Sexual Outcomes Research Articles

The dual lens of objectification: Perceived objectification, male partners’ reported objectification, and women’s detrimental sexual outcomes

Objectification theory posits that women are treated merely as a body, valued for its use, pleasure and consumption by and for others, mainly men. Women are also disadvantaged relative to men when it comes to sexually pleasurable experiences, including lower orgasm rates and a higher burden of performing sexual emotional labour (e.g., faking orgasm, performing desire for the partner, tolerating discomfort or pain during sex). We tested the hypothesis that objectification within romantic relationships (i.e., partner-objectification) may contribute to this tendency. Using data from 160 heterosexual couples, we aimed to explore how women’s self-objectification, perceived partner-objectification, and men’s self-reported partner-objectification are related to women’s orgasm rates and performance of sexual emotional labour. Self-objectification predicted women’s performance of sexual emotional labour but did not predict women’s orgasm rates. Our results further indicate that to the extent that women perceived themselves as being objectified by their male partner, they tend to report lower orgasm rates and greater performance of emotional labour. However, men’s self-reported partner-objectification did not. These findings suggest that women’s meta-perceptions are of greater importance for women’s sexual well-being than men’s self-reports. The research has implications for societal interventions aimed at preventing the consequences of partner-objectification, as well as for discussions in sex and relationship therapy for couples.

Translation and cross-cultural adaptation of the Nepali version of Sexual Interest and Satisfaction Scale (SIS): a cross-sectional study

Background and objectiveIndividuals with Spinal Cord Injury (SCI) rank regaining sexual function as their top priority. Sexual dissatisfaction often leads to low self-esteem, reduced intimacy, and relationship difficulties and hence forms an essential part of the rehabilitation process. In Nepal, where people generally hold fairly traditional views about sex and sexual health, a sexual outcome measure that is culturally sensitive is a must for addressing sexual problems. No study has yet been carried out to investigate the impact of SCI on sexual attitudes and satisfaction in Nepal. Therefore, this study aims to translate and cross-culturally adapt the Sexual Interest and Satisfaction Scale (SIS) in the Nepali language.Methods(1) Forward translation: Three translators translated the English version of SIS into Nepali. (2) Synthesis: The three translated versions were synthesized into a draft version. (3) Expert committee review: The expert committee meetings were held to reach a consensus for a sensible and applicable pre-final version of SIS. (4) Pre-test: The pre-final version of SIS was tested on 25 individuals with SCI. Their opinions and comprehension were documented for each question, and subsequent modifications were made to form the final version of Nepali SIS (SIS-NP). The internal consistency of SIS-NP was calculated using Cronbach’s alpha.ResultsThe translation and cross-cultural adaptation segregated the questions into two divisions: first, which could be answered by everyone irrespective of their sexual partner status, and second, which could only be answered by those with a sexual partner. No changes were made to the original questions; however, essential clarifications and definitions were added. A total of 66 individuals with SCI participated to evaluate internal consistency with a median duration of injury of 9.5 years (IQR = 9.25). Unmarried participants accounted for 40% (n = 27). Internal consistency was found to be 0.74.ConclusionSIS was translated to Nepali, adapting standard recommended guidelines. SIS-NP demonstrated adequate internal consistency to be used in SCI.

Sexuality myth endorsement is linked with poorer sexual and relational outcomes across demographic groups in a large and diverse sample

ABSTRACT Due to differences in access to sexual information, some people may be more likely to endorse sexuality myths, which could be linked to poorer sexual and relational outcomes. The goals of this study were to: 1) investigate predictors of sexuality myth endorsement; 2) examine links between endorsing myths and sexual and relational outcomes; and 3) assess whether group membership strengthened associations between myth endorsement and sexual and relational outcomes. A large and diverse sample of undergraduate students (N = 1,077) and community adults (N = 3,359) completed an online survey assessing their demographics, sexuality myth endorsement, and sexual and relational outcomes. Being assigned male at birth, identifying as cisgender, identifying as heterosexual, being younger, holding more conservative political views, being more religious, living in an urban locality during childhood, and not receiving sex education predicted greater sexuality myth endorsement. Greater sexuality myth endorsement predicted lower sexual satisfaction, lower sexual function (among people with vulvas), higher sexual distress, and lower relationship satisfaction. Generally, the strength of associations between myth endorsement and sexual and relational outcomes did not differ across demographic factors. Overall, findings provide insight into groups more likely to endorse sexuality myths, who thus may be at risk of poorer sexual and relational outcomes.

