Sexual health concerns everyone, regardless of age or sexual orientation. In 2015, the WHO recommended training primary healthcare providers in sexual health knowledge and developing communication skills related to sexuality (World Health Organization. Brief Communication on Sexuality (BCS). Recommendations for a public health approach. WHO 2015. 70 p). In France, the High Council for Public Health (HCSP) has just published a report on sexual and reproductive health (HCSP High Council for Public Health. Sexual and reproductive health. HCSP information, no. 339 – April 26, 2016. 92p.). The HCSP proposes implementing a national sexual health strategy to ensure physical, emotional, mental, and social well-being related to sexuality from birth to old age for the entire population.Engage participants to train them to discuss sexuality in general practice. The workshop aims to enable physicians to discuss sexuality with patients easily and fluently. This requires understanding the medical circumstances that justify addressing sexuality, knowing how to use appropriate language, and knowing when to discuss it.A group quiz, a list of keywords and situations justifying discussions about sexuality, and a debate in the room will clarify the topic. Practical examples will be illustrated by the three speakers to discuss the importance of screening for medication-related sexual disorders, sexual violence, and premature ejaculation, as well as the importance of knowing patient's sexual orientation to anable a targated prevention.Participants should find it easier to discuss sexuality with their patients, thanks to the practice, ideas, and vocabulary provided by the group during the workshop.Why and how should we discuss sexuality with adolescents and adults? Understanding the importance of this topic for the patient is essential to initiating discussions and making sexuality a topic easily addressed during consultations. Discussing sexuality with patients in primary care is a skill that can be learned.

In the context of persistent new HIV infections and evolving sexual practices associated with increased risk, pre-exposure prophylaxis (PrEP) has emerged as a key component of combination prevention strategies. Although its efficacy is well established, adherence in real-world settings remains a major challenge.To explore the determinants and barriers to PrEP adherence from the users’ perspective.This qualitative study was based on 13 semi-structured individual interviews with current and former PrEP users. Participants were recruited through purposive sampling on a voluntary basis. Data analysis followed a grounded theory approach.Daily dosing was the preferred regimen among participants. Adherence was supported by a sense of personal and collective safety, regular medical follow-up, and an improvement in sexual well-being. Conversely, stigma, social vulnerability, and the persistent taboo surrounding sexual health were major barriers contributing to treatment discontinuation.Identifying barriers to adherence, investing in sexual health, and normalizing PrEP use appear to be key levers for strengthening HIV prevention. The future of PrEP lies in a more personalized approach, tailored to users’ individual trajectories and needs, in order to foster sustained and inclusive adherence.PrEP fosters reassurance, autonomy, and sexual fulfilment for users when supported by stable, non-stigmatizing follow-up in primary care. Long-acting PrEP should be viewed as a complementary tool rather than a substitute for oral PrEP, whose relational and continuous nature remains essential to sustained engagement and equitable sexual health.

In the Reggio Emilia Local Health Authority (AUSL), the “Spazio Sessualità e Salute” (SSS) clinic of the Primary Care Department coordinates the sexually transmitted infections (STI) network and manages pre-exposure prophylaxis (PrEP) prescriptions, replacing the Infectious Diseases Department in this role.To characterize SSS users and identify determinants shaping infection risk perception among users and healthcare staff.We conducted a descriptive analysis of testing and counselling data for new users enrolled from Jan 1 to Dec 31, 2024, and for users prescribed PrEP at least once from Jan 1, 2019, to Aug 31, 2025.In 2024, 533 new users were enrolled: 65.1% male (208 heterosexual, 142 MSM), 33.8% female and 1.1% transgender; mean age was 35 (range 17-78). Asymptomatic presentation was prevalent in MSM (70.0%) and women (66.8%), whereas heterosexual men were mostly symptomatic (54.8%). While ~86% of users received serological testing, MSM underwent multisite microbiological testing twice as often (~50%) as heterosexuals. Past STIs were more common in MSM (33.8%) than in heterosexual men (15.4%) or women (13.4%). Syphilis and Gonorrhoea prevalences were higher in MSM, while Chlamydia was higher in women (0.187) and heterosexual men (0.169). Coinfection rates were higher in MSM (4.1%). Among 198 PrEP users (89.9% MSM), 64.1% had a history of STIs, yet 65.7% received no new STI diagnoses during the study period.Asymptomatic Chlamydia and Gonorrhoea were detected almost exclusively in MSM. Coinfection rates in MSM dropped to levels comparable to heterosexuals (1.63%) when excluding asymptomatic cases of Gonococcal and Chlamydia trachomatis infections. Strict PrEP and MSM protocols require comprehensive screening even without symptoms. This leads to higher detection of asymptomatic infections, some of uncertain clinical significance, potentially overestimating MSM risk while underestimating risk in heterosexual groups where screening is less aggressive.Prevalence differences often reflect testing disparities rather than behavioural risk alone. PrEP serves as a protective tool for high-risk users rather than merely facilitating condomless sex. Implementing counselling and screening based on specific sexual behaviours, rather than broad risk categories, could improve efficiency and support more equitable, non-stigmatising care. PrEP screening intervals should be reviewed to mitigate risk of over-diagnosis and over-treatment.

