Changes In Sexual Behavior Research Articles

Triggers of Change in Sexual Behavior Among People With HIV: The Swiss U U Statement and COVID-19 Compared.

We assessed changes in sexual behavior among people with human immunodeficiency virus (HIV) over 20 years. Condom use with stable partners steadily declined from over 90 to 29 since the Swiss U U statement, with similar trajectories between men who have sex with men (MSM) and heterosexuals. Occasional partnership remained higher among MSM compared to heterosexuals even during coronavirus disease 2019 (COVID-19) social distancing.

The Impact of Household Context on Self-Perceived Changes in Solo and Partnered Sexual Behaviors During the COVID-19 Pandemic: Findings from a U.S. Probability Survey.

To understand how household context factors impacted self-reported changes in solo and sexual behaviors in U.S. adults during early stages of the COVID- 19 pandemic, we conducted an online, nationally representative, cross-sectional survey of U.S. adults (N = 1010; aged 18-94years; 62% response rate) from April 10-20, 2020. We used weighted descriptive statistics with Wilcoxon rank sign tests to understand the population prevalence and significance of self-reported changes (five-point scale: much less to much more) in 10 solo and partnered sexual behaviors. Ordinal regression was used to assess the impact of household predictor variables-including number of children at home, number of adults in home, partnership status (unpartnered, partnered and not living together, partnered and living together) and employment status (not working, employed not as essential worker, employed as essential worker). All models were adjusted for gender, age, sexual orientation, race/ethnicity, and residence location (urban, suburban, rural).All solo and partnered sexual behaviors showed some amount of significant change-increased activity for some and decreased for others-for U.S. adults during the pandemic. Not living with a partner was broadly associated with decreased affectionate partnered sexual behaviors; unpartnered adults reported increased sexting. Individuals not employed reported increased oral sex and increased consumption of sexually explicit materials as compared to non-essential workers. Number of children at home and household size were not significantly linked to self-reported behavior change. Ongoing sexual health-focused research should continue to focus on understanding how adults manage opportunities and constraints to their sexual lives in the context of a still-going pandemic. While many aspects of social life look more "normal" (e.g., many people have returned to their in-person offices and children are largely back in school), new and more-infectious strains of COVID-19 have proven that the pandemic may still yet impact daily living. Lessons learned from COVID need to include sexual health planning both for any future strains of COVID, as well as for future public health emergencies.

Risk Compensation in Voluntary Medical Male Circumcision Programs.

Evidence from clinical trials identified the effectiveness of voluntary medical male circumcision (VMMC) as an additional strategy to reduce the risk of HIV transmission from women to men. However, concerns about post-circumcision sexual risk compensation may hinder the scale-up of VMMC programs. We reviewed the evidence of changes in risky sexual behaviors after circumcision, including condomless sex, multiple sex partners, and early resumption of sex after surgery. Most clinical trial data indicate that condomless sex and multiple partners did not increase for men after circumcision, and early resumption of sex is rare. Only one post-trial surveillance reports that some circumcised men had more sex partners after surgery, but this did not offset the effect of VMMC. Conversely, qualitative studies report that a small number of circumcised men had increased risky sexual behaviors, and community-based research reports that more men resumed sex early after surgery. With the large-scale promotion and expansion of VMMC services, it may be challenging to maintain effective sexual health educations due to various restrictions. Misunderstandings of the effect of VMMC in preventing HIV infection are the main reason for increasing risky sexual behaviors after surgery. Systematic and practical sexual health counseling services should be in place on an ongoing basis to maximize the effect of VMMC.