The role of parent-adolescent communication interventions in improving sexual and reproductive health outcomes in sub-Saharan Africa: protocol for a systematic review and meta-analysis

BackgroundAcross sub-Saharan Africa, adolescents face the triple tragedy: unintended pregnancies, unsafe abortion, and sexually transmitted infections including HIV due to various reasons, among them, poor parent-adolescent communication on sexual and reproductive health. Effective interventions such as improving parent‒adolescent communication has been recognized as a protective factor for adolescent sexual and reproductive health outcomes. Research shows that parent-adolescent communication is associated with reduced adolescent engagement in risky sexual behaviours, including early sexual initiation, lower rates of teenage pregnancy, sexually transmitted infections, and increased self-efficacy in decision making. Despite the potential role of parent-adolescent communication in promoting optimal adolescent sexual and reproductive health, limited research evidence exists on interventions to improve parent-adolescent communication on sexual and reproductive health in sub-Saharan African countries. The aim of this systematic review is to assess the role of parent-adolescent communication intervention programs in improving sexual and reproductive health outcomes.MethodsWe will pool evidence from published literature from January 1990 up to and including February 2024 from multiple databases: PubMed, Web of Science, Scopus, African Journals Online, JSTOR, Directory of Open Access Journals, and Google Scholar. Articles published in the English language will be included. Two reviewers will conduct screening for titles, abstracts, and full texts, while a third reviewer will arbitrate in cases of lack of concurrence. Experimental, quasi-experimental and observational study designs will be included.. A data extraction tool based on Microsoft Excel will be used to extract data items from different studies. We will focus on the following outcomes: initiation of sexual activity, use of condoms and contraceptives, reduced risky sexual behaviours such as unprotected sex, and lower rates of teenage pregnancy. When feasible, articles will be combined for statistical meta-analysis. Effect sizes, either reported as weighted mean differences for continuous data or as odds ratios for binary data, will be presented as proportions with 95% confidence intervals. We will use the random effects model to meta-analyse the include studies as we expect considerable variability across study designs. This will provide an average effect size that accounts for variability of results within studies. Sensitivity analysis will also be conducted to assess the robustness of the findings or conclusions of the meta-analysis. The review findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.DiscussionThis review provides insights into parent-based intervention programs that have been implemented in sub-Saharan African countries to improve adolescent sexual and reproductive health via promotion of parent-adolescent sexuality communication. The findings will guide further research on this issue as well as inform policy makers on which interventions have a potential effect in improving adolescent sexual and reproductive health.Protocol Registration Number: CRD42024525191 (PROSPERO), Date of registration: 27/03/2024.

Association of Sexual Dysfunctions and Sociodemographic Characteristics among Married Couples

Background: Sexual dysfunction is a prevalent issue that affects the quality of life and marital satisfaction among couples. This study aims to explore the association of sexual dysfunction with various sociodemographic characteristics among married couples in Bangladesh.Methods: This cross-sectional study was conducted in Shaheed Monsur Ali Medical College Hospital, Dhaka, Bangladesh during the period from January 2015 to 31st August 2015. A total of 49 married patients with substance use disorder were selected using purposive sampling. Data were collected using a structured questionnaire, DSM-5 criteria for substance use disorder, and the Bangla version of the Arizona Sexual Experience Scale (ASEX). Statistical analyses were performed using SPSS version 25.Results: The study found that sexual dysfunction was significantly associated with age, gender, education, and occupation. Specifically, 22.22% of participants under 25 years, 44.44% of those between 25 to 40 years, and 33.33% of those over 40 years reported sexual dysfunction (p=0.025). Males reported a higher incidence (83.33%) compared to females (0%) (p=0.04). Sexual dysfunction was more common among illiterate participants (16.67%) compared to those with higher education levels (p=0.04). Farmers reported higher rates of sexual dysfunction (33.33%) compared to other occupations, though this was not statistically significant (p=0.18). Income, habitat, and family history of psychiatric illness did not show significant associations with sexual dysfunction.Conclusion: The study underscores the significant impact of sociodemographic factors on sexual dysfunction among married couples in Bangladesh. Targeted interventions addressing these specific factors are essential for improving sexual health outcomes. Further research should aim to deepen the understanding of these associations and develop culturally appropriate strategies for prevention and management.

