Sexual Health Promotion Research Articles

Sexual health education knowledge required by health education teachers in Finland

ABSTRACT Health education teachers have a crucial role to play in delivering sexual health education in schools, with their own knowledge being key to providing comprehensive sexual health education to adolescents. The purpose of this study was to describe the sexual health education knowledge required by health education teachers in Finland. Qualitative methods were used to explore the perspectives of Finnish health education teachers using semi-structured interviews and e-forms. Data collection from 15 health education teachers took place in March and April 2023. The data were analysed using inductive content analysis. Findings highlight the importance of health education teachers having sound knowledge about: 1) the diversity of adolescent sexual health, 2) the functions of the adolescent body, 3) factors threatening adolescent sexual health, 4) factors promoting adolescent sexual health, and 5) relevant relevant forms of pedagogy. The findings from this study offer a unique perspective on the wide-ranging knowledge required by health education teachers regarding sexual health education in Finland. It is imperative that present and future health education teachers are well-trained and qualified. Both pre- and in-service training should be comprehensive and accessible to enable the delivery of high-quality sexual health education to adolescents and, consequently, the promotion of sexual health.

Promoting sexual health in schools: a systematic review of the European studies

Abstract Background Sexual ill-health causes a high health burden. There is, therefore, a need for more effective sexual health promotion interventions. Previous research has focused on preventive sexual health interventions and the limited evidence concerning school-based sexual health promotion interventions has not been synthesized. Hence, this study aimed to systematically review the current evidence on the effects of sexual health promotion interventions conducted in European schools. Methods A systematic review based on the JBI and PRISMA standards was performed, encompassing searches in seven databases to identify sexual health promotion interventions conducted in European schools between 2012 and 2022. Data coding was performed according to a predetermined protocol and a narrative synthesis of the included studies was performed, highlighting the collective results. Results The review included 17 records, reporting 16 individual studies conducted in 7 European countries. Of the 16 included studies, 13 had a quantitative research design, and three had a qualitative design. All qualitative studies described positive effects as experienced by the participants, and ten of the quantitative studies showed statistically significant positive effects on at least one of the outcomes of interest. Conclusions The findings indicate good evidence for the effectiveness of interventions with a health promotion approach, underscoring the importance of sexual health resources such as respect, communication skills, and attitudes. Most sexual health promotion intervention studies have focused on sexual health resource outcomes connected to attitudes and skills, whereas, e.g., sexual health literacy is less studied and can be recommended to be included in future research. Key messages • The synthesized evidence sheds light on the lack of evaluated interventions employing holistic and positive, resource-focused sexual health promotion interventions targeting European adolescents. • The included school-based sexual health promotion studies, although limited in number, show evidence of promising effects on sexual health outcomes among participants.

Sexual health communication targeting adolescents in public service Media: the case of Finland

Abstract Background Given the substantial time adolescents spend online, sexual health promotion and education through online media constitute a promising public health action. However, monitoring of sexual health-related online media content is warranted, and considering the scope and aims of public service media, this forum can be regarded as being of particular interest. This study aimed to analyze how and to what extent sexuality and sexual health-related content targeting adolescents is communicated and portrayed in public service media in Finland, with a particular interest in health promotion perspectives and participatory practices. Methods Based on predetermined inclusion criteria and guidance from professionals at the Finnish public service company Yle, podcasts were specified as the media format of interest. Three Finnish podcasts (a total of 66 episodes) produced during the years 2021-2023, targeting young people and focusing on sexual health, were included in this study and subject to critical content analysis. Results Most podcast episodes focused equally on the sexual health resource and risk perspectives, while a third emphasized a resource perspective. Concerning participatory practices, adolescents participate in only five episodes in total, and most often, the podcast hosts’ own experiences are at the center of the episodes. Conclusions The findings highlight how sexuality and sexual health content is communicated in public service media podcasts targeting adolescents in Finland, as well as how the communication aligns with health education and promotion guidelines. The study sheds light on participatory practices, emphasizing a lack of stakeholder involvement, i.e., dialogue between podcast hosts and listeners. Results carry implications for developing sexual health promotion through public service media targeting young people in Finland and other European countries alike. Key messages • The findings highlight how sexuality and sexual health content is portrayed in public service media podcasts in Finland and how the communication aligns with health promotion values and principles. • The findings show a lack of participatory practices in Finnish public service media podcasts targeting adolescent sexual health - a health promotion concern also pertinent to other countries.

