Sexual Activity Research Articles

Effectiveness of the Additional Risk Minimisation Measures for Valproate Among Healthcare Professionals and Patients: A Cross-Sectional Survey in Six European Countries.

To assess the impact of the 2018 European additional risk minimisation measures (aRMMs) regarding the use of valproate in women of childbearing potential (WCBP) and during pregnancy. A cross-sectional, non-interventional survey conducted in six European countries among 1982 healthcare professionals (HCPs) (July-October 2020) and 779 WCBP treated with valproate for epilepsy, bipolar disorder or other indications (August 2020-February 2021). HCPs were prescribing physicians (neurologists, psychiatrists, paediatricians and GPs), gynaecologists and pharmacists. Prespecified criteria were defined for success in the dimensions of awareness, knowledge and behaviour (correct answers to ≥ 80% of questions at individual level) and overall success (≥ 90%/80% successful HCPs/patients respectively, in the behaviour dimension and one of the two other dimensions). HCPs and patients did not meet the success criteria either overall or in any dimension. Highest success rates were in the behaviour dimension for gynaecologists (71.7%), pharmacists (49.7%) and patients (51.2%), and in the awareness dimension for prescribing physicians (23.6%). HCPs reported being unfamiliar with some educational materials and lacked knowledge of detailed prescribing conditions for valproate and the need for contraception regardless of sexual activity. More than 50% of patients were aware of the relevant patient materials and knew about the teratogenic risks of valproate. Self-reported levels of awareness, knowledge and behaviour varied considerably by HCP type and among patient respondents. Further investigation is needed into why certain measures of the pregnancy prevention programme are not well known and followed, to improve their effectiveness. This will be addressed in a qualitative study which will be based on interviews with HCPs and patients.

A molecular viewpoint of the intricate relationships among HNSCC, HPV infections, and the oral microbiota dysbiosis

HPV infection and the type of host microbiota play a role in the formation of HNCs. In contrast to other forms of OSCC, where the relationship between HPV and the cancer is less obvious, HPV-HNSCC is a particular type of oropharyngeal cancer. HPV has infected a stratified squamous epithelium, which includes the throat, mouth, anogenital tract, respiratory tract, and skin on the hands and feet. HPV DNA was found in high amounts in the saliva and gargle samples of patients with HPV-related HNSCC. It has been discovered that the specificity of oral mRNA (HPV) and HPV DNA identification varies from 23 % to 82 % in the identification of OPSCCs. The higher rate of HPV transmission through vaginal-oral compared to penile-oral sexual activity may be the reason for the difference in HPV-positive HNSCC patients between males and females. The researchers postulate that HPV-inactive tumours signify an advanced stage of HPV-positive HNSCC, which explains why there are racial disparities in gene expression that correspond to different disease progressions in Black and White patients. The increase of CD8+ T cells in the cancer microenvironment, linked to P16 activation, extends life expectancy in OSCC. tumour markers methylation caused by HPV and suggested using them as possible HNC biomarkers. Fusobacterium levels are much higher in patients with OSCC, while Actinobacteria phylum and Firmicutes are significantly lower. It also serves as a biomarker for notable variations found in Firmicutes, Actinobacteria, Fusobacteriales, Fusobacteriia, Fusobacterium, and Fusobacteriaceae. Therefore, based on this we evidence, we could investigate the role of oral microbiota as a maker for the HPV associated HNSCC.

Population-level impact of switching to 1-dose human papillomavirus vaccination in high-income countries: examining uncertainties using mathematical modeling.

