Journal of Mens Health

Methods and Efficacy of Processing Testicular Sperm Samples in Obstructive and Non-Obstructive Azoospermia: A Systematic Review
Tsou TC, Ray S, Maruf M, Kohn TP, Zaman MH, Ayenew MF, George AK and Herati AS
Intracytoplasmic sperm injection (ICSI) is a cornerstone in managing male infertility, especially in obstructive azoospermia (OA) and non-obstructive azoospermia (NOA), necessitating sperm retrieval via testicular sperm extraction (TESE) or microdissection TESE (mTESE). However, the varied post-sperm extraction processing methods pose uncertainty regarding optimal approaches. To address this, a systematic review following preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) guidelines was conducted, identifying 16 relevant studies. These studies exhibited significant heterogeneity in methodologies and outcomes, with mechanical preparation and enzymatic digestion being the primary techniques investigated. Mechanical methods, including shredding, mincing, vortexing, and crushing, yielded varying sperm counts per 100 mg of tissue, with mincing showing promise in NOA cases. Enzymatic digestion, particularly with collagenase type IV, also showed effectiveness, though inconsistently. Additionally, techniques such as microfluidics and magnetic levitation showed potential for improving sperm retrieval efficiency. However, the lack of standardization in outcomes and reporting impedes the establishment of best practice protocols. While collagenase type IV with elastase seemed promising for OA samples and microfluidics for NOA cases, further studies with standardized methodologies and outcomes are necessary. Assessment of DNA damage and comparisons of ICSI success rates between processing methods are crucial for informed clinical practice. In conclusion, optimizing sperm quantity and quality for ICSI necessitates standardized methodologies and outcomes, with microfluidics and collagenase type IV with elastase showing promise pending further validation through well-designed studies.
Exploration of experiences and attitudes associated with lung health promotion among Black males with a history of smoking
Matthews AK, Inwanna S, Oyaluade D, Chappel A, Akufo J, Kim SJ and Jeremiah R
To examine knowledge and attitudes about lung health promotion (smoking cessation and lung cancer screening) among Black male smokers in a large Midwestern city in the United States. Semi-structured, in-depth interviews were conducted with 25 study participants. Each interview lasted approximately 45 minutes. Participants also completed a brief (5-10 minutes) survey measuring demographic characteristics, smoking experiences and knowledge and attitudes about lung health promotion activities. Descriptive statistics were used for quantitative data, and deductive thematic analysis for qualitative data analysis. The mean age of study participants was 57.5 years. Eighty-four percent of participants were current smokers, with the majority being daily smokers. Perceived risk for lung cancer was mixed, with 56% of participants endorsing that they considered themselves to be at high or moderate risk and the remaining 44% at low or no risk for lung cancer. Forty percent of participants reported having had a test to check their lungs for cancer. Participants were aware of the health risks associated with smoking but reported limited assistance from providers regarding the receipt of smoking cessation treatments. Awareness of lung cancer screening was limited, but participants expressed openness to screening; however, barriers were anticipated, including costs, fear and a reduced willingness to be screened in the absence of symptoms. Study participants reported limited experiences with lung health promotion activities. Knowledge about the facilitators and barriers can be used to develop health promotion interventions targeting smoking cessation and lung cancer screening.
Impact of Somatic Conditions and Lifestyle Behaviours on Depressive Symptoms and Low Life Satisfaction among Middle-Aged and Older Adult Men in South Africa
Peltzer K and Pengpid S
The purpose of this study was to assess the association between somatic disorders, lifestyle factors, incident and persistent depressive symptoms, and low life satisfaction in a longitudinal study in South Africa.
is essential for xenograft tumor development in mice injected with the human prostate cancer cell-line, LNCaP, and modulates cell migration and invasion
Mukherjee A, Park A and Davies KP
A growing body of literature suggests modulated expression of members of the opiorphin family of genes (, and ) is associated with cancer. Recently, overexpression of was shown to be associated with prostate cancer, with evidence of a role in overcoming the hypoxic barrier that develops as tumors grow. The primary goal of the present studies was to support and expand evidence for a role of in the development and progression of prostate cancer.
