Sexual Health Curriculum Research Articles

What are future doctors learning about sex? An assessment of sexual health curricula across medical schools in the Northeastern United States.

Sexual health is an imperative area of study in medical school education, yet many medical schools do not offer a comprehensive curriculum nor is it standardized across the United States (US). This study aims to assess written curriculum materials from sexual health curricula in medical schools across the northeast region of the US and compare the current teachings to suggested standards. A compilation of academic resources including lecture materials and syllabi were systematically reviewed utilizing a standardized and validated rubric with variables assessed including: biological and psychological aspects of human sexual development, anatomy and physiology of the human sexual response cycle, sexual health in relation to human reproduction, and contraceptive options. We analyzed our data from the document analysis to look at the frequency of inclusion and exclusion of the sexual health topics included in our rubric. The outcomes of our data set were in line with our hypothesis that there is significant variance between sexual health curricula across institutions as well as an overall lack in material covering sexual health topics. The data show significant sex specific differences such that male-specific topics were covered more frequently than female-specific information. Additionally, only one of the 10 schools examined taught about vulvar conditions. There was also a paucity of information about sexuality in the post-partum period. The clinical implications of this study aim to highlight the discrepancy between an ideal sexual health curriculum and what is actually being taught in medical schools and help to guide future work of creating a comprehensive and standardized sexual medicine education in US. medical schools. The validity of this study was strengthened by analyzing direct curricula materials as opposed to previous use of subjective, self-reported questionnaires. However, the sample location being restricted to the Northeast was a limitation to generalize findings across the country. Future studies would aim to analyze medical school curricula across different regions in the US. This study shows that there is a lack of comprehensive and standardized sexual health curriculum in medical schools in the Northeastern US and serves as initial evidence for further investigation of this topic across American medical schools.

‘Sex ed’ exemptions in Ontario schools

This project explores how ‘sex ed’ exemptions are being enacted in Ontario classrooms. In August 2019, the Ministry of Education issued Policy/Program Memorandum 162, requiring Ontario school boards to have a policy or procedure allowing Grade 1-8 students to be exempted from Human Development and Sexual Health curriculum expectations at their parents' request. However, rather than limiting exemptions to formal lessons in the HDSH expectations of elementary Health and Physical Education, many teachers believe that they must exempt students from any conversation, formal or not, involving 2SLGBTQ+ topics. This has the potential to further stigmatize queer identities, as well as related topics and discussions. This research is also connected the conversation of how much sway “parental rights” have in the classroom. The first stage of this project has involved collecting exemption policy documents and board exemption forms, along with tracking how findable these documents are. As of today, 56 boards appear to have responded to PPM 162, either by passing a new policy or revising an existing one. Only 41% of school boards have a description of their exemption process available through Google search, while 30% of boards do not have their process available online at all. Unfortunately, problematic organizations like Parents as First Educators and Canadian Gender Report—both of which publish ‘resources’ claiming that parents have the right to exempt their children from all content about gender and sexual diversity—have materials which appear easily on Google search, sometimes even before authorized school board pages. If school boards do not have official exemption processes and forms readily available online, it is possible that parents will turn to these problematic documents instead. These gaps in the online availability of official board information may contribute to the dangerous misunderstandings present in how ‘sex ed’ exemptions are handled in Ontario schools.

