Sexual Health Interventions Research Articles

The Experience of Chemsex and Accessing Medical Care for Gay, Bisexual and Other MSM in Russia: An Interpretive Phenomenological Analysis

ABSTRACT The use of illicit drugs during sex (Chemsex) in gay, bisexual and men who have sex with men (GBMSM) has been a challenge for sexual health services globally. In Russia, HIV remains a significant public health concern and access to prevention and treatment services is limited. Little is known about the nature of Chemsex and the challenges GBMSM practicing Chemsex in Russia face when accessing medical care. This study explored GBMSM’s experience with Chemsex and access to medical care. We conducted three focus groups with GBMSM (n = 19) based in Moscow and Yekaterinburg in December 2020. The focus groups explored their experience with Chemsex and accessing medical care. We used an Interpretative Phenomenological Analysis to analyze the data. GBMSM engaged in Chemsex through social networks and cited pleasure as one of their main reasons for engaging. The men described their addiction and perceiving many dangers at Chemsex group sessions. They reported using several self-care mechanisms to recover after a group session. Many reported feeling stigmatization from other members of the GBMSM community. Perceived barriers to medical care included legal barriers and stigmatization from medical professionals. To better support GBMSM, they felt there was a need for better access to sexual health and HIV prevention services, and psychological support. Our study highlights the unmet need in services for GBMSM engaging in Chemsex in Russia. It highlights how societal perceptions of homosexuality and drug use act as barriers to effective interventions for both sexual health and drug use.

Process evaluation of a parent-child communication intervention for adolescent sexual and reproductive health in Uganda

BackgroundPrevious initiatives concerning adolescent sexual and reproductive health (SRH) education in Low-or-Middle Income Countries (LMICs) have been limited by cultural norms and misinformation perpetuated within families. Responding to the paucity of research on the implementation of SRH interventions in LMICs and limited knowledge regarding their mechanisms, this study undertakes a process evaluation of a parent-focused intervention to promote parent-adolescent communication about SRH in Uganda.MethodsThis paper explores the implementation, contextual factors and mechanisms of impact of the intervention, using the Medical Research Council (MRC) guidelines for process evaluations. Implementation was evaluated through indicators of dose, fidelity and adaptations, acceptability and feasibility. The contextual factors and mechanisms of impact were evaluated to refine the intervention’s causal assumptions. Data was collected during April - October 2021 in South-Western Uganda using a mixed-methods approach, including document analysis, intervention observations, interviews, focus group discussions and most significant change stories.ResultsThe acceptability of the intervention was related to its community engagement, the strong rapport with delivery agents, and individual characteristics of participants. Five contextual factors influencing implementation were highlighted; (i) cultural norms, (ii) perceptions about youth SRH, (iii) poverty, (iv) Covid-19 pandemic, and (v) prior research projects in the community. When considering the intervention’s mechanisms of impact, four causal pathways were identified; (i) Awareness of SRH needs helped parents overcome stigma, (ii) Parenting skills training improved SRH communication, (iii) Group learning stimulated shared parenting, and (iv) Group learning improved co-parenting.ConclusionThe paper presented three key learnings and corresponding recommendations for future research. Firstly, implementation success was credited to meaningful community engagement which improved acceptability and uptake. Secondly, the complex influences of contextual factors highlighted the need for contextual analysis in research studies to inform intervention design. Finally, this evaluation recognised the interplay between mechanisms of impact and suggested further research consider such combined impacts when designing intervention content.

A Digital Sexual Health Intervention for Urban Adolescent and Young Adult Male Emergency Department Patients: User-Centered Design Approach.