Predictors of annual prostate-specific antigen (PSA) screening among black men: results from an urban community-based prostate cancer screening program
Lewis-Thames MW, Khan S, Hicks V and Drake BF
Black men have an increased risk of prostate cancer mortality compared with any racial or ethnic group. Further, research on prostate cancer prevention and control messaging focusing on Black men is limited. Community screening events are successful in attracting members from high-risk groups, like Black men, and are a valuable source to collect cancer screening and health promotion data. Therefore, the authors examined data of Black men attending a community-based PCa screening event to evaluate predictors of annual PCa screening, and identify sub-populations of Black men needing targeted cancer prevention messaging.
Quality of preventive care before and after prostate cancer diagnosis
Wallner LP, Slezak JM, Quinn VP, Loo RK, Schottinger JE, Bastani R and Jacobsen SJ
To examine if the use of general preventive services were diminished in a cohort of men following their diagnosis of prostate cancer.
Thiazolidinedione and Metformin Use and the Risk of Benign Prostate Hyperplasia in Veterans with Diabetes Mellitus
Murff HJ, Roumie CL, Greevy RA, Grijalva CG, Hung AH, Liu X and Griffin MR
Chronic inflammation is important in the development of benign prostatic hyperplasia (BPH) and certain oral antidiabetic medications have anti-inflammatory properties. The purpose of this study was to determine if use of thiazolidinediones or metformin was associated with a reduced risk of requiring medical or surgical treatment for BPH compared to sulfonylureas among diabetic men.
Social Determinants Associated with Colorectal Cancer Screening in an Urban Community Sample of African-American Men
Mitchell JA, Watkins DC and Modlin CS
African-American men are disproportionately burdened with colorectal cancer (CRC). Research is scarce on the social determinants that may influence CRC screening as the primary strategy for early detection among African-American males.
Testosterone and Abnormal Glucose Metabolism in an Inner-City Cohort
Monroe AK, Dobs AS, Cofrancesco J and Brown TT
Low testosterone (T) has been associated with insulin resistance and diabetes mellitus (DM) among men in population-based studies. These studies included racially diverse men, but did not target for inclusion individuals with opiate use, Hepatitis C Virus (HCV) infection, or Human Immunodeficiency Virus (HIV) infection, which disproportionately affect inner-city populations and may alter the relationship between T and DM.
An observational study of plasma vascular endothelial growth factors (VEGF) A and D expression in non-localized prostate cancer
Verdoorn BP, Feng C, Ricke WA, Sahasrabudhe DM, Kilari D and Kohli M
The aim of the study was to measure plasma levels of the vascular endothelial growth factors (VEGF) A and D in serially collected blood specimens from non-localized prostate cancer (PCa) subjects.
Perceptions of HIV transmission risk in commercial and public sex venues
Downing MJ
BACKGROUND: Sexual behaviors of men who have sex with men (MSM) that occur in sexually charged venues (e.g., bathhouse, sex club, public park) are a target for research and intervention due to concerns about the role these venues may have in the transmission of HIV and other sexually transmitted infections (STIs). However, these efforts often exclude how individuals perceive HIV risk in terms of sex venue use. This paper analyzes how venue-specific perceptions of HIV transmission risk differ across venues and by onsite sexual behavior. METHOD: Cross-sectional data collected using an Internet survey completed by 139 MSM who attended at least one sex venue (e.g., bathhouse, sex club, gym/health club, public park) in the past month. RESULTS: Risk perceptions were highest for bathhouses and sex clubs, though no significant differences were detected between any of the venues. With few exceptions, men who reported not engaging in sex or low-risk behaviors (i.e., masturbation or mutual masturbation) during venue attendance perceived higher risks than those who engaged in high-risk behaviors (i.e., anal sex). Interestingly, risk perceptions of public bathrooms, parks, and video/buddy booths were lower for attendees who reported unprotected oral sex with ejaculation than men who reported safer or riskier behaviors. CONCLUSION: These findings provide important insights into how MSM perceive HIV risk in sex venues and highlight a need for expanded outreach and education in locations where sexual risk taking may be underestimated.
