Background:Sexology as a clinical and professional discipline remains underdeveloped in Sub-Saharan Africa, where formal education is limited and fragmented. Existing training typically focuses on HIV/AIDS and reproductive health, with little attention to broader sexual health issues such as dysfunction, diversity, and psychosexual wellbeing. This neglect is likely to contribute to persistent unmet needs and stigma surrounding sexual health care across the region. This paper examines Sub-Saharan Africa as part of a wider study on professional education and training in sexology. Methods:This mixed-methods study combined quantitative and qualitative approaches to examine current education in sexology. The Global Survey on Professional Education in Clinical Sexology (GLOPES) was distributed via professional networks in 11 Sub-Saharan African countries, yielding 28 responses. Additionally, seven semi-structured interviews were conducted with clinicians and educators in Clinical Sexology, to provide exploratory insights into training gaps, barriers and opportunities. Quantitative data described existing curricula, accreditation processes, and institutional structures, while qualitative analysis identified thematic challenges and innovations. Results:A total of 28 responses were received from 11 Sub-Saharan African countries. The majority of responses were from South Africa, contributing nearly half of all responses, 14 (48%). Botswana, Kenya, Nigeria, and the DRC each contributed two responses, while Gabon, Guinea, Liberia, Malawi, Mozambique, and Zimbabwe each contributed one. Findings revealed deficits in curriculum standardization, accreditation pathways, and postgraduate opportunities. Educational content is often dispersed across gynecology, psychiatry, and urology, lacking a cohesive framework. Interviews highlighted stigma, political and religious sensitivities, limited institutional ownership, and resource constraints alongside examples of emerging regional initiatives. Discussion:Participants emphasized the need for expanded, standardized, and culturally appropriate sexology education in Sub-Saharan Africa. Priorities include curriculum development, accreditation mechanisms, faculty training, and policy engagement to strengthen professional recognition. Regional collaboration and innovative delivery models may help address current gaps and resource limitations. Sustainable education frameworks are essential to improving sexual health in Sub-Saharan Africa.
Objectives:The aim of this study was to describe characteristics of professional education programs in clinical sexology, including organizers, academic affiliations, target groups, program levels, admission criteria, and jurisdictional recognition of sexology as a profession in Europe. This data will also improve our understanding of how sexology is used as a tool in education of counselors and therapists, and how sexology can be used to enhance sexual health. Methods:In 2023, the WAS committee for Professional Education and Training in Clinical Sexology (WAS PES) conducted an international survey of educational programs. An inductive approach was used to generate data about educational programs worldwide. A structured questionnaire was designed in collaboration with the University of Agder and distributed digitally to WAS organizational and individual members. Initial recruitment occurred via the WAS newsletter, with subsequent participant recruitment leveraging snowball sampling to include programs that had not responded to initial recruitment efforts. Results:The survey yielded 77 responses from 18 European countries. After excluding duplicates, non-clinical entries, and irrelevant submissions, 48 programs underwent further analysis. These included 10 full master's degrees, 14 university-affiliated master's-level courses, two sexological counseling certifications, 14 continuing education programs in psycho-sexual therapy, and eight short-term training courses. Conclusion:The proliferation of clinical sexology training programs underscores the need for curricula that align with both national standards and practitioner competencies. While the European region offers diverse educational pathways, there is a critical need to standardize accreditation frameworks and clinical guidelines at the European level. The World Association for Sexual Health (WAS), in partnership with the European Federation for Sexology (EFS), European Society for Sexual Medicine (ESSM), and national societies, is positioned to lead this standardization effort in line with the Porto Proclamation of 2025.
