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Frontiers in Public Health 2024This systematic review examines the impacts of suicide bereavement on men's psychosocial outcomes relating to suicidality, mental health, substance use, grief, and...
INTRODUCTION
This systematic review examines the impacts of suicide bereavement on men's psychosocial outcomes relating to suicidality, mental health, substance use, grief, and social functioning. Given the high global incidence of suicide and the substantial number of individuals affected by each suicide, understanding the specific experiences and outcomes for men is crucial, particularly in the context of observed gender differences in suicide rates, grief coping styles and mental health outcomes.
METHODS
Adhering to PRISMA guidelines, this review included peer-reviewed, English-language studies that involved men bereaved by suicide using quantitative, qualitative and mixed-methods designs. Searches were conducted in MEDLINE, Embase, Emcare, PsycINFO, and Scopus. Analysis used narrative synthesis methods due to the heterogeneity of findings. These were categorised based on comparison groups: non-bereaved men, or women bereaved by suicide. Prospero registration: CRD42023437034.
RESULTS
The review included 35 studies (25 quantitative, 8 qualitative, 2 mixed-methods) published between 1995 and 2023. Compared to non-bereaved men, suicide-bereaved men are more likely to experience adverse psychosocial outcomes included increased suicide mortality, heightened susceptibility to mental health problems such as depression and posttraumatic stress disorder, and challenges in interpersonal relationships and social functioning. The review also identified gender differences in grief responses and coping strategies, with men often exhibiting more pronounced grief reactions and facing unique challenges due to societal expectations and norms regarding masculinity.
DISCUSSION
The findings of this review underscore the elevated risk of adverse suicide- and mental-health related outcomes for suicide-bereaved men and the need for tailored postvention supports for this cohort. Gender-specific factors, including cultural norms and coping strategies, significantly influence men's experiences of suicide bereavement. Further qualitative and longitudinal quantitative exploration is needed to enhance understanding and effective support for men bereaved by suicide.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023437034.
Topics: Humans; Male; Bereavement; Suicide; Adaptation, Psychological; Mental Health
PubMed: 38655522
DOI: 10.3389/fpubh.2024.1372974 -
The Cochrane Database of Systematic... Apr 2015Hirsutism occurs in 5% to 10% of women of reproductive age when there is excessive terminal hair growth in androgen-sensitive areas (male pattern). It is a distressing... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Hirsutism occurs in 5% to 10% of women of reproductive age when there is excessive terminal hair growth in androgen-sensitive areas (male pattern). It is a distressing disorder with a major impact on quality of life. The most common cause is polycystic ovary syndrome. There are many treatment options, but it is not clear which are most effective.
OBJECTIVES
To assess the effects of interventions (except laser and light-based therapies alone) for hirsutism.
SEARCH METHODS
We searched the Cochrane Skin Group Specialised Register, CENTRAL (2014, Issue 6), MEDLINE (from 1946), EMBASE (from 1974), and five trials registers, and checked reference lists of included studies for additional trials. The last search was in June 2014.
SELECTION CRITERIA
Randomised controlled trials (RCTs) in hirsute women with polycystic ovary syndrome, idiopathic hirsutism, or idiopathic hyperandrogenism.
DATA COLLECTION AND ANALYSIS
Two independent authors carried out study selection, data extraction, 'Risk of bias' assessment, and analyses.