Rising sexually transmitted infections (STIs) incidence and the introduction of pre-exposure prophylaxis (PrEP) demand new organisational strategies. In the Reggio Emilia Local Health Authority (AUSL), STI management is entrusted to the Primary Care Department, and the "Spazio Sessualità e Salute” (SSS) clinic coordinates the STI network. At SSS, vaccinations are actively offered to users in guideline-defined at-risk categories, and to users with comparable sexual behaviours (e.g., unprotected oral-anal sex with multiple partners), alongside test & counselling activities and PrEP prescription.To assess whether this integrated primary care model improves vaccination coverage in key populations, and to compare our coverage with published data.We analyzed SSS vaccination reports (Jan 1, 2019–Aug 31, 2025), focusing on PrEP users during this period and new patients enrolled from Jan 1 to Dec 31, 2024.Annual vaccine doses (HAV, HBV, HPV) consistently exceeded new enrollments (e.g., 2023: 474 doses vs. 329 users). HPV doses doubled from 2019 (179) to 2024 (396), while HAV and HBV remained stable. Coverage increased across all 2024 cohorts (MSM, heterosexual men, women). Among MSM, coverage rose significantly from baseline: HAV (18.3% to 71.1%), HBV (72.5% to 81%), and HPV (16.2% to 90.1%). PrEP users showed similar gains: HAV (44% to 71.2%), HBV (84.8% to 95%), and HPV (36.4% to 85.9%). Among heterosexual men and women, coverage also improved: HAV from 10.1% and 15.9% to 19.7% and 26.2%, respectively, and HPV from 2.4% and 43.2% to 14% and 63.4%.The rise in HPV vaccinations reflects expanded eligibility for free doses and a decreasing male-to-female ratio among new users (from 3.49 in 2019 to 1.90 in 2025). Comprehensive counselling helps identify risk factors beyond assigned categories. Literature, including data from the Bologna STI centre, reports lower vaccination coverage (e.g., 41.3% for HPV among MSM), often due to Behavioural and Social Drivers (BeSD) barriers such as service fragmentation, access difficulties, lack of awareness, stigma and mistrust.An integrated primary care model combining prevention, diagnosis and treatment facilitates user access, improves vaccine coverage from baseline, optimises STI management and can help to overcome BeSD barriers, supporting more equitable care for stigmatised high-risk populations.

Sexually transmitted infections (STIs) can have a significant impact on sexual and reproductive health. Although condoms are an essential prevention tool, decisions about using them are often based on emotion.This study aimed to assess the link between attractiveness and condom use, and to identify characteristics of partners and relationships that are associated with condom use and perceived STI risk among young people in XXX.A cross-sectional observational study was conducted from May to October 2025 among young people aged 18 to 25 living in XXX. Sociodemographic data and characteristics of partners and relationships during the most recent sexual encounter were collected using a self-administered questionnaire. Mixed models were used to identify factors associated with condom use and perceived risk of STI among partners.A total of 913 responses from 610 participants were analysed. Higher perceived attractiveness was associated with lower condom use (adjusted odds ratio = 0.83, p = 0.004) and a lower perceived risk of the partner having an STI (p < 0.001). Condom use and risk perception varied according to sexual practices, type of relationship, having multiple partners, beauty, trust, feelings and how long participants had known their partners (p < 0.01).Our results suggest that attractiveness has an independent effect on preventive behaviour. They confirm that the observed effect relates not only to intention, as demonstrated in previous studies, but also to self-reported behaviour. Furthermore, the factors actually associated with condom use differ significantly from those reported by participants as influential. These findings highlight the importance of incorporating emotional and subjective factors, particularly attraction, into sexual health prevention programmes for young people. However, the overrepresentation of women and students limits the generalisability of the results. Further qualitative research into attraction could provide a more in-depth exploration of this subjective concept and its influence on condom use decisions.Partner attractiveness is negatively associated with condom use. Prevention strategies should take these emotional and relational factors into account to enhance the effectiveness of conventional cognitive and informational interventions.

