Concern For Men Research Articles

Persistent high-risk behavior and escalating HIV, syphilis and hepatitis B incidences among men who have sex with men living in Bangui, Central African Republic

IntroductionHIV in sub-Saharan Africa remains a great concern in men who have sex with men (MSM). Intervention on MSM is a key strategy to control the burden of HIV among this population. Herein we assessed the effect of 2 years of HIV testing and counseling on risk-tacking and HIV and STI incidences among MSM living in Bangui in the Central African Republic.MethodsThe incidences of HIV, syphilis and hepatitis B and the sexual behavior characteristics were assessed at inclusion and after 2 years of follow up in the prospective MSM cohort.Results99 MSM were included and followed up during 2 years. The mean age of study MSM was 24 years (range, 14-39); among those, the majority was single (84.8%) and unemployed (33.3%) or students (23.9%). The majority (up to 80%) were living in only 4 (out of 10) neighboring district of Bangui. Insertive anal intercourse showed significant decrease from 54% at inclusion to 46% after 2 years of follow up (P < 0.001). In contrast, we observed slight increase in receptive anal intercourse (60% versus 66%) and oral sex (70% versus 74%), but the difference did not reach statistical significance. Finally, the prevalences of HIV, syphilis and hepatitis B increased significantly from 29% to 41%, 12% to 21% and 14% to 23%, respectively.ConclusionThese observations indicate that medical care and counseling on MSM does not provide significant changes in risk-taking, whereas the incidences of HIV, syphilis and hepatitis B remained high. Innovative interventions should be conceived for the MSM population living in Bangui.

Aging as emasculation? Rethinking aging masculinities in contemporary U.S. fiction

ABSTRACTThis article explores the representation of men’s aging experiences in contemporary U.S. fiction. While most gendered approaches to aging have focused on women, which has contributed to the cultural invisibility of older men, this study focuses on men’s aging experiences as men, thus challenging the inverse correlation between masculinity and aging. To do so, the article draws on a selected number of contemporary U.S. male-authored fictional works, which question the widely held assumption that aging is a lesser concern for men, or that men and women’s aging experiences may be simply defined as opposed. The literary corpus includes male authors from different backgrounds so as to illustrate how (self-)representations of aging men vary according not only to gender but also to class, race, and sexual orientation, among other factors. The article thus ends up challenging the conventional equation of men’s aging processes with (sexual) decline, exemplifying their plurality as well as irreducible contradictions.

Considerations When Treating Cosmetic Concerns in Men of Color.

Men of color include a diverse population encompassing individuals with Fitzpatrick skin Types IV through VI. Yet, there is a paucity of data describing the cosmetic concerns of this population. To review the basic science of advantages and disadvantages of skin of color and pathophysiology, incidence, and treatment of disorders of cosmetic concern in men of color. A MEDLINE search was performed for publications on sex and racial differences in basic science of skin, common disorders in men of color, and evidence-based treatments. There are intrinsic differences in skin and hair of darker-complexioned men, particularly in Hispanics, African Americans, Asians, and Afro-Caribbeans. Advantages of darker skin include increased photoprotection, slowed aging, and a lower incidence of skin cancer. However, the increased content of melanin is associated with myriad dyschromias including melasma and postinflammatory hyperpigmentation (PIH). Additional common skin conditions of concern in men of color include pseudofolliculitis barbae, acne keloidalis nuchae, and keloids. A skin color conscious approach should be administered in caring for the cosmetic concerns of men of color that is cognizant of differences in biology of the skin and hair, associated PIH of disorders, and cultural/social practices among this population.

Bone Health and Bone-Targeted Therapies for Nonmetastatic Prostate Cancer: A Systematic Review and Meta-analysis.

Bone health is a significant concern in men with prostate cancer. To evaluate the effectiveness of drug, supplement, and lifestyle interventions aimed at preventing fracture, improving bone mineral density (BMD), or preventing or delaying osteoporosis in men with nonmetastatic prostate cancer. Ovid MEDLINE (1946 to 19 January 2017), EMBASE (1980 to 18 January 2017), and the Cochrane Database of Systematic Reviews (19 January 2017). Randomized trials and systematic reviews of trials that were published in English; involved men with nonmetastatic prostate cancer; and compared bone-targeted therapies with placebo, usual care, or other active treatments. Two reviewers independently extracted study characteristics and assessed study risk of bias for each outcome. Two systematic reviews and 28 reports of 27 trials met inclusion criteria. All trials focused on men with nonmetastatic prostate cancer who were initiating or continuing androgen deprivation therapy (ADT). Bisphosphonates were effective in increasing BMD, but no trial was sufficiently powered to detect reduction in fractures. Denosumab improved BMD and reduced the incidence of new radiographic vertebral fractures in 1 high-quality trial. No trials compared calcium or vitamin D versus placebo. Three lifestyle intervention trials did not show a statistically significant difference in change in BMD between exercise and usual care. Most trials were of moderate quality. Only 2 randomized controlled trials were designed to examine fracture outcomes. Potential harms of treatments were not evaluated. Both bisphosphonates and denosumab improve BMD in men with nonmetastatic prostate cancer who are receiving ADT. Denosumab also reduces risk for radiographic vertebral fractures, based on 1 trial. More trials studying fracture outcomes are needed in this population. Program in Evidence-Based Care.