Adolescents and young adults frequently present to the emergency department (ED) for medical care and continue to have many unmet sexual health needs. Digital interventions show promise to improve adolescent and young adult sexual health; yet, few interventions focus on male ED patients, despite their infrequent use of contraceptives and rising rates of sexually transmitted infections. This paper describes the design and development of Dr. Eric (Emergency Room Interventions to Improve Care), a digital app focused on promoting condom use among sexually active adolescent and young adult male ED patients. This study followed 4 phases of app development, which were based on user-centered design and the software development lifecycle. In phase 1, define, we explored our target population and target health problem (infrequent condom use among male ED patients) by collecting key stakeholder input and conducting in-depth interviews with male patients and urban ED medical providers. In phase 2, discover, we partnered with a digital product agency to explore user experience and digital strategy. In phase 3, design, we refined Dr. Eric's content, a 5-part sexual health educational module and a 10-week SMS text messaging program that focuses on condom use and partner communication about effective contraceptives. We conducted semistructured interviews with male adolescent and young adults to gather feedback on the app and perform usability testing, editing the app after each interview. We also interviewed informatics experts to assess the usability of a high-fidelity prototype. Interviews were recorded and analyzed via descriptive thematic analysis; informatic expert feedback was categorized by Nielsen's heuristic principles. In phase 4, develop, we created the technical architecture and built a responsive web app. These findings were gathered leading to the final version of the digital Dr. Eric program. Using data and key stakeholder input from phases 1 and 2, we iteratively created the Dr. Eric prototype for implementation in the ED setting. Interviews with 8 adolescent and young adult male ED patients suggested that users preferred (1) straightforward information, (2) a clear vision of the purpose of Dr. Eric, (3) open-ended opportunities to explore family planning goals, (4) detailed birth control method information, and (5) games presenting novel information with rewards. Five usability experts provided heuristic feedback aiming to improve the ease of use of the app. These findings led to the final version of Dr. Eric. Following these mobile health development phases, we created a digital sexual health mobile health intervention incorporating the principles of user experience and interface design. Dr. Eric needs further evaluation to assess its efficacy in increasing condom use among adolescent and young adult male ED patients. Researchers can use this framework to form future digital health ED-based digital interventions.

The “memeification” of sexual health communication on Instagram

ABSTRACT The lack of accurate and comprehensive sexual health education in the USA persists as a pressing public health issue. The Sex Wrap (TSW) is a multimedia sexual health podcast and social media presence that educates followers on sexual health and ancillary themes such as sexuality, relationships and communication. TSW’s Instagram account repackages the evidence-based sexual health information discussed during the podcast into Internet memes. We analysed the top-performing TSW posts from Jan 2019-Dec 2020 according to Instagram’s engagement metrics to determine what type of posts were most interesting to followers and begin to understand how social media helps drive interventions. The meme-based sexual health intervention via TSW’s Instagram increased engagement, improved reach, and converted followers to podcast listeners. Insight data demonstrates how social media can address the sexual health education disparities caused by the failure of abstinence-only-until-marriage (AOUM) curricula. This case study exhibits how social media-based interventions can comprehensively fill existing gaps in sexual health education.

A multimodal couple-coping intervention for enhancing sexual adjustment among breast cancer women: Study protocol for a randomised controlled trial.

To investigate the effects of a multimodal couple-based sexual health intervention for premenopausal women treated for breast cancer and their partners to provide personalised psychosexual care, and to understand participants' experience of, and adherence to, the intervention. This is an assessor-blinded, randomised controlled trial. Premenopausal women treated for breast cancer (N = 160) and their partners will be recruited. Dyads will be randomised into an intervention (n = 80) or attention control (n = 80) group. The intervention group will receive the multimodal couple-based sexual health intervention over eight weeks. The intervention comprises five face-to-face and virtual individual couple counselling sessions combined with online reading, a chat-based discussion forum, and telephone calls. The intervention is based on level I-II evidence and a robust theoretical framework. The attention control group will receive usual care plus telephone calls comprising general greetings and reminders to complete follow-up surveys. Sexual adjustment, relationship quality and quality of life will be measured at baseline, after completion of the intervention, three months and six months post-intervention. The project will adhere to the CONSORT-EHEALTH checklist. Qualitative interviews will explore the participants' experience of, and adherence to, the intervention. This study will provide the first pragmatic evidence of the effectiveness of a multimodal couple-coping intervention to support premenopausal women and their partners to improve sexuality, relationship quality and quality of life after treatment for breast cancer. Sexual health is a neglected area in clinical practice, for patients and partners. The ever-growing population of women treated for breast cancer at younger age has created a more pressing need for the development of tailored sexual health interventions. If effective, this intervention could be incorporated into routine cancer care to provide better support and care for this patient population to enhance sexual health, intimacy and overall well-being. ISRCTN35481498; prospectively registered on 08/05/2023.