A concern in high-income countries is that switching to 1-dose human papillomavirus (HPV) vaccination could cause a rebound in HPV infection and cervical cancer if 1-dose efficacy or duration were inferior to 2 doses. Using mathematical modeling and up-to-date trial-based data, we projected the population-level effectiveness of switching from 2-dose to 1-dose vaccination under different vaccine efficacy and duration assumptions in high-income countries. We used HPV-ADVISE (Agent-based Dynamic model for VaccInation and Screening Evaluation), a transmission-dynamic model of HPV infection and cervical cancer, varying key model assumptions to identify those with the greatest impact on projections of HPV-16 and cervical cancer incidence over time: 1) 1-dose vaccine efficacy and vaccine duration, 2) mechanisms of vaccine efficacy and duration over time, 3) midadult (>30 years of age) sexual behavior, 4) progression to cervical cancer among midadults, and 5) vaccination coverage and programs. In high-income countries, 1-dose vaccination would cause no appreciable rebound in HPV-16 infection, except for a limited rebound under the most pessimistic assumptions of vaccine duration (average, 25 years), because 1) the switch would occur when HPV prevalence is low because of high 2-dose vaccination coverage and 2) individuals would be protected during their peak ages of sexual activity (<35 to 40 years of age). Our model projects a more limited rebound in cervical cancer because of a shift to older age at infection, resulting in fewer life-years left to potentially develop cancer. Projections were robust when varying key model assumptions. High protection during peak ages of sexual activity in high-income countries would likely mitigate any potential rebounds in HPV infection and cervical cancer under the most pessimistic assumptions of 1-dose efficacy and duration.

The function of the endocrine system in women with infertility

Infertility is the inability of a couple of childbearing age to conceive a child within 1 year with regular unprotected sexual activity. In the modern world, the problem of infertility is felt very acutely. According to statistics, from 17 to 25% of couples are infertile, the indicators depend on the region. ART (assisted reproductive technologies) in the modern world often become the only possible solution for an infertile couple. In recent years, they have been resorted to much more often and this trend will clearly continue to be observed. Over the past 10 years, the number of women who have undergone embryo transplantation in the Department of Assisted Reproductive Technologies of the MRCCB Perinatal Center has increased from 203 to 501. Infertility of endocrine genesis is one of the main diagnoses with which patients seek the help of assisted reproductive technologies.

The sexual behaviors of young Polish women and their knowledge about contraception

Introduction. With the increasing trend of early sexual activity among adolescents, contraception has become a crucial topic. Poland ranks last in the Contraceptive Atlas, as the country with the poorest access to contraception methods and information. This results in a low level of contraceptive knowledge among young people, leading to unintended pregnancies and sexually transmitted infections. Adequate sexual education is a key element in promoting sexual health, enabling informed contraceptive choices based on medical knowledge. The responsibility for sexual education lies not only with parents but also with educators, pedagogues, doctors, and governmental bodies. Aim. To assess knowledge about contraception and investigate the sexual behaviors of women aged 15-25, comparing the results with available literature and indicating possible preventive actions in the studied area. Material and methods. An anonymous electronic survey was conducted among women aged 15-25 from across Poland. The survey was distributed on various internet groups, primarily comprising students. It included closed-ended questions verifying knowledge of the topic under study and a demographic section. Statistical analysis of the data was performed using Statistica and Microsoft Excel. Results. The average age of sexual initiation among respondents was 17.84±1.96 years, with one-third of them yet to engage in sexual activity. The majority of respondents (58%) had 1 to 3 sexual partners, and with increasing age and education level, the percentage of those with a higher number of sexual partners increased. The most popular contraceptive methods among respondents were barrier methods, combined oral contraceptive pills, and a combination of barrier and hormonal methods. The main sources of contraceptive information for the respondents were the internet, gynecologists, and scientific literature. Almost all respondents were aware of the definition of contraception, but only half were aware of the Pearl Index. Less than half of the respondents could identify the most effective contraceptive method, while almost all correctly identified the least effective method. The knowledge of the majority of respondents was assessed as moderate, good, or very good. Conclusions. Despite the generally good knowledge of contraception among the majority of respondents, there are still gaps that need to be filled. Due to the progressively decreasing age of sexual initiation, education on contraception is a priority that will help reduce the number of unintended pregnancies and sexually transmitted diseases in the future.

Investigating the Factors Affecting Sexual Myths in Women and Men Based on the Biopsychosocial Model: A Scoping Review

