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Prenatal Diagnosis Sep 2022Prenatal diagnoses of differences of sex development (DSD) are increasing due to availability of cell-free DNA screening (cell-free DNA screening (cfDNA)). This study...
OBJECTIVES
Prenatal diagnoses of differences of sex development (DSD) are increasing due to availability of cell-free DNA screening (cell-free DNA screening (cfDNA)). This study explores first-hand experiences of parents whose children had prenatal findings of DSD.
METHODS
Eligible parents were identified through chart review at a pediatric center and interviewed about their prenatal evaluation, decision making, informational sources, and support systems. Interviews were coded using a combined inductive and deductive thematic analysis. Parents also completed quantitative measures of decisional regret.
RESULTS
Seventeen parents (13 mothers; 4 fathers) of 13 children (with 7 DSD diagnoses) were recruited. Four children had discordance between sex predicted by cfDNA versus prenatal ultrasound, and 2 had non-binary appearing (atypical) genitalia on prenatal ultrasound. Of these 6, 3 were not offered additional prenatal testing or counseling. Most parents described tension between obtaining support through disclosure of their child's diagnosis and preserving their child's autonomy/privacy, highlighting the need for mental health support.
CONCLUSION
This is the first study to gather qualitative data from parents whose children had prenatal findings of DSD. We identified multiple targets for intervention to improve care for patients with DSD across the lifespan, including improvements in clinician education, pre- and post-test counseling, and patient education materials.
Topics: Cell-Free Nucleic Acids; Child; Counseling; Emotions; Female; Humans; Parents; Pregnancy; Qualitative Research
PubMed: 35670269
DOI: 10.1002/pd.6191 -
Global Health, Science and Practice Aug 2015Contraceptive effectiveness is the leading characteristic for most women when choosing a method, but they often are not well informed about effectiveness of methods.... (Review)
Review
Contraceptive effectiveness is the leading characteristic for most women when choosing a method, but they often are not well informed about effectiveness of methods. Because of the serious consequences of “misinformed choice,” counseling should proactively discuss the most effective methods—long-acting reversible contraceptives and permanent methods—using the WHO tiered-effectiveness model.
Topics: Contraception; Counseling; Family Planning Services; Human Rights; Humans; Sex Education; World Health Organization
PubMed: 26374797
DOI: 10.9745/GHSP-D-15-00096 -
PloS One 2023Provision of sexual health services requires gender-sensitive management, facilities, and staff, as well as planning for gender-sensitive caregivers and education....
BACKGROUND
Provision of sexual health services requires gender-sensitive management, facilities, and staff, as well as planning for gender-sensitive caregivers and education. Couples suffering from vaginismus face many types of barriers to accessing sexual health services. This qualitative study was conducted to explain the needs of sexual health services in women with primary vaginismus in Iran.
METHODS
This qualitative study was conducted through the participation of 20 participants including service providers, women with vaginismus and their husbands in 2022, Iran. The samples were selected using purposive sampling method and considering the maximum variation. For data collection, in-depth semi-structured individual interviews were conducted and continued until data saturation was reached. The collected data were analyzed in MAXQDA10 software using conventional content analysis approach based on the criteria proposed by Graneheim and Lundman.
RESULTS
Data analysis led to the emergence of three main themes: 1) Comprehensive preventive sex education which included the three categories of sex education in the education system, premarital sex education through the health system, and sex education through the media with scientific content; 2) Efficient sexual health clinics which included three categories of therapist's skills, empowerment of sexual therapist, and structural features of sexual health clinics and cultural considerations in establishing sexual health clinics; and 3) Protocol for management and treatment of sexual problems which consisted of sexual education and counseling content, treatment requirements, and sex education approaches.
CONCLUSION
Based on the results of the study, comprehensive preventive sex education through the education system and the Ministry of Health can improve the attitudes of adolescents and young people. Moreover, it can take a fundamental step in solving sexual problems by providing the infrastructure necessary for the establishment of efficient sexual health clinics and protocols required to manage and treat such problems.
Topics: Adolescent; Humans; Female; Vaginismus; Sexual Behavior; Qualitative Research; Sex Education; Counseling
PubMed: 37556497
DOI: 10.1371/journal.pone.0283732 -
BMC Public Health Jul 2016HIV testing and counseling (HTC) with linkage to care after known infection are key components for HIV transmission prevention. This study was conducted to assess HTC...
