sexual health

性健康
  • 文章类型: Journal Article
    背景:适当的生殖和性健康素养对于青少年获得,理解,评估和应用做出明智决策所需的信息,由于低识字率导致有害的决策,冒险和较差的健康和自我管理。这些因素增加了与性和生殖有关的问题的规模和严重程度,包括意外怀孕,艾滋病毒/性传播感染,不安全的堕胎和死亡。然而,关于青少年生殖健康和性健康识字状况和影响因素的信息很少。
    目的:评估青春期后期高中生的生殖和性健康素养状况及其相关因素。
    方法:横截面,基于机构的研究。
    方法:该研究包括埃塞俄比亚南部地区ArbaMinch镇(Gamo区)的8所中学和Sawla镇(Gofa区)的3所中学。
    方法:这项研究是在2023年5月20日至6月20日之间进行的,对象是青春期晚期的高中生。使用多级采样,招募了577名学生。使用青少年健康素养测量工具评估生殖健康素养。将数据加载到EpiData-V.3.1中并使用SPSS-V.25进行分析。二元logistic回归分析用于确定相关因素。双变量逻辑回归中p值<0.25的变量是多变量逻辑回归的候选变量。检查并满足了Hosmer-Lemeshow拟合优度统计数据。在p值<0.05时显示统计学显著性。
    结果:生殖和性健康素养有限的学生比例为69.6%(CI为65.3%至72.8%)。有限的识字状态与学校类型显着相关(公立学校AOR0.28(0.17至0.46)),母亲的职业(商人AOR0.42(0.23至0.76)),家庭月收入(收入10000-20000比尔AOR0.45(0.22至0.95)),有规律的体育锻炼>30分钟(每周超过一次,AOR0.44(0.23至0.84)),和有关避孕套的知识(差AOR2.23(1.38至3.64))。
    结论:明显的青少年表现出有限的生殖和性健康素养。结果强调,所有相关各方都必须努力工作,以确保学校青少年能够轻松获得,理解,评估和使用生殖和性相关信息。
    BACKGROUND: Adequate literacy in reproductive and sexual health is essential for adolescents to obtain, comprehend, evaluate and apply information necessary for making well-informed decisions, as low literacy leads to harmful decision-making, risk-taking and poorer health and self-management. These factors increase the magnitude and severity of problems related to sexuality and reproduction, including unintended pregnancy, HIV/sexually transmitted infections, unsafe abortion and death. However, information regarding the status and affecting factors of literacy in the reproductive and sexual health of adolescents is scarce.
    OBJECTIVE: To assess reproductive and sexual health literacy status and associated factors among late-adolescent high school students.
    METHODS: A cross-sectional, institution-based study.
    METHODS: The study included eight secondary schools in Arba Minch town (Gamo Zone) and three in Sawla town (Gofa Zone) in the South Ethiopia Region.
    METHODS: The study was done between 20 May and 20 June 2023, among late adolescent high school students. Using multistage sampling, 577 students were recruited. Reproductive health literacy was assessed using the Health Literacy Measure for Adolescents tool. Data were loaded into EpiData-V.3.1 and analysed using SPSS-V.25. Binary logistic regression analyses were used to identify associated factors. Variables with a p value <0.25 in bivariable logistic regression were candidates for multivariable logistic regression. A Hosmer-Lemeshow goodness-of-fit statistic was checked and satisfied. Statistical significance was indicated at a p value<0.05.
    RESULTS: The proportion of students with limited reproductive and sexual health literacy was 69.6% (CI 65.3% to 72.8%). The limited literacy status was significantly associated with school type (public school AOR 0.28 (0.17 to 0.46)), mother\'s occupation (merchant AOR 0.42 (0.23 to 0.76)), family monthly income (income 10 000-20 000 birr AOR 0.45 (0.22 to 0.95)), having regular physical exercise >30 min (more than once per week, AOR 0.44 (0.23 to 0.84)), and knowledge about condoms (poor AOR 2.23 (1.38 to 3.64)).
