Rates of Injury and Healthcare Utilization for Kink-Identified Patients.

BACKGROUND: Kink-involved people engage in atypical erotic activities such as bondage, rough sex, and other fetish activities that might risk injury or medical complication. To date, however, no one has examined the rate of injury or healthcare utilization for people who engage in these activities. AIM: To describe the type and rate of injuries from kink activities, and the use of healthcare by kink-involved people, including how many people disclose their involvement in kink when seeking care. METHODS: A survey of 1,398 kink-involved or kink-identified people, using a convenience sampling method. OUTCOMES: The study is the first to report on rates of injury and disclosure of kink involvement to care providers using a large community sample of kink-involved people. RESULTS: A high number of participants did not disclose their kink behavior to their physical healthcare clinician (58.3%) or to their mental healthcare clinician (49.6%). Past experiences of kink-related injuries were relatively common (13.5%), as was the number of people who reported delaying or avoiding healthcare because of anticipated or perceived stigma for kink involvement (19.0%). CLINICAL TRANSLATION: The findings of the current study point to the need for clinicians to address barriers to culturally competent care for kink-involved people. Anticipated stigma leads to non-disclosure of kink involvement and delay in seeking care, thereby creating barriers to health and well-being. STRENGTHS & LIMITATIONS: Strengths include a sample size large enough to examine regression models to predict disclosure to care providers, and lifetime rates of injury from kink activities overall. Limitations include the use of a convenience sampling method and self-report survey design, which affect the generalizability of the results. CONCLUSION: The patterns of anticipated stigma, delay or avoidance of care, and concealment of kink and/or BDSM involvement fit the Minority Stress Model, and we argue that kink-identified people should be considered a sexual minority for the purposes of healthcare. Sprott RA, Randall A, Smith K et al. Rates of Injury and Healthcare Utilization for Kink-Identified Patients. J Sex Med 2021;18:1721-1734.

Epidemiology of hookworm infection in Kintampo North Municipality, Ghana: patterns of malaria coinfection, anemia, and albendazole treatment failure.

A cross-sectional pilot study of hookworm infection was carried out among 292 subjects from 62 households in Kintampo North, Ghana. The overall prevalence of hookworm infection was 45%, peaking in those 11-20 years old (58.5%). In children, risk factors for hookworm infection included coinfection with malaria and increased serum immunoglobulin G reactivity to hookworm secretory antigens. Risk factors for infection in adults included poor nutritional status, not using a latrine, not wearing shoes, and occupation (farming). Although albendazole therapy was associated with an overall egg reduction rate of 82%, 37 subjects (39%) remained infected. Among those who failed therapy, treatment was not associated with a significant reduction in egg excretion, and nearly one-third had higher counts on repeat examination. These data confirm a high prevalence of low-intensity hookworm infection in central Ghana and its association with poor nutritional status. The high rate of albendazole failure raises concern about emerging resistance.