Search Results (360)

Persons with disabilities face barriers to accessing sexuality education. For those who identify as queer, these challenges are compounded by stigma, ableism, and heteronormativity, resulting in distinct and overlooked experiences. This study explored the sexuality education needs of persons with disabilities who identify as queer in Kenya—a neglected demographic—using a phenomenological approach. Data were collected through a focus group discussion with six participants and analyzed thematically. Three themes emerged: invisibility and erasure; unprepared institutions and constrained support networks; and agency and everyday resistance. Educational institutions often overlook the intersectional needs of persons with disabilities who identify as queer, leaving them without adequate tools to navigate relationships, sexuality, and rights. Support systems are often unprepared or unwilling to address these needs. Societal attitudes that desexualize disability and marginalize queerness intersect to produce compounded exclusion. Despite these challenges, participants demonstrated agency by using digital spaces and informal networks to resist exclusion. This calls for policy reforms that move beyond tokenism to address the lived realities of multiply marginalized groups. Policy reform means not only a legal or governmental shift but also a broader cultural and institutional process that creates space for recognition, protection, and participation. Full article

Background: Sexuality is a central aspect of being human, even if people experience it in different ways in various stages of life. Sexuality in older people may be expressed, as well as affection, companionship, touch, and physical contact. However, older peoples’ sexual needs are not properly considered by themselves, caregivers, or healthcare professionals. Reviews on barriers related to identification and satisfaction of sexual needs of people living in nursing home are scarce. In this scenario we intended to summarize the state of evidence regarding sexual need identification and satisfaction among older people living in nursing homes and possible barriers that could limit sexual need identification and satisfaction. Methods: We carried out a narrative review. The included studies responded to the research question, using the following key words: nursing homes, sexuality or sexual need, or sexual behavior, older people. Searched databases included PubMed, Embase, CINAHL, PsycInfo, and Scopus. Results: After searching and screening we included 22 studies, finding three main topics: 1. identification of sexual needs by residents and healthcare personnel attitude and practice; 2. barriers and reasons hindering the identification of sexual needs; and 3. manifestation and satisfaction of sexual needs. Conclusions: The findings showed that nursing homes’ residents have different sexual needs, but there are many organizational, educational, and cultural barriers and negative attitudes of healthcare personnel. Supporting nursing home residents to express their sexual needs is a challenge for the healthcare professionals and managers of nursing homes. Full article

Background and objectives: Duloxetine is widely used for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), and various types of neuropathic pain. While its efficacy is well documented in clinical trials, less is known about how it is perceived and utilized in routine psychiatric practice. To address this knowledge gap, we conducted a cross-sectional observational study involving 80 psychiatrists from Spain to assess real-world clinical attitudes toward duloxetine. Methods: Participants completed a 20-item multiple-choice questionnaire that examined familiarity, perceived efficacy in multiple conditions (MDD, GAD, neuropathic pain, somatization, and quality of life), and perspectives on tolerability, safety, adherence, and overall satisfaction. Results: Survey results indicated that a large majority of psychiatrists frequently prescribe duloxetine, particularly for patients with MDD and comorbid chronic pain. Notably, 94% rated it as either “more effective” or “much more effective” for diabetic peripheral neuropathic pain. Psychiatrists reported a high perceived efficacy of duloxetine: 94% rated it as “more effective” or “much more effective” for diabetic peripheral neuropathy, and 93% gave similarly positive ratings for general neuropathic pain. For somatization, 70% found it “effective” or “very effective”, and 83% observed improvements in quality of life for many of their patients. Psychiatrists generally reported favorable perceptions of duloxetine’s tolerability profile: 97.5% rated it as the antidepressant associated with the least weight gain, and 82.5% perceived fewer sexual side effects compared to other options. Sedation and gastrointestinal side effects were generally considered mild or less severe. In terms of treatment adherence, 69% rated it as “better” or “much better” than other antidepressants, and 80% found its combination with other antidepressants to be “favorable” or “very favorable”. Overall satisfaction was high, with 99% of psychiatrists reporting being either “satisfied” or “very satisfied” with its use. The side effect profile was generally viewed as manageable, with low perceived rates of weight gain, sedation, and sexual dysfunction. Furthermore, 96% of respondents expressed a willingness to recommend duloxetine to their colleagues. Conclusions: Psychiatrists reported highly favorable attitudes toward duloxetine, viewing it as a flexible treatment option in routine care. However, these findings reflect clinicians’ subjective perceptions rather than objective clinical outcomes and should be interpreted accordingly. Full article