The Impact of First UK-Wide Lockdown (March–June 2020) on Sexual Behaviors in Men and Gender Diverse People Who Have Sex with Men During the COVID-19 Pandemic: A Cross-Sectional Survey

The global COVID-19 pandemic resulted in strict social distancing measures restricting close physical contact. Men (cis and trans) and other gender diverse people who have sex with men (MGDSM) are at higher risk of sexually transmitted infections (STIs) and may have experienced changes in sexual behavior during government restrictions on social and sexual contact. We aimed to examine self-reported sexual behavior of MGDSM during the first UK-wide lockdown to identify the characteristics of the individuals who might most require sexual health promotion and clinical support. In April–May 2020, we conducted an online survey of MGDSM, promoted on social media and Grindr. Our exploratory approach used descriptive analysis to identify self-reported changes in sexual behavior and performed regression analyses to identify correlates of casual sex during the lockdown. A total of 1429 respondents completed the survey: mean age 36 years, 84% White, 97% male or trans male, 98% assigned male sex at birth, 2% female or non-binary, 65% degree educated or higher. During the lockdown, 76% reported not having any casual sex partners. While the majority reported reduced casual sex, 3% reported an increase in casual sex with one person and 2% with three or more people (group sex). About 12% of the sample engaged in casual sex with only one person and 5% with four or more sexual partners during the lockdown. Reporting casual sex during lockdown was associated with: lower level of education OR = 2.37 [95% CI 1.40–4.01]; identifying as a member of an ethnic minority OR = 2.27[1.40–3.53]; daily usage of sexual networking apps OR = 2.24[1.54–3.25]; being less anxious about contracting SARS-CoV-2 through sex OR = 1.66[1.12–2.44]; using PrEP before lockdown OR = 1.75[1.20–2.56]; continuing to use PrEP OR = 2.79[1.76–4.57]; and testing for STIs during lockdown OR = 2.65[1.76–3.99]. A quarter of respondents remained sexually active with casual partners, indicating a need to provide STI screening services and health promotion targeted to groups most likely to have need over this period. Future research is required to better understand how to support sexual and gender minorities to manage sexual risk in the context of pandemic public health initiatives.

Changes in Substance Use and Sexual Behaviors After a Sexually Transmitted Infection Diagnosis Among a Cohort of Men Who Have Sex With Men in Los Angeles, CA.

Despite declines in substance use and sexual behaviors after a sexually transmitted infection, reinfections were high suggesting that men who have sex with men with sexually transmitted infections occupy sexual networks with high transmission probabilities and prevention efforts should consider sexual network characteristics.BackgroundSexually transmitted infections (STIs), STI reinfection, human immunodeficiency virus (HIV) acquisition, and changes in behaviors after an STI were examined in a cohort of men who have sex with men (MSM) in Los Angeles, CA.MethodsData from a longitudinal study of MSM enrolled from 2014 with at least 1 follow-up visit through March 2020 were analyzed (n = 447; 1854 visits). Study visits every 6 months included self-interviews for sexual behaviors, substance use, and specimen collection for chlamydia, gonorrhea, syphilis, and HIV testing. Changes in behaviors were assessed using the McNemar test, and participants not diagnosed with an STI served as controls for a difference-in-difference (DiD) analysis of changes over time.ResultsCumulative incidence of an STI was 55% (248 of 447). At 24 months after STI diagnosis, methamphetamine use declined from 50% to 35% (P< 0.01), and median number of sex partners declined from 5 (interquartile range, 2–11) to 2 (interquartile range, 1–6;P< 0.01). Among participants at risk for HIV and diagnosed with an STI (n = 102), postexposure prophylaxis use was 35% and HIV seroconversion was 6%. Based on DiD analyses, participants diagnosed with an STI had higher levels of substance and a higher number of sex partners when compared with those with no STIs; however, declines in these behaviors were comparable to participants not diagnosed with an STI (PDID> 0.05).ConclusionsDespite behavior modifications after an STI diagnosis, STI/HIV incidence was high, suggesting that MSM with STIs occupy sexual networks where reductions in sexual and substance using behaviors do not protect them from ongoing exposure to STIs and HIV.

Sexual behavior, sexual function, and sexual satisfaction of women and men during the postpartum period.