MAIN RESULTS
We included 157 studies (sample size 30 to 80) comprising 10,550 women (mean age 25 years). The majority of studies (123/157) were 'high', 30 'unclear', and four 'low' risk of bias. Lack of blinding was the most frequent source of bias. Treatment duration was six to 12 months. Forty-eight studies provided no usable or retrievable data, i.e. lack of separate data for hirsute women, conference proceedings, and losses to follow-up above 40%.Primary outcomes, 'participant-reported improvement of hirsutism' and 'change in health-related quality of life', were addressed in few studies, and adverse events in only half. In most comparisons there was insufficient evidence to determine if the number of reported adverse events differed. These included known adverse events: gastrointestinal discomfort, breast tenderness, reduced libido, dry skin (flutamide and finasteride); irregular bleeding (spironolactone); nausea, diarrhoea, bloating (metformin); hot flushes, decreased libido, vaginal dryness, headaches (gonadotropin-releasing hormone (GnRH) analogues)).Clinician's evaluation of hirsutism and change in androgen levels were addressed in most comparisons, change in body mass index (BMI) and improvement of other clinical signs of hyperandrogenism in one-third of studies.The quality of evidence was moderate to very low for most outcomes.There was low quality evidence for the effect of two oral contraceptive pills (OCPs) (ethinyl estradiol + cyproterone acetate versus ethinyl estradiol + desogestrel) on change from baseline of Ferriman-Gallwey scores. The mean difference (MD) was -1.84 (95% confidence interval (CI) -3.86 to 0.18).There was very low quality evidence that flutamide 250 mg, twice daily, reduced Ferriman-Gallwey scores more effectively than placebo (MD -7.60, 95% CI -10.53 to -4.67 and MD -7.20, 95% CI -10.15 to -4.25). Participants' evaluations in one study with 20 participants confirmed these results (risk ratio (RR) 17.00, 95% CI 1.11 to 259.87).Spironolactone 100 mg daily was more effective than placebo in reducing Ferriman-Gallwey scores (MD -7.69, 95% CI -10.12 to -5.26) (low quality evidence). It showed similar effectiveness to flutamide in two studies (MD -1.90, 95% CI -5.01 to 1.21 and MD 0.49, 95% CI -1.99 to 2.97) (very low quality evidence), as well as to finasteride in two studies (MD 1.49, 95% CI -0.58 to 3.56 and MD 0.40, 95% CI -1.18 to 1.98) (low quality evidence).Although there was very low quality evidence of a difference in reduction of Ferriman-Gallwey scores for finasteride 5 mg to 7.5 mg daily versus placebo (MD -5.73, 95% CI -6.87 to -4.58), it was unlikely it was clinically meaningful. These results were reinforced by participants' assessments (RR 2.06, 95% CI 0.99 to 4.29 and RR 11.00, 95% CI 0.69 to 175.86). However, finasteride showed inconsistent results in comparisons with other treatments, and no firm conclusions could be reached.Metformin demonstrated no benefit over placebo in reduction of Ferriman-Gallwey scores (MD 0.05, 95% CI -1.02 to 1.12), but the quality of evidence was low. Results regarding the effectiveness of GnRH analogues were inconsistent, varying from minimal to important improvements.We were unable to pool data for OCPs with cyproterone acetate 20 mg to 100 mg due to clinical and methodological heterogeneity between studies. However, addition of cyproterone acetate to OCPs provided greater reductions in Ferriman-Gallwey scores.Two studies, comparing finasteride 5 mg and spironolactone 100 mg, did not show differences in participant assessments and reduction of Ferriman-Gallwey scores (low quality evidence). Ferriman-Gallwey scores from three studies comparing flutamide versus metformin could not be pooled (I² = 62%). One study comparing flutamide 250 mg twice daily with metformin 850 mg twice daily for 12 months, which reached a higher cumulative dosage than two other studies evaluating this comparison, showed flutamide to be more effective (MD -6.30, 95% CI -9.83 to -2.77) (very low quality evidence). Data showing reductions in Ferriman-Gallwey scores could not be pooled for four studies comparing finasteride with flutamide as the results were inconsistent (I² = 67%).Studies examining effects of hypocaloric diets reported reductions in BMI, but which did not result in reductions in Ferriman-Gallwey scores. Although certain cosmetic measures are commonly used, we did not identify any relevant RCTs.
