Perspectives on Sexual and Reproductive Health最新文献

{"title":"The Changing Landscape of Sexuality and Sexual Health in France.","authors":"Caroline Moreau, Nathalie Bajos, Aline Bohet, Armelle Andro","doi":"10.1111/psrh.70097","DOIUrl":"https://doi.org/10.1111/psrh.70097","url":null,"abstract":"","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208149","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":"Pills in the Post: Analysis of Australia-Based Requests to the Online Abortion Service Women on Web.","authors":"A Noonan, M Belfrage, E Millar","doi":"10.1111/psrh.70094","DOIUrl":"https://doi.org/10.1111/psrh.70094","url":null,"abstract":"<p><strong>Introduction: </strong>Medication abortion has transformed accessibility of abortion services. Telemedicine models-including asynchronous services where a clinician reviews a person's information without a live consultation-enable access to abortion care outside in-person health settings. This study analyzes the frequency, distribution, and motivations of Australia-based requests to Women on Web (WoW), an online referral platform that facilitates access to abortion pills and their self-management with a physician-supported email-based support team.</p><p><strong>Methods: </strong>We analyzed anonymized consultation forms submitted to WoW by people in Australia between 2015 and 2023. We summarized descriptive statistics on individuals' ages and location by state and remoteness. We classified reasons for contacting WoW (recorded from 2018 onwards) thematically and analyzed associations between these themes.</p><p><strong>Results: </strong>Over 8 years, WoW received 1573 requests from Australia-based abortion-seekers. Most requests included multiple reasons for accessing WoW's service, but cost, privacy, and preference for home-based care were the most frequently selected. When thematically analyzed, empowerment and consumer-centered care were the dominant themes, regardless of the person's age or location, alongside barriers to accessing local abortion care through Australia's formal health care system, including through including telemedicine.</p><p><strong>Conclusion: </strong>The small demand for care from WoW suggests that provision within the formal healthcare system is inaccessible to some, and that some abortion-seekers prefer models of care-such as asynchronous, clinician-reviewed telemedicine-with reduced medical oversight. Attention to how abortion is made available, including deregulating pills by post alongside public service provision, is needed to guarantee autonomy, freedom, and sexual and reproductive health and rights for all Australians.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116694","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":"LGBT+ People in France and Mental Health: Changing the Boundaries.","authors":"Elise Marsicano, Emmanuel Beaubatie, Louis Kuhn, Nathalie Bajos","doi":"10.1111/psrh.70089","DOIUrl":"https://doi.org/10.1111/psrh.70089","url":null,"abstract":"<p><strong>Introduction: </strong>Studies documenting the health of sexual and gender minorities have mostly relied on practices to define minorities and have failed to examine associations between sexual and gender minorities.</p><p><strong>Methods: </strong>Based on the CSF2023, a national population-based survey on sexuality and sexual health in France, we analyze (i) the multidimensionality of sexual orientation within the lesbian, gay, bisexual, and transgender, queer, or other sexual orientations and gender identities (LGBT+) population, and (ii) their experiences of sexual violence and discrimination and its impact on mental health.</p><p><strong>Results: </strong>While 8% of women and 7% of men aged 18-89 years reported having a same-sex partner, a higher proportion (23% of women and 15% of men) were not strictly heterosexual, that is, reported same-sex attraction, same-sex practices, or identification as non-heterosexual. Thinking about changing gender remained a rare phenomenon (2% of women and 3% of men). In a linear regression model using the Patient Health Questionnaire-9 (PHQ9) score, the mental health of non-strictly heterosexuals appeared to be worse than that of heterosexuals (c = 0.86 (0.42-1.31) for women; c = 1.00 (0.45-1.55) for men), as was the mental health of those who had thought about changing gender versus those who had not (c = 1.73 (0.63-2.84) for women; c = 2.10 (0.76-3.43) for men).</p><p><strong>Discussion: </strong>Considering indicators of sexual orientation and gender identity that go beyond practices significantly expands the boundaries of minority groups whose mental health appears to be impaired. This perspective is essential if we are to reach the target groups of mental health prevention policies.