The use of digital technologies to promote sexual health in young adults: a narrative review

Abstract Background New technologies have the potential to play an important role in promoting sexual health, especially among young people, who are the biggest users and those at greatest risk of contracting Sexually Transmitted Infections (STI). The risk behavior assumed by young people today highlights this vulnerability in several contexts, such as individual, social, economic, and family. In this sense, it becomes relevant to approach sex education in schools using digital technologies. Objectives To identify the evidence in the literature on the use of digital technologies to promote the sexual health of young adults. Methods Narrative literature review. Three independent reviewers extracted, analyzed and synthesized the articles and results. Results Through the selection process, four studies were included. The articles show that the use of digital technologies (mobile phones/applications) leads to increased knowledge, improved attitudes and sexual behavior among young adults. The interventions studied in the studies were based on Short Message Service, electronic mail interventions and the MyPEEPS mobile application, with the following main focuses: Increased knowledge, attitudes, and behaviors of young adults. Considering the results of the studies, all interventions proved to be effective as facilitators of sexual health promotion. Conclusions The use of digital technologies allowed an increase in the promotion of the sexual health of the participants, since there was an increase in the level of knowledge with the use of digital technologies such as SMS, emails and mobile applications when comparing the experimental and control groups. The use of these digital technologies also allowed for a change in attitudes and behaviors, such as a significant increase in serological testing for STIs and an increase in health care seeking. Key messages • The use of digital technology promotes the sexual health of young adults, so these strategies should be implemented by health professionals. • The dissemination of these digital strategies will have an impact on Public Health, specifically regarding the sexual health of young adults.

Development of Digital Health Gender and Sexual Health Literacy scale

Abstract Introduction Health literacy, as the ability to obtain, process and understand health information, including gender and sexuality awareness, appears to be underdeveloped in terms of measurement tools and thematic materials. The literature indicates the existence of serious deficits in gender and sexual health literacy at all levels, with implications for relationships with citizens and patients. Methods Delphi study agreement was conducted and a pool of potential scale items was generated, reflecting a range of skills and abilities within each domain. Items were carefully worded to ensure clarity, cultural sensitivity and relevance to different gender identities and sexual orientations. Expert review and cognitive pre-testing were employed to refine item wording, assess content validity, and ensure that the 10-item scale was comprehensible and relevant to the target population. Results The theoretical development of the 10-item Digital Health Gender and Sexual Health Literacy Scale was successfully completed. The scale items were designed to provide a comprehensive measure of an individual’s ability to navigate the digital landscape for gender and sexual health information. Conclusions The theoretical validation of the Digital Health Gender and Sexual Health Literacy Scale (DiGeSHeL) provides the community with a promising tool to assess individuals’ confidence and ability to use digital technologies for sexual health information and resources. However, further research is needed to validate the scale and test its reliability with a diverse group of participants. Once validated, this scale could be a valuable tool for sexual health promotion programmes to identify gaps and evaluate the impact of digital literacy interventions. Key messages • Gender and sexual literacy are crucial for health. • Health literacy as six vital sign.

Effectiveness of Cartoons, Comics, and Animation-Based Sexual Health Promotion and Education Interventions: A Scoping Review

Objective Sexual health education is crucial for promoting healthy sexual behaviors among people of all ages. Interventions involving cartoons, comics, and animations have emerged as effective tools due to their engaging and accessible nature. This scoping review explores the effectiveness of these interventions across different time frames and age groups. Methods Using the PICOS framework and PRISMA guidelines for scoping reviews, a review was conducted across 14 databases to include relevant studies published between 2000 and 31 May 2024. Results Analyzing 51 intervention studies meeting the inclusion/exclusion criteria revealed varied outcomes in interventions that highlight a significant shift in focus from developing educational tools and empowering youth in the earlier period (2000–2010) to implementing advanced technology-based cartoons, comics, and animations interventions and addressing diverse populations in the later period (2011–2024). The results of these studies were predominantly positive, with many reporting significant improvements in knowledge, behaviors, and engagement. Conclusion While many studies report positive outcomes, further investigation is needed into the long-term impact of digital-based cartoons, comics, and animation interventions on behavior change and health outcomes. Research should also explore the effectiveness of these tools in different cultural and socioeconomic contexts to ensure their broad applicability. Ongoing research and iterative development are warranted to ensure that these interventions continue to evolve and meet the changing needs of users in an increasingly digital world across diverse populations

