Search Results (805)

Background: Dyspareunia is a common female sexual pain disorder that significantly impairs quality of life. Despite the availability of evidence-based treatments, including multimodal pelvic floor physiotherapy and psychosexual interventions, patient awareness of these options remains insufficiently characterized. This study aimed to assess knowledge of dyspareunia management among affected women and to identify independent predictors of awareness. Methods: A cross-sectional survey was conducted in 2023 at the Central Clinical Hospital of the Medical University of Lodz, Poland, among 72 women with physician-confirmed dyspareunia. An 82-item questionnaire administered via structured face-to-face interviews assessed sociodemographic characteristics, clinical features including intercourse positions, penetration depth, and partner-related factors, and knowledge of pelvic floor therapy. Responses to 18 knowledge items were aggregated into a synthetic awareness variable (range 0–24 points). Internal consistency was evaluated using Cronbach’s alpha. Statistical analysis included item-level scoring, multiple linear regression, Mann–Whitney U test, Kruskal–Wallis test, and Spearman’s rank correlation. Effect sizes are reported as Cohen’s d for parametric comparisons and rank-biserial correlation for nonparametric comparisons. Results: The mean awareness score was 10.9 ± 6.1 out of 24 points. The awareness scale demonstrated good internal consistency (standardized Cronbach’s α = 0.880). Item-level analysis revealed critical knowledge gaps: biofeedback was recognized by only 15.3% of participants, and only 6.2% could correctly estimate the number of pelvic floor muscles. In multiple linear regression (R² = 0.224, adjusted R² = 0.153, p = 0.009), age (β = −0.305, p = 0.009) and current urogynecological physiotherapy use (β = 0.332, p = 0.019) were independent predictors of awareness. Physiotherapy users scored on average 5.6 points higher than non-users (16.0 ± 4.9 vs. 10.4 ± 6.0; p = 0.027; rank-biserial r = 0.51), although this finding should be interpreted with caution given the small number of physiotherapy users (n = 7) and the wide confidence interval. More than half of participants (55.6%) reported positional dependency of dyspareunia; in exploratory analyses, none of the assessed dyspareunia characteristics showed a statistically significant association with awareness. Younger women (≤24 years) demonstrated significantly higher awareness than older participants (12.1 ± 5.6 vs. 9.1 ± 6.5; p = 0.039; Cohen’s d = 0.51). Conclusions: Women with dyspareunia demonstrate modest and heterogeneous awareness of evidence-based treatments, with the largest deficits in knowledge of specific physiotherapeutic modalities. These findings highlight the need for targeted educational interventions and improved referral pathways to pelvic floor physiotherapy. This study establishes a conceptual framework for assessing patient awareness of dyspareunia treatments, which warrants validation in larger, multi-center studies. 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

Background/Objectives: Ovarian cancer is typically diagnosed in postmenopausal women, so there are limited data available for young adult cancer survivors (YACS). The aim was to assess the patient perspective of YACS. Methods: In this international and multicenter cross-sectional survey study, patient history, long-term side effects, and patient perspective were assessed. Long-term survival was defined as survival of at least five years after cancer diagnosis. Two groups were defined: (1) 18–40 years and (2) ≥41 years. Results: Altogether, 1833 long-term survivors (LTS) have been recruited, with 1771 patients ≥41 years and 62 patients 18–40 years at recruitment. FIGO stages were similar; among the patients, 99.0% had received primary surgery followed by chemotherapy in 90.3%. Almost 50% still experienced long-term side effects. Patients ≤ 40 years reported more frequently not only gastrointestinal symptoms such as nausea/vomiting (44.4%, p = 0.01), bloating (59.3%, p = 0.038), and constipation (60%, p = 0.015) but also depression (31.4%, p = 0.02), lymphedema (45.3%, p = 0.026), and concentration difficulties (30.6%, p = 0.002). Distress levels were also higher in YACS, especially concerning insurance/finances, work/school, child care, worries, and sadness. Polyneuropathy and secondary cancer were the only side effects that were more frequent in the elder cohort (polyneuropathy: 20.3% vs. 4.3%, p = 0.002, and secondary cancer: 8.4% vs. 0%, p = 0.014). YACS were more physically active (p = 0.003) and interested in studies about long-term cancer survivorship in 87.2%. Conclusions: Long-term side effects are equally common in YACS after ovarian cancer, but with a focus on practical problems, mental health, gastrointestinal problems, and sexuality. This knowledge should be incorporated into follow-up care of ovarian cancer patients in order to improve quality of life. Full article