Men's defense of their prototypicality undermines the success of women in STEM initiatives

Two studies tested the prediction that men in STEM (Science, Technology, Engineering, & Math; students in Study 1; professionals in Study 2), who believed that initiatives to increase women's representation in these fields were effective would experience prototypicality threat (men's concern that they would no longer be the gender group that best represents what it means to be a member of the STEM community). Among those who believed it is legitimate for men to represent STEM, men's prototypicality threat mediated the relationship between perceptions that more women were entering their field and resistance toward this change (i.e., opposing women in STEM initiatives, wanting women to conform to the field's traditional norms, and expressing exclusionary intentions toward women peers). The opposite pattern was observed among those who rejected the idea that men's claim to represent STEM was legitimate. This work highlights how diversity initiatives in STEM, if successful, can be undermined by triggering prototypicality threat among men.

Poly drug use, chemsex drug use, and associations with sexual risk behaviour in HIV-negative men who have sex with men attending sexual health clinics

BackgroundRecreational drug use and associated harms continue to be of significant concern in men who have sex with men (MSM) particularly in the context of HIV and STI transmission. MethodsData from 1484 HIV-negative or undiagnosed MSM included in the AURAH study, a cross-sectional, self-completed questionnaire study of 2630 individuals from 20 sexual health clinics in the United Kingdom in 2013–2014, was analysed. Two measures of recreational drug use in the previous three months were defined; (i) polydrug use (use of 3 or more recreational drugs) and (ii) chemsex drug use (use of mephedrone, crystal methamphetamine or GHB/GBL). Associations of socio-demographic, health and lifestyle factors with drug use, and associations of drug use with sexual behaviour, were investigated. ResultsOf the 1484 MSM, 350 (23.6%) reported polydrug use and 324 (21.8%) reported chemsex drug use in the past three months. Overall 852 (57.5%) men reported condomless sex in the past three months; 430 (29.0%) had CLS with ≥2 partners, 474 (31.9%) had CLS with unknown/HIV+ partner(s); 187 (12.6%) had receptive CLS with an unknown status partner. For polydrug use, prevalence ratios (95% confidence interval) for association with CLS measures, adjusted for socio-demographic factors were: 1.38 (1.26, 1.51) for CLS; 2.11 (1.80, 2.47) for CLS with ≥2 partners; 1.89 (1.63, 2.19) for CLS with unknown/HIV+ partner(s); 1.36 (1.00, 1.83) for receptive CLS with an unknown status partner. Corresponding adjusted prevalence ratios for chemsex drug use were: 1.38 (1.26, 1.52); 2.07 (1.76, 2.43); 1.88 (1.62, 2.19); 1.49 (1.10, 2.02). Polydrug and chemsex drug use were also strongly associated with previous STI, PEP use, group sex and high number of new sexual partners. Associations remained with little attenuation after further adjustment for depressive symptoms and alcohol intake. ConclusionThere was a high prevalence of polydrug use and chemsex drug use among HIV negative MSM attending UK sexual health clinics. Drug use was strongly associated with sexual behaviours linked to risk of acquisition of STIs and HIV.