Skills and competences of sexuality educators. Evidences from a qualitative research in Italy

Abstract Background The scientific literature recognizes the strategic role of educators in sexuality education projects in schools. If, however, there is often a discussion about the most effective professional figure (teachers, school experts or external experts), there is a little attention to the skills and competences that an educator should possess and to which he or she must be trained. Adopting a Comprehensive Sexuality Education (CSE) approach, which is evaluated as the most effective, it is necessary to consider a skill set for educators that should not be limited to the knowledge in the area of sexual health promotion and risk prevention. Methods In order to build evidence-based competencies and skills, a qualitative study was conducted. A total of 72 educators involved in school-based CSE interventions in 4 Italian Regions, in 24 middle and secondary schools (68 classes), during 2 consecutive school years were enrolled. Before, during, and after the activities in the classrooms, qualitative feedback was collected, through reflective journals written by educators themselves. These data were analyzed through a qualitative approach, according to the principles of empirical phenomenology. Results The phenomenological evidences confirm the need to overcome the conception of educator as instructor equipped only with knowledge in the field of sexual health. It is considered fundamental to possess and develop pedagogical competences and skills, such as: caring attitude, teaching skills, theoretical awareness, capacity to manage the unexpected. Moreover, educators reported the necessity of an initial and continuous training on these dimensions considered as the most challenging. Conclusions The research confirms the complexity of the competency profile of CSE educators. Therefore, their professional development should include tailored designed multi-disciplinary training programs, with particular attention to the pedagogical dimension. Key messages • Comprehensive sexuality education requires an adequate professional figure intended not as an instructor aimed only at risk prevention and health promotion, but as a real caring educator. • Pedagogical skills and competences should be included in the training processes for sex educator, through adequate activities.

Sexual and reproductive health: level of knowledge and source of information in adolescence.

To date, there is a lack of a structured national plan of sexual education in Italy, with large interregional differences and poor uniformity in the promotion and learning of sexual health. The aim of this study was to evaluate the level of knowledge on sexuality and reproductive function among adolescents before and after a sexual education program, considering gender differences in the results. A longitudinal and interventional study was conducted on high school students. Six sessions for each class were carried out by a multidisciplinary team. Anonymous questionnaires were administered to investigate basic knowledge of human sexuality and reproduction before and after intervention. Participants were high school students who completed the questionnaires. Outcomes included pre and posttest answers on the knowledge questionnaire in study population. We obtained data from 842 high school students (mean ± SD age, 16.11 ± 1.74years). The main informative sources on sexuality were social media in 37.9% of participants; family, school, and scientific material were the main source in 15.1%, 5.2%, and 4.4%, respectively. A total score of 12.6 ± 3.4 (range, 1-20) was obtained on the knowledge questionnaire; specifically, the score was higher in females than males (12.8 ± 3.4 vs 11.9 ± 3.4, P = .0001). In males and females, a statistically significant increase in level of knowledge was found after the multidisciplinary intervention (14.5 ± 3.6, P = .0001). The lack of sexual education programs in schools in Italy compels adolescents to refer to frequently unreliable sources, such as social media and peers, contributing to misinformation and adoption of risky sexual behaviors. This study is based on a large sample size and highlights the importance of sexual education programs. The main limitations are a greater representation of the female population and the inclusive nature of the school (ie, an artistic school), attracting students who identify with sexual minorities. Adolescents have limited knowledge about sexuality and reproduction, with a notable gender disparity; sexual education programs in schools, providing information from sexuality experts, led to a substantial increase in knowledge and a reduction in the gender gap.