Unmet Sexual Health Resource Needs and Preferences for Interventions to Address These Needs Among Female Partners of Patients With Prostate Cancer

ObjectivesTo characterize unmet sexual health resource needs and preferences for interventions to address unmet needs among female partners of patients with prostate cancer (PCa), given the significant negative impact of PCa on the sexual health of partners. MethodsWe conducted an exploratory sequential mixed methods study of female partners recruited from multiple U.S. clinical locations, websites, and support groups for caregivers. We first conducted semi-structured in-depth interviews. Qualitative results informed development of a cross-sectional survey, which was administered to a larger sample of partners. ResultsOverall, 12 and 200 female partners participated in the qualitative and quantitative portions of the study. Major emergent themes from interviews were the benefits and drawbacks of technology-based interventions, the importance of sexual health resources throughout the PCa journey, and a desire for sexual health support groups that include partners. In the survey, the most common sexual health topics that partners wanted more information about were male libido problems (30.0%), erectile dysfunction (26.5%), and female libido and arousal problems (24.5%). Additionally, 41.5% wanted more information about sexual health websites, 35.0% about partners-only support groups, 29.5% about support groups for couples, and 23.5% about sexual medicine specialists. ConclusionsTo our knowledge, this is the largest study to date on female partners’ unmet sexual health resource needs and preferences for sexual health interventions. Partners prefer technology-based interventions, desire sexual health-focused support groups, and want more information about a variety of sexual issues and specialists who treat them.

Applying Human-Centered Design to Replicate an Adolescent Sexual and Reproductive Health Intervention: A Case Study of Binti Shupavu in Kenya.

We present a case study describing the use of human-centered design (HCD) to determine how to adapt intervention components from an existing contraceptive uptake program for adolescent girls in 4 geographical contexts (Ethiopia, northern Nigeria, southern Nigeria, and Tanzania) for use in Kenya. First, we prioritized existing intervention components to be tested in Kenya using sacrificial concepts. Through these concepts, we identified key insights and behavioral archetypes from which to build higher-fidelity prototypes, leveraging existing program knowledge and resources while responding to unique opportunities for Kenyan adolescent girls. After 2 rounds of prototyping, we launched a high-fidelity intervention designed to improve contraceptive uptake among girls. We used program experience to identify strategies for improvement during early implementation. The resulting model, Binti Shupavu, is designed to tap into girls' aspirations and connect them with contraceptive use, build their trust in the health system, and work with influencers to build support for adolescent contraceptive use, following the global user journey. In the first year of implementation (January-December 2022), the intervention was scaled from 90 facilities to 360 facilities and reached 60,111 adolescent girls aged 10-19 years. Of these, 21,698 were new voluntary contraceptive users (36%) and an additional 3,873 (19%) were continuing users.Our design process suggests that HCD is a promising tool for navigating replication. The emphasis on users' perspectives, testing to learn, and collaboration facilitated a deep understanding of the new user population, thus guiding program designers to balance using existing components with developing new ones based on the population's unique needs. Finally, HCD has potential to support the localization agenda if design teams are supported by national, regional, and global experts to be aware of and use the evidence and implementation experience from earlier work.

‘I wouldn’t trust it …’ Digital transformation of young people’s sexual health services: a systems-informed qualitative enquiry

IntroductionDigital sexual health technologies for young people, such as websites, texting services and apps, could address some of the sexual health inequalities that many experience, since they have the potential...

Condom use correlates among youth living with HIV in South Africa: lessons for promoting safer sex

