Data collection covered various issues involving access to and use of SRH services by 405 migrant Venezuelan women aged 18-49 years. The Minimum Initial Service Package readiness assessment tools, available from the Inter-Agency Working Group on Reproductive Health in Crises, were used in the data collection. RESULTS: Most commonly, the women reported unmet family planning needs. Of these, a significant proportion reported being unable to obtain contraceptive methods, particularly long-acting reversible contraceptives, either due to the woman's inability to access them or their unavailability at healthcare centres. Although a significant proportion of women were largely satisfied with the attention received at the maternity hospital, both before and during childbirth, 24.0% of pregnant or postpartum women failed to receive any prenatal or postnatal care. CONCLUSION: Meeting the essential SRHR needs of migrant Venezuelan women in Roraima, Brazil is a challenge that has yet to be fully addressed. Given the size of this migrant population, the Brazilian healthcare system has failed to adapt sufficiently to meet their needs; however, problems with healthcare provision are similar for migrants and Brazilian citizens. Efforts need to be encouraged not only in governmental health sectors, but also with academic, non-governmental and international organisations, including a coordinated approach to ensure a comprehensive SRHR response. Given the current high risks associated with the SARS-CoV-2 pandemic, meeting the SRHR needs of migrant populations has become more critical than ever.


Subject(s)
Maternal Health/statistics & numerical data , Transients and Migrants/statistics & numerical data , Brazil , Female , Health Services Needs and Demand , Humans , Pregnancy , Reproductive Health , Reproductive Rights , Sexual Health , Venezuela/ethnology
15.
PLoS One ; 16(8): e0255704, 2021.
Article in English | MEDLINE | ID: covidwho-1365423

ABSTRACT

BACKGROUND: Governments commonly fund research with specific applications in mind. Such mechanisms may facilitate 'research translation' but funders may employ strategies that can also undermine the integrity of both science and government. We estimated the prevalence and investigated correlates of funder efforts to suppress health behaviour intervention trial findings. METHODS: Our sampling frame was lead or corresponding authors of papers (published 2007-2017) included in a Cochrane review, reporting findings from trials of interventions to improve nutrition, physical activity, sexual health, smoking, and substance use. Suppression events were based on a previous survey of public health academics. Participants answered questions concerning seven suppression events in their efforts to report the trial, e.g., [I was…] "asked to suppress certain findings as they were viewed as being unfavourable." We also examined the association between information on study funder, geographical location, targeted health behaviour, country democracy rating and age of publication with reported suppression. FINDINGS: We received responses from 104 authors (50%) of 208 eligible trials, from North America (34%), Europe (33%), Oceania (17%), and other countries (16%). Eighteen percent reported at least one of the seven suppression events relating to the trial in question. The most commonly reported suppression event was funder(s) expressing reluctance to publish because they considered the results 'unfavourable' (9% reported). We found no strong associations with the subject of research, funding source, democracy, region, or year of publication. CONCLUSIONS: One in five researchers in this global sample reported being pressured to delay, alter, or not publish the findings of health behaviour intervention trials. Regulation of funder and university practices, establishing study registries, and compulsory disclosure of funding conditions in scientific journals, are needed to protect the integrity of public-good research.


Subject(s)
Financial Management/trends , Health Behavior , Randomized Controlled Trials as Topic , Research Design , Research Personnel/economics , /economics , Alcoholism/prevention & control , Diet, Healthy , Europe , Exercise , Government Programs/economics , Humans , North America , Preventive Medicine/methods , Sexual Health , Surveys and Questionnaires , Tobacco Use/prevention & control
16.
Sci Rep ; 11(1): 16310, 2021 08 11.
Article in English | MEDLINE | ID: covidwho-1354118

ABSTRACT

The coronavirus disease (COVID-19) has already been declared a global pandemic. To our knowledge, there is very little information regarding the effects of COVID-19 on women seeking reproductive health services, specifically abortion. This study was aimed to assess the impact of the COVID-19 pandemic on reproductive and sexual health among women seeking abortion services. We conducted a series of preliminary analyses using data collected from ten maternal and child health hospitals of seven provinces in China before and during the COVID-19 lockdown. The present study showed that a significant decrease was observed in the frequency of sexual intercourse during the COVID-19 pandemic. Moreover, a significant increase in contraceptive use including condom, rhythm method and coitus interruptus whereas a decrease in choosing oral contraceptives were observed during the COVID-19 pandemic. In addition, the pandemic was associated with increased intention of seeking induced abortion due to social factors. Future research should look into the long-term impact of the COVID-19 pandemic on sexual and reproductive health.