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116647","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":"Restoring, Protecting, and Expanding Abortion Access in the United States: Seeking Consensus Through the Delphi Method.","authors":"Sarah Pickering, Meredith Manze, Jeffrey V Lazarus, Diana Romero","doi":"10.1111/psrh.70092","DOIUrl":"https://doi.org/10.1111/psrh.70092","url":null,"abstract":"<p><strong>Introduction: </strong>The Dobbs v. Jackson Women's Health Organization United States (US) Supreme Court decision exacerbated inequitable access to abortion rights in the United States. This study aimed to determine the degree of agreement on which strategies should be prioritized to restore, protect, and expand abortion access.</p><p><strong>Methodology: </strong>From July to December 2023, we convened a multidisciplinary, geographically diverse Delphi panel of clinical, research, policy, legal, and advocacy experts to reach consensus (i.e., agreement ≥ 67%) on recommended actions. Using feedback from three survey rounds, and input from an Expert Advisory Group (N = 10), we iteratively refined the statements and recommendations.</p><p><strong>Results: </strong>The expert panel (N = 85) developed 25 consensus statements and 32 recommendations for action by advocates, funders, policymakers, and clinical experts in states with protected, mixed, or restricted abortion policies as classified by the Guttmacher Institute at the time of each survey round (July, September, and November 2023). Key recommendations included incorporating abortion into primary care, establishing referral chains for individuals seeking abortion, and combatting gerrymandering and voter suppression.</p><p><strong>Discussion: </strong>Consensus was reached on actionable priorities to address inequitable access to abortion in varying policy environments, while also highlighting areas where strategic discussions are needed.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116663","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":"Unfit Mothers Only: Medical Gatekeeping of Second- and Third-Trimester Abortion in France.","authors":"Raphaël Perrin","doi":"10.1111/psrh.70095","DOIUrl":"https://doi.org/10.1111/psrh.70095","url":null,"abstract":"<p><strong>Background: </strong>In France, abortion is available without restriction as to reason until 14 weeks of pregnancy. Beyond this limit, medical authorization is required and \"medical termination of pregnancy\" is permitted for fetal malformation or serious danger to the woman's health, including from \"psychosocial distress.\" Little is known about how professionals interpret psychosocial distress criteria and which women are deemed eligible.</p><p><strong>Methods: </strong>This study is based on 6 months of ethnographic fieldwork (2021-2022) in two French university hospital maternity wards. Data collection included observations of abortion care, 12 multidisciplinary team meetings, and interviews with 25 healthcare professionals (gynecologists, general practitioners, psychiatrists, psychologists, social workers, and midwives). Analysis of case files from 27 past medical termination of pregnancy requests provided additional data.</p><p><strong>Results: </strong>Healthcare professionals pathologized reproductive nonconformity by constructing certain women as unfit for motherhood based on intersecting marginalization-class, racialization, age, disability, and family structure. Approval depended on intersecting characteristics distancing women from the \"good mother\" norm: poverty, violent relationships, incarceration, substance use, and psychiatric diagnosis. Professionals medicalized social inequality while regulating abortion seekers' emotions and behaviors. Gynecologists invoked fetal interests to refuse requests and conditioned approval on long-acting contraception or sterilization. Professional hierarchies shaped decisions, with gynecologists dominating.</p><p><strong>Conclusions: </strong>Medical gatekeeping of second- and third-trimester abortion care reinforces reproductive stratification by granting access primarily to marginalized women judged incapable of motherhood while subjecting them to contraceptive coercion. Physicians construct reproductive legitimacy through collective practices, transforming social and political issues into medical problems.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116696","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":"Trends in Abortion Utilization in West Virginia During a Period of Increased Abortion Restrictions, 2013-2020.","authors":"Cynthia Beavin, Mikaela H Smith, Shanan Ashton, Valarie Blake, Alison H Norris, Danielle Bessett, Michelle L McGowan","doi":"10.1111/psrh.70093","DOIUrl":"https://doi.org/10.1111/psrh.70093","url":null,"abstract":"<p><strong>Objective: </strong>To analyze changes in method, gestational duration, and out-of-state travel for abortion care in West Virginia and for West Virginians during a timeframe with increasingly restrictive abortion legislation and decreasing abortion availability.</p><p><strong>Methods: </strong>We used publicly available data from the Centers for Disease Control and Prevention and data obtained from the Guttmacher Institute to calculate abortion rates by state of occurrence and state of residence and describe trends in abortion by gestational duration and method from 2013 to 2020. We constructed a timeline of abortion restrictions and clinic closures in West Virginia using news reports and legislation from Nexis Uni and the WV Legislature website.