(077) WOMEN'S SEXUAL HEALTH: AN INTRODUCTION TO A BIOPSYCHOSOCIAL LECTURE FOR EARLY HEALTHCARE TRAINING

Abstract Introduction In 2009, The International Consultation in Sexual Medicine called for the implementation of a greatly expanded, national standard on sexual health education across the nation within medical schools (E Coleman et al. 2013). Yet, over half of medical students throughout the United States and Canada feel that their medical school education left them inadequately prepared to address their patients’ sexual health concerns (Shindel AW et al. 2010). A 2022 study illustrates that outside of basic female anatomy, over half of the Chicago area medical schools failed to address female sexual functioning in their curriculum (N Codispoti et al 2022). Furthermore, today's physicians share similar qualms, as they cite lack of education and training on sexual health as leading to barriers to care and a decrease in screening for sexual dysfunction (Parish SJ et al 2009). Our study delineates a proposed curriculum, analyzing for efficacy as well as the students perceived comfort with addressing this topic in clinic and their perspectives on its importance to their education. Objective Assess the need for curriculum supplementation based on student baseline knowledge and comfort with the topic of women's sexual health. Establish the supplemental curriculum, analyzing for efficacy of education and improved student comfort with addressed topics. Integration of supplemental curriculum into study location medical school curriculum and standardization to all area medical school curriculums. Methods This self controlled, cross-sectional, survey study investigates first year medical students' initial education level and perspectives on womens’ sexual function (WSF) and womens’ sexual dysfunction (WSD), and their post education knowledge level and perspective. The study team recruited 50 students for our study, approximately one third of the class. The study outcomes were assessed for the efficacy of each of the teaching materials through content based quiz questions, as well as the students perceived comfort with addressing this topic in clinic and their perspectives on its importance to their education as compared to the pre-education survey. Results The study resulted in statistically significant improvement from the pretest knowledge in subjects of postmenopausal atrophic vaginitis, perimenopausal risk factors and preventative care, and female HPG axis-based pubertal development. Notably within the demographic assessment, all medical specialties were selected as “of interest” by at least one participant. The participants also assessed that overall women’s sexual health should be taught in their preclinical curriculum and is valuable to their future career, despite the widely varied fields of medicine within interest. Conclusions With statistically significant improvement in knowledge of women’s sexual development and function through our proposed curriculum, we aim to advocate for implementation of a standardized preclinical women’s sexual health curriculum. Furthermore, our ongoing studies focus on the development of a curriculum directed at the pathology and treatments of female sexual dysfunction from a biopsychosocial perspective, resulting in a comprehensive curriculum. Disclosure No.

(080) ADVANCING PRECLINICAL MEDICAL STUDENT EDUCATION: A COMPREHENSIVE CURRICULUM FOR TEACHING SEXUAL AND REPRODUCTIVE HISTORY TAKING TO MEDICAL STUDENTS THROUGH MULTIMODAL TEACHING TECHNIQUES

Abstract Introduction Sexual and reproductive history taking is a fundamental yet often overlooked aspect of medical education. Most medical schools in North America do not provide adequate sexual health training to students, with 44% of schools lacking a sexual and reproductive health curriculum (1). Moreover, there are currently no national standards across medical schools for training students to take a sexual health history (2). Existing programs vary widely and often consist of limited hours or electives, leaving many medical graduates feeling unprepared (3). Objective To develop a multimodal course and standardized curriculum for first-year medical students. Methods Through a combination of video presentations, live demonstration, interactive lecture, and Group Observed Structured Clinical Experience (GOSCE) sessions with standardized patients, students were guided in learning and practicing sexual history taking skills. Post-course surveys were sent to all 52 students after completion of the course, with 46 students completing the survey (response rate 88%). Students were asked to rank their knowledge of the course topic on a scale from 1 (not at all knowledgeable) to 5 (extremely knowledgeable) both before and after participating. Results On average, there was a significant change in knowledge, regarding navigating sexual health biases and effectively obtaining a sexual history from patients, by 1.2 points after students partook in the course (p < 0.0001). The majority (80%) reported that there was the right amount of lecture and patient interactive learning. Ninety-six percent of students agreed that the course met the learning objectives and indicated they would use what they learned in the course in the future. Conclusions After participating in this multimodal sexual health course, students demonstrated an improvement in knowledge and indicated that the course met the learning objectives. These results suggest that multimodal teaching methods may address the gap in sexual health education. Disclosure No.

