Making sense of syphilis: beliefs, behaviours and disclosure among gay men recently diagnosed with infectious syphilis and the implications for prevention

Sexual Health ◽  
2006 ◽  
Vol 3 (3) ◽  
pp. 155 ◽  
Author(s):  
Natalie L. Lambert ◽  
John Imrie ◽  
Martin J. Fisher ◽  
Alan Phillips ◽  
Rod Watson ◽  
...  
Keyword(s):  
Sexual Health ◽  
Sexual Communication ◽  
Partner Notification ◽  
Risk Behaviour ◽  
Control Measures ◽  
Transmission Risk ◽  
Outpatient Services ◽  
Structured Interviews ◽  
Health Seeking ◽  
Convenience Sample

Background: The resurgence of syphilis in men who have sex with men (MSM) has proved remarkably resilient in the face of innovative control and prevention interventions. Understanding the determinants of the current outbreaks has been restricted by the available data. Qualitative work is needed to understand individual and community experiences of syphilis and to help guide new prevention and control efforts. Methods: An exploratory study using semi-structured interviews with a convenience sample of MSM (n = 15), recently diagnosed with infectious syphilis, attending sexual health and HIV-outpatient services in Brighton, England. Results: Analysis focussed on men’s beliefs about syphilis, their experience of testing and being given a syphilis diagnosis, mediators of ‘risky’ sexual behaviour and disclosure to social and sexual contacts. Two beliefs — ‘syphilis is rare’ and ‘syphilis is dirty’ — dominated respondents’ accounts. These beliefs coloured every aspect of respondents’ clinical and social experience of syphilis, and impeded disclosure and partner notification. They also contributed to misconceptions about behaviours with increased syphilis transmission risk, the mechanics of disease acquisition, health-seeking behaviours and risk-reduction strategies. Conclusions: The apparent failure of syphilis control measures so far may be due to our limited understanding of MSM’s views and experience of STIs other than HIV. Syphilis prevention needs to tackle MSM’s widely held beliefs about sexual communication, risk behaviour and other STIs. The most useful health education interventions are likely to be those that build on MSM’s significant knowledge base and address both the current syphilis crisis and wider sexual health promotion goals.

Sexual health knowledge and behaviour of young Sudanese Queenslanders: a cross-sectional study

Sexual Health ◽  
2017 ◽  
Vol 14 (3) ◽  
pp. 254 ◽  
Author(s):  
Judith Dean ◽  
Marion Mitchell ◽  
Donald Stewart ◽  
Joseph Debattista
Keyword(s):  
Sexual Health ◽  
Health Knowledge ◽  
Forced Migration ◽  
Risk Behaviour ◽  
Sexual Risk Behaviour ◽  
Hiv Knowledge ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Behaviour Score ◽  
Sexual Health Knowledge

Background Forced migration is associated with sexual vulnerability. However, little is known about the sexual health literacy and needs of refugee-background youth post resettlement. Methods: Conducted in partnership with the Queensland Sudanese community, this study used a cross-sectional survey to explore the sexual health knowledge, attitudes and behaviours of a convenience sample of 16- to 24-year-old Sudanese-background youth in Australia (n = 229). Results: Sexually transmissible infection (STI) and HIV knowledge scores were generally low, although they were found to significantly improve the longer participants had lived in Australia (P < 0.001). Female participants reported significantly higher levels of both STI and HIV knowledge compared with the male cohort (P < 0.001). The aggregated sexual risk behaviour score suggests generally low levels of risk-taking behaviour. However, of the 140 sexually active participants, 3.1% reported a STI diagnosis, 9.0% reported sex leading to a pregnancy and 33.1% reported they had experienced unwanted sex. Participants also reported engaging in behaviours such as anal sex (33%) and sharing injecting drug equipment. Conclusions: Patterns of sexual behaviour among this predominately refugee-background group are not dissimilar to those of other young Australians. Nonetheless, the self-reported patterns of risk behaviour combined with the low and inaccurate levels of sexual health knowledge suggest this group of young people remain sexually vulnerable, particularly early within their resettlement experience. Culturally and contextually informed sexual health interventions are needed early within the resettlement experience.