The postpartum period is a challenging period for a couple's sexuality and is accompanied by changes in sexual behavior. However, the study of sexual behavior in this period has mostly focused on (resuming) vaginal intercourse. Other sexual behaviors and their associations with sexual function and satisfaction have as yet not received much attention. This is especially the case for men, as most research on sexuality in the postpartum period has focused on women. The present study aimed to describe women's and men's sexual behavior after having a child, as well as the associations between sexual behavior, sexual function, and sexual satisfaction. A sample of 119 women and 59 men participated in an online survey, 3 to 12 months postpartum. They filled out questionnaires on the frequency of specific sexual behaviors during the past 4 weeks, on their sexual function, and on their sexual satisfaction. Overall, prevalence rates of sexual problems and sexual dysfunctions were higher in women than in men but no differences were found in sexual satisfaction, or frequency of partnered sexual behaviors reported by women and men. Men did report significantly more frequent solo manual stimulation than women did. Moreover, we found that sexual behavior, sexual function, and sexual satisfaction are stronger associated in women than in men. In women, sexual dysfunction was associated with a stronger decline in sexual satisfaction, and with a decline in the frequency of almost all sexual behaviors. In men, sexual dysfunction was associated with a decline in kissing, but a higher frequency of giving oral sex, solo manual stimulation, and anal intercourse. While women's and men's reports of sexual behavior and sexual satisfaction during the postpartum period did not differ much, women's sexual function was found to be more impaired and stronger associated with sexual behavior after the arrival of a child. None

Impact of universal testing and treatment on sexual risk behaviour and herpes simplex virus type 2: a prespecified secondary outcomes analysis of the HPTN 071 (PopART) community-randomised trial

Comprehensive HIV prevention strategies have raised concerns that knowledge of interventions to reduce risk of HIV infection might mitigate an individual's perception of risk, resulting in riskier sexual behaviour. We investigated the prespecified secondary outcomes of the HPTN 071 (PopART) trial to determine whether a combination HIV prevention strategy, including universal HIV testing and treatment, changed sexual behaviour; specifically, we investigated whether there was evidence of sexual risk compensation. HPTN 071 (PopART) was a cluster-randomised trial conducted during 2013-18, in which we randomly assigned 21 communities with high HIV prevalence in Zambia and South Africa (total population, approximately 1 million) to combination prevention intervention with universal antiretroviral therapy (ART; arm A), prevention intervention with ART provided according to local guidelines (universal since 2016; arm B), or standard of care (arm C). The trial included a population cohort of approximately 2000 randomly selected adults (aged 18-44 years) in each community (N=38 474 at baseline) who were followed up for 36 months. A prespecified secondary objective was to evaluate the impact of the PopART intervention compared with standard of care on herpes simplex virus type 2 (HSV-2) and sexual behaviour (N=20 422 completed final visit). Secondary endpoints included differences in sexual risk behaviour measures at 36 months and were assessed using a two-stage method for matched cluster-randomised trials. This trial is registered with ClinicalTrials. gov, number NCT01900977. The PopART intervention did not substantially change probability of self-reported multiple sex partners, sexual debut, or pregnancy in women at 36 months. Adjusted for baseline community prevalence, reported condomless sex was significantly lower in arm A versus arm C (adjusted prevalence ratio 0·80 [95% CI 0·64-0·99]; p=0·04) but not in arm B versus arm C (0·94 [0·76-1·17]; p=0·55). 3-year HSV-2 incidence was reduced in arm B versus arm C (adjusted risk ratio 0·76 [95% CI 0·63-0·92]; p=0·010); no significant change was shown between arm A versus arm C (0·89 [0·73-1·08]; p=0·199). We found little evidence of any change in sexual behaviour owing to the PopART interventions, and reassuringly for public health, we saw no evidence of sexual risk compensation. The findings do not help to explain the differences between the two intervention groups of the HPTN 071 (PopART) trial. National Institute of Allergy and Infectious Diseases, the National Institutes of Health, the International Initiative for Impact Evaluation (3ie), the Bill & Melinda Gates Foundation, the US President's Emergency Plan for AIDS Relief, and the Medical Research Council UK.