Affective–sexual education programs (ASEPs) are effective in combating gender violence (GV). Most previous studies have focused on the short-term effect these programs have on explicit sexist attitudes. The objective of this study was to analyze the short- and medium-term effect of an ASEP regarding sexist attitudes. An educational intervention study was carried out on 561 high school students in Tenerife (Spain). The 15 h intervention used a participatory methodology with debates, working groups, and game dynamics. Explicit attitudes were measured with the scale of sexist, violent, and stereotyped attitudes (SVSAs) and the gender role attitudes scale (GRAS), and implicit attitudes were measured with the assessment of the behavior of the characters of a brief tailored story, in which an interaction between two young people with an ambiguous component of gender violence is described. Four measurements were made: pre-intervention, post-intervention, 6 months, and 12 months. After the intervention, in the experimental group, scale scores decreased (SVSA from 28.7 ± 7.7 to 21.8 ± 2.1, p < 0.0001; GRAS from 30.6 ± 7.8 to 22.3 ± 2.8, p < 0.0001), and the level of approval of the behavior of the female character of the story improved (from 5.4 ± 2.6 to 7.6 ± 2.1, p < 0.0001). The effect of the intervention on sexist attitudes was maintained until the end of the 12-month follow-up period. Full article

Background/Objectives: Sexual attitudes, particularly those on the erotophilia (positive openness) to erotophobia (negative fear) scales, play a critical role in shaping behaviors and health decisions. While associations between sexual behavior and substance use have been documented, limited research has explored how sexual attitudes relate to mental health and substance use among Latin American university populations. This study aimed to examine the associations among erotophilic attitudes, mental health symptoms (anxiety and depression), substance use risk, and sexual behaviors in Mexican university students. Methods: A cross-sectional observational study was conducted between 2019 and 2023 with 1475 undergraduate students aged 17–25 years. Participants completed the Revised Sexual Opinion Survey (R-SOS) to assess sexual attitudes, the Hospital Anxiety and Depression Scale (HADS) for mental health evaluation, and adapted items from the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) to measure substance use risk. Erotophilic attitudes were defined as R-SOS scores ≥ 70. Statistical tests included the Kolmogorov–Smirnov test for normality, t-tests or Mann–Whitney U tests for group comparisons, Fisher’s exact test for categorical variables, and Spearman’s correlations. Multivariate binary logistic regression was used to calculate adjusted odds ratios (AdORs) and 95% confidence intervals (CIs), with a significance level of p < 0.05. Results: Erotophilic students were more likely to be male, older, initiate sexual activity earlier, and report a greater number of sexual partners. Erotophilia was positively associated with anxiety and tobacco, alcohol and marijuana use, and negatively associated with depressive symptoms. Multivariate analysis indicated that erotophilia was independently associated with male sex, age ≥ 20, higher anxiety, lower depression, low socioeconomic status, and increased risk of tobacco and marijuana use. Lower rates of consistent condom use were also reported among erotophilic individuals. Conclusions: Erotophilia may serve as a behavioral risk marker linked to anxiety symptoms and increased substance use, but not to depression. These findings highlight the need for integrated interventions addressing sexual health, substance use, and mental well-being in university populations. Full article

