Sexual and Reproductive Health Matters最新文献

{"title":"\"They're not used to people asking what they need\": work processes and care practices in feminist abortion accompaniment - a qualitative study.","authors":"Nathália Machado Cardoso, Naomi Braine, Ana Flávia Pires Lucas D'Oliveira","doi":"10.1080/26410397.2026.2676395","DOIUrl":"10.1080/26410397.2026.2676395","url":null,"abstract":"<p><p>This qualitative study examines the work process of feminist activists who provide accompaniment for self-managed abortions in a major urban centre in Brazil, where abortion remains criminalised in most circumstances. Based on in-depth interviews with eight accompaniers, and drawing on Brazilian collective health and feminist ethics of care, it analyses how they integrate technique, ethics, political commitment, and social awareness, thereby transforming accompaniment into a genuine practice of care. Findings show that accompaniment recognises those cared for as subjects with knowledge, desires, and evolving needs, rather than as passive recipients. Care is organised collectively but always tailored and responsive to the needs of each person, in an interactive, critical, and reflexive manner. In doing so, accompaniers combine technical-scientific knowledge with experiential knowledge built through prior care and exchanges within trusted networks. By engaging across all stages of the process, and guided by a project whose ultimate purpose is to make abortion a good experience for those accompanied, accompaniers prevent the fragmentation and alienation of care work. Accompaniment thus emerges as a model of care grounded in radical needs: needs that arise within existing social conditions but cannot be fully satisfied within them. Once recognised and collectively articulated, these needs expose the limits of the existing order and become a source of pressure for social transformation. The high personal cost of this activism, marked by overload, insecurity, and invisibility, challenges its sustainability and expansion. By describing its constitutive elements, this study broadens understanding of abortion accompaniment and underscores the need for public policies that integrate community-based knowledge, values and practices to foster more humanised, justice-oriented models of care. <i>DOI: 10.1080/26410397.2026.2676395</i>.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2676395"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual health and sexual behaviours in Chinese women of varied sexual identities: a sequential mixed methods study.","authors":"Chanchan Wu, Pui Hing Chau, Jung Jae Lee, Edmond Pui Hang Choi","doi":"10.1080/26410397.2026.2624200","DOIUrl":"10.1080/26410397.2026.2624200","url":null,"abstract":"<p><p>Globally, sex research has largely centred on Western contexts and has often overlooked women's sexuality. In China, there is a dearth of literature on women's sexual health and behaviours, especially those of sexual and gender minorities. This mixed-methods study addresses this gap by investigating the sexual health, behaviours, and lived experiences of Chinese women with diverse sexual identities. A cross-sectional online survey was conducted in 2021, followed by qualitative interviews in 2022-2023. Overall, 509 women aged 18-56 years participated in the survey, including 250 cisgender heterosexual women, 186 cisgender sexual minority women, and 73 transgender women or individuals assigned female at birth who identify as nonbinary. Additionally, semi-structured interviews were conducted with 33 participants (5 cis-heterosexual women, 18 sexual minority women, 2 transgender women, and 8 nonbinary individuals). Quantitative findings indicated that cis-heterosexual women tended to confirm their sexual identities at an earlier age but initiated sexual practices later than minority participants. Regarding safer sex behaviours, consistent condom use was more prevalent among cis-heterosexual women. In contrast, sexual minority participants, reflecting the diversity of their sexual practices, more often adopted women-controlled safer sex strategies, such as cleaning before sex. Four overarching themes were developed, including (1) women's sexuality has long been invisible but is changing; (2) diverse sexual identities and complex sexual practices; (3) the bond between sex and self-worth; and (4) disparities in safer sex awareness and practice. These findings underscore the crucial role of sexual identity and cultural context in the articulation and experiences of women's sexuality and sexual health.