Features of coping strategies and sexual behavior in women in an in vitro fertilization program

This study analyzes the identified features of coping strategies and sexual behavior in women with infertility in the program of assisted reproductive technologies. Infertility treatment requires a certain response to stressful situations and all procedures of in vitro fertilization (IVF), as well as changes in behavior, the emotional sphere, and in family relations from both spouses. For some couples, the period of infertility treatment in an in vitro fertilization program is a stressful period, which can affect not only the emotional state, but sexual behavior as well. This article examines the influence of infertility diagnosis on the choice of women»s preferred coping strategies and changes in sexual behavior and sexual attitudes.

Factors associated with suboptimal retention in HIV pre-exposure prophylaxis care among men who have sex with men

ABSTRACT Despite the efficacy of HIV pre-exposure prophylaxis (PrEP), retention in care in the United States remains suboptimal. The goal of this study was to explore factors that lead to suboptimal retention in PrEP care for men who have sex with men (MSM) in real-world clinical settings in the United States. Trained interviewers conducted semi-structured interviews with MSM (N = 49) from three clinics who had been engaged in PrEP care in the Midwest (n = 15), South (n = 15), and Northeast (n = 19) geographic regions and had experienced a lapse in PrEP use. Factors that emerged as related to suboptimal retention in PrEP care included structural factors such as transportation and out-of-pocket costs; social factors such as misinformation on media and in personal networks; clinical factors such as frequency and timing of appointments; and behavioral factors such as changes in sexual behavior and low perceived risk for HIV. Participants suggested reducing the out-of-pocket costs of medications and lab visits, having flexible appointment times, culturally responsive services, and comprehensive patient navigation to help retention in care. These findings leveraged real-world experiences and opinions of patients to inform gaps in current services and how to make changes to optimize PrEP care.

Changes in Sexual Behavior Over the COVID-19 Pandemic Among a Community-Based Cohort of Men Who Have Sex With Men in Columbus, Ohio.

The purpose was to assess COVID-19 beliefs and attitudes and examine COVID-19-related changes in sexual behavior of men who have sex with men during 3 time periods: April-July 2020 (T1), August-December 2020 (T2), January-May 2021 (T3). Data were analyzed from 157 men who have sex with men in Ohio recruited to participate in a longitudinal multisite network study of syphilis epidemiology in 3 US cities: Columbus, Ohio; Baltimore, Maryland; and Chicago, Illinois. In April 2020, a COVID-19 module was appended to existing baseline and follow-up surveys to assess beliefs, attitudes, and changes in sexual behavior. Sample characteristics were summarized. Correlations between demographic variables (age, racial identity) and COVID-19 outcomes were examined. In response to COVID-19 social distancing restrictions and self-reported anxiety, some men limited sexual activity at T1, but the majority (n = 105 [67%]) continued to engage in sex. The number of men engaging in sex increased over time (T2: n = 124 [79%]; T3: n = 121 [77%]). At T1, men not in a relationship more frequently reported having less sex compared with prepandemic (n = 39 [57%]). By T3, men in a relationship more frequently reported less sex (n = 32 [54%]). Increased anxiety about sex and condom use was positively correlated with identifying as a man of color (P < 0.001). Most of the sample reported either starting or increasing online sexual activity during each time period. Future efforts to target sexual health during a pandemic or other health emergencies should prioritize men of color and address the unique perspective of both single and partnered men.

Changes in high-risk sexual behavior, HIV and other STI testing, and PrEP use during the COVID-19 pandemic in a longitudinal cohort of adolescent men who have sex with men 13 to 18 years old in the United States.

