Understanding Practical, Robust Implementation and Sustainability of Home-based Comprehensive Sexual Health Care: A Realist Review.

This review identifies which elements of home-based comprehensive sexual health care (home-based CSH) impacted which key populations, under which circumstances. A realist review of studies focused on home-based CSH with at least self-sampling or self-testing HIV and additional sexual health care (e.g., treatment, counseling). Peer-reviewed quantitative and qualitative literature from PubMed, Embase, Cochrane Register of Controlled Trials, and PsycINFO published between February 2012 and February 2023 was examined. The PRISM framework was used to systematically assess the reach of key populations, effectiveness of the intervention, and effects on the adoption, implementation, and maintenance within routine sexual health care. Of 730 uniquely identified records, 93 were selected for extraction. Of these studies, 60% reported actual interventions and 40% described the acceptability and feasibility. Studies were mainly based in Europe or North America and were mostly targeted to MSM (59%; 55/93) (R). Overall, self-sampling or self-testing was highly acceptable across key populations. The effectiveness of most studies was (expected) increased HIV testing. Adoption of the home-based CSH was acceptable for care providers if linkage to care was available, even though a minority of studies reported adoption by care providers and implementation fidelity of the intervention. Most studies suggested maintenance of home-based CSH complementary to clinic-based care. Context and mechanisms were identified which may enhance implementation and maintenance of home-based CSH. When providing the individual with a choice of testing, clear instructions, and tailored dissemination successful uptake of STI and HIV testing may increase. For implementers perceived care and treatment benefits for clients may increase their willingness to implement home-based CSH. Therefore, home-based CSH may determine more accessible sexual health care and increased uptake of STI and HIV testing among key populations.

Receptive Anal Intercourse: Impact on Colorectal and Urologic Diagnoses.

Purpose: We evaluated the relationship between lifetime receptive anal intercourse (RAI) and the risk of common colorectal and urologic diagnoses. Methods: We conducted an internet-based survey on sensations during RAI between July 2022 and March 2023. We used multivariable logistic regression to assess the independent impact of lifetime RAI exposure on the diagnosis of common urologic and colorectal conditions. Participants completed a main survey and were invited to complete randomly assigned patient-reported outcome measures (PROMs), which measured pelvic symptoms, mental health symptoms, and sexual satisfaction. Results: In total, 1100 participants completed the main survey and 416 completed the PROMs. Participants of the main survey ranged from 18 to 78 years old and the median age of the sample was 32 years. There was no significant association between lifetime RAI exposure and any medical diagnosis, except for anal fissures, which increased linearly with additional RAI exposure. Both sexual satisfaction and mental health symptoms improved with RAI exposure. Conclusions: RAI was not associated with most of the colorectal and urologic diagnoses tested and was associated with fewer mental symptoms and increased sexual satisfaction. Development of anal fissures may be directly related to trauma of the anal canal from penetration.

Determinants of Sexual Health and Sexual Quality of Life after Cardiovascular Surgeries: An Integrative Review.

BACKGROUND AND AIM: Sexual health and sexual quality of life are key components of psychosocial adjustment after cardiac surgeries and are often linked with improving the general quality of life. Reviews have been conducted to highlight the associations between cardiovascular diseases and sexual dysfunctions, but no review reported determinants of sexual health and sexual quality of life in patients after cardiovascular surgeries. We aimed to comprehensively examine the determinants of sexual health and sexual quality of life among individuals with cardiovascular surgeries. METHODS: Literature was searched within PubMed, CINAHL, Scopus, Web of Science, and OVID databases. In total, 816 records were identified from database searches, 279 records were screened, and 11 empirical studies were included for review. Relevant data were extracted using literature summary tables and synthesised using an inductive approach. RESULTS: The core determinants of sexual health and sexual quality of life were type of surgery and comorbidities, fears and uncertainties regarding sexual activity, sexual health education and counselling, spousal relationship and communication, and demographic factors such as advanced age and literacy levels. Major surgeries performed were coronary artery bypass grafting (CABG) and heart valve surgeries. The data collection tools used to collect data for sexual health and sexual quality of life were the International Erectile Function Questionnaire (IEFQ), International Index of Erectile Function (IIEF), Female Sexual Function Index (FSFI), Sexual Knowledge CABG Scale (SKS-CABG), Sexual Quality of Life Questionnaire (SQOL), SKS-Myocardial Infarction Scale (SKS-MI), and Couple Communication Scale (CCS). CONCLUSIONS: Despite their importance, sexual health and quality of life are frequently overlooked during patient rehabilitation after cardiovascular surgeries. The lack of adequate education and counselling from healthcare professionals frequently leads to increased fear and uncertainties among individuals and their partners. Therefore, more person-centred educational and counselling approaches should be developed to address the sexual concerns of individuals and their partners.

