Search Results (42)

Background: The existing literature often oversimplifies the complex relationship between religion and Adolescent and Youth Sexual and Reproductive Health (AYSRH), particularly regarding church-based interventions. This study aimed to investigate the nature and implementation strategies of church AYSRH programmes within their belief systems to inform effective programme development. Methodology: An interpretive descriptive design was employed. Data were collected in the Vaal Triangle region of South Africa (Vanderbijlpark, Vereeniging, and Sasolburg) between August 2019 and February 2020. In-depth interviews were conducted with pastors, government officials, and school principals. Focus group discussions were held with parent and youth church groups alongside youth groups from Technical and Vocational Education and Training (TVET) colleges. Data were analyzed using Atlas.ti v.23. Results: Church-based AYSRH interventions primarily emphasize information provision and abstinence until marriage, aligned with prevailing moral values. These interventions are delivered through integration into existing church programmes and collaborations with external stakeholders for specialized areas like contraception. Limitations identified included ineffectiveness, superficiality, impracticality, tensions between religious doctrine and lived realities, a reductionist focus, a singular information-sharing approach, and limited pastor understanding and openness regarding AYSRH. Conclusions: Churches possess valuable communication platforms and partnerships that could be leveraged for AYSRH interventions. However, this study highlights a one-sided focus on church teachings and significant tensions between idealized approaches and practical implementation, raising critical questions about the overall efficacy of church-led AYSRH projects. This research validates prior findings on church-based AYSRH interventions while offering nuanced insights and heuristic perspectives for a more comprehensive and less simplistic understanding of church-driven AYSRH services. Full article

This paper details how, in partnership with young people, community workshops centred on queer joy can offer queer and trans youth sexuality education (SE) that is relevant to their experiences, lived realities, and desires. In the data, young people discuss how tailored content, queer pedagogies, youth-centric approaches, and affirming spaces that are responsive to their questions might improve their sexuality knowledge as well as their mental health. A total of 22 youth participants from a mid-size Canadian city, the vast majority of whom identified as queer and/or trans, registered in a weekend workshop to evaluate SE video lessons created by educators enrolled in our partner organization’s sexuality education training program. Through this process, young people leaned on both their expertise and experience to critically reflect on the content and pedagogies employed by the educators. Additionally, 14 youth participated in post-workshop interviews where they continued these conversations and reflected on their SE experiences. In contrast to queer and trans young people’s more violent experiences in classrooms, public spaces, and political discourses, this community intervention workshop cultivated community, knowledge, power, and solidarity between and among youth participants. As they used and created memes to laugh in the face of structures and situations that attempt to erase their bodies and experiences, young people reached for a vision of sexuality education that not only includes them but centres on their desires and curiosities. Full article

Sub-Saharan African (SSA) women experience a high prevalence of HIV, sexually transmitted infections (STIs), and unintended pregnancies, necessitating effective, integrated prevention strategies. Multipurpose prevention technologies (MPTs) offer a promising approach to address these overlapping health concerns by providing single products that simultaneously prevent HIV, other STIs, and/or unintended pregnancies. Given the persistent sexual and reproductive health (SRH) challenges faced by women in SSA, in this opinion piece, we explore practical considerations for MPT adoption and scale-up within the region. With this opinion article, we discuss the data on MPT development and identify key factors for successful MPT implementation in SSA. We examine the current MPT pipeline, product features, regulatory challenges, and structural, individual, and community barriers that impact MPT acceptance and usage among SSA women. Successful MPT uptake hinges on designing discreet, user-controlled products and engaging end-users, healthcare providers, and communities in product development and promotion. Structural factors such as robust supply chains, regulatory clarity, and financial support are also essential. Addressing socio-cultural norms, especially partner consent, and strengthening demand creation through community-driven, culturally sensitive strategies are critical for scaling MPTs. In conclusion, MPTs represent a transformative opportunity to reduce the burden of HIV, STIs, and unintended pregnancies in SSA. Strategic, culturally attuned approaches are essential to ensure the acceptability and accessibility of MPTs. Expedited pathways for regulatory approval, collaborative partnerships, and community-centered demand creation will be vital to realize the full potential of MPTs in advancing women’s SRH in SSA. Full article

Offenders convicted of trafficking human beings for sexual exploitation involve a high percentage of women compared to other similar offenses. Previous studies have searched for explanations for the dynamics of the illegal sex market and the coercion experienced by victims during the process of exploitation and exit. This article analyses the content of 58 judicial decisions involving a sample of 148 women convicted in Spain of trafficking in human beings between 2017 and 2024. Two main dimensions are explored: the criminal organizations performing the sexual exploitation phase in Spain and the characteristics, positions, and roles of women traffickers within the criminal organizations. Half of the sample occupies leadership roles, while the other half consists of supporters, especially in larger trafficking networks. Regarding the positions and roles of women offenders, supporters and partners in crime are at higher risk of being coerced due to the nature of their roles or partnerships. Full article