This study addresses the persistent issue of gender bias in project management by developing and validating a practical survey tool for monitoring gender-related perceptions within project implementation frameworks. Using a Knowledge, Attitudes, and Practices (KAP) approach, a survey instrument was designed to assess awareness of gender equity policies, perceptions of inclusivity, and experiences related to sexual harassment (SASH) within project teams. The tool was piloted in a Horizon Europe project (Healthy Sailing), with responses collected from 66 participants (academics, maritime professionals, researchers, and government stakeholders). Exploratory Factor Analysis (EFA) revealed a five-factor structure explaining 72.29% of total variance, with the two dominant factors—Perceived Gender Bias and Organizational Safety—demonstrating excellent internal consistency (Cronbach’s alpha > 0.90). Confirmatory Factor Analysis (CFA) and bifactor modeling indicated areas for further refinement, with RMSEA values exceeding optimal thresholds. The results underscore the potential of the KAP-based tool to support gender-sensitive quality management practices in project-based environments, while highlighting the need for ongoing psychometric validation. The study contributes a novel, empirically grounded instrument for promoting inclusivity and equity in project management. Full article

Sexual health in cancer care is often overlooked. This study examines oncology nurses’ knowledge and practices regarding sexuality care, identifying barriers and facilitators. A Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA)-guided search of Scopus, ScienceDirect, PubMed, and EBSCO focused on studies from 2014 to 2024. Of 1735 identified studies, only 11 met inclusion criteria. Findings revealed a lack of knowledge among nurses and dissatisfaction with sexual healthcare. Barriers include time constraints, cultural factors, and personal reservations. Routine discussions are often absent due to inadequate training. Education- and system-based strategies are needed to enhance nurses’ competence in addressing sexual concerns. Implementing training programs, structured records, evaluation tools, concept maps, and system support would improve patient care and oncology nursing practices. Addressing these gaps with practical measures can enhance communication, patient satisfaction, and quality of life. This unique analysis was conducted by two experienced advanced nurses in the Middle East, where discussions about sex are often regarded as taboo. Full article

Background: Gender-based violence has serious health impacts on survivors and is perpetuated by cultural norms, patriarchy, and traditional values. This study explored women’s (survivors) views, attitudes and the impact of gender-based violence on their health in a selected rural village within the Collins Chabane Municipality, Vhembe District, Limpopo Province. Methods: A qualitative descriptive design was used, involving 20 women aged 18 to 59. Semi-structured in-depth interviews were conducted, and data were analysed thematically using ATLAS.ti 8, based on Braun and Clarke’s six-step framework. Ethical considerations were prioritised due to the sensitive nature of the research. Results: The results revealed that women in the Collins Chabane Municipality experience multiple forms of GBV, including physical, sexual, emotional, and financial abuse, which severely impacts their mental and physical health. Additionally, socioeconomic factors like unemployment and financial dependence exacerbate their vulnerability, making it difficult to escape abusive relationships. Conclusions: Cultural norms, patriarchal beliefs, and limited community support intersect to shape women’s experiences and responses to abuse. Full article

Background: Sexual violence against adolescents and young people (AYP) remains a public health concern. This study explores patterns of sexual violence and help-seeking behaviour as well as their associated risk/protective factors with guidance of a technical package (INSPIRE) designed to reduce sexual violence in low-resource settings. Methods: The 2019 Violence Against Children Survey (VACS) dataset comprises 788 males and 1344 females. After describing the prevalence and patterns of sexual violence and help-seeking behaviour (informal disclosure, knowledge of where to seek formal help, seeking formal help, and receipt of formal help) among 13- to 24-year-old AYP, logistic regression models were then fitted to predict past-year sexual violence and informal disclosure among adolescent girls and young women (AGYW). Results: More young women than young men informally disclosed sexual violence experience (46% versus 23%). Gender inequitable attitudes [AOR 3.07 (1.10–8.56); p = 0.03], experiencing emotional violence at home [AOR 2.11 (1.17–3.81); p = 0.01] and cyberbullying [AOR 5.90 (2.83–12.29); p = 0.00] were identified as risk factors for sexual violence among AGYW. Life skills training [AOR 0.22 (0.07–0.73); p = 0.01] and positive parental monitoring [AOR 0.31 (0.10–0.99); p = 0.05] were found to be protective against sexual violence among AGYW. Positive parental monitoring [AOR 3.85 (1.56–9.46); p = 0.00] was associated with an increased likelihood of informal disclosure among AGYW. Conclusions: As Kenya intensifies efforts towards sexual violence prevention, this study underscores the need to develop and strengthen policies and programs on life skills training, cultural norms, and positive parenting, as well as improve awareness and access to post-violence response and support services. Full article

