Background: Genital herpes is one of the most common sexually transmitted infections in the United States. As genital herpes is incurable and contagious, individuals with genital herpes face the decision to disclose their status to potential sexual partners with each new relationship formed. Such disclosure places individuals with genital herpes in a position to face rejection, which is commonly reported as one of the most concerning aspects of having genital herpes. The present study seeks to further understand the nature of genital herpes disclosure by addressing two core aims: 1) to understand determinants of and reasons for disclosure and non-disclosure and 2) to explore the relationship between past partner reactions to a disclosure and future intentions to disclose. Methods: Data on genital herpes disclosure experiences were collected via an online questionnaire, which was distributed through a variety of online channels including social media websites and email lists. Individuals who self-identified as having genital herpes and were 18 years and older were eligible for participation. Results: In examining Aim 1, the majority of participants (80.4%) disclosed to their last sexual partner. Age, relationship length, type of relationship, and expectations of a partner's response were significantly associated with the decision to disclose at the bivariate level. Expectations of a partner's reaction (AOR = .20, 95% CI .074-.539) and relationship type (AOR = 8.31, 95% CI 1.96-35.32) remained significant in multivariable modeling, explaining 45.2% of the variance in disclosure. Respondents who reported being in socially committed relationships and those who expected more positive partner reactions to a disclosure were more likely to disclose. Disclosure was also significantly associated with many romantic relationship building activities (e.g., establishing an exclusive relationship) but largely not associated with the sexual progression of a relationship. The decision to disclose was commonly multi-faceted, with the majority of participants reporting more than one reason that they did or did not disclose. Primary reasons for disclosure included "I wanted to be honest", "To protect my partner from getting herpes", and "It's my partner's right to know", while the most common reasons for non-disclosure were "I was concerned my partner would react badly", "I was ashamed", and "I was concerned that my partner would have rejected me". Regarding Aim 2, participants reported low levels of negative reactions and perceived rejection in response to their last disclosure experience. Intentions to disclose in the future were high among those who anticipated future sex partners. Discussion: The decision to disclose is often multi-faceted, and relationship characteristics play a key role in the decision to disclose. Among those who did disclose in this study, the majority did not report negative repercussions, including bad partner reactions and rejection. Future studies should examine if individuals are able to accurately assess potential partner reactions in order to better understand the differences between those who choose not to disclose and those who choose to disclose but experience a negative partner reaction or rejection.

Bakgrund: Varje år könsstympas fler än 2 miljoner kvinnor. Traditionen att könsstympa kvinnor går så långt tillbaka i historien att ingen historiker i dagsläget kan säga exakt hur, var och varför denna sedvänja uppstod. Det förekommer i ett trettiotal länder. Ingreppet sker ofta utan smärtlindring, sterila instrument och kompetent personal. I Sverige är kvinnlig könsstympning brottsligt, lagen gäller alla svenska medborgare oavsett om det sker inom Sveriges gränser eller utanför. Antalet könsstympade kvinnor i Sverige har ökat i takt med ökad invandring. Kvinnlig könsstympning kan ses som ett övergrepp och kan ge konsekvenser för kvinnor livet ut. Syfte: Syftet var att belysa de fysiska, psykiska och sociala konsekvenserna för kvinnor som genomgått könsstympning. Metod: En litteraturstudie genomfördes enligt Forsberg (2006) och startade med sökningar i databaserna Cinahl och PubMed. Sju kvantitativa och fyra kvalitativa artiklar valdes ut för analys. Resultat: De fysiska konsekvenserna rörde främst miktion, menstruation och sexuellt samliv. Känslomässiga trauman och en känsla av förlust dominerade de psykiska konsekvenserna. Gällande de sociala konsekvenserna berördes kvinnornas identitet till stor del samt deras upplevelser av hur västerlänningar ser på dem. Resultatet visar på övervägande negativa fysiska, psykiska och sociala konsekvenser. Även positiva aspekter har framkommit. Diskussion: I resultatet framgick tre större teman som var gemensamt för de fysiska, psykiska och sociala konsekvenserna. Dessa var kulturkrock, sociala påtryckningar och individ. De kan bidra till att förbättra omvårdnaden av kvinnor som genomgått könsstympning. Diskussionen inspireras av teorin Theory of cultural marginality där fokus ligger på att förklara människors reaktioner då två kulturer kolliderar. / Background: Each year, about 2 million women undergoes genital mutilation. The tradition of genital mutilation of women goes so far back in history that no historians in our time can say exactly how, where and why this practice occurred. The only thing we know is that the practice of female genital mutilation is performed in about thirty countries. The surgery is often done without analgesia, sterile instruments and medically skilled personnel. In Sweden, genital mutilation is a crime and the law applies to all Swedish citizens, regardless of whether it occurs within Sweden's borders or outside. The number of genitally mutilated women in Sweden has increased in line with increased immigration. Genital mutilation can be seen as an assault and may have consequences for women throughout their lives. Purpose: The purpose was to illuminate the physical, psychological and social consequences for women who have undergone genital mutilation. Methods: A literature review was conducted in accordance to Forsberg (2006). The search started out by using two databases, Cinahl and PubMed. Seven quantitative and four qualitative articles were selected for analysis. Results: The physical consequences were related to urination, menstruation and sexual intimacy. Emotional trauma and a sense of loss dominated the psychological consequences. The two largest social consequences that were found were the women's identity and their experiences of how westerners experience them. The result shows predominantly negative physical, psychological and social consequences, although positive aspects also emerged. Discussion: The results showed three major themes that were common to the physical, psychological and social consequences. These were culture clash, social pressures and individuals. They can help to improve the care of women who have undergone genital mutilation. The discussion was inspired by the theory "Theory of cultural marginality" where the focus is on explaining people's reactions when two cultures collide.

