Sexual Health Curriculum Research Articles

(216) Insufficient Medical School Sexual Health Curriculum Leads to Inadequately Prepared Trainees

Abstract Introduction Sexual Health Curriculum (SHC) in medical schools has been insufficiently training medical students for many years. While most medical schools report teaching a SHC, many medical students and residents report being inadequately trained in sexual health. This has led to infrequent physician screening for sexual problems due to insufficient knowledge and a lack of training about sexual function and dysfunction. Objective To investigate the current body of literature for changes in SHC in medicals schools in the last 20 years, and to identify any discrepancies between SHC taught in medical school and resident and medical student comfort in treating Sexual Health Dysfunction. Methods A literature review was conducted in PubMed on “sexual health education in medical school”, and of 16,962 results 37 relevant papers published in the U.S. and Europe were identified and analyzed. Results In 2003 86% of medical schools reported teaching over 3 hours of SHC, but by 2021 only 65% of students and 50% of PGY 4/5 Urology residents recalled a dedicated SHC in medical school. Consistently 50% of medical students are unsatisfied with their SHC, 52% are rarely or never evaluated on their sexual history taking skills, and 7% report not learning about human sexuality at all. Most German medical students believe that sexual health courses should be mandatory. Medical students have overall positive attitudes towards sexual and gender minority populations but lack adequate knowledge, especially about transgender and intersex health. Only 55% of 3rd/4th year OBGYN residents reported feeling comfortable in performing a targeted sexual dysfunction exam, and 66% of residents in Family Med, IM, OBGYN, and Psych had no previous educational experience in sexual problem management. Conclusions Sexual health curriculum in medical schools has not significantly improved in the last 20 years, leading to students and residents inadequately prepared to treat sexual health dysfunctions. The adoption of previously proposed SHC competencies for medical schools should be strongly considered. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast

Implementation of Sexual Health Curriculum Series: Educational Initiative to Increase STI Screening and Treatment in Dallas, Texas.

A new monthly virtual education curriculum on sexual healthcare was launched in 2021. This is an analysis of the pilot education series designed to increase primary care providers' knowledge of sexual health best practices including taking thorough sexual histories, STI screening and treatment, and PrEP prescribing. A Sexual Health Curriculum Series was developed as part of a quality improvement initiative at a large urban safety-net hospital in Dallas County, Texas. Didactic sessions were administered to primary care providers and staff via a virtual meeting platform once a month from May 2021 to April 2022. A total of 52 participants completed the pre-series survey, and 21 participants filled out the final post-series survey. 70% of respondents who completed the post-series survey reported that they learned new information that was incorporated into their practice. The average percentage correct on individual pre-session surveys was 60% compared to 63% on individual post-session surveys (p = 0.03). Sexual health education is an important tool to help primary care providers adhere to sexual health best practices. There is a need for ongoing implementation of innovative strategies to improve knowledge and adherence to sexual health best practices. A sexual health curriculum may be effective in helping primary providers recognize patients at increased risk and apply evidence-based guidelines to their practices.

Declining nudes: Canadian teachers’ responses to including sexting in the sexual health and human development curriculum

ABSTRACT Addressing sexting in sexual health education classrooms is one way of supporting young people to become good sexual citizens and to emphasise respect and consent in their sexual practices and in their lives. While a fair amount of research has worked with youth to understand their motivations for sexting, less research has been conducted with in-service teachers to understand their perspectives, pedagogical approaches, and beliefs regarding young people and sexting. Set in this context, this paper discusses findings from interviews with Canadian teachers who were teaching a new Ontario Health and Physical Education curriculum that included discussions of sexting. Our findings suggest that many teachers are still engaging discourses of risk, shame and blame when they talk to their students about sexting. Likewise, longstanding gender norms and stereotypical sexual scripts are evident in the ways in which many teachers both understand and teach sexting. Some teachers, however, are engaging in more promising pedagogical practices that frame sexting as having a range of uses, outcomes, and purposes, painting a more holistic picture of young people’s sexting landscapes. Findings from this paper may be useful for educators and policymakers creating sexting curriculum for young people in educational settings.