This essay examines the relation between scientific inquiry and philosophical thought in the context of a Thomistic account of human sexual difference. I begin by considering Thomas’s own view and its explicit though brief appeal to biological observation. In particular, I focus on his claim that being male or female stems more from a substance’s matter than from its form. Then, I look at a fairly recent exchange between William Newton and myself, in which, drawing upon Thomistic thought in the context of contemporary science, we argued opposing positions. Mine held that sex stems more from form than from matter, while Newton maintained that Thomas’s original position is better. In reviewing this exchange, I note strengths in Newton’s argument and suggest a further distinction, even while concluding that my fundamental position is still a better account. Lastly, I turn to further questions and the necessity of continued partnership between philosophy and science. Full article

Mathematical modeling is widely used for describing infection transmission and evaluating interventions. The lack of reliable social parameters in the literature has been mentioned by many modeling studies, leading to limitations in the validity and interpretation of the results. Using data from the European MSM Internet survey 2017, we developed a network model to describe sex acts among MSM in Belgium. The model simulates daily sex acts among steady, persistent casual and one-off partners in a population of 10,000 MSM, grouped as low- or high-activity by using three different definitions. Model calibration was used to estimate partnership duration and homophily rates to match the distribution of cumulative sex partners over 12 months. We estimated an average duration between 1065 and 1409 days for steady partnerships, 4–6 and 251–299 days for assortative high- and low-activity individuals and 8–13 days for disassortative persistent casual partnerships, respectively, varying across the three definitions. High-quality data on social network and behavioral parameters are scarce in the literature. Our study addresses this lack of information by providing a method to estimate crucial parameters for network specification. Full article

Sexual and gender diverse (SGD) adolescent and young adult (AYA) cancer survivors are an increasing and vulnerable group with unique needs that often remain unmet in the healthcare system. This paper describes the conceptualization and development of a community-based organization dedicated to serving SGD AYAs, in addition to reporting on the results of a community-led needs assessment. A total of 56 SGD AYA community members completed the online survey. Most participants were between the ages of 26 to 33, identified as white, cisgender, bisexual women, and had hematologic malignancies. Identified unmet needs of SGD AYAs included the following: sexual health and family planning; gender affirmation; financial stability; and emotional support. Areas within the community organization were identified as gaps, areas of expansion, and assets. Results highlight the role of community and academic partnerships in improving cancer care delivery for SGD AYA cancer survivors. Full article

American Indian (AI) women are at risk of alcohol-exposed pregnancy (AEP) due to the higher prevalence of alcohol use disorders (AUDs) and risky drinking. The Native Changing High-Risk Alcohol Use and Increasing Contraception Effectiveness Study (Native CHOICES) was implemented in partnership with a Northern Plains Tribal community to address the effectiveness of a brief, motivational interviewing-based intervention to reduce AEP risk among adult AI women. A subgroup of the participants shared their perspectives in a qualitative interview conducted following the completion of the six-month post-baseline data collection. These interviews solicited participant perspectives on the Native CHOICES intervention and its satisfaction, reach, acceptability, and sustainability. The participants were delighted with Native CHOICES, felt the intervention helped them learn about AEP prevention and goal setting, learned valuable lessons, and believed Native CHOICES would be well-received by other women in their community and should be continued. The participants also shared how the COVID-19 pandemic affected their choices about drinking and birth control. The findings showed the receptivity to and acceptance of Native CHOICES among AI women. The interview findings offered a glimpse into the effectiveness of Native CHOICES and how it contributed to participants making healthier choices surrounding drinking and sexual health. Full article

Infidelity, a betrayal within a romantic partnership, often violates a person’s core beliefs about themselves and their significant other and can influence the degree to which a person can feel safe in romantic relationships. Infidelity can also increase exposure to sexually transmitted diseases that can compromise physical and mental health. Therefore, infidelity can be judged as central to one’s identity and potentially traumatic, possibly triggering outcomes similar to other DSM-5 Criterion A traumas. The current research examines the contribution of centrality perceptions to the development of PTG and PTS post-infidelity. Bivariate regressions examined the relationships between the judged centrality of infidelity and PTG and PTS, respectively. Exploratory analyses considered the moderating role of relationship form (i.e., casually dating, exclusively dating, and engaged/married) on those relationships. In a sample of 177 adults, greater judgments of the centrality of infidelity were associated with both PTG and PTS. Results demonstrated a significant moderating effect of relationship form on the relationship between the centrality of infidelity and PTG but not between the centrality of infidelity and PTS. Moderation results demonstrated that if infidelity is considered central in a casually dating relationship, it is more strongly related to PTG than in other relationship forms. Considering infidelity as central may generate both beneficial and problematic post-traumatic outcomes. However, an early infidelity experience may provide increased opportunities for engagement in different behaviors in the future (e.g., selecting a different partner, setting different relational boundaries), which, in turn, may be more conducive to growth. Full article

