Search Results (198)

Background/Objectives: Human immunodeficiency virus (HIV) has evolved from a fatal disease to a manageable chronic condition. However, stigma persists, affecting the lives and sexuality of HIV-positive people, particularly in the gay population. Research on their sexuality is limited, highlighting the need for studies that address their experiences and needs. The aim of the study is to explore the individuals’ experiences of sexuality in serodiscordant gay couples. Methods: A descriptive study was conducted using thematic content analysis. Data collection was carried out through in-depth interviews. Six gay men who have been and/or are in a serodiscordant relationship for at least one year participated in the research. Results: Five sub-themes were identified grouped into two main themes as follows: sexuality: a complex concept accentuated by HIV and the impact of serodiscordance on partners. Conclusions: It is essential to promote accurate information and health services tailored to the needs of people living with HIV while fostering gender equity and combating stigma related to HIV and the gay community. Experiencing sexuality in this context is not only possible but can be full and satisfying when adequate resources are available. Full article

Background and Objectives: Chronic kidney disease frequently progresses to end-stage renal disease, requiring dialysis, which imposes significant physical, psychological, and social burdens. Age is a key factor influencing symptom experience and quality of life in dialysis patients, yet findings on its impact remain mixed. This study aimed to examine how age relates to a broad range of health domains—including fatigue, pain, cognition, mental health, sexual satisfaction, bowel control, visual impairment, social support, and quality of life—among hemodialysis patients. Materials and Methods: A cross-sectional study was conducted at a single dialysis center in Poland, involving 79 adult patients undergoing maintenance hemodialysis. Standardized, validated psychometric instruments were used, including the Modified Fatigue Impact Scale (MFIS), Perceived Deficits Questionnaire (PDQ), Pain Effects Scale (PES), Mental Health Inventory (MHI), Modified Social Support Survey (MSSS), Sexual Satisfaction Scale (SSS), Bowel Control Scale (BWCS), Impact of Visual Impairment Scale (IVIS), and WHOQOL-BREF for quality of life. Spearman’s or Pearson’s correlation coefficients were used to evaluate relationships between age and scale scores. Full and abbreviated versions of scales were also compared. Results: Age showed moderate positive correlations with fatigue (ρ = 0.44–0.53), cognitive deficits (ρ = 0.37–0.45), pain (r = 0.41), bowel control issues (ρ = 0.32), and visual impairment (ρ = 0.37), all statistically significant (p < 0.01). No significant associations were observed between age and mental health (MHI), perceived social support (MSSS), or quality of life (WHOQOL-BREF). Abbreviated versions of the scales showed strong correlations with their full versions (ρ > 0.9). Conclusions: While age is linked to increased symptom burden in select domains such as cognition, fatigue, and pain, it does not significantly affect mental health, perceived social support, or overall quality of life in hemodialysis patients. These findings support the use of age-sensitive, multidimensional assessments to inform individualized care strategies. Full article

Background: Black sexual minority men (BSMM) are disproportionately affected by HIV incidence and have lower rates of HIV care engagement (e.g., retention in care, viral suppression), particularly in the US South. The COVID-19 pandemic exacerbated co-occurring psychosocial syndemic factors (e.g., depression, violence, substance use) that disproportionately impact BSMM living with HIV (BSMM+), but the impact of the pandemic on HIV care engagement among BSMM+ in the US South has not been explored in depth. Methods: BSMM+ (n = 27) were recruited from a longitudinal cohort in Dallas and Houston, Texas. Participants with less-than-optimal HIV care engagement, previous experiences of intimate partner violence (IPV), and prevalence of self-reported substance use were purposively selected for in-depth interviews from June 2022 to August 2023. Interviews lasted 54 min on average and were audio-recorded, transcribed, and de-identified before applying a thematic analysis approach. Results: Over half of participants experienced a relationship with IPV, used illicit substances in the past 60 days, and were depressed. Interviews highlighted that, during the COVID-19 pandemic, heightened levels of depression, substance use, and IPV individually and synergistically inhibited ART adherence and HIV care engagement. Participants described how IPV served to worsen their mental health and substance use, which, in turn, were the core drivers of poor HIV care engagement. Conclusions: The findings suggest that the COVID-19 pandemic exacerbated the syndemics of IPV, mental health, and substance use, and these acted as barriers to HIV care engagement. Future adherence interventions should synergistically address syndemic factors to maximize effectiveness. Full article

