Search Results (423)

The scientific literature was reviewed to systematically identify and characterize validated scales measuring homophobia, lesbophobia, biphobia, and transphobia, as well as the biopsychosocial consequences derived from these attitudes in sexual and gender minority (SGM) populations. The search was conducted in the WOS, Scopus, and Medline databases, limited to studies published between January 2015 and January 2024. This review was registered in the International Prospective Register of Systematic Reviews, and its quality was evaluated using the Effective Public Health Practice Project instrument. The criteria of the PRISMA declaration for systematic reviews were applied. Among the 78 articles initially selected, 9 met the established eligibility criteria. In these 9 articles, 13 validated scales were identified, covering attitudes toward sexual and gender minorities, internalised stigma, minority stress and resilience, parental acceptance, and experiences of bullying and cyberbullying in SGM populations. The findings reveal substantial fragmentation in the available measurement landscape, with most instruments lacking cross-cultural validation, measurement invariance testing, and construct coverage beyond Western, English- or Spanish-speaking contexts. These results should be interpreted with caution given the limited number of included studies and the absence of meta-analytic quantification. This review proposes the development of a novel intermodular measurement system as a priority research agenda and identifies key implications for specialized psychiatric and clinical practice, public health surveillance, and future research. Full article

Background: Chemsex, or sexualized drug use, exists along a continuum ranging from non-problematic, consensual recreational practice across diverse populations to problematic behaviors linked with clinical vulnerabilities, substance dependence, or compulsive disorders. Within nursing practice, understanding this spectrum is essential to mitigate healthcare-related stigma. Objective: To map and synthesize evidence on stigma and attitudes among nurses regarding chemsex, identifying implications for practice and research. Methods: A scoping review was conducted following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Searches were performed across PubMed/MEDLINE, Scopus, Web of Science, CINAHL, EMBASE, and LILACS. Studies involving nurses or healthcare teams focused on stigma, attitudes, or related constructs in chemsex care were included. Data underwent descriptive and thematic synthesis. Results: Six studies met the inclusion criteria, showing substantial heterogeneity. Only one focused exclusively on nurses. Stigma and attitudes were rarely assessed explicitly, emerging instead as underlying factors influencing clinical practice, communication, and patient engagement. Key themes included the necessity for non-judgmental care, significant gaps in knowledge and training, variability in clinical practice, and the impact of organizational barriers. A schematic representation was developed to illustrate the interrelationships between stigma, knowledge, professional attitudes, and structural factors influencing healthcare practice. Conclusions: This review positions stigma as a central mechanism influencing nursing care in chemsex contexts. The findings underscore critical gaps in nursing-specific evidence and emphasize the need for targeted training, validated measurement tools, and integrated care models. Strengthening stigma-informed, patient-centered approaches is essential to improve care delivery and health outcomes for this population. Full article

Implicit bias, automatic attitudes or stereotypes outside conscious awareness, may influence clinicians’ communication, diagnosis, and treatment decisions, contributing to inequities in care. We conducted a scoping review to map measurement strategies used to assess implicit bias among health professionals and students in healthcare and training settings. Using Joanna Briggs Institute guidance and PRISMA-ScR, we searched PubMed, Embase, BVS, Google Scholar, and institutional repositories for studies to November 2025; two reviewers independently screened and charted data (protocol was developed a priori but submitted internal in organization, and then uploaded in OSF. Of 1864 records, 93 studies from 28 countries were included. We identified 57 bias domains, most often race/ethnicity, weight, and sexual orientation. Across studies, 42 unique instruments were reported; the Implicit Association Test was most common, while psychometric validation and administration details were frequently limited, constraining comparability and interpretation. Evidence gap mapping showed concentration in academic and hospital settings, with fewer studies in primary care or community contexts and limited attention to age, disability, and intersectionality-related biases. The evidence base is growing but fragmented; future work should prioritize standardized administration and reporting, stronger validation, and tools that better capture automatic responding across diverse identities and care settings to support education and equity-oriented interventions. Full article

Previous research has shown that both victim intoxication and narrative framing can influence the levels of victim blame. However, far less attention has been paid to how coercive strategy and narrative framing may interact to shape victim-blaming judgements and perceptions of sexual assault. The present study addresses this gap by examining how combinations of coercive strategies (physical force versus alcohol facilitated), narrative framing (active versus passive), and rape myth acceptance (RMA) influence victim blame and the recognition of sexual assault. Participant gender and age were also assessed in relation to RMA and victim-blaming attitudes. A total of 202 participants aged 18–63 (78.7% of women, 21.3% of men, M_Age = 28.93, SD = 14.36) completed an online survey evaluating vignettes depicting a male perpetrator sexually assaulting a female victim. Age significantly predicted victim blaming, with older participants assigning greater blame to the victim. Gender predicted both RMA and victim blame, with men reporting higher RMA and greater victim blame than women. Active framing in both the physical force and alcohol-use conditions reduced participants’ recognition of the incident as sexual assault. Participants with lower RMA consistently reported lower victim blame across conditions, and were more likely to identify the incident as sexual assault in the physical force condition. These findings highlight the influence of coercive strategies and the importance of victim-centred language in policing, legal, and media contexts, where narrative framing can meaningfully shape the recognition of sexual assault. Full article