The COVID-19 pandemic has disrupted sexual health services among those most vulnerable to HIV acquisition, such as adolescent men who have sex with men (AMSM). We sought to characterize the changes in sexual-risk behaviors, HIV and other STI testing, and pre-exposure prophylaxis (PrEP) use among a longitudinal cohort of AMSM aged 13 to 18 years before and during the COVID-19 pandemic. We observed a significant decline in HIV testing and a marginal decrease in other STI testing since the pandemic began in March 2020. Outreach efforts and innovative remote delivery of sexual health services are needed to support access to healthcare services among AMSM as the pandemic persists.

The role of HPV CMV and EBV latent viruses of the development of Oropharyngeal squamous cell carcinoma (OPSCC)

Background:In recent years, a dynamic increase in the incidence of oropharyngeal squamous cell carcinoma (OPSCC) has been observed, especially in highly developed countries. As in the case of anal and genital cancers, a significant proportion of OPSCC (about 60%) is due to sexually acquired HPV infection, and the increase in OPSCC is attributed to changes in sexual behavior in Western countries. EBV and CMV viruses are also characterized by carcinogenesis, but the literature data on their participation in the development of neoplasms of the middle throat are still very limited.Objective:The aim of this article is to review the latest scientific reports on the impact of infections with latent viruses (HPV, EBV, CMV) on the oncogenesis process in the middle pharynx and to summarize the prophylactic options using the available multivalent vaccines against HPV infections.Conclusions:HPV-positive oropharyngeal squamous cell carcinoma of the middle pharynx is a significant clinical problem due to the increase in the number of cases, especially in young people, who lack classic risk factors, such as exposure to tobacco and alcohol. HPV-dependent neoplasms are characterized by a better prognosis and less invasive oncological therapy (radiotherapy and chemotherapy). Of central importance in the prevention of HPV-positive OPSCC in both women and men is prophylaxis with multivalent vaccination. Due to the lack of sufficient data on the participation of EBV and CMV viruses in the development of OPSCC, as well as the lack of prophylaxis, intensive research in this area is necessary.

Sexual behaviour changes and HIV infection among men who have sex with men: evidence from an open cohort in China

BackgroundThe HIV epidemic in key populations such as men who have sex with men (MSM) is a public health issue of worldwide concern. China has seen an increase in newly...

Hubungan Tingkat Pengetahuan dengan Motivasi Ibu Hamil Melakukan Konseling HIV/AIDS di Klinik Kandungan RSUD Dr. Doris Sylvanus Palangka Raya

Quality HIV (Human Immunodeficiency Virus) counseling is an effective component as a preventive effort to promote changes in sexual behavior to reduce HIV transmission. Pregnant women must know and understand to be motivated to do HIV/AIDS counseling as an effort to prevent HIV/AIDS transmission. But in reality, the motivation of pregnant women to do HIV counseling tends to be low, because pregnant women do not feel they have a vulnerability to HIV/AIDS transmission. This study was conducted to determine the relationship between the level of knowledge and the motivation of pregnant women to do HIV/AIDS counseling at the Obstetrics Clinic at RSUD dr. Doris Sylvanus Palangka Raya. This research uses correlation research with cross-sectional approach and non-probability sampling technique (accidental sampling). Respondents in this study amounted to 61 respondents who met the inclusion criteria. The data was collected using a questionnaire which was then analyzed using the sperman rank statistical test. From the 61 respondents, the results of statistical analysis showed that the level of knowledge of pregnant women was in the sufficient category 24 (39%), good category 21 (34%), poor category 16 (26%) and motivation of pregnant women in the medium category 38 (62%), strong category 16 (26%), weak category 7 (11%) with p value = 0, 000 (p &lt; 0, 05). There is a significant and significant relationship between the level of knowledge and the motivation of pregnant women in conducting HIV/AIDS counseling at the Obstetrics Clinic of RSUD dr. Doris Sylvanus.