Long-term quality of life and surgical outcome of female congenital adrenal hyperplasia patients.

To investigate the long-term quality of life and surgical outcome of female patients with congenital adrenal hyperplasia (CAH). Questionnaires for health-related quality of life (HRQoL) outcome (WHO-5, SF-36), lower urinary tract symptoms (ICIQ-FLUTS) and sexual outcome (ICIQ-FLUTSsex) were administered to adult CAH patients. Paediatric CAH patients and their parents were invited to complete WHO-5, PedsQL-4.0-SF15-Generic Core Scales and ICIQ-CLUTS. Six (46%) adults and 7 (54%) children with 21-hydroxylase-deficiency (age ranged from 8 years to 53 years) were recruited. Eleven (85%) had undergone a feminising genitoplasty. In the adult group, no statistically significant difference was identified in the HRQoL and ICIQ-FLUTS scores. Mean overall score of ICIQ-FLUTSsex was lower but not significantly in adult patients compared to controls (7.3 ± 2.9 vs. 2.9 ± 3.4, P = 0.06). A statistically significant negative correlation (r = -0.98, P = 0.02) was found between age at first operation and role limitations due to emotional problems in SF-36. No statistically significant difference was identified in the self-reported HRQoL and ICIQ-CLUTS scores in the paediatric group compared to controls. However, parent's report showed a statistically significant difference in school functioning (73.8 ± 18.9 vs. 91.2 ± 18.7, P = 0.02) and emotional functioning (80.3 ± 15.9 vs. 94.7 ± 12.7, P = 0.007). Our data did not show an impaired HRQoL nor long-term lower urinary tract symptoms in CAH patients' self-reports. Healthcare team should pay more attention to adult patient's sexual function.

Perception of orgasmic intensity changes between clitorally and vaginally activated orgasm: a psychometric analysis using the Orgasmometer scale.

Female orgasmic experience and intensity depend on several biological, anatomical, cultural, psychological and relational factors, yet studies have not explored how receptiveness to different stimulations (clitoral, vaginal, or both) affects subjectively perceived orgasmic intensity. Using data from sexually active, heterosexual women in two Italian nationwide surveys from 2021 and 2023, we evaluated orgasmic experience, sexual and psychological well-being using validated psychometric tools (FSFI, Orgasmometer, GAD-7, PHQ-9), also considering several socio-demographic factors, aiming to identify changes in terms of subjectively perceived orgasmic intensity according to different stimulations. The two surveys (Sex@COVID study, from April 7th to May 4th, 2020, n = 6821; and the FATHER Study, from May 12th to June 12th, 2023, n = 1845) were hosted on a dedicated website and were advertised through social media, radio broadcast, and interviews on national newspapers. Among 1,799 women meeting inclusion criteria, 40.7% primarily experienced clitorally activated orgasms (CAO, n = 733), 18% vaginally activated orgasms (VAO, n = 324), and 41.2% both types (Clitorally and Vaginally Activated Orgasms, CaVAO, n = 742). Significant psycho-sexological differences between the two studies were observed, with additional evidence suggesting the impact of lockdown and social distancing on sexual outcomes. Women experiencing CaVAO attained the highest FSFI and Orgasmometer scores, followed by those with VAO, and lastly, those with CAO (p < 0.001 for both). Regression analysis confirmed the same trend for Orgasmometer scores (R2 = 0.247, p < 0.001), also highlighting the relevance of sexual dysfunction (according to FSFI, β = -1.34 ± 0.08, p < 0.001) for orgasmic intensity. Lastly, women preferring masturbation to partnered sexual activity had lower orgasmic intensity (β = -0.41 ± 0.07, p < 0.001). Age, psychological status and relationship status had no significant effect on the model. Despite some limitations, this is the first study addressing the association between receptiveness to different stimulations and orgasmic intensity on a large sample using validated psychometric instruments.

Sexual and reproductive health of Sudanese refugee girls in Chad: mixed methods study with perspectives from 12-19 year old girls, parents, and health workers.