ABSTRACT Identifying factors associated with condom use can help inform the design of sexual reproductive health interventions for young people living with HIV. Data were collected from 294 sexually active youth in South Africa aged 14–24 years, living with HIV and aware of their status. Logistic regression found condom use was associated with partner status, disclosure, treatment adherence, knowledge, alcohol use, enacted stigma, and age at known status. Seventy-seven percent reported condom use at last sex, with higher odds among those who: disclosed their status to their last partner (OR = 2.13, 95% CI = 1.09–4.15), had not missed any ART doses in the previous week (OR = 2.67, 95% CI = 1.35–5.27), knew to use condoms when both partners have HIV (OR = 2.65, 95% CI = 1.34–5.25) and learned their status by age 12 (OR = 2.89, 95% CI = 1.30–6.43). Lower odds of condom use were among participants with an HIV-positive partner (OR = 0.36, 95% CI = 0.18–0.73), those who experienced recent stigma (OR = 0.55, 95% CI = 0.31–1.00), who drank at least 1 day per month (OR = 0.43, 95% CI = 0.22–0.84) and females (OR = 0.41, 95% CI = 0.20–0.84). Condom education and services promoting stigma management and safe disclosure could increase condom use among young people living with HIV. Lower condom use among adolescents reporting non-adherence to treatment underscores the critical need for effective interventions.

Assessing acceptability and effectiveness of a pleasure-oriented sexual and reproductive health chatbot in Kenya: an exploratory mixed-methods study

Integrating pleasure may be a successful strategy for reaching young people with sexual and reproductive health and rights (SRHR) interventions. However, sexual pleasure-related programming and research remains sparse. We aimed to assess chatbot acceptability and describe changes in SRHR attitudes and behaviours among Kenyan young adults engaging with a pleasure-oriented SRHR chatbot. We used an exploratory mixed-methods study design. Between November 2021 and January 2022, participants completed a self-administered online questionnaire before and after chatbot engagement. In-depth phone interviews were conducted among a select group of participants after their initial chatbot engagement. Quantitative data were analysed using paired analyses and interviews were analysed using thematic content analysis. Of 301 baseline participants, 38% (115/301) completed the endline survey, with no measured baseline differences between participants who did and did not complete the endline survey. In-depth interviews were conducted among 41 participants. We observed higher satisfaction at endline vs. baseline on reported ability to exercise sexual rights (P ≤ 0.01), confidence discussing contraception (P ≤ 0.02) and sexual feelings/needs (P ≤ 0.001) with their sexual partner(s). Qualitative interviews indicated that most participants valued the chatbot as a confidential and free-of-judgment source of trustworthy “on-demand” SRHR information. Participants reported improvements in sex-positive communication with partners and safer sex practices due to new learnings from the chatbot. We observed increases in SRHR empowerment among young Kenyans after engagement with the chatbot. Integrating sexual pleasure into traditional SRHR content delivered through digital tools is a promising strategy to advance positive SRHR attitudes and practices among youth.

“Too weak to fight, too scared to scream”: Understanding experiences of sexual coercion of Black female adolescents through digital storytelling

Black female adolescents are less frequently viewed as victims of violence or as agents of resistance. This study analyzed the experiences of sexual coercion of Black female adolescents on the South Side of Chicago through narrative scripts used to create digital stories. Using Sexual Script Theory and applying an intersectional lens, we analyzed a collection of 46 narrative transcripts from Black female youth, living on the South Side of Chicago, five of which specifically focused on the theme of sexual coercion. Under the broader theme of sexual coercion, the following subthemes were identified: (1) broken expectations of romance, (2) sex as a means of seeking attention from a male partner, (3) sex as a means of maintaining a partner, and (4) rape. By better understanding the social context of relationships for Black adolescent girls in heterosexual relationships, we may be able to better design sexual and reproductive health interventions for young women of color.

Sex and Female Empowerment (SAFE): Learning from health care providers, men and women to design a sexual health intervention for women with substance use disorders

BackgroundSubstance Use Disorder (SUD) treatment is a promising setting to provide sexual health education to women. This study examined barriers and possible solutions to effectively providing sexual health education and services during SUD treatment. MethodsTo obtain a full picture of the barriers and solutions, 29 cisgender women and 17 cisgender men in treatment for a SUD and four health care providers in North Carolina were interviewed regarding the domains of pregnancy-planning, barriers to reproductive health services and contraception, selecting a method of contraception and desired aspects and elements of a sexual health intervention. ResultsEight themes and 12 sub-themes emerged that included how addiction impacts pregnancy planning and pregnancy motivations, the stigma and fear regarding accessing health services, the lack of accurate knowledge of the human reproductive cycle and contraceptive methods and worries about contraception side-effects. Recommendations for interventions to reduce unintended pregnancy in this treatment population included the need for simple and focused information given by trusted communicators in a short time frame in accessible locations, and offering incentives for participation such as food and transportation. ConclusionAs SUD treatment providers and programs look to improve access to sexual health and contraceptive options for women with SUD, these eight themes provide helpful guidance in crafting future interventions.