Background: Wolfram syndrome (WFS), also known as DIDMOAD, is a rare monogenic neurodegenerative disorder characterized by four key components: non-autoimmune insulin-dependent diabetes mellitus (DM), optic atrophy, sensorineural hearing loss, and diabetes insipidus. Although it significantly affects quality of life, gonadal dysfunction, particularly hypogonadism, remains underrecognized. Methods: In total, 45 patients (25 men, 20 women) with genetically confirmed WFS from a single tertiary-care center were prospectively followed to assess gonadal function. Men underwent hormonal evaluations, semen analysis, imaging tests, and testicular biopsies. In women, data on age at menarche, menstrual irregularities, and age at menopause were recorded. Hormonal analyses, including anti-Müllerian hormone (AMH) levels, and imaging tests were also conducted. Results: Hypogonadism was identified in 19 men (76.0%), of whom 17 (68.0%) had hypergonadotropic hypogonadism and 2 (8.0%) had hypogonadotropic hypogonadism. Testicular biopsies showed seminiferous tubule damage, Sertoli cell predominance, and reduced Leydig cells. Azoospermia was observed in 12 patients, whereas others presented with oligozoospermia, teratozoospermia, or asthenozoospermia. Most patients exhibited low testosterone levels along with elevated LH and FSH, suggesting primary testicular failure, except for two cases of hypogonadotropic hypogonadism. Correlations between biomarkers, onset age and severity have been analyzed and provide important insights regarding medical treatment. In women, menstrual irregularities were universal, with 20% experiencing premature menopause. Four patients had low AMH levels, with ovarian atrophy in three and a postmenopausal uterus in two, indicating early hypogonadism risk. Conclusions: Gonadal dysfunction is a significant yet overlooked feature of WFS, requiring systematic evaluation during puberty and beyond. Proper management is essential to mitigate metabolic disturbances and psychological impacts, including infertility distress, relationship challenges, and quality of life concerns. Addressing sexual health is crucial as WFS patients live longer and aspire to establish relationships or start families. Full article

Background: Loneliness is both a social and a health-related problem, and among LGBT people, feelings of loneliness are often exacerbated. According to the minority stress theory, stress and loneliness can be directly related to the discrimination and stigma that are experienced over time in a heteronormative society. Exposure to social stigma causes mental health problems, stress, and loneliness, coupled with increased social and economic vulnerability. Method: The aim of this study was to conduct an exploratory analysis of homosexual men’s feelings of loneliness and their relationship with experiences of discrimination throughout their life. A qualitative methodology involving focus groups and individual interviews was utilized. Results: The results show the double or overlapping discriminations that gay men experience as a result of their age and sexual orientation and, in some cases, their HIV status, and the relationship between said discrimination and the feeling of unwanted loneliness. Exposure to such intolerance is more common among those with a reduced social network, which limits their social participation and has a negative impact on their well-being. Conclusion. The aging process of LGBT people implies a new context of intervention and research that must be addressed to prevent episodes of unwanted loneliness that negatively affect the quality of life among this demographic. Full article

Background/Objectives: To evaluate the quality of life (QoL) of adolescent and young adult males who had testicular prosthesis surgery during their childhood, as well as their own and their parents’ inner perceptions and feelings. To our knowledge, this is the first qualitative study and one of few with an integrated approach on the QoL of pediatric testicular prosthesis recipients. Methods: Recipients and their parents were interviewed regarding their life with the testicular prosthesis. Major QoL domains (i.e., physical and mental health, interpersonal relationships, sexuality) were assessed. Results: Although there were participants who viewed the outcomes with negativity, most expressed satisfaction. Daily routine returned to normal after a postoperative period with precautions, such as fear of damaging either the implant or the healthy testis. Prosthesis feeling was acceptable and normalized with time, while self-image and self-confidence were boosted by the presence of the prosthesis. All participants outlined the importance of privacy as being kept in the inner family circle. Some exhibited introverted behavior. Regarding sentimental and sexual intimacy, the prosthesis produced anxiety and concern both in experienced recipients and minors, which was moderated by a normal scrotal appearance. Conclusions: Testicular prosthesis surgery performed from childhood to adulthood may create profound and variable concerns, which may affect the recipients and their companions in the long term. Therefore, it should not be considered in a simplistic manner as a routine procedure and should be preceded by thorough conversation with experts. Full article

