Perspectives on Sexual and Reproductive Health最新文献

{"title":"Estimating the economic impact of restricting reproductive healthcare access in Ohio.","authors":"Travis Speice","doi":"10.1111/psrh.12286","DOIUrl":"https://doi.org/10.1111/psrh.12286","url":null,"abstract":"<p><strong>Objective: </strong>This study analyzes the economic impacts of Ohio's Senate Bill 23, which would ban abortion care after fetal cardiac activity is detected.</p><p><strong>Methods: </strong>Leveraging previous research and publicly available datasets, a unique set of calculations were developed to determine abortion outcomes, individual costs, and public costs in three scenarios in which abortion care is banned in Ohio. Scenario 1 assumes that all abortion care is sought out-of-state. Scenario 2 assumes that all pregnancies result in a birth. Scenario 3 assumes that pregnancies either result in receiving out-of-state abortion care or result in a birth.</p><p><strong>Results: </strong>The total additional economic impact of restricted abortion access in Ohio likely ranges between $98.8 million and $118.4 million, but could be up to $551.4 million per year.</p><p><strong>Conclusion: </strong>Regardless of the three scenarios analyzed, restrictions to accessing abortion care result in negative economic impacts for both individuals and the state. Several policy recommendations are proposed for consideration by policymakers and communities.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Trust Women\": Characteristics of and learnings from patients of a Shield Law medication abortion practice in the United States.","authors":"Angel M Foster, Alice Mark, Kyle J Drouillard, Maureen Paul, Susan Yanow, Sarah Shahi, Dipesh Suvarna, Andrea Peña","doi":"10.1111/psrh.12287","DOIUrl":"https://doi.org/10.1111/psrh.12287","url":null,"abstract":"<p><strong>Introduction: </strong>The 2022 Massachusetts Shield Law protects telemedicine providers who care for abortion seekers in other states from criminal, civil, and licensure penalties. In this article we explore the characteristics of patients of The Massachusetts Medication Abortion Access Project (The MAP).</p><p><strong>Methods: </strong>The MAP is an asynchronous telemedicine service that offers mifepristone/misoprostol to abortion seekers in all 50 states who are at or under 11 weeks pregnancy gestation on initial intake. The MAP charges USD250 using a pay-what-you-can model. We analyzed medical questionnaires and payments submitted by patients who received care from The MAP during its first 6 months of operations using descriptive statistics and for content and themes.</p><p><strong>Results: </strong>From October 1, 2023-March 31, 2024, 1994 patients accessed care through The MAP. Almost all (n = 1973, 99%) identified as women/girls and about half (n = 984, 49%) were aged 20-29. The MAP cared for patients in 45 states; 84% (n = 1672) of these patients received pills in abortion ban or restricted southern states. Patients paid USD134.50 on average; 29% (n = 577) paid USD25 or less. Nearly two-thirds (n = 1293, 65%) received subsidized care; financial hardship featured prominently in patient comments.</p><p><strong>Discussion: </strong>Considerable demand exists for medication abortion care from Shield Law providers. The MAP demonstrates that providers can trust women and other pregnancy capable people to decide for themselves whether to obtain medication abortion pills by mail and to pay what they can afford without being required to justify their need. Identifying ways to support Shield Law provision and further subsidize abortion care are needed.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual choking/strangulation and its association with condom and contraceptive use: Findings from a survey of students at a university in the Midwestern United States.","authors":"Debby Herbenick, Tsung-Chieh Fu, Callie Patterson Perry, Lucia Guerra-Reyes, Heather Eastman-Mueller, Dubravka Svetina Valdivia","doi":"10.1111/psrh.12285","DOIUrl":"https://doi.org/10.1111/psrh.12285","url":null,"abstract":"<p><strong>Introduction: </strong>Consensual sexual choking has become prevalent among young United States (US) adults. In sex between women and men, women are overwhelmingly the ones choked, perhaps reproducing traditional heteronormative power dynamics. No research has examined the relationship between being choked during consensual sex and the use of external condoms and other contraceptives.</p><p><strong>Methods: </strong>We administered a cross-sectional campus-representative survey to 4989 undergraduate students at a large public Midwestern US university.