    CONCLUSIONS: A notable segment of adolescents exhibited limited reproductive and sexual health literacy. The result emphasises the necessity of all relevant parties to work diligently to guarantee that school adolescents can easily obtain, comprehend, evaluate and use reproductive and sexuality-related information.
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  • 文章类型: Journal Article
    本范围审查旨在全面探讨禁忌的景观及其对性健康和生殖健康的影响。标题为“禁止对话”,“它深入研究了复杂的社会网络,文化,和宗教规范,这些规范导致性健康和生殖健康主题难以捉摸且往往受到污名化。该评论浏览了这些禁忌的多层面,揭示了它们对个人的影响,社区,和公共卫生,同时倡导向开放的范式转变,包容性,和知情对话。这篇评论中的分析跨越了十年,捕获最新和相关的文献来绘制性健康和生殖健康禁忌的景观。它探讨了持续的社会忧虑和随后围绕月经等主题的污名化,避孕,生育力,性取向,和性别认同。该评论通过追溯历史悠久的禁忌及其在不同文化和背景下的演变,将这些现行规范所带来的多方面挑战纳入了背景。范围审查确定了这些禁忌对公共卫生的深刻影响,强调它们是如何导致获得医疗保健的差距,永存的错误信息,侵犯个人的基本权利。它解决了性教育中的挑战,强调这些禁忌如何阻碍青少年和年轻人对性健康和生殖健康权利的全面理解和执行。本评论采取的交叉方法将这些禁忌置于更广泛的不平等体系中,强调它们对边缘化人群的复合影响。通过这次全面的探索,审查旨在提供可操作的见解,并确定现有的研究,政策,和练习差距。它力求为今后倡导污名化的倡议奠定基础,赋权,以及性健康和生殖健康方面的公平。最终,“禁止对话”旨在引导对话走向开放和包容,同时倡导不偏不倚,全面的性和生殖保健,为所有人提供尊严。
    This scoping review aims to comprehensively explore the landscape of taboos and their impact on sexual and reproductive health. Titled \"Forbidden Conversations,\" it delves into the intricate web of societal, cultural, and religious norms that have contributed to the elusive and often stigmatized nature of sexual and reproductive health topics. The review navigates through the multifaceted dimensions of these taboos, shedding light on their impact on individuals, communities, and public health while advocating for a paradigm shift toward open, inclusive, and informed dialogue. The analysis within this review spans a decade, capturing the most recent and relevant literature to map the landscape of taboos in sexual and reproductive health. It explores the persistent societal apprehensions and subsequent stigmatization surrounding topics such as menstruation, contraception, fertility, sexual orientation, and gender identity. The review contextualizes the multifaceted challenges presented by these prevailing norms by tracing historically rooted taboos and their evolution across different cultures and contexts. The scoping review identifies the profound implications of these taboos on public health, highlighting how they contribute to disparities in access to healthcare, perpetuate misinformation, and infringe upon the fundamental rights of individuals. It addresses the challenges in sexual education, emphasizing how these taboos impede comprehensive understanding and enforcement of sexual and reproductive health rights among adolescents and young adults. The intersectional approach taken in this review situates these taboos within broader systems of inequality, emphasizing the compounded impact they have on marginalized populations. Through this comprehensive exploration, the review aims to provide actionable insights and identify existing research, policy, and practice gaps. It seeks to lay the foundation for future initiatives that advocate for destigmatization, empowerment, and equity in sexual and reproductive health. Ultimately, \"Forbidden Conversations\" aims to steer the conversation toward openness and inclusivity while advocating for unbiased, comprehensive sexual and reproductive healthcare with dignity for all individuals.