AUTHORS' CONCLUSIONS
Treatments may need to incorporate pharmacological therapies, cosmetic procedures, and psychological support. For mild hirsutism there is evidence of limited quality that OCPs are effective. Flutamide 250 mg twice daily and spironolactone 100 mg daily appeared to be effective and safe, albeit the evidence was low to very low quality. Finasteride 5 mg daily showed inconsistent results in different comparisons, therefore no firm conclusions can be made. As the side effects of antiandrogens and finasteride are well known, these should be accounted for in any clinical decision-making. There was low quality evidence that metformin was ineffective for hirsutism and although GnRH analogues showed inconsistent results in reducing hirsutism they do have significant side effects.Further research should consist of well-designed, rigorously reported, head-to-head trials examining OCPs combined with antiandrogens or 5α-reductase inhibitor against OCP monotherapy, as well as the different antiandrogens and 5α-reductase inhibitors against each other. Outcomes should be based on standardised scales of participants' assessment of treatment efficacy, with a greater emphasis on change in quality of life as a result of treatment.
Topics: 5-alpha Reductase Inhibitors; Adult; Androgen Antagonists; Body Mass Index; Contraceptive Agents, Female; Cyproterone Acetate; Desogestrel; Drug Combinations; Eflornithine; Ethinyl Estradiol; Female; Finasteride; Flutamide; Hirsutism; Humans; Hypoglycemic Agents; Metformin; Quality of Life; Randomized Controlled Trials as Topic; Spironolactone
PubMed: 25918921
DOI: 10.1002/14651858.CD010334.pub2 -
PloS One 2022Prostate cancer has been shown to be susceptible to significant stigmatisation, because to a large extent it is concealable, it has potentially embarrassing sexual... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Prostate cancer has been shown to be susceptible to significant stigmatisation, because to a large extent it is concealable, it has potentially embarrassing sexual symptoms and has significant impact on the psychosocial functioning.
METHODS
This review included studies that focused on qualitative and/or quantitative data, where the study outcome was prostate cancer and included a measure of stigmatization. Electronic databases (CINAHL, Medline, PubMed, PsycInfo, Cochrane Library, PROSPERO, and the Joanna Briggs Institute) and one database for grey literature Opengrey.eu, were screened. We used thematic analysis, with narrative synthesis to analyse these data. We assessed risk of bias in the included studies using the RoBANS.
RESULTS
In total, 18 studies met review inclusion criteria, incorporating a total of 2295 participants. All studies recruited participants with prostate cancer, however four studies recruited participants with other cancers such as breast cancer and lung cancer. Of the 18 studies, 11 studies evaluated perceived or felt stigma; four studies evaluated internalised or self-stigma; three studies evaluated more than one stigma domain.
DISCUSSION
We found that patients living with prostate cancer encounter stigmatisation that relate to perception, internalisation, and discrimination experiences. We also identified several significant gaps related to the understanding of prostate cancer stigmatization, which provides an opportunity for future research to address these important public health issues.
REGISTRATION
This systematic review protocol is registered with PROSPERO, the international prospective register of systematic reviews in health and social care. Registration number: CRD42020177312.
Topics: Cultural Competency; Databases, Factual; Humans; Male; Masculinity; Prostatic Neoplasms; Quality of Life; Social Support; Stereotyping
PubMed: 35148315
DOI: 10.1371/journal.pone.0261557 -
The Cochrane Database of Systematic... Nov 2017Polycystic ovary syndrome (PCOS) is a common endocrine condition, affecting approximately one in 10 women. PCOS is defined by two of three features: oligo- or... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Polycystic ovary syndrome (PCOS) is a common endocrine condition, affecting approximately one in 10 women. PCOS is defined by two of three features: oligo- or anovulation, clinical or biochemical hyperandrogenism or both, or polycystic ovaries.Women with PCOS can have a wide range of health problems, including infrequent and irregular periods, unwanted hair growth and acne, and subnormal fertility. Long-term health concerns include an increased risk of heart disease, diabetes and the development of precancerous disease of the womb.
OBJECTIVES
To assess the effectiveness and harms of ovarian surgery as a treatment for symptomatic relief of hirsutism, acne and menstrual irregularity in PCOS.
SEARCH METHODS
We searched the Cochrane Gynaecology and Fertility Group specialized register, CENTRAL, MEDLINE, Embase and PsycINFO (from inception to 17 October 2016). We handsearched citation lists, registers of ongoing trials and conference proceedings.