Objectives:This study examined associations between awareness of the Undetectable = Untransmittable (U=U) message, U=U-related perceptions, mental health symptoms, and expectations regarding sexual protection among people living with HIV (PLWH). Methods:This cross-sectional study was conducted in Istanbul, Turkey, between 2023 and 2024 and included 210 PLWH aged 18-65 years. Participants completed the Hospital Anxiety and Depression Scale (HADS) along with self-report measures assessing U=U awareness and perceptions. Descriptive analyses and multivariable linear regression models were used. Results:Overall, 73.8% of participants reported being aware of the U=U message. U=U awareness was associated with relationship status, HIV status disclosure, and stronger beliefs regarding the psychological benefits of U=U dissemination but was not associated with expectations of discontinuing condom use. In unadjusted analyses, participants who were aware of U=U reported lower anxiety and depressive symptoms. However, in multivariable analyses, U=U awareness was no longer independently associated with mental health outcomes once U=U-related perceptions were included. In contrast, greater perceived psychological impact of U=U dissemination was independently associated with lower levels of both anxiety and depressive symptoms. Conclusions:These findings suggest that perceived psychological impact of the U=U message was more consistently associated with anxiety and depressive symptoms than U=U awareness after adjustment for relevant sociodemographic and relational factors. The potential value of integrating U=U into psychosocial counseling frameworks, rather than presenting it solely as biomedical information, warrants further examination in longitudinal and intervention studies. Given the cross-sectional design, the direction of these associations cannot be determined.
Objectives To assess the association of the Minority Stress Model to Brazilian sexual minority women's mental health, by evaluating whether resilience, internalized homonegativity, anticipation of rejection and experiences of discrimination were associated with depressive symptomatology.Methods An instrument based on the TransPulse Project was developed and culturally adapted for the Brazilian context. Data were collected through a web-based respondent-driven sampling method. Participants were cisgender women, older than 16 years, who have sex with other women, living in Rio Grande do Sul, Brazil. A total of 266 women were included in the final analysis.Results A hierarchical linear regression (using force-entry) and a structural equation modeling supported the applicability of the Minority Stress Model to this population. Enacted stigma was the only minority stressor independently associated with depressive symptomatology. Anticipation of rejection and internalized homonegativity operated differently than described in North American male samples.Conclusion The Minority Stress Model is applicable to Brazilian sexual minority women's mental health, though with culturally specific patterns. In a sociocultural context where enacted stigma is pervasive, public health interventions should prioritize its reduction as a primary target. Clinicians working with this population should be aware that internalized homonegativity may not directly predict depression in Latin American women as it does in other groups, and that fostering resilience represents a meaningful and modifiable protective pathway.
Backgrounds: Sexual violence (SV) in older adults is an underrecognized public health issue. As populations continue to age globally, comprehensive evidence on the magnitude, trends, and distribution of SV remains scarce. Objectives: We aimed to assess the global, regional, and national burden of SV among adults aged 60 years and older from 1990 to 2021. Methods: Data were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) across 204 countries and territories. We examined the prevalence and disability-adjusted life years (DALYs) of SV for older adults aged 60-95 from 1990 to 2021. The estimated annual percentage changes (AAPC) in the age-standardized prevalence rate (ASPR) and DALY rate (ASDR) of SV were calculated to evaluate the temporal trends by sex and Socio-Demographic Index (SDI). Results: In 2021, an estimated 20.8 million older adults globally experienced SV, resulting in approximately 134,000 DALYs. The burden increased steadily over the past three decades, with both prevalence and DALYs showing persistent upward trends. Women consistently experienced substantially higher prevalence rates than men. Moreover, the highest burdens were observed in regions with lower SDI, such as parts of Southeast Asia, Oceania, and sub-Saharan Africa, whereas high-SDI regions reported the lowest burdens. A significant inverse correlation between SDI and SV burden was confirmed (rho = -0.72 for prevalence; rho = -0.68 for DALYs; both P < 0.001). Conclusions: SV among older adults is increasing globally, with women and populations in socioeconomically disadvantaged regions bearing the greatest burden. Targeted prevention, screening, and support strategies are urgently needed to reduce these inequalities and address this growing public health challenge.