Nursing practices on sexual health for people with neurological disorders: A narrative review.

AIMS: To identify and describe nursing practices on the sexual health of people with neurological disorders. DESIGN: Narrative review. METHODS: Data were extracted from 1 January 2002, to 20 May 2021. Inclusion criteria were nursing practices, sexual health and people with neurological disorders. The main outcome measures were: context of nursing practice implementation (assumptions, knowledge, strategies and skills), facilitators of and barriers to addressing and treating the sexual health of people with neurological disorders, and benefits of nursing practices in sexual health. PRISMA reporting guidelines were used. DATA SOURCES: PubMed, Embase, ScienceDirect and CINAHL. RESULTS: In total, 926 articles were identified and nine were included. The involvement of nurses was recommended in most studies. Assumptions about the impact of neurology on sexuality and nurse's role in sexual healthcare, biopsychosocial knowledge, and skills (ethical, interpersonal, and technical) were highlighted. We found that the modes of knowledge proposed by Carper were mobilized in an unequal way. Sexual difficulties were the key focus and eroticization concerns were not addressed in any of the articles. CONCLUSION: Several studies advocate nursing intervention; however, few accurately present, detail and evaluate sexual health nursing practices of patients with neurological pathologies. Literature describes practices structured around disorders rather than the potentials, fails to address the brake of eroticism and provides little information on the results of interventions. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Developing teaching programs on sexual health in nursing programs may be necessary if nurses are to support a diverse range of patients in an inclusive and positive manner. These programs should highlight the domain-specific knowledge that is mobilized. IMPACT: Sexual health is a fundamental human right. Alterations in the nervous system have shown to affect sexual health, however, it is not often discussed among patients with neurological disorders, who are rarely provided with sexual health counselling. Our findings may impact healthcare professionals engaged in care with these patients. REPORTING METHOD: PRISMA. No patient or public contribution.

Sexual support and education for adults with mild intellectual disabilities: a Delphi study on multiple perspectives.

BACKGROUND: Providing appropriate sexual support and education for adults with mild intellectual disabilities (IDs) is a source of considerable debate, resulting in diverse, non-funded and potentially adverse practices. This study aims to identify a consensus among experts regarding what conditions are conducive to successful sexual support and education for adults with mild IDs. METHODS: A Delphi study was conducted with 13 experts, including experts-by-experience, relatives, support staff, psychologists and sexologists. Qualitative data on the conditions for sexual support and education were gathered in the first round and thematically analysed. In the following three quantitative rounds, consensus was achieved using Likert-type response scales and participants' feedback. RESULTS: Round 1 resulted in 82 conditions on six themes: 'the necessary attitude', 'requirements', 'approach to delivering sexual support and education', 'appropriate providers', 'settings and timing' and 'effective collaboration with the network'. In the following three quantitative rounds, the experts reached consensus on 68 conditions distributed across the six themes. CONCLUSIONS: The six themes highlight conducive conditions for successful sexual support and education for adults with mild IDs, emphasising the significance of a safe and supportive environment, comprehensive educational programmes, and the promotion of autonomy and protection. The consensus-based findings have distinct implications for practice and future research.

Psychosocial and sexual health among men with and without HIV who have sex with men: A cross-sectional nationwide study in Denmark.

OBJECTIVES: The HIV/AIDS epidemic has disproportionately affected men who have sex with men (MSM) since its onset. Despite important medical advancements in treatment, the enduring effects of living with HIV continue to adversely impact the health and well-being of this population. This cross-sectional nationwide study examined psychosocial and sexual health among MSM in Denmark, comparing those living with and without HIV. METHODS: Data from MSM living with HIV were collected from the SHARE study, a Danish nationwide survey that investigated psychosocial, sexual and reproductive health among people with HIV, and compared with data from MSM without HIV, retrieved from the nationally representative cohort study, Project SEXUS. Associations between HIV status and psychosocial and sexual health outcomes were examined using logistic regression models while controlling for potentially confounding variables. RESULTS: Among 369 MSM with HIV and 1002 MSM without HIV, logistic regression analyses revealed that living with HIV was significantly associated with having current symptoms of anxiety and depression and greater dissatisfaction with one's body. Additionally, MSM with HIV significantly more often than MSM without HIV reported low sexual desire, sexual inactivity, a lack of sexual needs in the last year and erectile dysfunction. Having received payment for sex was more frequently reported by MSM with HIV, as was sexualised drug use, including chemsex drugs. CONCLUSION: Compared with MSM without HIV, MSM with HIV in Denmark report a higher burden of mental health and sex life challenges.