The start of sexual health curriculum development and evaluation at Stellenbosch University

Stellenbosch University's (SU) Faculty of Medicine and Health Sciences (FMHS), developed a sexual health course to be integrated throughout the revised medical curriculum. To use the Sexual Health Education for Professionals Scale (SHEPS) to gather baseline and future follow-up data to inform curriculum development and evaluation. The first-year medical students (N = 289) of the FMHS SU. The SHEPS was answered before the start of the sexual health course. The knowledge, communication and attitude sections were answered with a Likert-type scale. Students had to describe their perceived confidence in their knowledge and communication skills to care for patients within specific sexuality-related clinical scenarios. The attitude section measured the students' level of agreement or disagreement on sexuality-related opinion statements. The response rate was 97%. Most students were female, and 55% of the class were first taught about sexuality in the age group 13-18 years. The students had more confidence in their communication skills than knowledge before any tertiary training. The attitude section revealed a binomial distribution, ranging from acceptance to a more restrictive attitude towards sexual behaviour. It is the first time the SHEPS has been used in a South African context. The results provide novel information about the range of perceived sexual health knowledge, skills and attitudes of first-year medical students before they start tertiary training.Contribution: Findings from this study will guide content development and evaluation of the sexual health course at the institution where the study was conducted, as well as allow for culture sensitive education.

Leveraging community partnerships: Conversion of a sexual health curriculum as a virtual teaching tool for middle schoolers

The disruption of in-person delivery of a sexual health education curriculum to students in 19 urban middle schools in the Midwestern United States was one of many complications in education due the COVID-19 pandemic. Given time constraints and need for program delivery, community partners collaborated to convert the curriculum for virtual delivery. A team of school health education experts, sexual health education professionals, educational psychologists, and an E-learning professional worked together in curriculum conversion, leveraging knowledge and expertise for production of a virtual sexual health education curriculum tool for educators to use for teaching middle school students learning in a virtual format and as an aid for future in-person delivery.

Community myths and misconceptions about sexual health in Tanzania: Stakeholders' views from a qualitative study in Dar es Salaam Tanzania.

Sexual and reproductive health problems are one of the top five risk factors for disability in the developing world. The rates of sexual health problems in most African countries are overwhelming, which is why HIV and other STIs are still such a challenge in sub-Saharan Africa. Talking about sex in most African countries is a taboo, leading to common myths and misconceptions that ultimately impact community sexual health. In this study, we conducted 11 key stakeholder individual interviews with community, religious, political, and health leaders (sexual health stakeholders) in Tanzania. Qualitative content analysis was used to analyze all the materials. Two main categories merged from the analysis. The first category, "Ambiguities about sexual health" focused on societal and political misconceptions and identified ten myths or misconceptions common in Tanzania. Stakeholders highlighted the confusion that happens when different information about sexual health is presented from two different sources (e.g., community leaders/peers and political leaders), which leaves the community and community leaders unsure which one is reliable. The second category, "Practical dilemmas in serving clients", addressed a range of professional and religious dilemmas in addressing sexual health concerns. This included the inability of religious leaders and health care providers to provide appropriate sexual health care because of internal or external influences. Myths and misconceptions surrounding sexual health can prevent communities from adequately addressing sexual health concerns, and make it more difficult for healthcare providers to comfortably provide sexual health care to patients and communities. Stakeholders affirmed a need to develop a sexual health curriculum for medical, nursing and midwifery students because of the lack of education in this area. Such a curriculum needs to address nine common myths which were identified through the interviews.

Developing a Culturally Responsive Sexual and Reproductive Health Curriculum for HIV Prevention among African Immigrant Women

Background: Incidence rates of HIV are higher among African-born immigrants than in the general US population. In Minnesota, African-born immigrant women accounted for 40% of all adult females (as assigned by birth) living with HIV and 39% of new diagnosis in 2021, while constituting only 2% of the female population. Findings from a preliminary study point to gender-specific, sociocultural factors as drivers of HIV in this population. Key among these is the lack of sexual and reproductive health knowledge, consequent to cultural norms that regard sex-related discussions as taboo, making African women particularly vulnerable to HIV infection. Conventional HIV prevention programming has not been effective as these approaches lack cultural congruence. In the absence of culturally responsive strategies, AB women are likely to remain at significant risk of HIV. Program Description: This report is a description of the process and key elements employed in developing a curriculum for culturally-responsive, community-based sexual and reproductive health education for HIV prevention among African-born women. The Curriculum Design Team (CDT) of five (5) AB immigrant women adapted and augmented the Becoming A Responsible Teenager (BART) curriculum and developed a culturally congruent theoretical framework to guide programming. Feedback on the curriculum and programming was sought from community members through focus groups with African-born men and women, respectively. Recommendations: Feedback from community-engaged efforts included alignment with cultural norms and values regarding the roles and influence of women; ensuring cultural appropriateness of content and delivery; racial-concordance of facilitators and participants; and use of informal social group setting as critical elements to facilitate engagement of African-born women in the proposed approach to HIV prevention in this population.