Implementation of School-Based Sexual Health Curriculum in Tanzania: Perspectives of Secondary School Adolescents in Southern Highlands

Implementation of School-Based Sexual Health Curriculum in Tanzania: Perspectives of Secondary School Adolescents in Southern Highlands

Adolescents’ Beliefs About Sex: The Moderating Effects of Peer Attitudes

Peer beliefs and attitudes play a prominent role in adolescent behaviors. Various curricula have been developed to teach students about sexual health from a skills-based perspective with successful, lasting effects. This study examined how adolescents’ expectancies for success in and values held for a sexual health curriculum are related to their attitudes toward waiting to have sex, attitudes toward using a condom, self-efficacy in negotiating condom use, self-efficacy in refusal skills, and self-efficacy in navigating tricky situations, depending on their perceptions of their peers’ attitudes. Results indicate that perceived peer attitudes toward waiting to have sex were a significant moderator, more so than peer attitudes about condom use. Additionally, results suggest that sex plays a role in students’ sexual health beliefs and self-efficacies. Future work should examine further explanatory paths and influences such as caregivers.

IJCM_2A: Perceptions of and challenges faced by college students in receiving sexual health education during their school days- An exploratory study

Background: Sexuality health education stands as an essential cornerstone in shaping the physical, emotional, and social well-being of young adults, and nowhere is this need more evident than in India. As a country known for its diverse culture, traditions, and a burgeoning youth population, addressing the unique challenges and opportunities pertaining to sexual health education is of paramount importance. Currently, there is no existing curriculum or syllabus for sexual health education in schools or colleges. Methodology: Qualitative data was obtained by conducting in depth interviews. Around 10-20 In depth interviews were conducted. Participants were college going students who gave consent and were open to talk about the topic. Interview was conducted using an interview guide and the process was audio recorded. Data was analysed manually using grounded theory. Results: The themes generated were previous exposure to sexual health education, Sources of information, topics under sexual health education. Challenges faced by young adults were explored under the following themes- difficulties faced during school/ college, past experiences, cultural taboos etc. Many young adults advocated the need for sexual health education. Surprisingly a few handfuls of students thought it was not necessary to teach sexual health education at all. However, all of them were not satisfied with the education they received on sexual health in the past. Conclusion: This study sheds a spotlight on the lack of sexual health education and its repercussions on young adults today. Difficulties faced by young college going students can be used to design an age appropriate culturally sensitive sexual health curriculum for school going adolescents.

Strategies to develop an LGBTQIA+-inclusive adolescent sexual health program evaluation.

Adolescent sexual health interventions are increasingly incorporating content that is inclusive of LGBTQIA+ youth (lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, and other marginalized sexualities and genders). Evaluations of such programs must also be inclusive to enhance the validity of evaluation results and avoid further marginalization. We present strategies for increasing LGBTQIA+-inclusivity based on our evaluation of SafeSpace, a sexual health curriculum. To design an LGBTQIA+-inclusive program evaluation, we leveraged LGBTQIA+ research staff's insights, pursued a parental consent waiver, developed an inclusive recruitment plan, and crafted demographic and sexual behavior survey measures with input from youth and equity experts. We conducted a pilot study with 42 youth ages 14-17 to assess the feasibility and efficacy of our strategies. We obtained a parental consent waiver and recruited a majority LGBTQIA+ pilot study sample (62%). Using themes from cognitive interviews with youth and experts regarding inclusive framing and use of plain language, we refined demographic measures and expanded sexual behavior measures. Findings suggest that the strategies used to enhance LGBTQIA+-inclusivity in our evaluation of SafeSpace were effective in respectfully and more accurately capturing a fuller range of experiences and identities of LGBTQIA+ and cis-straight youth. The strategies and survey measures developed for this study can be applied to increase LGBTQIA+-inclusivity in other adolescent sexual health program evaluations.

Applying an Evidence-Based Community Organizing Approach to Strengthen HIV Prevention for Cisgender Women in US South: Protocol for a Mixed Methods Study.