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2624200"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13112868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reparation, rights, and dissidence: a qualitative study of feminist advocacy for legal, safe, and free abortion in Ecuador.","authors":"Cynthia Carofilis, Paz Guarderas, Isabel Goicolea","doi":"10.1080/26410397.2026.2698235","DOIUrl":"10.1080/26410397.2026.2698235","url":null,"abstract":"<p><p>This article investigates the political practices related to abortion in Ecuador from their politicisation in 2006 until 2023, two years after the decriminalisation of abortion in all rape cases. We identify: (1) the discursive and embodied practices that construct and politicise the aborting body within feminist advocacy for legal, safe, and free abortion in Ecuador; (2) the effects of these practices; and (3) feminist challenges to conservative discourses that, in some cases, appropriate their rhetorical strategies. Based on participant observations of feminist demonstrations and the analysis of texts produced by Ecuadorian feminist organisations, we trace three \"tactical strategies\" (using Lugones' conceptualisation) that introduce different configurations of the body and propose different effects: (1) abortion as reparation, along with the notion of the victim body; (2) abortion as a right, along with the citizen body; and (3) abortion as dissidence, along with the configuration of the sovereign body. These tactical strategies need to be understood within the broader political context and evolving anti-choice forces. The coexistence of different strategies can lead to both complementary effects and friction.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2698235"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No justice in a genocide: sexual and reproductive health and rights in Gaza.","authors":"Cordelia Freeman, Hala Shoman","doi":"10.1080/26410397.2025.2523095","DOIUrl":"10.1080/26410397.2025.2523095","url":null,"abstract":"<p><p>Since October 2023, Gaza, Palestine, has been the site of a humanitarian crisis due to violence from Israel, with numerous violations currently undermining sexual and reproductive health and rights. In this commentary, we detail these violations through the activist and theoretical framework of reproductive justice which centres on three tenets: the right to have children, the right not to have children, and the right to parent in safe environments and with dignity. Through examples such as the destruction of healthcare facilities, the lack of access to contraception or abortion and the total inability to parent safely, we document that all three tenets have been decimated through the systematic sexual, reproductive and gender-based violence inflicted on Palestinians by the Israeli security forces. We end the commentary with a discussion of \"reproductive genocide\" which we believe to be a term that accurately captures the wholesale decimation of life in Gaza.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2523095"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12364106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abortion learning mechanisms for nurses and midwives: a scoping review of evidence.","authors":"Martha Nicholson, Lesley Hoggart","doi":"10.1080/26410397.2025.2518672","DOIUrl":"10.1080/26410397.2025.2518672","url":null,"abstract":"<p><p>Access to safe, affordable, and supported abortion care is a crucial component of reproductive justice and human rights. Abortion seekers consider nurses and midwives to be more supportive than other health professionals. Nurses and midwives have long been recommended providers of comprehensive abortion care, including second trimester care. This iterative scoping review aimed to explore the evidence on abortion learning mechanisms available to nurses and midwives and what can be improved about abortion training. Using the Arksey and O'Malley (Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1): 19-32) and Levac et al. (Scoping studies: advancing the methodology. Implement Sci. 2010;5(1): 69) scoping review frameworks, four databases were searched, resulting in 879 articles published in English from 01.01.2010 to 01.08.2024. The authors included 43 studies and identified five learning mechanisms. The evidence is presented under three themes: (1) the adequacy of abortion learning mechanisms for nurses and midwives, (2) listening to nurses and midwives' experiences, and (3) barriers to abortion training. This review found that in almost all legal and practice contexts, abortion training may be de-prioritised and hard to access because of institutional barriers, especially in centres of education. In conclusion, there is a low investment in abortion training for nurses and midwives. Policy-makers, health care systems, and educators should consider ways to continuously instil nurses and midwives with skills, confidence, and social authority to provide person-centred abortion care to combat harmful bias and mitigate the risk of reproductive coercion.