In humanitarian settings, refugee girls' vulnerability to negative sexual and reproductive health (SRH) outcomes and the barriers they face to access to SRH services increase. Despite global guidelines on adolescent sexual and reproductive health and rights (SRHR) in humanitarian settings, evidence on the diverse knowledge, attitudes, and behaviors of refugee adolescents are limited. This mixed methods study used a cross-sectional survey and participatory research activities to explore the knowledge, attitudes, and behaviors of 12-19 year old refugee girls from Darfur living in two refugee camps in Wadi-Fira, Chad. Focus group discussions with parents of adolescents and in-depth interviews with health workers were conducted to better understand community attitudes toward adolescent SRHR and barriers to accessing services. Overall, SRH knowledge, including of contraceptive methods, was mixed, but older girls had better knowledge than younger girls. Despite stigma around adolescent sexual activity expressed in this community, 20.9% of girls had already had sex. The majority of girls believed that health workers would maintain confidentiality if they sought contraception. Among girls who had ever had sex, 18.0% were currently using a modern contraceptive. None were using a long-acting method, but most obtained their method at the camp health center. Parents and health workers described how social stigma toward premarital sex and unintended pregnancy impeded adolescent access to SRHR information and services, although the midwives described helping girls to seek contraception. Despite community stigma towards premarital sex and contraception for adolescents, some girls in the camps successfully managed to receive a contraceptive method, demonstrating both their interest in and need for contraception. Although midwives were largely supportive of adolescent access, expanding contraceptive service delivery channels and making services more adolescent-responsive would further increase adolescent access. Gender transformative programming engaging girls and boys, should be expanded to improve adolescent knowledge and self-efficacy with respect to SRHR. These efforts must also engage parents and community members to create an enabling environment for adolescent SRHR and reduce stigma.

A Systematic Review of Sexual Assault Case Attrition in the United States from 2000 to 2020.

This article systematically reviewed research findings of five sexual assault case outcomes (founding, arrest, referral to prosecution, charging, and conviction) between 2000 and 2020. Records were collected from PsychINFO and ProQuest and had to report at least one quantitative criminal justice outcome, include data from a U.S. sample and involve original research. Thirty-six records (288,066 sexual assault cases) were analyzed. Results were stratified by reported cases, referred cases, charged cases, and victim age. Studies show that 72.09% to 92.66% of sampled cases are founded (M = 89.21%), 17.73% to 53.42% result in arrest (M = 27.25%), 13.60% to 69.57% result in referral (M = 31.36%), 3.28% to 83.16% result in charging (M = 19.58%), and only 1.86% to 40.31% result in conviction (M = 8.28%). This considerable variability in case outcomes is related to differences in cases included or excluded (e.g., age criterion, only sampling cases with sexual assault kits); thus, these studies are not reflective of all sexual assault cases. Studies were most likely to report arrest rates, followed by charging, referral, conviction, and founding. Overall, we have a good picture of what attrition looks like in adolescent-adult sexual assault cases from the 1980s to early 2010s in the Midwest and Southern CA. More updated research in the remaining parts of the country is needed, particularly from rural locales. Specific recommendations for more precise measurement and reporting methods are provided to improve our understanding of attrition and strengthen where, how, and with whom interventions are needed.

Beyond the Dichotomy: Understanding the Masking Effect of Binary Measures of “Status” on Foreign Nationals’ Lifetime Victimization Outcomes

Research on foreign nationals’ crime and victimization outcomes heavily relies on binary “immigration status” measures that fail to account for the legal parameters of U.S. citizenship and immigration laws. This study demonstrates the potential misclassification of foreign-born U.S. citizens, the sanitization of foreign nationals’ heterogeneity, and the masking effect the use of binary measures has on outcomes compared to legally informed proxy statuses. Using the Collaborative Psychiatric Epidemiological Surveys data, this study compares lifetime measures of witnessing violence and sexual victimization outcomes between birthright citizens and five proxy “statuses” as well as intra-group comparisons across foreign nationals. Three weighted multiple logistic regression models were estimated per outcome. The results reveal that using a dichotomized “U.S.-born/foreign-born” measure masks substantive differences in the outcomes. Subanalyses of foreign nationals also suggest that intragroup differences are concealed. The methodological, theoretical, and policy implications of this work are discussed.

