BACKGROUND

In response to the need to provide for mental health services to address gender-related concerns in a higher education institute, the University of the Philippines (UP) Manila Center for Gender and Women Studies (CGWS) commissioned a project to formulate a framework for the increasing volume of referrals.

METHODOLOGY

A mixed methods study was done in order to gather data to create a responsive and practical mental health care service provision framework with and for service providers and service users in the university. An online survey (N=135), focus group discussion, key informant interviews, and a round table discussion were conducted, with constituents of the university recruited through purposive sampling.

RESULTS

A stepped-care model was proposed, consisting of: 1. Preventive Well-Being Resources, 2. Supportive Well-Being Interventions and Initial Screening Resources, 3. Structured Interventions, and 4. Interventions for Severe Mental Health Problems.

CONCLUSION

The framework formulated in collaboration with service providers and service users in the university addresses the goals of optimizing existing resources and enhancing service provision. Implementation and evaluation of this framework, as well as further information regarding the target population and their use of this model, are proposed avenues for further research.

Human ; Gender ; Gender Identity ; Sexual Harassment ; Mental Health ; Mental Health Services ; Lgbtq ; Sexual And Gender Minorities ; Psychiatry ; Psychology

Female ; Humans ; Anti-Mullerian Hormone ; Sexual Development ; Peptide Hormones

BACKGROUND

Without adequate preparation and competence, nursing students entering the practice might not respond effectively to the growing health and healthcare disparities among the LGBTQ+ population.

OBJECTIVE

Guided by Pacquiao's Framework for Culturally Competent Healthcare, the study aimed to describe and to compare nursing students' self-rated LGBTQ+ care competence by personal, sociocultural, and educational characteristics, and identify the relationship between LGBTQ+ care competence, level of compassion, and the number of LGBTQ+-related topics offered in nursing curriculum.

METHODS

A cross-sectional study was implemented through online survey among fourth-year nursing students (N = 208) from nursing schools in Metro Manila using a sociodemographic questionnaire, the Lesbian, Gay, Bisexual, and Transgender-Nursing Education Assessment instrument, the Revised Short Version of the Compassionate Love for Humanity Scale, and the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale. Data were analyzed using descriptive and inferential statistics.

RESULTS

Nursing students' overall LGBTQ+ care competence mean rating score was 5.21 out of 7.0. Attitudinal awareness had the highest mean rating score (mean= 6.34, SD= 0.98), followed by basic knowledge (mean= 4.93, SD= 1.27) and clinical preparedness (mean=4.25, SD=1.23). Significant differences in the overall LGBTQ+ care competence mean rating scores were found based on exposure to LGBTQ+-related media contents (p=.03), personal experience in caring for LGBTQ+ clients (p=.00), ethnicity (p=.020), friends' acceptance of LGBTQ.

CONCLUSION

Findings show that the current generation of nursing students has more positive awareness, acceptance, and attitudes toward the LGBTQ+ population. Embedding LGBTQ+ health in the nursing curriculum must be strategically placed.

Cultural Competency ; Education, Nursing ; Students, Nursing ; Sexual And Gender Minorities

Female ; Humans ; Consensus ; East Asian People ; Urogenital Abnormalities/surgery* ; Sexual Dysfunction, Physiological/surgery*

OBJECTIVE: To explore the genetic basis for a rare case with Disorder of sex development. METHODS: Clinical data of the patient was collected. Chromosomal karyotyping, SRY gene testing, whole exome sequencing (WES), low-coverage massively parallel copy number variation sequencing (CNV-seq), fluorescence in situ hybridization (FISH), and whole genome sequencing (WGS) were carried out. RESULTS: The patient, a 14-year-old female, had manifested short stature and dysplasia of second sex characteristics. She was found to have a 46,XY karyotype and positive for the SRY gene. No pathogenic variant was found by WES, except a duplication at Yp11.32q12. The result of CNV-seq was 47,XYY. FISH has confirmed mosaicism for a dicentric Y chromosome. A 23.66 Mb duplication on Yp11.32q11.223 and a 5.16 Mb deletion on Yq11.223q11.23 were found by WGS. The breakpoint was mapped at chrY: 23656267. The patient's karyotype was ultimately determined as 46,X,psu idic(Y)(q11.223)/46,X,del(Y)(q11.223). CONCLUSION The combination of multiple methods has facilitated clarification of the genetic etiology in this patient, which has provided a reference for the clinical diagnosis and treatment.
Female ; Humans ; Adolescent ; DNA Copy Number Variations ; In Situ Hybridization, Fluorescence ; Y Chromosome ; Sexual Development ; Mosaicism

