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Background Given the negative impact of breast cancer and its treatment on women’s self-efficacy in various areas, including sexual function, investigating and understanding ways to enhance sexual function is crucial. The current study aimed to examine the impact of sexual counseling and education based on self-efficacy theory on the sexual function of women with breast cancer. Method The trial was a randomized controlled trial with a parallel design, including a pre-test, post-test, and one-month follow-up. Fifty married breast cancer survivors, having a disorder in at least one domain of sexual function (score below 3.9) and meeting other research criteria, visited clinics and hematology departments of hospitals in Bushehr (a city in southern Iran) between 2023 and 2024 were purposefully selected and randomly assigned to intervention and control groups using block randomization. The intervention group received two educational sessions and three counseling sessions based on the self-efficacy theory. Data collection utilized demographic information forms and a sexual function index for women, which consists of 19 questions that assess six domains of women’s sexual function (desire, arousal, lubrication, orgasm, satisfaction, and pain during intercourse) over a period of 4 weeks and completed by participants during the pre-test, post-test, and follow-up stages. Descriptive statistics (mean, standard deviation, percentage, frequency) and analytical tests, including the independent t-test, Mann‒Whitney U test, Chi-square test, and Fisher’s exact test and repeated-measures analysis of variance (ANOVA) followed by post hoc LSD test were used for data analysis, considering a significance level of less than 0.05 in all cases. Result The mean age of patients in the intervention and control groups was 44.42 ± 4.88 and 43.44 ± 5.20, respectively. The two groups did not have statistically significant differences in demographic and disease-related variables ( P  > 0.05). An independent t-test showed no significant difference between the two groups in terms of the average pre-test sexual function score and its domains ( P  > 0.05). Changes in overall sexual function and the arousal, orgasm, lubrication, and satisfaction domains from pre-test to post-test and from pre-test to follow-up increased in the intervention group and decreased in the control group, with statistically significant differences between the two groups ( P  < 0.05). However, the average changes from post-test to follow-up were not statistically significant between the two groups. Conclusion The total FSFI scores and most of its domains in the intervention group were higher than those in the control group, which can be attributed to the impact of sexual education and counseling. Therefore, the use of this non-invasive, cost-effective, and straightforward method along with other medical approaches is recommended. Trial registration IRCT20231102059930N1, 4 December 2023, Prospectively registered, at http//www.irct.ir.

Background In the United States, problematic stimulant use is a prevalent and difficult to treat problem among men who have sex with men (MSM), as well as a major driver of HIV transmission through the large number of sexual partners and concomitant condomless anal sex (CAS). Evidence-based behavioral studies that address problematic stimulant use in MSM at risk for HIV infection are also lacking. In this paper, we describe the design of a behavioral intervention trial to reduce sexual risk behavior and stimulant use in HIV-uninfected MSM. Methods This study, funded by the National Institute on Drug Abuse (NIDA), is a randomized controlled trial (RCT) testing an integrated HIV risk reduction and behavioral activation counseling intervention (IMPACT) for HIV-uninfected, stimulant using MSM in Boston, MA, and Miami, FL. Participants are randomized (2:2:1) to either (1) the IMPACT intervention; (2) a relaxation condition, an active therapy time- and intensity-matched control; or (3) a standard of care risk reduction counseling comparison. At enrollment, all participants receive an HIV test and pre- and post-test counseling. The primary outcome is the difference in the rate of change in the number of self-reported condomless anal sex acts without the protection of consistent Pre-Exposure Prophylaxis (PrEP) use, as well as reductions in stimulant use during the prior 4-months. Major assessments are conducted at baseline, 4-, 8-, and 12-month follow-up visits. Discussion Effective and sustainable behavioral interventions are sorely needed to reduce HIV acquisition in stimulant using MSM at risk for HIV infection. In this study, we will evaluate the evidence of efficacy of the IMPACT intervention to reduce HIV acquisition in HIV-uninfected, stimulant-using MSM. If found effective, the intervention tested here holds promise for being readily integrated into real-world clinical settings. Trial registration ClinicalTrials.gov number NCT03175159 , registered June 5, 2017.

Objective The aim of the study was to determine the effect of WhatsApp-based BETTER sex counselling on sexual function and sexual quality of life in breast cancer survivors in a randomized control trial. Methods This is a randomized controlled trial in which a total of 90 breast cancer survivors were recruited using convenience sampling and then randomly assigned to two groups of WhatsApp-based BETTER model counselling and routine care. Data collection tools consisted of a demographic questionnaire, the Sexual Quality of Life-Female (SQOL-F) and the Sexual Function Index (FSFI-BC). Participants in the intervention group were given access to the 6-week program. The program consisted of six consultation and assignment packages covering all six steps of the BETTER model. Data were analyzed using SPSS software version 20. Chi-square test, independent samples t-test and repeated measures analysis of variance were used. The significance level ( p -value) was considered to be less than 0.05. Results In the control group, the mean score of SQL scale changed from 35.16 ± 10.71 to 35.16 ± 12.97 ( P  > 0.05) and in the intervention group, it significantly increased from 34.76 ± 10.13 to 68.20 ± 20.48 ( P  < 0.001). Similarly, the comparison of mean of FSF in the control group showed a none-significant change from 58.13 ± 7.11 to 58.35 ± 6.11 ( P  > 0.05), and in the intervention group, it significantly improved from 59.49 ± 6.10 to 120.73 ± 25.54 ( P  < 0.001). The results of rANOVA indicated that there was a significant difference in the mean scores of the SQL and SFS between the two groups from pre- to post-intervention, and then over the 1-month follow-up period in the intervention group ( p  < 0.001). Considering partial eta squared, the effect of the intervention had the highest interaction effect on both variables of the sexual function index (η2 = 0.73) and sexual quality of life (η2 = 0.41). Conclusions The intervention program was a successful model for improving female sexual quality of life and female sexual function in breast cancer survivors. Trial registration IRCT20210926052601N1, 7–11-2021.

The unmet need for contraceptives among refugee adolescents is high globally, leaving girls vulnerable to unintended pregnancies. Lack of knowledge and fear of side effects are the most reported reasons for non-use of contraceptives amongst refugee adolescents. Peer counselling, the use of trained adolescents to offer contraceptive counselling to fellow peers, has showed effectiveness in increasing use of contraceptives in non-refugee adolescent resarch. To determine the effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda. A randomised controlled trial carried out in Palabek refugee settlement in northern Uganda, May to July 2019. Adolescents were included if they were sexually active or in any form of union, wanted to delay child bearing, and were not using any contraceptives. A total of 588 consenting adolescents were randomised to either peer counselling or routine counselling, the standard of care. Adolescents who received peer counselling were more likely to accept a contraceptive method compared to those who received routine counselling (PR: 1·24, 95% CI: 1·03 to 1·50, p = 0·023). Adolescents whose partners had attained up to tertiary education were more likely to accept a method than those whose partners had secondary or less education (PR: 1·45, 95% CI: 1·02 to 2·06, p = 0·037). In both groups, the most frequently accepted methods were the injectable and implant, with the commonest reasons for non-acceptance of contraception being fear of side effects and partner prohibition. Our data indicates that peer counselling has a positive effect on same day acceptance of modern contraceptives and should therefore be considered in future efforts to prevent adolescent pregnancies in refugee settings. Future peer counselling interventions should focus on how to effectively address adolescents' fear of side effects and partner prohibition, as these factors continue to impede decision making for contraceptive uptake.

This systematic review and meta-analysis study aimed to investigate the effect of sexual counseling based on PLISSIT (Permission, Limited Information, Specific Suggestions, and Intensive Therapy) and EX-PLISSIT models on sexual function, satisfaction, and quality of sexual life. We searched seven electronic databases (MEDLINE, CINAHL, Web of Science, Cochrane Library, ProQuest, Scopus, and PubMed). Studies published between January 1, 2010, and August 16, 2022, were included in the search. Eighteen articles were eligible for inclusion in the analysis. There was a significant difference in the sexual function scores of the PLISSIT and EX-PLISSIT groups and the comparison groups (standardized mean difference (SMD): 1.677; 95% CI 0.668, 2.686; p  < 0.05) and “sexual and communication satisfaction” sub-dimension of sexual life quality (SMD: 0.748; 95% CI 0.022, 1.475; p  < 0.05). There was no difference in the sexual satisfaction (SMD: 0.425; 95% CI − 0.335, 1.184; p  > 0.05) and quality of sexual life scores of the PLISSIT and EX-PLISSIT groups and the comparison groups (SMD: − 0.09; 95% CI − 0.211, 0.032; p  > 0.05). PLISSIT and EX-PLISSIT models-based sexual counseling on sexual function was affected by the moderator variables of the time of evaluation of the results after the intervention, type of comparison group, the study population, and by whom the intervention was applied. Sexual counseling based on the PLISSIT and EX-PLISSIT models improved sexual function scores and “sexual and communication satisfaction” sub-dimension of sexual life quality.

Pre-exposure prophylaxis (PrEP) for the prevention of HIV infection among young men who have sex with men is a critical part of the HIV prevention landscape in the US. Given the unique challenges and resources of young MSM negotiating safer sex practices, including PrEP, counseling and supportive discussions to optimize both PrEP use and sexual health protection more generally may facilitate reaching HIV prevention goals. Within the context of a large, open-label PrEP study (ATN110/113), support for sexual health promotion and PrEP use was provided through use of integrated Next Step Counseling (iNSC) as part of study visits. We detail iNSC and, using session documentation collected throughout this study, we characterize iNSC implementation and the content generated from these discussions. We detail features of iNSC, training of counselors and the implementation of iNSC in a multi-site PrEP study with young MSM in the US. Case report forms completed by iNSC counselors at study visits at weeks 4, 8, 12, 24, 36, and 48 were evaluated. Implementation of each intervention step for each discussion is summarized at and across timepoints, as well as features of specific steps (e.g., kinds of facilitators and barriers). Implementation differences by group (e.g., race/ethnicity, age) were examined. iNSC case report forms from 1000 sessions involving 178 unique participants ages 15–22 from sessions conducted between 2013 and 2015 were reviewed. High fidelity to iNSC steps in terms of inclusion in sessions was reported; 98–100% of sessions included critical steps for sexual health protection discussions and 96–98% for PrEP use discussions. The vast majority of sessions appeared to flow in line with iNSC’s emphasis on exploration and open discussion prior to considering specific needs and related strategies. Nearly three-quarters of sessions noted ‘commitment to staying negative’ as a motivator towards sexual health protection (more commonly reported by those identifying as White), while ‘assuming partner is negative’ was the most common challenge (less common for the older cohort), and ‘having access’ to a sexual health protection tool or strategy (besides PrEP) was the most common “need” (more common for those identifying as White or Latino). Carrying dose(s) to have them on-hand when needed was the most common PrEP adherence facilitator, drug and alcohol use was the most common challenge noted, and access to a dose when needed was the most common “need” (more common for participants self-identified as White). iNSC was implemented consistently throughout ATN110/113, and patient-centered discussions about sexual health protection and PrEP-use appeared feasible to incorporate into clinical care visits.

Background After hysterectomy, most patients experience psychological problems and sexual dysfunction that can affect their sexual quality of life (QOL). This study determined the effects of counselling based on the Extended Permission-Limited Information-Specific Suggestion-Intensive Therapy (EX-PLISSIT) model on sexual function and sexual QOL after hysterectomy among women attending hospitals in Sari, northern Iran. A randomised controlled trial was conducted between 2016 and 2017. Of 354 women undergoing hysterectomy, 80 women without anxiety, stress or depression who showed signs of sexual dysfunction were selected and, using blocked randomisation, were assigned to the intervention and control groups. The intervention group received two 1-h counselling sessions each week based on the EX-PLISSIT model. The control group received no counselling. Mood and sexual function and quality of life were measured using established tools (i.e. Depression, Anxiety and Stress Scale, Female Sexual Function Index (FSFI), and the Sexual Quality of Life - Female (SQOL-F)). Eight weeks after completion of counselling, outcomes were compared between the intervention and control groups using independent t-tests and Chi-squared, Mann-Whitney U, Wilcoxon, and Fisher tests. There were no significant differences between the two groups in terms of demographics and most other outcome variables. However, there were significant differences between the intervention and control groups in terms of sexual functioning (median (interquartile range (IQR) FSFI score 32.45 (28.47-33.52) vs 23.85 (20.52-26.45) respectively) and sexual quality of life (median (IQR) SQOL-F score 107.50 (91-108) vs 87 (62.75-96.25), respectively) at the 8-week follow-up (P < 0.001 for both). Use of the EX-PLISSIT model is recommended to sexual health care professionals.

Background: A concern with hierarchy messages, which promote male condoms and female-controlled barrier methods along a prevention continuum, is that they may discourage condom use. Goal: To measure male-condom and female-condom use among women who received hierarchy counseling and compare this with women counseled about condoms only. Study Design: Three observational cohorts that correspond to prevention message received were assembled, and consisted of female sexually transmitted disease clinic patients who were counseled about male condoms, female condoms, or a hierarchy message. The hierarchy message promoted male and female condoms, the diaphragm and cervical cap, spermicides, and withdrawal, in descending order of effectiveness against sexually transmitted diseases. After counseling, women were interviewed and returned for follow-up visits at 2 weeks, 4 months, and 6 months. The outcome was the mean proportion of male condom- or female condom-protected coital acts at each follow-up visit in the hierarchy cohort. The outcome was dichotomized as high (≥ 70% of coital acts protected) or low (< 70%), and generalized estimating equations were used to compare observed follow-up condom use with baseline within the hierarchy cohort and observed follow-up condom use between cohorts. It was assumed that condom use in persons not present at 6 months was equal to baseline levels, and condom use estimates were calculated for each full cohort that was initially enrolled. Results: The mean proportion of condom-protected coital acts in the hierarchy cohort was significantly increased from baseline at each follow-up visit. There were no differences in observed condom use during follow up between the hierarchy cohort and either the male-condom or the female-condom cohort. However, when the full cohort initially enrolled was considered, 6-month condom use was significantly higher in the hierarchy cohort than in the male-condom cohort. Conclusion: Hierarchy counseling was associated with a significant increase in condom use. Our findings suggest that offering a choice of male and female condoms results in increased protection over counseling in male condoms alone.

PurposeTo determine which health care provider and what timing is considered most suitable to discuss sexual and relational changes after prostate cancer treatment according to the point of view of men and their partners.MethodsA cross-sectional survey was conducted among men diagnosed with prostate cancer or treated after active surveillance, who received laparoscopic radical prostatectomy, brachytherapy, intensity-modulated radiotherapy, and/or hormonal therapy. If applicable, partners were included as well.ResultsIn this survey, 253 men and 174 partners participated. Mean age of participating men was 69.3 years (SD 6.9, range 45–89). The majority (77.8%) was married and average length of relationship was 40.3 years (SD 14.1, range 2–64). Out of 250 men, 80.5% suffered from moderate to severe erectile dysfunction. Half of them (50.2%, n = 101) was treated for erectile dysfunction and great part was partially (30.7%, n = 31) up to not satisfied (25.7%, n = 26). Half of the partners (50.6%, n = 81) found it difficult to cope with sexual changes. A standard consultation with a urologist-sexologist to discuss altered sexuality is considered preferable by 74.7% (n = 183). Three months after treatment was the most suitable timing according to 47.6% (n = 49).ConclusionsDuring follow-up consultations, little attention is paid to the impact of treatment-induced sexual dysfunction on the relationship of men with prostate cancer and their partners. A standard consultation with a urologist-sexologist 3 months after treatment to discuss sexual and relational issues is considered as most preferable.

ABSTRACT Objective: Reporting the experience of use of the PLISSIT model as tool for the nursing care of breast cancer survivors with sexual dysfunction. Method: case study developed from January to August 2017, in the outpatient mastology clinic and sexuality service of a maternity in Fortaleza, Ceará, Brazil, with 15 breast cancer survivors. Results: sexual counseling sessions were conducted using the PLISSIT model to address sexual issues, highlighting the particularities of women who experience survival after the treatment of breast cancer. Final considerations: the model used in the practice of nursing care is customary and allows identifying issues experienced by women, as it has easy availability and practicality for use by nursing professionals, helping to address sexual matters with greater tranquility. RESUMEN Objetivo: Informar la experiencia del uso del modelo PILSET como herramienta de cuidado de enfermería para sobrevivientes de cáncer de mama con disfunción sexual. Método: relato de experiencia desarrollado de enero a agosto de 2017, realizado en el ambulatorio de mastología junto con el servicio de sexualidad de una maternidad-escuela de Fortaleza, Ceará, Brasil, con 15 sobrevivientes de cáncer de mama. Resultados: se realizaron sesiones de asesoramiento sexual, utilizando el modelo PILSET para trabajar cuestiones sexuales, destacando las particularidades de la mujer que vive la sobrevida tras el tratamiento del cáncer de mama. Consideraciones finales: el modelo utilizado en la práctica del cuidado de enfermería es usual y permite identificar cuestiones vivenciadas por la mujer, pues es una herramienta de fácil disponibilidad y practicidad para profesionales de enfermería, ayudando a abordar cuestiones sexuales con mayor tranquilidad. RESUMO Objetivo: Relatar a experiência do uso do modelo PILSET como ferramenta de cuidado de enfermagem para sobreviventes de câncer de mama com disfunção sexual. Método: relato de experiência desenvolvido de janeiro a agosto de 2017, realizado no ambulatório de mastologia em conjunto com o serviço de sexualidade de uma maternidade-escola de Fortaleza, Ceará, Brasil, com 15 sobreviventes de câncer de mama. Resultados: realizaram-se sessões de aconselhamento sexual, utilizando o modelo PILSET para trabalhar questões sexuais, destacando as particularidades da mulher que vivencia a sobrevida após o tratamento de câncer de mama. Considerações finais: o modelo utilizado na prática de cuidado de enfermagem é usual e permite identificar questões vivenciadas pela mulher, pois é uma ferramenta de fácil disponibilidade e praticidade para profissionais de enfermagem, auxiliando abordar questões sexuais com maior tranquilidade.