An Advanced, Risk-Driven Sexual Health Curriculum for First-Year Internal Medicine Residents.

Despite recommendations for annual chlamydia screening for young, sexually active females, chlamydia rates continue to increase nationally. Medical school students often receive limited training in obtaining comprehensive, risk-based sexual histories, leading to less screening for sexually transmitted illnesses (STIs). Consequently, many internal medicine (IM) residents feel unprepared for advanced sexual history taking and site-specific STI testing based on sexual practices. We developed a case-based interactive didactic session for IM and med/peds residents. We focused on more advanced topics, such as comprehensive sexual history taking, secondary site testing for STIs, and patient counseling. Based on pre- and postcurriculum surveys, interns reported increases in comfort (scale: 1 = very low comfort, 5 = very high comfort) with counseling after positive STI results (Ms: pre = 2.9, post = 3.5, p < .01) and providing education on safe sex practices (Ms: pre = 3.0, post = 3.6, p < .01) and modest improvement in comfort with expedited partner therapy (EPT; Ms: pre = 2.1, post = 2.5, p = .06). An increase in self-reported confidence with collecting site-specific testing (composite Ms: pre = 2.7, post = 3.5, p < .01) was also seen. Percentage correct on knowledge questions increased from 48% to 78% postcurriculum (p = .01). This curriculum demonstrated improvement in knowledge and comfort with sexual history taking, STI screening, and counseling. Comfort also improved with EPT counseling, but not significantly, which could be addressed in future iterations of the curriculum.

Integration of an Inclusive Health Care Curriculum for Sexual Health and Gender Minorities

Context Research suggests that athletic training students lack knowledge and experience providing care to transgender patients. Additionally, research has identified a lack of comfort with sexual health screening in peer health professions. Objective To assess how a curriculum, including a standardized patient (SP) encounter, influenced attitudes and skills in working with sexual health and gender minorities. Design Prospective observational study. Setting Simulation lab. Patients or Other Participants Twenty cisgender postbaccalaureate professional athletic training students (females = 16, males = 4; age = 23 ± 2 years). Intervention(s) The intervention included a focused curriculum on transgender health care and sexual health. In a culminating SP encounter, one group (n = 10) interacted with a cisgender woman and the second group (n = 10) with a transgender woman. Main Outcome Measure(s) The students completed a postintervention survey. Instruments included the Attitudes Towards Transgender Patients tool, which is divided into 3 subscales: clinician education, transgender sport participation, and clinician comfort; and the the Sexual Health Knowledge and Attitudes and Sexual History–Taking instruments, which evaluated the effectiveness of the sexual health curriculum on knowledge, attitudes, and comfort. The investigator and SP actor evaluated the SP encounters. Data were analyzed using descriptive statistics, nonparametric Mann-Whitney U, and 1-way analyses of variance. Results We identified a significant difference between those completing a transgender SP encounter (mean = 5.30 ± 2.11) and those completing the cisgender SP encounter (mean = 3.50 ± 0.97) on the clinician education subscale (P = .035). There were no differences between groups on the transgender sport participation (P = .70) and clinician comfort (P = .32) subscales. On the SP actor evaluation, we found no significant differences (P = .08). Conclusions The curriculum and SP encounter influenced knowledge, attitudes, and comfort when working with gender minorities and screening for sexual health.