The diverse but common definitions of sex for young people in Australia

ABSTRACT Relationships and sexuality education is a key strategy for promoting safe sex and respectful relationships during adolescence. Understanding the ways in which young people define sex is critical to ensuring a shared understanding between sexual health educators and students. Young people aged 14–18 years (N = 6,043) who participated in a large-scale cross-sectional Australian study were asked to indicate whether various sexual practices (e.g. vaginal, anal or oral sex, genital rubbing, mutual masturbation) were included in their definition of ‘sex’. Associations between demographic characteristics, sexual experiences, and definitions of sex were identified using multiple logistic regression. Content analysis further examined open-text responses from 63 participants who expanded on their definitions. Almost all participants (99.1%) included vaginal sex in their definition of sex, 83.7% included anal sex and 59.7% included oral sex. Young people also included a diverse range of sexual practices that did not consistently align with common definitions used in sexuality education and sexual health promotion campaigns. Definitions of sex differed by gender and sexuality suggesting that when discussing sex with young people, educators and health professionals need to consider sexuality and gender diversity and take care to check common understanding of terminology.

Group sex and behavior change associated with the 2022 Mpox outbreak among men who have sex with men in Southern California.

The Monkeypox (Mpox) outbreak disproportionately affected sexually active gay, bisexual, and other men who have sex with men. To understand community-level changes in sexual behavior, we surveyed individuals in a semi-urban area in Southern California. Participants were recruited between October 2022 to April 2023, using palm cards, and geolocation-focused online advertisements on social media and dating apps. Eligible participants were male, ≥18 years, reported sex with men, residents of San Bernardino or Riverside counties, California, Human Immunodeficiency Virus (HIV)-negative, currently not taking pre-exposure prophylaxis (PrEP). Descriptive analyses were performed. Chi-square, Fisher's exact, and Student's T-tests examined the association between group sex behaviors and demographics. We enrolled 91 gay, bisexual, and other men who have sex with men with a median age of 35 years (range 18-70 years). Nearly half reported having participated in group sex in the past year. Overall, 48.9% of group sex participants reported changing their sexual behaviors to prevent Mpox transmission, with limiting the number of sex partners being the most reported prevention strategy (47.6%). To prevent Mpox infection, participants that engage in group sex reported limiting the number of sex partners (34.4%), using condoms for anal sex (16.7%), avoiding crowded social venues (14.3%), and asking partners about Mpox symptoms before sex (9.5%). Survey participants reported modest sexual behavior changes in response to the Mpox outbreak. Group sex may increase the risk for Mpox, HIV, and other sexually transmitted infections; therefore, public health messages should include specific discussion of safer group sex practices in sexual health promotion.

From Traditional-Aged Students to Teenage Fathers: A Qualitative Study of Social Challenges and Experiences of East Asian Second-Generation Teenage Fathers

This study aims to investigate East Asian second-generation teenage fathers’ stress and problems resulting from internal factors and external influences in the United States. The relationships between the changes in the teenage fathers’ family structures, social expectations, and experiences of educational and financial challenges during the pregnancy (of their partner) and into the period of their early fatherhood were examined. Based on the Interpretative phenomenological method, ten participants who had experienced stress and problems due to their characteristics as teenage fathers, particularly second-generation East Asian Americans, participated in this study. Three semi-structured interviews, one focus group activity, and one member-checking interview were used to collect in-depth lived stories. Three themes emerged: (1) Cultural characteristics: Detrimental perspectives from family members and the public, (2) Age: The hindrance of youth as a characteristic of teenage fathers, and (3) Career development: The challenges of earning a minimum salary and having an unforeseen career. The findings indicated that counseling services based on patients’ sociocultural backgrounds and practices should be considered to offer effective treatments to ethnic minorities, in this case, East Asian Americans. The results of this study can provide a map for public health researchers to use in refining sex education and sexual health promotion, and the approach can offer a blueprint for capturing the voices of other teenage parents.

Sexual health promotion interventions in Iranian postmenopausal women: A systematic review of randomized controlled trials

Sexual health promotion interventions in Iranian postmenopausal women: A systematic review of randomized controlled trials

Development of comprehensive sexual education applications to improve adolescent reproductive health

Background: Adolescence is a period of emotional, mental, and physical change. To improve health-seeking behavior, reduce risky sexual behaviors, and increase knowledge about sexual and reproductive health, adolescents need support and access to services. The increasing availability of mobile apps requires a thorough evaluation of the quality and classification of these mobile apps so that accurate and evidence-based information can reach their users. Because smartphones are a private (intimate) technology, they are a promising means of closing this gap. However, research focusing on sexual health promotion programs delivered through smartphones is still rare.Purposes: Developing and testing a smartphone and internet-based comprehensive sex education app.Methods: This study employed Research and Development consisting of 4 stages, namely Literature Study, Development Stage, Validity Expert, and Trial.Result: The SEMAR app has seven features, ranging from mental health education to human relationships. The convenience score is 70%. The results of the trial show that this application effectively improves health education. 50-83% agree to use it. The sex stigma variable has the most extensive r (r=0.955), which means it has a solid and positive relationship.Conclusion: This application benefits adolescents in improving health education and adolescent reproductive health.

