Search Results (500)

Young adulthood is a critical period for preventing alcohol-related harm, as heavy drinking and mental health challenges often peak, yet preventive counseling remains underused. This study examined associations between depressive and anxious symptoms and receipt of alcohol-related advice from healthcare providers among U.S. young adults aged 18–29, with attention to differences across sexual identity groups. Data were drawn from the 2022 National Health Interview Survey, with a final analytic sample of participants aged 18–29 (N = 2256). Weighted logistic regressions estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Overall, 49.0% of participants reported receiving alcohol advice. Odds were higher among lesbian/gay participants (aOR = 1.81; 95% CI: 1.03–3.18) and those with severe anxiety symptoms (aOR = 2.10; 95% CI: 1.11–3.94). Interaction effects indicated disparities by sexual identity, with plurisexual males showing the lowest predicted probability of receiving advice when meeting the clinical threshold for anxiety (20.9% vs. 62.4% for monosexual individuals). The findings underscore the need to strengthen alcohol-related counseling and integrate mental health screening in preventive care for diverse young adult populations. Full article

Sexual minorities in Nigeria face systemic discrimination that extends into tertiary institutions, where silence and institutional neglect perpetuate stigma and abuse. This institutional inaction reinforces a culture of impunity and highlights the urgent need to understand the mechanisms through which institutional structures and cultures contribute to the well-being or harm of this vulnerable student population. This qualitative study employed a narrative phenomenological approach to explore the perceptions of policy makers and peer supporters about sexual harassment among sexual minority students in a higher education institution in Nigeria. A purposive sampling technique was used to recruit seven institutional decision-makers on student affairs, and four peer supporters for sexual minority individuals in the institution for in-depth interviews. The analysis revealed a profound disconnect. While the university perceives no problem due to a lack of formal reports, the lived experiences of students point to a cycle of harassment, vulnerability, and institutional betrayal exacerbated by the university’s neglect. The findings expose a cycle where the institution’s chosen method of “seeing” through formal complaints perpetuates epistemic injustice, validating the need for mandatory structural reforms over incremental sensitization to genuinely ensure safety and dignity for all students. Full article

Background/Objectives: Integrating behavioral health and primary care services is a national public health priority in the US, especially in underserved settings like northern Arizona. This healthcare delivery model is crucial to meet the mental and physical health needs of people with SU/SUDs, particularly those belonging to culturally diverse populations. In collaboration with a behavioral health center in northern Arizona, the current study aimed to assess the perspectives of providers and administrative staff on the implementation of integrated primary care (IPC) services for people with SU/SUDs. Methods: In February 2023, twelve healthcare providers and administrative staff from diverse educational backgrounds were recruited using purposive sampling to capture a range of perspectives on IPC implementation at the behavioral health center. Participants completed individual, semi-structured interviews conducted via Zoom, which were audio recorded and lasted approximately 30 min. The interview recordings were transcribed verbatim using Trint Software, and analyzed on Google Docs using applied thematic analysis. Two researchers coded the transcripts, iteratively developing and refining themes through multiple cycles of review and team discussions. Additional team members provided feedback and verified the themes, with consensus reached through collaborative meetings. This rigorous, iterative approach ensured the reliability and validity of the final thematic framework. Results: We found that IPC supports SU/SUDs recovery by providing holistic care that integrates medical, mental health, and addiction services while addressing social and co-occurring needs. It fosters an empathetic environment where clients do not need to repeatedly disclose their SU/SUDs, improves access to preventive care, and offers continuous support and education. Implementation barriers included workforce shortages, limited internal communication, and insufficient interdisciplinary training. Gaps in culturally centered care were identified, including reliance on Western models, limited representation of Native American and sexual and gender minority staff, and inconsistent use of inclusive practices such as pronouns, traditional healing, and trauma-informed approaches. Additionally, community partnerships with multisectoral organizations help clients access supportive resources beyond the facility, including vision care, clothing, and dental services. Conclusions: The implementation of IPC was seen as important to support the behavioral health center in northern Arizona to foster an empathetic environment where clients with SU/SUDs can have their mental, physical, and social needs addressed, either within the facility or through community partnerships, thereby supporting their recovery. However, progress is hindered by barriers such as workforce shortages, limited internal communication, and insufficient interdisciplinary care training. Additionally, despite regular cultural competency training, gaps remain in culturally centered care for underserved populations, particularly Native American and sexual and gender minority clients. Full article