Sexual violence against young girls is a complex phenomenon encompassing multiple forms of abuse and leading to numerous negative outcomes. Therefore, rehabilitation measures play a critical role in reducing recidivism and enhancing victims’ safety. This study examined preliminary results of a 25-session individual intervention program (the INSIGHT Program) designed for individuals who sexually offended in Portugal, in both prison and community settings. In this pilot clinical trial, 19 participants were assigned to one of two conditions: INSIGHT plus treatment as usual (TAU) or TAU alone. Data was collected at baseline and at the end of the intervention. Proximal outcomes (e.g., attitudes toward child sexual abuse, victim empathy, interpersonal problems, and early maladaptive schemas) were assessed. The Reliable Change Index (RCI) was computed. Results indicated that participants receiving INSIGHT plus TAU evidenced greater clinical improvements in empathy toward victims and interpersonal problems compared with participants receiving TAU alone. Overall, the intervention demonstrates potential to reduce some risk factors among individuals who perpetrated sexual violence against young girls. However, we highlight the need to reconsider the work carried out on EMSs, particularly regarding the techniques used. Full article

Background: Sexuality remains an important dimension of well-being in later life, yet it is often surrounded by misconceptions and ageist stereotypes. Understanding sociodemographic, cognitive, attitudinal, motivational, and behavioral aspects of sexuality among older adults may contribute to a more comprehensive view of sexual well-being in aging. Objectives: This study aimed (1) to describe older adults’ knowledge, attitudes, sexual motivation, behaviors, and satisfaction; (2) to examine differences between individuals who reported engaging in partnered eroto-genital activity during the previous six months and those who did not; and (3) to identify sociodemographic (age, gender, religiosity and health condition), cognitive, attitudinal, and motivational factors associated with engagement in partnered eroto-genital activity. Methods: A cross-sectional study was conducted with 186 adults aged 65–88 years (M = 73.29). Participants completed the Aging Sexual Knowledge and Attitudes Scale (ASKAS) and a Sexual Behavior Questionnaire assessing sexual motivation, sexual behaviors, and sexual satisfaction. Descriptive analyses, group comparisons, and hierarchical logistic regression analyses were performed. Results: Participants showed relatively adequate knowledge and generally favorable attitudes, although several misconceptions persisted. Affective behaviors were more frequent than eroto-genital practices. Individuals reporting partnered eroto-genital activity showed higher knowledge, more positive attitudes, greater perceived importance of sexuality, and higher sexual satisfaction. Regression analyses indicated that age, gender, attitudes toward sexuality, and perceived importance of sex were significant predictors of partnered eroto-genital activity, with perceived importance of sex showing the strongest association. Conclusions: Sexuality in later life reflects diverse patterns shaped by cognitive, attitudinal, and especially motivational dimensions. These findings highlight the central role of subjective importance and attitudes in sexual engagement, suggesting that interventions may benefit from moving beyond information provision to also address motivational and relational aspects of sexuality in aging populations. Full article

Sexual objectification is the treatment of a person as a body or a collection of body parts that are valued primarily for their sexual appeal. The main purpose of this study was to determine the relevance of sexual objectification to women’s health and well-being across the life cycle, from middle adolescence to old age. Additionally, the relevance of age and education to sexual objectification and its association with traditional gender role attitudes was examined. This study was cross-sectional and the sample consisted of 6112 Spanish women between the ages of 16 and 85, who were assessed using seven questionnaires and scales. The results show that lower age and lower number of children were associated with greater importance of sexual and physical attractiveness and with a more sexualized image, although there were no differences between adolescent and emerging adult women. Greater importance placed on sexual and physical attractiveness, as well as total sexual objectification, was associated with greater mental distress, lower psychological well-being, lower life satisfaction, and lower self-esteem at every life stage. Greater importance placed on sexual and physical attractiveness was associated with more traditional gender role attitudes among all age groups, except for older women. We conclude that sexual objectification is a threat to women’s mental health and well-being. Full article

