Search

The study reported in this paper explores the experiences of 95 people with intersex variations constituting an international English-speaking sample who completed a mixed methods survey comprises questions designed by the authors to explore 1) genital variations and medical interventions (and pressures to undertake them), 2) experiences with sex education, and 3) experience of physical intimacy, including use of safer sex devices and sexually transmitted infections. Surgeries on minors were common and typically not consensual, often resulting in the need for revisions. Pressures for surgeries most commonly were made by doctors. Experiences of sex education often failed to be inclusive of intersex bodies, with information about menstruation and hygiene rarely provided, and many participants having to learn on their own. Participants had a diversity of experiences of physical intimacy beyond penetration. For those who had experienced penetration, vaginal intercourse was enjoyable for some, but many found it painful. Conversely, anal intercourse was enjoyed by many and rarely found to be painful. The paper concludes by highlighting the importance of an intersex-specific approach to sexual health for this population. [ABSTRACT FROM AUTHOR]

"Abortion Care is Health Care" by Barbara Baird provides a historical account of abortion services in Australia from the 1990s to the 2020s. The book argues that although abortion has been effectively pro-choice for decades, access to abortion services remains uneven and inequitable. Baird highlights that the majority of abortion services are provided by private clinics, resulting in limited access for marginalized and disadvantaged women. The book is meticulously researched and provides comprehensive information on providers, laws, regulations, and events in each Australian state and territory. However, it may be more suitable for scholars than a general audience. [Extracted from the article]

The United States Supreme Court's decision in Dobb's v. Jackson Women's Health Organization has heightened interest in the link between restrictions on abortion access and child maltreatment. Connecting decreased access to abortion to increases in child maltreatment and subsequent foster care entries presents substantive challenges related to the magnitude of any effect of abortion restrictions, methodological challenges related to limitations of existing sources of national child welfare data, and conceptual challenges related to the structure and function of child welfare systems. In this paper, we explore these substantive, methodological and conceptual challenges. Specifically, we consider both the actual impact of abortion restrictions on the occurrence of abortions and the complexities that studying the link between abortion restrictions and child maltreatment presents. We caution researchers about making causal links between abortion restrictions and either child maltreatment or foster care entries without sufficiently documenting limitations of national sources of child welfare data and accounting for multiple confounding factors. [ABSTRACT FROM AUTHOR]

Background: While foreign migrants contribute to economic development, they may impact public health by transmitting communicable diseases to the local population. With its geopolitical position, Thailand has been a primary destination for migrants from neighbouring countries in Southeast Asia and beyond. This positioning makes it a focal point for examining the complexities of migration dynamics and its implications for public health. Through a quantitative analysis, this paper investigates the influence of foreign migrants on physical health issues in Thailand, exploring their impact on various types of communicable diseases. The utilization of provincial-level data from Thailand offers insights into the localized effects of migrant populations on public health within the country. These insights can serve as a valuable resource for researchers and policymakers who conduct comparative analyses, facilitating a deeper understanding of the complex relationship between international migration and public health worldwide. Methods: A spatial panel autoregressive model (SAR) is applied on the provincial level communicable diseases and socio-economic data in Thailand from the period 2016 to 2021. Results: The results indicate that the influence of foreign migrants on communicable diseases in Thailand varies depending on the type of disease. While an increase in migrants correlates with a higher prevalence of respiratory and other communicable diseases, it conversely reduces the prevalence of vaccine-preventable diseases. Additionally, we found that migrants do not significantly impact the prevalence of food- and water-borne diseases, insect-borne diseases, animal-borne diseases, or sexually transmitted diseases in Thailand. Additionally, other factors, such as GPP per capita, unemployment, poverty, and technology access, strongly correlate with most types of communicable diseases. Conclusion: As revealed by this study, the increase in migrants leads to a rise in respiratory and other communicable diseases, as well as a decrease in vaccine-preventable diseases, which carries significant policy implications. These results urge policymakers, the Ministry of Labour, and the Ministry of Public Health to implement tailored policies and measures to enhance public health and effectively mitigate the risk of communicable diseases transmitted by migrants in the future. [ABSTRACT FROM AUTHOR]

In 2019 the For The Assessment Of Individualised Risk (FAIR) project began a review of UK blood donor selection policy to determine if a more individualised approach to donor selection could be safely implemented. An evidence base was required to inform selection policy to move from a population to a more individual based policy, specifically what sexual behaviours/indicators should be considered as screening questions to maintain the safety of the blood supply. Eight sexual behaviours/indicators were reviewed: history of bacterial sexually transmitted infections (STIs), chemsex, number of recent partners, condom use, type of sex, sexual health service (SHS) attendance, new sexual partner and exclusivity. We conducted searches in multiple databases to identify literature looking at the association between these behaviours/indicators and HIV/STI acquisition risk. A scoring system to determine strength of evidence was devised and applied to papers that passed screening. Key studies were identified which achieved the maximum score and more in‐depth reviews were conducted for these. We identified 58 studies, including 17 key studies. Strong evidence was found linking a previous bacterial STI, chemsex and increasing numbers of sexual partners to acquisition risk. Condom use, type of sex and new partners were found to have some strength of evidence for this link. SHS attendance and exclusivity had minimal evidence. We recommended that the behaviours/indicators viewed as having strong or some strength of evidence should be considered as screening questions in a more individualised approach to donor selection criteria. [ABSTRACT FROM AUTHOR]

Introduction: "Programme science" deploys scientific methods to address questions that are a priority to support the impact of public health programmes. As such, programme science responds to the challenges of making such studies: (1) feasible to undertake, (2) useful, (3) rigorous, (4) real‐world‐relevant, (5) informative, and undertaken by (6) equitable partnerships. The acronym "FURRIE" is proposed to describe this set of six challenges. This paper discusses selected HIV/STI (sexually transmitted infection) programme science case studies to illustrate how programme science rises to the FURRIE challenges. Discussion: One way in which programme science is made more feasible is through the analysis and interpretation of data collected through service delivery. For some questions, these data can be augmented through methods that reach potential clients of services who have not accessed services or been lost to follow‐up. Process evaluation can enhance the usefulness of programme science by studying implementation processes, programme−client interactions and contextual factors. Ensuring rigour by limiting bias and confounding in the real‐world context of programme science studies requires methodological innovation. Striving for scientific rigour can also have the unintended consequence of creating a gap between what happens in a study, and what happens in the "real‐world." Community‐led monitoring is one approach to grounding data collection in the real‐world experience of clients. Evaluating complex, context‐specific strategies to strengthen health outcomes in a way that is informative for other settings requires clear specification of the intervention packages that are planned and delivered in practice. Programme science provides a model for equitable partnership through co‐leadership between programmes, researchers and the communities they serve. Conclusions: Programme science addresses the FURRIE challenges, thereby improving programme impact and ultimately health outcomes and health equity. The adoption and adaptation of the types of novel programme science approaches showcased here should be promoted within and beyond the HIV/STI field. [ABSTRACT FROM AUTHOR]

Background: Mycoplasma genitalium is an emerging pathogen, which has been linked to cervicitis, urethritis and pelvic inflammatory disease (PID). With the advent of multiplex polymerase chain reaction (PCR) panels for sexually transmitted infections, it is increasingly being identified in pregnant women. Objectives: The aim was to review international guidelines, which had explicit recommendations for treatment of M. genitalium infection in pregnancy and breastfeeding. Search Strategy: PubMed, EMBASE and Cochrane databases were reviewed with no age, species, language or date restrictions. Selection Criteria: Studies were included if they had an explicit recommendation for treatment of M. genitalium in pregnancy. Studies were excluded if there was no recommendation in pregnancy, if they referred to other international guideline recommendations or were historical versions of guidelines. Data Collection and Analysis: References were manually reviewed and 50 papers were selected for review. Only four guidelines were included in the final analysis and they were from Europe, UK, Australia and Aotearoa New Zealand. Main Results: All studies recommended azithromycin as first‐line treatment, and advised against moxifloxacin use. The dosing schedule of azithromycin, varied between guidelines, as did the utility/safety of pristinamycin for macrolide resistant infections. Safety data was generally reassuring for azithromycin but inconsistent for pristinamycin. Conclusions: Azithromycin is the first‐line treatment for macrolide susceptible or unknown resistance infections, but there is a lack of consistency regarding dosing of azithromycin or the utility/safety of pristinamycin for macrolide resistant infections in pregnancy/lactation. Synopsis: While international guidelines recommend azithromycin as first‐line treatment for M. genitalium infections in pregnancy, there are inconsistencies around second‐line treatment options and azithromycin dosing. [ABSTRACT FROM AUTHOR]