Introduction: Testicular cancer (TC) is diagnosed at a young age and carries a remarkably high cure rate. Hence, there is a sizeable population living in the survivorship phase. Many studies have highlighted the plight of TC survivors as a result of the late side-effects of the different therapeutic modalities used for the treatment of TC. This is the first study in Ireland to highlight the impact of TC on socio-economic health, sexual health, and fertility in survivors. Method: We performed a questionnaire-based survey, which was fully anonymised to encourage participation. Questionnaires were designed to measure the self-reported impact on social, sexual, and economic health on a five-point Likert scale (ranging from no effect to very significant effect), whereas any effect on fertility was investigated with questions regarding biological children before and after cancer with or without medical assistance. Results: A total of 83 TC survivors participated in the study. Almost half of our respondents revealed some effect on their performance at work and personal finances. Around one-third suffered an impact on career choice, job security, and their relationship with their partner. Regarding sexual health, the worst repercussions were noted on sex drive and body image perception, where close to half of the respondents reported at least some deterioration. Ejaculation and erectile function were affected in 30% of the participants. Of all participants, 17% reported issues with fertility, and the same proportion reported seeking medical help to conceive after diagnosis or treatment of TC. Conclusions: In conclusion, some TC survivors experience significant impact on their socio-economic and sexual health. Full article

Objective: Sexual dysfunction (SD) is a prevalent but frequently overlooked condition that adversely affects women’s quality of life and psychological well-being. This study aimed to examine the relationship between SD and depression, anxiety, and stress levels during premenopausal, pregnancy, and postmenopausal. Methods: This prospective, cross-sectional study included 300 women aged 18–70 who presented with SD symptoms to a tertiary care gynecology outpatient clinic. Participants were categorized into premenopausal, pregnant, and postmenopausal groups. Sexual function was assessed using the Female Sexual Function Index (FSFI), and psychological status was evaluated with the Depression Anxiety and Stress Scale (DASS-21). Univariate and multivariate logistic regression analyses were conducted to identify risk factors associated with SD. Results: The results showed that SD prevalence varied across life stages, with the highest rate (96%) observed in postmenopausal women. Significant decreases were found in all FSFI subscales, particularly lubrication and orgasm, during the postmenopausal period (p < 0.001). Although DASS-21 total scores did not differ significantly between groups (p = 0.227), severe stress was more prevalent in premenopausal women (p = 0.018). Univariate logistic regression revealed that older age, higher parity, and menopause increased SD risk (p < 0.001), while employment (p = 0.006), higher education (p = 0.012), and pregnancy (p < 0.001) were protective factors. Multivariate analysis identified parity as the only independent variable significantly increasing SD risk (p = 0.011). Weak but significant negative correlations were found between FSFI total score and DASS-21 total (r = −0.137, p = 0.018), anxiety (r = −0.135, p = 0.019), and depression (r = −0.176, p = 0.002) scores. Conclusion: These findings highlight the importance of individualized assessment and treatment approaches for women’s sexual health across different life stages, considering the influence of various biological, psychological, and social factors. Full article