SELECTION CRITERIA
We included randomized controlled trials (RCTs) of women undergoing ovarian drilling in comparison to no treatment, medical treatment, or other forms of surgical treatment for the symptoms of PCOS.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures recommended by Cochrane. The primary outcome measures were improvement in menstrual regularity and androgenic symptoms of PCOS (hirsutism, acne); the secondary outcome measures included harms, change of body mass index (BMI), waist circumference, androgen levels, metabolic measures and quality of life. We assessed the quality of the evidence using GRADE methods.
MAIN RESULTS
We included 22 RCTs (2278 women analyzed) of participants with PCOS and symptoms of acne, hirsutism or irregular menstrual cycles, all of which included laparoscopic ovarian drilling (LOD) as an intervention.Two studies reported their funding source (Farquhar 2002 - supported in part by the Auckland Medical Research Foundation; Sarouri 2015 - the authors thank the Vice Chancellor for Research of Guilan University of Medical Sciences for funding this project).The quality of the evidence ranged from very low to moderate quality. The main limitations were imprecision associated with the low number of studies, inconsistency and risk of bias associated with the inability to blind participants. There were too few studies to assess risk of publication bias. Menstrual RegularityTwo studies compared LOD versus metformin (n=226) but no conclusions could be drawn with regard to menstrual regularity, as their findings were inconsistent and they were unsuitable for pooling. There appeared to be little or no difference in the rate of women reporting improvement in menstrual regularity when LOD was compared with medical treatment including metformin + clomiphene (OR 1.02, 95% CI 0.64 to 1.64, 2 studies, 332 women, I = 13%, low-quality evidence), letrozole (OR 1.08, 95% CI 0.64 to 1.84, 1 study, 260 women, low-quality evidence), or metformin + letrozole (OR 0.95, 95% CI 0.49 to 1.81, 1 study, 146 women, low-quality evidence). However, one study reported that LOD was superior to gonadotrophin (OR 19.2, 95% CI 3.17 to 116.45, 1 study, 35 women, very low-quality evidence).There appeared to be little or no difference in the rate of women reporting improvement in menstrual regularity when bilateral unipolar LOD was compared to unilateral LOD (OR 1.51, 95% CI 0.62 to 3.71, 2 studies, 104 women, I = 0%, moderate-quality evidence), transvaginal ultrasound-guided LOD (OR 1.23, 95% CI 0.64 to 2.37, 1 study, 147 women, low-quality evidence), LOD using adjusted thermal dose in accordance with the ovarian volume (OR 0.42, 95% CI 0.16 to 1.14, 1 study, 115 women, low-quality evidence) or bipolar LOD (OR 1.00, 95% CI 0.05 to 18.57, 1 study, 18 women, low-quality evidence).Four to five punctures per ovary may improve the rate of women reporting menstrual regularity compared with two or fewer (OR 16.04, 95% CI 4.19 to 61.34, 2 studies, 73 women, I = 0%, low-quality evidence). Androgenic SymptomsThere was probably little or no difference in improvement in androgenic symptoms when LOD was compared to metformin (OR 1.00, 95% CI 0.42 to 2.37, 1 study, 126 women, moderate-quality evidence) or gonadotrophins; acne (OR 3.20, 95% CI 0.33 to 30.94, 1 study, 25 women, low-quality evidence), hirsutism (OR 2.31, 95% CI 0.22 to 23.89, 1 study, 25 women, low-quality evidence).There appeared to be little or no difference in improvement of androgenic symptoms when LOD was compared to transvaginal ultrasound-guided LOD, with respect to hirsutism (OR 1.09, 95% CI 0.30 to 3.91, 1 study, 39 women, low-quality evidence) or acne (OR 0.84, 95% CI 0.20 to 3.50, 1 study, 31 women, low-quality evidence). HarmsLOD was associated with fewer gastrointestinal side effects than metformin plus clomiphene (OR 0.05, 95% CI 0.01 to 0.36, 2 studies, 332 women, I = 0%, moderate-quality evidence). One study suggested little or no difference in rates of ovarian hyperstimulation syndrome between LOD and gonadotrophins (OR 0.08, 95% CI 0.00 to 1.61, 1 study, 33 women, low-quality evidence).There were fewer adhesions with transvaginal hydrolaparoscopy compared to LOD (OR 0.10, 95% CI 0.05 to 0.18, 1 study, 246 women, moderate-quality evidence). There appeared to be little or no difference in adhesions when variable energy LOD was compared with standard LOD (OR 0.96, 95% CI 0.32 to 2.88, 1 study, 64 women, low-quality evidence). Another study (44 women) reported that none of the women who returned for surgery following either traditional or unilateral LOD were found to have adhesions.