Background: Risky sexual behaviors remain common among adolescents regardless of those with comprehensive knowledge of safer sex practices. Self-efficacy has been shown to have a positive relationship with safer sex practices. Thus, investigating self-efficacy, and enhancing it to agency is important. The current study explores the predictors of self-efficacy for avoiding risky sexual behaviors and what limits agency among sexually active adolescents (15–19 years) in Northern Uganda. Methods: The study consisted of a sub-sample of 396 sexually active adolescents (145 in school, 251 out of school) interviewed as part of a household survey for the program on Advancing Sexual Reproductive Health and Rights in Northern Uganda. Poisson and Poisson regression models with survey weights were implemented in Stata. Results: A total of 94% of male and 64% of female adolescents reported self-efficacy to avoid unsafe sex, including using condoms and avoiding multiple sexual partnerships or transactional sex. At multivariable analysis, a higher proportion of adolescents who listened to a radio or television program about sexual and reproductive health within the past 12 months had self-efficacy as compared to others (PR = 1.13, p-value = 0.002). Similarly, higher proportions of adolescents who knew all the sexual and reproductive health (SRH) rights (PR = 1.33, p-value = 0.007) and who had comprehensive knowledge about pregnancy, prevention of sexual transmission infections, and sources of SRH services (PR = 1.24, p-value = 0.013) had self-efficacy as compared to others. However, among those who reported self-efficacy, 42% of the girls and 53% of the boys could not uphold their self-efficacy in actual sexual encounters in the past 12 months. Partner’s refusal or girls’ fear to ask their sexual partner to use a condom were commonly cited reasons. Alcohol consumption was associated with failure to act on one’s self-efficacy (RR = 0.74, p-value = 0.048). Conclusions: Programs should target self-efficacy beliefs and attempt to enhance them into agency by increasing positive and decreasing negative expectations associated with risky sexual behavior. Full article

This paper presents and critically interrogates a comprehensive 7Ps framework for analysing and addressing gender-based violence. It takes the UN and the Council of Europe’s models as points of departure and develops the framework beyond the current state of the art, explains its different components, and offers reflections on its use in the practice of gender-based violence research. The UN 3P model, encompassing prevention, protection, and prosecution, later developed by the Council of Europe’s Istanbul Convention into a 4P model, comprising prevention, protection, prosecution, and integrated policies, has since been revisited, elaborated upon, and expanded in work focusing on gender-based violence in particular domains, such as female genital mutilation or gender-based violence in sport. To study gender-based violence in academia, the comprehensive 7Ps analytical framework has been deployed to interrogate the policies in place at national and institutional levels, including sexual harassment. Based on empirical data and conceptual analysis in the EU project UniSAFE: Gender-based violence and institutional responses: Building a knowledge base and operational tools to make universities and research organisations safe (2021–2024), the paper argues that the refined 7Ps model, comprising Prevalence, Prevention, Protection, Prosecution of offenders (and disciplinary measures), Provision of services, Partnerships between actors, and Policies specifically addressing the issue, allows for a more encompassing approach, in turn allowing a more fine-grained understanding of variations and explanations for success (or lack thereof) in terms of outcomes. Full article

Studies have linked HIV-risky behaviours among young people to several socio-contextual factors. However, the social factors that might increase African Canadian adolescents’ exposure to HIV-risky behaviours, including unprotected sex and forced or multiple-sexual partnerships, have received little or no attention in the literature. Using data from the British Columbia Adolescent Health Surveys (2003–2018) and guided by intersectionality and socio-ecological frameworks, we examined the social determinants of HIV-risky behaviours (HRB) among African Canadian adolescents in British Columbia. We observed a general decline in HRB from 2008 to 2018. However, more than half (54.5%) of the 1042 who were sexually experienced in 2018 reported having 2 or more sexual partners, and nearly half reported condom-less sex. Our results demonstrate an important need to evaluate the impacts of several social factors on health outcomes for a unique, marginalized population. Full article