Reaching people who use drugs with sexual and reproductive healthcare through syringe services programs: potential promise and missed opportunities

BackgroundPeople who use drugs are at elevated sexual and reproductive health risk but experience barriers to services. Syringe services programs (SSP) are an important venue to provide integrated health services. Few studies have examined SSP use within intersecting gender, racial, and ethnic groups, including by injection drug use (IDU), and differences in sexual and reproductive health among these groups.MethodsWithin a cohort study among people who use unprescribed opioids in New York City, we conducted a nested cross-sectional study from November 2021-August 2022 assessing sexual health with a survey (n = 120). The parent study measured baseline characteristics, and the cross-sectional study survey measured self-reported past-year SSP use and sexual and reproductive health. We estimated SSP use within gender, racial, and ethnic groups by IDU, and the prevalence of sexual and reproductive health outcomes by gender, race, ethnicity, and SSP use.ResultsAmong men (n = 61) and women (n = 54), SSP use was disproportionately low among Black participants irrespective of IDU. Women reporting SSP use had a higher prevalence of multiple, new, sex trade, and/or casual sex partners, history of STI symptoms, and lack of effective STI prevention, although women who did not use SSP had non-negligible levels of risk with variation between racial and ethnic groups. Among men, sexual and reproductive health varied across racial and ethnic groups but not as clearly by SSP use.ConclusionsSSP offer opportunity to address elevated STI risk among people who use drugs but may miss certain intersecting gender, race, and ethnic groups.

Davydov-Moore vaginoplasty in Mayer-Rokitansky-Küster-Hauser syndrome: sexual and surgical outcomes.

The aim of this study was to compare surgical and sexual outcomes after Davidov-Moore vaginoplasty in women with Mayer-Rokitansky-Küster-Hauser syndrome (MRKH). In the case-series study, we described seven women, at a median age of 22.6 ± and BMI 22.8 ± 2.3kg/m2. We measured peri- and postsurgical parameters, including surgery-related neovaginal length and sexual initiation time. Sexual outcomes were measured using the Female Sexual Function Index (FSFI) before and 6months after vaginoplasty. All surgical procedures were performed successfully, with one minor perioperative bleeding. The mean time of vaginoplasty was 82.1min and the mean duration of hospitalization was six days. After a 6-month follow-up, vaginal length was 8.1-times longer than before surgery (10 vs. 81mm). The time from the surgery to the initiation of vaginal intercourse was between 17 to 22weeks. The mean FSFI score indicated good results, with no women below 23 score, and was 4.3- times higher when compared with the pre-surgical one (6.7 vs 29.1). Contrary to the FSFI score before surgery, the post-surgical FSFI revealed higher scores in all six different domains: desire (2.5-times), arousal (4.1-times), lubrication (3.8-times), orgasm (3.4-times), satisfaction (3.3-times) and comfort (11-times). Laparoscopic Davydov-Moore vaginoplasty might be considered as a safe procedure with satisfactory anatomic and sexual outcomes. It should be considered as a treatment option for the creation of neovagina in women with MRKH.

Sexual outcomes following the surgical treatment of traumatic rupture of the corpora cavernosa.

Penile fracture is a post-traumatic condition affecting the tunica albuginea of the corpora cavernosa when erect. Clinical diagnosis and urgent surgical intervention are crucial to avoid severe functional complications, particularly erectile dysfunction. We aimed to evaluate male sexual function after surgical treatment in patients with penile fracture and to identify predictive factors of postoperative erectile dysfunction. We underwent a hospital-based retrospective study on patients who underwent surgical repair for fractures of the corpora cavernosa between 2012 and 2023. Included in this study were all patients who have a postoperative follow-up of at least 12 months. Patients were clinically evaluated for the presence of erectile dysfunction and the presence of postoperative penile curvature. The patients were asked to answer the structured questionnaire of the International Index of Erectile Function (IIEF-15). We included 87 patients. The mean age was 38 ± 12years. Fourteen patients (16%) developed a fibrous plaque, with a median onset time of 30days postoperatively. Erectile dysfunction was noted in forty-four patients (51%). Active smoking (p < 0.002), the surgical approach (p = 0.02), a consultation time > 7.5h (p = 0.01), a length of the discontinuity of the corpora cavernosa > 2.5cm (p = 0.01) and the use of an erection inhibitor postoperatively (p = 0.021) were independent predictive factors of erectile dysfunction at 1 year postoperatively. Considering the results of our study, we propose rapid and urgent surgical management for penile fractures, and an elective surgical approach may be considered. We emphasize the fundamental role of sexual education, especially for young people, in preventing this sexual accident that could negatively impact their sexual life.

