Although the social determinants of health have guided equity work with the tailoring of men\'s health promotion programs, the role of, and potential for, the commercial determinants of health in those interventions is rarely addressed and poorly understood. While four commercial products, tobacco, alcohol, ultra-processed food, and fossil fuels, account for more than a third of global deaths, there is a need to recognize that consumer goods industries can make both positive and negative contributions to health. This article begins much-needed discussions about what we might learn from, and strategically tap in the commercial sector to seed, scale, and sustain men\'s health promotion programs. Three case studies, online sports betting, beer and the rise of the nonny, and athleisurewear, are discussed. Connections between online sports betting and masculinities explain young men\'s disproportionate involvement and gambling addictions with recommendations to legislate an end to gambling advertisements and de-incentivize industry profiteering through penalties and higher taxes. Regarding beer and the rise of the nonny, brewers have innovated with non-alcoholic beer based on shifting consumption patterns and masculinities in their core market-men. The nonny reminds health promoters to know their end-user\'s values and behaviors to bolster program acceptability. Detailing Under Armour and Lululemon, two highly gendered but diversifying athleisurewear brands, the complexities of, and potential for, leveraging public health and industry collaborations are underscored. Taken together, the article findings suggest men\'s health promoters should rigorously explore tapping key commercial entities and tax revenues to advance the health of men and their communities.

UNASSIGNED: Emerging literature links fatherhood to men\'s health but lacks comprehensive assessment of health outcomes, especially among multiethnic populations. This study\'s objective was to evaluate the associations of fatherhood (age at onset and status) with cardiovascular health scores, incident cardiovascular disease, cardiovascular disease death, and all-cause mortality, examining differences by race/ethnicity.
UNASSIGNED: The study sample included men from Multi-Ethnic Study of Atherosclerosis, prospective cohort study that enrolled adults aged 45-84 years without known cardiovascular disease at baseline. Cardiovascular health was defined using the American Heart Association\'s Life\'s Essential 8 scores (0-100), excluding sleep (cardiovascular health score).
UNASSIGNED: In this sample of 2,814 men, mean age at cardiovascular health assessment was 62.2 years, 82% were fathers, 24% self-identified as Black, 13% self-identified Chinese, 22% self-identified Hispanic, and 41% self-identified White. Fathers who were aged <20 years and 20-24 years at their oldest child\'s birth had worse overall cardiovascular health than fathers who were aged >35 years (adjusted mean score of 61.1 vs 64.7 [p=0.01] and 61.0 vs 64.7 [p<0.001], respectively). Fathers had worse overall cardiovascular health (adjusted mean score of 63.2 vs 64.7, p=0.03) and more nicotine exposure (63.1 vs 66.6, p=0.04) than nonfathers. In age-adjusted models, fathers overall (hazard ratio=0.82; 95% CI=0.69, 0.98) and Black fathers (hazard ratio=0.73; 95% CI=0.53, 0.999) had a lower rate of all-cause mortality rate than nonfathers, but these associations were no longer significant in fully adjusted models.
UNASSIGNED: Fatherhood is a social determinant of health, and understanding its influence may provide opportunities to improve men\'s health, particularly among men of color.

OBJECTIVE: To describe and interpret the sexual health experiences of men with IBD.
METHODS: Interpretive qualitative study.
METHODS: In-depth, semi-structured interviews were conducted with 22 men with a diagnosis of Inflammatory Bowel Disease. Interviews were digitally audio-recorded and transcribed verbatim. Data were analysed using constant comparative, thematic analysis.
RESULTS: Three themes were identified from interview data: (1) the disease shapes intimate connections, (2) the disease thwarts sexual experiences and (3) the disease disrupts male gender norms. Men reported that active disease lowered libido and could change pre-, inter- and post-coital sexual practices. All participants noted that health professionals did not initiate the discussion of sexual health and well-being needs in the outpatient hospital setting. Men who engaged in receptive anal sex reported a lack of disease-specific guidance and understanding from professionals.
CONCLUSIONS: Inflammatory bowel disease can negatively impact the sexual well-being, gender identity and activities of men. Further research is required to identify the care preferences of men with IBD and clarify the barriers and facilitators to sexual health assessment so that nurses may better support the health needs of this population.
UNASSIGNED: This study highlights the need for sexual health and well-being support that is specific to disease and gender in IBD. There is a paucity of information and guidance for men with peri-anal disease and proctitis who engage in receptive anal sex, which requires urgent attention.
UNASSIGNED: Reporting follows the COREQ checklist.
UNASSIGNED: A patient and public involvement group informed the development of the study design. The group reviewed public facing documents and interview guides. One member of the group provided comments on the identified themes.