Objective Opportunities for professional education and training in clinical sexology vary widely across the provinces in Canada and the states of the United States. The goal of this study was to obtain a comprehensive understanding of clinical sexology training in North America.Method This mixed-methods study includes quantitative surveys and qualitative data obtained through interview and personal communication. Data were obtained independently and were integrated at the interpretation stage to allow deeper understanding of the strengths and barriers to clinical sexology training in North America.Results Clinical training in sexology is primarily available to health professionals as part of continuing education or post-graduate certificates and is often costly and time intensive. There is a dearth of integration of sexual health education throughout schooling, starting in grade school and continuing through advanced degrees in health care. While some degree programs in the health professions include competence in sexuality as part of their accreditation requirements, these competencies are inconsistently met by training programs. The lack of integrated sexual health training for health professionals reinforces stigma around discussing sexual health and is a violation of biomedical ethics. The additional burden of obtaining training in clinical sexology is a barrier to increasing the diversity of the sexual health workforce. A major exception to this overall trend is Quebec's recognition of sexology as an independent profession with its own accreditation standards and a full academic curriculum from bachelor to PhD in sexology.Conclusion Professional training in clinical sexology in the US and Canada has both strengths and weaknesses. Current sociocultural influences limit access to sex education across the lifespan and create challenges in advancing the profession. Future research should work to identify ways to advance access to comprehensive sex education and training in clinical sexology.
Objectives:Vaginismus is a complex sexual pain disorder that severely impairs sexual function and quality of life. Evidence regarding the effectiveness of therapeutic interventions remains fragmented and inconsistent. This systematic review and meta-analysis aimed to evaluate the effects of therapeutic interventions applied to women diagnosed with vaginismus on penetration-related outcomes and multidimensional sexual function, as assessed by validated outcome measures. Methods:The meta-analysis research and study selection were conducted independently by two researchers. The final literature search was completed on July 28, 2025. Studies published between January 2013 and July 2025 were searched in PubMed, Scopus, Web of Science, Cochrane Library, PsycINFO, and TR Dizin databases. Study quality was assessed using the GRADE approach, and risk of bias was evaluated using the Risk of Bias tool. Data synthesis and analyses were performed using Review Manager software. Results:Fifteen RCTs (n = 950; 494 intervention, 456 control) were included. Therapeutic interventions significantly improved overall sexual function in women with vaginismus (FSFI total score(SMD = 0.94; 95% CI:0.37-1.51, p = 0.001; I2=93%) and penetration success (SMD = 0.61; 95% CI:0.38-0.84, p < 0.00001; I2=43%). Mindfulness/ACT (SMD = 0.33; 95% CI: 0.07-0.60; I2=0%) and technology-based interventions (SMD = 0.49; 95% CI:0.15-0.83; I2 = 0%) showed consistent, moderate effects. Pelvic floor-based approaches had the largest effect (SMD = 4.49; 95% CI: 0.10-8.87; I2=98%). FSFI subdomains improved significantly, except orgasm. Independent pain outcomes were non-significant (SMD = 0.02; 95% CI:-1.12 to 1.16, p = 0.97; I2=91%), while combined psychological outcomes showed small improvements (SMD=-0.35; 95% CI:-0.64 to -0.05, p = 0.02; I2=48%). Conclusion:Therapeutic interventions for vaginismus are associated with meaningful improvements in penetration-related outcomes and multiple dimensions of sexual function, without implying complete resolution of the condition. Mindfulness/ACT-based and technology-assisted approaches appear to offer the most consistent benefits. These findings highlight the importance of integrating evidence-based, multidisciplinary strategies into clinical practice and underscore the need for well-designed, standardized randomized controlled trials to optimize treatment outcomes.
Objectives This study examines the development and institutionalization of clinical sexology training in Morocco, Egypt, and Lebanon. It explores how political, socio-cultural, and academic contexts influence the recognition of this field within health and education systems.Methods A mixed-methods approach was used, combining a review of academic literature and policy documents on sexual health education, a mapping of existing clinical sexology training programs, and semi-structured interviews with key stakeholders, including clinical sexologists, trainers in sexual and reproductive health, and experts in sexual health education, research, and advocacy. The analysis was informed by critical perspectives on the medicalization of sexuality and the institutionalization of sexual medicine within health systems.Results We reveal a lack of formal recognition of clinical sexology in national health strategies and higher education policies across the three countries. Existing initiatives are limited, fragmented, and mainly driven by individual academics or civil society organizations rather than embedded in national frameworks. Sexology training is largely situated within medical faculties and clinical specialties such as psychiatry, gynecology, and reproductive medicine, reinforcing a biomedical and therapeutic approach focused on sexual dysfunctions, diagnosis, and treatment. While sexual medicine remains dominant in institutional settings, broader sexual health perspectives grounded in public health, psychosocial, gender, and human rights approaches are weakly institutionalized. Key barriers include socio-cultural taboos, religious sensitivities, institutional resistance, lack of regulatory frameworks, shortage of trained professionals, and limited political prioritization. Nevertheless, emerging opportunities include increased civil society engagement, feminist advocacy for sexual rights, development of flexible training initiatives, and growing interest among young professionals in rights-based approaches.Conclusions Strengthening policy support, developing interdisciplinary training, and fostering collaboration between medical, psychosocial, public health, and civil society actors are essential to better integrate clinical sexology into health and education systems and to improve access to comprehensive, rights-based sexual health services in the MENA region.
