Sexual Conversion Research Articles

Do Adolescents and Young Adults Learn About Condoms from Healthcare Providers? Findings from a US Probability Sample

Using data from the 2018 National Survey of Sexual Health and Behavior, we determined the prevalence and content of adolescents’ and young adults’ communication with healthcare providers about condom use. Adolescents (14–17 years old; n = 283) and young adults (18–24 years old, n = 225), who discussed sexual health with a healthcare provider in the past year, reported if they had discussed condom use with a healthcare provider, and among those who did, they also reported why healthcare providers recommended condoms, if they demonstrated correct condom use, and/or provided condoms. Data collection occurred in February and March 2018. Most adolescents (71.0%) and young adults (66.7%) who discussed sexual health with a healthcare provider reported discussing condom use. Condoms were most often recommended for both pregnancy and STD prevention. Fewer adolescents and young adults were shown how to use condoms (11.4% of adolescents; 5.7% of young adults) or provided condoms (14.9% of adolescents; 14.7% of young adults). Only 3.2% of adolescents and 1.3% of young adults had healthcare providers who discussed, demonstrated, and provided condoms. Sexual health conversations with healthcare providers are likely to include condoms. But few adolescents and young adults were shown how to use condoms or provide condoms. Providing healthcare providers with resources and trainings about how to talk about condoms with patients may lead to more adolescents and young adults learning medically accurate information about condoms. Healthcare offices and clinics could also provide condom use resources outside of provider-patient interactions.

Patient perspectives and experiences of sexual health conversations and cardiovascular disease: A qualitative study.

This study aimed to explore the experiences of individuals discussing sexual well-being with healthcare professions within the context of their cardiac illness to determine their sexual health information needs. Cardiovascular disease is the leading cause of morbidity and mortality worldwide and known to have a detrimental impact on sexual health. Despite sexual health being recognised as a fundamental component of well-being, it may be a neglected aspect of care within the context of cardiovascular disease. A qualitative exploratory study conducted in accordance with COREQ guidelines. We conducted semi-structured interviews with participants (n=13) aged between 30-77years who had been diagnosed with a cardiovascular disease. Data were transcribed and subject to thematic analysis. Analysis revealed two major themes-Sexual healthcare information and expectations: I expect them to tell me and Experiences of sexual adversity: it's really scary. Although participants expected and welcomed information in relation to their illness and sexual health, this was rarely received. Subsequently, when some participants experienced sexual adversity including erectile dysfunction, they felt anxious and distressed which impacted their intimated relationships. It was often when participants sought information associated with adversity that information was provided and this was primarily in relation to medication associated with assisting dysfunction. Individuals who have cardiovascular disease may require sexual health care. Nurses are well placed to provide information and education associated with cardiovascular disease and associated sexual well-being to promote positive outcomes for individuals and minimise distress around sexual adversity. Findings highlight the importance of providing clear and accurate information about sexual well-being and function to patients experiencing cardiovascular disease. Provision of information should be considered an essential and routine aspect of care with patients being afforded opportunities to discuss concerns associated with their sexual well-being.

Magnitude of Gender-Based Violence and Its Associated Factors among Female Night Students in Bahir Dar City, Amhara Region, Ethiopia.