Background: Maternity care for vulnerable pregnant women presents a particular challenge within midwifery practice. In Germany, maternity services lack standardized frameworks to adequately address the specific needs of individuals who have experienced, among other factors, sexualized violence, poverty, female genital mutilation/cutting (FGM/C), or discrimination. Limited access to healthcare among these populations contributes to increased maternal and neonatal morbidity and mortality. Emerging evidence indicates that comprehensive medical and psychosocial support provided by midwives can substantially improve obstetric outcomes for marginalized pregnant women. Methods: An elective course, Antenatal Care for Vulnerable Women, was offered in the sixth semester of the Bachelor’s program in Midwifery Science at the University of Tübingen in 2025. The course provided insights into the psychosocial challenges faced by vulnerable pregnant women and prepared students for these specific aspects of midwifery practice. The curriculum incorporated foundational lectures and innovative teaching formats aimed at cultivating constructivist approaches to problem-solving. All sixth-semester midwifery students were asked to assess their knowledge and skills across five vulnerability categories: asylum-seeking, FGM/C, intimate partner violence, trauma, and racism. A pilot pre–posttest analysis using a 6-point Likert scale (1 = very good, 6 = poor) was conducted as hypothesis-generating and curriculum-guiding. The pretest included 38 respondents. The posttest included 11 respondents who attended the course. Results: Students who attended the course demonstrated observable gains in knowledge and skills across all categories, with the greatest improvements in asylum-seeking, median of 5 (IQR 4–5) vs. 2 (2–3); FGM/C, 5 (4–5) vs. 2 (2–3); and racism, 5 (3–5) vs. 2 (2–3). Conclusions: Innovative teaching methods may contribute to preparing midwifery students for targeted care of vulnerable pregnant women. Findings from the pre- and posttests provide preliminary insight into the potential value of experiential learning and may inform the further development of practice-oriented teaching methods. Full article

Background: Assisted Partner Notification Services (APNS) support HIV disclosure and reduce HIV transmission. Despite this potential, APNS remains underutilized due to several barriers. A clearer understanding of APNS utilization, barriers, and the facilitators is essential to guide APNS improvement. Objectives: This study aimed to determine the level of APNS utilization, barriers, and facilitators for its uptake among people living with HIV (PLWH) in Singida. Methods: We employed a convergent mixed-methods design. A cross-sectional survey quantified APNS utilization and its associated factors among PLWH who have sexual partners, while complementary qualitative interviews explored perceived barriers and facilitators from the perspectives of both PLWH and healthcare providers. Results: In the Singida region, only forty percent of participants reported the use of APNS. Higher knowledge of HIV disclosure was positively associated with uptake (AOR = 2.65, 95% CI: 2.28–2.81; p = 0.02), whereas depressive symptoms reduced engagement (AOR = 0.95, 95% CI: 0.91–0.99; p = 0.027). Qualitative interviews in Singida identified multilevel barriers, including stigma, gender dynamics, and cultural constraints. Facilitators provided supportive medical advice, non-judgmental counseling, and assurances of confidentiality. Conclusions: Findings reveal low APNS uptake in Singida, constrained by stigma and cultural dynamics. Strengthening knowledge of disclosure, providing supportive medical advice, and ensuring confidentiality may enhance the use of APNS. Full article