Background: The burden of early sexual engagement among youth is enormous. It directly raises the risk of sexually transmitted infections(STIs) and indirectly contributes to unintended pregnancy, unsafe abortion, premature childbirth, and psychosocial issues. The aim of this paper was to estimate the timing of sexual debut and examine the factors influencing the timing of first sexual intercourse following menarche among female youth aged between 15 and 24 in Uganda. Method: Self-reported data were extracted from the 2016 Uganda Demographic and Health Survey (UDHS), with a sub-sample of 7964 female youth from the individual woman file. Kaplan-Meier survival curves, decrement life-table analysis, and the discrete-time logit model were used to examine the timing of sexual debut and associated factors. Results: 67.4% of the female youth had experienced first sexual initiation. Overall, the meantime to sexual debut was 4.4 years and the median time was 4.3 years, and all the female youth had experienced first sexual initiation by the end of the twelfth year following menarche. Significant factors found to influence the timing of sexual initiation include having higher education level (OR = 0.724: 95% CI = 0.59–0.89; p = 0.003), residing in the Northern region (OR = 0.877:95% CI = 0.79–0.97, p = 0.012), being employed (OR = 1.085: 95% CI = 1.01–1.16; p = 0.021), and being literate (OR = 1.155; 95% CI = 1.07–1.25; p < 0.001). Conclusions: These findings are expected to be central in the bid to delay first sexual intercourse. Also they shed light on some of the factors associated with the timing of sexual debut which may be addressed at community level for non-school going youth and in schools, as school based prevention sexual and reproductive health programs. The findings highlight the need for future studies to collect more data to explore further the linkage between time to first debut since menarche and, mass media, religion, type of residence, and wealth index. [ABSTRACT FROM AUTHOR]

The Islamic government of Iran recently passed and announced a new law titled "Rejuvenation of the Population and Protection of the Family." This legislation is a noteworthy example of biopolitics-influenced biolaw. In terms of abortion, contraception, prenatal screening, and population control, this law clearly contrasts with women's fundamental rights and freedoms and has significant health-related consequences for different sectors of the population. A historical review of the population policies of the Islamic Republic of Iran shows the occurrence of multiple abrupt and radical changes in such policies over the past four decades. This new law, promoted by religious biopolitics, is the most recent example, and places stringent limits on abortion. According to it, all decisions concerning abortion must be made in courts rather than in health clinics. Such courts are typically presided over by male religious scholars. This law also limits prenatal screening to the degree that will increase the rate of genetic defects, especially in the population's lower socioeconomic strata. By strictly limiting access to contraception, this law will increase the rate of unwanted pregnancies and sexually transmitted diseases. This paper argues that such an influence of biopolitics on biolaw contrasts with the principles of bioethics. Still, Iran's current institution of bioethics cannot address it effectively. Therefore, a new model of interaction between bioethics, biopolitics, and biolaw is needed to prevent the detrimental consequences of such pieces of legislation. Such a paradigm shift is demanded by the current "Woman, Life, Freedom" movement of the Iranian people. [ABSTRACT FROM AUTHOR]

Background: The European Union (EU) faces many health-related challenges. Burden of diseases information and the resulting trends over time are essential for health planning. This paper reports estimates of disease burden in the EU and individual 27 EU countries in 2019, and compares them with those in 2010. Methods: We used the Global Burden of Disease 2019 study estimates and 95% uncertainty intervals for the whole EU and each country to evaluate age-standardised death, years of life lost (YLLs), years lived with disability (YLDs) and disability-adjusted life years (DALYs) rates for Level 2 causes, as well as life expectancy and healthy life expectancy (HALE). Results: In 2019, the age-standardised death and DALY rates in the EU were 465.8 deaths and 20,251.0 DALYs per 100,000 inhabitants, respectively. Between 2010 and 2019, there were significant decreases in age-standardised death and YLL rates across EU countries. However, YLD rates remained mainly unchanged. The largest decreases in age-standardised DALY rates were observed for "HIV/AIDS and sexually transmitted diseases" and "transport injuries" (each -19%). "Diabetes and kidney diseases" showed a significant increase for age-standardised DALY rates across the EU (3.5%). In addition, "mental disorders" showed an increasing age-standardised YLL rate (14.5%). Conclusions: There was a clear trend towards improvement in the overall health status of the EU but with differences between countries. EU health policymakers need to address the burden of diseases, paying specific attention to causes such as mental disorders. There are many opportunities for mutual learning among otherwise similar countries with different patterns of disease. Key-points: • This article, systematically analysing GBD 2019 study estimates, presents an overview of the state of health in the European Union in 2019, compared to 2010. • There was an improvement in the overall health status of the EU, despite substantial differences between Member States. • Cardiovascular diseases and neoplasms are the major contributors to the overall burden of diseases in the EU in 2019. • The age-standardised rate of years lived with disability due to mental disorders has been increasing and is expected to increase even more because of the COVID-19 pandemic. • This report provides a framework upon which to base further region- and country-specific health policies and interventions, to support health planning and priority setting. [ABSTRACT FROM AUTHOR]

This document is an editorial from the journal Andrology discussing the need for male contraception and the development of guidelines in this area. Despite the availability of contraceptive methods for women, the global unintended pregnancy rate remains high, with a significant number resulting in abortion. The editorial highlights the importance of male-directed contraceptive methods and the potential benefits of introducing new hormonal and non-hormonal options. The document also includes summaries of various papers in the journal's special issue, which cover topics such as the role of the World Health Organization in male contraceptive development, the potential efficacy of a combination gel, and the ethical considerations surrounding male contraception. The editorial emphasizes the importance of gender equity in family planning and the need for further research and development in this field. [Extracted from the article]

Background: There is an increase in number of Human Papillomavirus related head and neck squamous cell carcinoma (HPV-related HNSCC) High risk HPV(HR-HPV) types can be cleared by an infected person, however, some can persist and develop HN cancer. There is a broad knowledge gap regarding HPV and related cancers. Main text: The aim of this review is to assess existing published knowledge on oral-genital HPV transmission, concordance of HPV genotypes and risk of oral or/and genital lesions among spouses/partners of patients diagnosed with HPV-related HNSCC, identify gaps in the current research and highlight areas that requires further inquiry. Method: Database like Pub med, Google Scholar, Scopus, Puplon, Wiley online library were used for search strategy. Published papers on transmission, concordance of HPV genotypes and genital lesions among spouses/partners of patients diagnosed with HPV-related HNSCC were included. Papers published from January1,2000 to October 31, 2022 were included. The published papers included are 8 Case reports, 2 cross-sectional studies, 3 Cohort studies and 2 systematic reviews. Results: A total of 2125 citations were retrieved from the five sources. 15papers were included. Case reports reported concurrent HPV-related oropharyngeal, tonsillar, unspecified HNSCC, laryngeal and nasopharyngeal carcinoma among couples. The two cross-sectional studies were done. Almost all the tumors taken from patients with HPV-related oropharyngeal carcinoma (HPV-related OPC) and their spouses were positive for identical HPV 16 type. The three cohort studies showed an increase risk of upper aero-digestive tract cancer among male spouses of females with cervical cancer. Two systematic reviews reviewed literature studies which evaluated concurrent cases of HPV-related Oropharyngeal cancers. Examination of these papers showed that the majority of the studies suggested that there is HPV transmission, concordance and risk of HNSCC cancer among spouses with HPV-related oral-genital cancer. No studies evaluated the risk of developing genital cancer in spouses of patients with HNSCC. Conclusion: The findings of this review highlighted big need of further research on oral-genital HPV infection among spouses of patients diagnosed with HPV-related HNSCC. Studies are needed to evaluate the risk of getting genital and upper aero-digestive tract HPV-related cancer among spouses with HPV-related HNC. [ABSTRACT FROM AUTHOR]

The Deadly Liver Mob (DLM) is a peer-delivered incentivised health promotion program by and for Aboriginal and Torres Strait Islander Australians, and was introduced in response to the disproportionate number of Aboriginal and Torres Strait Islander Australians who are impacted by blood borne viruses (BBVs) and sexually transmitted infections (STIs). The goal of the program is to increase access to BBV and STI education, screening, treatment, and vaccination in recognition and response to the systemic barriers that Aboriginal and Torres Strait Islander peoples face in accessing health care. This commentary introduces a series of papers that report on various aspects of the evaluation of the Deadly Liver Mob (DLM) program. In this paper, we explain what DLM is and how we constructed an evaluation framework for this complex health promotion intervention. [ABSTRACT FROM AUTHOR]

Adolescents are the most vulnerable group, who are denied to access information and guidance related to sexual and reproductive health needs because of the social taboos that lead them to encumbrances. This review study helps to understand the different perspectives of sexual and reproductive health based on cultural, sociological, physiological, and economical aspects. The paper explains sexuality from the theoretical perspectives. Adolescence is the transitional stage where physiological, biological, and psychological changes occur, at the same time proper knowledge about sexual and reproductive health should be provided with importance of sexual and reproductive health interventions. It intricates the availability and effectiveness of adolescent sexual and reproductive health (ASRH). The methodology is a systematic review with PRISMA guidelines sourced from various databases of PubMed databases, Research Gate, Science Direct, BMC Public Health, Web of Science, SAGE, Scopus, WHO library, and other websites relevant to this study. The recent literature highlighted the importance of sexual and reproductive health interventions among adolescents. The study has concluded with the findings impact of Adolescent Sexual and Reproductive Health (ASRH) intervention programmes and to develop an increase in effective ASRH programmes, which will help the adolescents to know the importance of sexual hygiene and reproductive hygiene. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) is a sexually transmitted pathogen and is the main cause of cervical cancer. Cervical cancer is the second most prevalent cancer in Indonesia. One of the prevention measures used to tackle this disease is using HPV Vaccine. Previous studies have shown that HPV vaccine acceptance is influenced by lack of knowledge regarding the vaccine, high cost, and contradicting local beliefs and faiths. The aim of this study is to identify the factors influencing HPV vaccine acceptance in ASEAN countries. Three databases were searched for qualitative and quantitative studies published up to August 2023. Papers were included if they were in English or Indonesian, available in full text, and had a focus on knowledge, cost, beliefs, acceptance of the HPV vaccine. Among 23 studies, most mentioned factors regarding HPV vaccination acceptance are knowledge, cost, and beliefs. Despite being frequently discussed, knowledge doesn't always represent vaccine acceptance rate. There are no contradictions found regarding cost as a factor within those studies. Vaccination cost is the main factor that influences HPV vaccine acceptance. Though a common factor, knowledge may not always represent HPV vaccine acceptance. Other factors such as beliefs also contribute to HPV vaccine's acceptance in ASEAN countries. [ABSTRACT FROM AUTHOR]

