ABSTRACT
OBJECTIVES: To characterize the sexual and reproductive health (SRH) services available to men from publicly funded family planning clinics in California. STUDY DESIGN: We conducted a cross-sectional telephone survey in 2018 to compare the accessibility of SRH services for male clients at Planned Parenthood clinics in California to those visiting a random sample of 200 other publicly funded family planning clinics, selected from a California Department of Health Care Services list of 773 that had served at least 15 male clients in the prior year. A representative at each clinic answered questions about provision of 20 clinical services. We examined differences in individual service provision by clinic affiliation using χ2 tests. RESULTS: Only one-third (773/2348) of publicly funded clinics in California served more than 15 male clients each year, with rural clinics less likely than urban counties to do so. We were able to contact 62 of 107 Planned parenthood clinics and 81 of the 200 other publicly-funded family planning clinics that we attempted to reach. Most (95%) offered HIV and STI screening; 65% offered vasectomy consultation, but only 5% provided vasectomy services. Planned Parenthood clinics were more likely than other publicly funded clinics to provide condom demonstrations, emergency contraception, STI testing, HPV vaccination, penile/testicular exams, and infertility testing (p < 0.05 for all comparisons). CONCLUSIONS: Male family planning services are less frequently offered by rural clinics and by publicly funded clinics in California that are not affiliated with Planned Parenthood. IMPLICATIONS: Men's underutilization of family planning may be partially explained by a lack of access to clinical services.
Subject(s)
Family Planning Services , Vasectomy , Ambulatory Care Facilities , Cross-Sectional Studies , Health Services Accessibility , Humans , Male , Sex EducationABSTRACT
Prostate cancer (PCa) is the second leading cause of cancerrelated mortality among American males. Studies suggest that cigarette smoking is associated with the progression of PCa; however, the molecular mechanisms underlying this process have not been extensively investigated. PCa progression is characterized by increased cell migration and alterations in extracellular matrix (ECM) and cell adhesion molecule (CAM)related gene expression. In the present study, the influence of cigarette smoke medium (SM) on cell migration and on the expression of ECM and CAMrelated genes in PC3 prostate adenocarcinoma cells was investigated. According to a woundhealing assay, SM treatment promoted PC3 cell migration. RNA expression levels from SMtreated and control cells were analyzed using a polymerase chain reaction (PCR) array. Of 84 genes analyzed, 27.38% (23/84) exhibited a ≥2fold change in threshold cycle in PC3 cells following 0.5% SM treatment. Functional gene grouping analysis demonstrated that SM treatment modulated the RNA transcription of approximately 18.4% of CAMs and 33.93% of ECMrelated genes. Quantitative PCR analysis showed that SM treatment led to a significant decrease in transcription levels of the following genes: Collagen 5 α1(V), connective tissue growth factor, integrin ß2, kallmann syndrome 1, laminin α 3, matrix metallopeptidase 7 (MMP7), MMP13, secreted protein acidic cysteinerich, thrombospondin2 and versican; and that SM significantly increased the transcription levels of MMP2 and MMP12. Furthermore, MMP2 knockdown significantly reduced the migration of SMtreated PC3 cells. The present study provides novel insights into the association of cigarette smoking with PCa progression, via the alteration of ECM/CAM interactions.