</p><p><strong>Results: </strong>From 2013 to 2020, West Virginia enacted six abortion restrictions and one of two clinics in the state closed. During this time, the abortion rates both in West Virginia and for West Virginians experienced greater decreases compared to abortion rates in the South and United States (US). Patients in West Virginia had a lower percentage of abortions before 7 weeks (22%) compared to 41% in the region and 38% nationally. Patients in West Virginia had proportionally more aspiration abortions (79% compared to 70% in the South and US) until 2019, when state trends began to resemble regional and national trends. By 2020, a majority (52%) of all abortions for West Virginia residents occurred out of state, compared to 14% in the South and 9% in the US.</p><p><strong>Conclusion: </strong>Abortion restrictions and a clinic closure coincided with decreased abortions at earlier gestational durations, increased use of medication abortion, and more out-of-state travel to a wider variety of states.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076281","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":"\"…If the Doctor Didn't Suggest it, Then I Would Probably Push the Idea Farther in My Head.\": Centering the Diverse Voices of Black Women to Understand PrEP Awareness and Access in the United States South.","authors":"Courtney Peasant Bonner, Erin Cox, Indya Hairston, Ayanna Smith, Brittni Howard, Felicia A Browne, Sarah T Roberts, Kineka J Hull, Dazon Dixon Diallo, Wendee M Wechsberg","doi":"10.1111/psrh.70082","DOIUrl":"https://doi.org/10.1111/psrh.70082","url":null,"abstract":"<p><strong>Context: </strong>In Atlanta, Georgia Black women account for most of new HIV diagnoses among women and 30% of Black women may benefit from pre-exposure prophylaxis (PrEP). Yet their PrEP knowledge, awareness, and access are low.</p><p><strong>Methods: </strong>This study centers the voices of an economically diverse sample of 22 Black women-annual incomes from $0 to greater than $150,000-to explore their perspectives about PrEP. After consenting, women engaged in focus groups (n = 6). Rapid qualitative analysis was used to identify themes.</p><p><strong>Results: </strong>Participants indicated that there was low percieved appropriateness of PrEP among Black women; expressed that Black women desired PrEP; emphasized the importance of providers' recommendations in PrEP decision-making; and identified stigma, racial bias, cost, and side effects as PrEP access and initiation barriers. Most women indicated a preference for injectable PrEP.</p><p><strong>Conclusion: </strong>Marketing that appeals to Black women; efforts that address the cost of PrEP; and PrEP education for clinicians may increase PrEP awareness, access, and uptake among Black women.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041278","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":"Pre-Dobbs Perspectives on Abortion Restrictions From Survivors of Intimate Partner Violence in Pennsylvania.","authors":"Carly O'Connor-Terry, Swetha Jasti, Isabel Carulli, Danielle Burton, Tejasvi Gowda, Adrianne Laing, Beatrice A Chen, Judy C Chang","doi":"10.1111/psrh.70090","DOIUrl":"https://doi.org/10.1111/psrh.70090","url":null,"abstract":"<p><strong>Introduction: </strong>From 2017 to 2029, we performed a study exploring reproductive health needs, concerns, and experiences of woman-identifying intimate partner violence (IPV) survivors that included soliciting their opinions on various abortion restriction policies relevant in Pennsylvania prior to the Dobbs v. Jackson Women's Health Organization (Dobbs) decision.</p><p><strong>Methodology: </strong>We conducted semi-structured interviews with IPV survivors regarding their opinions and perspectives related to abortion care and specific abortion policies. This article focuses on their reactions to and thoughts about three abortion restrictions: mandated counseling scripts, 24-hour (24-h) waiting periods, and spousal notification requirements. We coded and reviewed interview transcriptions to identify patterns and themes.</p><p><strong>Results: </strong>Participants described how the complexity of their IPV experiences shaped their opinions on abortion. They also described concerns about potential physical and psychological risks for people experiencing IPV with all three restrictions. Although they noted that the 24-h waiting period could also have risks, they acknowledged possible benefit in having time to consider options and advised using the time to provide IPV-related support and information.</p><p><strong>Conclusions: </strong>Our findings highlight how the context and complexity of IPV situations may lead to nuances in survivors' personal opinions regarding abortion. Additionally, while survivors described concerns for unique safety challenges from abortion restrictions, they also suggested ideas on how to make these policies more useful by providing IPV support and resources. Although this study was conducted prior to Dobbs, our analysis adds insight to the implications of current abortion restrictions on those experiencing IPV.