Social media use, knowledge, attitudes, and risky sexual behavior of HIV transmission: A survey among boarding school adolescent students in Indonesia.

Background: Social media has many positive and negative influences on individuals, especially for adolescents related to HIV. However, little is known about how social media impacts HIV-related outcomes among adolescents in boarding schools. Objective: This study aims to investigate the social media use, knowledge, attitudes, and sexual behavior at risk of HIV transmission and their relationship with the demographic characteristics of adolescent students at boarding schools. Methods: This study was school-based and used a cross-sectional design. The questionnaires were used to assess social network site usage, knowledge, attitudes, and risky behavior. Cluster random sampling involved students (n = 214) from three boarding schools in Cirebon City, West Java, Indonesia, in 2022. Chi-square tests and Cramer's V were used to explore correlations between social and demographic factors. Results: A considerable number of adolescent students exhibited high social media addiction (58.4%), with the majority possessing limited knowledge of HIV transmission (54.7%). Additionally, nearly half displayed a negative attitude towards preventing HIV transmission (47.2%), while only a small fraction engaged in risky behavior (2.8%). Bivariate analysis revealed that social media use was moderately associated with the type of social media application (φc = 0.246, p <0.05). Knowledge of HIV transmission exhibited a moderate correlation with age (φc = 0.331, p <0.05), education level (φc = 0.240, p <0.001), and exposure to information (φc = 0.269, p <0.001). Similarly, attitudes toward HIV prevention demonstrated moderate associations with age (φc = 0.341, p = 0.001), education level (φc = 0.317, p <0.001), and exposure to information (φc = 0.266, p <0.001). Furthermore, risky sexual behavior exhibited a strong association with exposure to pornographic content (φc = 0.730, p <0.001). Conclusion: The study found a high prevalence of social media usage among adolescents, coupled with low knowledge about HIV, negative attitudes, and risky behavior. Significant relationships were observed between social media use, knowledge, attitudes, and risky sexual behavior related to HIV transmission and demographic characteristics. This study emphasizes the vital role of nurses and healthcare professionals in implementing targeted educational interventions in boarding schools to address gaps in HIV risk knowledge influenced by social media, ultimately improving strategies for adolescents' sexual health.

Research trends of Moringa oleifera Lam as Remedy toward Cattle's embryo according to the frequently used words in content of papers and citations.

Moringa oleifera is an herb that has the potential to reduce the mortality rate of an embryo. Research about Moringa oleifera treatment toward an embryo of livestock was quite a number. However, there were still very few previous studies that explain the trend of research related to that topic in this decade, 2010-2023. This study tried to observe the research trend related to Moringa oleifera treatment to embryos of livestock in terms of frequently used words inside papers along with their citations. This study gathered 132 data samples from Scopus and 41 data from PubMed and processed them using the bibliometric method. The bibliometric software used was Vosviewer to produce the image of the author's keyword connection and trend and biblioshiny for depicting frequently words used as a title and inside content and mean of total citation/year. This study also used R Studio to complement Vosviewer in conducting the bibliometric method. The result showed that there was no author's keyword that depicted ruminant-type animals instead of cow, and no name of the animal as livestock that was being used as a title of the sample papers. There were also no papers that observed Moringa oleifera to treat sick embryos of livestock and the previous studies used as samples also had a low mean of total citation/year.

Improving young patient - practitioner communication about sexual health during medical visits.