How do social and gender norms influence the sexual and reproductive health of younger adolescents in sub-Saharan Africa? A scoping review protocol

Introduction Younger adolescents (aged 10–14 years) in sub-Saharan Africa (SSA) have disproportionate sexual and reproductive health (SRH) outcomes due to structural, behavioural, socioeconomic and other factors. Social and gender norms have important consequences for the SRH and wellbeing of younger adolescents both now and over their life course. SRH programming often focuses on older adolescents (aged 15–19 years), overlooking younger ones. This scoping review sets out to explore how gender and social norms influence younger adolescents’ SRH in SSA, to inform tailored interventions. Methods The Arksey and O'Malley strategy will be used to review the available literature. Online databases (PubMed/MEDLINE, CINHAL, EMBASE, PsycINFO, Cochrane Library, and African Index Medicus) will be searched for original studies published between 1 January 2000 and 30 September 2024. Further, a manual search to include relevant grey literature will be performed. The steps in the review are: 1) defining the research question, 2) identifying relevant studies, 3) selecting studies, 4) charting the data, and 5) collating, summarising, and reporting the results. Results Findings will be reported in accordance with the guidance provided in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement. Discussion The review will generate the most up-to-date evidence and identify gaps in literature in addition to informing future research on how gender and social norms influence younger adolescents’ SRH in SSA. Findings will inform and influence future interventions and evaluations in this area.

Early sexual debut among adolescent girls and young women in Sierra Leone: A multilevel analysis of prevalence and predictors

BackgroundEarly sexual debut among young women is associated with adverse sexual and reproductive health outcomes, including unintended pregnancies and sexually transmitted infections. Despite its negative impact, there is limited research on this issue in Sierra Leone. This study aims to address this gap by examining the prevalence of early sexual debut and its associated factors among adolescent girls and young women aged 15–24 years in Sierra Leone.MethodsData from the 2019 Sierra Leone Demographic and Health Survey was used for the study. Provincial variations in the proportion of early sexual debut were visualised using a spatial map. A mixed-effect multilevel binary logistic regression analysis was performed to examine the factors associated with early sexual debut. The results were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI) and intraclass correlation coefficients.ResultsThe prevalence of early sexual debut was 26.1% [24.3, 28.0]. Adolescent girls and young women aged 20–24 were less likely to engage in early sexual debut [aOR = 0.52; 95% CI: 0.41, 0.65] than those aged 15–19. The odds of early sexual debut was lower among adolescent girls and young women with secondary/higher education [aOR = 0.62; 95% CI: 0.45, 0.85] compared to those with no education. Adolescent girls and young women who used the internet in the last 12 months [aOR = 0.50; 95% CI: 0.34, 0.73] and those who belonged to the Fullah ethnic group [aOR = 0.25; 95% CI: 0.07, 0.85] were less likely to engage in early sexual debut relative to those who did not use the internet and those belonging to the Creole ethnic group respectively. Adolescent girls and young women who intend to use contraceptives [aOR = 0.60; 95% CI: 0.46, 0.77] and those who do not intend to use contraceptives [aOR = 0.65; 95% CI: 0.49, 0.88] were less likely to engage in early sexual debut than those who were using contraceptives. Conversely, adolescent girls and young women who were working [aOR = 1.41; 95% CI: 1.12, 1.77] had higher odds for early sexual debut than those not working. The odds of early sexual debut were higher among adolescent girls and young women who were married/cohabiting [aOR = 1.72; 95% CI: 1.32, 2.22] and previously married [aOR = 3.26; 95% CI: 1.61, 6.56] than those who were never married. Adolescent girls and young women living in the North Western area [aOR = 1.81; 95% CI: 1.05, 3.13] had higher odds for early sexual debut than those living in the Eastern province.ConclusionEarly sexual debut is prevalent among adolescent girls and young women in Sierra Leone. Age, education, internet use, ethnicity, contraceptive use intention, marital status, employment status, and province of residence were the factors associated with early sexual debut. The study underscores the need for policymakers, government, and non-governmental organisations to design and implement comprehensive and multifaceted interventions to promote informed decision-making and reproductive health among adolescent girls and young women in Sierra Leone.