BACKGROUND
HIV testing and counseling (HTC) with linkage to care after known infection are key components for HIV transmission prevention. This study was conducted to assess HTC uptake, HIV risk perception and linkage to care among Thai university students.
METHODS
An outreach HTC program was conducted in a large public university in Thailand from January 2013 to December 2014. The program consisted of brief HIV knowledge assessment, free HTC, HIV risk assessment and education provided by the healthcare personnel. Students were categorized into low, moderate and high-risk groups according to the pre-defined HIV risk characteristics.
RESULTS
One-thousand-eight-hundred-one students participated in the program, 494 (27 %) underwent HTC. Independent characteristics associated with no HTC uptake included female sex (P < 0.001), lower HIV knowledge score (P < 0.001), younger age (P < 0.001) and students from non-health science faculties (P = 0.02). Among the 494 students undergoing HTC, 141 (29 %) were categorized into moderate or high-risk group, of whom 45/141 (32 %) had false perception of low HIV risk. Being heterosexual was independently associated with false perception of low HIV risk (P = 0.04). The rate of new HIV infection diagnosis was 4/494 (0.8 %). Of these 4 HIV-infected students, 3 (75 %) were men who have sex with men and only 2 of the 4 students (50 %) showed up for HIV continuity care.
CONCLUSIONS
An outreach HIV prevention program with HTC was feasible and beneficial in detecting HIV risk and infection among the university students. However, interventions to improve HTC uptake, HIV risk perception and linkage to care are needed.
Topics: Adult; Counseling; Female; HIV Infections; Health Knowledge, Attitudes, Practice; Heterosexuality; Humans; Male; Mass Screening; Risk-Taking; Safe Sex; Students; Thailand; Universities; Young Adult
PubMed: 27405648
DOI: 10.1186/s12889-016-3274-8 -
American Journal of Public Health Oct 2007Against the background of debates about expanding HIV testing and counseling, we summarize the evidence on the social and behavioral dimension of testing and its... (Review)
Review
Against the background of debates about expanding HIV testing and counseling, we summarize the evidence on the social and behavioral dimension of testing and its implications for programs. The discrepancy between acceptance of testing and returning for results and the difficulties of disclosure are examined in light of research on risk perceptions and the influence of gender and stigma. We also summarize the evidence on the provision of testing and counseling, the implementation of practices regarding confidentiality and consent, and the results of interventions. We demonstrate that social factors have a considerable impact on testing, show that the services linked to testing are key determinants of utilization, and consider the implications of these findings for HIV testing programs.
Topics: Attitude to Health; Confidentiality; Counseling; Female; HIV Infections; Health Behavior; Humans; Male; Prejudice; Self Disclosure; Sex Factors; Social Alienation
PubMed: 17761565
DOI: 10.2105/AJPH.2006.096263 -
European Journal of Medical Genetics Mar 2021Despite numerous clinical series, consistent karyotype-phenotype correlations for Turner syndrome have not been established, although a lower level of 45,X is generally...
Despite numerous clinical series, consistent karyotype-phenotype correlations for Turner syndrome have not been established, although a lower level of 45,X is generally thought to be associated with a milder phenotype. This limits personalized counseling for women with 45,X/46,XX mosaicism. To better understand the phenotypic spectrum associated with various levels of 45,X/46,XX mosaicism, we compared patients evaluated in the Massachusetts General Hospital Turner Syndrome Clinic to determine if cardiac, renal, and thyroid abnormalities correlated with the percentage of 45,X cells present in a peripheral blood karyotype. of the 118 patients included in the study, 78 (66%) patients had non-mosaic 45,X and 40 (34%) patients had varying levels of 45,X/46,XX mosaicism. Patients with ≤70% 45,X compared with those with >70% 45,X had a significantly lower frequency of cardiac and renal anomalies. The presence of hypothyroidism was somewhat lower for the ≤70% 45,X group, but was not statistically significant. Supplemental tissue testing on another tissue type, typically buccal mucosa, was often useful in counseling patients with 45,X mosaicism. Given the modest sample size of patients with varying levels of mosaicism and the variability of Turner syndrome abnormalities, we hope this preliminary study will inspire a multicenter collaboration, which may lead to modification of clinical guidelines. Because several patients with ≤70% 45,X were ascertained from perinatal care referrals, we still advise women with 45,X mosaicism pursuing pregnancy to receive standard Turner syndrome cardiac surveillance. There is an opportunity to personalize counseling and surveillance for patients based on percentage of 45,X cells on chromosome analysis.