Boundaries of sexual communication: a mixed-method study exploring Chinese young adults’ engagement with online sexual health information

Sexual Health ◽  
2016 ◽  
Vol 13 (3) ◽  
pp. 281 ◽  
Author(s):  
Jingwen Zhang ◽  
Chloe Nurik ◽  
John B. Jemmott
Keyword(s):  
Young Adults ◽  
Sexual Health ◽  
Health Information ◽  
Mixed Method ◽  
Family Income ◽  
Sexual Communication ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Sexual Health Information ◽  
Chinese Young Adults

Background: Although previous research suggests that a majority of Chinese young adults get sexual health information through the Internet, the details of this process and how it translates into subsequent actions are unknown. This study aims to understand the dynamic nature of Chinese young adults’ engagement with online sexual health information (OSHI) through various communication channels to inform the development of effective sexual health intervention strategies. Methods: A mixed-method approach was used, involving individual semi-structured interviews (n = 30) and cross-sectional online surveys (n = 561) with Chinese young adults aged 18 to 25 years. Qualitative themes and prevalence and predictors of engagement with OSHI were analysed. Results: Three themes emerged from the interviews: (1) problem-based searching; (2) multi-criteria evaluation; and (3) stigma of online sharing and discussion. After engaging with OSHI, 87.3% of the survey participants followed online advice on at least one occasion, and 54.9% discussed this information with others (mostly with partners and friends) offline. Having sexual intercourse in the past 3 months was a consistent predictor of engagement with OSHI (P < 0.05). Contrary to previous findings, participants with higher family income were more likely to engage with OSHI (P < 0.05). Conclusions: Chinese young adults obtain sexual health information from online sources when personal problems arise and then circulate this information offline within their peer networks. Although social media interventions have shown some promise, researchers should first increase risk awareness and be cautious about designing programs that promote online sharing or discussion. Finally, researchers need to make extra effort to target young adults with limited resources.

scholarly journals Men’s use of sexual health and HIV services in Swaziland: a mixed methods study

Sexual Health ◽  
2016 ◽  
Vol 13 (3) ◽  
pp. 265 ◽  
Author(s):  
Joelle Mak ◽  
Susannah H. Mayhew ◽  
Ariane von Maercker ◽  
Integra Research Team ◽  
Manuela Colombini
Keyword(s):  
Sexual Health ◽  
Hiv Testing ◽  
Adult Population ◽  
Healthcare Services ◽  
Traditional Healers ◽  
Service Users ◽  
Structured Interviews ◽  
Health Seeking ◽  
Hiv Services ◽  
Hiv Test

Background: Over one-quarter of the adult population in Swaziland is estimated to be HIV positive. Men’s use of sexual health (SH) services has significant implications for HIV prevention. This study aimed to understand Swazi men’s health-seeking behaviours in relation to SH and HIV services. Methods: A household survey was conducted in Manzini (n = 503), complemented by 23 semi-structured interviews and two focus group discussions (with a total of 10 participants). Results: One-third of male survey participants used SH services in the past year, most commonly HIV testing (28%). Service users were more likely to be sexually active (aOR 3.21, 95% CI: 1.81–5.68 for those with one partner; and aOR 2.35, 95% CI: 1.25–4.41 for those with multiple partners) compared with service non-users. Service users were less likely to prefer HIV services to be separated from other healthcare services (aOR 0.50, 95% CI: 0.35–0.71), or to agree with travelling further for their HIV test (aOR 0.52, 95% CI: 0.33–0.82) compared with non-users, after controlling for age-group and education. Men avoided SH services because they feared being stigmatised by STI/HIV testing, are uncomfortable disclosing SH problems to female healthcare providers, and avoided HIV testing by relying on their wife’s results as a proxy for their own status. Informal providers, such as traditional healers, were often preferred because practitioners were more often male, physical exams were not required and appointments and payment options were flexible. Conclusion: To improve men’s uptake of SH services, providers and services need to be more sensitive to men’s privacy concerns, time restrictions and the potential stigma associated with STI/HIV testing.

scholarly journals “It Had a Lot of Cultural Stuff in It”: HIV-Serodiscordant African American Couples’ Experiences of a Culturall y Congruent Sexual Health Intervention