AUTHORS' CONCLUSIONS
There was no clear evidence that LOD improves menstrual regularity or the androgenic symptoms of PCOS, compared to most of the medical treatments used in the included studies. LOD was associated with fewer gastrointestinal side effects compared to metformin and clomiphene.There was also no clear evidence of different effectiveness between types of LOD, except that LOD with four to five punctures per ovary may be more effective than two or fewer punctures. There was little evidence comparing LOD with different types of surgery, although one study concluded that transvaginal hydrolaparoscopy had a lower risk of adhesions than LOD.There was evidence from one small study of benefit from LOD compared to gonadotrophins for menstrual regulation. However, gonadotrophins are seldom used for this indication.
Topics: Acne Vulgaris; Clomiphene; Female; Gonadotropins; Hirsutism; Humans; Laparoscopy; Letrozole; Menstruation Disturbances; Metformin; Nitriles; Ovary; Polycystic Ovary Syndrome; Punctures; Randomized Controlled Trials as Topic; Triazoles
PubMed: 29125183
DOI: 10.1002/14651858.CD009526.pub2 -
Rural and Remote Health Aug 2021The aim of this research is fourfold: (i) analyze which countries have the most publications on suicide among agricultural workers, (ii) understand the factors that lead...
INTRODUCTION
The aim of this research is fourfold: (i) analyze which countries have the most publications on suicide among agricultural workers, (ii) understand the factors that lead to either suicide or intent, (iii) identify the methods of suicide or attempted suicide, and (iv) propose preventive measures so that rural agricultural workers are not exposed to risk factors to suicide.
METHODS
A literature review was conducted for the period 1996-2019; the Scopus, Lilacs, PubMed/MEDLINE, and Science Direct databases were searched, resulting in 44 articles deemed relevant to this research.
RESULTS
Agricultural workers were considered to be workers who perform agricultural activities, as either employees or employers. Australia, China, India, and Brazil had the most publications, and the causes of suicide were mostly easy access to or exposure to pesticides, and socioeconomic factors, such as masculinity, conditions of poverty, and social isolation.
CONCLUSION
Compared with other workers, agricultural workers can be a group at risk, with a great number of factors leading to suicide. Based on the available literature, proposals for suicide prevention are suggested.
Topics: Agriculture; Farmers; Humans; Male; Risk Factors; Rural Population; Suicide, Attempted
PubMed: 34384223
DOI: 10.22605/RRH6067 -
Archives of Sexual Behavior Oct 2023Sexual and dating violence (SDV) by male youth (≤ 25 years)-including sexual harassment, emotional partner violence, and rape-is a worldwide problem. The goal of...
Sexual and dating violence (SDV) by male youth (≤ 25 years)-including sexual harassment, emotional partner violence, and rape-is a worldwide problem. The goal of this preregistered (PROSPERO, ID: CRD42022281220) systematic review was to map existing SDV prevention programs aimed at male youth, including their characteristics (e.g., content, intensity), intended psychosexual outcomes, and empirically demonstrated effectiveness, guided by the principles of the theory of planned behavior (TPB). We conducted searches in six online databases for published, peer-reviewed quantitative effectiveness studies on multi-session, group focused, and interaction based SDV prevention programs for male youth ending March 2022. After screening of 21,156 hits using PRISMA guidelines, 15 studies on 13 different programs, from four continents were included. Narrative analysis showed, first, broad ranges in program intensity (2-48 h total), and few program curricula included explicit discussion of relevant aspects of the TPB. Second, programs' main intended psychosexual outcomes were to change SDV experiences, or related attitudes, or norms. Third, significant effects were found mostly on longer term behaviors and short-term attitudes. Other theoretical proxies of SDV experiences, such as social norms and perceived behavioral control, were sparsely investigated; thus, program effectiveness on these outcomes remains largely unknown. Assessed with the Cochrane Risk of Bias Tool, moderate to serious risk of bias arose in all studies. We present concrete suggestions for program content, such as explicit attention to victimization and masculinity and discuss best practices for evaluation research, including assessments of program integrity, and examining relevant theoretical proxies of SDV.