Background and Objectives: Aquablation, a robot-assisted, heat-free resection technique, has emerged as a promising minimally invasive surgical therapy (MIST) for benign prostatic hyperplasia (BPH). Its precision and potential for preservation of sexual function distinguish it from traditional surgical options. This systematic review aimed to evaluate the safety profile of Aquablation, with emphasis on perioperative complications and functional outcomes. Materials and Methods: We systematically searched PubMed/MEDLINE, Scopus, and the Cochrane Library through June 2025 in accordance with PRISMA 2020 guidelines (PROSPERO CRD420251074479). Eligible studies included randomized and non-randomized trials of Aquablation in men with BPH, reporting adverse events by type, frequency, or severity. Risk of bias was assessed with ROB-2 and ROBINS-I tools. Results: Forty-seven studies were included, spanning randomized controlled and prospective observational designs. Most complications were minor (Clavien-Dindo grade 1–2). Bleeding was the most frequent perioperative event, with transfusion required in 1–8% of cases, more often in large prostates. Severe complications (grade ≥ 3) were uncommon and usually related to bleeding or urinary retention. Long-term sequelae such as strictures or bladder neck contracture were rare. Compared with transurethral resection of the prostate, Aquablation yielded lower rates of ejaculatory dysfunction (10% vs. 36%), with continence and erectile function largely preserved. Outcomes were comparable to holmium laser enucleation, but Aquablation demonstrated superior ejaculatory preservation. Conclusions: Aquablation demonstrates a favorable safety profile across prostate sizes, with its greatest advantage being preservation of sexual function. While bleeding remains the principal perioperative concern, life-threatening events are rare. Further independent, long-term comparative studies are warranted. Full article

Background and Objectives: Sexual violence constitutes a major public health concern that undermines safety, bodily integrity, and autonomy. This study aimed to assess the prevalence, risk factors, and preventive strategies related to sexual misconduct in party-related social settings in Poland. Materials and Methods: A cross-sectional survey was conducted between 18 and 27 March 2025 among a representative sample of 1000 adults using computer-assisted web interviews. The questionnaire covered perceived risk, preventive measures, and personal or witnessed experiences of sexual violence. Data were analyzed using chi-square tests and multivariable logistic regression. Results: More than half of respondents reported unwanted touching (53.8%) or persistent harassment (46.9%), and 54.1% had encountered sexual comments. Drug-facilitated assaults were reported by approximately 10% of participants, while 12.3% indicated forced sex. Despite frequent reliance on precautionary measures (e.g., returning home with friends in 64.2% of cases), concerns about sexual victimization were widespread. Multivariable analysis showed that women (aOR 1.91), young adults (aOR 2.80 for those aged 18–24 years), and sexual minorities were disproportionately affected. Conclusions: This study highlights that sexual violence in party-related settings is a structural rather than marginal problem in Poland. Women, young adults, and sexual minorities are disproportionately affected. Effective prevention requires multilevel interventions, including bystander programs, venue-level safety policies, and broader public health strategies to reduce tolerance for sexual harassment and violence. Full article

Cybersexual victimization is a growing public health concern with severe psychosocial consequences, particularly for younger populations. Despite growing awareness of its prevalence, understanding how cybersexual victimization evolves across different demographic and regional contexts remains limited. The aim was to analyze sex- and age-specific temporal trends and projections of cybersexual victimization in Spain (2011–2022), disaggregated by sex, age group, autonomous community, and offense type, to identify where disparities emerge and persist (particularly from adolescence (<18) into midlife) while also examining gender and regional inequalities to provide evidence for prevention strategies that are both gender-sensitive and tailored to different developmental stages and territorial contexts. Spanish national police-reported data on seven cybersexual offenses (sexual abuse, sexual harassment, corruption of minors, grooming, exhibitionism, child sexual abuse images, and sexual provocation) from 2011 to 2022 were analyzed. Data were disaggregated by sex, age group, and regions. Mean rates per 100,000 inhabitants were calculated, independent-sample t-tests assessed sex differences, and linear regression models projected trends to 2035 for each age-sex group. Between 2011 and 2022, cybersexual crimes in Spain increased across most offense types, with grooming, child sexual abuse images, and contact offenses showing the steepest upward trends (all p < 0.001). Women consistently presented higher mean victimization rates than men in most offense types and age groups. Among those under 18, mean grooming rates were 2.55 for females versus 0.95 per 100,000 for males (p < 0.001), with significant differences also in corruption of minors (p < 0.01). In young adulthood (18–25 years), women showed higher rates in sexual harassment (p < 0.001) and sexual abuse (p < 0.01), while, in midlife (26–40 and 41–50 years), female predominance persisted for sexual harassment, sexual abuse, and sexual provocation (all p < 0.05). Projections to 2035 indicate that sex gaps will remain or widen, particularly among females under 18 and in the 26–40 age group. The Balearic, Canary Islands, and Andalusia regions recorded the highest mean rates, whereas Galicia and Castilla-La Mancha reported the lowest. Cybersexual victimization in Spain disproportionately affects females from adolescence into midlife, with the most considerable disparities emerging before age 18 and persisting into adulthood. The combination of rapid offense growth, persistent sex-based disparities, and marked regional inequalities underscores the urgent need for gender-sensitive, developmentally targeted prevention strategies that address both early vulnerability and the reinforcement of risk in adult digital environments. Full article