Are benefits conferred with greater socioeconomic position undermined by racial discrimination among African American men?
Hudson DL, Bullard KM, Neighbors HW, Geronimus AT, Yang J and Jackson JS
BACKGROUND: conventional wisdom suggests that increased socioeconomic resources should be related to better health. Considering the body of evidence demonstrating the significant association between racial discrimination and depression, we examined whether exposure to racial discrimination could attenuate the positive effects of increased levels of socioeconomic position (SEP) among African Americans. Specifically, this paper investigated the joint interactive effects of SEP and racial discrimination on the odds of depression among African Americans. METHODS: racial discrimination was measured using two measures, major and everyday discrimination. Study objectives were achieved using data from the National Survey of American Life, which included a nationally representative sample of African Americans (n =3570). Logistic regression models were used to estimate the effects of SEP and racial discrimination on the odds of depression. RESULTS: reports of racial discrimination were associated with increased risk of depression among American African men who possessed greater levels of education and income. Among African American men, significant, positive interactions were observed between education and experiences of major discrimination, which were associated with greater odds of depression (P = 0.02). Additionally, there were positive interactions between income and both measures of racial discrimination (income x everyday discrimination, P = 0.013; income x major discrimination, P = 0.02), which were associated with increased odds of depression (P = 0.02). CONCLUSIONS: it is possible that experiences of racial discrimination could, in part, diminish the effects of increased SEP among African American men.
Social determinants of cardiovascular disease risk factor presence among rural and urban Black and White men
Quarells RC, Liu J and Davis SK
BACKGROUND: Social determinants of health are increasingly being addressed as a causal factor for disparities in health. The purpose of this study was to assess the effects of specified social determinants of health on cardiovascular disease (CVD) clinical risk factors in Black and White men residing in rural and urban Georgia. METHODS: Self-report data were collected on a total of 548 Black and White men aged >18 years from 2004-2005. Data were derived from a random telephone survey. Separate logistic regression models were conducted to examine the effects of specified social determinants on the presence of two or more CVD clinical risk factors. In addition, differences within rural and urban men were also assessed. RESULTS: Lower education, unemployment, lower income, and higher general stress were all significantly related to the presence of two or more CVD clinical risk factors. As expected, the covariates of age, race, and residential location also played a significant role in cardiovascular health. Rural men were nearly twice as likely to have two or more CVD risk factors compared to their urban men (P <0.01). Models examining location separately found urban Black men to be 2.6 times as likely to have more than two CVD risk factors (P <0.02). CONCLUSION: Findings reveal social determinants are associated with CVD risk factor differences between Black and White men and between rural and urban residents. It is important for policymakers and the healthcare industry to address these social determinants of health as they try to improve the health of the people they serve.
Psychosocial, socio-cultural, and environmental influences on mental health help-seeking among African-American men
Holden KB, McGregor BS, Blanks SH and Mahaffey C
The social determinants unique to African-American men's health contribute to limited access and utilization of health and mental health care services and can have a deleterious effect on their overall health and well-being. There is a need to examine the complex issues concerning African-American men's help-seeking behaviors relative to mental health concerns. Current research estimates that African-American men are approximately 30% more likely to report having a mental illness compared to non-Hispanic Whites and are less likely to receive proper diagnosis and treatment. There is an extensive body of research that supports the view that women are more likely to seek help for psychological problems than African-American men. This review explores the psychosocial, environmental and socio-cultural factors that influence mental health help-seeking behavior among African-American men and explains the urgency to engage various stakeholders to pursue effective behavioral strategies. Research literature concerning the relationships between social determinants of health and their mental health help-seeking behaviors is reviewed and discussed in this paper. The article illustrates the need for mental health providers and researchers to establish feasible, culturally competent prevention and intervention strategies to increase help seeking behavior among African-American men, thereby contributing to the reduction of mental health disparities.