OBJECTIVES: Young people face barriers that lead to gaps in sexual and reproductive health care communications. Issues such as discomfort discussing sexual health lead to inadequate delivery of services resulting in unintended pregnancies and STIs. Closing this communication gap between patients and health care practitioners would improve communication and health outcomes. The objective of this study was to gain feedback from focus groups about: (a) barriers and facilitators to communication surrounding sexual health and (b) the feasibility and acceptability of a question prompt list (QPL) and informational video emphasizing asking questions about sexual health during medical visits as tools young people could use to be more involved during visits. METHODS: Three focus groups were conducted: two with young adults (n=14) and one with practitioners (n=5) of sexual/reproductive health care services. Practitioners were recruited from healthcare clinics. RESULTS: Young adults were aged 18-22 years old. Participants identified barriers to communication such as embarrassment over sexual health topics and practitioner assumptions about patients' base of knowledge. A facilitator to communication was patient-friendly language. Focus group participants offered suggestions on how to improve the QPL as well as themes that should be covered in an educational video. Participants viewed the QPL and educational video as useful for encouraging conversations between patient and practitioner. CONCLUSIONS: Many barriers obstruct communication between young adults and practitioners on topics relating to sexual health. Both the QPL and an educational video could be used to enhance patient-practitioner communication.

Sexual health and testosterone concentration in male lymphoma survivors: A systematic review.

Advancements in lymphoma treatment have increased the number of long-term survivors who may experience late effects such as impaired sexual function and testosterone deficiency. The aim of this review was to determine the prevalence of testosterone deficiency and sexual dysfunction among male lymphoma survivors; and associations between the two. A systematic search identified 20 articles for inclusion. The prevalence of low total testosterone was 0%-50 %, with mean values within reference levels, and for luteinizing hormone above reference levels in 0%-80 %. Four studies included SHBG and free testosterone, with mixed results. Compromised sexual health was found in 23%-61 %. Overall, total testosterone and sexual health were associated. The risk of bias (ROBINS-E and RoB 2) was high/very high, leading to low/very low overall confidence in the bulk of evidence (GRADE). Longitudinal studies evaluating biologically active testosterone and sexual health are needed, to develop evidence based standard procedures for follow-up of sexual health.

Erectile dysfunction and sleep related bruxism: An exploratory review of an improbable association.

The World Health Organization recognizes sexual health as not merely the absence of disease, but a state of physical, mental, and social well-being in relation to one's sexuality. Achieving sexual satisfaction is pivotal for many individuals, as it significantly contributes to their quality of life. Among various sexual disorders, erectile dysfunction (ED) is notably prevalent, affecting an estimated 10-20 million men in the United States alone. This condition impacts not just the person experiencing it but also significantly influences their intimate connections with partners. Although the causes of ED are multifactorial, recent research highlights a compelling association between sleep disorders, such as sleep deprivation, obstructive sleep apnea (OSA), and insomnia, and the incidence of ED. Furthermore, engaging in night work has been observed to exacerbate the risk of developing ED. One common sleep disorder, sleep related bruxism (SRB), despite its prevalence, has not generally been associated with ED. However, there is some interesting evidence hinting at a potential relationship, including a few studies reporting a high prevalence of ED in individuals with SRB. This review delves into the epidemiological, etiological, and mechanistic links between ED and SRB, aiming to uncover potential intersections between these two conditions. These insights could pave the way for innovative research avenues, possibly exploring treatments like vasodilation medication, that might concurrently address both ED and SRB.

Quality, acceptability and usability of self-sampling kits used by non-healthcare professionals for STI diagnosis in Spain: a single-blind study.

OBJECTIVES: Sexually transmitted infections (STIs) have markedly increased over the last decade in Spain, calling for prevention and control innovative approaches. While there is evidence indicating the effectiveness of self-sampling for STI diagnosis, no kits for this purpose have been authorised in Spain. METHODS: A prospective single-blind cross-sectional study carried out between November and December 2022 in an STI clinic in Madrid, Spain, to determine the validity, feasibility and acceptability of self-sampling kits used by non-healthcare professionals from vagina, pharynx, rectum and urethra to diagnose Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). Self-samples were compared with samples collected by healthcare professional (HC samples) and analysed by PCR. Frequency of CT and NG diagnosis by sample type was compared using McNemar's test for paired data. Sensitivity and specificity of self-samples for CT and NG diagnosis were also calculated. RESULTS: 306 self-samples from 51 participants were analysed. 80% were men with median age of 33 (IQR: 28-38) years. Self-samples and HC samples showed no significant statistical differences in CT and NG diagnosis. Self-samples had a sensitivity of 81% for CT and 93% for NG, with a specificity of 97% for CT and 95% for NG. More than 90% of participants had no difficulty understanding the kit instructions and 71% expressed high levels of satisfaction with the self-sampling kit. CONCLUSION: Self-sampling kits for CT and NG diagnosis can be safely and effectively used by non-healthcare professionals in Spain. National strategies for STI prevention and control should prioritise self-sampling strategies.