Early sources of urologic and venereologic sexual medicine from Vienna : Protagonists at the interface of two new medical specialties

The Austrian Society for the Promotion of Sexual Medicine and Sexual Health (Österreichische Gesellschaft zur Förderung der Sexualmedizin und der Sexuellen Gesundheit [ÖGFSSG]) was founded in 2014. This foundation looked back upon the increasing efforts to develop this field of academic knowledge since the middle of the 19thcentury, in which Viennese medicine played an important role. This article highlights key Viennese players who had aparticular interest in sexual medicine from aurological perspective around 1900. They worked in the wider area of several disciplines, striving for specialization in the environment of arapidly growing metropolis with multiple cultural influences. The scholars presented here as acollection of sources contributed to the upswing in sexual medicine through their work by venturing into an area in which no medical or other discipline had previously been able to claim sovereignty of interpretation.

A Brief Alcohol Intervention (BAI) to reduce alcohol use and improve PrEP outcomes among men who have sex with men in Vietnam: study protocol for a randomized controlled trial

BackgroundIn Vietnam and other global settings, men who have sex with men (MSM) have become the population at greatest risk of HIV infection. Although HIV pre-exposure prophylaxis (PrEP) has been implemented as a prevention strategy, PrEP outcomes may be affected by low persistence and adherence among MSM with unhealthy alcohol use. MSM have a high prevalence of unhealthy alcohol use in Vietnam, which may affect PrEP outcomes.MethodsDesign: We will conduct a two-arm hybrid type 1 effectiveness-implementation randomized controlled trial of a brief alcohol intervention (BAI) compared to the standard of care (SOC) at the Sexual Health Promotion (SHP) clinic Hanoi, Vietnam.Participants: Sexually active MSM (n=564) who are newly initiating PrEP or re-initiating PrEP and have unhealthy alcohol use will be recruited and randomized 1:1 to the SOC or BAI arm. A subgroup of participants (n=20) in each arm will be selected for longitudinal qualitative interviews; an additional subset (n=48) in the BAI arm will complete brief quantitative and qualitative interviews after completion of the BAI to assess the acceptability of the intervention. Additional implementation outcomes will be assessed through interviews with clinic staff and stakeholders (n=35).Intervention: Study participants in both arms will receive standard care for PrEP clients. In the BAI arm, each participant will receive two face-to-face intervention sessions and two brief booster phone sessions, based on cognitive behavioral therapy and delivered in motivational interviewing informed style, to address their unhealthy alcohol use.Outcomes: Effectiveness (PrEP and alcohol use) and cost-effectiveness outcomes will be compared between the two arms. Intervention implementation outcomes (acceptability, feasibility, adoption) will be assessed among MSM participants, clinic staff, and stakeholders.DiscussionThis proposed trial will assess an alcohol intervention for MSM with unhealthy alcohol use who initiate or re-initiate PrEP, while simultaneously preparing for subsequent implementation. The study will measure the effectiveness of the BAI for increasing PrEP persistence through reducing unhealthy alcohol use in a setting where excessive alcohol consumption is a normative behavior. If effective, implementation-focused results will inform future scale-up of the BAI in similar settings.Trial registrationNCT06094634 on clinicaltrials.gov. Registered 16 October 2023.

Managing the business of sex: swinger club managers and sexual health promotion

The increased popularity of swinger clubs across the UK in the past two decades has not been met with commensurate public health initiatives or interventions that engage with the relationship between swinger clubs and sexual health. Consequently, the responsibility for sexual health promotion within these establishments largely depends on the discretion of club managers. Drawing on data from semi-structured interviews with 10 managers from across the UK, the study suggests that the managers’ perceptions of the club-consumer relationship shape the nature of sexual health promotion. Three distinct approaches were evident in the research: those who perceive sexual health promotion as financially detrimental; those who see it as an individual rather than a collective club concern; and those who consider it as part of a broader social community responsibility. These findings highlighted an implicit beneficence of managers towards their customers; a shared assumption that an ideal consumer was heterosexual, partnered and in their forties; and differing perceptions of manager responsibility towards the sexual health of customers. The paper concludes by suggesting that the swinger community is a blind spot in sexual health discussion in the UK and that by talking to the managers of swinger clubs we can further develop our understanding of the area.