Most new HIV diagnoses among cisgender women in the United States occur in the South. HIV pre-exposure prophylaxis (PrEP), a cornerstone of the federal Ending the HIV Epidemic (EHE) initiative, remains underused by cisgender women who may benefit. Awareness and access to PrEP remain low among cisgender women. Moreover, improving PrEP reach among cisgender women requires effectively engaging communities in the development of appropriate and acceptable patient-centered PrEP care approaches to support uptake. In a community-clinic-academic collaboration, this protocol applies an evidence-based community organizing approach (COA) to increase PrEP awareness and reach among cisgender women in Atlanta. The aim of this study is to use and evaluate a COA for engaging community members across 4 Atlanta counties with high-priority EHE designation, to increase PrEP awareness, interest, and connection to PrEP care among cisgender women. The COA, consisting of 6 stages, will systematically develop the skills of community members to become leaders and advocates for HIV prevention inclusive of PrEP for cisgender women in their communities. We will use the evidence-based COA to develop and implement a PrEP-specific action plan to create broader community change by raising awareness and interest in PrEP, reducing stigma associated with HIV or PrEP, and connecting women to sexual health clinics providing PrEP services. In the first 4 stages, to prepare for and develop action plans, we will gather data from one-on-one interviews with up to 100 individuals across Atlanta to capture attitudes, motivations, and influences related to women's sexual health with a focus on HIV prevention and PrEP. Informed by the community interviews, we will revise a sexual health curriculum inclusive of PrEP and community-centered engagement. We will then recruit and train community action team members to develop action plans to implement the curriculum during community-located events. In the last 2 stages, we will implement and evaluate COA's effect on PrEP awareness, interest, HIV or PrEP stigma, and connection to PrEP care among cisgender women community members. This project was funded by the National Institutes of Health and approved by the Emory University institutional review board in July 2021. Data collection began in December 2021 and is ongoing. COA stage 1 of the study is complete with 70 participants enrolled. Community events commenced in November 2023, and data collection will be completed by November 2025. Stage 1 qualitative data analysis is complete with results to be published in 2024. Full study results are anticipated to be reported in 2026. Through a community-clinic-academic collaboration, this protocol proposes to mount a coordinated approach across diverse Atlanta counties to strengthen HIV prevention for cisgender women and to create a sustainable systems approach to move new sexual health innovations more quickly to cisgender women. DERR1-10.2196/56293.

(350) Assessment of Fundamental Knowledge and Comfortability of Medical Trainees in the Diagnosis and Treatment of Genito-pelvic Pain Penetration Disorder

Abstract Introduction Genito-Pelvic Pain/Penetration Disorder (GPPPD) is a common condition affecting up to 25% of the US population. Despite its prevalence, significant barriers exist for patients to obtain appropriate diagnosis and treatment. Lack of uniform education in vulvar anatomy, physiology, and vulvar pain conditions in medical schools for trainees may be a contributing factor in the delay to diagnosis for patients. The vulvar examination is pivotal in diagnosing GPPPD but is often omitted, despite its importance, due to shortcomings in medical education. The lack of formal education may leave many healthcare workers feeling unprepared to care for their patients' sexual health. Objective Our study aims to assess the fundamental knowledge of medical trainees who treat vulvar health in the diagnosis and treatment of GPPPD. We also aim to assess the knowledge and confidence of physician residents on how to conduct a comprehensive vulvar examination. Methods This cross-sectional analytical survey study uses Qualtrics to administer the survey after obtaining IRB approval. The target audience includes urology residents, obstetrics and gynecology residents, dermatology residents, internal medicine residents, family medicine residents, emergency medicine residents, and medical students. The survey link and a brief description of the project were emailed to all residency program directors in these specialties who had valid email addresses provided in the FREIDA American Medical Association Residency Database. Program directors were instructed to share the link to the anonymous online survey with their current resident cohorts. Results Survey collection is currently ongoing and formal results are forthcoming. We hypothesize that the results will demonstrate that resident physicians in urology, obstetrics and gynecology, dermatology, internal medicine, family medicine, and emergency medicine as well as medical students are not receiving instruction or counseling on vulvar anatomy, how to diagnose common vulvar conditions, or how to treat common vulvar conditions. Each of these shortcomings significantly contributes to the lack of access and misdiagnosis that patients with GPPPD experience which leads to overutilization of the healthcare system and significant disruption in patient’s quality of life. We aim to show the disparities that exist in order to affect a systematic change and standardization in how we teach vulvar sexual health curriculum nationwide. Conclusions It is crucial to assess these knowledge gaps in training to create educational tools to alleviate these medical education shortcomings. We believe that our findings will provide evidence that will warrant targeted interventions, such as the creation of a nationwide standardized curriculum of medical school training in vulvar anatomy and physiology. Furthermore, we hope this work serves as a catalyst for increased cultural competency training for medical trainees to better address structural barriers for patients with GPPPD to obtain health care with the goal of effectively increasing equity, diversity, and inclusion in the healthcare landscape. Disclosure No.

