Perspectives on Sexual and Reproductive Health最新文献

{"title":"Experiences with and unmet needs for medication abortion support: A qualitative study with US abortion support providers.","authors":"Jane W. Seymour, S. Ruggiero, Lynsie R. Ranker, T. Thompson","doi":"10.1111/psrh.12263","DOIUrl":"https://doi.org/10.1111/psrh.12263","url":null,"abstract":"INTRODUCTION\u0000Quality abortion care must be person-centered. Although academic literature has focused on full-spectrum and abortion doulas supporting instrumentation abortion (also referred to as procedural abortion) clients, clients undergoing medication abortion remain understudied and may have unique needs. We aimed to understand United States (US) abortion support providers' perceptions of medication abortion clients' support needs by exploring which needs they address, which needs remain unmet, and how remote support provision might help address client needs.\u0000\u0000\u0000METHODOLOGY\u0000Between April and October 2018, we conducted 60- to 90-min semi-structured, in-depth interviews by telephone with medication abortion support providers. The interviews focused on their experiences providing support to medication abortion clients in the US. We used a deductive thematic analysis approach.\u0000\u0000\u0000RESULTS\u0000We interviewed 16 abortion support providers affiliated with nine US-based organizations. Six participants provided in-person support to medication abortion clients, five provided remote support, and five provided both remote and in-person support. Both in-person and remote providers described offering support that addressed clients' informational, emotional, physical, spiritual, and logistical needs. Through participant narratives, we identified interwoven benefits and challenges to remote support care provision. Participants highlighted that most medication abortion clients did not have a support provider.\u0000\u0000\u0000DISCUSSION\u0000Participants revealed that abortion support providers, including remote support providers, can be a critical component of high-quality abortion care provision. More work is needed to ensure all abortion clients have access to support services as the abortion landscape in the US continues to evolve.","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140652900","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":"Can someone be both pro-life and pro-choice? Results from a national survey of US adults.","authors":"Kathryn J LaRoche, K. Jozkowski, Brandon L. Crawford, Frederica Jackson","doi":"10.1111/psrh.12262","DOIUrl":"https://doi.org/10.1111/psrh.12262","url":null,"abstract":"\"Pro-life\" and \"pro-choice\" are closely associated with discussions about abortion; we refer to the extent that people identify with these terms as \"abortion identity.\" Most polling measures present pro-life and pro-choice as mutually exclusive options, but there is a dearth of information about people who might simultaneously endorse both (or neither) labels.\u0000\u0000\u0000METHOD\u0000We administered a survey to adults in the United States (n = 580) that included two different formats for participants to select their abortion identity: a categorical item with response options ranging from strongly pro-choice to strongly pro-life (and \"both\" and \"neither\") and two separate items (sliders) that asked people the extent to which they identify with each term. We asked participants endorsing both pro-life and pro-choice to some extent on the slider items to explain their responses in an open-ended item. We used logistic regression to examine the relationship between participants' socio-demographic characteristics and the likelihood of dual identification slider scores; we analyzed open-ended data for content and themes.\u0000\u0000\u0000RESULTS\u0000On the sliders, more than 64% of participants identified as both pro-life and pro-choice to some extent. Variability existed between people's abortion identity on the close-ended items and their response to the open-ended questions. Among those with mixed abortion identities, participants described abortion as a serious and undesirable option but reflected positively on notions of personal choice and bodily autonomy.\u0000\u0000\u0000CONCLUSIONS\u0000Our findings demonstrate complexity in measuring people's endorsement of abortion identity labels. We recommend developing more nuanced and consistent measures to assess abortion attitudes.","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140658390","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":"Medication abortion for adolescents in the United States: Strengthening the role of pediatric primary care providers.","authors":"A. Starosta, Julen Harris, Aileen Gariepy, Shefali Pathy, Julia Cron","doi":"10.1111/psrh.12264","DOIUrl":"https://doi.org/10.1111/psrh.12264","url":null,"abstract":"BACKGROUND\u0000Recent legal changes have led to mounting abortion restrictions in the United States (US), disproportionately impacting adolescents, who already face multifaceted barriers to abortion care. Informed by the framework of reproductive justice, adolescents who become pregnant deserve comprehensive, unbiased, and non-judgmental pregnancy options counseling, inclusive of all choices for pregnancy continuation and termination. Pediatric primary care providers are at the front lines of caring for adolescent patients' reproductive health needs and frequently diagnose pregnancy, provide pregnancy options counseling, and assist patients in accessing abortion care. They are uniquely poised to provide this care given their trusted, ongoing relationships with adolescent patients and their families, and their values of deep respect for adolescents' individuality and autonomy.