High-risk Human papillomavirus 16/18 in oral mucosa and cervix of sexually active women: A comparative pilot study using conventional nested PCR and an in-house real-time PCR

BackgroundHuman papillomavirus (HPV) is known to be associated with both cervical and oropharyngeal cancers, yet little are known about the co-occurrence of similar HPV subtypes in these subsites. With the changing sexual behaviour it is necessary to evaluate the risk of a woman with abnormal cervix developing cancer of the oropharynx. A study evaluating HPV infection in both oral mucosa and the cervix is therefore needed to understand the co-occurrence of HPV infection in 2 different sites MethodsOral mucosa and cervical wash specimens were collected from a total of 100 women aged 20-60 years who visited for routine Pap test. DNA was extracted and then subjected to an in house real-time PCR and conventional nested PCR for the detection high risk HPV 16/18 subtypes. A limit of detection was established using serially diluted HPV positive DNA from cell lines and the sensitivity and specificity of both the assays were evaluated ResultsThe prevalence of HPV-16/18 in the cervical samples (19.7% vs 6.2%) and the oral mucosa (16.6% vs nil) were higher as detected by our in house real-time PCR in comparison to the conventional nested PCR. Oral HPV infection was found in 25% of the women with SCC of the cervix ConclusionDue to the changing sexual behaviour there is a possibility that women with HPV-related cervical lesions can easily transfer the virus to the partner or even self-inoculate which might lead to the development of lesions in the head & neck turning into cancer.

Estimating Changes in Population Size and Behavioral Characteristics in Men Who Have Sex With Men Between 2014 and 2019: Longitudinal Study.

BackgroundMen who have sex with men (MSM) are at high risk for HIV infection. Accurate estimation of the population size and monitoring the risk sexual behavioral change of MSM is of great importance to develop targeted HIV prevention and interventions.ObjectiveThe goal of the research was accurate estimation of the population size and monitoring the risk sexual behavioral change of MSM.MethodsStreet interception investigation methods were conducted among males aged 16 years and older in selected sites in Shenzhen in 2014 and 2019. A population survey was used to estimate the population size of MSM. Logistic regression analysis was applied to evaluate the difference in behavioral characteristics in MSM from 2014 to 2019.ResultsIn this study, we surveyed 10,170 participants in 2014, of whom 448 (4.41%, 95% CI 4.01%-4.80%) participants were men who have ever had sex with another man (MSMe) and 229 (2.25%, 95% CI 1.96%-2.54%) were men who had sex with another man in the previous 6 months (MSMa). A total of 10,226 participants were surveyed in 2019, of which 500 (4.90%, 95% CI 4.47%-5.31%) and 208 (2.03%, 95% CI 1.76%-2.31%) participants were MSMe and MSMa, respectively. The results showed that the population size of MSM who are active (MSMa) in Shenzhen was 155,469 (2.29%, 95% CI 2.28%-2.30%) in 2014 and 167,337 (2.05%, 95% CI 2.04%-2.06%) in 2019. It was estimated that there were about 12,005,445 (2.04%, 95% CI 2.04%-2.04%) MSMa in China in 2019. Compared with 2014, the MSMa in 2019 were more likely to seek sex partners through mobile phone apps and less likely to have male and female sex partners in addition to having inconsistent condom use and more than 6 sex partners in the previous 6 months.ConclusionsIn Shenzhen, the proportion of MSMa among the general male population was lower in 2019 than in 2014, and the prevalence of HIV risk behavior was reduced in 2019. Although the preferred platform to find male sex partners among MSM has changed, intervention with high–HIV risk MSM could still help to reduce HIV risk behaviors among the whole MSM group. Because MSM prefer to seek sex partners through mobile phone apps, further study is needed to strengthen internet interventions with high–HIV risk MSM to curb the spread of HIV.