From a critical feminist perspective, it is hypothesised that the gender digital divide may be related to new forms of virtual gender-based violence that particularly affect girls and young women. If this is the case, these forms of violence would fall within the dimension of exploitation or quality of use of technologies that characterises the digital divide. To test this hypothesis, a documentary analysis of the phenomenon was carried out by reviewing different cases reported in various media outlets, which show that the well-being of girls and adolescents is at risk when technology is involved. Four categories emerge that reflect situations in which technology becomes a tool for promoting self-harm and suicide among minors through exposure to harmful content, grooming, sexting and/or sextortion; the digital sexual exploitation of underage girls through deepfakes or intimate images generated with artificial intelligence; the consumption of violent and hateful content in mass chats; and the incitement of gender-based violence through video games. The results show the reproduction and perpetuation of gender-based violence in the digital world. To guarantee safe, inclusive and equitable digital environments, various measures are essential, including European policies or plans aimed at guaranteeing digital security and rights, and those related to critical digital literacy with a gender perspective in formal education (school and university) and informal education (parents, carers and guardians). Finally, we urge that the focus be placed on personal digital resilience, since thinking of a completely secure digital world is a naive and unattainable utopia. Full article

Romantic chemistry is an important indicator of compatibility between prospective romantic partners, but, despite theoretical work, lay understandings of romantic chemistry that could inform theory are still unclear. We used an online survey question to collect romantic chemistry conceptualisations from 571 Australian adults who were currently looking for a romantic partner, of whom 53.06% identified with minority gender and/or sexual identities. We analysed responses using inductive content analysis, which resulted in the construction of categories and sub-categories concerning the multifaceted nature of romantic chemistry, the importance of mutual feelings, and central concepts of interactivity, connection, and attraction. We performed a deductive content analysis using these categories and sub-categories to re-code responses and observed little evidence of differences between groups based on assigned sex, gender, sexual, and minority identities. Our findings suggest that romantic chemistry is only perceivable when multiple facets are experienced and that experiences of facets vary individually, which provides ample grounds for future investigation and measurement of romantic chemistry. Full article

Cyber-sexual crimes have become a growing concern in the digital age, as rapid technological progress continues to create new forms of violence and victimization. These offenses affect society unevenly, striking more intensely among minors, women, and other vulnerable groups. Their prevalence is shaped by structural inequalities, educational, economic, and technological, that condition both exposure to digital risks and the capacity for protection. Although international research has connected these disparities with digital victimization, evidence from Spain remains limited. The aim was to analyze the regional distribution of cyber-sexual crimes in Spain between 2011 and 2022 and to explore how education, income, and digital access relate to their incidence. To this end, official data from the Spanish Statistical Crime Portal (PEC) were combined with structural indicators provided by the Spanish National Institute of Statistics. The analysis encompassed reported cases of sexual abuse, sexual harassment, corruption of minors, online grooming, exhibitionism, pornography, and sexual provocation, using standardized incidence rates per 100,000 inhabitants. Statistical methods included ANOVA with post hoc comparisons, correlation analyses, and K-means clustering to identify territorial patterns. Results revealed a sustained national increase in cyber-sexual crimes, with grooming and sexual harassment showing the most pronounced growth. The Balearic Islands (mean 4.9), Canary Islands (4.0), and Andalusia (3.9) registered the highest incidence rates, well above the national average (3.0). Educational disadvantages and low income were linked to sexual abuse and corruption of minors, whereas greater digital connectivity, expressed through higher mobile phone use, broadband access, and computer ownership, was strongly associated with grooming and other technology-facilitated offenses. Cluster analysis identified three distinct territorial profiles: high-incidence regions (Balearic and Canary Islands, Andalusia), intermediate (Murcia, Madrid, Navarre, Valencian Community), and low-incidence (Galicia, Catalonia, Castile and León, among others). In conclusion, the findings demonstrate that cyber-sexual crimes in Spain are unevenly distributed and closely linked to persistent structural vulnerabilities that shape digital exposure. These results underscore the need for territorially sensitive prevention strategies that reduce educational and economic inequalities, foster sexual and digital literacy, and promote safer online environments. Without addressing these underlying structural dimensions, public policies risk overlooking the conditions that sustain regional disparities and limit adequate protection against technology-driven sexual crimes. Full article