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  • 文章类型: Journal Article
    背景:中低收入国家的青少年和年轻妇女在接触艾滋病毒方面面临障碍,性健康和生殖健康(SRH)和相关的基于性别的暴力(GBV)服务。本文介绍了主持人,机遇,以及增加艾滋病毒吸收的障碍,GBV,赞比亚某些地区的少女和年轻妇女(AGYW)中的SRH服务。
    方法:本研究在崇高进行,Mazabuka,赞比亚少女和年轻妇女中的蒙古区。采访了主要线人(n=29)以及校内和校外青少年和年轻人(n=25)。目的抽样用于选择和招募研究参与者。访谈被逐字转录,并采用内容分析法进行分析。
    结果:用于加强服务的促进者包括获得关于青少年艾滋病毒和基于性别的暴力综合服务的健康教育信息。非政府组织是这一信息的主要来源。这些机会与提供服务的综合方法的可用性以及加强社区和卫生中心与转介专业服务的联系有关。然而,研究人员注意到个人的一些障碍,社区,和卫生系统水平。拒绝或延迟寻求服务,担心与避孕药相关的副作用,到医疗机构的长距离影响了服务的使用。社会耻辱和文化信仰也影响了社区对可用服务的理解和使用。卫生系统的障碍是;基础设施不足,人员配备水平低,工作人员提供所有服务的能力有限,提供者的年龄和性别,缺乏商品和专业服务。
    结论:研究人员承认促进和机会,提高艾滋病毒的吸收,GBV,SRH服务。然而,未能解决个人和卫生系统层面的障碍总是对已知和有效干预措施的采用产生负面影响。他们建议方案管理人员利用已查明的机会,加强为年轻人提供这些服务。
    BACKGROUND: Adolescents and young women in low-middle-income countries face obstacles to accessing HIV, Sexual and Reproductive Health (SRH), and related Gender-Based Violence (GBV) services. This paper presents facilitators, opportunities, and barriers to enhance uptake of HIV, GBV, and SRH services among Adolescent Girls and Young Women (AGYW) in selected districts in Zambia.
    METHODS: This study was conducted in Chongwe, Mazabuka, and Mongu Districts among adolescent girls and young women in Zambia. Key informants (n = 29) and in and out-of-school adolescents and young people (n = 25) were interviewed. Purposive sampling was used to select and recruit the study participants. Interviews were transcribed verbatim, and a content analysis approach was used for analysis.
    RESULTS: The facilitators that were used to enhance the uptake of services included having access to health education information on comprehensive adolescent HIV and gender-based violence services. Non-governmental organisations (NGOs) were the main source of this information. The opportunities bordered on the availability of integrated approaches to service delivery and strengthened community and health center linkages with referrals for specialised services. However, the researchers noted some barriers at individual, community, and health system levels. Refusal or delay to seek the services, fear of side effects associated with contraceptives, and long distance to the health facility affected the uptake of services. Social stigma and cultural beliefs also influenced the understanding and use of the available services in the community. Health systems barriers were; inadequate infrastructure, low staffing levels, limited capacity of staff to provide all the services, age and gender of providers, and lack of commodities and specialised services.
    CONCLUSIONS: The researchers acknowledge facilitators and opportunities that enhance the uptake of HIV, GBV, and SRH services. However, failure to address barriers at the individual and health systems level always negatively impacts the uptake of known and effective interventions. They propose that programme managers exploit the identified opportunities to enhance uptake of these services for the young population.
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  • 文章类型: Journal Article
    目标:尽管有可用的支持,性需求是前列腺癌男性中最常见的未满足需求,这可能是由于低的求助率。以生态系统框架为理论基础,我们对现有文献进行了范围审查,以了解哪些因素影响接受治疗的男性前列腺癌治疗后性问题的求助行为.