2020 ◽  
Vol 30 (2) ◽  
pp. 269-276
Author(s):  
Jacqueline Mthembu ◽  
Alison B. Hamilton ◽  
Norweeta G. Milburn ◽  
Deborah Sinclair ◽  
Siyabulele Mkabile ◽  
...  
Keyword(s):  
African American ◽  
Sexual Health ◽  
Cultural Values ◽  
Sexual Behaviors ◽  
Sexual Communication ◽  
People Living With Hiv ◽  
Structured Interviews ◽  
Serodiscordant Couples ◽  
Culturally Congruent ◽  
Positive Prevention

Objective: The increased life expectancy of people living with HIV has brought about an increase in serodiscordant couples, in which there is risk of HIV transmission. Therefore, interventions that promote sexual health and reduce risk are critical to develop for these couples. Given the disproportionate burden of HIV among populations of color, it is also critical that these interventions are culturally congruent. The EBAN intervention for African American serodiscordant couples recognizes the centrality of culture in shap­ing sexual behaviors and helps couples develop intimacy and positive prevention behaviors. The analytic objective of our study was to examine the knowledge and awareness gained by participants in the intervention.Participants: Participants (n=17) who com­pleted at least half of the eight intervention sessions.Methods: Brief post-implementation semi-structured interviews were conducted be­tween January 1, 2016 and December 31, 2016. Team-based, targeted content analysis focused on knowledge and awareness gains.Results: Participants described learning about sexual health, expanded sexual options, and sexual communication. The “EBAN café,” a component that gives couples a menu of options for safer sex behaviors, was particularly popular. Partici­pants also noted the value of learning how to communicate with one another about their sexual health-related concerns and preferences. They appreciated the “cultural stuff” that was infused throughout the ses­sions, including the emphasis on learning from one another as couples.Conclusions: Couples at risk for HIV trans­mission benefit from strengthening skills and knowledge related to healthy sexual­ity. A behavioral intervention that aligns with cultural values and imparts culturally congruent sexual health information appeals to couples who seek ways to enhance their intimacy and sexual options while also re­ducing risk. Ethn Dis. 2020;30(2):269-276; doi:10.18865/ed.30.2.269

scholarly journals 346 How Do we Increase Adherence to Home Exercise Programmes? Interviews with Older Adults and Physiotherapists

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Siti Khalijah ◽  
Suzanne Timmons
Keyword(s):  
Older Adults ◽  
Cardiovascular Health ◽  
Home Exercise ◽  
Video Content ◽  
Structured Interviews ◽  
Timed Up And Go ◽  
Convenience Sample ◽  
Improve Compliance ◽  
Exercise Programmes ◽  
Purposive Sample

Abstract Background Regular exercise and physical activity can maintain function and cardiovascular health, and prevent cognitive decline, in older adults. However, studies show that there is often poor adherence to home exercise programmes (HEP). The purpose of this study was to explore how HEP are perceived by both older adults and physiotherapists. Methods A convenience sample of 28 older adults attending outpatient physiotherapy clinics were given an exercise journal to record their adherence to the HEP prescribed by their physiotherapists for six weeks. Subsequently, semi-structured interviews were conducted with a purposive sample, and the corresponding prescribing physiotherapists, to achieve maximal variation in terms of HEP adherence, age and sex. The interviews were audio recorded, transcribed, and simple content analysis performed. Results Fourteen participants returned their exercise journal. Median age was 80; half were female; median Berg Balance Score and Timed-up-and-Go-Test were 49 and 16 seconds respectively. Participants exercised a median 79.8% of the prescribed dose, or 5.6 days per week. Seven older adults were interviewed; about half had a positive attitude towards exercise. They were also moderately positive about their HEP (comments ranged from “doable” and “nothing bad about it” to “enjoyable”). Barriers included time, mood, boredom, remembering to do the HEP, and variable health status. Enablers included simple instructions and design, family encouragement, and sense of achievement. Physiotherapists (n=5) perceived that many older adults aren’t compliant with HEPs, but there was some therapeutic nihilism (“you can’t force them”). Their HEP instructions varied from verbal to written instructions/diagrams; one physiotherapist used individualised video content. Notably, participants with good adherence understood their HEP well in terms of content and purpose, although this may be cause or effect. Conclusion To improve compliance with HEP, healthcare professionals need to take time to motivate the recipient, simplify their instructions, and trouble-shoot potential barriers at the time of prescription.