The elephant in the room: a study on the dialogue about sexuality during Assisted Reproductive Technology visits.

Despite ongoing medical advancements in infertility treatment, the significant impact of sexuality on this journey often goes unaddressed. The present research aims to examine sexual conversations during ART visits, including who initiate the conversation and their content.This quali-quantitative study delves into analyzed video-recorded ART visits to explore how "sex" conversations are broached during healthcare interactions. Our findings reveal a strikingly low proportion of utterances related to sexuality, accounting for only 1.3% of the total 14,372 utterances analyzed. Sex utterances were mainly introduced by physicians (72%), while regarding those introduced by the couple, 64% were reported by men. From the qualitative analysis on the utterances emerged three distinct levels of communication about sex: explicit, almost explicit, and implicit. While physicians and males exhibit an almost balanced distribution across the 3 levels, female patients primarily respond to explicit and almost explicit communication initiated by physicians. The low percentage of sexual utterances underscores the rarity of these conversations during ART interactions, despite the clinical field where sexual health should deserve a crucial attention. Opening the door to conversations about sexuality could help to create a safe and supportive space for patients to talk about sex, with a potential impact on well-being and quality of care during the ART process.

Facilitators and Barriers to Implementing a Comprehensive Sexual Health Education Policy in Chicago Public Schools.

BACKGROUND: In 2013, the Chicago Public Schools (CPS) district passed a policy requiring schools to deliver comprehensive sexual health education (SHE) to all K-12th grade students. A performance improvement case study was conducted in the 2019-2020 school year to evaluate the implementation of the policy and identify lessons learned to support implementation in schools. METHODS: Key informant interviews were conducted with 11 school principals and 29 teachers to discuss SHE implementation at their school. Interviews were recorded, transcribed, and analyzed to assess school and classroom factors that affect implementation. Themes that cut across these factors were then identified and summarized by 2 evaluators. RESULTS: The following themes were identified across key informant interviews: (a) principal prioritization of SHE helps ensure SHE is implemented, (b) the expansion of school and teacher capacity facilitates SHE implementation, and (c) the creation of accountability mechanisms in classrooms and schools fosters adherence to SHE policy. CONCLUSIONS: Principals play a crucial role in building capacity to deliver SHE and ensuring SHE accountability mechanisms are implemented in their school. CPS is using these findings to adjust technical assistance and resources provided to principals and SHE instructors.

Women's Pornography Use Patterns and Sexuality Education in U.S. Public Schools.

This study investigated the relationship between sexuality education in U.S. public schools and women's pornography use. Utilizing quantitative methods, we examined a sample of women attending U.S. public schools who reported regular pornography use. Results revealed that, regardless of the type of sexuality education received, women exhibited similar rates of pornography use, with 60% reporting its use. A substantial portion (69%) of the women began using pornography during childhood or adolescence. Women who received abstinence only sexuality education reported higher frequencies of pornography use compared to their comprehensive sexuality education counterparts. About 79% of women using pornography perceived it as a source of sexuality learning, especially regarding sexual pleasure. However, they expressed reluctance in using pornography for sexual education and did not consider it a preferred method for learning about sexuality. The findings suggest the need for comprehensive sexuality education that addresses essential topics, such as sexual pleasure and sexual script development, to cater to women's diverse learning needs, ideally taught by parents or primary caregivers, but may be necessary for public education in the absence of parental instruction. Policymakers and educators should bridge these gaps to develop more effective sexuality education curricula. This study contributes valuable insights, highlighting the importance of an inclusive approach to sexuality education in U.S. public schools. Future research should explore the implications of different sexuality education approaches on women's sexual development and well-being, emphasizing comprehensive education to foster healthy sexual behaviors among women.

An examination of the sexual health behaviors and cognitions of young U.S. community college students with respect to the intersection of gender and sexual identity.