Female genital cutting/circumcision/mutilation (FGC) is found predominantly in the Sahel, Northern Africa, removing parts/all of the clitoris, labia minora and majora in girls. Cutting the highly innervated external genitalia may change sensory processing leading to chronic pain. Fourteen Somali women in the Greater Toronto Area (21-46, Type III FGC) completed qualitative, quantitative and psychophysical methods to evaluate pain. Interviews analyzed by interpretive phenomenology form the core method, examining circumcision stories and present, embodied life. The second Short Form McGill Pain Questionnaire and quantitative sensory testing with a vulvalgesiometer form secondary components. Somali women with FGC have pain-filled stories about circumcision and daily life. Socio-cultural considerations are central for women to comprehend how their own bodies feel. SF-MPQ-2 indicates low intensity or no pain symptoms; however, many body regions were indicated. QST reveals low vulvar pressure-pain thresholds. Reports from three measures suggest that FGC may cause sensory changes including chronic pain.

Female genital cutting/circumcision/mutilation (FGC) is found predominantly in the Sahel, Northern Africa, removing parts/all of the clitoris, labia minora and majora in girls. Cutting the highly innervated external genitalia may change sensory processing leading to chronic pain. Fourteen Somali women in the Greater Toronto Area (21-46, Type III FGC) completed qualitative, quantitative and psychophysical methods to evaluate pain. Interviews analyzed by interpretive phenomenology form the core method, examining circumcision stories and present, embodied life. The second Short Form McGill Pain Questionnaire and quantitative sensory testing with a vulvalgesiometer form secondary components. Somali women with FGC have pain-filled stories about circumcision and daily life. Socio-cultural considerations are central for women to comprehend how their own bodies feel. SF-MPQ-2 indicates low intensity or no pain symptoms; however, many body regions were indicated. QST reveals low vulvar pressure-pain thresholds. Reports from three measures suggest that FGC may cause sensory changes including chronic pain.