Background: Sexual myths are mainly devoid of any substantial evidence and are passed on by word of mouth. Myths about sexuality may thus diminish the quality of sexual activities, cause sexual dysfunctions, including erectile dysfunction (impotence), vaginismus, difficulty reaching an orgasm, and premature ejaculation, and make individuals feel dread, anxiety, and failure or inadequacy, which can have adverse effects on their sexual identity. Objective: This study investigated the factors affecting sexual myths in women and men based on the biopsychosocial model. Methods: In this scoping review, the research databases of PubMed, Google Scholar, Magiran, PsycINFO, IranDoc, Ovid, ProQuest, Scientific Information Database (SID), and the Cochrane Library were systematically searched. For this purpose, a systematic search was conducted to retrieve the relevant articles from November 3 to 21, 2023, using the keywords of “sexual myth, sexual beliefs, wrong beliefs, dysfunctional sexual beliefs, sexuality, opinions, and associated factors.” The Newcastle-Ottawa Scale (NOS) further evaluated the quality of the included studies. The data were then extracted from all the articles that met the eligibility criteria based on the study objectives. Results: In total, 12 articles were reviewed, whose data were grouped into three general categories, viz., (i) biological factors (i.e., age and gender), (ii) psychological factors (that is, sexual dysfunction, political opinions, opinions on virginity), and (iii) social factors (namely, educational attainment, occupation, place of residence, marital status, type of marriage, age at marriage, premarital sexual experience, parents’ educational attainment, spouse’s educational attainment, number of children, parent’s employment status, spouse’s occupation, primary source of information about sex and feelings about sexual conversations, information about sexual life, academic department, sexual health assessment, and religious beliefs). Conclusion: Biopsychosocial factors could significantly affect sexual myths; therefore, considering their mediating role in providing sex education to women and men is crucial.

Sexual life in adults treated for brain tumors: a retrospective study.

Sexual functioning is a multifaceted aspect of human life that can be profoundly affected in patients with glioma. Most frequent symptoms include reduced sexual desire, difficulties in sexual arousal, or low satisfaction. Such symptoms may cause distress or interpersonal difficulties, inevitably resulting in negative outcomes on different domains of patients' quality of life. Despite this, sexuality is rarely addressed by medical staff and remains understudied. An important question still unanswered is whether sexual dysfunctions in glioma patients correlate with features of the tumor itself, with its treatment, or with the secondary effects of the tumor on the patient's psychological status. To answer this question, the present study aims to investigate the incidence of sexual life impairments in a very large population of patients with low- and high-grade gliomas, focusing on demographic, clinical, and treatment factors associated with their occurrence and developments. A total of 148 patients treated for glioma were evaluated for sexual functioning, i.e., sexual dysfunction (SD), relationship status (RS), intercourse frequency (IF), and sexual satisfaction (SS), by using a specific anonymous questionnaire. Descriptive statistics were utilized to investigate participant characteristics and to evaluate the occurrence of sexual problems. Chi-squared tests were performed to detect the association between "SS" or "IF" and different clinical/demographic factors as well as between "SS" or "IF" and the "subjective-personal skills judgment". Results showed no difference between male and female patients, a very low frequency (1.4%) of SD, but a consistent percentage (25%) of subjective deterioration in sexual wellbeing. Notably, 24% of patients reported to have interrupted their relationship after the diagnosis. Chi-squared analyses reveal an association between adjuvant treatments (chemotherapy and radiotherapy) and reduction of IF. Interestingly, "SS" or "IF" was not associated with demographic, clinical, or histomolecular factors. Our study showed that sexual problems in glioma patients are not uncommon, and they are especially linked to SS, RS, and IF. Specifically, intercourse frequency reduction is associated with the adjuvant treatments. Results highlight the need for improved assessment strategies and interventions tailored to the unique needs of brain tumor patients.

Genital Attacks in Hereditary Angioedema and Their Effects on Sexual Life

Background and Objectives: Hereditary angioedema (HAE) is characterized by unpredictable skin and mucosal angioedema attacks. We aimed to find the frequency of sexual-activity-triggered attacks (STAs) and understand how the sexual life of HAE with C1-inhibitor deficiency (HAE-C1INH) patients is affected. Materials and Methods: Adult HAE-C1INH patients were included in this cross-sectional study, which started in March 2020. Demographic information, marriage properties, gender-specific sexual life characteristics, and the HAE-specific histories of the patients were collected. The Hospital Anxiety and Depression Scale (HADS) and the Turkish version of the New Sexual Satisfaction Scale (NSSS) were applied to all participants. Results: Among 42 symptomatic HAE patients, 33 (78.57%) had genital attacks and 17 (42.5%) had STAs. Ten (58.8%) had genital pain, tenderness, or swelling, and five (29.4%) had isolated abdominal and groin pain. Eight (47.1%) patients with STAs experienced a HAE attack during their first time engaging in sexual intercourse. Anxiety/depression scales, NSSS scores, and distribution of other HAE attack localizations were similar in patients with and without STAs, and no gender differences were observed. Compared to the patients without STAs, the ratio of patients who stated that their sexual lives were negatively affected and that they lost their sexual desire was higher in patients with STAs. Conclusions: Genital or abdominal attacks triggered by sexual activity may be more common than thought. Sexual activity should also be questioned for evaluating attack triggers. There is a possibility of triggering an attack with the first and ongoing sexual intercourse, and patients should be informed to keep their attack treatment medications ready in advance.