Background and Aims: Loneliness represents a critical public health concern, significantly affecting mental and physical health. Adverse childhood experiences (ACEs) have been recognized as predictors of loneliness, yet the underlying mechanisms remain unclear. The level of personality functioning, determined by self- and interpersonal impairments, has been proposed as a potential mediator but has not been empirically explored in this context. This study examined whether personality functioning mediates the relationship between cumulative and specific types of ACEs and loneliness using a cross-sectional design. Methods: An online survey of 334 participants (mean age = 25.96; 65% female) were assessed for ACEs using a modified version of the KERF-40-I scale, their personality functioning using the Level of Personality Functioning Scale (LPFS-BF), and loneliness using the revised UCLA Loneliness Scale. Results: Higher ACE exposure was significantly associated with loneliness and greater impairments in overall personality functioning and self-functioning. After controlling for other ACE subtypes, emotional neglect remained associated with the overall level of personality functioning, while emotional neglect and sexual violence were associated with self-functioning impairments. Mediation analyses indicated that the overall level of personality functioning was consistent with a full mediation model of the ACE–loneliness association, accounting for 64% of the total effect. When examining self-functioning separately, an indirect effect accounted for 78% of the total association. In models testing specific ACE types, self-functioning fully mediated the associations between emotional neglect, sexual violence, and loneliness. Conclusions: The findings highlight self-functioning impairments as a key mechanism linking both cumulative and specific ACEs and loneliness, suggesting a need for a targeted focus on self-related impairments. Longitudinal studies are needed to clarify the developmental trajectories. Full article

Chinese tongue sole (Cynoglossus semilaevis) is an important marine fish in China. It has sexual dimorphism. The weight and growth rate of female fish are much greater than those of male fish. However, high temperatures can induce sex reversal in genetic female fish (ZW) to phenotypic male fish; thus, identifying the genetic elements involved in temperature perception will provide the molecular basis for sex control. The heat shock transcription factor (hsf) is known as an important component of temperature sensing and mediates the heat shock response in fish such as Danio rerio; however, its function in C. semilaevis is unclear. In this study, five hsf genes (hsf1, hsf2, hsf4, hsf5a, and hsf5b) were identified in tongue sole and found to be expressed in the gonads at different developmental stages, peaking from 7M to 1Y. Gonadal in situ hybridization revealed that hsf gene signals were mainly localized in germ cells, e.g., sperm in the testis and all-stage oocytes in the ovary. Upon high-temperature stimulation, the expression of the hsf gene in the gonads increased gradually with increasing stimulation time, but different hsf genes presented different response patterns. After the RNA interference of hsf in the testis and ovarian cell lines, a series of sex-related genes, such as foxl2 and dmrt1, significantly changed. In vivo RNA interference had an effect on the female gonads and mainly affected neurl3 expression. On the basis of these data, we speculate that hsf responds to temperature stimulation and plays an important role in sex differentiation. This study helps elucidate the relationship between temperature sensing and sex differentiation in C. semilaevis. Full article

This exploratory qualitative study investigates the challenges faced by young adults (aged 18–40) with severe mental illness (SMI), intellectual disabilities (IDs), and autism spectrum disorder (ASD) in navigating body perception, affectivity, intimacy, gender identity, and sexuality. Through semi-structured interviews with 13 participants recruited from a community habilitation center, thematic analysis revealed systemic barriers rooted in societal stigma, familial overprotection, and institutional neglect. Key findings highlight tensions between bodily autonomy and familial control, with prolonged caregiver dependency in intimate hygiene reflecting patterns of infantilization. We found that participants’ self-image was shaped by gendered expectations and familial critiques, reinforcing internalized stigma. Romantic relationships were often idealized through cultural narratives, yet lacked practical guidance on consent or boundaries, exacerbating vulnerabilities. Fragmented sexual education left individuals reliant on pornography or peers, perpetuating misconceptions and anxiety. Despite these barriers, participants demonstrated resilience and agency in advocating for inclusive interventions. This study underscores the urgent need for trauma-informed, rights-based approaches that prioritize autonomy, dignity, and intersectionality. Recommendations include structured skill-building programs for independence, disability-adapted comprehensive sexuality education, and systemic reforms fostering interdisciplinary collaboration. By centering lived experiences, this work challenges structural inequities and advocates for community care models that honor the diverse needs of individuals navigating the intersection of disability, identity, and sexuality. Full article