Many African states including South Africa practice cultural activities including Male Circumcision (MC) to instil principles in young boys. MC is regarded as the transition from boy to manhood. However, this practice has been associated with many forbidden activities such as risky sexual behaviours, and drug abuse as compared to the previous years. This forbidden activity has many debates about the relevance of MC in current generation. This study sought to explore the relevance of male circumcision in Xhosa tribe in the 21st century. The qualitative research approach, through unstructured interviews, was employed in the paper and the participants were approached purposely. The collected data was analysed using a thematic approach. The findings revealed that MC is relevant for the prevention of sexually transmitted diseases such as STIs or HIV and the enhancement of sexual pleasure, however, the study also found that the tradition is relevant for preserving the Xhosa cultural customs, instilling good principles and ensuring human dignity. It further states that MC is irrelevant in the 21st century as it no longer serves its initial purpose and there are now more safer health practices for circumcision. The study thus recommended that the tradition must be preserved but subjected to health regulations. The MC needs to ensure that it suits the environment, is done by experienced people and it must not be compulsory. [ABSTRACT FROM AUTHOR]

Education is a powerful medium to bring about reform among the youth masses of India. Quality education is an important goal in sustainable development, but the scope of quality education has been exclusive to sexual education, especially in India. Given the current situation of sexual violence and misconduct in India, it is evident that there is a dire need for Sex Education for the masses. The present research is a survey study in which a sample of 234 Indian college students between the age ranges of 18-23 years was chosen. The sample was collected using a convenient sampling method via Google Forms. In this study, the authors measured the sexual and reproductive health knowledge of university students and found a serious lack of awareness regarding sexual and reproductive health practices. For instance, on average 14% of participants did not know any contraceptive methods for women or men. A whopping 82% of participants have never had a sexual examination while being sexually active. Several other instances were seen in the survey results, and hence the authors introduced a foundation course on sexual education that can be recommended to the education authorities. This course will be a compulsory paper for all freshers in their first semester of undergraduate studies and possibly extend the proposed model to the high school curriculum. The authors have introduced modules on sexual orientation, reproductive health, physical awareness, sexual violence and consent, sexual health and masturbation, cultural norms about sex, and more. This paper will have high applicability because, if the course is adapted to the educational system, there is a chance that this course can make the youth aware of several sexual problems, leading to safer sex, a reduction in sexually transmitted infections (STIs), a reduction in sexual violence cases, and fewer teen pregnancies. “In future research”, the authors can also address the menstrual hygiene problems faced by young girls in large parts of the country. [ABSTRACT FROM AUTHOR]

Background: Transmissible venereal tumour (TVT), also called Sticker Tumour, is a round cell tumour whose transmission occurs mainly through sexual contact between animals or direct transplantation of the neoplastic cell through licking or through direct contact with the lesioned area. TVT is the most common tumor found in stray dogs and predominantly affects the genital area and, in case of bitches, occurs in the vagina and foreskin, as well as the oral and nasal cavities. Intracavitary TVT is rarely reported. The aim of this paper is to report a case of an old neutered bitch affected by vaginal and intracavitary TVT, treated at the Veterinary School Clinic (CVE) of the Federal University of Santa Catarina (UFSC), Curitibanos campus, Brazil. Case: An approximately 10-year-old mixed breed bitch, weighing 18,5 kg and, neutered 2 years previously at the same institution, was brought by her owner, who reported dyskinesia, constipation, and serosanguinous vaginal discharge for a few weeks. Physical examination showed a row of 4 smooth, round masses with a soft consistency ranging from 1 to 2 cm at the bottom of the vaginal roof. The patient was referred for an ultrasound (US) and a vaginal swab was taken for cytological examination, whose result demonstrated TVT. The result of the US scan showed a heterogeneously shaped structure, with a more hypoechogenic center in relation to the periphery and irregular contours, measuring around 2.63 x 6.10 cm, in the uterine topography caudally to the bladder. Exploratory laparotomy was performed with total removal of the mass, which was surrounding the proximal urethra, and the material was sent for histological and cytological analysis, whose both results indicated TVT. Chemotherapy was then initiated, with 6 intravenous administrations of vincristine (0.5 mg/m2) with an interval of 15 days between each administration. The animal underwent a total of 6 chemotherapy sessions, without complete improvement of the vaginal tumours. A 2nd chemotherapy protocol based on doxorubicin was suggested, which was not accepted by the owner. Three months after the end of the original chemotherapy protocol, the patient was assessed again and it was found that there had been no progression of the vaginal masses on vaginal palpation and no signs of recurrence of the intracavitary mass on ultrasound. Discussion: TVT is a venereal tumor that affects almost 100% of non-neutered animals, males and females. In the case of bitches, the most common sites are the vagina (53%), vulva (13%) and extragenital areas (14%). This animal had no intracavitary mass at the time of her castration 2 years earlier. At the time of diagnosis, she had the extragenital form of the tumor, consisting of an intra-abdominal mass, in addition to the genital masses in the vaginal roof. The chemotherapy drug vincristine is the drug of choice for the treatment of transmissible venereal tumors, due to its high efficacy associated with 4 to 6 sessions. However, in this case, there was no total improvement, so it was classified as a case of proven pharmacological resistance as the chemotherapy was ineffective for the complete regression of the tumor. It was therefore concluded that the occurrence of intracavitary TVTs, although rare, warrants a thorough physical examination combined with diagnostic tools such as ultrasound and histology, even in castrated old patients. [ABSTRACT FROM AUTHOR]

Background: The Transmissible Venereal Tumour (TVT) is a round cell neoplasm that affects dogs. Its localisation is predominantly venereal; however, it can be found in extragenital regions, such as skin, nostrils, mouth and eyes. This paper describes a case of nasal TVT in a geriatric dog, performing its clinical, laboratory, therapeutic and prognostic analysis. Case: A 13-year-old male dog, mixed breed, non-castrated, domiciled, weighing 19,200 kg, was attended at the Small Animal Medical Clinic (CMPA) of the University Veterinary Hospital (HVU) of the Multidisciplinary Centre of the Barra Campus, Federal University of Western Bahia (UFOB), presenting cachexia, reactive lymph nodes except the popliteal ones, dehydration, dyspnoea, arrhythmia, frequent sneezing with serous and yellowish nasal discharge, cough, difficulty in breathing, increased volume in the face (left nasal plane), enlarged volume above the right eye with a suppurative wound just below. The animal's haemogram revealed the presence of normocytic normochromic anaemia, neutrophilic leukocytosis with left regenerative shift and hyperproteinaemia. The serum biochemical tests for renal function (urea and creatinine) and hepatic function (ALT, AST and AF) showed normal levels. The cytological evaluation showed a monomorphic population of large cells with a round nucleus, condensed chromatin and 1 to 2 prominent nucleoli, abundant and slightly basophilic cytoplasm, with multiple punctuated vacuoles, showing discrete anisocytosis and anisokaryosis and mitotic figures, confirming a case of TVT. In addition, the presence of neutrophils was evidenced, indicating an inflammatory process. Simultaneously, an X-ray of the skull was requested, which was not returned. A chemotherapy protocol was instituted using vincristine sulphate [0.025 mg/kg IV], for 5 sessions with an interval of 1 week between each session, clinical and laboratory monitoring of the regression of neoplastic cells, demonstrating total efficacy. It is worth noting that after the 2nd application of the pharmaceutical, the animal presented adverse reactions, with clinical symptoms of emesis, decreased appetite and weight loss; so, the animal was then subjected to fluid therapy, treatment with immunostimulants, appetite stimulants and antiemetics, which influenced its clinical improvement. Discussion: The importance of complementary diagnostic tests in the routine of veterinary clinics and hospitals is noticeable, aimed at establishing the diagnosis and therapeutic monitoring of diseases. In the present report, diverging from the majority of cases described in the literature, the animal showed signs of neoplasia at 13 years of age, in a context of reduced sexual activity. It is believed that the fact that he has free access to the street and has olfactory habits inherent to the canine species in terms of contact with the genital region of other animals, left him exposed to factors that determined the transmissibility of the neoplasm. Weekly clinical follow-up as well as laboratory tests, was essential to ascertain the effectiveness of the treatment, the presence of adverse reactions and the introduction of new drugs. The normocytic normochromic anaemia possibly occurred in response to the nodular and haemorrhagic characteristics of the tumour tissue. The leukocytosis due to neutrophilia and hyperproteinaemia would be related to the occurrence of an acute infectious process, probably bacterial. It is concluded that although geriatric patients present immunosuppression more easily than other age groups, in cases of TVT, the therapeutic approach with vincristine sulphate, and the clinical and laboratory follow-up adopted influence the good prognosis concerning neoplastic regression. [ABSTRACT FROM AUTHOR]