BackgroundSexology as a clinical and professional discipline remains underdeveloped in Sub-Saharan Africa, where formal education is limited and fragmented. Existing training typically focuses on HIV/AIDS and reproductive health, with little attention to broader sexual health issues such as dysfunction, diversity, and psychosexual wellbeing. This neglect is likely to contribute to persistent unmet needs and stigma surrounding sexual health care across the region. This paper examines Sub-Saharan Africa as part of a wider study on professional education and training in sexology.MethodsThis mixed-methods study combined quantitative and qualitative approaches to examine current education in sexology. The Global Survey on Professional Education in Clinical Sexology (GLOPES) was distributed via professional networks in 11 Sub-Saharan African countries, yielding 28 responses. Additionally, seven semi-structured interviews were conducted with clinicians and educators in Clinical Sexology, to provide exploratory insights into training gaps, barriers and opportunities. Quantitative data described existing curricula, accreditation processes, and institutional structures, while qualitative analysis identified thematic challenges and innovations.ResultsA total of 28 responses were received from 11 Sub-Saharan African countries. The majority of responses were from South Africa, contributing nearly half of all responses, 14 (48%). Botswana, Kenya, Nigeria, and the DRC each contributed two responses, while Gabon, Guinea, Liberia, Malawi, Mozambique, and Zimbabwe each contributed one. Findings revealed deficits in curriculum standardization, accreditation pathways, and postgraduate opportunities. Educational content is often dispersed across gynecology, psychiatry, and urology, lacking a cohesive framework. Interviews highlighted stigma, political and religious sensitivities, limited institutional ownership, and resource constraints alongside examples of emerging regional initiatives.DiscussionParticipants emphasized the need for expanded, standardized, and culturally appropriate sexology education in Sub-Saharan Africa. Priorities include curriculum development, accreditation mechanisms, faculty training, and policy engagement to strengthen professional recognition. Regional collaboration and innovative delivery models may help address current gaps and resource limitations. Sustainable education frameworks are essential to improving sexual health in Sub-Saharan Africa.
ObjectivesThis study examines how Ghanaian women interpret and experience sexual vocalizations during intimate encounters, focusing on the socio-cultural norms, gender expectations, and power relations shaping these expressions and their meanings.MethodThe study employed a qualitative interpretive design informed by post-structural feminist theory and symbolic interactionism. In-depth interviews were conducted between October and December 2025 with 31 women aged 20-50 in Camp, Sunyani, and Cape Coast, Ghana. Data were analyzed using reflexive thematic analysis.ResultsFindings showed that sexual vocalizations are complex and context-dependent rather than direct expressions of pleasure. Three themes emerged: interpretations of vocalization during intimacy, socio-cultural meanings attached to women's sexual expression, and gendered power dynamics influencing communication and interpretation within relationships. Participants reported that vocalizations could communicate pleasure, intimacy, reassurance, performance, compliance, discomfort, or distress. Many also indicated that male partners frequently interpreted vocal expressions as evidence of enjoyment even when they reflected pain, emotional discomfort, obligation, or coercive relational experiences.ConclusionsThe study argues that sexual vocalization is not a transparent indicator of pleasure or consent but a socially constructed and relationally negotiated practice shaped by cultural expectations and unequal gender relations. The findings contribute to sociological and African feminist scholarship on sexuality, agency, consent, and intimate communication.