The potential influence of masculine identity on health-improving behavior in midlife and older African American men
Hooker SP, Wilcox S, Burroughs EL, Rheaume CE and Courtenay W
To gain a greater understanding of masculinity and its potential influence on health-improving behavior in midlife and older African American (AA) men.
Human papillomavirus (HPV): college male's knowledge, perceived risk, sources of information, vaccine barriers and communication
Katz ML, Krieger JL and Roberto AJ
BACKGROUND: Human papillomavirus (HPV) is a common sexually transmitted infection. With the U.S. Food and Drug Administration (FDA) approval of an indication for the HPV vaccine for males, it is important to assess male college student's HPV knowledge, perceived risk, and sources of information, as well as HPV vaccine barriers and communication. METHODS: This was a cross-sectional survey study of 165 male college students. The participants completed a survey about HPV and the HPV vaccine. RESULTS: Among the 165 participants, most males had poor HPV knowledge, in that 132 (80.0%) reported having had sexual intercourse, but only 20 (12.1%) perceived being at risk for acquiring HPV. Information sources about HPV were commercials/advertisements, friends, news and health education programs. Concern about the HPV vaccine's long-term effects and cost were the most frequently reported barriers. Most students reported having a regular healthcare provider, but had difficulty getting to their provider, and finding time to discuss the HPV vaccine with their provider. Additionally, most students reported relying on their parents when making medical decisions and being willing to discuss the HPV vaccine with their healthcare provider to make an informed decision about the vaccine. CONCLUSIONS: Educational programs providing information about HPV, the HPV vaccine, and communication skills training are needed for male college students, parents, and healthcare providers. Findings from this study will guide the development of HPV vaccine messages and educational programs that should be tested in future research.
Living with a `women's disease': risk appraisal and management among men with osteoporosis
Solimeo SL
BACKGROUND: There is clear evidence that men suffer from osteoporosis (OP) in increasing numbers, but that men commonly remain underdiagnosed, undertreated and experience poorer outcomes than do women. The widespread sociocultural association of OP with postmenopausal women reflects their greater risk for developing the disorder, but the sexing of OP as a women's disease disadvantages at-risk men. METHODS: This paper reports on qualitative data gathered from 23 community-residing men who have an OP diagnosis. RESULTS: Interviews with men reveal that the sexing of OP as a female disease may affect men's risk appraisal. Men clearly associate OP risk factors with women and accordingly may feel protected from the disorder. Subsequent to diagnosis, men's OP-related risk management strategies reveal that men's gender identity constrains their ability to enact risk-reducing behavior. CONCLUSIONS: Men may internalize the association of OP with women and incorporate it into a sense of perceived invulnerability to the condition, which, in turn, contributes to delayed diagnosis and treatment. Limited male-specific treatment and support options as well as social expectations of male gender performance play roles in men's health behavior.
Understanding preventive behaviors among mid-Western African-American men: a pilot qualitative study of prostate screening
Harvey IS and Alston RJ
BACKGROUND: African-American men bear a disproportionate burden for disease compared to other ethnic and racial groups. Due to gender differences in socialization and lifestyle practices, men are more likely to adopt attitudes and beliefs that undermine their health and well-being, including beliefs related to masculinity. The purpose of this study was to explore and understand the contextual factors in the attitudes and beliefs of African-American men's view of health in general, and as related to prostate cancer in particular. METHODS: Qualitative data from 15 African-American men were collected from two focus groups and analyzed for common themes using a qualitative descriptive design. RESULTS: Three themes emerged that focused on the beliefs and attitudes regarding general health and prostate cancer screening: (i) traditional beliefs about masculinity; (ii) psychosocial impact from family medical history; and (iii) sexual mores regarding digital rectal exams. CONCLUSIONS: The socialization of African-American men and masculinity ideologies may be significant factors in the focus group member's decisions to seek preventive health behavior changes. Further research is needed to examine the determinants of African-American men's health seeking behavior, in particular on the influence of masculine beliefs.