(111) Evaluation of Sexual Education Needs in Spina Bifida Adolescents and Correlation Between Sexual Satisfaction with Depression and Anxiety

Abstract Introduction Spina bifida is a congenital disorder with many neurological sequelae, most notably, decreased sexual function and infertility. While some neuro-urological related factors have been extensively studied among patients with spina bifida, sexual health and infertility continue to be largely unaddressed in this population, especially in the adolescent population. Although previous studies show the need to address sexual health in spina bifida patients, they do not assess the level of sexual health knowledge adolescents possess or the degree to which their psychological functioning is impacted by sexual dysfunction. Although a validated sexual and reproductive empowerment scale exists for adolescents, it has not been utilized in spina bifida patients. This can be due to stigmas that patients with spina bifida may not be engaging in or desire sexual activity. Overall, the stigma of addressing sexual health in adolescents and the inadequacy of current sexual health curriculum, prevents adolescent spina bifida patients from accessing sexual health related information. Objective This study will assess the baseline sexual health literacy and sexual health needs of adolescents with spina bifida. The second aim of this study is to identify the barriers that adolescent spina bifida patients face when attempting to gather information regarding their sexual health. The third aim of this study is to determine whether sexual literacy and sexual empowerment scores are associated with self-reported depression and anxiety as measured by the PHQ-9 and GAD-7 in this population. Methods English- and Spanish-speaking adolescent patients aged 15-21 presenting to a Spina Bifida Multidisciplinary Clinic for routine clinical care will be prospectively recruited for participation in a cross-sectional questionnaire study designed in REDCap. Correlation analysis will be utilized to identify the association between depression, anxiety, sexual health literacy, and sexual empowerment scores. The Patient Health Questionnaire-9 and then Generalized Anxiety Disorder-7 questionnaire will be utilized to assess depression and anxiety, respectively. Results Per literature review multiple studies show that adolescents with spina bifida do not have sexual health needs addressed by any provider or family member. Many of these patients feel that their providers assume they do not engage in sexual activity, or view them as asexual, and potential partners are hesitant to discuss sexual desire due to physical limitations. Studies done assessing sexual dysfunction and related emotional well-being, were based on interview studies and extrapolating significant themes. Upon an initial survey of 2 pediatric urologists at CHLA, we have found that many patients do not feel comfortable addressing sexual health and that there are no current tools for pediatric urologists to initiate sexual health related discussion. Currently no such validated comprehensive questionnaire exists to assess level of sexual health knowledge, sexual desires, and psychological state for adolescent spina bifida patients. Conclusions There is a need to establish a communication tool for providers to initiate discussion regarding sexual health in adolescents with spina bifida. Disclosure No.

Parents’ Attitudes towards Inclusion of Sexuality Education in Malaysian Schools

The present study examined the attitudes of Malaysian rural parents regarding sexual health education in elementary schools. Using a comprehensive list of sex education topics, parents were asked to examine which topics they believed should be taught at schools. In addition, the study also assessed the relationship between parents’ demographic characteristics such as age, gender, education, and occupation and their approval of sexual health education. The respondents of the study included parents (n=211) of children registered in four selected schools in Kedah, Malaysia. The majority of them (73%) supported the inclusion of various sexual health topics in school curriculum provided the contents were in line with religious teachings. The study has generated important empirical findings regarding local community’s response to school-based sexuality education. This information is needed in facilitating the development of sexual health policy at various institutional levels, and in the effective implementation of sexual health curriculum in Malaysian schools.