Background Gender-based violence (GBV) is a major public health issue that affects the health and well-being of millions of young people worldwide each year. Gender-based violence was prevalent throughout Sub-Saharan Africa. However, research in Africa is extremely diverse. Objective The purpose of this study is to determine the extent and risk factors of gender-based violence among night female students in Bahir Dar, Ethiopia. Methods This cross-sectional study was conducted among 788 elementary and high school night female students in Bahir Dar from October 15 to November 15, 2019. Data was gathered using self-administered questionnaires. A binary and multiple logistic regression model was used to identify factors associated with gender-based and sexual violence. An adjusted odds ratio (AOR) with a 95 percent confidence interval (CI) was calculated to determine the level of significance. Results The overall lifetime prevalence of gender-based violence (sexual, physical, and emotional violence) was 71.1% with a 95% CI of 67.8%-74.1%. The lifetime prevalence of sexual violence, physical violence, and emotional violence was 49.1%, 57.5%, and 41.6%, respectively. Rural childhood residence (AOR: 3.37, 95% CI: (2.17-5.54)), low school performance (AOR: 3.44, 95% CI: (2.13-5.56)), lack of sexual and reproductive health conversation experience (AOR: 3.68, 95% CI: (2.07-6.54)), poor family control (AOR: 5.62, 95% CI: (3.25-9.71)), and being sexually active (AOR: 3.79, 95% CI: (2.35-6.12)) increased significantly the risk of gender-based violence. The risk factors for sexual violence were young people living with both parents (AOR: 0.28, 95% CI: (0.19-0.41)), peer pressure (AOR: 5.73, 95% CI: (4.11-7.98)), and family support (AOR: 0.31, 95% CI: (0.22-0.43)). Conclusion In the study area, the lifetime prevalence of sexual violence, physical violence, and emotional violence was high. As a result, it is recommended that policymakers, district officials, schools, and other stakeholders pay attention to and act on gender-based values.

Interest in Sex and Conversations About Sexual Health with Health Care Providers Among Older U.S. Adults

ABSTRACT Objectives: Sexual health is an important component of overall health and well-being for older adults. Despite this, little is known about the importance of sex to quality of life, as part of romantic relationships for older adults, and potential drivers of interactions between healthcare providers and older adults about sexual health. In this study using a nationally representative population, we describe perceptions and experiences of sex among older adults. Methods: A nationally representative, cross-sectional sample of community-dwelling U.S. adults aged 65–80 was surveyed about their sexual health and interaction with their health care providers about sexual health. Results: The survey completion rate was 75% (N = 1,002). Overall, 50.9% of men and 30.8% of women reported being sexually active. In all, 17.3% of adults aged 65–80 reported speaking to their health care provider about sexual health in the past two years and of those, 60.5% of patients initiated the conversation. Multivariable logistic regression demonstrated that sexual activity (yes/no), interest in sex, and satisfaction with sex life are major drivers of sexual health conversations between patients and healthcare providers. Conclusions: Many adults aged 65–80 are interested in and engage in sexual activity. While the majority of older adults reported a willingness to discuss their sexual health with their health care providers, few had done so, and most conversations were initiated by patients. Iterest in sex and satisfaction with sex life may be targets for intervention and offer a segue for providers as they begin the conversation to engage with older adults about their sexual health. Clinical Implications: Providers may have conversations with older adults about sexual health and may need sexual health training to have effective discussions; age nor chronic conditions should preclude this essential conversation. Clinical gerontologists may be helpful in this training and in encouraging patients to bring up sexual health concerns during their medical appointments.

Sexual Offending Pathways and Chat Conversations in an Online Environment.

People from all over the world pay for live streaming video images of minors, also called webcam child sex tourism (WCST). Although there is an increase in research about online sexual offending, relatively few studies have investigated the approaches used by people who have committed WCST offenses (PWCST). In addition, these studies describe these approaches as active-orientated without mentioning an avoidant pathway. The aim of the study was to investigate whether PWCST use similar pathways as the four offending pathways identified by Ward and Hudson. Using qualitative thematic analysis, 195 cases of online chat conversations between PWCST and operators posing as a minor were analyzed. The Ward and Hudson pathways model was partially replicable. Evidence was found for an approach and avoidant pathway. The data also suggest three other sub-pathways and a mixed pathway. Most PWCST in this study used an approach pathway to immediately approach minors for sex, which provides important insight into the diverse nature of sexual grooming.