An estimated one in three gay and bisexual (GB) male couples receive a prostate cancer (PCa) diagnosis over their life course with limited understanding of the impacts on their relationships. Psychological distress related to PCa diagnosis and treatment-related side effects have been shown to disrupt established GB partnership dynamics. Communication barriers often develop within GB relationships affected by PCa, further exacerbating couple tensions, isolating partners, and lowering quality of life for both patients and partners. In order to elaborate on these phenomena following a PCa diagnosis, we conducted focus group discussions with GB men in relationships. Men were recruited nationally through PCa support groups, and after completing consent procedures, they were invited to one of two focus group discussions conducted through video conference. Topics discussed included the diagnosis and medical decision making pertaining to PCa; healthcare provider experiences; the emotional, physical, and sexual impact of PCa diagnosis and treatment; sources of support and appraisal of resources; and partner involvement and communication. There were twelve GB men who participated in focus group discussions that were audio-recorded and transcribed, and analyzed using a thematic approach. GB couple experiences with PCa during and after treatment choice and recovery identified common patient–provider communication barriers. In particular, GB men reported difficulties in disclosing their sexuality and relationship to their providers, limiting conversations about treatment choice and partner engagement in care. Both patients and partners experienced times of being alone after treatment, either by choice or to give space to their partner. However, partners often did not explicitly discuss their preferences for being alone or together, which resulted in partners’ disengagement in their relationship and the prostate cancer healthcare process. This disengagement could blunt the notable PCa survival benefits of partnership for GB men. Full article

Community involvement engages, empowers, and mobilises people to achieve their shared goals by addressing structural inequalities in the social and built environment. Through this review, we summarised published information on models, frameworks, and/or processes of community organising used in the context of health initiatives or interventions and documented the outcomes following their use. A systematic scoping review was conducted in three databases with no restrictions on the date of publication, country, or written language. Out of 5044 studies, 38 met the inclusion criteria and were included in the review. The targeted health outcomes explored by the studies were diverse and included sub-domains such as the promotion of a healthy lifestyle, sexual and reproductive health, access to healthcare and equity, and substance abuse and chronic disease management. The outcomes of most initiatives or interventions were promising, with positive changes reported for the target populations. A wide variation was noted in the models, frameworks, or processes of community organising utilised in these studies. We concluded that variation implies that no single model, framework, or process seems to have predominance over others in implementing community organising as a vehicle of positive social change within the health domain. The review also highlighted the need for a more standardised approach to the implementation and evaluation of these initiatives. We recommend that it is essential to foster public and non-governmental sector partnerships to promote community-driven health promotion efforts for a more sustainable approach to these initiatives. Full article

Chlamydia trachomatis and human papillomavirus (HPV) are the most common pathogens found in sexually transmitted infections (STIs), and both are known to increase the risk of cervical cancer (CC) and infertility. HPV is extremely common worldwide, and scientists use it to distinguish between low-risk and high-risk genotypes. In addition, HPV transmission can occur via simple contact in the genital area. From 50 to 80% of sexually active individuals become infected with both C. trachomatis and HPV viruses during their lifetime, and up to 50% become infected with an HPV oncogenic genotype. The natural history of this coinfection is strongly conditioned by the balance between the host microbiome and immune condition and the infecting agent. Though the infection often regresses, it tends to persist throughout adult life asymptomatically and silently. The partnership between HPV and C. trachomatis is basically due to their similarities: common transmission routes, reciprocal advantages, and the same risk factors. C. trachomatis is a Gram-negative bacteria, similar to HPV, and an intracellular bacterium, which shows a unique biphasic development that helps the latter continue its steady progression into the host throughout the entire life. Indeed, depending on the individual’s immune condition, the C. trachomatis infection tends to migrate toward the upper genital tract and spread to the uterus, and the fallopian tubes open up a pathway to HPV invasion. In addition, most HPV and C. trachomatis infections related to the female genital tract are facilitated by the decay of the first line of defense in the vaginal environment, which is constituted by a healthy vaginal microbiome that is characterized by a net equilibrium of all its components. Thus, the aim of this paper was to highlight the complexity and fragility of the vaginal microenvironment and accentuate the fundamental role of all elements and systems involved, including the Lactobacillus strains (Lactobacillus gasseri, Lactobacillus jensenii, Lactobacillus crispatus) and the immune–endocrine system, in preserving it from oncogenic mutation. Therefore, age, diet, and genetic predisposition together with an unspecific, persistent low-grade inflammatory state were found to be implicated in a high frequency and severity grade of disease, potentially resulting in pre-cancerous and cancerous cervical lesions. Full article