Acquired Immunodeficiency Syndrome (AIDS) is a sexually transmitted disease that can be passed from partner to partner, mother to child, or through blood exchange using infected syringes. AIDS symptoms might vary depending on characteristics such as age, gender, and physical activity. Headaches, muscle and joint discomfort, rashes, diarrhoea, weight loss, coughing, night sweats, sore throat, stomatitis, swollen lymph nodes, malaise, oral yeast infections, shingles (herpes zoster), and lung infections are all common symptoms. The Food and medication Administration (FDA) of the United States authorised Lenacapavir, a novel AIDS therapy medication, in 2022. Lenacapavir is a capsid inhibitor available in tablet and injection form that directly targets the Human Immunodeficiency Virus Type 1 (HIV-1) Capsid Protein. Various research and papers, like the Capella study, which assessed the safety and efficacy of subcutaneous Lenacapavir, were used to assess the safety and efficacy of Lenacapavir. The Calibrate study shed light on the absence of phenotypic resistance to Lenacapavir in HIV Gag cleavage site mutants and isolates resistant to existing medication classes. These studies also included data from a proof-of-concept clinical research on HIV patients examining phenotypic resistance to Lenacapavir and its efficacy as a monotherapy. The approval of Lenacapavir represents a viable new therapy option for those living with HIV. Its method of action, as well as promising safety and efficacy results from numerous studies, offer hope for better outcomes in the treatment of this severe disease. [ABSTRACT FROM AUTHOR]

Disparities in sexual health outcomes for youth with disabilities require new and creative approaches to address the complex and often individualized barriers facing this diverse population. The Disability-inclusive Sexual Health Network (DSHN) establishes, funds, coordinates, and supports a multidisciplinary network of partners to explore, develop, test, refine, and evaluate innovative interventions that will improve optimal health, prevent teen pregnancy, and address sexually transmitted infections (STIs) for youth with disabilities in Virginia. DSHN developed the Monthly Reporting Instrument (MRI) to support communication, coordination, monitoring, and evaluation of the project, and shares findings from data collected using this tool. A mixed method analysis was conducted on data collected in year 1 using the MRI. A total of 67 MRI submissions were collected across eight DSHN Partners between March 2021 and March 2022. Analysis of the year 1 MRI data gives a rich understanding of the common barriers faced, accomplishments and progress achieved in the face of those challenges, and Partners' relationships to the Network and each other. This paper proposes solutions to common barriers in implementing Network support and coordination activities in year 2 and reflects on the utility of the MRI as a multi-purpose tool for communication and engagement as well as monitoring and evaluating DSHN as a systems-level intervention. [ABSTRACT FROM AUTHOR]

This paper presents the results of formative research conducted from January to June 2020 in the Department of Atlántico, Caribbean region of Colombia, whose findings were used as inputs to design the national strategy for comprehensive sexuality education (CSE) outside school – Tírala Plena – including its curriculum. This is within the framework of the multi-country project coordinated by UNFPA and WHO aimed at generating evidence on the role of facilitators in the delivery of CSE in non-school contexts. The research was carried out in four municipalities in northern Colombia, in rural and marginal urban contexts with conditions of vulnerability for the adolescent population, including a strong presence of migrant populations from Venezuela. A total of 150 male and female adolescents ages 10–17 participated in the formative research. Workshops such as patchwork quilt, body mapping and talking maps were used as methods to gather information. The groups were divided by sex and age (10–13 years old and 14–17 years old). Knowledge, attitudes and social norms regarding adolescent pregnancy, sexually transmitted infections, including human immunodeficiency virus, and gender-based violence, were identified in adolescents (schooled and not schooled, but with minimal or no access to CSE). All of the above enabled us to establish a set of recommendations for the strengthening of the CSE strategy Tírala plena. [ABSTRACT FROM AUTHOR]

Background: The quality of school-based sex and relationships education (SRE) is variable in the UK. Digitally-based interventions can usefully supplement teacher-delivered lessons and positively impact sexual health knowledge. Designed to address gaps in core SRE knowledge, STASH (Sexually Transmitted infections And Sexual Health) is a peer-led social network intervention adapted from the successful ASSIST (A Stop Smoking in Schools Trial) model, and based on Diffusion of Innovation theory. This paper describes how the STASH intervention was developed and refined. Methods: Drawing on the Six Steps in Quality Intervention Development (6SQuID) framework, we tested a provisional programme theory through three iterative stages -: 1) evidence synthesis; 2) intervention co-production; and 3) adaptation - which incorporated evidence review, stakeholder consultation, and website co-development and piloting with young people, sexual health specialists, and educators. Multi-method results were analysed in a matrix of commonalities and differences. Results: Over 21 months, intervention development comprised 20 activities within the three stages. 1) We identified gaps in SRE provision and online resources (e.g. around sexual consent, pleasure, digital literacy), and confirmed critical components including the core ASSIST peer nomination process, the support of schools, and alignment to the national curriculum. We reviewed candidate social media platforms, ruling out all except Facebook on basis of functionality restrictions which precluded their use for our purposes. 2) Drawing on these findings, as well as relevant behaviour change theories and core elements of the ASSIST model, we co-developed new content with young people and other stakeholders, tailored to sexual health and to delivery via closed Facebook groups, as well as face-to-face conversations. 3) A pilot in one school highlighted practical considerations, including around peer nomination, recruitment, awareness raising, and boundaries to message sharing. From this, a revised STASH intervention and programme theory were co-developed with stakeholders. Conclusions: STASH intervention development required extensive adaptation from the ASSIST model. Although labour intensive, our robust co-development approach ensured that an optimised intervention was taken forward for feasibility testing. Evidencing a rigorous approach to operationalising existing intervention development guidance, this paper also highlights the significance of balancing competing stakeholder concerns, resource availability, and an ever-changing landscape for implementation. Trial registration: ISRCTN97369178. [ABSTRACT FROM AUTHOR]

Background: In 2020, SARS-CoV-2 and the COVID-19 pandemic had a huge impact on the access to and provision of ART treatments. Gradually, knowledge of the virus and its transmission has become available, allowing ART activities to resume. Still, questions on the impact of the virus on human gametes and fertility remain.Objective and Rationale: This article summarizes published data, aiming to clarify the impact of SARS-CoV-2 and the COVID-19 disease on human fertility and assisted reproduction, as well as the impact of vaccination, and from this, provide answers to questions that are relevant for people contemplating pregnancy and for health care professionals.Search Methods: PUBMED/MEDLINE and the WHO COVID-19 database were searched from inception to 5 October 2022 with search terms focusing on 'SARS-CoV-2' and gametes, embryos, reproductive function, fertility and ART. Non-English studies and papers published prior to 2020 were excluded, as well as reviews and non-peer reviewed publications. Full papers were assessed for relevance and quality, where feasible.Outcomes: From the 148 papers included, the following observations were made. The SARS-CoV-2-binding proteins, angiotensin-converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2), are expressed in the testis, but co-expression remains to be proven. There is some evidence of SARS-CoV-2 RNA in the ejaculate of COVID-19 patients with severe disease, but not in those with mild/moderate disease. SARS-CoV-2 infection can impair spermatogenesis, but this seems to resolve after one spermatogenic cycle. Testosterone levels seem to be lower during and after COVID-19, but long-term data are lacking; disease severity may be associated with testosterone levels. COVID-19 cannot be considered a sexually transmitted disease. There is no co-expression of ACE2 and TMPRSS2 in the myometrium, uterus, ovaries or fallopian tubes. Oocytes seem to have the receptors and protease machinery to be susceptible to SARS-CoV-2 infection; however, viral RNA in oocytes has not been detected so far. Women contemplating pregnancy following COVID-19 may benefit from screening for thyroid dysfunction. There is a possible (transient) impact of COVID-19 on menstrual patterns. Embryos, and particularly late blastocysts, seem to have the machinery to be susceptible to SARS-CoV-2 infection. Most studies have not reported a significant impact of COVID-19 on ovarian reserve, ovarian function or follicular fluid parameters. Previous asymptomatic or mild SARS-CoV-2 infection in females does not seem to negatively affect laboratory and clinical outcomes of ART. There are no data on the minimum required interval, if any, between COVID-19 recovery and ART. There is no evidence of a negative effect of SARS-CoV-2 vaccination on semen parameters or spermatogenesis, ovarian function, ovarian reserve or folliculogenesis. A transient effect on the menstrual cycle has been documented. Despite concerns, cross reactivity between anti-SARS-CoV-2 spike protein antibodies and Syncytin-1, an essential protein in human implantation, is absent. There is no influence of mRNA SARS-CoV-2 vaccine on patients' performance during their immediate subsequent ART cycle. Pregnancy rates post-vaccination are similar to those in unvaccinated patients.Wider Implications: This review highlights existing knowledge on the impact of SARS-CoV-2 infection or COVID-19 on fertility and assisted reproduction, but also identifies gaps and offers suggestions for future research. The knowledge presented should help to provide evidence-based advice for practitioners and couples contemplating pregnancy alike, facilitating informed decision-making in an environment of significant emotional turmoil. [ABSTRACT FROM AUTHOR]