Topics: Humans; Male; Adolescent; Intimate Partner Violence; Rape; Sex Offenses; Violence; Sexual Harassment
PubMed: 37226034
DOI: 10.1007/s10508-023-02596-5 -
Performative Masculinity: A META-Ethnography of Experiences of Men in Academic and Clinical Nursing.International Journal of Environmental... Nov 2022Gender differences and stereotypes have been widely studied. Performative masculinity or "doing gender" is the adoption of traits considered to be "masculine" to achieve...
Gender differences and stereotypes have been widely studied. Performative masculinity or "doing gender" is the adoption of traits considered to be "masculine" to achieve acceptance in society. Performative masculinity, as it relates to career development for men in nursing, could be affected by internal attitudes and career choice, and external influences of culture. There are no critical systematic reviews to describe this process. The aim of this study was to synthesize research on how men in nursing experience masculine identity at work. A systematic literature search and qualitative synthesis using meta-ethnography guided this study. The literature search included studies from the electronic databases of PubMed, CINAHL, Medline, and Airiti Library, published in English or Chinese from 1994 to 2016. Eleven studies met the inclusion criteria. The meta-syntheses identified three themes describing how men in nursing experience masculine identity at work: (1) Nursing could be a gendered-neutral occupation suitable to both genders; (2) performative masculinity; and (3) strategies used when providing bodywork and care. Exploring insights about the tensions of performative masculinity among men in nursing, this study may help to address the challenges encountered in nursing education, practice, and career development. Establishing a male nursing model based on evidence from academic and clinical practice for nursing students and professional nurses could help to meet the increasing demand for nurses.
Topics: Humans; Male; Anthropology, Cultural; Education, Nursing; Masculinity; Nurses, Male; Students, Nursing
PubMed: 36429531
DOI: 10.3390/ijerph192214813 -
BMC Health Services Research Jul 2021The caregiving's impact on informal carers' quality of life and gender-based stereotypes make older individuals' informal care a complex process for which our knowledge...
BACKGROUND AND PURPOSE
The caregiving's impact on informal carers' quality of life and gender-based stereotypes make older individuals' informal care a complex process for which our knowledge is still limited. The purpose of this review is to identify how gender relates to informal carers' experiences of providing care for people aged 60 years and over with mental and physical health needs by synthesising the available empirical data published between 2000 to 2020.
DESIGN AND METHODS
The systematic method for reviewing and synthesising qualitative data was performed using the PRISMA checklist and ENTREQ statement. The CASP tool was used to examine the quality of the included papers. Thematic synthesis was used as the methodological framework.
RESULTS
This review produced two analytical themes, the impact of gender on the caregivers' labour and negotiating gender identity with self, society, and cultural norms. While informal caregivers share motivators, a linkage between traditional gender stereotypes impacts caregiving burden and coping strategies. Informal carers' experiences entail a constant pursuit of self-agency after acquiring the caregiver role. Cultural values and their intersection with gender appear to influence caregivers' healthy adjustment into their new caregiving identities. The flexibility to move beyond gender boundaries could mediate caregivers' negotiations between self and society on developing their new caregiving identity. Providing intensive informal primary care to older people affects both men's and women's mental and physical health. Gender ideals of the feminine nurturing role further disadvantage women as they determine the caregiving arrangements, the strategies and resources to sustain the caring burden, and the adaptability to experience their new caregiving role positively. Men appear more flexible to debate their hegemonic masculinity and defend their existence in the caregiving role.