Topics: 46, XX Disorders of Sex Development; Cells, Cultured; Female; Genetic Testing; Humans; Karyotyping; Mosaicism; Phenotype; Precision Medicine; Turner Syndrome
PubMed: 33524610
DOI: 10.1016/j.ejmg.2021.104140 -
MedEdPORTAL : the Journal of Teaching... 2022Despite recommendations for annual chlamydia screening for young, sexually active females, chlamydia rates continue to increase nationally. Medical school students often...
INTRODUCTION
Despite recommendations for annual chlamydia screening for young, sexually active females, chlamydia rates continue to increase nationally. Medical school students often receive limited training in obtaining comprehensive, risk-based sexual histories, leading to less screening for sexually transmitted illnesses (STIs). Consequently, many internal medicine (IM) residents feel unprepared for advanced sexual history taking and site-specific STI testing based on sexual practices.
METHODS
We developed a case-based interactive didactic session for IM and med/peds residents. We focused on more advanced topics, such as comprehensive sexual history taking, secondary site testing for STIs, and patient counseling.
RESULTS
Based on pre- and postcurriculum surveys, interns reported increases in comfort (scale: 1 = 5 = ) with counseling after positive STI results (s: pre = 2.9, post = 3.5, < .01) and providing education on safe sex practices (s: pre = 3.0, post = 3.6, < .01) and modest improvement in comfort with expedited partner therapy (EPT; s: pre = 2.1, post = 2.5, = .06). An increase in self-reported confidence with collecting site-specific testing (composite s: pre = 2.7, post = 3.5, < .01) was also seen. Percentage correct on knowledge questions increased from 48% to 78% postcurriculum ( = .01).
DISCUSSION
This curriculum demonstrated improvement in knowledge and comfort with sexual history taking, STI screening, and counseling. Comfort also improved with EPT counseling, but not significantly, which could be addressed in future iterations of the curriculum.
Topics: Female; Humans; Sexually Transmitted Diseases; Sexual Health; Sexual Behavior; Curriculum; Surveys and Questionnaires
PubMed: 36605541
DOI: 10.15766/mep_2374-8265.11287 -
Skin Appendage Disorders Mar 2023Although hidradenitis suppurativa (HS) is associated with psychosocial comorbidities such as depression as well as modifiable comorbidities such as obesity, rates of...
INTRODUCTION
Although hidradenitis suppurativa (HS) is associated with psychosocial comorbidities such as depression as well as modifiable comorbidities such as obesity, rates of psychosocial screening and lifestyle counseling in the USA have not been characterized.
METHODS
This cross-sectional study utilized publicly available data from the National Ambulatory Medical Care Survey (NAMCS) between 2008 and 2018 to identify visits with a diagnosis of HS (ICD-9 code 705.83, ICD-10 code L73.2). tests and multivariate logistic regressions analyzed trends in rates of screening and counseling while controlling for race, sex, and age. Survey weights are applied to each visit to represent a national sample.
RESULTS
Depression screening was completed in only 2% of reported visits. No visits reported screening for alcohol misuse, substance abuse, or domestic violence. There were low rates of counseling for weight reduction (7.8%), diet and nutrition (3.3%), exercise (2.4%), smoking (1.0%), and substance abuse (0.7%). Black patients and individuals with public health insurance received less screening and counseling overall.
CONCLUSION
Rates of psychosocial screening and counseling on lifestyle modifications are low in ambulatory clinic visits for HS patients, and there are disparities based on race and insurance status. Implementing strategies to incorporate routine psychosocial screening and lifestyle counseling into visits may improve HS patient outcomes.
PubMed: 36937161
DOI: 10.1159/000528253 -
Iranian Journal of Nursing and... 2021More than half of the population of women suffer from cyclic mastalgia which can interfere with women's sexual function and affect their sexual satisfaction. The current...