A Collective Case Study: Parent-Child Sexual Health Communication of Current and Former Teen Parents in Lawrence County, Indiana

Background/Objective: 
 In Lawrence County, Indiana, the birth rate for females ages 15-19 is 32.2 births per 1,000, which is significantly higher than the national average of 18.8. Project UNITE, a collaboration between the Lawrence County Pregnancy Coalition and the IU School of Public Health, aims to address this issue through a multifaceted evidence-based intervention. Since parent-child communication shapes values and behaviors, a collective case study was conducted with current and former teen parents to explore their perceptions of sexual health communication with their parents and, if applicable, with their children. 
 Methods: 
 Of the 58 semi-structured telephone interviews conducted through Project UNITE, eight were selected for this study based on transcript availability and identification as a current teen parent (2) or former teen parent (6). All participants recalled whether they had sexual health conversations with their parents and the extent of the discussions. Five shared experiences talking with their children. Deductive and inductive approaches were used to generate themes, which were then analyzed. 
 Results: 
 Most participants (7 of 8) reported little to no communication about sexual health with their parents due to a lack of comfortability, limited desire, and poor relationships. In contrast, all respondents with children over the age of five (5 of 5) reported open and frequent conversations with them. Several (3 of 8) recommended providing parents with resources about initiating discussions, and some suggested (2 of 8) a community program to promote sexual health communication. 
 Conclusions/Potential Impact: 
 The results revealed that while teen parents experienced a lack of sexual health conversations with their parents, they favored open and honest communication with their children. Barriers related to comfortability and knowledge could be alleviated through parental resources and parent-child programs. Medical professionals play a role in this solution by encouraging conversations about sexual health and engaging in educational programs.

The Tablet-Based, Engagement, Assessment, Support, and Sign-Posting (EASSi) Tool for Facilitating and Structuring Sexual Well-Being Conversations in Routine Prostate Cancer Care: Mixed-Methods Study.

BackgroundLong-term side-effects associated with different prostate cancer treatment approaches are common. Sexual challenges are the most frequently occurring issues and can result in increased psychological morbidity. It is recognized that barriers to communication can make initiating discussions around sexual concerns in routine practice difficult. Health care professionals need to routinely initiate conversations, effectively engage with patients, and assess needs in order to provide essential support. One proposed method that could support health care professionals to do this involves the use of prompts or structured frameworks to guide conversations.ObjectiveThis study aimed to assess feasibility, acceptability, and satisfaction with the tablet-based Engagement, Assessment, Support, and Sign-posting (EASSi) tool designed to facilitate and structure sexual well-being discussions in routine prostate cancer care.MethodsHealth care professionals (n=8) used the EASSi tool during 89 posttreatment appointments. Quantitative data were recorded based on program usage and surveys completed by health care professionals and patients. Qualitative data exploring perceptions on use of the tool were gathered using semistructured interviews with all health care professionals (n=8) and a sample of patients (n=10).ResultsSurveys were completed by health care professionals immediately following each appointment (n=89, 100%). Postal surveys were returned by 59 patients (66%). Health care professionals and patients reported that the tool helped facilitate discussions (81/89, 91% and 50/59, 85%, respectively) and that information provided was relevant (82/89, 92% and 50/59, 85%, respectively). The mean conversation duration was 6.01 minutes (SD 2.91). Qualitative synthesis identified the tool’s ability to initiate and structure discussions, improve the “depth” of conversations, and normalize sexual concerns.ConclusionsThe EASSi tool was appropriate and acceptable for use in practice and provided a flexible approach to facilitate routine brief conversations and deliver essential sexual well-being support. Further work will be conducted to evaluate the effectiveness of using the tablet-based tool in prostate cancer care settings.