</p><p><strong>Results: </strong>Half of respondents (n = 1803) had ever been choked during sex. Having been choked was associated with a significantly lower likelihood of event-level condom use (OR = 0.32 [0.19, 0.54] for >5 times lifetime choking among men and OR = 0.35 [0.27, 0.45] for >5 times lifetime choking among women compared to those with no choking experiences) and in the past 6 months (OR = 0.42 [0.24, 0.72] for >5 times lifetime choking among men and OR = 0.59 [0.43, 0.81] for >5 times lifetime choking among women compared to those with no choking experiences). Also, having ever been choked was associated with a significantly greater likelihood of having used an implant/intra-uterine device in the past 6 months (OR = 1.85 [1.28, 2.68] for >5 times lifetime choking compared to those with no choking experiences).</p><p><strong>Conclusion: </strong>Recognition that sexual choking is prevalent among young people has only recently emerged and educational programs are lacking. Study findings could be used to engage people in discussions about choking in relation to gender, power, and reproductive health agency.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding abortion legality and trimester of abortion care in Ohio, West Virginia and Kentucky, three abortion‐restrictive states","authors":"Annamarie L. Beckmeyer, Jeremy A. Brenner‐Levoy, B. Jessie Hill, Tamika C. Odum, Abigail Norris Turner, Alison H. Norris, Danielle Bessett, Katherine L. Rivlin","doi":"10.1111/psrh.12284","DOIUrl":"https://doi.org/10.1111/psrh.12284","url":null,"abstract":"IntroductionIn the era of Dobbs, legality of abortion care in the United States depends upon state law. Even before Dobbs, while abortion remained legal mounting restrictions and debate surrounding legal abortion could have led to confusion about abortion legality and discouraged patients from accessing legal abortion. We hypothesized an association between believing abortion is illegal or uncertainty about legality with later timing of abortion care.MethodsWe surveyed patients seeking abortion care in Ohio, West Virginia, and Kentucky from April 2020 to April 2021. We asked about their understanding of abortion legality at the time they were first deciding to have an abortion. Using unconditional logistic regression models, we examined associations between beliefs about abortion legality (measured as belief that abortion is legal or sometimes legal versus. illegal or unsure) and timing of abortion care (measured as trimester of abortion).ResultsOver half (57%) of the 1,479 patients who met eligibility criteria and completed the survey believed abortion was always legal, 21% thought abortion was sometimes legal, 12% believed abortion was illegal, and 10% did not know. Most (92%) had a first trimester abortion (&lt;14 weeks gestation). Belief that abortion was illegal, or uncertainty about abortion legality, was not significantly associated with second trimester abortion care (unadjusted odds ratio [uOR]: 0.78, 95% confidence interval [CI]: 0.50–1.20). This association did not change meaningfully after adjusting for demographic and clinical variables (adjusted OR [aOR]: 0.83, 95% CI: 0.51–1.33).DiscussionMore than one in five patients presenting for abortion care in three abortion‐restrictive states prior to Dobbs erroneously believed that abortion was illegal or were unsure. Understanding of legality was not significantly associated with timing of abortion care. These misunderstandings could escalate under Dobbs.","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring adolescent-facing US clinicians' perceptions of their contraceptive counseling and use of shared decision-making: A qualitative study.","authors":"Madeline Thornton, Emily S Mann, Brooke W Bullington, Joline Hartheimer, Kavita Shah Arora, Bianca A Allison","doi":"10.1111/psrh.12283","DOIUrl":"10.1111/psrh.12283","url":null,"abstract":"<p><strong>Background: </strong>Adolescent contraceptive decision-making is influenced by a number of patient and clinician-driven factors. Although the AAP continues to endorse an efficacy-based model of contraceptive counseling, many professional organizations are shifting to a shared decision-making model as the optimal approach for providing unbiased and patient-driven contraceptive counseling. While SDM is intended to reduce the influence of clinician bias, it can exacerbate inequity if a clinician tailors a conversation based on their assumptions of a patient's goals or preferences. In this qualitative study, we explored self-reported contraceptive counseling practices among US-based clinicians who see adolescent patients to assess how these practices create barriers or facilitators to SDM and person-centered contraceptive care.</p><p><strong>Methods: </strong>We interviewed 16 clinicians at the 2022 AAP Annual Meeting who counsel adolescent patients about contraception. We used thematic content analysis to analyze interview transcripts using Dedoose.