Among the models of romantic relationships, consensual non-monogamy (CNM) is one in which several affective and/or sexual relationships are allowed simultaneously. This type of relationship, still considered non-normative, has experienced a considerable increase in recent years. However, research is still limited, and studies on the subject in Spain are scarce. To better understand the differences and similarities between monogamous and CNM relationships, this study investigated both relational models, divided by sex, for four factors concerning romantic relationships: relationship satisfaction, sexual desire, jealousy, and conflict resolution styles. In a sample of 210 persons, the results showed that CNM females reported significantly higher levels of consensus and dyadic sexual desire than monogamous females. Jealousy levels were similar in both types of relationships. People in CNM relationships displayed greater conflict resolution skills through negotiation and compromise, whereas monogamous females reported using the non-constructive style of conflict engagement more than CNM females and monogamous males. CNM males indicated a greater use of withdrawal compared to CNM females. Overall, females showed more passionate jealousy than males. This investigation highlights the importance of studying romantic relationships and their different models. Full article

Background/Objectives: Relationship quality is closely tied to sexual health. This study compared the effects of tadalafil cream and oral tadalafil on Dyadic Adjustment Scale (DAS) subscales and assessed the influence of age on treatment outcomes. Methods: This study includes a secondary analysis of data collected during a previously published randomized controlled crossover trial, but they were not published at that time. The participants (n = 35) completed both tadalafil cream and oral tadalafil interventions in a crossover design. Dyadic Adjustment, including DAS subscales, was assessed at baseline and after each intervention. Improvements across all DAS subscales were greater in the tadalafil cream group compared to the oral tadalafil group. Statistically significant differences were observed for Affective Expression (5.45, 95% CI: 0.22–10.67, p = 0.041) in the multivariate model. Notable gains were observed in Affective Expression and Dyadic Cohesion for the cream route. Within-group analysis showed statistically significant improvements in Affective Expression for both treatments and in Dyadic Cohesion for the cream route. The results show that younger participants benefited more from treatment, particularly in Affective Expression, Consensus subscales, and overall for Dyadic Adjustment. Conclusion: This study provides evidence that tadalafil intervention had a favorable impact on relationship dynamics, particularly in Affective Expression and Dyadic Cohesion. Full article

Sexual health is a vital aspect of overall well-being, yet individuals with autism spectrum disorder (ASD) face significant stigma and discrimination, affecting self-esteem, relationships, and sexual expression. This review examined the recent literature (2020–January 2024) on intimacy and sexuality among adolescents and young adults with ASD, incorporating 32 studies. Findings highlight poorer sexual health among autistic individuals compared to the general population, with difficulties in forming romantic relationships and navigating sexual interactions due to hypersensitivity. Autism is also linked to non-conforming gender identities and asexuality, exposing individuals to dual stigma within the LGBTQ+ community. Autism-related traits hinder sexual health knowledge, increasing risks of victimisation, abuse, and sexually transmitted infections. Comprehensive sexual education and inclusive support are crucial to address these challenges and promote sexual well-being for autistic individuals. Full article

Background: This study aimed to explore the relationship between acetabular dysplasia (AD), a known risk factor for pelvic floor dysfunction (PFD), and its effects on sexual function and psychological well-being in women. Methods: A cross-sectional study was conducted with 125 female patients experiencing genitopelvic pain and penetrative disorders. Participants were categorized into AD-positive and AD-negative groups based on anteroposterior pelvic radiographs. Sexual function was evaluated using the Golombok–Rust Sexual Satisfaction Inventory (GRISS), while pain and psychological well-being were assessed using the Visual Analog Scale (VAS) and the Beck Depression Inventory (BDI), respectively. Results: Results showed that AD-positive patients had significantly higher pain (VAS: 8.15 ± 1.1, p < 0.001) and anxiety scores (BDI: 12.3 ± 11.0, p < 0.02). Sexual function was notably impaired in the AD-positive group, with lower sexual satisfaction and a higher prevalence of anorgasmia (p = 0.01). The AD-negative group demonstrated better scores in frequency and satisfaction with touch (p = 0.04, p = 0.03). Additionally, AD-positive patients exhibited limited hip rotation and a higher incidence of osteoarthritis and Legg–Calvé–Perthes disease. Conclusions: This study highlights the broader impact of AD on women’s quality of life, emphasizing the need for targeted therapeutic interventions to address sexual dysfunction and psychological distress in affected patients. Full article