Although sexuality education is delivered in schools, Chinese adolescents’ preferred sources may still be inconsistent with where they currently receive sex education. Based on two theories (Objectivism and Sex-Positivity) that emphasize the use of information and rational choice in seeking information with a desire to learn more, this explanatory study analyses survey data on sexual health topics, the sources Chinese adolescents used and preferred, and the gender differences in how they seek information on sexual topics. From 17 secondary schools, Chinese adolescents in Hong Kong, aged 14–18 (n = 4869), took a 51-question survey on sexual risks and sex education sources conducted by a local agency. Using the secondary dataset, a discrepancy score was computed by matching 15 actually used and 15 preferred sources for getting sexual knowledge listed in the survey. The discrepancy scores were shifted along the X-axis to eliminate negative values and create the dependent variable, ‘Discrepancy-S’, which ranged from 1 to 11, where 1 = no discrepancy, and 11 = wide discrepancy (Cronbach Alpha = 0.750). The higher the score, the higher the discrepancy. Regression results indicated that the youth’s prior coitus and different information sources (except school) could explain the “use–prefer” discrepancy. Although these adolescents regarded parents as the primary sex educators, most did not consult with their families. They preferred electronic media and peers as their top “go-to” choices. Sex education should come from sources that teenagers rely on and choose to access. Personal responsibility must be explicitly discussed in various sexual health sources as teens prepare for transitions to adulthood. Full article

Background/Objectives: Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide and causes cervical cancer in women. Patients with human immunodeficiency virus (HIV) are particularly susceptible to this virus. An effective vaccine against high-risk HPV genotypes is available. This study sought to evaluate barriers to HPV vaccination in HIV-positive female patients between the ages of 18 and 65 in a county clinic in Houston. Methods: A cross-sectional survey was conducted in May–June 2025 with 131 patients at Thomas Street Health Center in Houston. The survey assessed patient demographics, attitudes toward and knowledge of HPV vaccination (at least one dose), as well as self-reported cervical dysplasia and HPV infection history. Clinical data on available cervical dysplasia history were also gathered from the electronic medical record. Descriptive statistics were compiled, and comparisons between vaccinated and unvaccinated participants were performed using one-way analysis of variance for continuous variables and chi-square tests for categorical variables in R. Results: 75% of patients had prior knowledge of the HPV vaccine, but only 33% reported receiving at least one dose. The most common reason for not receiving the vaccine was never having been offered the vaccine by a provider. Separately, almost 40% of unvaccinated individuals had never heard of the vaccine. Of note, only 8.6% of respondents reported fully understanding the implications of vaccination and still choosing to decline. In this cross-sectional study, there was no statistically significant association between vaccination status and either recent dysplasia history in the electronic record or reported dysplasia or HPV infection history. Among eligible unvaccinated participants, 41% received the HPV vaccine after completing the survey. Conclusions: Addressing gaps in HPV vaccine communication and supporting clinicians in delivering confident counseling may improve vaccination rates in this at-risk population. Full article

The objective of this review is to synthesize current knowledge and evidence on male reproductive health by addressing preventive medicine strategies and biomarkers, as well as to provide clinicians, researchers, and policy makers with a coherent framework for prevention of male reproductive health. In this review male (in)fertility and determinants of male reproductive health as well as preventive strategies with special attention to primary, secondary and tertiary prevention in male reproductive health will be analyzed. From primary preventive measures: education, weight management, physical activity, sleep, healthy diet, alcohol and smoking consumption will be assessed, while from secondary preventive measures: sexually transmitted infection (STI) from the point of transmission prevention, testicular self-examination, hormonal testing and management, chronic diseases and semen analysis will be discussed; and from tertiary preventive measures: treatment of STI, treatment of congenital abnormalities, infertility treatment and urogenital cancer treatment will be elaborated. Additionally, biomarkers in male reproductive health will be synthesized and discussed. Bridging the gap between evidence and practice will ultimately lead to better understanding of the complex state of male reproductive health, thus minimizing the potential missed windows of opportunities in timely adequate preventive interventions implementations, as well as on time diagnostic and optimal treatment options. Full article