Inclusion Goals: What Sex Education for LGBTQIA+ Adolescents?

According to the World Health Organization and the World Association for Sexual Health (WAS) Declaration of Sexual Rights, sex education aims to provide children and adolescents with comprehensive knowledge, skills, attitudes, and values, promoting equality and nondiscrimination while upholding freedom of thought and expression. However, current school curricula often focus on dichotomous sexual identity and hetero-cis-normative prevention strategies, neglecting the needs of gender minority (GM) and sexual minority (SM) youths. In family settings, discussions typically revolve around sexual risk reduction and basic contraception, omitting relational aspects and components of sexual identity such as orientations and gender expressions. This discrepancy highlights a gap between the official goals of sex education and its practical implementation, reflecting a cultural deficit in familial sex education. This study reviews the scientific literature on sexual health promotion interventions from 2015 to 2024 to identify inclusive approaches that enhance the participation of all youths, not just hetero-cis-normative individuals. The hypothesis is that most interventions primarily serve heterosexual and cisgender youths, indicating a need for more inclusive strategies to achieve better sexual health and educational outcomes. The study also suggests expanding curricula to align with recognized guidelines and the diverse needs of youth.

Sexual health interventions with social marketing approach targeting young people: a scoping review.

In a fast-paced digital and global environment, sexual education must keep up with young people's sexual health needs. Social marketing is an approach that has been used in sexual health promotion for young people. The objective of the scoping review is to identify and map the use of social marketing in sexual health promotion for young people. Specifically, the content, delivery methods and effects of interventions on sexual health were researched. Six databases were systemically searched to capture the relevant peer-reviewed quantitative, qualitative and mixed methods articles without time restrictions that provided evidence of sexual health-related social marketing interventions targeting young people aged 11-25. An inductive and deductive content analysis was performed. Nineteen studies were included in the data. The content of interventions was dominated by sexual risks and risk prevention, focusing particularly on sexually transmitted diseases, unwanted pregnancies and sexual violence. Additionally, interventions included topics of morals of sexual relationships and changes in the body. The delivery of interventions occurred through various media channels, events and activities, while the effects of interventions were monitored as improvements in sexual perceptions and sexual behaviour, limited gender-related effects, limited evidence of intervention attributed to behaviour and effects in different age groups. The social marketing approach was mostly preventive and concentrated on the risks, whereas the delivery methods were diverse and creative, combining modern and already well-established channels. Sexuality should be seen comprehensively, and interventions should respond to the full range of young people's needs.

Epidemiology of Chlamydia trachomatis and Repeat Positivity Following Detection in New York State.

In New York State, excluding New York City, chlamydia remains a persistent health concern. Our aim was to characterize chlamydia epidemiology and identify groups at higher risk of repeat positivity to inform targeted public health interventions. We analyzed demographic and clinical data of laboratory-confirmed chlamydia cases in New York State from 2015 to 2019. Repeat positivity was defined as a second positive chlamydia test within 31 to 365days of the initial positive test. We compared characteristics of individuals with single and repeat positivity and evaluated associations with repeat positivity using multivariable logistic regression models. During the study period, 176273 individuals were diagnosed with chlamydia, with 17253 experiencing repeat positivity. Repeat positivity was more common among individuals assigned female at birth. Key predictors of repeat positivity among females included non-Hispanic Black (adjusted odds ratio [aOR]: 1.33; 95% confidence interval [CI], 1.27-1.40) race/ethnicity, ages 13 to 19 (aOR: 1.62; 95% CI, 1.55-1.69), prior sexually transmitted infection (STI) diagnosis (aOR: 1.24; 95% CI, 1.18-1.31), symptomatic examination (aOR: 1.07; 95% CI, 1.02-1.13), and county/community (aOR: 1.10; 95% CI, 1.05-1.15) or private/public (aOR: 1.18; 95% CI, 1.11-1.25) provider. Among males, predictors included non-Hispanic Black (aOR: 1.57; 95% CI, 1.45-1.70) race/ethnicity, ages 13 to 19 (aOR: 1.27; 95% CI, 1.17-1.38), HIV coinfection (aOR: 1.30; 95% CI, 1.10-1.54), prior STI diagnosis (aOR: 1.31; 95% CI, 1.20-1.43), extragenital infection site (aOR: 2.59; 95% CI, 2.27-2.95), symptomatic examination (aOR: 1.21; 95% CI, 1.12-1.31), and county/community health (aOR: 1.09; 95% CI, 1.02-1.17) provider. Our findings provide valuable insights for sexual health interventions to prevent chlamydia transmission and recurrence. Prioritizing resources for prevention interventions and tailored sexual health promotion among non-Hispanic Black individuals is crucial. Additionally, targeted STI prevention efforts are needed for males who have sex with men and those initially diagnosed with extragenital infection. Research is warranted on STI prevention among people living with HIV or at high risk of HIV infection. Strengthening prevention strategies through Expedited Partner Therapy and sexual health education for individuals at risk of repeat positivity could enhance prevention efforts.