An Implementation Pilot of Web-Based Self-Training Programs on Sexual Dysfunctions in the Dutch Public Sexual Health Setting: Mixed Methods Study.

Web-based sexual health interventions may be more acceptable to people compared with face-to-face support, given the stigma and embarrassment often associated with sexual problems. The Dutch public sexual health clinics (SHCs) conducted an implementation pilot with 4 web-based self-training programs on sexual dysfunctions (WSTPs) for young people. In addition to a basic sexuality program, the WSTPs focused on the following complaints: pain during intercourse, premature ejaculation, and no sex drive. This study aims to gain insight into the potential reach of the freely offered WSTPs; use, acceptance, evaluation, and perceived impact of the WSTPs by young people; and evaluation and acceptance of the WSTPs by nurses of the SHCs. A quantitative baseline measurement (BM) and a follow-up measurement (FM) were conducted among the users. In addition, qualitative data were gathered through video interviews with a sample of respondents of the FM and nurses of the SHCs to gain more in-depth insights into their assessment of the WSTPs. Participants were recruited via social media, posters, and referrals by nurses of the SHCs. Quantitative data were analyzed using descriptive statistics. Independent 2-tailed t tests and one-way independent ANOVAs were used to compare the scores between subgroups based on background characteristics. Dependent 2-tailed t tests were used to assess the possible changes between BM and FM. The interviews were analyzed using a thematic analysis. A total of 1028 young people (aged 16-24 y) completed the BM, 666 started with 1 of the WSTPs, and 104 participants completed the FM. In addition, 8 users and 8 nurses were interviewed. Of the participants who completed the BM, 87.74% (902/1028) experienced moderate (411/1028, 39.98%) to high (491/1028, 47.76%) severity of complaints, of which 20.43% (210/1028) had had them for >1 year and 27.82% (286/1028) even for ≥2 years, and 38.91% (400/1028) were dissatisfied with their sex lives. Only 8.75% (90/1028) had sought professional help in the past 2 years. At FM, users rated satisfaction with their sex life more positively than they did at BM, and they experienced less discomfort from their complaints. The overall rating was positive, with a mean report grade of 7.3 (SD 1.45; on a 10-point scale). Anonymity, clear information and explanation, and practical exercises are indicated as strengths of the WSTPs, leading to more understanding and normalization. Nurses appreciate the high quality of information and accessibility of the WSTPs. They consider them as a valuable addition to the consultation hours. WSTPs can reach a large number of young people with sexual problems who are less likely to seek professional help. This can result in an improved understanding of their issues, a decrease in complaints, and reduced barriers to communicating with a partner or professional.

The use of social marketing approach in adolescent sexual health promotion

Abstract Background To tackle adolescent sexual health challenges, sexual health promotion must be versatile and originate from adolescents’ needs. Social marketing, an audience-centered approach that aims at changing people's behavior, can be used in adolescent sexual health promotion. This scoping review researched the content and delivery methods of social marketing interventions in adolescent sexual health. To our knowledge, these objects have not been previously reviewed. Methods Six databases were searched to capture the peer-reviewed quantitative, qualitative, and mixed methods articles without time restrictions that provided evidence of sexual health-related social marketing interventions targeting adolescents aged 11-25. An inductive-deductive content analysis was performed. Nineteen studies were included in the data. Results The content of interventions included sexual risks, risk prevention, morals of sexual relationships, and changes in the body. Risks and risk prevention dominated the data, and they focused on sexually transmitted diseases, unwanted pregnancies, and sexual violence. Morals of sexual relationships included values such as fidelity toward one's partner, whereas changes in the body were observed from a reproductive perspective. Delivery of interventions occurred through various media channels, events, and activities. Conclusions The interventions were mostly preventive and concentrated on the risks, whereas the delivery methods were diverse and creative, combining modern and already well-established channels. Sexuality should be seen comprehensively, and interventions should respond to the full range of adolescents’ needs in a way that also positive aspects, such as love and relationships, respect, and equality are included. Key messages • The study improves public understanding of the phenomena by summarizing the existing knowledge. • The results are beneficial in planning social marketing interventions and other sexual health programs.