&lt;b&gt;Vivencias de la sexualidad en mujeres adultas costarricenses sobrevivientes de cáncer de&lt;/b&gt; &lt;b&gt;mama&lt;/b&gt;

The present study aims to analyze the experience of sexuality of adult Costa Rican women who are breast cancer survivors. A virtual interview was conducted with 16 participants using open-ended questions through the Google Forms tool; the data collection lasted four months. A qualitative analysis was performed in which categories were established to ensure organization and effectiveness of the results. The findings encompass categories such as body image and its relationship with sexual satisfaction, sexual desire and psychological changes, which involve various issues such as identity problems regarding femininity, self-esteem alteration, pain, decreased interest and limited sexual interactions, anxiety, depression, feeling inadequate, among others.

HPV Vaccines

Human papillomavirus (HPV) is a double-stranded DNA virus and a source of infection that primarily affects the skin and mucous membranes. It can be transmitted through sexual contact and contaminated surfaces. There are over 200 genotypes of HPV, approximately 40 of which infect the anogenital region. High-risk HPV types, such as HPV-16 and HPV-18, can lead to the development of various cancers, particularly cervical cancer. Factors that increase the risk of transmission include having multiple sexual partners, early initiation of sexual activity, and having an uncircumcised male partner. Low socioeconomic status, poor nutrition, immunosuppression, and co-infections with HIV, genital herpes, or chlamydia can result in persistent and severe HPV infection. Three types of vaccines have been developed against HPV: bivalent, quadrivalent, and nonavalent vaccines. The bivalent vaccine provides protection against HPV-16 and HPV-18; the quadrivalent vaccine is effective against HPV-16, HPV-18, as well as HPV-6 and HPV-11. The nonavalent vaccine offers the broadest protection, covering nine different types of HPV. All vaccines are approved for males and females aged 9 and older. Vaccination before the onset of sexual activity significantly increases protection against cervical cancer.

Upaya Peningkatan Pengetahuan tentang Infeksi Menular Seksual pada Remaja di SMAN 4 Palangka Raya

Sexually Transmitted Infection (STI) is an infection triggered by bacteria, viruses, protozoa, parasites and fungi which is transmitted mainly through sexual contact, including anal and oral. Apart from that, STIs can also be transmitted through direct contact with contaminated objects, for example towels, sex toys, syringes, thermometers, and also through pregnant women to their fetuses or during the birth stage. One age group that is vulnerable to STIs is teenagers. Teenagers are more often encouraged to explore sexual experiences, which can increase the risk of experiencing STIs. One of the problems of teenagers at SMAN 4 Palangka Raya based on the results of interviews with students related to STI cases is the low level of knowledge about STIs. This service activity aims to increase teenagers' knowledge about STIs and spread this knowledge to the surrounding environment. The method used is a lecture containing material about the definition and meaning of STIs, the causes of STIs, symptoms caused by STI-causing agents in both men and women, how STIs are transmitted and how to prevent them. Service activities begin with socialization, implementation and evaluation of results. The implementation of Community Service activities in the form of efforts to increase knowledge about sexually transmitted infections in adolescents at SMAN 4 Palangka Raya was successful, participants enthusiastically listened to the material presented. There was a significant increase in knowledge after counseling compared to the pretest. Counseling can increase students' knowledge about the types of STIs and their complications.

Post stroke sexual dysfunction - a current review.