scholarly journals User testing a patient information resource about potential complications of vaginally inserted synthetic mesh

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nikolina Angelova ◽  
Louise Taylor ◽  
Lorna McKee ◽  
Naomi Fearns ◽  
Tracey Mitchell
Keyword(s):  
Lived Experience ◽  
Patient Information ◽  
Pelvic Organ ◽  
Synthetic Mesh ◽  
Information Resource ◽  
User Testing ◽  
Structured Interviews ◽  
Convenience Sample ◽  
Asking Questions ◽  
Direct Guidance

Abstract Background Vaginal mesh implants are medical devices used in a number of operations to treat stress urinary incontinence and pelvic organ prolapse. Although many of these operations have delivered good outcomes, some women have experienced serious complications that have profoundly affected their quality of life. To ensure that evolving patient information is up-to-date, accurate and appropriate, the Transvaginal Mesh Oversight Group ‘user-tested’ a newly developed Scottish patient resource, the first to focus exclusively on the issue of complications. The aim of this research was to gather feedback on usability, content, language and presentation to inform the development of the resource from a user perspective. Methods The experience of using the patient resource was captured through semi-structured interviews that followed a ‘think-aloud’ protocol. The interviewer observed each participant as they went through the resource, asking questions and making field notes. Participants’ comments were then categorised using a validated model of user experience and subsequently analysed thematically. Results Thirteen people participated in the user testing interviews, including women with lived experience of mesh implants (n = 7), a convenience sample of staff working for Healthcare Improvement Scotland (n = 5) and a patient’s carer (n = 1). The majority of participants considered the resource as clear and helpful. Respondents reported that some presentational aspects promoted usability and understandability, including the use of a font that is easy to read, bullet lists, coloured headings and simple language. Barriers included the reliance on some technical language and an explicit anatomical diagram. Participants endorsed the valuable role of health professionals as co-mediators of patient information. Conclusions The findings illustrate the value of undertaking in-depth user-testing for patient information resources before their dissemination. The study highlighted how the direct guidance or navigation of a patient information resource by a health professional could increase its salience and accuracy of interpretation by patients, their families and carers. These insights may also be useful to other developers in improving patient information.

scholarly journals Video-Based Intervention for Improving Maternal Retention and Adherence to HIV Treatment: Patient Perspectives and Experiences

2021 ◽  
Vol 18 (4) ◽  
pp. 1737
Author(s):  
Steven Masiano ◽  
Edwin Machine ◽  
Mtisunge Mphande ◽  
Christine Markham ◽  
Tapiwa Tembo ◽  
...  
Keyword(s):  
Positive Impact ◽  
Low Cost ◽  
Hiv Treatment ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Structured Interviews ◽  
Convenience Sample ◽  
Long Term Conditions ◽  
Art Initiation ◽  
Retention In Hiv Care

VITAL Start is a video-based intervention aimed to improve maternal retention in HIV care and adherence to antiretroviral therapy (ART) in Malawi. We explored the experiences of pregnant women living with HIV (PWLHIV) not yet on ART who received VITAL Start before ART initiation to assess the intervention’s acceptability, feasibility, fidelity of delivery, and perceived impact. Between February and September 2019, we conducted semi-structured interviews with a convenience sample of 34 PWLHIV within one month of receiving VITAL Start. The participants reported that VITAL Start was acceptable and feasible and had good fidelity of delivery. They also reported that the video had a positive impact on their lives, encouraging them to disclose their HIV status to their sexual partners who, in turn, supported them to adhere to ART. The participants suggested using a similar intervention to provide health-related education/counseling to people with long term conditions. Our findings suggest that video-based interventions may be an acceptable, feasible approach to optimizing ART retention and adherence amongst PWLHIV, and they can be delivered with high fidelity. Further exploration of the utility of low cost, scalable, video-based interventions to address health counseling gaps in sub-Saharan Africa is warranted.