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2518672"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Full, free, and informed: defining and operationalising informed choice for menstrual supplies.","authors":"Lucy C Wilson, Tanya Dargan Mahajan","doi":"10.1080/26410397.2025.2538357","DOIUrl":"10.1080/26410397.2025.2538357","url":null,"abstract":"<p><p>Informed choice is a cornerstone of bodily autonomy and dignity, yet remains underdeveloped in menstrual health programmes and markets, particularly in low- and middle-income countries. Currently, menstruation-related stigma and gaps in access, availability, and education constrain individuals' ability to choose menstrual supplies that best suit their needs. This article proposes a gender-transformative definition of informed choice for menstrual supplies, adapted from the \"full, free, and informed\" framework widely used in family planning. Informed choice for menstrual supplies means having access to the broadest possible range of supplies, the freedom to choose without stigma or coercion, and access to accurate, unbiased information. The range of menstrual supplies should include single-use and reusable products, contraception, pain relief, and supportive items. Pathways for operationalising this framework in both commercial and free distribution settings are explored, with recommendations for expanding choice, addressing systemic barriers, and improving menstrual literacy. Ultimately, enabling full, free, and informed choice in menstrual health can improve individual health outcomes, reduce stigma, enhance equity, and foster well-functioning markets responsive to the needs of all who menstruate.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2538357"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissecting autonomy in a resource-constrained setting: a descriptive qualitative study of women's decisions on the surgical treatment of early breast cancer in northern Sri Lanka.","authors":"Ramya Kumar, Gopikha Sivakumar, Dhivya Thuseetharan, Chrishanthi Rajasooriyar","doi":"10.1080/26410397.2025.2494396","DOIUrl":"10.1080/26410397.2025.2494396","url":null,"abstract":"<p><p>Breast cancer treatment is a contested space in which therapeutic decisions often collide with women's values and preferences. In northern Sri Lanka, mastectomy remains the mainstay of surgical treatment of early breast cancer (EBC) despite evidence of equivalent survival following breast conserving surgery (BCS) and radiotherapy. This study explores autonomy in decision-making among women with EBC who were eligible for BCS and underwent mastectomy in northern Sri Lanka. A descriptive qualitative study was carried out among 15 women referred for adjuvant therapy to Tellippalai Trail Cancer Hospital in Jaffna district after having a mastectomy for EBC. Participants were recruited between January and May 2022 until data saturation was reached. Data were gathered through semi-structured interviews, which were transcribed in Tamil, translated into English, coded using QDA Miner Lite software, and analysed thematically. Women's autonomy in EBC treatment decisions is limited by various factors in northern Sri Lanka. The hospital setting is not conducive to informed decision-making, and women do not receive sufficient information. Neither survival rates nor risks/benefits of the surgical options are discussed in a systematic way. Although many women appear to be satisfied with their involvement in decision-making, their decisions are guided by incomplete information and fears of spread/recurrence communicated by treating teams. In the absence of policies and protocols to support patient autonomy, women \"choose\" the more invasive option: mastectomy. While it behoves medical professionals to provide evidence-based information, governments and the global health community must support strengthening healthcare systems to advance women's health and rights in lower-resource settings.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":"33 1","pages":"2494396"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study on healthcare providers' biases towards transgender and gender diverse people accessing contraceptive care.","authors":"Yasaman Zia, Connie Folse, Adrien Lawyer, Felix Zeid, Alejandra Alvarez, Erica Somerson, Kathryn Albergate Davis, Dane Menkin, Mitzi Hawkins, Jen Hastings, Cynthia Harper","doi":"10.1080/26410397.2025.2577002","DOIUrl":"10.1080/26410397.2025.2577002","url":null,"abstract":"<p><p>Bias in sexual and reproductive health care (SRH) undermines the quality and delivery of essential services. For transgender and gender diverse (TGD) patients, barriers to care may be acute when seeking gendered services, such as contraception. Few studies have assessed providers' perceptions of TGD patients in SRH. Our objective was to examine bias in contraceptive providers' attitudes towards and experiences with TGD patients. We conducted in-depth interviews, from August 2022 to August 2024, with 41 healthcare providers located throughout the US and attending CME-accredited trainings on contraceptive counselling. We utilised deductive thematic analysis to identify the domains of implicit and explicit bias specific to TGD patients. Many providers struggled to understand gender diversity and had difficulty using gender-inclusive frameworks in care delivery. Explicit biases were exemplified in the pervasiveness of gender binarism within the healthcare system and providers' lack of experience with TGD patients. Providers demonstrated implicit biases through their deficits in knowledge regarding TGD patients' medical needs and culturally insensitive approaches. They offered suggestions to mitigate bias, including institutional changes to make clinics more trans-inclusive and affirming. Biases and disparities specific to TGD patients are perpetuated through a lack of awareness and stigmatisation in healthcare settings. Our findings highlight areas to improve awareness of bias, dispel confusion with evidence on gender-inclusive care, and integrate structural changes within clinics to reduce the burdensome impacts of bias on TGD patients. Advocacy at both the provider and institutional levels is needed to offer quality contraceptive care for TGD patients.