Sexual Health Education- Using Animated Videos to Teach Teenagers and Young Adults

ABSTRACT Introduction Sexual and reproductive health is an important determinant of overall wellness. Sexual health goes beyond preventing STI or unwanted pregnancy; rather, it improves the quality of life, promotes healthy relationships, and enhances positive body image. However, sexual education has been considered a taboo in most homes and cultures. Even among more liberal societies, it remains an uncomfortable discussion for most. Current formal sexual health curriculum are often inadequate and limited to topics such as STI prevention and contraception. Recently, the rise of social media and technology has increased accessibility to sexual education content. Adolescents are increasingly aware of the importance of normalizing discussions on sexual preparation. However, even with the increased awareness, there remains a challenge to provide quality and effective sexual health education. Parents and teachers may not feel adequately prepared to discuss the breadth of sexual health with teenagers and young adults. Using animated videos for education appear to be a powerful tool to increase knowledge and promote healthy discussions on this topic. Objective The purpose of this review was to 1)investigate the current utilization of animated videos to teach sexual health topic, 2)analyze the effectiveness of using animated videos to teach this topic 3) Identify some current challenges to effective utilization and 4) propose some future trends and best practices for using these videos. Methods Online databases including PubMed and google scholar were accessed, with search keywords “sexual health,” “animated videos,” “challenges” “web based teaching” Results Animated videos can be helpful tools to supplement and enhance the traditional method of sexual health education. A few online platforms use animated videos to provide a comprehensive sexual health education. However, limited research is available on the effectiveness of incorporating this innovative, multimodal learning tool into sexual education curriculum. Using animated videos has been shown to improve adolescent knowledge by stimulating thoughts, feelings, concerns, and willingness to learn. Employing effective learning tools to communicate essential sexual health topics may reduce adolescent vulnerabality to sexual abuse, coercion, sexually transmitted infections and improve health and wellness. In addition, with increasing global accessibility to technology these videos can impact a large number of teenagers. Conclusions Increased access to technology and digital media allows the health care team to incorporate creative methods in the provision of comprehensive sexual health education. Animated videos can be an effective method for teaching this topic by providing a fun and informative method of delivering vital information without the added discomfort that may be associated with traditional methods. This empowers teenagers and young adults to take control of their sexual health, become responsible and well informed adults and promote overall health and wellness. Disclosure No

Developing Sexual Self-Efficacy Beliefs During Adolescence: Do Health Teachers Really Matter?

Teacher attitudes and instructional strategies impact success of human sexuality programs. Limited prior research has examined the relations of teachers' attitudes and instruction to the development of adolescents' sexual self-efficacy beliefs. This study examined how adolescents' perceptions of their health teachers (i.e., teacher value of content, teacher affinity, teacher caring for students) predict changes in efficacy beliefs related to HIV/STD and pregnancy prevention, and if perceptions of mastery goal structure predicted adaptive efficacy beliefs. Data were collected in 4 Midwestern/Appalachian high schools in health class where the delivery of a 14-lesson sexual health curriculum occurred. Participants included 561 students (50.4% 9th graders, 43.5% female, 56.3% White, 53.7% did not have a current romantic partner, and 59.7% had previously not engaged in sexual activity). The findings indicate students' perceptions of teachers valuing the content predicted perceptions of mastery goal structure for all sexual self-efficacy beliefs: learning efficacy, condom negotiation efficacy, refusal self-efficacy, and situational self-efficacy. Students who perceive a mastery goal structure in health class, and who feel their teachers value learning about HIV/STD and pregnancy prevention, are likely to experience positive adaptive self-efficacy beliefs related to sexual health, ultimately leading to behaviors indicative of decreased STDs among teenagers and safe sexual practices, such as abstinence, the use of a condom, and saying "no" to having sex.

Tailoring a sexual health curriculum to the sexual health challenges seen by midwifery, nursing and medical providers and students in Tanzania.

BackgroundTanzania is a country experiencing multiple sexual health challenges, but providers receive no formal training in sexual health.AimThis study aimed to assess (1) what sexual health challenges are commonly seen in clinics in Tanzania, (2) which are raised by patients, (3) which are not addressed and (4) which topics to prioritise for a sexual health curriculum.SettingHealthcare settings in Tanzania.MethodsParticipants were 60 experienced and 61 student doctors, nurses and midwives working in Dar es Salaam. The authors conducted 18 focus groups stratified by profession (midwifery, nursing or medicine) and experience (practitioners vs. students).ResultsProviders identified six common sexual health concerns: (1) Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) and sexually transmissible infection (STI) (especially syphilis and gonorrhoea), (2) sexual violence (including intimate partner violence and female genital mutilation), (3) early and unwanted pregnancy (including early sexual debut and complications from abortion), (4) sexual dysfunctions, (5) key population concerns (e.g. lesbian, gay, bisexual, transgender (LGBT); sex work) and (6) non-procreative sexual behaviour (including pornography and masturbation in males and oral and anal sex practices in heterosexual couples). Across professions, few differences were observed. Homosexuality, sex work, masturbation and pornography were identified as taboo topics rarely discussed. Most participants (81%) wanted one comprehensive sexual health curriculum delivered across disciplines.ConclusionA sexual health curriculum for health students in Tanzania needs to address the most common sexual health concerns of patients. In addition to teaching sexual science and clinical care, skills training in how to address taboo topics is recommended. Students endorsed almost all sexual health topics, which suggests that a comprehensive curriculum is appropriate.