Objective: To assess the sexual health of young community college students so that health promotion priorities can be identified and tailored programming can be implemented for this understudied population. Participants: A national sample of 1,678 community college students. Methods: Survey data was analyzed to understand trends in sexual health - including differences by gender and sexual identity. Results: While 54% of the sample have had vaginal sex and 16% have had anal sex, rates of condom use for these behaviors are low (respectively 51% and 42%). Only 52% of students have communicated with a medical professional about sexual health and 42% have been tested for STIs. Young men have the lowest odds of communicating with a medical professional about sexual health. Heterosexual men have particularly low odds of getting tested for STIs. Conclusions: Community college students need additional resources - eg, education, accessible health care - to promote their sexual health.

Predictors of sexual and reproductive health knowledge and utilization of services among adolescents in Ghana's Adaklu district.

Objective: To explore factors associated with adolescents' sexual and reproductive health (SRH) knowledge and their engagement with educational and clinical services. Design: Regression analysis of secondary data collected during a community survey. Setting: Adaklu district, Volta Region, Ghana. Participants: 221 adolescent caregiver pairs. Main outcome measures: The study employed three main outcome measures: (1) adolescents' level of SRH knowledge (assessed via questionnaire), (2) membership in district-sponsored adolescent health clubs (AHCs), and (3) ever-utilization of clinical SRH services. Results: Greater SRH knowledge was significantly associated with older age, AHC membership, and relying primarily on teachers or friends for SRH information. Increased odds of AHC membership were observed among females (AOR = 2.38, 95% CI 1.14-4.95); those who had communicated with one parent about sexual issues (OR 2.70, 95% CI 1.17-6.21); and those with a history of transactional sex (OR 5.53, 95% CI 1.04-29.37). Decreased odds were observed among adolescents whose caregivers were educated to the primary level (AOR = 0.24, 95% CI = 0.07-0.79). Overall, utilization of clinical SRH services was low, but higher odds were detected among individuals reporting a history of forced sex (AOR = 117.07, 95% CI 3.82-3588.52) and those who had discussed sexual issues with both of their parents (AOR = 13.11, 95% CI 1.85-92.93). Conclusions: Awareness of the predictors of knowledge, AHC involvement, and clinical service utilization can empower adolescent SRH initiatives-both present and future-to enhance their teaching, develop targeted outreach to underserved groups, and promote engagement with key clinical resources. Funding: This work has been supported by grants from the International Development Research Centre [108936] (IDRC), Canada.

A Digital Sexual Health Education Web Application for Resource-Poor Regions in Kenya: Implementation-Oriented Case Study Using the Intercultural Research Model.

BACKGROUND: Developing a digital educational application focused on sexual health education necessitates a framework that integrates cultural considerations effectively. Drawing from previous research, we identified the problem and essential requirements to incorporate cultural insights into the development of a solution. OBJECTIVE: This study aims to explore the Solution Room of the self-established Intercultural Research Model, with a focus on creating a reusable framework for developing and implementing a widely accessible digital educational tool for sexual health. The study centers on advancing from a low-fidelity prototype (She!Masomo) to a high-fidelity prototype (We!Masomo), while evaluating its system usability through differentiation. This research contributes to the pursuit of Sustainable Development Goals 3, 4, and 5. METHODS: The research methodology is anchored in the Solution Room of the self-expanded Intercultural Research Model, which integrates cultural considerations. It uses a multimethod, user-centered design thinking approach, focusing on extensive human involvement for the open web-based application. This includes gathering self-assessed textual user feedback, conducting a System Usability Scale (SUS) analysis, and conducting 4 face-to-face semistructured expert interviews, following COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines. RESULTS: Based on the identified limitations of the low-fidelity prototype, She!Masomo (SUS score 67), which were highlighted through textual user feedback (63/77) and prototype feature comparisons, iterative development and improvement were implemented. This process led to the creation of an enhanced high-fidelity prototype (We!Masomo). The improved effectiveness of the enhanced prototype was evaluated using the qualitative SUS analysis (82/90), resulting in a favorable score of 77.3, compared with the previous SUS score of 67 for the low-fidelity prototype. Highlighting the importance of accessible digital educational tools, this study conducted 4 expert interviews (4/4) and reported e-survey results following the CHERRIES (Checklist for Reporting Results of Internet E-Surveys) guideline. The digital educational platform, We!Masomo, is specifically designed to promote universal and inclusive free access to information. Therefore, the developed high-fidelity prototype was implemented in Kenya. CONCLUSIONS: The primary outcome of this research provides a comprehensive exploration of utilizing a case study methodology to advance the development of digital educational web tools, particularly focusing on cultural sensitivity and sensitive educational subjects. It offers critical insights for effectively introducing such tools in regions with limited resources. Nonetheless, it is crucial to emphasize that the findings underscore the importance of integrating culture-specific components during the design phase. This highlights the necessity of conducting a thorough requirement engineering analysis and developing a low-fidelity prototype, followed by an SUS analysis. These measures are particularly critical when disseminating sensitive information, such as sexual health, through digital platforms. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12905-023-02839-6.