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2577002"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12624886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stated preferences of adolescents and young adults for sexual and reproductive health services in Africa: a systematic review.","authors":"Melaku Birhanu Alemu, Richard Norman, Jaya Dantas, Daniel Gashaneh Belay, Tsegaye G Haile, Gavin Pereira, Gizachew A Tessema","doi":"10.1080/26410397.2025.2520682","DOIUrl":"10.1080/26410397.2025.2520682","url":null,"abstract":"<p><p>Adolescents and young adults (AYAs) constitute approximately 30% of the African population and face significant challenges in accessing sexual and reproductive health (SRH) services. Low service uptake, despite availability, may indicate service provision misalignment with AYAs' preferences. This reflects the health sector gap and will partly compromise AYAs' rights. This study synthesised stated preference studies on SRH services among AYAs in Africa, following the PRISMA 2020 guidelines. Searches were conducted across six databases (MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus and Global Health) and Google Scholar for grey literature on 24 April 2024. The attributes used to measure SRH preferences were classified based on the Donabedian quality of healthcare framework. A risk of bias assessment was conducted to evaluate the quality of included studies. The review was registered in PROSPERO (CRD42023386944). From 8,329 identified records, 16 studies with 8,005 participants from six countries were included in the final analysis. The attributes used were related to the structural (44.3%), process (41.7%) and outcome-related (13.9%) dimensions. The most important attributes were the cost of services, effectiveness of treatment and treatment frequency. Conversely, the least important attributes were treatment side effects, treatment and medical test sample collection characteristics, provider characteristics (age, gender and profession), and incentive type and recipient. In conclusion, AYAs' preferences were mainly influenced by cost, treatment effectiveness and incentive distribution methods. Policymakers need to develop affordable and effective SRH programmes with tailored incentives to align with AYAs' preferences to improve service uptake. However, these insights reflect data from a limited range of African countries.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2520682"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who receives abortions at 6- or 16-weeks' gestation? A case study from Ohio.","authors":"Pragi Patel, Payal Chakraborty, Bucky Foster, Jacob Kepes, Danielle Bessett, Alison H Norris, Mikaela H Smith","doi":"10.1080/26410397.2026.2637322","DOIUrl":"10.1080/26410397.2026.2637322","url":null,"abstract":"<p><p>In the United States, states enacted gestation-based bans following the US Supreme Court case <i>Dobbs v. Jackson Women's Health Organization</i>. We examined how patient characteristics differed by gestation at abortion. We used data from a 20% random sample of charts at three Ohio abortion facilities for patients who visited 2014-2018. We used logistic regression to calculate unadjusted and adjusted odds of abortion before 6 weeks and at 16 weeks or after, based on sociodemographic characteristics. We analysed 4,926 charts. Black patients and those of another race had lower odds of abortion before 6 weeks compared to White patients (odds ratio [OR]: 0.30, CI: 0.21-0.42, <i>p</i> < 0.001; and OR: 0.64, CI: 0.41-0.995, <i>p</i> = 0.048, respectively), as did those from out-of-state (OR: 0.22, CI: 0.11-0. 42, <i>p</i> < 0.001). Patients aged 30 and older (compared to those under 25; OR: 1.66, CI: 1.25-2.21, <i>p</i> < 0.001), those with a college degree (OR: 2.60, CI: 2.03-3.33, <i>p</i> < 0.001), married patients (OR: 1.77, CI: 1.27-2.46, <i>p</i> < 0.001), and those without children (OR: 1.29, CI: 1.01-1.66, <i>p</i> = 0.041) had higher odds. Patients with a college degree and those without children had lower odds of abortion at 16 weeks or after (OR: 0.67, CI: 0.49-0.91, <i>p</i> = 0.010; and OR: 0.75, CI: 0.58-0.97, <i>p</i> = 0.030, respectively), while those from out-of-state had higher odds (OR: 2.18, CI: 1.64-2.90, <i>p</i> < 0.001). Laws restricting access to abortion create inequitable harms to pregnant people, with particular impacts on patients of colour, those with less education, younger patients, and parents. As states restrict abortion, accessing timely care may become particularly challenging for those experiencing systemic discrimination.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2637322"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13011096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}