Peer Pressure and Risk-Taking Behaviors Among Adolescent Girls in a Region Impacted by HIV/AIDS in Southwestern Uganda

PurposeThis paper uses data from a 3-arm Cluster Randomized Control Trial, Suubi4Her (N = 1260; 14–17-year-old school-going girls) to (1) assess the relationship between peer pressure and adolescent risk-taking behaviors; and (2) test the mediating effect of peer pressure on an intervention on adolescent risk-taking behaviors. MethodsStudents in the southwestern region of Uganda were assigned to three study arms: control (n = 16 schools, n = 408 students) receiving usual care comprising of sexual and reproductive health curriculum; and two active treatment arms: Treatment 1 (n = 16 schools, n = 471 students) received everything the control arm received plus a savings led intervention. Treatment 2 (n = 15 schools, n = 381 students) received everything the control and treatment arms received plus a family strengthening intervention. We used multilevel models to assess the relationship between peer pressure and risk-taking behaviors. We ran structural equation models for mediation analysis. ResultsUsing baseline data, we found that direct peer pressure was significantly associated with substance use risk behaviors, (β = 0.044, 95% CI = 0.008, 0.079). We also found a statistically significant effect of the intervention on acquiring STIs through the mediating effect of sexual risk-taking significant (β = −0.025, 95% CI: −0.049, −0.001, p = .045) and total indirect (β = −0.042, 95% CI: −0.081, −0.002, p = .037) effects. Also, there was a significant mediation effect of the intervention on substance use through peer pressure (β = −0.030, 95% CI: −0.057, −0.002, p = .033). DiscussionOverall, the study points to the role of peer pressure on adolescent girls' risk-taking behaviors; and a need to address peer pressure at an early stage.

Is sexual misconduct training sufficient in the UK's medical schools: Results of a cross-sectional survey and opportunities for improvement.

Sexual misconduct adversely affects the mental and physical health of millions of people each year and has been declared a global pandemic. Incidence in both educational and clinical settings remains high. In the last 5 years, the NHS spent over £4 million settling sexual misconduct-related claims. Effective prevention requires training across all stages of career, beginning in clinical school. Here, we explore training in the UK's medical schools to identify provision and areas for improvement. Freedom of Information Act 2000 requests for data on training delivery and curricula content. 34 public UK universities offering medical education. not applicable. Provision and delivery of training, mode of delivery, theme, and continuation of training. All 34 universities responded. Twenty-two identified offering training. Seventeen made it compulsory. A review of curricula identified, however, only 18 did more just than mentioned sexual misconduct. Nine offered training more than once. Twelve did not offer training, of which three identified no plans to offer such training in the future. The most common delivery modes for training were workshops and lectures. The training was most often within the sexual health curriculum, disconnecting it from professionalism. There is no standardisation of sexual harassment training across the UK's public medical schools. Many future doctors will not have received relevant education when they assume posts in the NHS. Considering the magnitude of this issue and its critical connection to professionalism and collegiality, universities and professional bodies urgently should address this deficiency.

Nursing students' perceived attitudes toward addressing sexual health in their future profession: A longitudinal quantitative study