Misinformation is a rising concern for providers and patients alike. We aimed to assess where patients acquire information prior to their andrological urologic appointment and assess patients\' perception regarding the reliability of this information. A cross-sectional study was conducted at an outpatient men\'s health clinic between June and August of 2022 with questionnaires distributed to adult males seen for their primary visit. The study included 314 consenting adult patients who independently completed the questionnaire (mean age: 51.2 ± 17.2). Overall, 55.1% of patients indicated they searched for their condition online. However, 39.2% and 27.7% of respondents agreed and strongly agreed, respectively, that misinformation is a concern when searching for health information. Only 59.9% of patients discussed their concerns with others and those that did not chose not wanting to (65.1%) as their top choice. However, 27.4% of respondents were embarrassed to do so. Finally, 38.2% and 12.4% of patients agreed and strongly agreed, that learning information prior to your appointment affects their relationship with the physician. These findings emphasize the need for urologists to be aware of where their patients are gathering health information and to address concerns regarding misinformation.

Improving physical activity (PA) and healthy eating is critical for primary and secondary prevention of cardiovascular disease (CVD). Behaviour change programmes delivered in sporting clubs can engage men in health behaviour change, but are rarely sustained or scaled-up post trial. Following the success of pilot studies of the Australian Fans in Training (Aussie-FIT) programme, a hybrid effectiveness-implementation trial protocol was developed. This protocol outlines methods to: (1) establish if Aussie-FIT is effective at supporting men with or at risk of CVD to sustain improvements in moderate-to-vigorous PA (primary outcome), diet and physical and psychological health and (2) examine the feasibility and utility of implementation strategies to support programme adoption, implementation and sustainment.
A pragmatic multistate/territory hybrid type 2 effectiveness-implementation parallel group randomised controlled trial with a 6-month wait list control arm in Australia. 320 men aged 35-75 years with or at risk of CVD will be recruited. Aussie-FIT involves 12 weekly face-to-face sessions including coach-led interactive education workshops and PA delivered in Australian Football League (Western Australia, Northern Territory) and rugby (Queensland) sports club settings. Follow-up measures will be at 3 and 6 months (both groups) and at 12 months to assess maintenance (intervention group only). Implementation outcomes will be reported using the Reach, Effectiveness, Adoption, Implementation, Maintenance framework.
This multisite study has been approved by the lead ethics committees in the lead site\'s jurisdiction, the South Metropolitan Health Service Human Research Ethics Committee (Reference RGS4254) and the West Australian Aboriginal Health Ethics Committee (HREC1221). Findings will be disseminated at academic conferences, peer-reviewed journals and via presentations and reports to stakeholders, including consumers. Findings will inform a blueprint to support the sustainment and scale-up of Aussie-FIT across diverse Australian settings and populations to benefit men\'s health.
This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12623000437662).

BACKGROUND: Erectile dysfunction (ED), premature ejaculation (PE), and low libido (LL) are reported as the most common male sexual dysfunctions.
OBJECTIVE: To evaluate the prevalence of ED, PE, and LL and associations with lifestyle risk factors and comorbidities in middle-aged men.
METHODS: This study included a population-based random sample of 2500 50-year-old men who completed validated questionnaires, including the International Index of Erectile Function, the Erection Hardness Score, the Sexual Complaints Screener, and further questionnaires. Multiple logistic regression of outcomes ED, PE, and LL was used to model the association with explanatory factors.
RESULTS: The prevalence of at least one sexual dysfunction was 30%. 21%, 5.2%, and 7.2% of men had ED, PE, and LL, respectively. The risk of ED increased with PE (odds ratio [OR]: 1.94, 95% confidence interval [95%CI]: 1.22-3.08), LL (OR: 2.04, 95%CI: 1.26-3.29), higher waist circumference (OR: 2.23, 95%CI: 1.67-2.96), and lower urinary tract symptoms (LUTS) (OR: 1.88, 95%CI: 1.39-2.55), partnership was associated with a lower risk (OR: 0.57, 95%CI: 0.39-0.85). The risk of PE increased with ED (OR: 1.94, 95%CI: 1.23-3.07), partnership (OR:5.42, 95%CI: 1.30-22.60), depression (OR: 2.37, 95%CI: 1.09-5.14), and LUTS (OR: 2.42, 95%CI: 1.52-3.87), and decreased with physical activity (OR: 0.44, 95%CI: 0.21-0.93). The risk of LL increased with ED (OR: 2.09, 95%CI: 1.31-3.34) and poorer self-rated health (OR: 2.97, 95%CI: 1.54-5.71).
CONCLUSIONS: Roughly one in three 50-year-old men experience some form of sexual dysfunction and risk factors identified in this study underline the multifactorial nature of ED, PE, and LL. Many risk factors are modifiable which underlines the role of patient education. Modifiable risk factors should be addressed in patient education and men should take active measures to remove the risk posed by these factors.