\u0000\u0000\u0000METHODS\u0000In this commentary, we aim to describe the medical and legal landscape of adolescent abortion access in the US and provide recommendations to support pediatric primary care providers' involvement in abortion care. We focus on medication abortion, as the provision of medication abortion has the potential to encompass a broad group of clinicians, including pediatric primary care providers.\u0000\u0000\u0000RESULTS\u0000We discuss the importance of providing options counseling to adolescents within the reproductive justice framework, improving abortion education for pediatric providers, and expanding access to abortion care by supporting providers at an institutional level if they opt to provide medication abortions.\u0000\u0000\u0000CONCLUSION\u0000In light of the current legal landscape, the role of pediatric primary care providers in ensuring adolescent access to abortion care is ever more critical. Although many pediatric and adolescent providers already provide this important care, we, a team of obstetricians/gynecologists and adolescent medicine physicians, echo prior calls for improved training and institutional support for pediatric providers to counsel about and provide abortion-related care. We hope that highlighting the role of pediatric providers in this sphere will help center the needs of adolescent patients and help them fulfill their family planning goals.","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140654197","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":"\"Maybe if we weren't in the pandemic, I would have reconsidered\": Experiences of abortion care-seeking during the COVID-19 pandemic in Maryland.","authors":"Jessica L Dozier, Anne E Burke, Hayley V McMahon, Blair O. Berger, Madeline Quasebarth, Carolyn Sufrin, Suzanne O Bell","doi":"10.1111/psrh.12265","DOIUrl":"https://doi.org/10.1111/psrh.12265","url":null,"abstract":"OBJECTIVE\u0000To understand the COVID-19 pandemic's impact on abortion care-seeking in Maryland, a state with Medicaid coverage for abortion, high service availability, and laws supporting abortion rights.\u0000\u0000\u0000METHODS\u0000We conducted semi-structured telephone interviews with 15 women who had an abortion between January 2021 and March 2022 at a hospital-based clinic in a mid-sized Maryland city. We purposively recruited participants with varied pandemic financial impacts. Interview questions prompted participants to reflect on how the pandemic affected their lives, pregnancy decisions, and experiences seeking abortion care. We analyzed our data for themes.\u0000\u0000\u0000RESULTS\u0000All participants had some insurance coverage for their abortion; over half paid using Medicaid. Many participants experienced pandemic financial hardship, with several reporting job, food, and housing insecurity as circumstances influencing their decision to have an abortion. Most women who self-reported minimal financial hardship caused by the pandemic indicated they sought an abortion for reasons unrelated to COVID-19. In contrast, women with economic hardship viewed their pregnancies as unsupportable due to COVID-19 exacerbating financial instability, even when they desired to continue the pregnancy. All participants expressed that having an abortion was the best decision for their lives. Yet, when making decisions about their pregnancy, the most financially disadvantaged women weighed their desires against the pandemic's constraints on their reproductive self-determination.\u0000\u0000\u0000CONCLUSIONS\u0000The pandemic changed abortion care-seeking circumstances even in a setting with minimal access barriers. Financial hardship influenced some women to have an abortion for a pregnancy that-while unplanned-they may have preferred to continue.","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140664846","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":"“I wouldn't have felt so alone”: The sexual health education experiences of transgender and gender diverse youth living in the southeastern United States","authors":"Paula E. Jayne, Leigh E. Szucs, Catherine A. Lesesne, Rose Grace Grose, Michelle M. Johns","doi":"10.1111/psrh.12258","DOIUrl":"https://doi.org/10.1111/psrh.12258","url":null,"abstract":"Transgender and gender diverse youth experience multiple disproportionate adverse sexual health outcomes. Sexual health education teaches knowledge, attitudes, and skills for promoting sexual health, including reducing risk for sexually transmitted infection, HIV acquisition, and unintended pregnancy. Provision of sexual health education may be protective, but research remains scarce.","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140590465","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 using public and private insurance coverage for abortion in Illinois: Implementation successes and remaining gaps","authors":"Madeline Quasebarth, Madeleine Boesche, Tecora Turner, Amy Moore, Danielle Young, Debra Stulberg, Lee Hasselbacher","doi":"10.1111/psrh.12259","DOIUrl":"https://doi.org/10.1111/psrh.12259","url":null,"abstract":"ContextInsurance coverage for abortion in states where care remains legal can alleviate financial burdens for patients and increase access. Recent policy changes in Illinois required Medicaid and some private insurance plans to cover abortion care. This study explores policy implementation from the perspectives of patients using their insurance to obtain early abortion care.MethodologyBetween July 2021 and February 2022, we interviewed Illinois residents who recently sought abortion care at ≤11 weeks of pregnancy. We also interviewed nine key informants with experience providing or billing for abortion or supporting insurance policy implementation in Illinois. We coded interview transcripts in Dedoose and developed code summaries to identify salient themes across interviews.ResultsMost participants insured by Illinois Medicaid or eligible for enrollment received full coverage for their abortions; most with private insurance did