Health Promotion: Results of focus groups with African-American men
Heeren GA and Jemmott JB
BACKGROUND: Almost half (49%) of the people diagnosed with HIV/AIDS in the United States (US) are African-Americans. Although African-Americans represent only about 13% of the overall population, they continue to account for a higher proportion of cases at all stages of HIV/AIDS. Most documented interventions targeting the African-American population have focused on women, children, men who have sex with men or drug addicts. METHODS: Six focus group sessions with African-American men (39) and women (15) were conducted in a heterogeneously populated American city. We used a pre-focus group questionnaire to collect data about the socio-economic background of the participants. In our focus group sessions we examined the feasibility of instituting a health promotion program for African-American men. RESULTS: The men who participated in the sessions showed great interest in attending the health promotion program. They had no prior knowledge of positive behavioral practices that could promote their individual health and well-being. HIV infection rates in the African-American population remain the highest in the US. CONCLUSION: The results of our focus group sessions showed that the heterosexual African-American men were eager to learn how to protect themselves against communicable and non-communicable diseases in health promotion programs.
A Self-Guided Lifestyle Intervention for Young Men: Findings from the ACTIVATE Randomized Pilot Trial
Reading JM, Crane MM, Carlyle K, Perera RA and LaRose JG
Young men are at high risk for developing obesity-related health complications, yet are markedly underrepresented in lifestyle interventions. This pilot study examined the feasibility and preliminary efficacy of a lifestyle intervention (self-guided + health risk messaging) targeting young men.
Evidence-based circumcision policy for Australia
Morris BJ, Katelaris A, Blumenthal NJ, Hajoona M, Sheen AC, Schrieber L, Lumbers ER, Wodak AD and Katelaris P
The aim was (1) to perform an up-to-date systematic review of the male circumcision (MC) literature and (2) to determine the number of adverse medical conditions prevented by early MC in Australia. Searches of PubMed using "circumcision" with 39 keywords and bibliography searches yielded 278 publications meeting our inclusion criteria. Early MC provides immediate and lifetime benefits, including protection against: urinary tract infections, phimosis, inflammatory skin conditions, inferior penile hygiene, candidiasis, various STIs, and penile and prostate cancer. In female partners MC reduces risk of STIs and cervical cancer. A risk-benefit analysis found benefits exceeded procedural risks, which are predominantly minor, by approximately 200 to 1. It was estimated that more than 1 in 2 uncircumcised males will experience an adverse foreskin-related medical condition over their lifetime. An increase in early MC in Australia to mid-1950s prevalence of 85% from the current level of 18.75% would avoid 77,000 cases of infections and other adverse medical conditions over the lifetime for each annual birth cohort. Survey data, physiological measurements, and the anatomical location of penile sensory receptors responsible for sexual sensation indicate that MC has no detrimental effect on sexual function, sensitivity or pleasure. US studies found that early infant MC is cost saving. Evidence-based reviews by the AAP and CDC support early MC as a desirable public health measure. Although MC can be performed at any age, early MC maximizes benefits and minimises procedural risks. Parents should routinely be provided with accurate, up-to-date evidence-based information in an unbiased manner early in a pregnancy so that they have time to weigh benefits and risks of early MC and make an informed decision should they have a son. Parental choice should be respected. A well-trained competent practitioner is essential and local anaesthesia should be routinely used. Third party coverage of costs is advocated.