Sexual dysfunction manifests as various challenges during sexual activity and is a prevalent condition that significantly impacts quality of life. Post stroke sexual dysfunction (PSSD) is particularly concerning, yet it is often overlooked by both healthcare providers and patients. We conducted a comprehensive literature review, examining research and reports related to sexual dysfunction following stroke. Our aim is to synthetize an extensive, detailed and up-to-date overview of its prevalence, underlying mechanisms, and interventions. PSSD, often underestimated among stroke survivors, has a high incidence but remains poorly understood in terms of its neurobiological mechanisms. Swift and accurate diagnosis, coupled with timely rehabilitative intervention, is crucial. However, the development of comprehensive guidelines is impeded by a lack of high-quality literature. This review seeks to present recent advances in understanding PSSD, and to advocate for a structured strategy in terms of the long-term rehabilitation of stroke survivors.

EXPLORING THE ECONOMIC AND SOCIAL IMPLICATIONS OF CELIBACY SYNDROME: SOCIETAL TRENDS AND THEIR IMPACT IN JAPAN

This study investigates the complex impact of celibacy syndrome on social and economic aspects in Japan, where there has been a noticeable reduction in interest and engagement in romantic relationships and sexual activities, particularly among the younger generation. To meet the objective of this study, descriptive research design has been used. The data has been collected from secondary sources like national reports on fertility survey of Japan, news articles, and statista database, published research articles and research papers. In conclusion, the impact of celibacy syndrome in Japan extends across individuals, society, business, and the economy, showcasing a nuanced interplay of both positive and challenging consequences. While financial autonomy, personal transformation, and a focus on learning emerge as positive individual outcomes, there are concerns regarding social withdrawal, loneliness, and potential mental health challenges. Societal impacts include shifts in cultural norms and challenges to social cohesion. In the business realm, a highly dedicated workforce may be a positive outcome, but demographic challenges and changes in consumer behavior pose economic risks. This study can be further extended by collecting first hand data and experience from the individuals to support with empirical evidences.

Comparison of human immunodeficiency virus-related risky sexual behaviors between men who have sex with men only and men who have sex with men and women: A cross-sectional study in Eastern China

BackgroundMen who have sex with men (MSM) are a significant population contributing to human immunodeficiency virus (HIV) transmission. Nevertheless, few studies have focused on the heterogeneity in MSM. The characteristics of men who have sex with men and women (MSMW) may differ from men who have sex with men only (MSMO). MethodsFrom October 2022 to March 2023, a cross-sectional study for MSM was conducted in Eastern China. An electronic questionnaire was used to collect the demographic characteristics and sexual behaviors of participants. A multivariable logistic regression model was used to assess the differences in HIV-related risky sexual behaviors between MSMO and MSMW. ResultsA total of 1993 MSM were enrolled in the study, with 1221 MSMO and 772 MSMW. Compared to MSMW, MSMO reported younger age at first anal sex, higher coerced homosexual experiences, and observed different characteristics of sexual behavior in the past six months. Multivariable analysis indicated that MSMW were more likely to seek casual partners and use stimulants online and offline. MSMW showed inconsistent condom use with online partners (aOR = 0.51, 95 %CI: 0.38–0.68) and more frequent anal sex after drinking (aOR = 2.27, 95 %CI: 1.54–3.35). They also had higher risks of commercial (aOR = 2.47, 95 %CI: 1.71–3.57) and group sexual behaviors (aOR = 1.88, 95 %CI: 1.24–2.83) compared to MSMO. ConclusionOur findings suggest that the differential factors may lead MSMW to become a subgroup at high risk of HIV infection. The gender identity and sexual orientation within MSM should be considered when formulating acquired immune deficiency syndrome (AIDS) prevention and control strategies.

Genitourinary Syndrome of Menopause (GSM) and its impact on Quality of Life (QoL) among Midlife Women in Accra, Ghana