A Pilot Sexual and Gender Minority Health Curriculum for the Largest Public Health Care System in the United States.

Sexual and gender minority (SGM) people face multiple health disparities. Clinicians often lack adequate training to address health needs of SGM people. In this setting, some health care organizations have sought to develop system-wide curricula to build clinician knowledge and capacity around SGM health. NYC Health + Hospitals partnered with the National LGBTQIA+ [lesbian, gay, bisexual, transgender, queer, intersex, asexual] Health Education Center at The Fenway Institute to design and implement a novel SGM health care curriculum, offered from 2017 to 2020. The pilot program featured a 90-minute live introductory session, a pretest, a post-test, and six 45-minute online modules focusing on a range of topics in SGM health care. Of approximately 35,000 employees from a range of settings and professional roles across NYC Health + Hospitals, 792 participated in the pilot program; most were clinicians at acute care hospitals, with the single largest group being attending clinicians. The proportion of eligible employees completing each component of the curriculum varied: 544 of 792 (68.7%) completed the online pretest, while 373 of 792 (47.1%) completed the module on behavioral health. Of 373 participants who completed both the pre- and post-tests, mean scores rose significantly from 60.9 on the pretest to 81.9 on the post-test ( P &lt; .001). Future efforts should focus on increasing staff participation in the curriculum through scale-up efforts across the health care system, as well as measuring patient outcomes to assess the clinical impact of the initiative.

Exploring the Interpretation of Medical Students of the Brief Sexual Attitudes Scale

Effectively addressing the sexual health concerns of patients is critical to supporting and improving overall health for individuals and communities. This study aimed to collect validity evidence for use of the Brief Sexual Attitudes Scale (BSAS) in a sexual health curriculum among undergraduate medical students. A qualitative thematic analysis was conducted with three focus groups of medical students. Early findings indicate the need to modify the current version of the instrument to make it more useful to learners. A modified BSAS survey could help students understand their own perspectives about sexuality and how their perspectives influence their ability to provide non-judgmental patient care.

Sexual Health Teaching in the Family Medicine Clerkship: Results of a CERA Survey.

With growing efforts to provide comprehensive and inclusive sexual health care, family medicine clerkships are well positioned to educate learners about a spectrum of related topics. This study investigated the current state of sexual health instruction in family medicine clerkships, including specific factors impacting its delivery. Questions about sexual health curricula were created and included as part of the 2020 Council of Academic Family Medicine's Educational Research Alliance survey of family medicine clerkship directors. The survey was distributed via email to 163 recipients between June 1, 2020 and June 25, 2020. One hundred five (64.42%) of 163 clerkship directors responded to the survey. Our results revealed that during family medicine clerkships, family planning, contraception, and pregnancy options counseling are covered significantly more often than topics related to sexual dysfunction and satisfaction and LGBTQ+ health. Most clerkship directors (91.5%) reported less than 5 hours of sexual health training in their curriculum. Those with more dedicated sexual health curricular hours were more likely to include simulation. Lack of time (41.7%) was the most frequently reported barrier to incorporating sexual health content into the clerkship. Coverage of sexual health topics during the family medicine clerkship is limited in scope and delivery. To support curricular development and integration, future studies should more thoroughly examine the factors influencing the inclusion of sexual health content in family medicine clerkships as well as the development of assessment methods to determine competency.