</p><p><strong>Results: </strong>We identified six aspects of contraceptive counseling that clinicians commonly employed with adolescent patients. These were: (1) sociodemographic characteristics driving counseling, (2) reliance on tiered effectiveness counseling, (3) initiating counseling conversations using \"ask then explain\" or \"explain then ask\" approaches, (4) emphasis on teen pregnancy prevention, (5) the influence of method accessibility on counseling, and (6) parental involvement in decision-making and patient confidentiality. We describe how these themes align with or diverge from each component of the SDM framework.</p><p><strong>Conclusion: </strong>Clinicians in this study frequently engaged in non-patient-centered techniques during contraceptive counseling with adolescents. These findings can inform practice recommendations to support clinicians in providing high-quality contraceptive counseling using shared decision-making.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of state Medicaid coverage of abortion on people accessing care in three states.","authors":"Susan K R Heil, Koray Caglayan, Graciela Castillo, Cristian Valenzuela-Mendez, Coretta Mallery Lankford, Gina Sgro, Manxi Yang, Lori Downing, Meera Bhalla, Stephanie McNally Davis","doi":"10.1111/psrh.12275","DOIUrl":"https://doi.org/10.1111/psrh.12275","url":null,"abstract":"<p><strong>Context: </strong>Medicaid is a major funder of reproductive health services, including family planning and pregnancy-related care, especially for people with limited income and people of color. Federal Medicaid funds cannot be used for abortion however 16 states allow state Medicaid funds to pay for abortion. In recent years, Illinois and Maine implemented, and West Virginia discontinued, state Medicaid coverage of abortion.</p><p><strong>Methodology: </strong>With retrospective procedure- and patient-level data obtained from clinics in these three states, we used an interrupted time series design, multivariable regression models, and descriptive statistics to assess changes in procedure volume and patients' share of total procedure price (patient price).</p><p><strong>Results: </strong>In Maine and Illinois, implementing state Medicaid coverage of abortion contributed to an immediate overall increase in abortion access (as seen by a rise in monthly procedure volume at the time of the policy's implementation), a decrease in patient price (by 36% in Maine and 44% in Illinois) after policy implementation as compared to pre-implementation, and overall improved access among people of color. Conversely, when West Virginia discontinued coverage, access to care decreased, patient price increased by 130%, and the share of abortion procedures among people of color decreased.</p><p><strong>Conclusions: </strong>In the fragmented abortion access landscape of the post-Roe era, our study provides new evidence that financial assistance offered through state Medicaid policies that cover abortion may be most helpful to those facing traditional structural inequities to access, while discontinuation of Medicaid coverage of abortion further burdens those already economically marginalized.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief of over 300 reproductive health researchers as Amici Curiae in FDA v. Alliance for Hippocratic Medicine.","authors":"Amanda Barrow, Cathren Cohen, Jaclyn Serpico, Melissa Goodman, Daniel Grossman, Sarah Raifman, Ushma Upadhyay","doi":"10.1111/psrh.12281","DOIUrl":"https://doi.org/10.1111/psrh.12281","url":null,"abstract":"<p><p>On January 30, 2024, over 300 researchers filed an amicus brief in FDA v. Alliance for Hippocratic Medicine, a United States (US) Supreme Court case that could have severely impacted access to mifepristone, one of the two drugs commonly used in medication abortion. The researchers summarize the legal challenges to the US Food and Drug Administration's (FDA's) original approval of mifepristone in 2000 and its 2016 and 2021 decisions modifying mifepristone's Risk Evaluation and Mitigation Strategy (REMS) Program and label, the responses from the FDA and drug manufacturer to the challenges, and the potential implications of the Court's decision on access to mifepristone in the US. The researchers detail how the FDA relied on a robust scientific record analyzing tens of thousands of patient experiences that conclusively demonstrated the safety and effectiveness of the changes to the mifepristone REMS Program and label and urge the Supreme Court to rely on the clear scientific record and preserve access to mifepristone without reimposing restrictions. What follows is a reprint of this brief.