The transcriptome of circulating sexually committed Plasmodium falciparum ring stage parasites forecasts malaria transmission potential

Malaria is spread by the transmission of sexual stage parasites, called gametocytes. However, with Plasmodium falciparum, gametocytes can only be detected in peripheral blood when they are mature and transmissible to a mosquito, which complicates control efforts. Here, we identify the set of genes overexpressed in patient blood samples with high levels of gametocyte-committed ring stage parasites. Expression of all 18 genes is regulated by transcription factor AP2-G, which is required for gametocytogenesis. We select three genes, not expressed in mature gametocytes, to develop as biomarkers. All three biomarkers we validate in vitro using 6 different parasite lines and develop an algorithm that predicts gametocyte production in ex vivo samples and volunteer infection studies. The biomarkers are also sensitive enough to monitor gametocyte production in asymptomatic P. falciparum carriers allowing early detection and treatment of infectious reservoirs, as well as the in vivo analysis of factors that modulate sexual conversion.

Opportunities to Improve Sexual and Reproductive Care Among Hospitalized Adolescents.

Improved access to sexual and reproductive care (SRC) improves adverse outcomes among adolescents, yet barriers continue to exist. Although the continued declining rate of adolescent pregnancy over the past decades is encouraging, adolescents in the United States still experience disproportionately high rates of unplanned pregnancy and sexually transmitted infections (STIs) compared with adolescents in other industrialized countries.1–3 Nearly 90% of adolescent pregnancies are unplanned, leading to increased risk for preventable outcomes, including preterm delivery, low birth weight, and neonatal mortality.4,5 In addition, unintended teen-aged pregnancy is associated with reduced education attainment and career earning potential.6 Rates of STIs among adolescents remain high, with nearly 1 in 4 girls testing positive for an STI annually.7 In addition, only half of adolescents are fully vaccinated against the human papillomavirus (HPV), leaving those who are unvaccinated at risk for developing HPV-associated cancers.8 Despite multiple national organizations advocating for provision of comprehensive care for adolescents at every clinical encounter, adolescent reproductive and sexual health needs often go unmet.9,10 In light of recent events, including the COVID-19 pandemic as well as the current administration’s health care reform policies, access to evidence-based SRC is even further decreased, particularly among vulnerable populations, including adolescents; thus, efforts to address these needs are now more critical than ever.11,12 Many adolescents, particularly those at highest risk for unintended pregnancy and STIs, have limited access to SRC because of numerous barriers, including poor access and confidentiality concerns.13–15 Open parent-teenager communication regarding sexual and reproductive health promotes reduced risk behaviors, but most teenagers do not receive these discussions with their parents, guardians, or health care providers.16 Among …

Artemisinin exposure at the ring or trophozoite stage impacts Plasmodium falciparum sexual conversion differently

Malaria transmission is dependent on the formation of gametocytes in the human blood. The sexual conversion rate, the proportion of asexual parasites that convert into gametocytes at each multiplication cycle, is variable and reflects the relative parasite investment between transmission and maintaining the infection. The impact of environmental factors such as drugs on sexual conversion rates is not well understood. We developed a robust assay using gametocyte-reporter parasite lines to accurately measure the impact of drugs on sexual conversion rates, independently from their gametocytocidal activity. We found that exposure to subcurative doses of the frontline antimalarial drug dihydroartemisinin (DHA) at the trophozoite stage resulted in a ~ fourfold increase in sexual conversion. In contrast, no increase was observed when ring stages were exposed or in cultures in which sexual conversion was stimulated by choline depletion. Our results reveal a complex relationship between antimalarial drugs and sexual conversion, with potential public health implications.