Purpose: Self‐sampling packs for sexually transmitted infections (STIs) and blood‐borne viruses (BBVs) are widely offered. There are ongoing problems with reach and sample return rates. The packs have arisen without formal intervention development. This paper illustrates initial steps of an intervention optimization process to improve the packs. Methods: Eleven focus groups and seven interviews were conducted with convenience samples of patients recruited from sexual health clinics and members of the public (n = 56). To enable intervention optimization, firstly, we conducted an inductive appraisal of the behavioural system of using the pack to understand meaningful constituent behavioural domains. Subsequently, we conducted a thematic analysis of barriers and facilitators to enacting each sequential behavioural domain in preparation for future behaviour change wheel analysis. Results: Overall, we found that self‐sampling packs were acceptable. Participants understood their overall logic and value as a pragmatic intervention that simultaneously facilitated and reduced barriers to individuals being tested for STIs and BBVs. However, at the level of each behavioural domain (e.g., reading leaflets, returning samples) problems with the pack were identified, as well as a series of potential optimizations, which might widen the reach of self‐sampling and increase the return of viable samples. Conclusions: This paper provides an example of a pragmatic approach to optimizing an intervention already widely offered globally. The paper demonstrates the added value health psychological approaches offer; conceptualizing interventions in behavioural terms, pinpointing granular behavioural problems amenable for systematic further improvement. [ABSTRACT FROM AUTHOR]

Introduction: Travel medicine is an emerging branch of medicine concerned with the well-beings of travellers before, during, and after travel. Pre-travel health advice and medical services are important to keep travellers healthy and ensure a safe and pleasant journey by minimising impact of illness and accidents. Objective: This paper serves as a literature review paper on the pre-travel health advice seeking behaviours amongst travellers as well as the pre-travel health advice and medical services provided by the health professionals. Methodology: An extensive online literature search using the search terms of "pre-travel", "health advice", "medical services", and "health professionals" was done on electronic bibliographic databases including PubMed and Scopus supplemented by Google Scholar. Results: Twenty original studies as retrieved from the online databases which fulfilled the inclusion criteria were included in the review. Prevalence of pre-travel advice seeking behaviour is reportedly low in Malaysia (36.8% - 40.5%). Studies done amongst pharmacists in Malaysia revealed that the Malaysian pharmacists have been actively involved in providing pre-travel health advice and medical services (76.6% - 85%). High percentages of healthcare professionals in Europe and American (68% - 94.7%) provide pretravel advice and medical services, followed by 79.5% in Saudi and 44.7% in Qatar. The top 5 topics of health advice most frequently cited were on malaria, travel insurance, sexually transmitted disease/HIV, vaccinations and first aid kit. The average duration spent for pre-travel consultation range from 5 to 30 minutes. Conclusion: Travellers should be educated on the importance of seeking pre-travel advice and vaccinations to raise their awareness. Healthcare practitioners should be well-trained and informed to provide good pre-travel advice and services. [ABSTRACT FROM AUTHOR]

Background: The Deadly Liver Mob (DLM) program is a peer-led health promotion program that aims to improve access to screening and treatment for blood borne viruses and sexually transmissible infections for Aboriginal and Torres Strait Islander Australians. In this paper, we used client and staff insights to explore the successes and challenges of implementing the DLM program according to the RE-AIM framework, which explores real-world implementation of interventions according to reach, effectiveness, adoption, implementation, and maintenance. Methods: Clients and staff were recruited through the DLM program. Semi-structured interviews were conducted with four Aboriginal and Torres Strait Islander and 11 non-Aboriginal or Torres Strait Islander health workers, as well as 33 Aboriginal and Torres Strait Islander clients of the program. Results: Findings show the positive effects of the DLM program, in creating a culturally safe and sensitive environment for Aboriginal and Torres Strait Islander clients to access care. In particular, the employment of frontline Aboriginal and Torres Strait Islander workers to deliver the education was touted as one of the primary successes of the program, in enabling workers to build trust between clients and mainstream health systems, which has the flow on effect of encouraging clients to go through to screening. The use of the RE-AIM framework illustrates the challenges of implementing real-world interventions across various locations, such as the difficulties in delivering DLM in regional and remote areas due to covering large geographic areas with minimal public transport available. Conclusions: The data emphasise the need for interventions to be adaptable and flexible, altering elements of the program to suit local and community needs, such as by offering mobile and outreach services to enable access across regional and rural areas. The findings of this evaluation have been used to develop tools so that the learnings from DLM can be shared with others who may be hoping to implement DLM or other similar programs. [ABSTRACT FROM AUTHOR]

Endometriosis is defined as the presence of endometrial tissue outside of the uterine cavity. It is a chronic disease affecting approximately 10% of women. In addition to producing a vast array of symptoms, including chronic pelvic pain and dysmenorrhea, the condition significantly impacts quality of life. Over the past century, several theories have attempted to explain the pathogenesis of this complex disease. Recent studies have investigated the potential role of human papillomavirus (HPV) infection in the development of endometriotic lesions. The objective of this review was to conduct a search of online databases (Embase, Medline and PubMed) for available literature from June 2013 to June 2023 concerning the association between HPV and endometriosis. After screening 110 articles, 23 studies met the eligibility criteria, and 8 were included in the systematic review. Out of the 8 reviewed papers, 3 described a statistically significant correlation between HPV infection and endometriosis. 3 others only demonstrated a higher incidence of HPV infection in patients with confirmed endometriosis. A difference in the dominant type of HPV serotype among patients diagnosed with endometriosis was also observed. Given these results, it is difficult to propose a viral origin of the disease. Further research is necessary to determine the role of HPV infection in the development of endometriosis. [ABSTRACT FROM AUTHOR]

Background: Aboriginal and Torres Strait Islander Australians are disproportionately impacted by blood-borne viruses (BBVs) and sexually transmissible infections (STIs). Stigma remains one of the key barriers to testing and treatment for BBVs and STIs, particularly among Aboriginal and Torres Strait Islander people. The Deadly Liver Mob (DLM) is a peer-delivered incentivised health promotion program by and for Aboriginal and Torres Strait Islander Australians. The program aims to increase access to BBV and STI education, screening, treatment, and vaccination for Aboriginal and Torres Strait Islander Australians in recognition of the systemic barriers for First Nations people to primary care, including BBV- and STI-related stigma, and institutional racism. This paper presents routinely collected data across nine sites on the 'cascade of care' progression of Aboriginal and Torres Strait Islander clients through the DLM program: hepatitis C education, screening, returning for results, and recruitment of peers. Methods: Routinely collected data were collated from each of the DLM sites, including date of attendance, basic demographic characteristics, eligibility for the program, recruitment of others, and engagement in the cascade of care. Results: Between 2013 and 2020, a total of 1787 Aboriginal and Torres Strait Islander clients were educated as part of DLM, of which 74% went on to be screened and 42% (or 57% of those screened) returned to receive their results. The total monetary investment of the cascade of care progression was approximately $56,220. Data highlight the positive impacts of the DLM program for engagement in screening, highlighting the need for culturally sensitive, and safe programs led by and for Aboriginal and Torres Strait Islander people. However, the data also indicate the points at which clients 'fall off' the cascade, underscoring the need to address any remaining barriers to care. Conclusions: The DLM program shows promise in acting as a 'one stop shop' in addressing the needs of Aboriginal and Torres Strait Islander people in relation to BBVs and STIs. Future implementation could focus on addressing any potential barriers to participation in the program, such as co-location of services and transportation. [ABSTRACT FROM AUTHOR]

Background: Treatment for partners of patients diagnosed with sexually transmitted infections (STI), referred to as expedited partner therapy (EPT), is infrequently used in the emergency department (ED). This was a pilot program to initiate and evaluate EPT through medication-in-hand ("take-home") kits or paper prescriptions. In this study we aimed to assess the frequency of EPT prescribing, the efficacy of a randomized best practice advisory (BPA) on the uptake, perceptions of emergency clinicians regarding the EPT pilot, and factors associated with EPT prescribing. Methods: We conducted this pilot study at an academic ED in the midwestern US between August-October 2021. The primary outcome of EPT prescription uptake and the BPA impact was measured via chart abstraction and analyzed through summary statistics and the Fisher exact test. We analyzed the secondary outcome of barriers and facilitators to program implementation through ED staff interviews (physicians, physician assistants, and nurses). We used a rapid qualitative assessment method for the analysis of the interviews. Results: During the study period, 52 ED patients were treated for chlamydia/gonorrhea, and EPT was offered to 25% (95% CI 15%-39%) of them. Expedited partner therapy was prescribed significantly more often (42% vs 8%; P < 0.01) when the interruptive pop-up alert BPA was shown compared to not shown. Barriers identified in the interviews included workflow constraints and knowledge of EPT availability. The BPA was viewed positively by the majority of participants. Conclusion: In this pilot EPT program, expedited partner therapy was provided to 25% of ED patients who appeared eligible to receive it. The interruptive pop-up alert BPA significantly increased EPT prescribing. Barriers identified to EPT prescribing should be the subject of future interventions to improve provision of EPT from the emergency department. [ABSTRACT FROM AUTHOR]