Effectiveness of Native STAND: A Five-Year Study of a Culturally Relevant Sexual Health Intervention

Culturally relevant interventions have the potential to improve adolescent health and protective factors associated with sexual risk taking. We evaluated the impact of the Native STAND curriculum with American Indian and Alaska Native (AI/AN or Native) high school students living across the U.S. using a pre-post evaluation design. Native STAND is a comprehensive sexual health curriculum for Native high school students that focuses on sexually transmitted infections, HIV/AIDS, and teen pregnancy prevention, while also covering drug and alcohol use, suicide, and dating violence. The curriculum was implemented in 48 AI/AN communities from 2014 to 2019. A significantly higher percentage of youth reported at post-test having a serious conversation about sex with their friends (post 36% vs. pre 28%, p &lt; 0.001), thinking about lessons learned (post 24% vs. pre 7%, p &lt; 0.0001), and sharing lessons learned during the conversation (post 21% vs. pre 4%, p &lt; 0.001). A lower percentage of AI/AN youth reported being bullied in the last year (post 31% vs. pre 37%, p &lt; 0.001). Family social support was moderated by dose, with subscale scores of 3.75 at post-with &lt;27 sessions vs. 3.96 at post-with all 27 sessions (p = 0.02). The results demonstrate the effectiveness of Native STAND when delivered in a variety of settings. Efforts are now underway to update Native STAND for medical accuracy, improve alignment with typical class periods, and promote its use and an effective EBI for AI/AN youth.

Perceptions of Sexual Healthcare Provision in Tanzania: a Key Informant Qualitative Study

IntroductionSexual health care services must be standard and unbiased, guided by a structured health care system. There is a scarcity of data on how sexual health care is delivered in Tanzania.MethodsTo address this gap, in July 2019 we interviewed eleven key informants: cultural and public health experts, and political, religious, and community leaders, selected from different organizations in Dar es Salaam, Tanzania. Participants were asked for their opinions about clinical practices of health care professionals when providing care to patients, with an emphasis on sexual health.ResultsParticipants’ responses were classified into three subcategories: strengths, barriers, and gaps in sexual health care. Availability of services, service delivery to adults, and code of conduct were among the strengths observed in clinical care services. Barriers included the health care provider’s attitudes, moral values, and inadequacy in health policies and treatment guidelines. Vulnerable populations including youth were frequently reported to face most challenges when seeking sexual health care services. In terms of gaps, informants emphasized gender equity in sexual health services provision within care settings.Conclusion and ImplicationData indicate that lack of training in sexual health and guidelines for dealing with sexual issues are a barrier to comprehensive health care. These findings can inform the main areas for curriculum developers to focus on, when developing an Afro-centric sexual health curriculum suitable for students in health care professional courses. Moreover, these findings can be useful when developing treatment guidelines and policies that are beneficial to the sexual health wellbeing of individuals.

Sexual Health Education in Obstetrics and Gynecology (Ob-Gyn) Residencies—A Resident Physician Survey

Many women will experience a sexual health concern and present to their Obstetrics and Gynecology (Ob-Gyn) care provider, yet a large portion of graduating Ob-Gyn resident physicians in the United States may not feel comfortable helping patients with some sexual health issues. To perform a cross-sectional study of U.S. Ob-Gyn resident physicians that assesses sexual health education didactic sessions and comfort level with sexual health clinical vignettes. A 32-item anonymous survey was sent to all 4,065 Ob-Gyn residents on June 7, 2016. Respondents voluntarily completed the survey electronically. The primary outcome measures are the comfort level of Ob-Gyn resident physicians in taking a sexual history and providing counseling to patients represented in clinical vignettes, which were based on sexual health learning objectives from the Council on Resident Education in Obstetrics and Gynecology (CREOG). Of the 4,065 eligible U.S. examinees, 968 (23.8%) agreed to participate in the study, and 802 (19.7%) completed the survey and were included in the final analysis. Nearly two-thirds of the residents indicated that sexual health training was a priority in residency. However, more than half were not able to describe the disorders of sexual function or list common medications that effect sexual function. When posed with clinical vignettes, residents felt very comfortable obtaining a sexual history (98.5%) and providing counseling (97.0%) for a 16-year-old seeking contraception, yet fewer felt very comfortable obtaining a history and providing counseling for a 26-year-old who is a refugee from Somalia (77.2% and 73.8%). Smaller cohorts felt prepared to take a sexual history and provide counseling for a 17-year-old who discloses that she is a victim of sex trafficking (61.2% and 57.7%), and for a 58-year-old transgender patient planning hormone therapy and surgery (49.9% and 37.9%). In logistic regression analysis, the factors that were influential in an Ob-Gyn resident physician's program to prepare them to describe the disorders of sexual function were post-graduate year (OR 1.387, 95% CI 1.189, 1.618; P = .0001), those that rated the importance of a sexual health curriculum highly (OR 0.701, 95% CI 0.569, 0.864; P = .0012), and a greater number of didactic sessions on sexual health in the residency curriculum (OR 0.685, 95% CI 0.626, 0.750; P < .0001). These findings highlight strengths in the comfort of Ob-Gyn resident physicians about sexual health and illustrate areas of opportunity to engage resident learners by improving the sexual health curriculum.