Reconciling intimacy and safety: a qualitative systematic review of HIV pre-exposure prophylaxis implementation among gay and bisexual men

This review synthesises qualitative research on pre-exposure prophylaxis (PrEP) uptake by sexual minority men to provide an overarching conceptualisation of the implementation processes involved. Twenty-four studies—comprising 734 participants from USA, UK, France, Canada, and Taiwan—were synthesised using thematic synthesis. The synthesis elucidates the dual significance of PrEP uptake: (1) risk management: reinforcing relational circumstances, and rebalancing safety and risk; and (2) sexual empowerment: reclaiming health and sexuality and refocusing on sexual fulfillment and intimacy. Overall, the findings show how gay and bisexual men use PrEP to reconcile their antagonistic desires for intimacy and safety by recalibrating protection and reimagining intimacy. This review conceptualises the essence of users’ experiences of PrEP implementation as reconciliation work—the labour and agency in making and remaking practices to manage discontinuities and incongruities—about the new HIV prevention modality. The concept of reconciliation work illustrates how using PrEP influences users’ practices, which in turn, shape the meanings of PrEP use within the community. This work engenders contingent transformations and outcomes beyond HIV protection, encompassing the broader aspects of health and sexuality. Findings support the adoption of more holistic and empowering approaches to sexual health promotion and intervention.

Understanding how social norms influence access to and utilization of adolescent sexual and reproductive health services in Northern Nigeria.

This study explored the influence of social norms on the access and utilization of sexual and reproductive health services by adolescents. Apart from individual and environmental barriers, social norms influence contraceptive decisions and ultimately sexual and reproductive health outcomes. Social norms that shape group behavior describe acceptable standards of behavior and evoke sanctions when such behavior standards are not adhered to. Sexually active adolescents in Nigeria have a relatively low level of modern contraceptive use being influenced by social norms. Scaling up adolescent reproductive health interventions that integrate normative change for a wider impact of programs remains challenging. Using data from 18 communities, 188 married and unmarried adolescents (F52% and M48%) and 69 (F37%; M63%) reference group participants were purposively sampled and participated in a social norms exploration intervention study conducted through focus group discussion and in-depth interviews between October and November 2019. The Advancing Learning and Innovation on Gender Norms (ALIGN) Social Norms Exploration Tool (SNET) was adapted for the data collection into discussion guides and vignettes. Pilot testing of the tools informed review and validation prior to actual data collection. Low contraceptive uptake by adolescents was characterized by early and forced marriage in childhood; a prominent practice enshrined in social norms around girl-childchastity, family honor, and disapproval of pre-marital sex and pregnancy out of wedlock. The understanding of harmful social norms, normative change actors, and potential norm-shifting factors for contraceptive decisions by adolescents is essential for effective adolescent sexual and reproductive health interventions for wider impact and adaptive programming in behavior change interventions for improving the access to and utilization of modern contraceptives by adolescents for improved sexual health outcomes, the attainment of the Family Planning (FP) 2030 commitment and universal health coverage policy.

Impact of preparing nursing students to deliver a parent-based sexual health intervention on attitudes and intentions for sexual health education and parent communication counseling: a mixed methods study