CONCLUSION AND IMPLICATIONS
Transgressing gender lines and expanding gender possibilities can ease the caregiving burden and strengthen caregivers coping potentials. Health professionals can empower informal careers to challenge gender binaries and expand gender possibilities by intentionally injecting the language of diversity in caring information and caring processes. The review findings outline a path for research on gender identity development in older people's care.
Topics: Aged; Caregivers; Female; Gender Identity; Humans; Male; Men; Middle Aged; Patient Care; Quality of Life
PubMed: 34301248
DOI: 10.1186/s12913-021-06736-2 -
Archives of Sexual Behavior Oct 2015HIV affects over 1.2 million people in the United States; a substantial number are men who have sex with men (MSM). Despite an abundance of literature evaluating... (Review)
Review
HIV affects over 1.2 million people in the United States; a substantial number are men who have sex with men (MSM). Despite an abundance of literature evaluating numerous social/structural and individual risk factors associated with HIV for this population, relatively little is known regarding the individual-level role of masculinity in community-level HIV transmission risk. To address this gap, the current analysis systematically reviewed the masculinity and HIV literature for MSM. The findings of 31 sources were included. Seven themes were identified: (1) number of partners, (2) attitudes toward condoms, (3) drug use, (4) sexual positioning, (5) condom decision-making, (6) attitudes toward testing, and (7) treatment compliance. These factors, representing the enactment of masculine norms, potentiate the spread of HIV. The current article aligns these factors into a masculinity model of community HIV transmission. Opportunities for counseling interventions include identifying how masculinity informs a client's cognitions, emotions, and behaviors as well as adapting gender-transformative interventions to help create new conceptualizations of masculinity for MSM clients. This approach could reduce community-level HIV incidence.
Topics: Adolescent; Adult; Condoms; Counseling; HIV Infections; Homosexuality, Male; Humans; Male; Masculinity; Middle Aged; Risk Reduction Behavior; Risk-Taking; Sexual Behavior; Sexual Partners; United States; Young Adult
PubMed: 25917411
DOI: 10.1007/s10508-015-0501-9 -
BMJ Open Jan 2019To summarise and evaluate evidence from men who had not been diagnosed with prostate cancer about their perspectives on prostate care and prostate cancer.
OBJECTIVES
To summarise and evaluate evidence from men who had not been diagnosed with prostate cancer about their perspectives on prostate care and prostate cancer.
DESIGN
A systematic review of qualitative research, on the perspectives of non-cancerous men regarding prostate cancer prevention and care.
SETTING
A wide range of settings including primary and secondary care.
PARTICIPANTS
Men from varied demographic backgrounds ranging between 40 to 80 years of age.
DATA SOURCES
Three databases (Ovid MEDLINE, Informit, PsychInfo) and Google Scholar were searched for peer-reviewed papers in English reporting research using qualitative methods (in-depth or semistructured interviews and focus groups).
REVIEW METHODS
Thematic analysis using inductive and deductive codes. Thematic synthesis was achieved through iterative open, axial and thematic coding.
RESULTS
Eight papers (reporting seven studies conducted in Australia, UK and Germany) met inclusion criteria. Four major themes were identified: understanding prostate cancer, masculinity and prostate cancer, barriers to prostate healthcare and managing prostate health. It was reported that men often did not understand screening, prostate anatomy or their prostate cancer risk, and that concerns about masculinity could deter men from seeking health checks. There was evidence of a need to improve doctor-patient communication about case finding.
CONCLUSION
Further investigation is required to identify and understand any differences in the perspectives and experiences of men who have not been diagnosed with prostate cancer in metropolitan and regional areas, especially where there may be variations in access to healthcare.
Topics: Communication; Health Knowledge, Attitudes, Practice; Humans; Male; Men's Health; Physician-Patient Relations; Prostatic Neoplasms; Qualitative Research
PubMed: 30782686
DOI: 10.1136/bmjopen-2018-022842