Barriers to help-seeking behaviors in transgender populations in non-Western contexts are both understudied and poorly understood. Using a quantitative cross-sectional design, this study examined the psychological help-seeking attitudes of 109 transgender persons from Pakistan in relation to their psychological distress and attitudes toward sexuality. This research further identified which components of distress (stress, anxiety, or depression) were stronger predictors and assessed the role of particular demographic/behavioral factors in help-seeking attitudes. Participants completed three validated assessment tools translated into Urdu: Beliefs about Psychological Services Scale, the Depression, Anxiety, and Stress Scale (DASS-21), and the Sexual Attitude Scale. The results indicated that psychological distress predicted expertness and intent but not stigma tolerance. Post hoc analysis using DASS-21 subscales revealed that stress and anxiety were the stronger predictors of attitudes related to expertness and intent. The Sexual Attitude Scale marginally predicted stigma tolerance directly and also moderated the relationship between psychological distress and help-seeking attitudes for stigma tolerance. Finally, a role for demographic/behavioral factors—possibly serving as a proxy for mental health literacy—was identified for stigma tolerance. These findings reiterate the importance of tailored mental health awareness initiatives within the transgender community in non-Western settings and highlight the need for qualitative research to further understand the dynamics of psychological distress along with other linked factors. Full article

This study explores how ideological, relational, and sociodemographic factors predict women’s perceptions of severity and self-responsibility across different types of intimate partner violence (IPV). Using an intra-subject design, 257 women completed the measures of interest, 191 experiencing IPV and 66 non-victims, according to their responses to WHO instruments. Participants were recruited via dissemination of the study through WhatsApp, Instagram, Facebook and institutional email. The results indicated that the primary predictors of perceived severity were ambivalent sexism in physical violence; favorable attitudes toward IPV (all forms of violence); feminist identity (physical violence and controlling behaviors); dependency (psychological violence); commitment (physical sexual, and controlling behaviors); education level (physical violence); and age (sexual violence). For attributed self-responsibility, ambivalent sexism and favorable attitudes toward IPV were predictors for controlling behaviors. Commitment and dependency, being a victim and age-influenced psychological violence, whereas being a victim predicted sexual violence. In addition, physical violence is perceived as the most severe and controlling behavior, eliciting greater levels of attributed self-responsibility than other forms of IPV. These results highlight the main predictors of cognitive distortions (perceived severity of violence and attributed self-responsibility), offering insight into the processes that victims in IPV situations undergo. Full article

Background/Objectives: Sex and gender minorities (SGMs) include individuals who do not comply with sexual binarism and heteronormative standards. They represent a high-risk population for Human Papillomavirus (HPV) infection and potential target of an HPV vaccine offer. This study investigates SGMs’ knowledge, awareness and vaccination attitude regarding HPV. Methods: This is a cross-sectional, questionnaire-based study. The target population was represented by SGMs living in Italy and using social media platforms of SGM rights associations. The study questionnaire was based on the literature and disseminated via said associations’ social media. It included items regarding knowledge and awareness, expressed as seven-point Likert scales, and questions about personal information, sexual anamnesis and vaccination attitude. Data collection started on 1 November 2023 and ended on 8 December 2023. Results: The questionnaire was answered by 177 people. Knowledge and awareness scores were generally high (45.98 ± 6.14 and 34.21 ± 4.62, respectively). Regarding attitude, 31.64% of participants reported being hesitant or refusing HPV vaccination, mainly due to prohibitive costs or low perception of the vaccine’s utility. Higher education was associated with a higher knowledge score (coeff.: 2.25; 95%CI: 0.69–3.82); likewise, a history of HPV-related lesions positively influenced the score (coeff.: 2.47; 95%CI: 0.20–4.75). The awareness score was only increased by a greater number of sexual partners (coeff.: 0.06; 95%CI: 0.01–0.11). Older age was proven to significantly increase the odd of vaccine hesitancy (OR: 1.07; 95%CI: 1.02–1.12). Conclusions: Despite a good level of knowledge and awareness, the study population manifested significant barriers to vaccination. The main ones were related to the vaccine’s cost and lack of medical information. Future efforts should focus on reinforcing vaccine offers to SGMs. Full article