Prostate Cancer Prognosis Defined by the Combined Analysis of 8q, PTEN and ERG

Overtreatment is a major concern in men diagnosed with prostate cancer. The aim of this study was to evaluate the combined prognostic role of three frequent molecular alterations in prostate cancer, namely relative 8q gain, ERG overexpression, and loss of PTEN expression, in a series of 136 patients with prostate cancer treated with prostatectomy and with a long follow-up. Fluorescent in situ hybridization was used to detect the relative copy number of 8q and immunohistochemistry was used for quantitative assessment of ERG and PTEN expression. During a median follow-up period of 117.8 months, 66 (49%) patients had disease recurrence. Relative 8q gain, ERG overexpression, and loss of PTEN expression were observed in 18%, 56%, and 33% of the cases, respectively. No association with patient recurrence-free survival was found for relative 8q gain or ERG overexpression on their own, whereas loss of PTEN expression was associated with worse recurrence-free survival (P=.006). Interestingly, in the subgroup of patients with normal PTEN expression, we found that the combined relative 8q gain/ERG overexpression is associated with high risk of recurrence (P=.008), suggesting that alternative mechanisms exist for progression into clinically aggressive disease. Additionally, in intermediate-risk patients with normal PTEN expression in their tumors, the combination of 8q gain/ERG overexpression was associated with a poor recurrence-free survival (P<.001), thus indicating independent prognostic value. This study shows that the combined analysis of 8q, ERG and PTEN contributes to an improved clinical outcome stratification of prostate cancer patients treated with radical prostatectomy.

The Association Between Men's Concern About Demonstrating Masculine Characteristics and Their Sexual Risk Behaviors: Findings from the Dominican Republic.

Quantitative analyses exploring the relationship between masculinities and men's sexual risk behaviors have most commonly used one dimension of masculinities: men's gender ideology. Examining other dimensions may enhance our understanding of and ability to intervene upon this relationship. In this article, we examined the association between gender role conflict/stress (GRC/S)-men's concern about demonstrating masculine characteristics-and three different sexual risk behaviors (having two or more sex partners in the last 30days; never/inconsistent condom use with non-steady partners; and drinking alcohol at last sex) among a sample of heterosexual men in the Dominican Republic who were participating in an HIV prevention intervention (n=293). The GRC/S Scale we used was adapted for this specific cultural context and has 17 items (α=0.75). We used logistic regression to assess the relationship between GRC/S and each sexual behavior, controlling for sociodemographic characteristics. In adjusted models, a higher GRC/S score was significantly associated with increased odds of having two or more sex partners in the past 30days (AOR 1.33, 95% CI 1.01-1.74), never/inconsistent condom use with non-steady partners (AOR 1.45, 95% CI 1.04-2.01), and drinking alcohol at last sex (AOR 1.56, 95% CI 1.13-2.17). These results highlight the importance of expanding beyond gender ideology to understanding the influence of GRC/S on men's sexual risk behaviors. Interventions should address men's concern about demonstrating masculine characteristics to reduce the social and internalized pressure men feel to engage in sexual risk behaviors.

Sexual Dysfunction in Type 2 Diabetes at Diagnosis: Progression over Time and Drug and Non-Drug Correlated Factors.

AimsTo present the longitudinal data of the SUBITO-DE study, a prospective survey involving male patients with new or recently diagnosed type 2 diabetes mellitus (T2DM) (<24 months).Materials and MethodsSexual function was assessed in male patients with T2DM at baseline (phase 1) and after a mean follow-up of 18 months (phase 2). Standard metabolic parameters and sexual and depressive symptoms were evaluated.ResultsSix of the 499 enrolled patients died of different causes during phase 1. Of the 493 surviving men invited to participate in phase 2, 450 (mean age 59.0±9.0 years) (90.2%) accepted and 43 (8.2%) were lost to follow-up. As compared to baseline, the proportion of the men who reported improvement in erectile dysfunction (ED) at follow-up was nearly double that of the men who reported worsening of ED (22.6% vs. 12.8%). The increase in frequency of sexual activity the men reported at follow-up assessment indicates that many never treated before baseline were taking an ED drug during the study period (106 subjects). Phosphodiesterase type 5 inhibitors (PDE5i) were the ED drugs most commonly taken at both baseline and follow-up. An overall improvement over baseline values was observed in metabolic targets for T2DM and depressive symptoms. Conversely, no change in lifestyle behaviors was recorded during the study.ConclusionsSexual dysfunction is a major concern in men with T2DM. The SUBITO-DE study demonstrates that, when combined with adequate counseling and tailored PDE5i therapy, an integrated approach to achieving metabolic targets in men with T2DM can improve sexual function as well as depressive symptoms.

Mastery, Isolation, or Acceptance: Gay and Bisexual Men’s Construction of Aging in the Context of Sexual Embodiment After Prostate Cancer

Age is the predominant risk factor for developing prostate cancer, leading to its description as an “older man’s disease.” Changed sexual embodiment is a concern for men who develop prostate cancer, often compounding experiences of age-related sexual decline. Although research has examined heterosexual men’s experiences of aging in the context of sexual embodiment after prostate cancer, gay and bisexual men have received little attention. This qualitative study used a material-discursive analysis, drawing on positioning theory and intersectionality, to explore constructions of aging following prostate cancer in 46 gay or bisexual men. Thematic decomposition of one-to-one interviews identified three subject positions: “mastering youth,” involving maintaining an active sex life through biomedical interventions, accessing commercial sex venues, or having sex with younger men; “the lonely old recluse,” involving self-positioning as prematurely aged and withdrawal from a gay sexual scene; and “accepting embodied aging,” involving the incorporation of changed sexual function into intimate relationships and finding pleasure through nonsexual activities. These subject positions are conceptualized as the product of intersecting masculine and gay identities, interpreted in relation to broader cultural discourses of “new aging” and “sexual health,” in which sexual activity is conceptualized as a lifelong goal.