This study critically examines the civil–religious influence of Korean conservative Protestantism, which mobilizes heteronormative strategies to oppose anti-discrimination and family rights legislation, through the lens of Christian normativity. These movements justify heteronormative values by appealing to the immutability of the “creation order” in Genesis. Yet such literalist interpretations disregard contemporary findings in evolutionary biology and animal behavior that document same-sex phenomena across species, thereby framing creation and evolution in rigid opposition. Imported from American fundamentalism, “creation science” has further fueled an anti-intellectual public sentiment that naturalizes heterosexuality as divine law. The absolutism of the creation order and special revelation exposes deep theological contradictions when confronted with the existence of diverse sexual and gender identities. In response, this study turns to process theology, which reimagines creation as open-ended, dynamic, and co-creative. Engaging Catherine Keller’s apophatic theology to reopen theological space for sexual minorities, it further develops Justin Sabia-Tanis’s interpretation of transgender transformation as a process of co-evolution, in dialogue with Donna Haraway’s notion of cyborg hybridity. Moreover, drawing on John B. Cobb Jr.’s “persuasive political theology,” it argues that participation in divine co-creation must be expanded into the socio-political sphere. Ultimately, this study seeks to resist anti-intellectualism and advocate for a transformative Christian civil religion in Korea—one oriented toward justice, inclusion, and continual co-creation. Full article

Background: This study characterizes the current representation of sociodemographic groups within Canadian radiation oncology training programs and trainees’ lived experiences. Methods: A 59-item ethics-approved, bilingual survey assessed sociodemographics, training perceptions, mentorship, discrimination/harassment experienced, and open-ended questions. Electronic surveys were distributed to all Canadian radiation oncology residents/fellows. Descriptive statistics summarized survey responses. Categorical groups were compared using chi-squared/Fisher’s exact tests. Thematic analysis was performed on open-ended responses. Results: Between July and December 2023, 98 of 177 (56%) trainees participated: 70% were residents, 52% identified as male, 62% as a racialized minority, and 10% as a sexual minority. Most respondents reported training program satisfaction (83%) and a respectful workplace culture (69%); however, discrimination during training was reported by 38%. Less than half (45%) felt comfortable reporting discrimination/harassment within their workplace. Women were more likely to feel under-represented in-training (46% vs. 13%, p = 0.001) and perceived more discrimination events (64% vs. 19%, p < 0.001). Three themes emerged as follows: importance of offering EDI education, ensuring pathways for reporting learner mistreatment, and creating appropriately diverse selection committees. Conclusions: Although most Canadian radiation oncology trainees reported satisfaction and a respectful culture, key differences between groups were observed. Targeted strategies and stronger institutional policies to improve representation and reduce rates of discrimination/harassment are needed. Full article

Previous research has shown that Two-Spirit Indigenous people may experience more trauma, interracial violence, and violent crimes than youth from other cultural backgrounds. This study aims to examine how identifying as Two-Spirit, an identity that integrates both non-cisgender and non-heterosexual identities, as well as Indigenous identities simultaneously and congruently, may allow one to feel more resilient and empowered. The sample consisted of Indigenous, sexual gender minority emerging adults (N = 91) with ages ranging from 18 to 29 with an average age of 24.78 (SD = 2.35). This sample reported perceived discrimination for being Indigenous, for their gender identity, and for their sexual orientation. The amount of discrimination for each of these categories was not significantly different, but the source was, and the predominant source for all three types was White individuals. The combined effects were related to lower self-esteem; more psychological symptoms of anxiety, depression, and somatization; and greater identity distress and higher scores on disturbed identity and lack of identity. In this study, Two-Spirit identification did not reduce the negative effects of discrimination by connecting with historical memory through this identity, but that does not necessarily mean that it cannot, only that its potential has yet to be fulfilled. Many participants did not have a full understanding of the label and its history. Further research into this idea is another area of study that might be fruitful. Full article