Diversity in Reproductive Health and Human Sexuality: Assessing Attitudes Comfort and Knowledge in Learners Before and After Pilot Curriculum.

A majority of medical students believe that treating sexual concerns is important for their careers. However, a minority feel that they have received adequate instruction in medical school. This novel supplemental reproductive and sexual health curriculum at a large academic medical center aimed to address this gap and to improve attitudes, comfort, and knowledge about sexual and reproductive health topics among learners. Students participated in a series of sexual and reproductive health workshops taught by interdisciplinary health care workers, with the first cohort in a classroom setting and the second cohort using a virtual format due to the COVID-19 pandemic. We administered a novel pre- and postcourse survey to assess attitudes, comfort, and knowledge about the topics. We performed unpaired 1-tailed t tests and χ2 tests to compare the scores on the pre- and postcourse surveys. Sample size was 12 students for the first cohort and 23 students for the second cohort. Reported levels of comfort with taking sexual histories in different age groups and discussing reproductive and sexual health topics increased significantly: 0.92 for the classroom setting, and 0.50 for the virtual setting, with an average increase of 0.65 points on a 4-point Likert scale. There were no significant changes in student attitudes toward or knowledge of reproductive and sexual health. This course elaborated on topics to which medical students traditionally lack adequate exposure, with significant improvement in comfort counseling patients. A disparity between the classroom and virtual setting suggests limitations of online learning for these topics.

Effects of a randomized controlled trial of a brief, student-nurse led, parent-based sexual health intervention on parental protective factors and HPV vaccination uptake

BackgroundParents play a pivotal role in adolescent sexual health and Human Papillomavirus (HPV) vaccination. Nurses are on the frontlines of healthcare and play a critical role in promoting HPV vaccination and parent-child sexual health communication. We enhanced the Families Talking Together (FTT) parent-based sexual health curriculum to include adolescent vaccinations herein, FTT + HPV, and trained student nurses to provide a strong HPV vaccination and parent-child sexual health communication endorsement.MethodsUsing a randomized attention-controlled trial design, we examined the efficacy of FTT + HPV among 519 parents and their 11–14 year old youth recruited from medically underserved communities between 2015 and 2018. Participants were recruited from 22 after-school programs (e.g., Boys and Girls Clubs) and 19 charter schools. For parents, we examined protective factors including parent-child sexual health communication and parental involvement. For youth, we examined sexual health knowledge, parent-child sexual health communication, and parent-child connectedness. To assess HPV vaccination initiation and completion, we searched IMMTRAC immunization registry records for 85% of youth and used parental report for youth without registry records. Group differences were calculated using the estimated mean difference at one- and six months post-intervention with significance set at the p < 0.05 level.ResultsBaseline rates of HPV vaccination were low at 55.7%. No significant difference between the groups was seen in vaccination initiation or completion rates by one-month post-intervention. However, by six-months post intervention, there was a significant difference between the groups with 70.3% of the intervention group initiating the HPV vaccination series vs. 60.6% for the control group (p = 0.02). No difference between the groups was found for HPV series completion at six-months. There were significant differences in condom knowledge (p = 0.04), parent-child connectedness (p = 0.04), and communication frequency (p = 0.001) with greater improvement in the intervention vs. the control group. Rates of sexual activity remained low in both groups throughout the six-month follow-up period.ConclusionA brief parent-based adolescent sexual health and HPV vaccination intervention delivered by student nurses can improve sexual health outcomes including protective parental factors, adolescent sexual health knowledge, and HPV vaccination initiation rates.Trial registrationClinicalTrials.gov Identifier: NCT02600884. Prospectively registered September 1, 2015.