What can we learn from critical periods of weight gain in military personnel?

What can we learn from critical periods of weight gain in military personnel?

Penile Enhancement Surgery: An Overview

Penile size is a frequently observed concern in men of all ages. The way in which some men see their personality is defined, appraised, or reflected by their penis, with the view that ‘bigger is better’, is termed ‘phallocentrism’. In this review article, we assess the literature and evaluate the evidence on what is ‘normal’ in relation to penile size, and evaluate techniques for penile lengthening and girth augmentation with emphasis on the possible benefits and complications of the procedures reviewed.

Senior Men's Concern About Appearance and Their Cosmetics Buying Behavior

In our increasingly aged society, the term centenarian, meaning people 100 years old or older, is used more and more frequently. Indeed, anticipating long life, middle-aged to advanced-age people have changed their lifestyles to purchase goods for themselves. In addition, as the social trend of careful grooming for positive appearance spreads within the Korean society, the demand for senior male cosmetic products is likely to grow as the society ages further. However, previous large studies on the market for senior male cosmetics are limited. Since information is lacking about senior male consumers' awareness of cosmetics, this study examined their use of cosmetic products, purchase behaviors, and demand for cosmetics in order to explore correlations among interest levels in appearance, cosmetic purchase behavior, and cosmetic demand levels through diverse factors related to multiple variables. The results of this study were as follows : First, the more senior men managed their practical appearance, the more frequent their functional and psychological purchase behaviors. Second, the higher their practical purchase behavior, the stronger their demand for reasonable cosmetic prices. Third, the higher their value-oriented purchase behavior, the stronger the demand for greater product diversity. This study investigated men aged 50 or older residing in Seoul. Therefore, generalizing the findings of this study will be limited. Relevant subsequent studies should examine men aged 50 or older in each Korean region and more clearly identify the correlations among interest in appearance, cosmetic product purchase behavior, and cosmetic product demand using various factors related to multiple variables.

Erectile Dysfunction: A Review of Historical Treatments With a Focus on the Development of the Inflatable Penile Prosthesis.

Erectile dysfunction has been a concern for men since the beginning of written history. For many men it can lead to severe psychological distress and humiliation. The treatment of erectile dysfunction has advanced significantly over the past 200 years. Men today are presented with many more viable therapy options leading to improved efficacy and more satisfactory sex lives. The objective of this article is to explore historical options for the treatment of erectile dysfunction, with particular emphasis on the development and progression of the inflatable penile prosthesis.

The evolution of evaluation and management of urinary or fecal incontinence and pelvic organ prolapse

Sexual function is an important concern in men receiving intensity modulated radiation therapy (IMRT) for prostate cancer. Our aim was to study the impact of IMRT and androgen deprivation therapy (ADT) on sexual function over time and to report the effectiveness of sexual medications or aids.A total of 179 men, median age 69, received definitive IMRT for prostate cancer and completed 2 surveys (Expanded Prostate Cancer Index Composite-26 and a sexual medicines/devices survey) for at least 2 time points. Surveys were prospectively collected at baseline (before all therapy), and 2, 6, 12, 18, and 24 months after IMRT. Median dose was 76 Gy to the prostate. ADT was administered to 59% of patients (median duration 5 months, initiated 2 months before IMRT). Global scores were generated for the Expanded Prostate Cancer Index Composite-26 questions. Longitudinal analysis was performed by constructing a generalized estimation equations model, and clinical variables were tested for association with global scores.Overall, there was a significant decline in global sexual score through 2 years. Men receiving ADT had a lower sexual score at 2 and 6 months, but this difference disappeared at 24 months. Analysis of individual sexual symptoms showed no significant difference at 24 months except that men on ADT were less likely to be sexually active (P = .02); this difference was not observed for men receiving short-term ADT only. Longitudinal analysis revealed that duration of ADT was the only factor associated with global sexual score. Phosphodiesterase inhibitors were attempted by roughly half of all men, with 66% experiencing benefit, whereas other aids were attempted by roughly 5% of men.Although ADT adversely affected short-term sexual function, there was no significant difference in global score and most sexual symptoms by 24 months. These data are useful for anticipatory guidance regarding expectations after IMRT.