Females increase aggression for mating opportunities and for acquiring reproductive resources. Although the close relationship between female aggression and mating status is widely appreciated, whether and how female aggression is regulated by mating-related cues remains poorly understood. Here we report an interesting observation that Drosophila virgin females initiate high-frequency attacks toward mated females. We identify 11-cis-vaccenyl acetate (cVA), a male-derived pheromone transferred to females during mating, which promotes virgin female aggression. We subsequently reveal a cVA-responsive neural circuit consisting of four orders of neurons, including Or67d, DA1, aSP-g, and pC1 neurons, that mediate cVA-induced virgin female aggression. We also determine that aSP-g neurons release acetylcholine (ACh) to excite pC1 neurons via the nicotinic ACh receptor nAChRα7. Together, beyond revealing cVA as a mating-related inducer of virgin female aggression, our results identify a neural circuit linking the chemosensory perception of mating-related cues to aggressive behavior in Drosophila females.
Animals ; Male ; Female ; Drosophila/physiology* ; Drosophila Proteins/physiology* ; Cues ; Sexual Behavior, Animal/physiology* ; Aggression/physiology* ; Drosophila melanogaster/physiology*

OBJECTIVE: To explore the discrepancy between behavioral-indicated candidacy and perceived candidacy (behavioral-perceived gap) and its associated factors of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM), so as to identify the focus population of PrEP interventions and to design and implement targeted interventions. METHODS: We recruited a sample of 622 HIV-negative MSM who were regular clients of a community-based organization located in Chengdu, China, from November to December 2021. A cross-sectional questionnaire was used to collect the participants' information on social demographics, PrEP-related knowledge and cognitions, and risk behaviors. In this study, behaviorally eligible for PrEP was defined as performing at least one type of high-risk behavior in the past six months, including inconsistent condom use, sex with an HIV-positive partner, confirmed sexual transmitted infections (STI) diagnosis, substance use, and post-exposure prophylaxis (PEP) experience. Logistic regression models were fitted, and multivariate analyses were adjusted for social demographics. RESULTS: Among the 622 eligible participants, 52.6% (327/622) were classified as behaviorally eligible for PrEP. Only 37.9% (124/327) of the participants perceived themselves as appropriate candidates for PrEP and 62.1% (203/207) had discrepancy between behavioral-indicated and perceived candidacy. 85.9% (281/327) had heard of PrEP, and 14.2% (40/281) accessed PrEP information through health care providers. Of the 327 participants eligible for behavior-indicated PrEP use, about half (47.1%) knew how to obtain PrEP medication and 33.0% had a professional PrEP counseling experience. The majority (93.3%) had no or few friends using PrEP. 54.1% scored eight or above in PrEP knowledge level. 66.7% reported having two or more sexual partners in the past six months. After adjusting for age and recruitment channel, we found six factors that were associated with perceived candidacy for PrEP, including PEP use [adjusted odds ratio (OR_A)=2.20; 95% confidence interval (CI): 1.33-3.63], PrEP availability (OR_A=1.69; 95%CI: 1.06-2.68), a greater number of PrEP-using friends (OR_A=4.92; 95%CI: 1.77-13.65), PrEP know-ledge (OR_A=2.21; 95%CI: 1.38-3.56), multiple sexual partnership (OR_A=1.77; 95%CI: 1.07-2.94), and perceiving a higher risk of HIV infection (OR_A=4.02; 95%CI: 1.73-9.32). Substance use during sex and PrEP information channel were not statistically associated with this beha-vioral-perceived gap. CONCLUSION We observed a high discrepancy between behavioral-indicated and perceived candidacy for PrEP among Chengdu MSM in China. Future PrEP implementation efforts should be made in skills training in assessing HIV infection risk, increasing PrEP knowledge, providing professional PrEP counselling, and fostering PrEP support environment.
Male ; Humans ; Homosexuality, Male/psychology* ; HIV Infections/psychology* ; Pre-Exposure Prophylaxis ; HIV ; Cross-Sectional Studies ; Sexual and Gender Minorities