Social Cognitive Theory as a Theoretical Framework to Predict Sexual Risk Behaviors among Older Adults

ABSTRACT Objectives Older adults vary in their safe and unsafe sexual behaviors. While researchers are beginning to understand more about the sexual and intimate expression of older adults, only recently are they beginning to understand how older adults make decisions about sexual risk. Bandura’s social cognitive theory offers a frame for understanding how self-efficacy, environmental factors, and goal motivation are related to sexual risk behaviors for older adults, including the interplay between these variables. Methods Using a diverse sample of older adults (n = 720) age 50+ years, social cognitive theory was modeled to determine the relationship between environment variables (age, gender, and sexual health conversations with practitioners), behavioral variables (self-efficacy), and cognitive variables (importance of sexual wellness goals) with the outcome variable of sexual risk behaviors. Results Self-efficacy had an indirect effect on sexual risk via sexual wellness goal motivation. Healthcare provider conversations had both direct and indirect effects on older adults’ sexual risk through sexual wellness goal motivation. Models were similarly predictive for older men and women. Conclusions Sexual risk behaviors among older adults are more influenced by environmental factors in their healthcare settings and their perception and prioritization of sexual wellness goals. Clinical implications Providers play a key role in initiating and maintaining sexual health discussions with older patients, potentially mitigating sexual risk and bolstering self-efficacy.

P42 A new tool for sparking nonjudgmental sexual and reproductive health conversations between adolescents and healthcare providers developed with adolescents using participatory design

P42 A new tool for sparking nonjudgmental sexual and reproductive health conversations between adolescents and healthcare providers developed with adolescents using participatory design

LGBTQ cultural competence for pharmacists

LGBTQ cultural competence for pharmacists

The sacred versus the secular in UK psychiatry

SUMMARYI comment on two papers by Koenig and colleagues that advocate the integration of religion into routine psychiatric practice. In my opinion, their selective overview of research, although useful, lacks balance. It omits any mention of the literature on worldwide scandals over child sex abuse (and other abuses of power) perpetrated and facilitated by religious authority within several faith groups. There is no mention of damaging ‘religiously informed’ treatments such as sexual orientation conversion therapy, which is still practised in the UK despite widespread condemnation. Their recommendations for clinical practice conflate association with causation. They do not offer practice guidance on managing the impact of power imbalances associated with religion in multicultural societies. In summary, despite more than a decade of research and debate, there are still no generally accepted ways of avoiding boundary violations where psychiatrists introduce religion into their clinical practice.

Sexual Health Education: Knowledge Level of Oncology Nurses and Barriers to Discussing Concerns With Patients.

Cancer treatment has a significant impact on a patient's sexual health and function. However, numerous communication barriers deter healthcare professionals from initiating a sexual health conversation with patients. This study assessed the effects of a nurse-focused sexual health education workshop on change in knowledge of sexual concerns, barriers to discussing sexuality, and frequency of bringing up sexual concerns. A train-the-trainer approach was used to educate oncology nurse managers, who then trained oncology nurses (N = 65) at 10 education workshops. Each workshop provided four hours of content on sexual health and incorporated role-play and lecture. Mean knowledge scores were improved, and barriers to discussing sexuality at the three- and six-month follow-ups were reduced. Frequency in discussing sexual concerns increased at three months and was sustained at six months.

Talking about sex with friends: perspectives of older adults from the Sex, Age & Me study in Australia

This qualitative study explored the barriers and facilitators to sexual communication between older adults and friends. Fifty-three women and men aged 58 and older were interviewed about their intimate relationships and sexual behaviours and attitudes. Findings indicated that talking about sex with friends played an important role in providing support and sharing information. The privacy of the topic meant that trust and confidentiality had to be in place before sexual conversations occurred, and that discretion was required for those married or in a relationship due to potential breaches of privacy. Stereotypes associated with older age made talking about sex ‘risky’ as participants were vulnerable to scrutiny. Growing-up during a time when sex was taboo influenced willingness and comfort in talking about sex today. Among those who did talk with friends, women tended to talk to women and men to men. These findings are significant in the context of an increasing global population of older adults and silence around sex and ageing. By exploring sexual communication outside of the healthcare context, where previous research has focused, the findings indicate novel ways to support the sexual health and well-being of older adults.

Conditional expression of PfAP2-G for controlled massive sexual conversion in Plasmodium falciparum.

