Evidence map›Paper›PMID 40965729›Full record

ArticleAIDS and behavior2026

Mechanisms of Action and Preliminary Impact of a Stigma-Mitigation Training to Enable Healthcare Discussions About Anal Pleasure and Health in China: A Sequential Explanatory Mixed Methods Pilot Study.

Bryan A Kutner, Kathrine Meyers, Yumeng Wu, Benjamin Lane, Gang Yang, Baichun Hou, Iván C Balán

Abstract read
In one paragraph

Article in AIDS and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Bryan A KutnerAlbert Einstein College of Medicine & Montefiore Medical Center, Psychiatry Research Institute at Montefiore Einstein, 1225 Morris Park Ave., 4A, Bronx, NY, 10461, USA. bryan.kutner@einsteinmed.edu.ORCID https://orcid.org/0000-0002-4544-708X
Kathrine MeyersAaron Diamond AIDS Research Center, Columbia University Irving Medical Center, New York, NY, 10032, USA.ORCID https://orcid.org/0000-0002-8573-1958
Yumeng WuAaron Diamond AIDS Research Center, Columbia University Irving Medical Center, New York, NY, 10032, USA.ORCID https://orcid.org/0000-0002-4586-0675
Benjamin LaneAaron Diamond AIDS Research Center, Columbia University Irving Medical Center, New York, NY, 10032, USA.
Gang YangChina AIDS Walk Special Fund, Inc, Flushing, NY, 11355, USA.ORCID https://orcid.org/0009-0007-6101-8545
Baichun HouAlbert Einstein College of Medicine & Montefiore Medical Center, Psychiatry Research Institute at Montefiore Einstein, 1225 Morris Park Ave., 4A, Bronx, NY, 10461, USA.ORCID https://orcid.org/0009-0003-3045-8813
Iván C BalánCenter for Translational Behavioral Science, Florida State University College of Medicine, Tallahassee, FL, 32310, USA.ORCID https://orcid.org/0009-0003-9954-5720

Funding

The Statistics, Data Science, and Data Management (SDM) CoreP30MH043520 · NIMH · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · PI MILTON L WAINBERG · 2003 to 2026
$48.2M
Mitigating sexual stigma within healthcare interactions to improve engagement of MSM in HIV preventionK23MH124569 · NIMH · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · PI KUTNER, BRYAN A. · 2021 to 2025
$885k
NIMH NIH HHS K23 MH124569NIMH NIH HHS K23MH124569NIMH NIH HHS P30 MH043520NIMH NIH HHS P30MH043520Rockefeller University Shapiro-Silverberg Fund for the Advancement of Translational Research
6 · The paper itself

Abstract

Stigma toward anal sex impedes engagement in health services that are vital to Ending the HIV Epidemic. We evaluated a stigma-reduction training to build HIV worker capacity to address anal pleasure and health during HIV service encounters in China. In a sequential explanatory mixed-methods design, we assessed the training's preliminary impact on anal health promotion activities and, based on the Theoretical Domains Framework, mechanisms of action among 51 health workers. We conducted descriptive statistics, bivariate comparisons, and thematic analyses based on pre/post-training online surveys and post-training in-depth interviews. The frequency of anal health promotion activities among the 38 participants who completed pre/post-training surveys increased by 7-8% of the scale range, but not significantly (p-values between 0.06 and 0.08). Mechanisms for discussing anal sex (knowledge, skills, role responsibility, self-efficacy, organizational acceptability, and positive emotions) shifted from baseline (5%-36% range), primarily due to boosts in knowledge and skills (28% and 36%, all p < .05). Additional mechanisms of comfort addressing sexual orientation, anal health, and sex-related concerns also increased (4-14% range, all p < .05). Qualitative analysis revealed mechanistic themes of heightened empathy, weakened stereotypes, and a shift toward accepting role responsibility to discuss anal sex. Gay and bisexual workers reported notable personal growth to optimize their own anal health. Although knowledge and communication skills increased provider confidence, some participants remained hesitant to initiate discussion during HIV service encounters. For most participants the theoretically-informed training activities operated as hypothesized, to enhance mechanisms that could increase provider-initiated discussion of anal pleasure and health.

Indexed as

Health PersonnelHealth PromotionHIV InfectionsSexual BehaviorSocial StigmaAdultChinaFemaleHealth Knowledge, Attitudes, PracticeHumansInterviews as TopicMaleMiddle AgedPilot ProjectsPleasureQualitative ResearchBehavior and behavior mechanismsImplementation scienceIntervention studySocial stigmaTheoretical domains framework

Identifiers

PMID40965729
PMCPMC12685002

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.