There has been a dramatic increase in very young adolescent pregnancies in recent years, with pregnancies documented in children as young as 10 years old, likely from sexual abuse. This article presents a 10-year-old female who initially consulted at the emergency room in her 27th week of pregnancy as a result of recurrent sexual abuse. Prompt assessment, diagnosis, and appropriate referrals to Obstetrics, Pediatric Adolescent Clinic, Psychiatry, and Child Protection Unit rendered optimal management for the patient. Dilemmas encountered in managing the case included preterm labor, large-for-gestational-age baby, immature pelvis, and approach to the appropriate mode of delivery compounded with management of trauma from sexual abuse. A multidisciplinary approach in managing these dilemmas achieved optimal outcomes with the patient delivering a live baby boy, appropriate for gestational age via cesarean section at term.
Child abuse ; pregnancy in adolescence ; preteen pregnancy ; teenage pregnancy ; sexual

HIV testing is the first step in HIV prevention and control, the rate of HIV infection is high and the rate of HIV testing is low among men who have sex with men (MSM) in China. HIV self-testing provides MSM with a new choice and plays a vital role in expanding the coverage of HIV testing in this population. This paper reviews HIV self-testing and associated factors among MSM in China and provides a reference for promoting HIV self-testing in this population.
Male ; Humans ; HIV Infections/epidemiology* ; Homosexuality, Male ; Self-Testing ; Sexual and Gender Minorities ; HIV Testing ; China/epidemiology*

Objective: To understand the compliancy to on-demand HIV pre-exposure prophylaxis (PrEP) and related factors in men who have sex with men (MSM) accessing to PrEP service through an Internet platform. Methods: A cross-sectional study method was used to recruit survey respondents through the Heer Health platform from July 6 to August 30, 2022, and a questionnaire survey on the current status of medication use was conducted in MSM who use PrEP through the platform and take medication on demand. The MSM's information collected in the survey mainly included socio-demographic characteristics, behavioral characteristics, risk perception characteristics, PrEP awareness and the status of dose taking. Univariate and multivariate logistic regression analyses were used to evaluate factors related with compliancy to PrEP. Results: A total of 330 MSM who met the recruitment criteria were included during the survey period, with a valid response rate of 96.7% (319/330) to the questionnaire survey. The age of the 319 MSM was (32.5±7.3) years. Most of them had education level of junior college or college and above (94.7%, 302/319), most of them were unmarried (90.3%, 288/319), most of them had full-time works (95.9%, 306/319), and 40.8% of them had average monthly income ≥10 000 yuan (130/319). The proportion of the MSM with good compliancy to PrEP was 86.5% (276/319). The results of univariate and multivariate logistic analyses showed that the MSM with good awareness of PrEP had relatively better compliancy to PrEP compared with those with poor awareness of PrEP (aOR=2.43, 95%CI:1.11-5.32). Conclusions: The compliancy to on-demand PrEP was good in MSM who accessed to the services through Internet platform, but there is still a need to strengthen PrEP promotion in MSM for the further improvement of PrEP compliancy and reduction of the risk for HIV infection in this population.
Male ; Humans ; Adult ; HIV Infections ; Cross-Sectional Studies ; Homosexuality, Male ; Pre-Exposure Prophylaxis ; Sexual and Gender Minorities ; Internet