Background: Despite major advances in antiretroviral therapy, HIV transmission remains an important public health challenge. Pre-exposure prophylaxis (PrEP) is a highly effective prevention strategy, offering a significant opportunity to further reduce new HIV infections through expanded access and optimized implementation. Methods: A national multidisciplinary consensus process was conducted to define principles and operational pathways for PrEP referral and linkage in Romania. Experts from different medical fields, professional societies, academic institutions, and community-based organizations participated in structured discussions. Results: The consensus highlighted relevant knowledge gaps related to HIV prevention and PrEP among specialists working outside the field of infectious diseases, including difficulty recognizing risk factors for HIV, uncertainty about next steps after identifying risk factors, and uneasiness discussing sexual health. The consensus also emphasized a shared commitment of these professional societies to address these gaps through pragmatic, specialty-adapted training. Key priorities included improved HIV risk recognition in routine care, development of communication skills, and clear referral pathways to PrEP services. Existing barriers were also discussed, underscoring the importance of multidisciplinary networks and community engagement. Conclusions: This consensus provides a structured, context-adapted framework to support the upcoming nationwide implementation of PrEP in Romania. By strengthening provider education, clarifying clinical pathways, and fostering interdisciplinary collaboration, it offers a foundation for equitable and sustainable HIV prevention. Full article

Academic literature often frames African girls through a lens of sexual and reproductive vulnerability, with limited attention to their self-defined experiences. This study used photovoice methodology to explore how Ghanaian girls living in Nima, a neighborhood in Accra, represent their lives. Drawing on Afro-feminism and Black Girlhood Studies, the study engaged six girls in a participatory process of documenting perceptions of their lives through photographs, artists’ statements, and interviews. Thematic analysis of their visual and narrative data produced a counternarrative of girls’ lives in Nima, offering a multifaceted vision emphasizing intergenerational bonds between women and girls, and national, cultural, and spiritual pride. By centering Ghanaian girls’ voices, this study calls for a reimagining of how African girlhood is represented in social research. It affirms youth-voice knowledge production as vital to more just and accurate scholarship. Full article

Relationship and sexuality education research has largely centred on adult perspectives, particularly in exploring home-based sexuality education. This study shifts the lens to youth voices by examining how adolescents from LGBTQ+ families in South Africa experience and actively participate in home-based sexuality conversations. Using arts-based collage-creating methods with the adolescent participants, youth interpretations of sexuality learning in LGBTQ+ family homes were explored. The findings reveal that youth are not passive recipients but active co-creators of family sexuality knowledge, developing critical literacies about heteronormativity through ongoing and responsive home-based conversations. Youth identified home as a distinct pedagogical space characterised by safety, personalisation, ongoing responsive dialogue, inclusivity of diverse sexual and gender identities, and responsiveness to their developmental needs. However, youth also navigate tensions between LGBTQ+-affirming home environments and heteronormative public spaces, developing sophisticated strategies for managing these boundaries. This study contributes empirical evidence for valuing informal sexuality education spaces and positions youth from LGBTQ+ families as knowledge producers whose experiences can inform more inclusive, dialogue-based approaches. The findings have implications for supporting family-based sexuality education and challenging adult-centric assumptions about youth capacities in sexuality learning. Full article

Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide and is responsible for the majority of cervical, anal, and vaginal cancers. The first prophylactic HPV vaccine was introduced in the United States in 2006. Extensive evidence demonstrates the HPV vaccine is highly efficacious and effective, particularly when administered prior to HPV exposure. Despite strong safety data and proven cost-effectiveness, HPV vaccine uptake in the United States and globally remains suboptimal. Barriers to vaccination include limited knowledge, safety concerns, and logistical challenges. Current advancements focus on single-dose vaccine regimens, development of therapeutic vaccines, and higher-valent formulations. Expanding HPV vaccine coverage is essential to reduce HPV-related diseases, strengthen herd immunity, and advance cancer prevention efforts. Full article