Loneliness has been extensively linked to negative physical and mental health outcomes. Often defined as a subjective emotion, the influence of sex and gender has regularly been cited as vital to understanding individuals\' experiences. Despite this, little research has explored men\'s perspectives of loneliness using interpretivist approaches. This study addresses this by exploring how gender influences men\'s constructions and experiences of loneliness in an interview study with a diverse sample of 20 UK-based men. Theoretical thematic analysis led to the generation of a novel conceptualisation of loneliness comprising four interconnected themes: socially negotiated self-worth (an intersubjectively defined mental state); being positively occupied (a mental state of meaningful focus/action); social connections (vital for consistently achieving these mental states); and capacity to form social connections. A second \'layer\' in the findings describes how cultural norms of masculinity impacted loneliness defined in this way. Notions of invulnerability and social comparison could render it more difficult for men to form intimate and supportive connections or seek help for loneliness. However, as they were normative, they could also promote self-worth, and facilitate social connections, despite these negative effects. Similarly, masculine roles, in particular family roles, represented a normative framework for preventing loneliness, and could be both beneficial or problematic depending on other aspects of life, identity, or needs. The study offers insight into how men negotiate loneliness within a habitus incorporating multiple and varied gendered norms, values, and structures. Policy and practice interventions could usefully consider and mitigate the risks posed by non-conformity, aim to promote mental states of self-worth and positive occupation, and work to deconstruct masculine norms and values where appropriate.

Testicular sperm extraction (TESE) is an essential therapeutic tool for the management of male infertility. However, it is an invasive procedure with a success rate up to 50%. To date, no model based on clinical and laboratory parameters is sufficiently powerful to accurately predict the success of sperm retrieval in TESE.
The aim of this study is to compare a wide range of predictive models under similar conditions for TESE outcomes in patients with nonobstructive azoospermia (NOA) to identify the correct mathematical approach to apply, most appropriate study size, and relevance of the input biomarkers.
We analyzed 201 patients who underwent TESE at Tenon Hospital (Assistance Publique-Hôpitaux de Paris, Sorbonne University, Paris), distributed in a retrospective training cohort of 175 patients (January 2012 to April 2021) and a prospective testing cohort (May 2021 to December 2021) of 26 patients. Preoperative data (according to the French standard exploration of male infertility, 16 variables) including urogenital history, hormonal data, genetic data, and TESE outcomes (representing the target variable) were collected. A TESE was considered positive if we obtained sufficient spermatozoa for intracytoplasmic sperm injection. After preprocessing the raw data, 8 machine learning (ML) models were trained and optimized on the retrospective training cohort data set: The hyperparameter tuning was performed by random search. Finally, the prospective testing cohort data set was used for the model evaluation. The metrics used to evaluate and compare the models were the following: sensitivity, specificity, area under the receiver operating characteristic curve (AUC-ROC), and accuracy. The importance of each variable in the model was assessed using the permutation feature importance technique, and the optimal number of patients to include in the study was assessed using the learning curve.
The ensemble models, based on decision trees, showed the best performance, especially the random forest model, which yielded the following results: AUC=0.90, sensitivity=100%, and specificity=69.2%. Furthermore, a study size of 120 patients seemed sufficient to properly exploit the preoperative data in the modeling process, since increasing the number of patients beyond 120 during model training did not bring any performance improvement. Furthermore, inhibin B and a history of varicoceles exhibited the highest predictive capacity.
An ML algorithm based on an appropriate approach can predict successful sperm retrieval in men with NOA undergoing TESE, with promising performance. However, although this study is consistent with the first step of this process, a subsequent formal prospective multicentric validation study should be undertaken before any clinical applications. As future work, we consider the use of recent and clinically relevant data sets (including seminal plasma biomarkers, especially noncoding RNAs, as markers of residual spermatogenesis in NOA patients) to improve our results even more.