'From women for women': A citizen science approach engaging women in the isolation and application of the vaginal health-associated bacterium Lactobacillus crispatus.

A vaginal microbiome rich in Lactobacillus crispatus is associated with good reproductive and sexual health outcomes. Dysbiosis, indicated by the loss of Lactobacillus crispatus, is a risk factor for urogenital infections, such as the clinical diagnosis of bacterial vaginosis (BV) or urinary tract infections. While many scientists have explored probiotics using a conventional pharmaceutical approach, concerns about accessibility and affordability prompt an investigation into a preventive approach using this naturally occurring bacterium. Our study aimed to explore a potential woman-friendly vaginal probiotic product using the naturally occurring bacterium, Lactobacillus crispatus. Citizen scientists actively participated in a two-day practicum and successfully performed the procedures using self-collected vaginal swabs. The practicum received positive responses from participants who demonstrated notable engagement and enthusiasm. With expert guidance, participants without a laboratory background were able to execute assigned tasks successfully. From the Dutch crispatus Citizen Science Collective of 48 women, 22 succeeded in isolating their own Lactobacillus crispatus strains using a Loop-Mediated Isothermal Amplification (LAMP) protocol for identification. Additionally, 48 metagenomes and 54 whole genomes from 22 individuals were sequenced for comparative analysis. This project effectively engaged a community of women in the isolation of Lactobacillus crispatus strains from their vaginal microbiota, followed by in vitro characterization experiments and a hackathon for the development of a probiotic product. Our citizen science approach opens up collaboration possibilities and new avenues for exploration of vaginal health, facilitating community involvement and the development of targeted interventions to enhance women's well-being.

Sexual size dimorphism affecting mate choice and reproduction in the pine sawyer beetle, Monochamus alternatus.

Monochamus alternatus is a notorious pest of the pine forests across East Asian countries. Both large and small individuals of either sex coexist in the wild. However, whether and how body size affects sexual selection outcomes and longevity remains unknown. In this study, we allowed a male or a female of small or large size to choose between two mates of varying sizes, which were from a wild-caught population. Our results revealed that mating latency and frequency of mating attempts varied across different social environments. Both large males and large females preferred larger mates, whereas this preference was not observed for the small males and small females. Male-male competition had no significant effect on ejaculation duration and frequency or sperm number in ejaculates. When a single male had an opportunity to choose between two females of different sizes, the reproductive investment of small males towards the small females was almost doubled compared to that of the large males, i.e., longer ejaculation duration, higher ejaculation frequency, and greater numbers of sperm transferred. However, the greater mating efforts of small males did not translate to greater fecundity/fertility of small females. We also showed that regardless of their body size, females always had greater fertility when they mated with large males but evidence for a trade-off between fecundity and longevity was not found. Alternatively, female fecundity was positively associated with longevity, and fertility was negatively associated with longevity and fecundity. We discussed these results placing it in a broader context of mate choice evolutionary dynamics.

Using systems thinking to leverage adolescent sexual and reproductive health in rural Latino communities

Disparities in adolescent sexual and reproductive health (SRH) outcomes in rural areas of the USA persist as a concern in achieving health equity for youth. A growing body of literature recognises that improving adolescents’ health necessitates systems thinking to address the culture and environment in which adolescents live. This paper uses systems thinking to identify leverage points to improve adolescent SRH in rural Latino communities in California. We conducted focus group discussions with 22 young people and interviewed 10 adult stakeholders to centre the perspectives of youth and youth-serving professionals. Transcripts were coded and analysed using systems thinking. Five themes were developed: (1) community and cultural norms can be a source of both support and stigma for youth; (2) families are key to supporting health education and services; (3) rural schools provide a central hub for programme delivery; (4) community-based organisations can work to serve rural youth, but limited resources and transport are challenges; and (5) youth face considerable barriers accessing SRH services in their communities. Using systems thinking to identify leverage points and gaps in interactions between system components influencing youth can aid in the development of more holistic and culturally responsive approaches for rural youth SRH.