Introduction: Syphilis is a preventable sexually transmitted infection (STI) with severe health outcomes, yet it is not included in Saudi Arabia’s national premarital and antenatal STI screening programs. This study assessed knowledge, attitudes, and practices (KAP) toward syphilis in Saudi Arabia and identified predictors of acceptance for including syphilis testing in such programs. Methods: A cross-sectional online survey was conducted among 935 participants aged ≥20 years. Data included sociodemographic characteristics and measures of KAP and screening acceptance. Continuous variables were summarized as medians (IQR) and categorical variables as frequencies and percentages, with bivariate and multivariate logistic regression used to identify predictors of screening acceptance. Results: Knowledge and preventive practices were low, while attitudes were predominantly neutral (median attitude score: 34 IQR 32–38). Although intentions for personal testing were low (17%), support for syphilis testing in premarital (60.8%) and antenatal (48.9%) programs was considerable. Employment in the health sector, older age, and positive attitudes predicted acceptance of screening policies. Knowledge and practice showed a weak correlation (r = 0.14), whereas knowledge and attitude were moderately correlated (r = 0.55). Conclusion: KAP toward syphilis is influenced by specific sociodemographic factors. Although acceptance of screening is high at the policy level, individual-level preventive behaviors remain low. Full article

Gender-based violence (GBV) in higher education is increasingly recognized as a systemic problem across offline and online contexts, yet the pathways linking gender-related attitudes, victimization, and formal help-seeking remain insufficiently understood in Southern Europe. This study examined whether Sexual Harassment/Assault and Coercive Control mediate associations between ambivalent sexism, Acceptance of Dating Violence, Perceived Behavioral Control, and Formal Help-Seeking Intentions among women students in Greek higher education. An anonymous online survey was completed by 550 women students, and structural equation modeling tested direct, mediated, and multi-group associations by age, education level, and perceived financial situation. Coercive Control was the strongest predictor of Formal Help-Seeking Intentions, followed by Acceptance of Dating Violence and Perceived Behavioral Control, whereas Hostile and Benevolent Sexism had no significant direct effects. Mediation analyses showed that Coercive Control, rather than Sexual Harassment/Assault, provided the more consistent pathway to help-seeking intentions. Multi-group analyses indicated broadly stable patterns, with selected differences by age, education, and financial situation. The findings suggest that university GBV policies should move beyond incident-based responses, address patterned Coercive Control, and improve students’ perceived ability to access formal support services. Full article

Globally, intimate partner violence (IPV) is a public health concern and the most prevalent type of violence against women. Social norms that condone violence have been strongly associated with intimate partner violence, making them relevant to women’s wellbeing. The identification of social norms unique to a population is necessary for interventions based on shifting social norms. Thus, the current research is aimed at examining the association between women’s attitudes toward wife-beating (a social norm) and women’s experiences of partner’s controlling behavior, physical violence, and emotional and sexual abuse in Tanzania from national representative data. The cross-sectional data used for the study were from Tanzanian women (n = 3033) aged 15–49 years who have ever been married or in a relationship and responded to the domestic violence questionnaire. Nearly, 60% of women reported that their most recent partner had engaged in controlling behavior, 27.5% had experienced physical violence, while 23% and 9.1% had experienced emotional and sexual violence, respectively. The multivariate analysis revealed that IPV was more common among women who had a positive attitude toward wife-beating. In addition to other behavioral and structural interventions, changing societal norms that support violence against women may be helpful to prevent IPV among Tanzanian women. Full article

This study examined whether attitude toward sport moderates the association between attitude toward violence and attitude toward sexual harassment among university students. Based on evidence that harassment-supportive beliefs are embedded within broader violence-supportive orientations, sport-related values were tested as a conditional factor. A cross-sectional correlational design was used with 350 undergraduates (45.1% female; M_age = 21.81, SD = 2.57) from a public university in Türkiye. Participants completed validated measures of attitudes toward sexual harassment, violence, and sport. Moderation analysis was conducted using Hayes’ PROCESS Macro (Model 1) with 5000 bootstrap resamples and HC3 standard errors. Gender was included as a control variable; male participants reported significantly higher tolerance toward sexual harassment (β = 7.258, p < 0.001). Attitude toward violence was positively associated with attitude toward sexual harassment (B = 0.271, p < 0.001). Attitude toward sport showed a small negative main effect (B = −0.199, p < 0.001) and significantly moderated this association (B = −0.010, p = 0.0008). The model explained 26.06% of the variance (R² = 0.261, F (4, 345) = 33.607, p < 0.001). The association weakened at higher sport attitude levels but remained significant, indicating a pattern of conditional attenuation. Full article