BackgroundSexual health is a necessary component of human wellbeing. Nurses espouse holistic care but in practice often overlook a person's sexual health. Disparities linked to sexual health persist nationally and globally, including those among gender and sexual minorities. Inconsistent sexual health curriculum in nurse education in the United States has led to gaps in learning. This study aimed to understand nursing students' attitudes toward addressing sexual health issues in their future profession during an Associate of Science in Nursing program in the United States. MethodsA convenience sample of Associate of Science in Nursing students from a university voluntarily participated in this longitudinal quantitative study. All eligible students enrolled in the first semester completed the Students' Attitudes Toward Addressing Sexual Health instrument. Summary statistics and Pearson r correlation were used to analyze the data. ResultsThe 159 students were relatively young, female, and White, non-Hispanic. The total score of students' attitudes toward addressing sexual health was 83.48, ranging from 41 to 109. Regarding the positively loaded items of the Students' Attitudes Toward Addressing Sexual Health, the results showed students believed they would have too much to do for handling sexual issues (M = 4.44), need to get basic knowledge about sexual health (M = 4.31), and take time to deal with patients' sexual issues (M = 4.24). ConclusionIn this study, nursing students reported positive attitudes toward addressing sexual health in their future profession but acknowledged they would need basic education. Due to the homogeneity of participants' backgrounds, the generalizability of study results might be limited. It is suggested that nurse educators should develop an innovative curriculum for building students' competence and prepare graduates to deliver sexual health care for meeting a person's health needs.

Don't go it alone: Locating the sexual health curricula available to families of students with intellectual disability

AbstractStudents with intellectual disabilities (ID) have reduced access to sexuality education at school, tasking families with filling the gap. This limited access contributes to persistent health inequities, psychosocial risk, and reduced self‐determination for individuals with ID. To understand the resources that families may encounter when filling this service gap, a naturalistic scoping review and content analysis of ID‐specific sexual health curricula (SHC) was conducted. This analysis found a limited number of SHC available to family members who may seek them out online, and even fewer SHC designed for the specific needs of family‐led delivery. While curricula identified in this study generally include the minimum recommended content areas for comprehensive sexuality education, they less frequently provide actionable guidelines for caregivers tasked with adapting teaching practices and outcomes assessment to the diverse profiles of students with ID. By understanding the SHC available to families of students with ID, school psychologists can improve their partnerships with families, disseminate needed resources, implement collaborative intervention practices, and advocate for inclusive sexuality education practices.

Perceived influence of medical school sexual health education on specialty selection in young urologists specializing in sexual dysfunction.

To determine effects of sexual health curriculum (SHC) in medical school and mentorship on future specialty/subspecialty selection, we sought to evaluate the experiences of urology trainees and practicing urologists. Residents, fellows, and practicing urologists completed a 15-question survey regarding their exposure to a SHC during medical school, topics covered, and the influence of mentors in their career choice. Summary statistics were used to identify trends based on survey responses. Ninety-four respondents, primarily post-graduate training year 4 and 5 (46%), completed the survey. Approximately 50% recalled a dedicated SHC during medical school with 46% planning to pursue fellowship training in sexual medicine/reconstruction. Topics commonly covered included reproductive anatomy/physiology and sexual history-taking, while respondents rarely recalled topics such as sexual aids/toys and pornography. Only 25% felt their SHC provided an adequate fund of knowledge to address sexual health concerns in patients, and only 14% felt that exposure to a SHC influenced their decision to pursue urology. Individuals intending to pursue fellowship were more likely to have an attending mentor, a mentor with expertise in sexual dysfunction, and considered their mentor as important or very important in their decision to subspecialize (P<0.05). Most urology trainees do not have strong exposure to a SHC during medical school and cite mentorship as a more important role in the decision to pursue subspecialty training. These data support the need for a standardized formal SHC and continued exposure to sexual health experts during training to ensure continued interest in sexual medicine/reconstruction fellowship.

The Impact of COVID-19 on Instruction for and the Implementation of Quebec’s Sexual Health Curriculum

In March 2020, the COVID-19 pandemic necessitated school closures across Quebec. Educators shifted to online learning and complied with COVID-19 safety measures for in-person teaching, impacting the implementation of Quebec’s Sexuality Education program. Drawing on responses from a sample of 165 in-service teachers working in English school boards across Quebec, this study discusses the challenges that characterized teaching sexual health education (SHE) during the COVID-19 pandemic. The data analyzed in this study consist of teachers’ responses to one qualitative question: How has the COVID-19 situation affected your teaching and incorporation of Quebec’s comprehensive sexual health education curriculum in your classroom? The results indicate that educators taught less SHE during the COVID-19 pandemic due to a lack of time and other core curriculum subjects taking precedence. Other challenges were present, including a lack of clarity from school administrators on how SHE should be implemented, reduced ability to supplement SHE classes with guest speakers, difficulty facilitating discussions due to students’ home environments, and decreased student engagement. Despite these barriers, teachers felt that teaching SHE during the COVID-19 pandemic was important and expressed the need for more pedagogical development and training opportunities to improve SHE both online and in person.