BackgroundNurses are well positioned to promote sexual health but are not adequately prepared in their nursing programs to engage families on this topic and often lack the knowledge and confidence necessary to counsel families about sexual health communication. The purpose of this study was to determine how facilitating a parent-based sexual health intervention would impact nursing students’ attitudes and intentions about sexual health education and parent communication counseling.MethodsUsing an embedded mixed-methods design, which integrated a quasi-experimental framework, we examined the impact of participation in a parent-based sexual health intervention among 126 baccalaureate nursing students enrolled in a community/public health nursing clinical course. Independent t-tests, chi-squared tests, and the Mann-Whitney U test were used to compare intervention and control groups at baseline. Multiple linear regression was used to compare the groups for pre-post changes. Qualitative content analysis was used to analyze exit interview transcripts.ResultsWe found statistically significant differences in nursing students’ confidence to teach sexual health (p = < 0.001), satisfaction with skills as a sexual health educator (p = < 0.001), beliefs about the efficacy of parent-adolescent communication for reducing negative sexual outcomes among adolescents (p = < 0.001), and intentions to counsel parents on sexual health (p = < 0.001), with greater improvements in the intervention group than in the control group. Furthermore, we found statistically significant differences in nursing students’ intentions to counsel parents about the HPV vaccine (p = < 0.01) and to endorse the HPV vaccine (p = < 0.05), with greater improvements in the intervention group than in the control group. Across all survey categories, qualitative findings confirmed improvements seen on the pre-post survey.ConclusionProviding evidence-based adolescent sexual health training, including sexual health education content and discussion strategies, can prepare nursing students to strongly endorse sexual health communication and HPV vaccination uptake and to counsel parents on initiating and navigating these conversations with their youth. Our project exemplifies how a nursing program could organize an immersive experience, or elective within a specialty area, that aligns with the competency-based approach endorsed by the American Association of Colleges of Nursing.Trial registrationThis study was registered with ClinicalTrials.gov (NCT02600884) on 09/01/2015; the first participant was recruited on 09/29/2015.

The Development of a Systems-Level Approach to Address Adolescent Access to Health Care: A Novel Confidentiality Policy Intervention.

Most evidence-based interventions in adolescent sexual and reproductive health and mental health remain largely aimed at individual-level outcomes and do not conceptualize adolescent health within a social-ecological model. Interventions to affect policy, systems, and environmental change offer potential for sustained population impact. The current initiative used an innovation framework to develop a novel systems-level approach to address adolescent access to health care. The Framework for Public Health Innovation provided an approach to develop a novel intervention. Confident Teen is a systems-level intervention that creates the opportunity, through organizational policy change, to increase adolescents' access to confidential sexual and reproductive health services through organizational policies. Gaps in adolescents' access to health care services allowed for a systems-level approach to be designed through an adolescent pregnancy prevention innovation initiative. Confidentiality is a right and critical component to their health care; therefore, a policy and conversation between provider and patient is a prioritized component of the novel intervention.

Sexual health problems of patients with cancer: A bibliometrics study and visualization analysis via CiteSpace

PurposeThis study aimed to conduct a bibliometric analysis of the data acquired and clarified the current research status of sexual health problems in patients with cancer, to provide a comprehensive visual perspective suitable as a reference for subsequent research. MethodsWe searched the Web of Science Core Collection (WoSCC) up to April 30, 2023 to identify studies associated with sexual health problems in patients with cancer. CiteSpace was used to create visualization networks for countries, institutions, authors, and journals. ResultsA total of 3183 publications related to sexual health problems in patients with cancer were collected from the WoSCC. In terms of volume, the USA (1259 papers) was the leading country, the Memorial Sloan Kettering Cancer Center (119 papers) was the leading institution, and Carter (39 papers) was the author with the most publications. The top-cited references and keywords were related to quality of life. The top five clusters of reference cocitation were ‘brachytherapy’, ‘prostate cancer’, ‘radical prostatectomy’, ‘hypogonadism’, and ‘breast cancer’. Meanwhile, the top five clusters of keyword cocitation were ‘breast cancer’, ‘prostate cancer’, ‘rectal cancer’, ‘testicular cancer’, and ‘sexual function’. The analysis of the top 25 references and keywords with the strongest citation bursts of published papers on sexual health problems in patients with cancer to reveal the research hotspots and trends. ConclusionsResearch on sexual health among patients with cancer is constantly developing. The current research focuses on the impact of different treatment options for sexual health and quality of life of patients with breast, rectal, and genitourinary neoplasms. Exploring the long-term changing regularities of sexual function among cancer survivors and formulating sexual health interventions toward patient-reported outcomes and needs are key research directions.

A Randomized Sexual Health Intervention for Women in Treatment for Opioid Use Disorder: Sex And Female Empowerment (SAFE) Increases Reproductive Knowledge and Contraceptive Self-Efficacy

Objectives: Women with Opioid Use Disorder (OUD) commonly report unintended pregnancies. Clinics providing Medication for OUD (MOUD) treatment serve as ideal sexual health education settings.