Introduction: Genitourinary syndrome of menopause (GSM) is a chronic, progressive, vulvovaginal, sexual, and lower urinary tract condition characterized by a broad spectrum of signs and symptoms. It is a consequence of the hypoestrogenic state associated with reproductive aging and impacts the quality of life of affected women. Even though the condition mainly affects postmenopausal women, it is seen in many premenopausal women as well This study sought to determine the prevalence, associated factors and quality of life impact associated with GSM among midlife women reporting for cervical routine screening in a tertiary hospital. Method: A cross-sectional study of 400 women aged 40 to 60 years who had a routine cervical smear at the Korle Bu Teaching Hospital (KBTH) from February 2022 to September 2022. GSM was defined by using three parameters: one symptom of GSM, one physical sign of vaginal atrophy and vaginal pH &gt; 5. Quality of life was determined using the Day-to Day Impact on Vaginal Aging (DIVA) Questionnaire. Multiple logistic regression was used to assess significant association and 95% confidence intervals calculated around the estimates generated. Results: The prevalence of GSM was 46.8%. The most common symptom and sign was vaginal dryness (57%) and vaginal pallor (85%) respectively. Age, frequency of sexual activity and anogenital index were significantly associated with GSM. Participants with GSM had higher mean DIVA scores as well as higher scores for the sexual dysfunction and self-perception domains. Conclusion: The study found a high prevalence of GSM significantly associated with increasing age, frequency of sexual activity and high anogenital index. As GSM negatively impacted the QoL of the women. It is important to screen and intervene early to improve QoL

Love On The Different Spectrum

People with Autism Spectrum Disorder (ASD) have often been wrongly viewed as asexual. However, research suggests that their romantic and sexual experiences are more nuanced and deserving of further exploration. By addressing these areas, the study aimed to foster a more supportive and understanding environment for individuals with ASD as they navigate the complexities of relationships. This study delved into the romantic and sexual lives of young adults with ASD, focusing on a young man to understand how his condition influenced his partner preferences and relationships with friends, classmates, and family. Through a semi-structured interview and interpretative phenomenological analysis (IPA), the study uncovered three key themes: (a) navigating social interactions and boundaries; (b) understanding love and relationships; and (c) desires and expectations in relationships. These insights highlighted the need for tailored sex education, family support, and positive media portrayals. According to the study, a male adolescent with autism spectrum disorder (ASD) has difficulty interacting socially, particularly when it comes to recognizing cues and establishing limits with others. His romantic aspirations may be impacted by his inability to comprehend emotions and the impact of societal prejudices. The results show that to normalize his experiences and promote healthy relationships, family support, specialized sex education, and favorable media portrayals are essential.

"I Don’t has the Desire to has Sex”: Quality of Life and Sexual Concerns of Women with Secondary Infertility in the Tamale Metropolis

Background Infertility adversely affects the general quality of life and sexual satisfaction among women. This study explored the quality of life and sexual concerns among women with secondary infertility in the Tamale metropolis. Methods A qualitative exploratory descriptive design was used. Individual in-depth interviews were conducted using a semi-structured interview guide. Ethical approval was received from the Ghana Health Services ethics review committee. Fourteen (14) participants with secondary infertility receiving treatment at the Tamale Teaching Hospital were purposively selected and interviewed for the study, each lasting about 30 minutes to one hour. The interviews were audiotaped with permission from the participants, transcribed verbatim and content analyzed. Conclusion The findings from this study revealed that happiness, well-being and value in life were compromised among these women. Concerning sexual satisfaction, the majority of the participants experienced low sexual drive and physical pain during sexual intercourse which led to poor sexual satisfaction. There is a need for more exploration into the sexual health of women with infertility

The Lived Experiences and Well-Being of Female Partners Following Discovery or Disclosure of Their Male Partner’s Compulsive Sexual Behaviours: An Australian Phenomenological Study

Abstract Introduction There has been an upsurge of research articles in the last two decades about sexual addiction (SA) and compulsive sexual behaviour (CSB). In the literature, SA/CSB is mainly presented as comparable to other behavioural addictions and similarly involves a problematic consumption model: loss of control, psychosocial impairments, and risky sexual activities. Despite this recent rise in research interest in this area, only a small number of studies have focused on the partners’ lived experiences and well-being. Methods This qualitative descriptive phenomenological investigation aimed to examine female partners’ lived experiences and well-being following the discovery or disclosure of their male partners’ SA/CSB. Individual in-depth semi-structured interviews were conducted (2020–2022) with primary participants (female partners; n = 12) and supplementary participants (counsellors; n = 15). Results The analysis reveals that this group has encountered several detrimental consequences of CSB-associated betrayal trauma (BT), including but not limited to suicidal thoughts and self-harm, compulsive self-comparisons with other women, physical and behavioural difficulties, and diminished self-esteem. Conclusions This empirical research is the first study in Australia to examine the voices and experiences of female partners upon learning of their mates’ CSBs. The findings contribute to the field of SA/CSB and enhance understanding of the multifarious consequences for the emotional, physical, sexual, spiritual and/or relational well-being of intimate female partners and their general outlook on life. Policy Implications Based on the results, there are strong indications with implications for policy that this population requires validation and multifaceted support systems to better navigate the challenging, complex, and stressful processes of discovery/disclosure and subsequent recovery.