Malaria transmission requires that some asexual parasites convert into sexual forms termed gametocytes. The initial stages of sexual development, including sexually committed schizonts and sexual rings, remain poorly characterized, mainly because they are morphologically identical to their asexual counterparts and only a small subset of parasites undergo sexual development. Here, we describe a system for controlled sexual conversion in the human malaria parasite Plasmodium falciparum, based on conditional expression of the PfAP2-G transcription factor. Using this system, ~90 percent of the parasites converted into sexual forms upon induction, enabling the characterization of committed and early sexual stages without further purification. We characterized sexually committed schizonts and sexual rings at the transcriptomic and phenotypic levels, which revealed down-regulation of genes involved in solute transport upon sexual commitment, among other findings. The new inducible lines will facilitate the study of early sexual stages at additional levels, including multiomic characterization and drug susceptibility assays.

'That might be a bit sexy for somebody your age': Older adult sexual health conversations in primary care.

Many older adults are sexually active, and STIs are rising amongst this cohort. In primary care, sexual health discussions are limited as health-care practitioners commonly assume older patients aged 60+ are not sexually active or are unwilling to discuss sex. Studies have either examined patient or clinician views, but not both. This study investigates sexual health discussions in general practice. It is unique in that it sought perspectives of different groups: older patients, health-care professionals and key informants. Qualitative interviews revealed that older patients expect clinicians to bring up sexual concerns, whereas clinicians prefer older patients to do so. A simple electronic solution to circumvent this impasse was suggested and discussed. Older adults would like to discuss sexual concerns with their health-care providers. Given the rising rates of STIs in later life, sexual health discussions with older patients must become part of routine care.

Genome-wide study on the polysomic genetic factors conferring plasticity of flower sexuality in hexaploid persimmon.

Sexuality is one of the fundamental mechanisms that work towards maintaining genetic diversity within a species. In diploid persimmons (Diospyros spp.), separated sexuality, the presence of separate male and female individuals (dioecy), is controlled by the Y chromosome-encoded small-RNA gene, OGI. On the other hand, sexuality in hexaploid Oriental persimmon (Diospyros kaki) is more plastic, with OGI-bearing genetically male individuals, able to produce both male and female flowers (monoecy). This is thought to be linked to the partial inactivation of OGI by a retrotransposon insertion, resulting in DNA methylation of the OGI promoter region. To identify the genetic factors regulating branch sexual conversion, genome-wide correlation/association analyses were conducted using ddRAD-Seq data from an F1 segregating population, and using both quantitative and diploidized genotypes, respectively. We found that allelic ratio at the Y-chromosomal region, including OGI, was correlated with male conversion based on quantitative genotypes, suggesting that OGI can be activated in cis in a dosage-dependent manner. Genome-wide association analysis based on diploidized genotypes, normalized for the effect of OGI allele dosage, detected three fundamental loci associated with male conversion. These loci underlie candidate genes, which could potentially act epigenetically for the activation of OGI expression.

Sikap terhadap Perilaku Seksual Berisiko pada Siswa Etnik Jawa

<p>Adolescence is a period of high risk associated risky sexual behavior. It is quite reasonable because in adolescence began to emerge a strong sex drive due to hormonal changes. Risky sexual behavior is influenced by the attitude. Attitudes toward sexual behavior in adolescents is influenced by several factors including biological, psychological and social or shortened to biopsychosocial. Results of studies with sample sizes of 90, mention of sexual behavior that have been committed by teenagers there are 1.11% of students have agreed attitudes towards risky sexual behavior with 1.11% of students agreed the details of the activity of kissing, amounting to 1.11% of students agreed to the activity of necking and 2.22% of students agreed to the importance of a healthy activity, and no one who had agreed to the activity of intercourse. The small percentage of teen attitudes toward sexual behavior are at risk due to the Javanese culture that is still taboo sexual conversation. Javanese in discussing the sexual use of symbols as smoothing.</p><p><strong> </strong></p>