The paper asks: 'What can we learn from COVID-19 pandemic about effective use of scientific and technical information (STI) in policymaking and how might the lessons be put to use?' The paper employs the political rhetoric of 'follow the science' as a lens for examining contemporary concerns in the use of STI, including (1) 'Breadth of Science Products', the necessity of a broader concept of STI that includes by-products science, (2) 'Science Dynamism', emphasizing the uncertainty and impeachability of science, (3) 'STI Urgency' suggesting that STI use during widespread calamities differs from more routine applications, and (4) 'Hyper-politicization of Science', arguing that a step-change in the contentiousness of politics affects uses and misuses of STI. The paper concludes with a discussion, STI Curation, as a possible ingredient to improving effective use. With more attention to credibility and trust of STI and to the institutional legitimacy of curators, it should prove possible to improve the effective use of STI in public policy. [ABSTRACT FROM AUTHOR]

In the post-WWII decolonization era, the prospect of an open, decolonized Greenland, with unrestricted mobility for inhabitants, intensified medical experts' pre-existing concerns over sexually transmitted diseases. During the colonial phase, medical and administrative authorities could govern Greenlanders as subjects and accordingly control their mobility and interactions with Europeans. However, the decolonization agenda threatened to undermine this situation. Greenland could no longer remain a colony, enclosed and sealed off from the rest of world by trade monopoly and strict limitations on access to the country imposed by the Danish authorities. Doctors were concerned by two impending shifts that threatened to undermine efforts to control sexually transmitted diseases. First, Greenland's decolonized status would entail more or less free access to the country. Second, after decolonization, Greenlanders would have the status as citizens, and authorities could no longer govern them as (colonial) subjects. This paper demonstrates how medical authorities struggled with the Greenlanders' transition from controllable (sexual) subjects to rights-bearing (sexual) citizens. The paper provides a fresh perspective concerning this watershed moment, between colonialism and the process of decolonization in Greenland. [ABSTRACT FROM AUTHOR]

Background: The slow pace of fertility decline in Africa relative to other parts of the world has important implications for the region's economic development. Modern contraceptive use is seen as important population control and family planning strategy by governments worldwide. This paper examines the socioeconomic determinants of modern contraceptive use and choice among Ghanaian men and women. Methods: We use the most recent and nationally representative Ghana Demographic and Health Survey conducted in 2014. The analysis is observational, with no causal implications. Bivariate and multivariate methods are used to analyse the data. We first use logistic regression to explore the correlates of modern contraceptive use among Ghanaian men and women. Second, we explore the socioeconomic factors influencing the choice of modern contraceptive methods among contraceptive users using multinomial logistic regression. We classify the modern methods of contraception into three groups: long-acting reversible contraceptives (LARC), short-acting contraceptives (SAC), and permanent contraceptives. Results: Marital status proves to be the most significant predictor for both men and women, with women in monogamous unions having a greater propensity to use modern methods of contraception (OR = 1.4, p < 0.00). We also find that different factors affect the use and choice of modern methods of contraception among men and women in Ghana. Muslim men had a higher likelihood than Catholics to choose the permanent (sterilisation) method (OR = 11.9, p < 0.05), while their female counterparts were 0.25 times less likely to choose sterilisation over SAC (p < 0.05). Moreover, women who ever tested for HIV had higher use of LAC than the SAC ((RRR = 1.6, p < 0.01). The modern contraceptive users (women) with at most basic education were more likely than those with tertiary education to choose LAC over SAC. Finally, rural women with health insurance were 0.75 times (p < 0.01) less likely to use modern methods of contraception. Conclusions: The paper reiterates the need to intensify and sustain public health education on the health benefits of using modern methods of contraception among the adult population. The paper suggests that including family planning services on Ghana's national health insurance benefits package is commendable. It can promote modern contraceptive use and curtail unwarranted population growth. [ABSTRACT FROM AUTHOR]

Background: Black girls are disproportionately impacted by HIV and sexually transmitted infections (STIs), underscoring the urgent need for innovative strategies to enhance the adoption and maintenance of HIV/STI prevention efforts. Historically, Black male caregivers have been left out of girls' programming, and little guidance exists to inform intervention development for Black girls and their male caregivers. Engaging Black male caregivers in Black girls' sexual and reproductive health may reduce sexual risk-taking and improve the sustainability of preventative behaviors. Objective: This paper describes the formative phases, processes, and methods used to adapt an evidence-based mother-daughter sexual and reproductive health intervention for Black girls 9–18 years old and their male caregivers. Methods: We used the ADAPT-ITT model to tailor IMARA for Black girls and their male caregivers. Diverse qualitative methods (interviews, focus groups, and theater testing) were used throughout the adaption process. Results: Findings support using the ADAPT-ITT model to tailor an evidence-based HIV/STI intervention for Black girls and their Black male caregivers. Findings highlight the importance of community engagement and the use of qualitative methods to demonstrate the acceptability and feasibility of the adapted intervention. Key lessons learned are reviewed. Conclusions: Adapting evidence-based interventions to incorporate Black girls and their Black male caregivers should be driven by a relevant theoretical framework that aligns with the target population(s). Adapting the intervention in partnership with the community has been shown to improve acceptability and feasibility as it is responsive to community needs. Using a systematic process like the ADAPT-ITT model will ensure that the new program is ready for efficacy trials. [ABSTRACT FROM AUTHOR]

Background: Black girls are disproportionately impacted by HIV and sexually transmitted infections (STIs), underscoring the urgent need for innovative strategies to enhance the adoption and maintenance of HIV/STI prevention efforts. Historically, Black male caregivers have been left out of girls' programming, and little guidance exists to inform intervention development for Black girls and their male caregivers. Engaging Black male caregivers in Black girls' sexual and reproductive health may reduce sexual risk-taking and improve the sustainability of preventative behaviors. Objective: This paper describes the formative phases, processes, and methods used to adapt an evidence-based mother-daughter sexual and reproductive health intervention for Black girls 9–18 years old and their male caregivers. Methods: We used the ADAPT-ITT model to tailor IMARA for Black girls and their male caregivers. Diverse qualitative methods (interviews, focus groups, and theater testing) were used throughout the adaption process. Results: Findings support using the ADAPT-ITT model to tailor an evidence-based HIV/STI intervention for Black girls and their Black male caregivers. Findings highlight the importance of community engagement and the use of qualitative methods to demonstrate the acceptability and feasibility of the adapted intervention. Key lessons learned are reviewed. Conclusions: Adapting evidence-based interventions to incorporate Black girls and their Black male caregivers should be driven by a relevant theoretical framework that aligns with the target population(s). Adapting the intervention in partnership with the community has been shown to improve acceptability and feasibility as it is responsive to community needs. Using a systematic process like the ADAPT-ITT model will ensure that the new program is ready for efficacy trials. [ABSTRACT FROM AUTHOR]

The subspecies T. pallidum pallidum is the cause of the most infamous sexually and congenitally transmitted disease, syphilis. This disease has an estimated incidence of six million infections every year. Multiple studies have noted that the prevalence of syphilis has been steadily increasing worldwide in recent decades, especially among MSMs and HIV-positive patients. Clinically, syphilis presents in four stages with multiple different clinical manifestations. In this paper, we examine the current literature to determine the history and progression, pathogenesis, clinical features, and testing of secondary syphilis. Secondary syphilis is a stage of the disease with the most exuberant local and systemic clinical manifestations. The basis of the pathogenesis of SS underscores the unique mechanisms by which Treponema pallidum utilizes to escape immune recognition while simultaneously induces inflammation. SS can affect multiple organ systems and become more than just an STD. The most common presentation of secondary syphilis is rash, which manifests as a copper-colored maculopapular lesion on the trunk, palms, and soles. Although the RPR, VDRL, and FTA-ABS tests are perhaps the most commonly used diagnostic tools for syphilis and make up the traditional and reverse algorithms, there are other methods, including morphology and immunohistochemistry. [ABSTRACT FROM AUTHOR]