The Effect of Sex Counseling Based on (Permission, Limited Information, Specific Suggestions, Intensive Therapy) Model on Sexual Satisfaction in Women with Cyclic Mastalgia: A Randomized Controlled Clinical Trial.
BACKGROUND
More than half of the population of women suffer from cyclic mastalgia which can interfere with women's sexual function and affect their sexual satisfaction. The current study was conducted to determine the effect of sexual counseling on sexual satisfaction in women with cyclic mastalgia.
MATERIALS AND METHODS
This randomized controlled trial study was performed on 81 women with cyclic mastalgia. The subjects were randomly divided into two groups of intervention ( = 40) and control ( = 41). Intervention was performed as Permission, Limited information, Specific suggestions, Intensive therapy (PLISSIT) sex counseling in four sessions for a maximum of 90 min in the intervention group. The demographic checklist and Index of Sexual Satisfaction (ISS) were used for data collection. Follow-up was performed 1 and 3 months after the intervention. The obtained data were analyzed using repeated-measures test.
RESULTS
The intervention and control groups were in good balance in terms of demographic characteristics and sexual satisfaction scores prior to the intervention and no statistically significant differences were observed. There was a statistically significant increase in the mean (SD) score of female sexual satisfaction in the intervention group: 93 (12.52), 101.15 (7.70),101.37 (5.31), ( = 27.4, < 0.001). We also observed a decrease in the mean (SD) score of sexual satisfaction in the control group: 93.39 (13.12), 90.68 (8.41), 90.85 (6.57), ( = 11.9, < 0.001) 1 and 3 months following the intervention.
CONCLUSIONS
This study revealed that individual counseling by PLISSIT sex counseling could lead to improvement in sexual satisfaction index in women with cyclic breast pain.
PubMed: 34900658
DOI: 10.4103/ijnmr.IJNMR_159_20 -
PloS One 2021Available evidence suggests that provision of quality of care in family planning services is crucial to increasing uptake and continuation of use of contraception. Kenya...
BACKGROUND
Available evidence suggests that provision of quality of care in family planning services is crucial to increasing uptake and continuation of use of contraception. Kenya achieved a modern contraceptive prevalence rate of 60% in 2018, surpassing its 2020 target of 58%. With the high prevalence, focus is geared towards improved quality of family planning services. The objective of this study is to examine the quality of family planning counseling and its associated factors in health facilities in Kenya.
METHODS
We conducted a secondary analysis of the 2019 Kenya Performance Monitoring and Action, client exit data of women who had received family planning services. Quality of counseling was assessed using the Method Information Index Plus. We conducted a multivariable ordinal logistic regression analysis of data from 3,731 women to establish determinants of receiving quality family planning services.
RESULTS
The Method Information Index Plus score for higher-quality counseling was 56.7%, lower-quality counseling 32.4%, and no counseling 10.9%. Women aged 15-24 years (aOR = 0.69, 95% CI = 0.56-0.86, p = 0.001) had lower odds of receiving better counseling compared to women aged 35 years and above. Those with no education (aOR = 0.52, 95% CI = 0.33-0.82, p = 0.005), primary (aOR = 0.56, 95% CI = 0.44-0.71, p<0.001) and secondary (aOR = 0.79, 95% CI = 0.65-0.98, p = 0.028) were less likely to receive better counseling compared to those with tertiary education. Women who received long acting and reversible contraception methods (aOR = 1.75, 95% CI = 1.42-2.17, p<0.001), and those who were method switchers (aOR = 1.24, 95% CI = 1.03-1.50, p = 0.027), had a higher likelihood of receiving better quality of counseling as compared to those on short-term methods and those who were continuers, respectively.
CONCLUSION
The quality of family planning counseling in Kenya is still sub-optimal considering that some women receive no form of counseling at service delivery point. There is need to review the existing FP guidelines and training packages to increase focus on the quality of counseling services offered by health providers. Social accountability strategies that empower women to demand quality services should be included in community-level family planning interventions.
Topics: Adolescent; Adult; Contraception; Contraception Behavior; Counseling; Delivery of Health Care; Family Planning Services; Female; Health Facilities; Humans; Interviews as Topic; Middle Aged; Quality of Health Care; Sex Education; Young Adult
PubMed: 34506509
DOI: 10.1371/journal.pone.0256295