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031534","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":"Self-Care for Sexual and Reproductive Health: Results From the French 2023 National Survey on Sexuality and Sexual Health.","authors":"Caroline Moreau, Armelle Andro","doi":"10.1111/psrh.70074","DOIUrl":"https://doi.org/10.1111/psrh.70074","url":null,"abstract":"<p><strong>Introduction: </strong>Digital platforms have accelerated sexual and reproductive health (SRH) self-care practices, but evidence is limited regarding the demand and usage of these resources and their potential to reduce SRH inequities.</p><p><strong>Methods: </strong>We draw on the CSF-2023 study, a national cross-sectional survey on sexuality in France. Our sample included 6305 sexually active individuals aged 18-49 who reported on SRH digital health care practices. We conducted logistic regressions to identify factors influencing the acceptability, information-seeking, and purchasing of services online across SRH domains (oral contraception, medication abortion pills, sexually transmitted infection/HIV treatment, and sexual enhancement).</p><p><strong>Results: </strong>Men demonstrated higher acceptance of SRH online self-care than women (59% vs. 53%), although overall acceptability was low (ranging from 10% for medication abortion pills to 23% for HIV Prep). Women sought more information about any topic (75% vs. 70%) and contraception and abortion specifically, while men focused more on sexual enhancement. Younger, more educated respondents and those with multiple partners or who met partners online sought a wider range of information. Acceptance was greater among men who had sex with men and respondents who reported sexual violence or unintended pregnancies, whereas rural residents were less accepting and sought less information. Recent medical care correlated with lower acceptance but did not affect information-seeking.</p><p><strong>Conclusion: </strong>This study highlights a limited interest in digital prescription-free SRH services in France, despite increasing reliance on digital platforms for SRH information. Targeted programmatic and policy investments are needed to bridge the digital divide, improve service quality, and explore alternative in-person channels for SRH self-care needs.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920994","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":"A Pilot Study to Develop and Evaluate an In-Person Group Prenatal Contraceptive Counseling Intervention in the United States.","authors":"Neena Qasba, Lisbet Lundsberg, Nancy Stanwood, Aileen Gariepy","doi":"10.1111/psrh.70086","DOIUrl":"https://doi.org/10.1111/psrh.70086","url":null,"abstract":"<p><strong>Context: </strong>We aimed to develop and pilot a patient-centered group prenatal contraceptive counseling intervention to assist pregnant people in selecting a postpartum contraceptive method.</p><p><strong>Methods: </strong>In this United States-based mixed-methods study, we conducted focus group discussions (FGDs) with pregnant and postpartum participants to identify priorities and preferences for contraceptive counseling. We then designed a group prenatal contraceptive counseling intervention and administered the intervention among a group of pregnant individuals, with pre- and post-intervention assessments of changes in contraception knowledge, participant satisfaction, and decisional conflict.</p><p><strong>Results: </strong>Twenty-four FGD participants identified several counseling priorities: hearing others' experiences; addressing contraception while breastfeeding and experiencing menstrual changes and/or weight gain; and seeing and holding contraceptive method models. We incorporated these priorities into the group prenatal contraceptive counseling intervention and tested it among 39 pregnant participants. Compared to pre-intervention, contraceptive knowledge post-intervention improved regarding intrauterine devices' relative effectiveness versus oral contraceptive pills (p = 0.015) and sterilization compared to external condoms (p = 0.035), as did knowledge of individual contraceptive methods' potential impact on breastfeeding (all p values < 0.0001). Most (87%) reported high satisfaction with the counseling intervention and would recommend it to others. Based on a validated decisional conflict scale, most participants (97-100%) felt they had enough support and knowledge after the intervention to choose a contraceptive method.</p><p><strong>Conclusions: </strong>We successfully developed a patient-centered, group prenatal contraceptive counseling intervention based on people's values and preferences, demonstrating high satisfaction, acceptability, and improved contraceptive knowledge. This intervention, designed to address participants' priorities, can be an innovative approach to prenatal contraception counseling.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920883","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}