Subject(s)
Abortion, Induced , COVID-19/physiopathology , Reproduction , Sexual Health , Adolescent , Adult , Cohort Studies , Contraception/statistics & numerical data , Female , Humans , Middle Aged , Prospective Studies , Sexual Behavior , Young Adult
17.
BMJ Sex Reprod Health ; 47(4): e16, 2021 10.
Article in English | MEDLINE | ID: covidwho-1352566

ABSTRACT

OBJECTIVE: A weak and politicised COVID-19 pandemic response in the United States (US) that failed to prioritise sexual and reproductive health and rights (SRHR) overlaid longstanding SRHR inequities. In this study we investigated how COVID-19 affected SRHR service provision in the US during the first 6 months of the pandemic. METHODS: We used a multiphase, three-part, mixed method approach incorporating: (1) a comprehensive review of state-by-state emergency response policies that mapped state-level actions to protect or suspend SRHR services including abortion, (2) a survey of SRHR service providers (n=40) in a sample of 10 states that either protected or suspended services and (3) in-depth interviews (n=15) with SRHR service providers and advocacy organisations. RESULTS: Twenty-one states designated some or all SRHR services as essential and therefore exempt from emergency restrictions. Protections, however, varied by state and were not always comprehensive. Fourteen states acted to suspend abortion. Five cross-cutting themes surrounding COVID-19's impact on SRHR services emerged across the survey and interviews: reductions in SRHR service provision; shifts in service utilisation; infrastructural impacts; the critical role of state and local governments; and exacerbation of SRHR inequities for certain groups. CONCLUSIONS: This study demonstrates serious disruptions to the provision of SRHR care that exacerbated existing SRHR inequities. The presence or absence of policy protections for SRHR services had critical implications for providers and patients. Policymakers and service providers must prioritise and integrate SRHR into emergency preparedness planning and implementation, with earmarked funding and tailored service delivery for historically oppressed groups.


Subject(s)
COVID-19 , Sexual Health , Female , Humans , Pandemics , Pregnancy , Reproductive Health , SARS-CoV-2 , United States
18.
BMJ Open ; 11(7): e047034, 2021 07 26.
Article in English | MEDLINE | ID: covidwho-1327662

ABSTRACT

OBJECTIVES: Pharmacists are increasingly providing patient-focused services in community pharmacies, including in the area of sexual and reproductive health (SRH). Specific SRH areas have been the focus of research, but a broader perspective is needed to position pharmacists as SRH providers. This review explored research that described and evaluated professional pharmacy services across a broad range of SRH areas. DESIGN: Scoping review DATA SOURCES: Medline, EMBASE, CINAHL, Web of Science, Scopus and Cochrane Library (January 2007-July 2020). STUDY SELECTION: Studies reporting on the description and evaluation of professional pharmacy SRH services provided by community pharmacists. DATA EXTRACTION: Two investigators screened studies for eligibility, and one investigator extracted the data. Data were analysed to primarily describe professional pharmacy services and intervention outcomes. RESULTS: Forty-one studies were included. The main SRH areas and professional pharmacy services reported were sexually transmitted and bloodborne infections (63%) and screening (39%), respectively. Findings showed that pharmacists' delivery of SRH services was feasible, able to reach vulnerable and high-risk groups, and interventions were highly accepted and valued by users. However, integration into daily workflow, pharmacist remuneration, cost and reimbursement for patients, and policy regulations were some of the barriers identified to implementing SRH services. Studies were primarily in specific areas such as chlamydia screening or hormonal contraception prescribing, while studies in other areas (ie, medical abortion provision, long-acting reversible contraception prescribing and vaccine delivery in pregnant women) were lacking. CONCLUSION: This scoping review highlights the expansion of pharmacists' roles beyond traditional product-focused services in a number of SRH areas. Given the potential feasibility, users' acceptability and reach, pharmacists are ideally situated to enhance SRH care access. Future research describing implementation and evaluation of professional pharmacy services in all SRH areas is needed to promote access to these services through community pharmacies and position pharmacists as SRH providers worldwide.


Subject(s)
Community Pharmacy Services , Pharmacies , Reproductive Health Services , Sexual Health , Female , Health Services Accessibility , Humans , Pharmacists , Pregnancy , Professional Role
20.
Health Promot Pract ; 22(6): 764-766, 2021 11.
Article in English | MEDLINE | ID: covidwho-1299307

ABSTRACT

The Dignity Pack Project is a small-scale, crisis-oriented supply chain in Atlanta, Georgia, designed to meet the acute personal hygiene,menstrual health, and sexual health needs of people experiencing homelessness (PEH). It was organized in response to conditions during the COVID-19 pandemic that continue to illuminate and exacerbate the distinct and complex challenges PEH face when trying to meet their basic needs and maintain their health. In addition to being particularly vulnerable to COVID-19 due to underlying conditions, crowding, and shared living spaces, the pandemic makes it harder for PEH to access already scant resources. Specifically, shelters across the United States have experienced outbreaks and, as a result, have reduced capacity or closed completely. Social support organizations have paused or restricted services. Donations and volunteering have decreased due to economic conditions and social distancing requirements. This practice note describes how we integrated feedback from PEH at the outset of the Dignity Pack project-and continue to do so-enabling the development of a pragmatic, humanistic outreach model that responds to the evolving needs of PEH as pandemic conditions and the seasons change. We detail how we established complementary partnerships with local organizations and respond to critical insights provided by PEH. We offer lessons and recommendations driven by the needs and preferences of PEH.


Subject(s)
COVID-19 , Homeless Persons , Sexual Health , Georgia , Humans , Hygiene , Pandemics , SARS-CoV-2 , United States
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