    方法:遵循PRISMA指南,在Medline上进行系统搜索,PsychInfo,Embase,Emcare,和Scopus进行了鉴定成年前列腺癌患者治疗后的研究,报告了寻求性健康问题的障碍和/或促进者。使用乔安娜·布里格斯研究所的评估工具进行质量评估,并对结果进行定性合成。
    结果:在3870个独特的结果中,只有30项研究符合纳入标准.总的来说,研究被认为是中等到良好的质量,尽管只有六个使用标准化措施来评估寻求帮助的行为。在生态系统框架的所有五个层面上都确定了寻求性帮助的障碍和促进者,包括年龄,治疗类型,和以前的帮助寻求经验(个人水平),医疗保健专业沟通和合作伙伴支持(微系统),财务成本和支持的可获得性(中观/外系统),最后是尴尬,阳刚之气,文化规范,和性少数(宏观系统)。
    结论:解决通常报告的障碍(相反,加强促进者)寻求帮助解决性问题对于确保患者得到适当支持至关重要。根据我们的结果,我们建议医疗保健专业人员将性健康讨论作为所有前列腺癌患者的标准护理,无论接受何种治疗,年龄,性取向,和伙伴关系地位/参与。
    OBJECTIVE: Despite available support, sexuality needs are the most frequently reported unmet need among men with prostate cancer, which may be due to low help-seeking rates. Using the Ecological Systems Framework as a theoretical foundation, we conducted a scoping review of the available literature to understand what factors impact help-seeking behaviour for sexual issues after prostate cancer treatment among men who had received treatment.
    METHODS: Following PRISMA guidelines, a systematic search on Medline, PsychInfo, Embase, Emcare, and Scopus was conducted to identify studies of adult prostate cancer patients post-treatment, which reported barriers and/or facilitators to help-seeking for sexual health issues. Quality appraisals were conducted using Joanna Briggs Institute appraisal tools, and results were qualitatively synthesised.
    RESULTS: Of the 3870 unique results, only 30 studies met inclusion criteria. In general, studies were considered moderate to good quality, though only six used standardised measures to assess help-seeking behaviour. Barriers and facilitators for sexual help-seeking were identified across all five levels of the Ecological Systems Framework, including age, treatment type, and previous help seeking experience (individual level), healthcare professional communication and partner support (microsystem), financial cost and accessibility of support (meso/exosystem), and finally embarrassment, masculinity, cultural norms, and sexuality minority (macrosystem).
    CONCLUSIONS: Addressing commonly reported barriers (and inversely, enhancing facilitators) to help-seeking for sexual issues is essential to ensure patients are appropriately supported. Based on our results, we recommend healthcare professionals include sexual wellbeing discussions as standard care for all prostate cancer patients, regardless of treatment received, age, sexual orientation, and partnership status/involvement.
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  • 文章类型: Journal Article
    泰国人对生殖器白癜风的了解有限。
    这项研究评估了临床表现,生活质量,生殖器白癜风的性健康后果。
    这个横截面,在Siriraj医院进行了一项以问卷调查为基础的研究,该研究涉及18岁或18岁以上有过去或现在生殖器受累的白癜风患者.它还测量了性健康和生活质量的各个方面。
    41名参与者的平均年龄为48.2岁,男性24人(58.5%)。所有参与者都出现生殖器白癜风。在男性中,阴茎轴(45.8%),阴囊(45.8%),和龟头(33.3%)主要受影响。在女性中,蒙斯(64.7%),大阴唇(23.5%),小阴唇(23.5%)经常受累。男女都报告了耻骨区的痛苦(41.5%),腹股沟区(36.6%),臀部(34.1%),和口腔粘膜(34.1%)。26.8%的患者以瘙痒为主要症状。皮肤病学生活质量指数评分中位数有显著差异(女性6,男性3.5)。与男性相比,女性的自尊心较低(41.2%vs29.2%),对婚姻的担忧增加(11.8%对8.3%),以及对性活动的尴尬(23.5%对16.7%)。值得注意的是,65.9%的患者没有与医生讨论过生殖器白癜风,51.2%的医生没有询问或检查生殖器受累情况。
    生殖器白癜风对生活质量和自尊产生不利影响,尤其是女性患者。患者和医生之间缺乏交流,这凸显了提高意识和积极临床调查以增强患者护理和满意度的必要性。
    UNASSIGNED: The understanding of genital vitiligo among Thai individuals is limited.
    UNASSIGNED: This study evaluated the clinical presentation, quality of life, and sexual health consequences of genital vitiligo.
    UNASSIGNED: This cross-sectional, questionnaire-based study involving vitiligo patients aged 18 years or older with past or present genital involvement was conducted at Siriraj Hospital. It also measured aspects of sexual health and quality of life.
    UNASSIGNED: The mean age of the 41 participants was 48.2 years, and 24 (58.5%) were males. All participants presented with genital vitiligo. In males, the penile shaft (45.8%), scrotum (45.8%), and glans (33.3%) were predominantly affected. In females, the mons pubis (64.7%), labia majora (23.5%), and labia minora (23.5%) were frequently involved. Both sexes reported afflictions in the pubic area (41.5%), inguinal region (36.6%), buttocks (34.1%), and oral mucosa (34.1%). Itching was the principal symptom in 26.8% of the patients. The median Dermatology Life Quality Index scores were significantly different (females 6, males 3.5). Compared with their male counterparts, females exhibited lower self-esteem (41.2% vs 29.2%), greater apprehension about marriage (11.8% vs 8.3%), and embarrassment about sexual activities (23.5% vs 16.7%). Remarkably, 65.9% of patients had not discussed their genital vitiligo with their doctors, and 51.2% of physicians had not inquired about or examined for genital involvement.
    UNASSIGNED: Genital vitiligo adversely impacts quality of life and self-esteem, particularly among female patients. The lack of discourse between patients and physicians highlights a need for increased awareness and proactive clinical investigations to enhance patient care and satisfaction.
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  • 文章类型: Journal Article
    目的:对妇女的暴力行为是一个广泛的公共卫生问题,对妇女的性健康和生殖健康造成严重影响,包括更高的流产或死产风险,意外怀孕和人工流产。这项研究调查了女性遭受身体暴力之间的关系,心理暴力和性健康和生殖健康结果(避孕药具的使用,流产或死产和流产)在德国。
    方法:本研究采用横断面研究设计,分析通过德国成人健康访谈和检查调查收集的关于暴力侵害妇女行为以及性健康和生殖健康(SRH)结果的数据,第一波,2008年至2011年(n=3149名女性,18-64岁)。使用多变量逻辑回归模型来评估女性暴力经历与性健康和生殖健康结果之间的关联。考虑到社会人口统计学和健康相关因素的影响(年龄,婚姻状况,社会经济地位,社会支持,儿童数量,酒精消费,健康状况,慢性疾病)。
    结果:在完全调整的模型中,三个关联仍然显着(p<0.05):(i)父母或照顾者对身体暴力的暴露以及避孕药的使用(aOR,调整后的赔率比,95%CI:1.36,1.02-1.81)(ii)自16岁起遭受身体暴力和流产或死产(aOR,95CI:1.89,1.17-3.04);以及(iii)父母或照顾者和堕胎的心理暴力(aOR,95CI:1.87,1.30-2.70)。
    结论:结果表明,自16岁起遭受身体或心理暴力的德国成年妇女,包括父母或照顾者的暴力行为,更有可能报告流产或死产和流产。对妇女的暴力经历的直接评估应由医疗保健专业人员在临床中进行,特别是妇产科专家,预防妇女不良的性健康和生殖健康结果。此外,暴力应被视为主要的公共卫生问题,并通过多部门方法加以解决,涉及医疗保健和教育部门,研究人员和相关政策制定者。
    OBJECTIVE: Violence against women is a widespread public health concern with severe effects to women\'s sexual and reproductive health, including higher risks for miscarriage or stillbirth, unintended pregnancy and induced abortion. This study examined the association between women exposure to physical violence, psychological violence and sexual and reproductive health outcomes (contraceptive use, miscarriage or stillbirth and abortion) in Germany.
    METHODS: This study used a cross-sectional research design to analyze data on violence against women and sexual and reproductive health (SRH) outcomes collected through the German Health Interview and Examination Survey for Adults, Wave 1, between 2008 and 2011 (n = 3149 women, aged 18-64 years). Multivariable logistic regression models were used to assess the association between experiences of violence among women and the presence of sexual and reproductive health outcomes, considering the influence of socio-demographic and health-related factors (age, marital status, socioeconomic status, social support, number of children, alcohol consumption, health status, chronic conditions).
    RESULTS: Three associations remained significant (p<0.05) in fully-adjusted models: (i) exposure to physical violence by a parent or caregiver and birth control pill utilization (aOR, adjusted Odds Ratio, 95% CI: 1.36, 1.02-1.81) (ii) exposure to physical violence since the age of 16 and miscarriage or stillbirth (aOR, 95%CI: 1.89, 1.17-3.04); and (iii) exposure to psychological violence by a parent or caregiver and abortion (aOR, 95%CI: 1.87, 1.30-2.70).
    CONCLUSIONS: The results suggest that adult German women who experienced physical or psychological violence since the age of 16, including violence perpetrated by a parent or caregiver, were more likely to report miscarriage or stillbirth and abortion. Direct assessment of violence experiences against women should be conducted by healthcare professionals in clinical encounters, particularly by obstetrics and gynaecological specialists, for the prevention of women´s adverse sexual and reproductive health outcomes. Furthermore, violence should be treated as a major public health concern and addressed through a multisectoral approach, involving the healthcare and educational sectors, researchers and relevant policymakers.
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  • 文章类型: Journal Article
    在过去的几十年中,大量索马里妇女在全球各地迁移。对于东道国的医护人员来说,了解索马里妇女的医疗保健需求至关重要。大多数索马里女性移民经历女性生殖器切割(FGC)。索马里最常见的类型是3型或阴锁,阴道口变窄.下阴锁假手术可打开入口,以减少不良的健康结果和/或允许阴道分娩。在这项研究中,我们探讨了居住在美国的索马里妇女对去阴锁的看法。我们通过基于社区的参与研究方法招募了75名经历过FGC的索马里妇女。双语社区研究人员用索马里语或英语进行了定性访谈。大学教师和社区研究人员在参与式分析过程中将数据编码在一起。我们确定了四个主题。(1)个人观点:参与者报告了对去阴锁的积极态度,并且在婚前去阴锁的适当性方面有所不同。(2)好处:确定的好处包括减轻健康问题;改善性健康,特别是减少或预防性疼痛;以及恢复身体和女性。(3)障碍:这些障碍包括相关的耻辱和提供者缺乏知识。(4)决策:大多数报告说,丈夫,医疗保健提供者,年长的女性社区成员可以提供有关是否和/或何时寻求去阴部的建议,尽管有些人认为去阴部的决定完全取决于受影响的女性。生态框架用于构建调查结果,并确定医护人员在协助被告知的妇女做出决定方面的重要性。
    The past decades have seen large numbers of Somali women migrate across the globe. It is critical for healthcare workers in host countries to understand healthcare needs of Somali women. The majority of Somali female migrants experience female genital cutting (FGC). The most common type in Somalia is Type 3 or infibulation, the narrowing of the vaginal introitus. Deinfibulation opens the introitus to reduce poor health outcomes and/or allow for vaginal births. In this study, we explored the perspectives of Somali women living in the United States about deinfibulation. We recruited 75 Somali women who had experienced FGC through community-based participatory research methods. Bilingual community researchers conducted qualitative interviews in Somali or English. University faculty and community-based researchers coded data together in a participatory-analysis process. We identified four themes. (1) Personal Views: participants reported positive attitudes toward deinfibulation and varied on the appropriateness of deinfibulation before marriage. (2) Benefits: identified benefits included alleviation of health problems; improved sexual health, in particular reduction or prevention of sexual pain; and reclamation of body and womanhood. (3) Barriers: these included associated stigma and lack of knowledge by providers. (4) Decision-Making: most reported that husbands, healthcare providers, and elder female community members may provide advice about if and/or when to seek deinfibulation, though some felt deinfibulation decisions are solely up to the impacted woman. An ecological framework is used to frame the findings and identify the importance of healthcare workers in assisting women who have been infibulated make decisions.
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