Sexual Function and Satisfaction in Young Women with Breast Cancer: A Five-Year Prospective Study.

Young women with breast cancer (YWBC) face unique challenges that can impact their sexual health. This study aimed to identify factors associated with sexual activity, function, and satisfaction in YWBC up to five years post-diagnosis. We conducted a prospective cohort study of 474 women aged ≤40 years diagnosed with non-metastatic breast cancer in Mexico. Sexual function and satisfaction were assessed using the Female Sexual Function Index and the Sexual Satisfaction Inventory, respectively. Factors associated with sexual health outcomes were examined using mixed-effects models. The prevalence of sexual dysfunction increased from 33.6% at baseline to 52.9% at 4-5 years post-diagnosis. Factors associated with worse sexual function included older age (mean predicted FSFI score -1.35, p = .037), treatment-induced amenorrhea (-2.86, p < .001), depression (-4.11, p < .001), and anxiety (-2.13, p < .001). Lower sexual satisfaction was associated with lower educational attainment (mean predicted SSI score -5.61, p = .002), being single (-6.41, p < .001), treatment induced amenorrhea (-3.76, p = .004), bilateral oophorectomy (-8.21, p = .017), depression (-11.29, p < .001), and anxiety (-7.50, p < .001). Quality of life, body image, and systemic therapy side effects significantly impacted both outcomes. Three distinct trajectories of sexual function were identified: high (62.2%), intermediate (24.3%), and markedly declining (13.5%). Four trajectories of sexual satisfaction were found, ranging from intermediate-to-high (57.3%) to progressively worsening (27.5%). Sexual dysfunction is prevalent and persistent among YWBC. Multiple biological, psychological, and social factors influence sexual health outcomes in this population. These findings highlight the importance of routine screening and tailored interventions to address the sexual health of YWBC throughout survivorship.

Ask Your Relative: A mixed method analysis of the Sexual Health and Healthy Relationship Q&As submitted by American Indian Alaska Native young adults

BackgroundDisparities in sexual health outcomes persist among American Indian and Alaska Native (AIAN) youth due to intersectional challenges accessing youth-friendly health services. AIAN youth have an increased prevalence of STIs and teen pregnancy. To address disparities in sexual health outcomes, the Ask Auntie/Ask Your Relative (AYR) Q&A service has been used by AIAN youth and young adults for over seven years as a trusted resource for information on sensitive health topics. There is a continued need to better understand the health-seeking behaviors of AIAN youth, especially those related to healthy relationships and sexual health, to improve the alignment of health resources to their needs.MethodsThis mixed-method study began with two phases. Phase 1 involved an analysis of all AYR data using Google Analytics and basic frequency counts. Phase 2 reviewed all questions and answers related to sexual health and healthy relationships (N = 240) using thematic analysis, NVivo 12.0, and intersectionality, guided by the social determinants of health. All AYR answers were coded based on type, name/location, number of times viewed, and examples. The final step of the analytic process was to utilize an intersectional approach and socioecological model (Individual, Community, Tribe/Nation, and World) to create a visual model with results.ResultsPhase 1—Since We R Native began tracking AYR data, the service has been utilized by 2.37 M users, with 1.16 M unique pageviews. The average time on the page was 4 min and 46 s. The number of AYR questions submitted varied by year, and were most frequent in 2016, then decreased in subsequent years. In Phase 2, the main themes identified in AYR questions were (1) Reaching Out for Help, (2) Identity and Physical Development, and (3) Healthy Relationships. Analysis of the Q&A answers identified 244 resources, and of these, 100 were Native-specific. The context-specific resources represented 21 uniquely coded health topics, ranging from women's health to behavioral health.ConclusionsThe broad range of healthy relationship and sexual health questions submitted to the AYR service reflects the types of health information that AIAN young adults want to know about. Resources provided in response to their questions connected Q&A viewers to a wide variety of organizations and programs designed to support AIAN young adults in their health and wellness journey. Findings from this study may be useful for creating additional culturally tailored resources.