Sexes

The 2S LGBTQIA+ (Two-Spirit, Lesbian, Gay, Bisexual, Trans, Queer and/or Questioning, Intersex, Asexual, and additional sexually and gender-diverse self-identities) population often faces barriers to care in the context of cervical cancer screening. With the shift from primary cervical cytology (Papanicolaou test) to primary human papillomavirus (HPV)-DNA testing, it is crucial to examine these populations’ healthcare needs. An intersectionality framework with an anti-oppressive lens is needed to restructure a healthcare system whose systems have traditionally erased the care needs of diverse populations through colonial, racialized, and cis-heteronormative practices. Barriers to cervical screening in 2S LGBTQIA+ populations include stigma, discrimination, limited provider guidance and understanding, and high rates of physical, sexual, and medical trauma. Self-sampling for HPV is a less invasive alternative to traditional Pap tests with a high rate of acceptability. The option to self-sample may increase participation in cervical screening based on improved privacy, comfort, and feelings of empowerment. Organizational, psychosocial, and physical recommendations for practice are shared to create a welcoming environment that reflects the diversity of populations in all aspects of healthcare. Affirmative care aims to make clients feel safe and accommodated by prioritizing dignity and respect as essential elements of eliminating cervical cancer in 2S LGBTQIA+ populations.

Background: This study focused on a community located in Sumbe, in the Kwanza Sul province of Angola. The community’s limited resources significantly affect the healthcare of its residents. Local beliefs and traditions exacerbate this issue. Considering this scenario and a preliminary diagnosis by the research team, the Seigungo project aimed to evaluate the effectiveness of a training programme with different health-related modules. The module addressed in this study focused on sexual and reproductive health. Methods: This exploratory, quantitative, observational before-and-after study employed a descriptive-correlational analysis with a sample of 30 participants (n = 30) who finished the training programme. Statistical analysis was conducted using IBM^® SPSS^® Statistics, version 29.0. Results: The sexual and reproductive health literacy module of the implemented training programme proved effective. Considering the results before the training, 53.3% of the health promoters presented inadequate literacy levels, and after the training this number decreased to only 3.3%. Conclusions: Our findings demonstrate that education and community engagement may significantly improve the levels of literacy in sexual and reproductive health, which may result in better health decisions and outcomes.

Objective: This study aimed to investigate aspects of sexual response in cisgender women by querying what participants deem to be important physiological and subjective components of sexual arousal. It was also explored whether education about the role of genital blood flow influenced participant responses. Methods: Standard sexuality-based questionnaires were administered assessing function, desire, flexibility, satisfaction, and history, prior to administering a short semi-structured interview. Experiences of sexual arousal were explored in the interview in an open-ended fashion. A brief educational video condition was shared with half of the participants at random. We explored whether being presented additional information about genital function changed the way women describe their physiological response. Those in the control group completed the interview questions once. Those in the educational condition group completed the interview, watched the brief educational video and then repeated the interview questions. Following the interview, all participants completed a brief follow-up questionnaire assessing preferred arousal terminology. Results: The sample size included 30 cisgender women with a mean age of 21.10 (4.38), with 70% in a committed relationship. Additionally, there were no group difference found with those who reported a history of sexual trauma/abuse vs. no trauma/abuse in regard to sexual function, satisfaction, distress and flexibility. The physical arousal sensations described most often in the interview included lubrication (n = 27), blood flow (n = 23), and pulsating (n = 9), whereas, in the ranked term analysis, the three most highly ranked genital sensations were wetness, throbbing and tingling. For non-genital sensations, those most often reported in the interviews included nipples/breast changes (n = 17), skin sensitivity (n = 13), and changes in body temperature (n = 12), whereas them most highly ranked non-genital sensations were heart rate increase, hardness of nipples/breast changes, and skin sensitivity. There were no group differences in the reporting of full-body or genital sensations and the frequency of use of terminology related to blood flow. The two most important themes emerging from the qualitative analysis included the distinct themes of subjective and physiological arousal. The majority of participants placed an emphasis on subjective arousal, deeming it the most important part of their sexual response, with physiological arousal largely deemed important only when subjective arousal was also present. Conclusions: The same themes were present in both groups, indicating that the brief educational video was unlikely to have influenced the way women described their physiological arousal. Participants in both groups placed a dominant emphasis on sensations related to genital blood flow and the importance of subjective arousal.