To assess ecological, structural, community and individual level correlates of health services utilization along a continuum of HIV care, and sexual health and support services among gay and bisexual men worldwide.
Using a nonprobability internet sample of 6,135 gay and bisexual men, we assessed correlates of utilization of health services. Chi-Square Tests of Independence were performed to assess drop off along a continuum of HIV care. Multivariable logistic regression analyses using generalized estimating equation models were conducted adjusting for geographic region and clustering by country. In multivariable analyses, we determined the association between utilization outcomes, and ecologic, structural, community and individual correlates by fitting separate generalized estimating equation (GEE) logistic regression models for each of the outcomes, fitted with robust SEs, and accounting for clustering by country. Stratified by sexual identity, analyses adjusted for variables that could influence HIV-related health outcomes including racial/ethnic minority status, participant age, insurance, ability to make ends meet, as well as country-level income (income of country of residence defined by the World Bank).
Among men living with HIV (n = 1001), being in HIV care (n = 867) was associated with being on ART (X2 = 191.17, p < .001), and viral load suppression (X2 = 14.03, p < .001); and using ART (n = 840) was associated viral load suppression (X2 = 21.66, p < .001). Overall, the pattern of utilization outcomes were similar for both gay and bisexual men. For example, utilization of PrEP, being in HIV care and utilization of most of the sexual health and support services were negatively associated with sexual stigma. Whereas, utilization of most HIV prevention, and sexual health and support services were positively associated with provider discrimination. Utilization of all HIV prevention and all sexual health services were positively associated with greater community engagement, and receiving services from LGBT-led organizations. Bisexual men had higher odds of reporting provider discrimination when utilizing condom services (gay: AOR = 1.14, [0.95-1.36]; bisexual: 1.58, [1.10-2.28]), PrEP (gay: AOR = 1.06, [0.77-1.45]; bisexual: AOR = 2.14, [1.18-3.89], mental health services (gay: AOR = 1.03, [0.86-1.23]; bisexual: AOR = 1.32, [1.07-1.64]), and community-based support (gay: AOR = 1.23, [1.05-1.45]; bisexual: AOR = 1.49, [1.14-1.93]) than gay men. Bisexual men also reported higher odds of accessing services from LGBT-led organizations when utilizing PrEP (gay: AOR = 5.26, [2.50-11.05]; bisexual: AOR = 7.12, [3.16-16.04]), and community-based support/self-help groups/individual counseling (gay: AOR = 2.63, [1.72-4.01]; bisexual: AOR = 3.35, [2.30-4.88].
It is essential that barriers to health services utilization be addressed at structural and community levels. Structural interventions should be designed to reduce sexual stigma, as well as train and sensitize healthcare providers; and strengthen community level interventions that bring gay and bisexual men together to lead comprehensive health services.

BACKGROUND: Our goal was to determine the rate of complications, early revision and removal after full ambulatory implantation of bulbar AUS in men; secondly, to describe satisfaction and short-term continence rate.
METHODS: Between April 2018 and April 2019, 28 consecutive patients underwent AUS implantation in a newly organised ambulatory setting. A prospective database of all included patients was established with comprehensive data collected on medical history, aetiology and severity of SUI, surgical procedures, postoperative complications and patient satisfaction.
RESULTS: Twenty-eight patients were included (30 consecutive procedures: 22 primary AUS placement, 6 complete revisions, 2 partial revisions), with a mean follow up of 223±220.5 days. Fourteen patients had prior radiotherapy. Readmission rate was 6.7% in the first 30 days after surgery. Both revision and removal rates were 6.7%. Complications were reported in 26.7% of procedures, mainly Clavien-Dindo I. Patient satisfaction of ambulatory surgery organisation and experience was high (87/5% satisfied or very satisfied). Full continence & social continence were achieved for, respectively, 55.6% and 88.9% of procedures.
CONCLUSIONS: Ambulatory placement of AUS is safe and can be performed successfully. Larger patient cohorts and randomised trials are crucial to improve knowledge on non-indications for full ambulatory AUS implantation in men.
METHODS: