OBJECTIVES: The epidemic of acquired immune deficiency syndrome (AIDS) among men who have sex with men (MSM) is severe in China. And MSM has now become a key population for the infection and transmission of AIDS. At present, the bottleneck of AIDS prevention and control among MSM population is low rate of continuous condom use and high incidence of unsafe sexual behavior. Inductive summarization of the literature revealed that the most critical reason for low rate of continuous condom use among the MSM population was condom-related stigma. Although many studies mentioned condom-related stigma among MSM populations, there has been no any definition of MSM-related condom stigma and no measurement for it. Therefore, the paper aims to explore barriers to condom use among MSM, then construct the conceptual and operational definition of "MSM-related condom stigma" through Meta synthesis and concept synthesis, and provide a new perspective for AIDS prevention and control among MSM. METHODS: Based on evidence-based method, "PICoS" framework and Meta-synthesis was used to include the literatures. Then, we used synthesized qualitative evidence from included studies to construct the concept and operational definition of MSM-related condom stigma by the means of thematic analysis and concept synthesis. RESULTS: According to the results of the concept synthesis, MSM-related condom stigma refers to any taboos or misbeliefs about condom use or feeling ashamed or embarrassed to talk about using condoms which perceived by individuals at the individual, interpersonal, and social levels.It was demonstrated through 4 sub-themes at operational level: a symbol of distrust, a symbol of HIV/sexual transmitted infections (STIs) prevention, a symbol of an embarrassing topic, and a symbol of violating the traditional cognition of sexual intercourse. According to the Social-ecological Model (SEM), a symbol of distrust refers to that the MSM population believes that not using condoms represents mutual trust between sexual partners, while using condoms is difficult to express intimacy, trust and loyalty between sexual partners. A symbol of HIV/STIs prevention at the interpersonal level refers to that the MSM population believes that condom use is a "symbol" for the prevention or infection of AIDS; on the one hand, if someone proposes to use condoms, he may be considered infected with HIV or have unsafe sex experiences, thus, making it difficult to propose condom use; on the other hand, if they believe that sexual partners are "AIDS free" (often a wrong perception, such as sexual partners may have the risk of AIDS infection although they do not have AIDS), it is considered that condom use is completely unnecessary. The environmental level includes a symbol of an embarrassing topic and a symbol of violating the traditional cognition of sexual intercourse. A symbol of an embarrassing topic refers to the MSM population feels shame about topics related to sexual behavior and is embarrassed to carry/buy/propose condom use or be ashamed to engage in conversations about whether to use condoms during sexual behavior. And a symbol of violating the traditional cognition of sexual intercourse: The MSM population have limitations in their perception of "sex" or "sexual behavior" and believe that real sex (behavior) is unobstructed contact between the bodies and exchange between all body fluids. CONCLUSIONS The concept of MSM-related condom stigma is proposed for the first time, and its operational definition is given. The concept includes 3 levels and 4 dimensions. It is helpful to understand MSM people's attitude and cognition towards condoms, and adds indicators with cultural sensitivity and behavioral sensitivity to the behavioral intervention for AIDS in the future.
Acquired Immunodeficiency Syndrome/prevention & control* ; Coitus ; Condoms ; HIV Infections/prevention & control* ; Homosexuality, Male ; Humans ; Male ; Sexual Partners ; Sexual and Gender Minorities

PURPOSE: This study aimed to identify the factors that impact the intention of sexual abstinence among female college students. The approach was based on Ajzen's theory of planned behavior and the parent-adolescent communication of contextual factors. METHODS: A total of 189 female university students in the first to fourth grades at two universities in Honam region participated in the study. The collected data were analyzed using hierarchical stepwise multiple regression using SPSS 21.0. RESULTS: The major factor that influences the intention of sexual abstinence among female college students was attitudes toward sexual behavior (β=0.53, p<0.001). Other factors, in descending order of their impact, were subjective norms toward friends (β=0.25, p<0.001), experience of sexual intercourse (β=−0.19, p<0.001), and subjective norms toward parents (β=0.09, p=0.040). Taken together, the aforementioned factors explained 81.1 % of the total variance. CONCLUSION: Female college students' intention to abstain from sexual behaviors requires education promoting moderate and conservative positions. The participants' subjective norms concerning sexual behaviors as perceived by friends and parents were also important. The results of this study provide meaningful implications for education of parents, sexual education of female college students, and sexual counseling programs.
Coitus ; Counseling ; Education ; Female ; Friends ; Humans ; Intention ; Parents ; Sexual Abstinence ; Sexual Behavior

Recto-vaginal fistulas are difficult to treat due to their high recurrence rate. Currently, no single surgical intervention is universally regarded as the best treatment option for rectovaginal fistulas. We present a case of recurrent recto-vaginal fistula surgically treated with a gracilis pull-through flap. The surgical goals in this patient were complete excision of the recto-vaginal fistula and introduction of fresh, vascularized muscle to seal the fistula. A defunctioning colostomy was performed 1 month prior to the present procedure. The gracilis muscle and tendon were mobilized, pulled through the freshened recto-vaginal fistula, passed through the anus, and anchored externally. Excess muscle and tendon were trimmed 1 week after the procedure. Follow-up at 4 weeks demonstrated complete mucosal coverage over an intact gracilis muscle, and no leakage. At 8 weeks post-procedure, the patient resumed sexual intercourse with no dyspareunia. At 6 months post-procedure, her stoma was closed. The patient reported transient fecal staining of her vagina after stoma reversal, which resolved with conservative treatment. The fistula had not recurred at 20 months post-procedure. The gracilis pull-through flap is a reliable technique for a scarred vagina with an attenuated rectovaginal septum. It can function as a well-vascularized tissue plug to promote healing.
Anal Canal ; Cicatrix ; Coitus ; Colorectal Surgery ; Colostomy ; Dyspareunia ; Female ; Fistula ; Follow-Up Studies ; Humans ; Reconstructive Surgical Procedures ; Rectovaginal Fistula ; Recurrence ; Tendons ; Vagina

OBJECTIVES: This study aimed to analyze nationwide representative data from the 11(th) Korean Youth Health Risk Behavior Web-Based Survey to determine whether factors including socio-demographics, smoking and alcohol consumption, were factors related to high school students that had experienced sexual intercourse. METHODS: A total of 33,744 students (17,346 boys and 16,398 girls) in 1(st), 2(nd), and 3(rd) grade at high school were analyzed. SPSS complex samples methods were used for analyses. Socio-demographic and health risk behaviors (type of region of residence, family structure, and economic status, student academic achievement, gender, high school grade, pocket money, student smoking, alcohol consumption, and having engaged in sexual intercourse) were considered as independent variables. RESULTS: There were 3.6% of girls and 9.9% of boys in high school that were sexually active. This behavior and the average number of cigarettes smoked daily, and alcohol consumed weekly, represented a dose-response relationship, after considering confounding factors. Compared with students that did not smoke or consume alcohol, smoking 1–9 cigarettes per day and consuming 1–6 cups of alcohol and group “smoking more than 10 cigarettes per day and consuming more than 7 cups of alcohol, had a 5.94 and 22.25 higher risk of having had sexual intercourse, respectively. CONCLUSION: Cigarette smoking and alcohol consumption were associated with an increased likelihood of high school students engaging in sexual intercourse.
Adolescent ; Alcohol Drinking ; Coitus ; Female ; Humans ; Risk-Taking ; Sexual Behavior ; Smoke ; Smoking ; Tobacco Products

PURPOSE: This study was conducted to investigate the relationship between short message service and social media use, and sexual intercourse of high school students in Cambodia. METHODS: Four hundred and eighty-three high school students from three schools in rural provinces were interviewed with structured questionnaires. RESULTS: Sexual intercourse was found significantly more frequent among male students than among female students (p=.001), among alcohol drinkers than among non-drinkers (p<.001), among those who were not taking pictures with mobile phones than among those who were (p=.045), and among those who were exchanging SMS between boyfriend and girlfriend than among those who were not (p=.006). The students who were sending SMS by mobile phones were 5.83 times as likely to have sexual intercourse as their counterparts (p=.020), who were taking pictures with mobile phone were 0.04 times as likely as those who were not (p=.045) and the odds ratio was 15.19 times as high in alcohol drinkers as in non-drinkers (p=.001). CONCLUSIONS: Efforts should be made to encourage positive and effective use of social media among adolescents to maintain their sexual health.
Adolescent ; Cambodia ; Cell Phones ; Coitus ; Female ; Humans ; Male ; Odds Ratio ; Reproductive Health ; Social Media ; Text Messaging

OBJECTIVES: This study investigates the relationship between risky health behaviors, occurrence of oral symptoms, and oral health-related behaviors. METHODS: The subjects were 60,040 adolescents selected from the web-based survey from the 2018 Korean Youth Health Behavior of Korean Center for Disease Control. The data were analyzed using a combined sample analysis method. The software SPSS version 12.0 was used to conduct the analyses. RESULTS: 1. Men were observed to partake in risky health behavior at significantly higher rates than were women in terms of smoking, drinking, drugs, and sexual intercourse. Our data showed the percentages of men taking part in these behaviors to be 21.1%, 46.4%, 1.3%, and 7.6%, respectively (P<0.01). 2. Of all subjects, 49.1% brushed their teeth more than three times a day, and 43.6% brushed more than twice a day. Further, a significantly higher number of men (46.0%) did not brush their teeth after lunch compared with women (29.1%) (P<0.01). 3. Of all subjects, 52.9% had developed oral symptoms in the previous year. The rate of women experiencing oral symptoms was significantly higher, at 58.1%, compared with men (48.1%, P<0.01). 4. Risky health behavior, such as smoking, drinking, drugs, and sexual intercourse, was significantly associated with occurrence of oral symptoms (P<0.01). Those that had not partaken in smoking, drinking, and sexual intercourse were significantly lower by 0.73, 0.87, and 0.89 times, respectively, compared with those that responded with “yes” (P<0.01). CONCLUSIONS: We have evaluated the rates of risky health and oral health-related behavior in Korean youth and identify their association with the oral symptoms. It is essential to understand the risks of oral diseases so that appropriate oral health education can be provided to adolescents for promoting behavioral changes.
Adolescent ; Centers for Disease Control and Prevention (U.S.) ; Coitus ; Drinking ; Education ; Female ; Health Behavior ; Humans ; Korea ; Lunch ; Male ; Methods ; Oral Health ; Risk-Taking ; Smoke ; Smoking ; Tooth

Male sexual dysfunction refers to a phenomenon in which a man experiences difficulty at any stage during the process of sexual intercourse. In general, erectile dysfunction is regarded as the most representative form of sexual dysfunction, but various other diseases can also be categorized as male sexual dysfunction, including sexual arousal disorder, decreased libido, ejaculation disorder, and Peyronie's disease. Causes of sexual dysfunction include chronic diseases, such as diabetes, hypertension, dyslipidemia, and obesity. In addition, some medications, surgical procedures, and traumas can cause sexual dysfunction. However, aging is the most important cause of male sexual dysfunction. To diagnose and treat elderly patients who complain of male sexual dysfunction, it is first necessary to become familiar with the characteristics of sexual dysfunction in elderly men. The prevalence rates of metabolic syndrome, hypertension, diabetes, dyslipidemia, coronary artery disease, stroke, and depression are higher among elderly men than among younger men; furthermore, the elderly are at a higher risk for the development of kidney, hepatic, spinal cord, and neurological diseases. Notably, anti-hypertensive agents can affect erectile function in elderly men: sexual dysfunction may be severe or the response to treatment may be poor. For satisfactory treatment, spousal factors should also be considered.
Aged ; Aging ; Antihypertensive Agents ; Chronic Disease ; Coitus ; Coronary Artery Disease ; Depression ; Diagnosis ; Dyslipidemias ; Ejaculation ; Erectile Dysfunction ; Eunuchism ; Humans ; Hypertension ; Kidney ; Libido ; Male ; Obesity ; Penile Induration ; Prevalence ; Sexual Dysfunction, Physiological ; Sexual Dysfunctions, Psychological ; Spinal Cord ; Stroke ; Testosterone

The increase in life expectancy has caused attention to be focused on quality of life in the elderly. Sexual health is an important part of physical health and quality of life, and poor health is associated with both a decline in sexual activity with age and sexual dysfunction. Herein, we review the topics of sexual function, sexual activity, the prevalence rate of sexual dysfunction and its risk factors, changes in sexuality-related attitudes, the relationship between sexual health and physical health, and the effects of sexual health on quality of life in the elderly. Sexual activity is associated with physical health, and is also an important component of enjoying life. Sexual activities include sexual intercourse and physical intimacy, which are indicators of sexual health in the elderly. Good physical health, stable sexual partners, and regular sexual activity are important for maintaining sexual health in old age Therefore, sexual health needs to be considered as part of the management of geriatric patients.
Aged ; Coitus ; Humans ; Life Expectancy ; Prevalence ; Quality of Life ; Reproductive Health ; Risk Factors ; Sexual Behavior ; Sexual Partners

PURPOSE: This study investigated the sexual behaviors, emotional state, and suicide-related characteristics of female adolescents with sexual experience. METHODS: This is a secondary data analysis study using the data of the 11th (2015) Youth Health Behavior Online Survey. The subjects were 889 female students who had sexual intercourse experience in middle and high schools in the Republic of Korea. For data analysis, descriptive statistics, χ² test, and hierarchical logistic regression were used. RESULTS: Among the subjects, 22.2% reported having experienced homosexual or bisexual relations. The sexual debut time of 31.9% of the subjects was in elementary school or earlier, while 8.1% and 10.7% experienced pregnancy and sexually transmitted diseases, respectively. They reported negative emotional states (high stress 51.7%, unhappiness 17.8%, depressive mood 9.8%) and substantial suicide experiences (suicidal ideation 33.6%, suicidal plan 16.6%, suicidal attempt 13.2%). Through hierarchical logistic regression (Cox & Snell R²=.31), the influencing factors for suicide ideation identified included being subjected to sexual relations, experience of pregnancy, perceived stress and happiness, and depressive mood. CONCLUSION: It is important to prevent negative mental health consequences among female students with early sexual experience. Sexual education should strengthen their physical and mental safety through psychological care strategies.
Adolescent ; Bisexuality ; Coitus ; Education ; Female ; Happiness ; Health Behavior ; Homosexuality ; Humans ; Logistic Models ; Mental Health ; Pregnancy ; Republic of Korea ; Sexual Behavior ; Sexually Transmitted Diseases ; Statistics as Topic ; Suicidal Ideation ; Suicide

ObjectiveTo study the clinical application value of the penile erectile strength measurement (PESM) band in the differentiation of psychogenic from organic erectile dysfunction (ED).

METHODSEighty ED patients unable to achieve or maintain adequate penile erection to complete sexual intercourse were included in the experimental group and another 40 healthy subjects with normal erectile function enrolled as controls. The ED cases were classified into mild, moderate and severe ED according to the IIEF-5 scores and divided into psychogenic and organic ED based on the results of the nocturnal penile tumescence (NPT) test. Then all the subjects underwent a three-night continuous monitoring with the PESM band and, according to the band fracture rate, the ED cases were also classified into psychogenic and organic ED. The rates of missed diagnosis, misdiagnosis and diagnostic coincidence of PESM were calculated with the results of NPT as the standard for differentiating psychogenic from organic ED.

RESULTSThe results of NPT tests revealed 51 cases of psychogenic and 29 cases of organic ED in the experimental group. The band fracture rate in PESM was 95.0% in the mild, 80.9% in the moderate and 52.8% in the severe ED patients. Of the 51 cases of psychogenic ED detected by NPT test, 43 were diagnosed as psychogenic and the other 8 as organic ED with the PESM band, with a coincidence rate of 84.3%. Of the 29 cases of organic ED revealed by NPT test, 5 were diagnosed as psychogenic and the other 24 as organic ED by PESM, with a coincidence rate of 82.8%. Normal erectile function with three-level fracture of the band was observed in the PESM of the normal controls, which showed a coincidence rate of 100% with the results of NPT tests. Based on the standard of the NPT test, the rates of missed diagnosis, misdiagnosis and diagnostic coincidence of the PESM band in differentiating psychogenic from organic ED were 15.7%, 17.2%, and 83.8%, respectively, with a Kappa value of 0.656 (P <0.05).

CONCLUSIONSThe penile erectile strength measurement band can be used as a screening tool for initial differentiation of psychogenic from organic ED.

Case-Control Studies ; Coitus ; Diagnostic Errors ; statistics & numerical data ; Erectile Dysfunction ; classification ; diagnosis ; physiopathology ; psychology ; Humans ; Male ; Penile Erection ; physiology