Bakgrund: Kvinnlig könsstympning är en gammal sed som är vanligt förekommande i flera länder. Seden innebär att delar av det kvinnliga könsorganet avlägsnas. Det beräknas att två miljoner flickor utsätts årligen. I vilken omfattning ingreppet sker i Sverige är okänt, men det förekommer. I Sverige är alla former av ingreppet förbjudet. Skolsköterskan har möjlighet att möta och hjälpa flickor som riskerar eller har utsatts för kvinnlig könsstympning. Syftet: Syftet med denna studie är att belysa skolsköterskors upplevelser kring kvinnlig könsstympning bland flickor i skolan. Metod: Kvalitativa intervjuer med fyra skolsköterskor i en kommun i Mellansverige samt frågeformulär från sju skolsköterskor i olika delar av Sverige. Kvalitativ innehållsanalys användes som analysmetod. Resultat: Skolsköterskorna upplevde känslor av Kluvenhet, Osäkerhet och Medkänsla. Samt att kvinnlig könsstympning var Känsligt men angeläget att samtala om. Diskussion: Resultatet i denna studie fokuserar på skolsköterskors upplevelser, vilket skiljer sig ifrån tidigare studier i ämnet. I denna studie framkommer det en osäkerhet och rädsla inför att samtala, samt en vilja att hjälpa utan att döma. Detta tyder på att skolsköterskor upplever en utmaning. De behöver stöd och utbildning för att våga möta flickor som utsatts eller riskerar att utsättas för kvinnlig könsstympning. / Background: Female genital mutilation is an old ritual common in several different countries. In female genital mutilation parts of the female genital organ are removed. About two millions girls are exposed every year. Female genital mutilation occurs in Sweden, but to what extent is unknown. All types of genital mutilation are forbidden in Sweden. School nurses have an opportunity to meet and aid girls who are at risk or have been subject to genital mutilation. Aim: The aim of this study is to highlight school nurses´ experience of female genital mutilation among girls in school. Method: A qualitative interview study with four school nurses in a municipality in the central of Sweden as well as qualitative questionnaire from seven school nurses in different parts of Sweden. The material was analyzed using qualitative content analysis. Results: School nurses experienced feelings of Ambivalence, Uncertainty and Compassion. As well as the subject being Sensitive but Vital to talk about. Discussion: The results of this study focus on school nurses experience, which differs from previous studies on the subject. The study shows an uncertainty and fear of talking, and a willingness to help without judging. This indicates that school nurses experience challenges and are in need of support and training in order to meet girls who have been or may be subject to female genital mutilation.

Today around 28 000 women originally from countries where FGM is practised, are living in Sweden. Many of them are at childbearing age which means that knowledge about FGM and its consequences is of outmost importance during delivery. The aim of this study is to describe current research on how to manage the delivery, regarding deinfibulation and the following stitching as well as the risk of complications when the labouring woman is mutilated. This review of literature is based on 12 scientific articles published between years 1989 – 2005. Five different databases have been searched with use of a large number of keywords.The review found that no scientific research has been carried out that describes how deinfibulation and following stitching should be managed when the woman is mutilated. All available articles within this area are referring to best practice only. The review also found that the conclusions of the studies are contradictory. The majority, however, show an increased frequency for prolonged labour that could be related to FGM. The three largest studies also show an increased rate of caesarean section among mutilated women. In the few studies that examine haemorrhage, the majorities show an increased tendency to bleed, that could be related to FGM. Several articles emphasize the importance of good routines for deinfibulation to reduce the risk for complications.In summary it can be established that due to methodological problems in many studies, no reliable conclusion can be made that the researched complications exists to a greater extent when the woman is mutilated

Some cultures have customs against women. The sati tradition in India is one of them. According to sati, if the husband dies the woman is set on fire with his corpse. These women are believed to become immortal saints. A woman who dies burning herself on her husband&rsquo / s funeral fire is considered virtuous, and are believed to go to Heaven. Another tradition is &ldquo / female circumcision.&rdquo / It is performed in African countries. People believing in the necessity of this custom circumcise women by cutting their clitoris. Circumcised women cannot have sexually pleasure. These women are there to satisfy men&rsquo / s desires and give birth to babies. The third tradition is the general name of which is t&ouml / re is performed in the eastern parts of Turkey. According to t&ouml / re, women are put on trial by their families and killed if they have any sexual relationships without marriage bond. In other words, even if a woman is raped, she is found guilty because of having a sexual relationship. In this thesis, these issues and how women are degraded in cultures will be discussed by using the works of famous Indian, Black American and Turkish writers. The books that are discussed in this thesis, Nayantara Sahgal&rsquo / s &ldquo / Rich Like Us,&rdquo / Lakshmi Persaud&rsquo / s &ldquo / Raise the Lanterns High,&rdquo / &ldquo / Possessing the Secret of Joy&rdquo / by Alice Walker and &ldquo / Bliss&rdquo / by Z&uuml / lf&uuml / Livaneli all contribute to this study showing how women are oppressed by different customs in different countries, the common point of which is to serve men&rsquo / s interests.

