Faculty Bibliography

STUDY OBJECTIVE/OBJECTIVE:Published information on the sexual health and well-being of individuals with complete androgen insensitivity syndrome (CAIS) remains limited. In this study, we aimed to evaluate the vaginal lengths, sexual well-being and body image findings of a relatively large, young cohort of individuals with CAIS, with the goal of guiding clinical practice toward more accurate and individualized patient-centered counseling. METHODS:In this interim analysis of a prospective IRB-approved AIS Natural History Study funded by the National Institutes of Health (NIH), we collected demographic information and vaginal length measurements from 23 individuals with CAIS between 2021 and 2025. Participants over 18 were invited to complete the PROMIS Sexual Function and Satisfaction (PROMIS SexFS) questionnaire and the Body Image Scale (BIS) questionnaire. RESULTS:The cohort (n = 23) ranged in age from 14 to 65 (median = 19). Fourteen participants (61%) identified as heterosexual, 7 (30%) had undergone complete gonadectomy, and 1 had undergone vaginoplasty. Three participants reported practicing serial vaginal dilations. Vaginal length measurements (n = 14) ranged from 25 to 90mm (median = 60mm). Of those who completed the PROMIS SexFS (n = 11), mean t-scores were within one standard deviation of normalized U.S. female population ranges. Of those who completed the BIS (n = 15), the average mean-item score was 0.9 on a Likert scale from 0 "not at all" to 3 "very much". CONCLUSION/CONCLUSIONS:Aside from one outlier, vaginal lengths in our cohort did not differ significantly from those reported in the general population, and most participants reported a positive body image and the ability to engage in fulfilling sexual activity.

BACKGROUND:The opioid epidemic continues to cause significant morbidity and mortality. Although there are effective medications for opioid use disorder (OUD), a minority of patients receive these treatments. OUD is common among patients hospitalized for traumatic injury and hospitalization could be an opportunity to initiate medications and link to ongoing buprenorphine care. METHODS:This retrospective cohort study based on electronic health record review included patients who were: (1) hospitalized between January 1, 2018 and June 30, 2019, (2) age ≥18 years, (3) seen by an Addiction Medicine Consult Service, and (4) initiated on buprenorphine with plans for continuation post-discharge. Descriptive statistics identified differences between trauma and non-trauma groups and regression analysis identified predictors of 30 day buprenorphine follow up. RESULTS:Of 197 eligible patients, 60 (30.5 %) were hospitalized for traumatic injuries. Compared to non-trauma patients, trauma patients were younger, more likely to be employed, more likely to report using cannabis and tobacco, less likely to have recently injected drugs, and hospitalized longer. Among patients with follow-up data available (n = 147), 63.2 % of trauma patients were seen within 30 days, compared to 48.2 % of non-trauma patients (p = 0.16). There were no significant differences between the two groups with regards to urine drug test results or acute care utilization in the follow-up period. CONCLUSIONS:Among hospitalized patients with OUD who initiate buprenorphine, those who were hospitalized for trauma were at least as likely to link to out-patient treatment. Trauma admissions represent an important opportunity for diagnosing and linking patients with OUD to buprenorphine treatment.