Background: Human Papilloma Virus (HPV) is the most common sexually transmitted infection worldwide. Globally, both men and women have a 50% risk of being infected at least once in their life. HPV prevalence is among the highest in sub-Saharan Africa (SSA), at an average of 24%. HPV causes different types of cancers, including cervical cancer (CC), which is the leading cause of cancer deaths among women in SSA. HPV-vaccination has been proven to be effective in reducing HPV induced cancers. SSA countries are delayed in reaching the WHO's target of fully vaccinating 90% of girls within the age of 15 by 2030. Our systematic review aims to identify barriers and facilitators of HPV-vaccination in SSA to inform national implementation strategies in the region. Methods: This is a mixed method systematic review based on the PRISMA statement and The Joanna Briggs Institute Reviewers' Manual. Search strategies were adapted to each selected database: PubMed/MEDLINE, Livivo, Google Scholar, Science Direct, and African Journals Online for papers published in English, Italian, German, French and Spanish between 1 December 2011 and 31 December 2021. Zotero and Rayyan were the software used for data management. The appraisal was conducted by three independent reviewers. Results: A total of 20 articles were selected for appraisal from an initial 536 articles. Barriers included: limited health system capacities, socio-economic status, stigma, fear and costs of vaccines, negative experience with vaccinations, COVID-19 pandemic, lack of correct information, health education (HE) and consent. Additionally, we found that boys are scarcely considered for HPV-vaccination by parents and stakeholders. Facilitators included: information and knowledge, policy implementation, positive experience with vaccinations, HE, stakeholders' engagement, women's empowerment, community engagement, seasonality, and target-oriented vaccination campaigns. Conclusions: This review synthesizes barriers and facilitators of HPV-vaccinations in SSA. Addressing these can contribute to the implementation of more effective HPV immunization programs targeted at eliminating CC in line with the WHO 90/70/90 strategy. Registration and funding: Protocol ID: CRD42022338609 registered in the International Prospective Register of Systematic Reviews (PROSPERO). Partial funds: German Centre for Infection research (DZIF) project NAMASTE: 8,008,803,819. Contributions to the literature: Our review synthesizes factors influencing the successful implementation of HPV vaccination programs in SSA in order to improve roll-out and coverage. Our review provides an overview and contextualizes the barriers and facilitators of HPV vaccination implementation in 12 countries in SSA. These span the health care system ranging from personal experiences to economic, social, and political factors. Lessons learnt from past experiences of HPV vaccination in SSA as identified by our review, can contribute to more effective national HPV vaccination programs targeted at eliminating CC and implementing the WHO 90/70/90 triple intervention strategy. [ABSTRACT FROM AUTHOR]

The incidence of sexually transmitted infections (STI) is rising, especially in high-risk groups, namely people living with human immunodeficiency virus (HIV), men who have sex with men, and people with multiple sexual partners. Additionally, the growing availability and use of pre-exposure prophylaxis to prevent HIV infection appears to be associated with an increased risk of infection by venereal agents. The correct recognition of these infections is crucial, not only for individual patients, but also in terms of public health. Furthermore, a diligent diagnostic assessment is key for an efficient therapeutic approach. Infectious proctitis (IP) predominantly occurs in individuals with a history of receptive anal exposure, being a frequent cause for referral to a gastroenterology specialist. The most frequently identified agents are Neisseria gonorrhoeae, Chlamydia trachomatis, Herpes simplex virus, and Treponema pallidum. This paper aims to provide a practice-oriented and up-todate review regarding the diagnostic and therapeutic approaches to patients with suspected IP. The authors reviewed the most important issues in terms of clinical history, physical examination, and specific diagnostic and therapeutic methods. It is also highlighted the most important topics regarding vaccination, screening for other STIs and differential diagnosis with inflammatory bowel disease. Identification of high-risk groups, screening of potential STIs, and notification of diagnosed anorectal diseases are extremely important and essential to prevent transmission and other complications. [ABSTRACT FROM AUTHOR]

Introduction: Syphilis is a sexually transmitted disease (STD) caused by Treponema pallidum subspecies pallidum. In 2016, it was declared an epidemic in Brazil due to its high morbidity and mortality rates, mainly in cases of maternal syphilis (MS) and congenital syphilis (CS) with unfavorable outcomes. This paper aimed to mathematically describe the relationship between MS and CS cases reported in Brazil over the interval from 2010 to 2020, considering the likelihood of diagnosis and effective and timely maternal treatment during prenatal care, thus supporting the decision-making and coordination of syphilis response efforts. Methods: The model used in this paper was based on stochastic Petri net (SPN) theory. Three different regressions, including linear, polynomial, and logistic regression, were used to obtain the weights of an SPN model. To validate the model, we ran 100 independent simulations for each probability of an untreated MS case leading to CS case (PUMLC) and performed a statistical t-test to reinforce the results reported herein. Results: According to our analysis, the model for predicting congenital syphilis cases consistently achieved an average accuracy of 93% or more for all tested probabilities of an untreated MS case leading to CS case. Conclusions: The SPN approach proved to be suitable for explaining the Notifiable Diseases Information System (SINAN) dataset using the range of 75–95% for the probability of an untreated MS case leading to a CS case (PUMLC). In addition, the model's predictive power can help plan actions to fight against the disease. [ABSTRACT FROM AUTHOR]

Syphilis is a sexually transmitted disease that spreads widely around the world, infecting tens of millions of people every year. In China, syphilis not only causes more than 1 million infections every year, but also has its own characteristics in spreading pattern: this disease always spreads with the migration of floating population. There have been many related investigations and studies on the transmission of syphilis with the floating population in China, but the study of quantitative modeling in this field is very limited. In this paper, based on the Markov process model and datasets collected in Zhejiang Province, China, we construct a new model to analyze the transmission and immigration process of syphilis. The results show that immigrant patients are one of the sources of infection of syphilis in Zhejiang province, and the infection rate is remarkable which should not be ignored. By using the PRCC method to analyze the relationship between parameters and infected cases, we also find two main effective measures that can control the spread of syphilis and reduce the infection rate: the self-attention of infected persons, and the use of sexual protection measures. With the increasing frequent exchanges of people among different countries and regions, studying the transmission of diseases with the floating populations has become more and more important. The method we use in this paper gives a new insight studying this issue, providing a quantitative research method using the data of diagnosed cases. All the methods and models in this paper can be extendly used in the studies of other diseases where immigrant patients should be considered. [ABSTRACT FROM AUTHOR]

Introduction: Syphilis is a sexually transmitted disease (STD) caused by Treponema pallidum subspecies pallidum. In 2016, it was declared an epidemic in Brazil due to its high morbidity and mortality rates, mainly in cases of maternal syphilis (MS) and congenital syphilis (CS) with unfavorable outcomes. This paper aimed to mathematically describe the relationship between MS and CS cases reported in Brazil over the interval from 2010 to 2020, considering the likelihood of diagnosis and effective and timely maternal treatment during prenatal care, thus supporting the decision-making and coordination of syphilis response efforts.Methods: The model used in this paper was based on stochastic Petri net (SPN) theory. Three different regressions, including linear, polynomial, and logistic regression, were used to obtain the weights of an SPN model. To validate the model, we ran 100 independent simulations for each probability of an untreated MS case leading to CS case (PUMLC) and performed a statistical t-test to reinforce the results reported herein.Results: According to our analysis, the model for predicting congenital syphilis cases consistently achieved an average accuracy of 93% or more for all tested probabilities of an untreated MS case leading to CS case.Conclusions: The SPN approach proved to be suitable for explaining the Notifiable Diseases Information System (SINAN) dataset using the range of 75-95% for the probability of an untreated MS case leading to a CS case (PUMLC). In addition, the model's predictive power can help plan actions to fight against the disease. [ABSTRACT FROM AUTHOR]

[Display omitted] • Trichomonas vaginalis has extensive cellular transport machinery, eg. AP complexes. • Their extent and evolution in Trichomonas and other Parabasalia is unclear. • We show that such expansion occurred deep in the mostly endobiotic Parabasalia. • We newly identify components in the free-living relative of this endobiotic lineage. • Modification of this machinery correlates with parasitism but more with endobiontism. The eukaryotic phylum Parabasalia is composed primarily of anaerobic, endobiotic organisms such as the veterinary parasite Tritrichomonas foetus and the human parasite Trichomonas vaginalis , the latter causing the most prevalent, non-viral, sexually transmitted disease world-wide. Although a parasitic lifestyle is generally associated with a reduction in cell biology, T. vaginalis provides a striking counter-example. The 2007 T. vaginalis genome paper reported a massive and selective expansion of encoded proteins involved in vesicle trafficking, particularly those implicated in the late secretory and endocytic systems. Chief amongst these were the hetero-tetrameric adaptor proteins or 'adaptins', with T. vaginalis encoding ∼3.5 times more such proteins than do humans. The provenance of such a complement, and how it relates to the transition from a free-living or endobiotic state to parasitism, remains unclear. In this study, we performed a comprehensive bioinformatic and molecular evolutionary investigation of the heterotetrameric cargo adaptor-derived coats, comparing the molecular complement and evolution of these proteins between T. vaginalis , T. foetus and the available diversity of endobiotic parabasalids. Notably, with the recent discovery of Anaeramoeba spp. as the free-living sister lineage to all parabasalids, we were able to delve back to time points earlier in the lineage's history than ever before. We found that, although T. vaginalis still encodes the most HTAC subunits amongst parabasalids, the duplications giving rise to the complement took place more deeply and at various stages across the lineage. While some duplications appear to have convergently shaped the parasitic lineages, the largest jump is in the transition from free-living to endobiotic lifestyle with both gains and losses shaping the encoded complement. This work details the evolution of a cellular system across an important lineage of parasites and provides insight into the evolutionary dynamics of an example of expansion of protein machinery, counter to the more common trends observed in many parasitic systems. [ABSTRACT FROM AUTHOR]