Sexual Intercourse Frequency During Pregnancy: Weekly Surveys Among 237 Young Women From A Random Population-Based Sample

Significant differences in sexual frequency during pregnancy have been documented in cross-sectional and once-per-trimester longitudinal studies, with the highest sexual frequency in the first trimester and the lowest in the third trimester. However, changes in sexual frequency may be more complex than these comparisons suggest; patterns of sexual frequency have not been assessed using frequent (e.g., weekly) assessments throughout a woman's pregnancy. To assess changes in the frequency of sexual intercourse across all weeks of pregnancy. We used data from 237 women (54% White; 43% Black) who reported a pregnancy during the Relationship Dynamics and Social Life (RDSL) study. RDSL was based on a random population-based sample of 992 women in the United States, aged 18 or 19, who completed a baseline interview and brief weekly follow-up surveys for 2.5 years. We used generalized multilevel modeling to fit and compare linear, quadratic, and piecewise (via b-splines) models. Weekly probability of sexual intercourse. Sexual intercourse frequency clearly declined across pregnancy, yet the pattern followed the course of common pregnancy symptomology (i.e., nausea, fatigue) more closely than trimester cutoffs. The best fitting model demonstrated that the probability of sexual intercourse declined sharply (∼18% each week) between conception and 11 weeks, subsequently increased by ∼3% each week between weeks 11 and 21, and then declined steadily (∼6% each week) through the end of pregnancy. Documenting more precise patterns of change in sexual frequency during pregnancy provides important information to many who wish to maintain sexual intimacy while pregnant, or to those who would otherwise find the sexual disruptions particularly challenging. This study is the first to document changes in sexual intercourse frequency throughout all weeks of pregnancy as they naturally occurred among a representative sample of young women. The focus on sexual intercourse limits the findings to only one aspect of human sexuality. The narrow age range of the sample precludes generalization to all pregnant women. Changes in sexual frequency are more complex than the general declines suggested by other studies; within-trimester patterns reveal the shortcomings in understanding sexual behavior changes when aggregated by trimester, such as severely underestimating the degree of fluctuation in the first trimester. Pregnancy symptomology may be most favorable to intercourse towards the end of the first and beginning of second trimesters, and least favorable near the end of the pregnancy. Shari M. Blumenstock, Jennifer S. Barber. Sexual Intercourse Frequency During Pregnancy: Weekly Surveys Among 237 Young Women From A Random Population-Based Sample. J Sex Med 2022;19:1524-1535.

Provider Perspectives on HIV Pre-Exposure Prophylaxis Service Disruptions and Adaptations During the COVID-19 Pandemic in Baltimore, Maryland: A Qualitative Study.

The COVID-19 pandemic continues driving unprecedented disruptions to health care provision, including HIV pre-exposure prophylaxis (PrEP) services. We explored service provider experiences promoting and prescribing PrEP to marginalized populations during the COVID-19 pandemic in Baltimore, Maryland. In February to April 2021, we facilitated four virtual focus group discussions with 20 PrEP providers, representing various professional cadres and practice settings. Employing an iterative, team-based thematic analysis, we identified salient enablers and constraints to PrEP promotion, initiation, and maintenance in the COVID-19 era, along with innovative adaptations to PrEP service delivery. Discussants described attenuated demands for PrEP early in the pandemic, exemplified by high PrEP discontinuation rates. This was attributed to changes in clients' sexual behaviors and shifting priorities, including caregiving responsibilities, during the pandemic. Substantial systems-level disruptions impacting PrEP provision were identified, including outreach service suspension, personnel shortages, and facility restrictions on face-to-face visits. Providers emphasized that these disruptions, though occurring early in the pandemic, had protracted impacts on PrEP accessibility. The transition to telemedicine rendered health care services, including PrEP, more accessible/convenient to some clients and expeditious to providers. However, structural barriers to telehealth engagement (telephone/internet access), coupled with limitations of the virtual care environment (difficulty establishing rapport), impeded efforts to equitably promote and prescribe PrEP. Expanding the PrEP outreach workforce and availing alternatives to telemedicine (e.g., community-based PrEP provision, specimen self-collection) could facilitate PrEP care continuity, especially as COVID-19 transitions from an acute to a protracted health crisis.