Background/Objectives: Persons identifying as lesbian, gay, bisexual, pansexual, omnisexual, queer, questioning, fluid, asexual, or other non-heterosexual orientations (LGB+ persons) have been identified as a risk group for sexual victimization (SV), which can have long-lasting negative effects on well-being and physical, mental, sexual, and reproductive health. Othering-Based Stress (OBS)—reflecting societal processes of othering and resulting from stigma, prejudice, and discrimination—may contribute to increased vulnerability to SV and its consequences in LGB+ persons and affect help-seeking behavior following victimization. This study examines the impact of SV on LGB+ persons and their help-seeking behavior after victimization. Methods: Using a mixed-methods explanatory sequential design, first survey data from a nationally representative sample of the Belgian population on SV, its consequences, and subsequent help-seeking behavior were collected from 4632 individuals. Of these, 2965 participants (2601 heterosexual and 364 LGB+ individuals) experienced SV and represented the final sample for the quantitative analyses. In a second phase, in-depth interviews were conducted with 40 LGB+ victims to explore their experiences more thoroughly. Results: LGB+ individuals reported more negative consequences following SV than heterosexual persons, particularly regarding identity-related processes such as questioning gender expression and decreases in self-esteem. They also reported additional barriers to disclosing SV and seeking help from professional services or the police, including fears of stigma, invalidation, and concerns about professionals’ LGB+ competence. No significant differences were found between LGB+ persons who explicitly identified as belonging to a sexual minority group and those who did not, neither in the perceived consequences of SV nor in help-seeking barriers. Conclusions: LGB+ victims of sexual violence experienced more severe identity-related consequences and faced greater barriers to professional support than heterosexual victims. These results highlight the urgent need for trauma-informed, LGB+-inclusive services and structural policy measures to improve access to appropriate care. Full article

Aims: To ask UK women with diabetes whether they have discussed sexual health with healthcare professionals (HCPs) during diabetes care, and to explore communication barriers. Methods: An online questionnaire was developed, based on a published HCP communication survey, piloted by six women with diabetes. A total of 163 participants, recruited via social media and HCP network, completed Part 1 by selecting Likert or narrative response options, providing descriptive data. We report proportions with 95% confidence intervals (Wilson); percentages are calculated using the number responding to each item. Item-level missingness is retained as a non-analysed category, and the n is reported per question. No inferential comparisons were planned a priori. After Part 1 completion, participants could choose to finish, or to continue to Part 2 questions regarding vulval anatomy, function, and vocabulary (77 completed 2A: 80 completed 2B). Part 2 data was analysed thematically. Results: During diabetes care, a minority of participants, 44/163 (27%), said they had ever discussed sexual health, or had been advised how to access sexual health support, 28/163 (17%). If an HCP discussed sexual health, many women said they expected to feel surprised, 114/163 (70%), or pleased, 88/163 (54%). Some participants said they expected HCPs would find the topic inappropriate, 56/163 (36%), or annoying, 44/163 (27%). Some participants expressed HCP gender preference (75/163 [46%] female and 4/163 [3%] male) for such discussion. Part 2 findings revealed unmet sexual health literacy needs with potential to impact on communication with HCPs. Conclusions: Women reported infrequent communication about sexual health and diabetes during diabetes care. Findings highlight potential communication barriers for some participants including the following: unmet educational needs regarding diabetes and sexual health, lack of confidence about available support, fear of a negative HCP response, and preference for the gender of the HCP. Whereas in previous research, HCPs feared upsetting women by discussing sexual health, many participants said they expected to respond positively. Full article

Sexual and reproductive health and rights (SRHRs) remain a sensitive issue in Indonesia due to entrenched structural, cultural, and social barriers, particularly affecting adolescents, women, and minority groups. In response, the Indonesian Planned Parenthood Association of Yogyakarta Special Region (PKBI DIY) actively promotes SRHR access through value-based, community-centred communication strategies. This study explores how PKBI DIY applies strategic communication to strengthen SRHR advocacy by employing collaborative and participatory methods. Using a qualitative case study approach, researchers conducted in-depth interviews with 11 key informants. Thematic analysis identified three core strategies. First, PKBI DIY fosters inclusive and non-discriminatory communication through educational outreach that challenges stigma and engages diverse audiences. Second, it adopts value-driven, community-focused communication practices that reflect its organisational ethos and build public trust. Third, it practices reflective and collaborative communication with government bodies, civil society, and the media to reinforce advocacy and ensure sustainable outcomes. PKBI DIY illustrates that NGO communication transcends message delivery by embodying advocacy values, affirming organisational identity, and supporting long-term impact. The findings contribute to the broader discourse on value-based strategic communication in human rights work and provide practical guidance for NGOs aiming to implement ethical and socially impactful communication models in SRHR. Full article