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"It shouldn't be just hush-hush\": A qualitative community-based study of menstrual health communication among women in Philadelphia.","authors":"Allison R Casola, Lynette Medley, Brianna C Kunes, Nya McGlone, Alexis Silverio","doi":"10.1111/psrh.12277","DOIUrl":"https://doi.org/10.1111/psrh.12277","url":null,"abstract":"<p><strong>Introduction: </strong>Although menstruation is a natural biological process, many people feel embarrassed of their menses and struggle to discuss it. To mitigate menstrual communication stigma, it is necessary to first elucidate communication experiences and perceptions. Thus, we qualitatively explore menstrual communication among cisgender women who menstruate and their family, friends, healthcare providers, and community.</p><p><strong>Methodology: </strong>In partnership with No More Secrets (NMS), a Philadelphia menstrual health non-profit, we conducted a community-based participatory research (CBPR) project in Fall 2020. Cisgender, menstruating individuals ages 18-45 recruited from NMS' catchment in Philadelphia participated in semi-structured interviews about their menstrual experiences and communication (N = 20). A deductive, theory-driven approached based on the social-ecological model was used to analyze the data.</p><p><strong>Results: </strong>Varying emotional responses arose across social-ecological levels: communication was awkward and simplistic with family; positive and supportive with friends and community members; and uncomfortable and frustrating with healthcare providers. Participants echoed the importance of menstrual communication as a means of sharing information, feeling less alone, and decreasing menstrual stigma.</p><p><strong>Discussion: </strong>Findings can inform future CBPR workshops that address stigma in familial, healthcare, and community-based discussions to improve menstrual health and experiences for cisgender girls and women, transgender men, and gender non-binary individuals who menstruate.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amicus brief of over 300 reproductive health researchers supports mifepristone's safety and effectiveness.","authors":"Amanda Barrow, Cathren Cohen, Jaclyn Serpico, Melissa Goodman, Daniel Grossman, Sarah Raifman, Ushma Upadhyay","doi":"10.1111/psrh.12282","DOIUrl":"https://doi.org/10.1111/psrh.12282","url":null,"abstract":"<p><p>On January 30, 2024, over 300 researchers filed an amicus brief in FDA v. Alliance for Hippocratic Medicine, a United States (US) Supreme Court case concerning the regulatory status of mifepristone, one of two drugs used in medication abortion. In this Comment we summarize the legal challenge, responses from the FDA and drug manufacturer to these challenges, oral arguments presented before the Court, and the implications of the Court's decision on access to mifepristone in the US. We also summarize the content of the accompanying amicus brief.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient experiences switching from in-clinic to self-administration of injectable contraception in two Western US states.","authors":"Rebecca L Newmark, Caroline C Hodge, Grace Shih, Jennifer Karlin","doi":"10.1111/psrh.12278","DOIUrl":"https://doi.org/10.1111/psrh.12278","url":null,"abstract":"<p><strong>Objective: </strong>We describe the experiences and preferences of women who switched from clinic-administered intramuscular depot medroxyprogesterone acetate (DMPA-IM) to self-administered subcutaneous DMPA (DMPA-SC) in the context of the COVID-19 pandemic.</p><p><strong>Methods: </strong>We conducted interviews with women in California and Washington about their experiences with self-administered DMPA-SC. We interviewed women after their first or second self-administered DMPA-SC injection and conducted follow-up interviews after their third or fourth injection. We performed both thematic and descriptive content analyses.</p><p><strong>Results: </strong>We completed 29 interviews with 15 women. Most participants (n = 10) were between the ages of 20 and 39 and the majority (n = 12) used DMPA primarily for contraception. Most (n = 13) described self-administered DMPA-SC as \"very easy\" or \"somewhat easy\" to use and reported greater convenience, decreased pain, fewer logistical and financial challenges, increased privacy, and improved comfort with injection compared to DMPA-IM. Participants identified difficulties obtaining DMPA-SC from pharmacies and safe needle disposal as barriers. Most (n = 13) would recommend DMPA-SC to a friend and desired to continue self-administration beyond the COVID-19 pandemic. Participants recommended counseling all patients about this option alongside other contraceptive methods, and offering clinician supervision, if desired.</p><p><strong>Conclusion: </strong>Women who switched from in-clinic DMPA-IM to self-administered DMPA-SC during the COVID-19 pandemic preferred the latter and intended to continue self-administration. Self-administration of DMPA-SC should be routinely offered and easily accessible to patients.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}