Reasons for PrEP Discontinuation After Navigation at Sexual Health Clinics: Interactions Among Systemic Barriers, Behavioral Relevance, and Medication Concerns.

Pre-exposure prophylaxis (PrEP) for HIV prevention requires engagement throughout the PrEP care continuum. Using data from a PrEP navigation program, we examine reasons for PrEP discontinuation. Participants were recruited from New York City Health Department Sexual Health Clinics with PrEP navigation programs. Participants completed a survey and up to 3 interviews about PrEP navigation and use. This analysis includes 94 PrEP initiators that were PrEP-naive before their clinic visit, started PrEP during the study, and completed at least 2 interviews. Interview transcripts were reviewed to assess reasons for PrEP discontinuation. Approximately half of PrEP initiators discontinued PrEP during the study period (n = 44; 47%). Most participants (71%) noted systemic issues (insurance or financial problems, clinic or pharmacy logistics, and scheduling barriers) as reasons for discontinuation. One-third cited medication concerns (side effects, potential long-term side effects, and medication beliefs; 32%) and behavioral factors (low relevance of PrEP because of sexual behavior change; 34%) as contributing reasons. Over half (53.5%) highlighted systemic issues alone, while an additional 19% attributed discontinuation to systemic issues in combination with other factors. Of those who discontinued, approximately one-third (30%) restarted PrEP during the follow-up period, citing resolution of systemic issues or behavior change that increased PrEP relevance. PrEP continuation is dependent on interacting factors and often presents complex hurdles for patients to navigate. To promote sustained engagement in PrEP care, financial, clinic, and pharmacy barriers must be addressed and counseling and navigation should acknowledge factors beyond sexual risk that influence PrEP use.

EFFICACY OF Nigella sativa OIL TO RELIEVE EFFECTS OF THE LEAD MONOXIDE TOXICITY ON TESTICULAR EFFICIENCY AND SEXUAL BEHAVIOUR DISORDERS IN ALBINO RATS

The prevalence of testicular toxicity induced via contamination with heavy metals is increasing worldwide, and a close connection between testicular toxicity and lead has recently been identified. The present study demonstrated the possible therapeutic and protection properties of Nigella sativa oil (NSO) against dangerous testicular toxicity and sexual behaviour disorders in rat models induced by lead monoxide (PbO) food poisoning. A total of 24 male rats were used and divided into four groups, consisting of Group 1: Control (1 mL of distilled water); Group 2: PbO (80 mg/kg); Group 3: NSO (0.5 mL/rat); and Group 4: (NSO+PbO) 0.5 mL/rat of NSO, followed by PbO (80 mg/kg/day) respectively for 60 days. The testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17 beta-hydroxysteroid dehydrogenase activity (17β-HSD), sperm parameters, and sexual behaviour (copulation behaviour test) were measured. The results showed that sex hormone levels were significantly decreased (p&lt;0.05) in rats exposed to PbO, while the levels of these hormones were significantly higher in rats exposed to NSO and NSO+PbO. The sperm parameters (numbers, concentrations, motilities, and abnormality) were lower in rats exposed to PbO compared to those in the control, NSO, and NSO+PbO groups that showed significant increases. Sperm abnormality and 17β-HSD activity showed a significant increase at p&lt;0.05 in the group exposed to the PbO compared to those of the control, NSO, and NSO+PbO groups. The results also significantly suppressed sexual behaviour in rats exposed to PbO compared to those in the control, NSO, and NSO+PbO groups, rats were administered NSO+PbO showed improvement in sexual behaviour parameters compared to PbO groups. PbO toxicity was obvious in the reproductive tract through severe histopathological changes. The impact of lead on tissues was partially mitigated by NSO. The study showed protective effects of N. sativa oil against changes in sex hormones, sperm characteristics, and sexual behaviour in male rats exposed to lead monoxide-induced testicular toxicity.