The presence of Silba adipata in countries outside its native range has raised increasing concern among fig (Ficus carica L.) producers due to its growing economic importance. Information on this lonchaeid remains scarce and is frequently fragmented across regional reports, technical documents, and isolated scientific studies. The lack of consolidated and reliable knowledge on S. adipata, together with its sporadic impacts on figs and frequent confusion with closely related species, has hindered the development of effective and sustainable management strategies. Here, we provide a comprehensive synthesis of the current geographic distribution of S. adipata and its expansion into new areas, addressing diagnostic aspects and potential misidentifications reported in the literature that have the potential to confound distribution records and assessments of its pest status. We critically review current knowledge of the biology, ecology, and behavior of S. adipata, together with existing and emerging management and control approaches, including cultural practices, monitoring tools, mass trapping strategies, and biological- and chemical-based tactics. The strengths and limitations of these approaches are discussed in the context of their applicability to fig production systems. Advancing the management of S. adipata requires not only accurate species identification and evaluation of conventional control methods, but also a deeper understanding of its ecology and sexual behavior. Addressing these knowledge gaps will be essential for the development of innovative, effective, and environmentally sustainable management strategies for this emerging pest. Full article

Background/Objectives: Stevens–Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, potentially fatal immunological conditions that affect cutaneous and mucosal surfaces and have the potential to involve the genitourinary tract. While genital involvement is common, urological manifestations are under-recognised clinically and there is a paucity of clear, evidence-based management pathways specific to urological manifestations of SJS/TEN. To map the spectrum of urological manifestations of SJS/TEN, to describe the short- and long-term outcomes of these manifestations, and to synthesise management and prevention strategies to inform clinical practice. Methods: This was a scoping review conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guideline. Data sources: Medline and PubMed articles published in English with publication date up to December 2025. Study selection: Eligible studies included case reports, case series, observational studies, clinical guidelines, and review articles describing urological manifestations, outcomes, management, or prevention strategies for patients with SJS/TEN. Articles limited to renal or isolated gynaecological involvement were excluded. Data extraction and synthesis: Articles were screened independently by two reviewers using a pre-defined data extraction template covering four domains: urological manifestations, outcomes and sequelae, management strategies, and prevention strategies. This criterion was refined after a pilot of 20 studies. Discrepancies were resolved by consensus with a third reviewer. Formal risk-of-bias assessment was not performed, consistent with scoping review methodology. Results: One hundred and four studies published between 1987 and 2025 were included in this review. Selected articles included case reports (n = 63), retrospective cohort studies (n = 23), prospective studies (n = 2), guidelines (n = 5), and summary articles (n = 11). Reported urological involvement ranged from genital cutaneous and mucosal disease including erosions, adhesions, and balanitis to urethral manifestations such as urethritis, stenosis, and strictures, as well as scarce upper urinary tract involvement including ureteric stricture and ureteric mucosal sloughing. While some manifestations resolved with supportive care, others progressed to chronic sequelae including persistent urethral strictures, voiding dysfunction, sexual dysfunction, recurrent infection, and in rare cases, obstructive uropathy. A multidisciplinary approach was recommended for all patients with SJS/TEN. Urological management centred around early and repeated urogenital examination, manual lysis of adhesions, urinary catheterisation, and timely intervention for urethral or ureteric obstruction. Long-term urological follow-up of 12 months was recommended for patients with significant urogenital involvement. Conclusions: Urological manifestations of SJS/TEN are diverse, clinically significant, and frequently under-recognised. Early urological involvement, systematic genital and urinary tract assessment, and proactive preventative measures may reduce long-term morbidity. This review provides a comprehensive synthesis of knowledge and recommendations to support urologists’ role in multidisciplinary care of patients with this pathology. This review also highlights the need for prospective research to guide further evidence-based management of urological complications of SJS/TEN. Full article