Recommendations from Black and Latinx sexual minority males to include pharmacists to increase greater accessibility and OnlyFans stars to promote uptake of injectable PrEP.

BACKGROUND: Pre-exposure Prophylaxis (PrEP) medication is the keystone of preventative measures to curtail the spread of HIV. However, oral PrEP, the pill intended to prevent HIV, has been slow to proliferate among men who have sex with men (MSM). This is of major concern as MSM account for the largest number of new HIV diagnoses in the U.S. More recently, the newest generation of PrEP in the form of a long-acting injectable (LAI) is to be administered every two months as an intramuscular injection and many MSM indicate preferring LAI-PrEP to the oral form of PrEP. However, uptake of PrEP, in all forms, remains low. Research is sparse that focuses on LAI-PrEP uptake among Black/African American and Latinx men who have sex with men (BLMSM). OBJECTIVE: To address this concern, this study explored the willingness to uptake LAI-PrEP, and recommendations for increasing awareness and encouraging uptake of LAI-PrEP among BLMSM. METHODS: Qualitative data were collected between February 2022 to December 2022 through focus groups via Zoom with BLMSM (N=30; Black=14, Latinx=16) aged 18 to 29 (Mean = 23, SD = 3) in Los Angeles County. RESULTS: Findings revealed that while 90% of BLMSM were aware of PrEP in oral form, only 10% were aware of LAI-PrEP. Findings from the qualitative analysis suggested to consider self-administration of LAI-PrEP, allow local community pharmacists to assess and administer it, and promote uptake of LAI-PrEP using high-profile male content creators and stars on OnlyFans social media platform. CONCLUSION: Increasing PrEP uptake, in all forms available, such as promoting awareness through popular social media stars, and engaging community pharmacists in feasible ways, is critical for addressing the disproportionate impact of HIV among the BLMSM community.

Awareness of chronic hepatitis B and C in men who have sex with men in Belgium: epidemiological survey and on-site screening.

OBJECTIVES: To eliminate hepatitis B and C virus (HBV/HCV) as a public health threat by 2030, the WHO focuses on screening key populations, including men who have sex with men (MSM).This study aims to assess HBV and HCV knowledge and awareness and HCV prevalence in MSM in Belgium. METHODS: First, a questionnaire was designed to assess MSM's knowledge of HBV and HCV infection (disease process, vaccination, treatment and transmission routes). This questionnaire was conducted online, and by means of a tablet-based face-to-face questionnaire at the Antwerp and Belgian Pride. Second, HCV and HIV prevalence data were collected during outreach projects and office screening for sexually transmitted infections (STIs) organised by Sensoa and Exaequo, a Flemish and Walloon sexual health organisation. RESULTS: 300 MSM completed the questionnaire (median age 36 years; 7.7% HIV+). Mean overall survey scores were low (HBV: 41.1%; HCV: 39.8%). Few participants identified all transmission routes correctly (HBV: 15%; HCV 1%).The degree of education was significantly correlated with HBV knowledge and showed a trend towards correlation with HCV knowledge. HCV knowledge was significantly correlated with high-risk sexual behaviour.The prevalence of HCV and HIV was 0.3% and 1.0%, respectively, in MSM attending commercial gay venues and 0% and 1.9% in MSM attending office STI screening. CONCLUSIONS: Knowledge of HBV and HCV infection in MSM is poor. More awareness campaigns are needed, focusing on frequent HCV risk factors (group sex, chemsex, receptive fisting, and sharing of anal toys and anal douching devices), especially targeting low-educated MSM. HBV vaccination of MSM requires continued attention.The prevalence of HCV and HIV was remarkably low in commercial gay venues and may be higher in older MSM or in subcultures where risk factors coexist (eg, chemsex). The cost-effectiveness of internet-based approaches with subsequent at-home testing needs to be evaluated in the future.