Introduction: Sexual and reproductive health is a critical aspect of medical education, yet significant knowledge gaps persist even among future healthcare professionals. This study aimed to evaluate the knowledge, behaviors, and attitudes of Romanian medical students regarding sexually transmitted infections (STIs) and contraceptive practices. Materials and Methods: A cross-sectional observational study was conducted on 510 undergraduate medical students, using a validated 30-item online questionnaire assessing socio-demographic data, sexual behaviors, STI knowledge, and attitudes towards sexual health. Descriptive statistics, chi-square, and Spearman correlation tests were used to analyze the data. Results: Participants demonstrated a good understanding of common STI pathogens and transmission routes, with 99.02% identifying unprotected vaginal intercourse as a risk factor. However, only 58.82% correctly identified Chlamydia trachomatis, and awareness of less common pathogens remained low. Long-term complications such as infertility (85.29%) and cervical cancer (87.25%) were well recognized, although misconceptions about STI severity persisted, with over 40% believing that STIs are not dangerous because they are treatable. Male students reported earlier sexual debut and more frequent high-risk behaviors, while females were more likely to consult specialist doctors and receive HPV vaccination. The level of knowledge correlated positively with parental education and faculty program. Conclusions: Despite generally high awareness of STI-related topics, considerable gaps and misconceptions persist among Romanian medical students. These findings highlight the need for comprehensive, structured sexual health education integrated into medical curricula to ensure future healthcare providers are well-equipped to promote public health. Full article

Background/Objectives: Erectile dysfunction (ED) is a prevalent condition worldwide that significantly affects men’s sexual health and overall quality of life. ED is often associated with both psychological and organic factors and may serve as an early indicator of underlying health conditions such as diabetes mellitus, hypertension, and cardiovascular diseases. This study aimed to assess the attitudes and help-seeking behaviors of patients with ED who attended primary healthcare centers for non-urological reasons. Methods: A cross-sectional survey was conducted among 384 men aged 18 years and older who attended primary care clinics. Erectile dysfunction was evaluated using a structured questionnaire designed to assess patients’ attitudes toward ED, help-seeking behaviors, and treatment preferences. Results: Approximately half of the participants (49.5%) acknowledged the necessity of seeking treatment. However, the majority (53.1%) had not consulted specialized clinics, primarily due to social stigma and a preference for self-medication. Concerning sources of information on ED treatment, 30.7% of participants relied on their partners and healthcare providers. Conclusions: The study underscores critical barriers to ED management, including social stigma and reliance on self-medication, which may impede optimal treatment engagement and access to specialized care. Full article

Background/Objectives: Care-oriented perspectives in the LGBTIQ+ community are essential to ensure adequate and comprehensive health care. This population faces multiple barriers imposed by society, including discrimination in access to healthcare services. This research aims to analyse the perspective of nursing students in relation to the provision of care for people with sexual and gender diversity. Methods: A qualitative phenomenological research-action study was conducted. Data were collected using a semi-structured face-to-face interview consisting of 23 questions. The interviews were transcribed, read thoroughly and analysed. Results: Forty students were interviewed, and four main themes emerged: (1) personal perspective, (2) professional and disciplinary training, (3) nursing education and (4) health implications. The results show that students have mixed perspectives and attitudes towards LGBTQ+ populations, although they are interested in receiving more LGBTQ-focused training. Furthermore, respondents reported that the training received in the degree course and the preparation of lecturers in relation to caring for LGBTQ+ people are lacking. Finally, it emerged that inequalities in access to health services can still be observed and that there is a need for the development of manuals that are at the forefront of comprehensive health in this population. Conclusions: Based on the results, the implementation of Madeleine Leininger’s Sunrise model is suggested. Acceptance of sexual and gender diversity is essential to ensure the elimination of inequalities and make care a transformative process. Finally, education on these aspects needs to be implemented by including activities such as practical training scenarios, workshops and conferences to highlight the specific needs of the LGBTIQ+ population. Full article