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BackgroundSexual well-being is fundamental to physical and emotional health, and the ability to achieve it depends on access to comprehensive sexuality information and high-quality sexual health care from evidence-informed, nonjudgmental providers. Adequate and timely delivery of these components to individuals who are at high risk for sexually transmitted infections (STIs), including HIV, and unintended pregnancies promotes sexual health and mitigates consequences arising from risky sexual behavior. Brief interventions that allow health care providers to improve the information available to clients and motivate and help them to develop risk-reduction skills are seen as efficient ways to improve knowledge, change client behavior, and reduce provider stigma regarding sexual health. ObjectiveThe aim of the study is to evaluate five aspects of feasibility (acceptability, willingness, safety, satisfaction, and process) of a brief sexuality-related communication (BSC) intervention based on motivational interviewing and behavior change techniques in primary health care settings in low- and middle-income countries (LMICs). MethodsThis protocol outlines a multisite, multiphase study of feasibility of a BSC intervention in primary health care settings in LMICs that will be examined across four phases of the study. Phases I through III involve the collection of formative, qualitative data to examine provider and client perceptions of the feasibility of the intervention, adaptation of the intervention guide, and training providers on how to implement the final version of the BSC intervention. During phase IV, the feasibility of the intervention will be tested in a nonrandomized pre-post test trial where providers and clients will be followed for 6 months and participate in multiphase data collection. ResultsPhase I is currently underway in Moldova, and phases I and II were completed in Peru in late 2019. Results are expected for the feasibility study in 2021. ConclusionsThis feasibility study will determine whether the implementation of brief intervention programs aimed at improving sexual health outcomes is possible in the constraints of LMIC health systems and will add to our understanding of factors shaping clinical practice among primary care providers. International Registered Report Identifier (IRRID)DERR1-10.2196/15569

Objective To assess the prevalence of physical and sexual violence motivated by perception of sexual orientation and gender identity in sexual and gender minorities. Methods We searched nine databases without language restrictions for peer- reviewed and grey literature published from 2000 to April 2016. We included studies with more than 50 participants that measured the prevalence of physical and sexual violence perceived as being motivated by sexual orientation and gender identity or gender expression. We excluded intimate partner violence and self-harm. Due to heterogeneity and the absence of confidence intervals in most studies, we made no meta-analysis. Findings We included 76 articles from 50 countries. These covered 74 studies conducted between 1995 and 2014, including a total of 202607 sexual and gender minority participants. The quality of data was relatively poor due to a lack of standardized measures and sometimes small and non-randomized samples. In studies where all sexual and gender minorities were analysed as one population, the prevalence of physical and sexual violence ranged from 6% (In a study including 240 people) to 25% (49/196 people) and 5.6% (28/504) to 11.4% (55/484), respectively. For transgender people the prevalence ranged from 11.8% (of a subsample of 34 people) to 68.2% (75/110) and 7.0% (in a study including 255 people) to 49.1% (54/110). Conclusion More data are needed on the prevalence, risk factors and consequences of physical and sexual violence motivated by sexual orientation and gender identity in different geographical and cultural settings. National violence prevention policies and interventions should include sexual and gender minorities. Objectif Estimer la prevalence des violences physiques et sexuelles motivees par la perception de l'orientation sexuelle et de l'identite de genre dans les minorltes sexuelles. Methodes Nous avons recherche dans neuf bases de donnees, sans restriction de langue, des documents soumis a comite de lecture ou non et publies entre 2000 et avril 2016. Nous avons Indus les etudes de plus de 50 participants qul ont mesure la prevalence des violences physiques et sexuelles pergues comme etant motivees par l'orientation sexuelle et l'identite ou l'expression de genre. Nous avons exclu les violences conjugales et les actes auto-agresslfs. En raison de l'heterogenelte des etudes et de l'absence d'Intervalle de confiance dans la plupart d'entre elles, nous n'avons pas realise de meta-analyse. Resultats Nous avons pris en compte 76 articles provenant de 50 pays. Ceux-cl s'interessaient a 74 etudes, menees entre 1995 et 2014, qul portaient sur un total de 202 607 participants issus de minorites sexuelles. La qualite des donnees etait relativement mauvalse a cause de l'absence de mesures standardlsees et, parfols, d'echantillons reduits et non randomises. Dans les etudes qui ont analyse l'ensemble des minorites sexuelles comme une seule population, la prevalence des violences physiques et sexuelles allait respectivement de 6% (dans une etude sur 240 personnes) a 25% (49/196 personnes) et de 5,6% (28/504) a 11,4% (55/484). Pour les personnes transgenre, la prevalence allait de 11,8% (dans un sousgroupe de 34 personnes) a 68,2% (75/110) et de 7,0% (dans une etude sur 255 personnes) a 49,1 % (54/110). Conclusion Il est necessalre d'avoir davantage de donnees sur la prevalence, les facteurs de risque et les consequences des violences physiques et sexuelles motivees par l'orientation sexuelle et l'identite de genre dans dlfferentes regions et dlfferents contextes cultureis. Les politiques et les actions nationales de prevention de la violence devralent prendre en compte les minorltes sexuelles. Objetivo Evaluar la prevalence de la violencia fisica y sexual motivada por la percepcion de la orientacion sexual y la Identidad de genero en las minorias sexuales y de genero. Metodos Se realizaron busquedas en nueve bases de datos sin restricciones de idioma en busca de literatura gris y examinada por expertos publicada desde 2000 hasta abril de 2016. Incluimos estudios con mas de 50 participantes que midieron la prevalencia de la violencia fisica y sexual percibida como motivada por la orientacion sexual y la identidad o la expresion de genero. Excluimos la violencia en la pareja intima y la autolesion. Debido a la heterogeneidad y la ausencia de intervalos de confianza en la mayoria de los estudios, no realizamos ningun metanalisis. Resultados Se incluyeron 76 articulos de 50 paises. Estos cubrieron 74 estudios realizados entre 1995 y 2014, incluyendo un total de 202.607 participantes de minorias sexuales y de genero. La calidad de los datos fue relativamente baja debido a la falta de medidas estandarizadas y, en ocasiones, muestras pequenas y no aleatorizadas. En los estudios en los que todas las minorias sexuales y de genero se analizaron como una unica poblacion, la prevalencia de la violencia fisica y sexual vario del 6% (en un estudio que incluia a 240 personas) al 25% (49/196 personas) y del 5,6% (28/504) al 11,4% (55/484), respectivamente. Para las personas transexuales, la prevalencia vario del 11,8% (de una submuestra de 34 personas) al 68,2% (75/110) y del 7,0% (en un estudio que incluyo a 255 personas) al 49,1% (54/110). Conclusion Se necesitan mas datos sobre la prevalencia, los factores de riesgo y las consecuencias de la violencia fisica y sexual motivada por la orientacion sexual y la identidad de genero en diferentes entornos geograficos y culturales. Las politicas e intervenciones nacionales de prevencion de la violencia deberian incluir las minorias sexualesy de genero., Introduction On 17 June 2011, the United Nations (UN) Human Rights Council passed a resolution that expressed grave concern at violence and discrimination against individuals based on their sexual orientation [...]