(069) ASSESSING READABILITY, UNDERSTANDABILITY, ACTIONABILITY, AND QUALITY OF ONLINE HEALTH RESOURCES FOR SEXUAL HEALTH DURING MENOPAUSE

Abstract Introduction Recent studies indicate that over half of adults in the United States rely on the internet for accessing health-related information. (1) Patients experiencing menopause may feel a sense of embarrassment about their sexual health and, consequently, turn to online resources to maintain a sense of anonymity. Despite a shift in information-seeking patterns within the last decade, there remains a significant gap in the research assessing the quality of the content that patients encounter online. While prior research has investigated the readability of materials for sexual health promotion and sexual health in men, there are no prior investigations addressing the quality of sexual health materials for individuals experiencing menopause. Objective Our objective was to evaluate online patient- oriented health resources concerning sexual health during menopause for their readability, understandability, actionability, and overall quality. Methods We conducted a Google keyword search for “sexual health during menopause,” reviewed the first three pages of results, and included 22 unique, relevant resources after excluding journal articles and materials not intended for patient education. We assessed readability using multiple established indices, including the Flesch-Kincaid Grade Level. Understandability and actionability were evaluated with the Patient Education Materials Assessment Tool (PEMAT), with a threshold of 70% for actionable or understandable resources. (2) The JAMA benchmark criteria were used to evaluate the quality of each site.(3) Further analysis will consist of qualitative content analysis and assessment of accuracy. Finally, these resources will be compared by the website publisher's industry for any statistically significant differences in any of these outcomes. Results No materials met the American Medical Association's recommended readability standards by any metric.(4) The reading level of the reviewed resources ranged from grades 7 to 18. PEMAT scoring revealed that three resources reached the threshold for understandability though none met the criteria for actionability. On average, understandability was 60.1% and actionability was 51.8%. No resource met all four JAMA benchmark criteria. The average criteria met was 2.0. Correlation analysis demonstrated a strong negative correlation between materials’ readability and understandability (r = −0.459, P < .05). Conclusions These findings underscore the need for improved patient resources for women’s sexual health during menopause. Future efforts in patient education materials development should prioritize patient concerns and enhancing readability, understandability, and actionability. Sources: 1. Wang X, Cohen RA. Health information technology use among adults: United States, July–December 2022. NCHS Data Brief, no 482. Hyattsville, MD: National Center for Health Statistics. 2023. DOI: https://dx.doi.org/10.15620/cdc:133700. 2. Shoemaker SJ, Wolf MS, Brach C. Development of the Patient Education Materials Assessment Tool (PEMAT): a new measure of understandability and actionability for print and audiovisual patient information. Patient Educ Couns. 2014;96(3):395–403. 3. Silberg WM, Lundberg GD, Musacchio RA. Assessing, Controlling, and Assuring the Quality of Medical Information on the Internet: Caveant Lector et Viewor-Let the Reader and Viewer Beware. JAMA. 1997;277(15):1244–1245. doi:10.1001/jama.1997.03540390074039 4. American Medical Association. CHAPTER 9: OPINIONS ON PROFESSIONAL SELF-REGULATION. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/code-of-medical-ethics-chapter-9.pdf Published 2016 Disclosure No.