HIV-1 transmission clusters and drug resistance in men who have sex with men in Portugal

Abstract Introduction In 2022, 45.8% of diagnoses in the EU/EEA with known route of transmission were in Men who have Sex with Men (MSM). We aim to characterise HIV transmission clusters and transmission of drug resistance (TDR), as well as its determinants, using integrated sociodemographic, behavioural, clinical, and viral genomic data of MSMs newly diagnosed in Portugal between 2014 and 2019. Methods This study included data from 340 MSM who were diagnosed with HIV-1 infection. These individuals were newly diagnosed at 17 hospitals in Portugal between September 2014 and December 2019. Phylogenies were constructed and transmission clusters were identified with branch support ≥ 90% and 1.5% genetic distance. Logistic regression models were computed to examine the factors associated with clusters of transmission and with the presence of TDR. Results We identified 38 transmission clusters with 104 MSM, which included 26.6% of the total 305 MSM from our database used for cluster analysis. The overall prevalence of TDR was 8.2%. Only subtype C was significantly associated with TDR. 10.5% of the clusters had at least 1 drug resistance mutation (K103N, L90M or N88S). There was no significant difference in the prevalence of TDR between MSM inside and outside clusters. 50% of the clusters were composed of portuguese native MSM only, whereas 16% had exclusively migrant MSMs. No significant difference was found in the proportion of portuguese and migrant MSM inside and outside clusters. Factors associated with HIV-1 transmission clusters were age at diagnosis, district of residence, unprotected anal or vaginal sex with a woman, HIV testing frequency, presenter status and subtype. 87% of men engaged in sexual activity only with other men, while 13% with both men and women. Conclusions Specific subgroups of MSM are contributing to HIV dissemination in Portugal. Direct and precise prevention measures based on molecular epidemiology should be developed. Key messages • Specific subgroups of MSM are contributing to HIV dissemination in Portugal. • Direct and precise prevention measures based on molecular epidemiology should be developed.

Early exposure to (hetero)sexism in medical settings: young patients’ experiences with gynaecology

Abstract Background Gynaecology is a highly gendered specialty where gender norms are particularly susceptible to shape patient-provider interactions. Consultations about contraceptive practices, reproductive choices, and sexual activity are fertile settings for the potential confrontation of different sets of gender-related expectations, and the expression of gender-based discrimination, i.e. sexism and heterosexism. We therefore investigated young patients’ first experiences with gynaecological care in Germany with a focus on their experiences of (hetero)sexism. Methods We conducted 15 qualitative interviews with a gender-inclusive sample of patients aged 16-25 who narrated their first consultations and experiences of gynaecological care. We analysed the data thematically. Results Cis-gender heterosexual women composed the majority of the sample; a trans man and two persons who reported being at some point in same-sex relationships were also included. The main reasons for a first consultation were painful periods and contraception. Participants narrated examples of gender-based discrimination, with providers making what was perceived as gender-insensitive, demeaning, or plainly homophobic remarks. Those were particularly present in relation to conversations about the contraceptive pill, with either providers refusing to prescribe it on the account that the patient didn’t have sex or “real sex” (i.e. heterosexual intercourse) or with providers pushing for use of the pill “just in case”, even when patients didn’t need nor want it. Additionally, sexist, unrequited arguments about how the pill could enhance a patient’s breast or skin occurred in several conversations. Conclusions Our study shows clear occurrences of (hetero)sexism on the part of gynaecologists, from demeaning comments to more subtle reminders of sexist gender norms. It highlights the need to implement more patient-centred, gender-sensitive gynaecological practise to support the promotion of respectful care. Key messages • Young patients are exposed to various forms of gender-based discrimination in gynaecological care in Germany, highlighting how entrenched traditional, (hetero)sexist gender norms are among providers. • Promoting more gender-sensitive, respectful care could start with a reflection on consultations around the contraceptive pill, as they often crystallise the manifestation of damaging gender norms.