Sexuality education in XXX residential youth institutions is frequently inconsistent, despite the complex needs of the young people they support. A structured sexuality education intervention was therefore developed for two residential care institutions. This initiative aligns with the community mission of family medicine and primary care (PC), by promoting health literacy, reducing risk behaviours, and fostering health development in vulnerable populations.The primary objective was to evaluate the impact of a participatory sexuality education session on adolescents’ attitudes toward sexuality using a validated instrument. Secondary objectives included identifying institutional needs and contextual factors that may support long-term, primary care-led health promotion strategies.A mixed-methods design was adopted. In the qualitative phase, focus groups with multidisciplinary staff explored institutional contexts, priority themes, and perceived challenges related to sexuality education. These findings informed the adaptation of the educational sessions to the characteristics of each institution’s population. In the quantitative phase, following each session, adolescents completed a validated instrument assessing attitudes across domains such as sexual health, relationships, consent, digital behaviour, and gender norms. Data was analysed to examine variations between institutions and age groups. The intervention was delivered by primary care (PC) professionals, reinforcing intersectoral collaboration with residential care settings.Qualitative analysis revealed a lack of structured sexuality education, variability in staff confidence, concerns regarding digital exposure, consent, contraception, emotional development, and cultural diversity, as well as strong openness to collaboration with PC professionals. Quantitative results included more positive and informed attitudes toward sexuality, improved risk perception, and increased willingness to seek guidance from professionals.The integration of qualitative contextual assessment with the validated instrument ensures that the educational content is tailored to each institution’s needs. The involvement of PC professionals reinforces the discipline’s role in promoting equity, strengthening intersectoral links, and delivering developmentally appropriate health education in vulnerable youth.This study identifies important gaps in sexuality education within residential youth care and demonstrates the feasibility of implementing a structured, participatory intervention supported by PC. Findings will guide the development of a scalable, sustainable sexuality education programme embedded within PC practice.

Sexually transmitted infections (STIs) are rising worldwide, particularly among adolescents, reflecting changing sexual behaviors and inconsistent barrier use. In women, these infections are often mild or asymptomatic, unlike men whose infections usually cause clear urethral symptoms, delaying diagnosis and increasing the risk of infertility or chronic pelvic pain. Recognizing these disparities is essential to improve gender equity in healthcare.A 17-year-old female with no relevant medical history presented with a 5-day history of right lower quadrant pain, anorexia, and nausea. Laboratory results were normal, and abdominal ultrasound was inconclusive for appendicitis. She was discharged with analgesia. No pregnancy test was performed, and sexual history was not obtained. Twenty hours later, she returned to primary care with persistent pain. A new anamnesis, including pregnancy risk and recent sexual activity, revealed a recent unprotected encounter. A targeted gynecological examination, including bimanual pelvic assessment, showed cervical motion tenderness, raising suspicion for pelvic inflammatory disease (PID). She was referred to the gynecology emergency department and admitted. During hospitalization, Chlamydia trachomatis infection was confirmed, and her clinical course was favorable.In young women, sexual history and pregnancy risk should be routinely assessed when evaluating abdominal pain. High suspicion for Chlamydia and possible gonococcal coinfection, combined with targeted pelvic examination and prompt empiric antibiotic therapy, can prevent infertility and other serious complications.STIs in women often present with mild or nonspecific symptoms, leading to misdiagnosis. In pelvic inflammatory disease Chlamydia trachomatis is the most frequent pathogen, often coexisting with Neisseria gonorrhoeae. Early empiric antibiotic therapy was initiated in our patient, preventing serious complications such as infertility, tubo-ovarian abscesses, and chronic pelvic pain.In primary care, we already have most of the tools needed to raise clinical suspicion or establish an early diagnosis of STIs, making it our responsibility to maintain a high index of suspicion. Integrating these practices may reduce gender-related diagnostic disparities.