Evaluating the History-Taking Process of Sexual Reproductive Health Problems in Tanzania: Lessons from a Study of Health Students and Practitioners.

Building trust and therapeutic relationships between healthcare providers and patients are crucial for delivering high-quality, comprehensive sexual and reproductive health (SRH) services. Yet, while patients face substantial SRH disparities in Tanzania, little is known about health care professionals' [HCPs] SRH history-taking practices and experiences. This paper describes HCPs' interdisciplinary practices, experience in conducting SRH taking, and the critical lessons learned to optimize quality SRH care. We conducted 18 focus group discussions in June 2019 in Dar es Salaam, Tanzania, with 60 healthcare practitioners and 61 students in midwifery, nursing, and medicine. We implemented a purposive, stratified sampling design to explore the experiences and perspectives of HCPs regarding providing sexual health services. We employed a grounded theory approach to perform the analysis. We provided seven scenarios to participants to discuss how they would manage SRH health problems. The scenarios helped us evaluate the practice and experience of SRH in Tanzania. Four broad themes and sub-themes emerged during the discussion; 1) SRH history-taking practices and experiences in the health care facilities; 2) the perceived benefit of effective SRH history-taking; 3) Factors hindering the SRH history-taking process; 4) The power of confidence. These findings have implications for strengthening a sexual health curriculum for medical students and continuing education programs for practicing health professionals designed to address the observed health disparities in Tanzania. These findings affirm that proper SRH history-taking requires a conducive environment, knowledge of relevant SRH-related laws and regulations; application of evidence-based techniques; and giving patients autonomy to make decisions for their health while making recommendations regarding standard care. Comprehensive SRH history-taking identifies critical data for illness diagnosis, provides foundational information for risk-reduction behavioural change counselling, and reduces medical costs. Therefore, the primary goal is to optimize health professional training on SRH issues and history-taking skills within the medical interview.

Gender and Sexual Health-Related Knowledge Gaps and Educational Needs of Parents of Transgender and Non-Binary Youth

Parents can have a substantial impact on adolescent sexual decision-making, but few studies have explored the role of parents in providing sexual health information to transgender and non-binary (TNB) youth, a population that experiences significant sexual and mental health disparities and lower levels of perceived family support compared with other youth. This study aimed to elucidate existing knowledge gaps and content deemed important for a sexual health curriculum and educational materials for parents of TNB youth. We conducted 21 qualitative interviews with five parents of TNB youth, 11 TNB youth aged 18+, and five healthcare affiliates to identify parents’ educational needs. We analyzed the data using theoretical thematic analysis and consensus coding. Parents self-reported multiple knowledge deficits regarding gender/sexual health for TNB individuals and were primarily concerned with long-term impacts of medical interventions. Youth goals for parents included greater understanding of gender/sexuality and sufficient knowledge to support youth through social transition to their affirmed gender identity. Content areas suggested for a future curriculum for parents of TNB youth included: basics of gender/sexuality, diverse narratives of TNB experiences/identities, gender dysphoria, non-medical gender-affirming interventions, medical gender-affirming interventions, and resources for peer support. Parents desired access to accurate information and wanted to feel equipped to facilitate affirming conversations with their child, something that could combat health disparities among TNB youth. An educational curriculum for parents has the potential to provide a trusted information source, expose parents to positive representations of TNB individuals, and help parents support their TNB child through decisions about potential gender-affirming interventions.