The impact of hormonal therapy on sexual quality of life in men receiving intensity modulated radiation therapy for prostate cancer

PurposeSexual function is an important concern in men receiving intensity modulated radiation therapy (IMRT) for prostate cancer. Our aim was to study the impact of IMRT and androgen deprivation therapy (ADT) on sexual function over time and to report the effectiveness of sexual medications or aids. Methods and materialsA total of 179 men, median age 69, received definitive IMRT for prostate cancer and completed 2 surveys (Expanded Prostate Cancer Index Composite-26 and a sexual medicines/devices survey) for at least 2 time points. Surveys were prospectively collected at baseline (before all therapy), and 2, 6, 12, 18, and 24 months after IMRT. Median dose was 76 Gy to the prostate. ADT was administered to 59% of patients (median duration 5 months, initiated 2 months before IMRT). Global scores were generated for the Expanded Prostate Cancer Index Composite-26 questions. Longitudinal analysis was performed by constructing a generalized estimation equations model, and clinical variables were tested for association with global scores. ResultsOverall, there was a significant decline in global sexual score through 2 years. Men receiving ADT had a lower sexual score at 2 and 6 months, but this difference disappeared at 24 months. Analysis of individual sexual symptoms showed no significant difference at 24 months except that men on ADT were less likely to be sexually active (P = .02); this difference was not observed for men receiving short-term ADT only. Longitudinal analysis revealed that duration of ADT was the only factor associated with global sexual score. Phosphodiesterase inhibitors were attempted by roughly half of all men, with 66% experiencing benefit, whereas other aids were attempted by roughly 5% of men. ConclusionsAlthough ADT adversely affected short-term sexual function, there was no significant difference in global score and most sexual symptoms by 24 months. These data are useful for anticipatory guidance regarding expectations after IMRT.

Environmental problems of modern societies

Man's concern about his environment and technosystem is only slowly reaching the level of awareness and seriousness which would be adequate to meet the threats and challenger before him. The magnitude of human activity is in every possible measure approaching that of the living Nature. Yet we lack conceptual patterns for an understanding of what all of this might came to mean to man himself and to Nature, and for seeing the new directions for real development. In this paper such mental patterns are presented, strategic questions of development raised, and answers outlined. The concept of entropy is regarded as being highly important for any proper understanding of the technosystem.

Gender differences in depression

Depression is one of the most prevalent and debilitating diseases. In recent years there has been increased awareness of sex- and gender-specific issues in depression. This narrative review presents and discusses differences in prevalence, symptom profile, age at onset and course, comorbidity, biological and psychosocial factors, the impact of sexual stereotyping, help-seeking, emotion regulation and doctor-patient communication. Typically, women are diagnosed with depression twice as often as men, and their disease follows a more chronic course. Comorbid anxiety is more prevalent in women, whereas comorbid alcohol abuse is a major concern in men. Sucide rates for men are between three and five times higher compared with women. Although there are different symptom profiles in men and women, it is difficult to define a gender-specific symptom profile. Socially mediated gender roles have a significant impact on psychosocial factors associated with risk, sickness behavior and coping strategies. In general, too little attention has been paid to the definition and handling of depression and the gender-related requirements it makes on the healthcare system.

Huebner’s Critical Encounter with the Philosophy of Heidegger in Being and Time: Learning, Understanding, and the Authentic Unfolding of History in the Curriculum

This paper responds to the following question: “What are the issues concerned with potential educational reform that arise from Huebner’s critical encounter with Heidegger and the tradition in education and curriculum theory?” In attempting a rejoinder, I revisit Huebner’s groundbreaking essay, “Curriculum as Concern for Man’s Temporality,” which introduces the phenomenological method in education and curriculum studies, with the goal of examining in detail the underlying themes, issues, and concepts, which ground Huebner’s reconceptualization of curriculum reform, as they emerge from Heidegger’s philosophy. I show that Huebner’s understanding of Beingin-the-world in terms of the design of the educational environment, not only mirrors, but as well, embodies the flux, flow, and rhythmic dynamics of history’s “dialectic” unfolding as a temporal phenomenon, which for Heidegger represents our authentic “historizing” in the “moment of vision,” or Augenblick, and this for Heidegger is the definitive embodiment of Dasein’s authentic mode of existence as historical Being-in-the-world as Being-with Others.

Substance use disorders: an international concern for men's health

Substance use disorders: an international concern for men's health