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Table 4 Fertility care, sexual function and psychosexual counselling in MENA: characteristics of users and health care professionals

From: Scoping review of sexual and reproductive healthcare for men in the MENA (Middle East and North Africa) region: a handful of paradoxes?

Characteristic

Clients/users

Health Care Professionals

Knowledge

â–¸ RH: inadequate knowledge about the concept, availability and benefits [73].

â–¸ Premarital checkup:

• Egypt: lack of knowledge among general population even among educated respondents [78].

• KSA: university students aware of its importance in preventing transmission of hereditary diseases to offsprings and ensuring their partner’s health [79].

â–¸ Sexual Health:

• Younger boys: more aware of physiological/emotional puberty changes of their own sex; but not of opposite sex [28].

• Adults: dialogue between patients and their treating physicians regarding ED assists patients to seek proper/safe medical advice [80].

â–¸ Healthcare workers sometimes displayed low knowledge e.g., about ICSI [73, 75, 76].

â–¸ Clinical practitioners: more likely to have accurate knowledge of FP options than oncologists [74].

â–¸ Sexual Health:

• Urologists: more knowledgeable about ED, but gynecologists had better attitude towards ED patients [81].

• Nurses: most were not very knowledgeable about/confident to address sexuality, viewing it as not within their responsibilities [82, 83].

• HCP: lacked confidence in their sex education skills and knowledge [84].

Attitude

â–¸ RH services: users not always satisfied with HCP attitudes, stating it was unpleasant, with poor communication and inappropriate management approach [73].

â–¸ Premarital checkup:

• Egypt: among general population, most respondents, except unmarried males, had favorable attitude [78].

• KSA: most university students had generally positive attitude and good intended practices toward PMS. Most participants demanded implementing a law that prohibits incompatible marriages [79].

â–¸ Sexual Health:

• Many adolescent boys found female genital cutting necessary, favoured polygamous marriage at younger age, but not consanguineous marriages [28].

• ED: sensitive issue among older clients, hence in rarely consulting. Conversely, university students were more liberal toward sex, had more risky behaviours [80, 85].

• Gay communities: highly knowledgeable but had high-risk behavior (low condom use/ HIV testing), most disclosed their sexual orientation only to their partners and not to their HCP even if needed [86].

â–¸ Physicians and HCP with previous SRH had better youth-friendly attitudes [87].

â–¸ Family physicians: favorable attitudes toward infertility management, but attitude varied with age, gender and experience [77].

â–¸ Oncologists: low perception of importance of FP, leading to poor referral to specialists; gender bias in informing males about FP options prior to cancer treatment compared to females [74, 75].

â–¸ Sexual Health:

• Nurses: negative attitude influenced by their beliefs about sex/sex education (viewing early sex education as problematic), negative attitude was associated with sex (female) and no previous training on sexuality [82,83,84].

• Lebanon: HCP had positive attitudes towards LGBT patients; mental health providers less likely to believe that homosexuality is mental health disorder, but more likely a natural variation on the sexual orientation spectrum [88].

  1. HCP Health care professionals, KSA Kingdom of Saudi Arabia, PMS Pre-marital screening, ED Erectile dysfunction, LGBT Lesbian, gay, bisexual, and transgender, FP Fertility preservation, SRH Sexual and reproductive health, RH Reproductive health, ICSI Intracytoplasmic sperm injection