Social actions are studied in different scientific disciplines and considered from different perspectives. Applying systems theory in the study of social actions began together with the inception of the idea of systems thinking and has been widely used since. This study concentrates on the pattern of the development of social actions, which seems to be essential for understanding multiagent social actions. This paper draws on a systemic approach to analyze multiagent actions in different spheres of human activity, such as migration, the diffusion of sexually transmitted diseases (STDs), the acceptance of new fashion and others; then, it attempts to scrutinize a common pattern of spatiotemporal development common to all of these processes. The study is based on the secondary use of published data. Similarities in the evolution of social actions in various fields were observed, and a common wave-like pattern of their development was detected. All social wave-like social actions include stages of inception, implementation, and termination that are followed by a shift in the actors to other activities. This work draws attention to the fact that any multiagent social action includes acceptance of innovation, and since this process is wave-like, any social action also evolves as a wave-like process. Comparing similar social actions observed at different stages of wave-like evolution can result in mistaken conclusions. Seeing social action as a multiagent process developing in time according to a universal wave-like pattern can facilitate its understanding. [ABSTRACT FROM AUTHOR]

The topic of occupational health and safety (OHS) has been investigated for many years and continues to be a concept often researched today. Generally speaking, OHS research has been centered around food safety, construction safety, transportation safety, fire safety, drug and alcohol testing, health and medical management, and industrial hygiene, to name a few. However, the concept of OHS concerning female commercial sex workers (FCSWs) has rarely been investigated, often neglected, seldom discussed, and is lacking in sound research. Although regarded as the "oldest profession", commercial sex work (CSW) has consistently been ignored, disregarded, and under-researched due to the illegality and stigmatization of prostitution. This paper reviews occupational safety and health issues faced by FCSWs in Tema and Accra, Ghana, through in-depth interviews, visits to women's homes, fieldwork, informal conversations, and observations with FCSWs during the summer of May 2012–July 2012. Facets of OHS that emerged among FCSWs included: sexually transmissible infections, risks associated with harassment and violence from police and clients, alcohol and drug use, irregular hospital visits or lack of hospital visits, immigration issues, legal hazards, and working conditions. We argue that CSW be viewed as an occupation in great need of interventions to reduce workplace risks. [ABSTRACT FROM AUTHOR]

Nature has been a great source of therapeutic compounds. The use of plants and plant-derived products as medicine has been a popular tradition as the beginning of human civilization. Plants are considered as the richest source of traditional and modern medications as well as food supplements, pharmaceutical intermediates and chemical entities for synthetic drugs. Among them, Azadirachta indica is one of the most versatile, multitudinous tree having immense potentials. Since Vedic times, it has been known as the multi-directional therapeutic uses in India. It is economically cheaper and safe and its different parts such as leaves, flowers, bark, fruits, gum, seeds, oil possesses great medicinal properties. The aim of this review is to assemble all the information regarding the distribution, botanical description, commercial and medicinal values of Azadirachta indica. This paper is fully based on secondary data. Information was gathered from about 28 published articles from various online portals and these gathered information is analyzed and presented well here in this paper. Azadirachta indica is commonly known as ‘Neem’ which is regarded beneficial to humans and animals. Different parts of neem has been used for treating various diseases such as cancer, Dental diseases, stress, ulcers, heart diseases, malaria, skin diseases, viral diseases, AIDS, oral diseases, sexually transmitted diseases, etc. Chemically diverse and structurally complex phytochemical constituents such as azadirachtin, nimbolinin, nimbidin, gedunin, nimbidol, Quercedin, gallic acid, glycoside, amino-acid, ascorbic acid, salannin and many others are found in Azadirachta indica which show anti-diabetic, antiviral, anti-oxidant, anti-microbial, anti-parasitic, anti-malarial, anti-cancer, anti-ulcer, hepatoprotective and gastro-protective activities. Thus, more attention must be given for the production of this plant. [ABSTRACT FROM AUTHOR]

Changed health behaviours can contribute significantly to improved health. Consequently, significant investments have been channelled towards health behaviour change initiatives in Africa. Health behaviour change initiatives that address social, economic and environmental levers for behaviour change can create more sustained impact. Through a scoping study of the literature, we explored the literature on behaviour change initiatives in Africa, to assess their typologies. We explored whether the availability of initiatives reflected country demographic characteristics, namely life expectancy, gross domestic product (GDP), and population sizes. Finally, we assessed topical themes of interventions relative to frequent causes of mortality. We used the Behaviour Change Wheel intervention categories to categorise each paper into a typology of initiatives. Using Pearson's correlation coefficient, we explored whether there was a correlation between the number of initiatives implemented in a country in the specified period, and socio-demographic indicators, namely, GDP per capita, total GDP, population size, and life expectancy. Almost 64% of African countries were represented in the identified initiatives. One in five initiatives was implemented in South Africa, while there was a dearth of literature from Central Africa and western parts of North Africa. There was a positive correlation between the number of initiatives and GDP per capita. Most initiatives focused on addressing sexually transmitted infections and were short-term trials and/or pilots. Most initiatives were downstream focused e.g. with education and training components, while upstream intervention types such as the use of incentives were under-explored. We call for more emphasis on initiatives that address contextual facilitators and barriers, integrate considerations for sustainable development, and consider intra-regional deprivation. [ABSTRACT FROM AUTHOR]

Objective. To understand the sexual and reproductive health (SRH) experiences of migrant women and girls of reproductive age (15--49 years) from the Northern Triangle of Central America (El Salvador, Guatemala and Honduras) during their journey to the United States. Methods. A descriptive, qualitative research design included 39 in-depth interviews with migrant women and unaccompanied migrant girls from El Salvador, Guatemala and Honduras from January to June 2022. Participants were recruited using purposive sampling. Interviews were transcribed, coded and analyzed using thematic analysis. Results. Migrant women and girls lack information and resources to manage their SRH during migration. The SRH of those traveling with smugglers is compromised due to their limited access to menstrual pads, water and sanitation services; the risks of transactional sex and sexual violence; the high risk of sexually transmitted infections; the inability to report sexual violence; the lack of access to SRH and prenatal services; and limited knowledge about their sexual and reproductive rights. Conclusions. There is a significant need for improved interventions during the predeparture phase of migration to inform migrant women and girls about the SRH risks they may encounter and to provide information and resources to support their SRH throughout their journey. Special attention should be directed towards trying to reach girls and women who will travel with smugglers. [ABSTRACT FROM AUTHOR]

Trans masculine, two-spirit, and non-binary people who are gay, bisexual or otherwise have sex with men (TGBM) are under-tested for sexually transmitted infections (STI) and may face complex, intersectional barriers that prevent them from accessing STI testing. As part of a study on gay, bisexual and other men who have sex with men's (GBM) experiences of current STI testing systems in Ontario, Canada, this paper reports on the findings from TGBM participants' experiences with in-person STI testing in a range of venues (i.e. Family doctors, walk-in clinics, and community-based organizations) to explore testing barriers specific to TGBM. Using a community-based research approach, between June 2020 and December 2021 peer researchers who identified as GBM conducted focus groups and interviews with 38 cis and trans GBM, 13 of whom identified as TGBM. Data were analyzed following grounded theory. When questioned about past experiences with testing, TGBM participants reported several barriers to STI testing within current testing models in Ontario due to cisnormativity and heteronormativity. Cisnormativity is the assumption that everyone identifies as the gender they were assigned at birth, and those who do not are considered "abnormal", while heteronormativity is when it is assumed that everyone is heterosexual. From our research we identified three overarching themes concerning testing barriers among TGBM participants: (1) non-inclusive clinic environments, (2) lack of provider knowledge and competency, and (3) legal documentation. Inherent cis and heteronormativity in healthcare institutions appear to be factors shaping the historical under-testing for STI in the TGBM population. These findings suggest the relevance of implementing trans-specific clinical practices that reduce the stigma and barriers faced by TGBM in STI testing contexts, including: hosting all-gender testing hours, opening more LGBTQ+ clinics, offering training in transgender health to testing providers, and conducting a review of how gender markers on health documents can be more inclusive of trans, two-spirit, and non-binary communities. [ABSTRACT FROM AUTHOR]

The disease commonly known as the 'pox' or the 'French Disease' ravaged the European continent following its initial appearance circa 1495. Its devastating physical effects and sensory assaults, ranging from stinking sores to baldness and collapsed noses, invited both a social and medical evaluation of what was quickly recognized to be a sexually transmitted disease. Despite the prevalence and visibility of the pox in sixteenth‐century Europe, its visual language has not been studied in much depth. This essay examines how cheap narrative prints issued between 1550 and 1650 helped construct the iconography of pox and disseminate medical information about it in late Renaissance Italy. Focusing on a group of best‐selling Venetian and Roman prints, the essay argues that multimedial picture stories combining text and image provided one of the many sources of vernacular information by which Italians learned to read the body. In recounting stories of diseased prostitutes and their clients in vivid detail, these prints expanded vernacular health literacy and provided a ready‐made language of disease. The prints analysed here enjoyed enormous social reach as components of a new health‐promoting, communicative object – the hand‐held paper fan – whose popularity cemented visual and epistemic connections between pox and prostitution. [ABSTRACT FROM AUTHOR]