Background: Sexual Assault Care Centres (SACCs) in Belgium provide integrated medical and psychological care, a forensic examination and the option to report to the police to victims of sexual assault (SA). Understanding victims’ acceptability of these services is essential for improving SACC’s effectiveness and informing policy. Methods: In-depth interviews were conducted with 19 victims and 14 support persons to explore victims’ experiences with SACCs. The victims represented diverse characteristics (gender, age, SACC site and police reporting status). Data were analysed using thematic framework analysis, guided by Sekhon’s “Theoretical Framework of Acceptability”. Results: Participants viewed SACCs as a highly acceptable integrated model of specialised care for victims of recent SA. They expressed strong appreciation for the care provided at the SACC and its set-up (affective attitude), and they identified key professional qualities of SACC professionals (ethicality). Participants demonstrated good understanding of the functioning of the SACCs (intervention coherence). The model was perceived as effective in providing medical care, mental health support, and facilitating police reporting, though gaps were noted in linking victims with other actors in the criminal justice system (perceived effectiveness). Organisational strengths included the holistic, long-term, proactive, affordable and accessible nature of the care offered (perceived effectiveness, burden and opportunity cost). Victims faced challenges in linking to, engaging with and remaining in care due to distress post-SA, with support persons playing a crucial role in helping them navigate these challenges (self-efficacy). Conclusions: The study highlights the acceptability of an integrated, multidisciplinary approach to specialised SA care. Key elements include embedded psychological support, the option for forensic examination without mandatory reporting, and the possibility of police reporting at the SACC. These findings may inform the development of specialised SA services in other settings. Full article

(1) Background: The non-consensual dissemination of intimate images constitutes a severe form of online gender-based violence (OGBV) that inflicts profound harm on victims’ sexual privacy, psychological well-being, and social functioning. Taiwan enacted comprehensive legislative reforms in 2023—commonly referred to as the “Four Acts on Sexual Violence Prevention”—to strengthen criminal responses and expand victim protection mechanisms. However, the extent to which these reforms have translated into effective frontline practice remains insufficiently examined. (2) Methods: This qualitative study employed reflexive thematic analysis to investigate frontline professionals’ experiences with enforcing intimate image offence legislation and delivering victim support services. Semi-structured, in-depth interviews were conducted with 20 practitioners, including social workers, police officers, prosecutors, and lawyers. (3) Results: Three superordinate themes emerged across macro, meso, and micro structural levels. At the macro level, limited public awareness and persistent victim-blaming attitudes undermine prevention, help-seeking, and reporting. At the meso level, legislative fragmentation, challenges in preserving and analysing digital evidence, and inter-agency coordination gaps constrain enforcement capacity. At the micro level, procedural delays, risks of secondary victimization, and perceived inadequacies in compensation and support mechanisms weaken victims’ trust in institutional responses. (4) Conclusions: While Taiwan’s legislative reforms represent a significant institutional advancement, legal reform alone is insufficient to address digital sexual violence effectively. Comprehensive responses require integrated public education initiatives, enhanced inter-agency coordination, strengthened digital investigation capacity, and trauma-informed victim protection practices across all structural levels. In particular, the findings underscore an urgent public health need to establish rapid digital evidence preservation and takedown mechanisms to limit the proliferation of non-consensual sexual images and mitigate the associated mental health harms among victims. Full article

Adolescence and youth are key stages for acquiring responsible sexual behaviour. Previous research has focused on measuring knowledge; however, in order to achieve the goal of developing safe sexual behaviour, it is necessary to complement this with measures of attitudes, for which there is currently a lack of valid and reliable measurement tools specifically focused on attitudes toward contraceptive use. The objective of this research is to develop and psychometrically validate the Attitudes Toward Contraceptive Use Scale (ACUS) in university students. A cross-sectional correlational validation study was designed using Item Response Theory. The sample consisted of 411 nursing students aged between 18 and 25 years. The final version of the scale, comprising 12 items, was evaluated using the Rasch Rating Scale Model (Andrich model), and its reliability was assessed in terms of internal consistency and temporal stability. The Rasch model showed an excellent overall fit, high item reliability (0.989), adequate person reliability (0.81), and good temporal stability (ICC = 0.796). The ACUS is a valid and reliable instrument for assessing attitudes toward contraception among university students. It can be used to identify less favourable attitudinal profiles toward contraceptive use and subsequently guide educational interventions. Full article

Despite growing interest in the sexuality and gender identity of people with disabilities (PWD), this topic remains underexplored in both research and institutional policies, owing to prevailing views that ignore PWD sexual life. This contributes to the invisibility of individuals who identify as lesbian, gay, bisexual, and trans (LGBT) and to inadequate attention to the specific needs of LGBT people with disabilities (LGBT PWD). Background/Objectives: Given the lack of Portuguese studies that examine the intersection of LGBT and disability identities, this study aimed to understand professionals’ attitudes and practices toward PWD regarding sexuality and LGBT belonging. Methods: We conducted qualitative research using semi-structured interviews with eleven professionals (two psychologists, three occupational therapists, and six personal assistants). We analyzed the data using reflexive thematic analysis. Results: Key findings highlight professionals’ limited knowledge, prevailing cis-heteronormative attitudes, and emerging affirmative practices. Conclusions: Training and institutional changes are needed to make services more inclusive and responsive to the needs of LGBT PWD. Full article