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, but few studies have examined the progression from HPV infection to disease in men. Genital condyloma are the most common clinical manifestation of HPV infection. Though not associated with mortality, condyloma are a source of emotional distress, and treatment is often painful with a high recurrence rate. The aims of this study were to examine the distribution of HPV types present on the surface of condyloma, estimate the incidence of condyloma overall and after type-specific HPV infections, assess the sociodemographic and sexual behavior factors independently associated with incident condyloma, and examine the concordance between HPV types detected on the surface and in the tissue of condyloma. Participants included 2,487 men from the United States, Brazil, and Mexico who were enrolled in the prospective HPV in Men (HIM) Study and followed every six months for up to four years. At each study visit men completed a computer-assisted-self-administered risk factor questionnaire and samples of healthy penile skin were obtained to test for HPV DNA. A trained clinician examined men for the presence of condyloma and swabbed the surface of lesions to test for HPV DNA. Men were followed for a median of 17.9 months and 112 incident condyloma were identified. Thirty-four external genital lesions were also biopsied to test for HPV within the lesion tissue. PCR was used to test for HPV DNA and Linear Array was used to genotype 13 oncogenic and 24 non-oncogenic HPV types in samples obtained from swabbing the lesion surface. The LiPa assay was used to genotype 20 HPV types in biopsy samples. The Kaplan-Meier method was used to estimate incidence and Cox proportional hazards models were used to examine factors independently associated with incident condyloma. Using biopsy samples as the gold standard, sensitivity and specificity were calculated to examine concordance between HPV types detected on the surface and within the tissue of condyloma. Condyloma incidence was 2.35 per 1,000 person-years. HPV 6 (43.8%), 11 (10.7%), and 16 (9.8%) were the most common types detected on condyloma. The probability of developing condyloma within 24-months of an incident HPV 6/11 infection was 14.6% (95% confidence interval (CI): 7.5-21.1). The median time to condyloma development was 17.1 months (95% CI: 12.4-19.3), with the shortest time to detection observed among men with incident HPV infections with types 6/11 only (6.2 months; 95% CI: 5.6-24.2). Factors associated with condyloma were incident HPV 6/11 infection (hazard ratio (HR) = 12.42; 95% CI: 3.78-40.77), younger age (HR = 0.43; 95% CI: 0.26-0.77; 45-70 vs. 18-30 years), high lifetime number of female partners (HR = 5.69; 95% CI: 1.80-17.97); 21 or greater vs. 0), and sexual behaviors in the previous three months including infrequent condom use (HR = 2.44; 95% CI: 1.16-5.14;

The immune-reactive sperm are kept separate from the body by epithelial barriers such as the blood-testis barrier (BTB). While these barriers are beneficial for the protection of sperm from toxicants, they can make treating these areas difficult due to preventing the entry of pharmacological agents. This is especially an issue in the treatment of HIV and Ebola infection based on the ample evidence that these viruses are able to survive and spread from within the male genital tract (MGT), but only a few antiviral drugs are known to access the MGT. Transporters that line the epithelial barriers of the MGT, especially the BTB, are important for determining whether or not a drug is able to penetrate into the MGT through transepithelial transport. Several nucleoside analogs (NSA), which are used to treat HIV infection and leukemias, are known to be able to accumulate in seminal plasma, which makes them a useful tool for understanding transepithelial transport for the BTB. The purpose of these studies is to characterize the transport profile for the MGT, in particular the BTB, to gain a better understanding of how xenobiotics, especially ones based on nucleosides, can access the MGT. The chief finding of this work is the discovery of a transepithelial transport pathway expressed by Sertoli cells that allows for the entry of nucleosides (necessary for germ cell development) and NSA into the MGT. This pathway depends on equilibrative nucleoside transporter (ENT) 1 uptake and ENT2 efflux and occurs in both rats and humans. These studies provide the foundation for being able to predict the penetration of novel drugs into the MGT.

Recent findings suggest that there is considerable inter-individual variability in how mood affects sexual arousal. The current research proposes that the Dual Control Model may be important to explaining this variation. Thirty-three participants (18 male and 15 female) aged 18 to 45, attended three laboratory sessions where they completed questionnaires assessing pre-existing mood and propensity for sexual excitation and inhibition, then watched a series of neutral and erotic films. Participants continuously indicated their subjective sexual arousal during each film, while genital temperature was measured using thermographic imaging. The results indicated that mood interacted with the elements of the Dual Control Model to significantly predict both genital and subjective sexual arousal. The interactions between mood and sexual excitation and inhibition tended to better predict genital arousal for female participants and subjective sexual arousal for male participants. The results suggest that Dual Control Model is an important factor in understanding how mood affects sexual arousal. / Canadian Institutes of Health Research, Canadian Male Sexual Health Council, Fonds Recherche Santé du Québec, Pfizer and the Ontario Ministry of Training, Colleges and Universities.