scholarly journals Paradigm Shift in Clinical Practice of Sexual Health in Men During COVID-19 Pandemic

2021 ◽  
pp. 263183182110323
Author(s):  
Aditya Prakash Sharma ◽  
Japleen Kaur ◽  
Ravimohan S. Mavuduru ◽  
Shrawan K. Singh
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
Surgical Procedures ◽  
Care Center ◽  
Tertiary Care ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Health Seeking ◽  
Number Of Patients ◽  
The Impact

Sexual health-care seeking behavior and practices have been affected during COVID-19 pandemic. The impact of COVID-19 on this subspecialty is far reaching. This study aimed to assess the impact of COVID-19 on health-care seeking practice pertaining to sexual health in men in our tertiary care center and review the relevant literature regarding impact of COVID-19 on sexual health seeking practice and challenges faced. Outpatient data was analyzed from January 2019 to April 2021. Patients awaiting surgical procedures due to COVID were documented. A narrative synthesis of literature based on systematic search using the keywords sexual health, sexual health seeking, sexual health practice, andrology, and COVID with operators “AND” and “OR” was carried out in three search engines PubMed, Scopus, and Embase. The study outcomes were obtained by comparing data of outpatient attendance and compiling the reviewed literature. The mean attendance fell significantly from 95.11±11.17 to 17.25±13.70 persons (P <.0001) per outpatient clinic, March 2020 being the reference point. Teleconsultation has taken over physical consultation. In 98/949 cases, teleconsult could not be provided despite registration. Over 25 patients were waiting for surgical procedures pertaining to andrology due to shut down of elective services. Similar trends have been reported from other countries. Number of patients seeking consultation for sexual health problems has dramatically decreased during COVID-19 era. Establishment of data safe teleconsultation facility and its widespread advertisement is needed to encourage patients to seek consult.

scholarly journals Service-user efforts to maintain their wellbeing during and after successful withdrawal from antipsychotic medication

2021 ◽  
Vol 11 ◽  
pp. 204512532198913
Author(s):  
Miriam Larsen-Barr ◽  
Fred Seymour
Keyword(s):  
Antipsychotic Medication ◽  
Online Survey ◽  
Structured Interviews ◽  
Obsessive Compulsive ◽  
Convenience Sample ◽  
Internal Resources ◽  
Compulsive Disorder ◽  
What Works ◽  
Systemic Factors ◽  
The Impact

Background: It is well-known that attempting antipsychotic withdrawal can be a fraught process, with a high risk of relapse that often leads people to resume the medication. Nonetheless, there is a group of people who appear to be able to discontinue successfully. Relatively little is known about how people do this. Methods: A convenience sample of adults who had stopped taking antipsychotic medication for more than a year were recruited to participate in semi-structured interviews through an anonymous online survey that investigated antipsychotic medication experiences in New Zealand. Thematic analysis explored participant descriptions of their efforts to maintain their wellbeing during and after the withdrawal process. Results: Of the seven women who volunteered to participate, six reported bipolar disorder diagnoses and one reported diagnoses of obsessive compulsive disorder and depression. The women reported successfully discontinuing antipsychotics for 1.25–25 years; six followed a gradual withdrawal method and had support to prepare for and manage this. Participants defined wellbeing in terms of their ability to manage the impact of any difficulties faced rather than their ability to prevent them entirely, and saw this as something that evolved over time. They described managing the process and maintaining their wellbeing afterwards by ‘understanding myself and my needs’, ‘finding what works for me’ and ‘connecting with support’. Sub-themes expand on the way in which they did this. For example, ‘finding what works for me’ included using a tool-box of strategies to flexibly meet their needs, practicing acceptance, drawing on persistence and curiosity and creating positive life experiences. Conclusion: This is a small, qualitative study and results should be interpreted with caution. This sample shows it is possible for people who experience mania and psychosis to successfully discontinue antipsychotics and safely manage the impact of any symptoms that emerge as a result of the withdrawal process or other life stressors that arise afterwards. Findings suggest internal resources and systemic factors play a role in the outcomes observed among people who attempt to stop taking antipsychotics and a preoccupation with avoiding relapse may be counterproductive to these efforts. Professionals can play a valuable role in facilitating change.

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