not and faced challenges learning about coverage status. Some opted not to use insurance, often citing privacy concerns. Participants who benefited from abortion coverage expressed relief, gave examples of other financial challenges they could prioritize, and described feeling in control of their abortion experience. Those without coverage described feeling stressed, uncertain, and constrained in their decision‐making.ConclusionWhen abortion was fully covered by insurance, it reduced financial burdens and enhanced reproductive autonomy. Illinois Medicaid policy—with seamless enrollment options and appropriate reimbursement rates—offers a model for improving abortion access in other states. Further investigation is needed to determine compliance among private insurance companies and increase transparency.","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140590366","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":"Perspectives from the pandemic epicenter: Sexual and reproductive health of immigrant women in New York City","authors":"Goleen Samari, Heather M. Wurtz, Sheila Desai, Kate Coleman‐Minahan","doi":"10.1111/psrh.12260","DOIUrl":"https://doi.org/10.1111/psrh.12260","url":null,"abstract":"ContextThe United States' response to COVID‐19 created a policy, economic, and healthcare provision environment that had implications for the sexual and reproductive health (SRH) of racialized and minoritized communities. Perspectives from heterogenous immigrant communities in New York City, the pandemic epicenter in the United States (US), provides a glimpse into how restrictive social policy environments shape contraception, abortion, pregnancy preferences, and other aspects of SRH for marginalized immigrant communities.MethodsWe conducted in‐depth interviews in 2020 and 2021 with 44 cisgender immigrant women from different national origins and 19 direct service providers for immigrant communities in New York City to explore how immigrants were forced to adapt their SRH preferences and behaviors to the structural barriers of the COVID‐19 pandemic. We coded and analyzed the interviews using a constant comparative approach.ResultsPandemic‐related fears and structural barriers to healthcare access shaped shifts in contraceptive use and preferences among our participants. Immigrant women weighed their concerns for health and safety and the potential of facing discrimination as part of their contraceptive preferences. Immigrants also described shifts in their pregnancy preferences as rooted in concerns for their health and safety and economic constraints unique to immigrant communities.ConclusionUnderstanding how immigrant women's SRH shifted in response to the structural and policy constraints of the COVID‐19 pandemic can reveal how historically marginalized communities will be impacted by an increasingly restrictive reproductive health and immigration policy landscape.","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140590459","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 prospective study of sexual risk patterns associated with delinquency and justice involvement among child welfare system-involved male adolescents in the United States.","authors":"Nickholas Grant, Gabriel J Merrin, Keisha April, Ayana April-Sandars, Ishita Arora, Derrick Gordon","doi":"10.1111/psrh.12255","DOIUrl":"10.1111/psrh.12255","url":null,"abstract":"<p><strong>Introduction: </strong>Early sexual activity and teen pregnancy are known risk factors for delinquency and justice involvement among male adolescents. However, less is known about these patterns among child welfare system (CWS)-involved boys who face significant social barriers and past/current traumatic experiences.</p><p><strong>Methods: </strong>We prospectively examined these associations among male adolescents who identified as low and high risk for child-maltreatment via a secondary data analysis of the Longitudinal Studies of Child Abuse and Neglect dataset-a large scale assessment of children, their parents, and their teachers in the United States to understand issues of child abuse and neglect. We extracted and examined data from 657 boys who were identified as at-risk for maltreatment or with histories of substantiated maltreatment at ages 6, 8, 12, 14, and 16. We used structural equation modeling to examine the relationship between sexual activity (i.e., age of sexual debut, actively having sex, and sex resulting in a child) and changes in delinquency and justice involvement.</p><p><strong>Results: </strong>Male adolescents who have engaged in sex and/or have fathered a child had greater increases in delinquency over time compared to those who have not had sex. Further, fathering a child was significantly associated with justice involvement, especially for the high-risk group.</p><p><strong>Conclusion: </strong>Results indicate that greater efforts should be taken to ascertain CWS-involved male adolescents' sexual health practices and parenting status. Male adolescents in the CWS require support with accessing developmentally appropriate sexual health education and family services.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029320","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":"Application of the unified theory of behavior to strengthen sexual health discussions between providers and young patients in the United States.","authors":"Yzette Lanier, Dennis Rivera-Cash, Claudine Lavarin, Alena Goldstein, Luke Cantu, Baomi Phung, Vincent Guilamo-Ramos, Madeline Sutton","doi":"10.1111/psrh.12253","DOIUrl":"10.1111/psrh.12253","url":null,"abstract":"<p><strong>Context: </strong>Sexual health discussions between healthcare providers and adolescent and young adult patients are an important strategy for addressing and improving sexual health. However, healthcare providers often do not engage in comprehensive sexual health discussions with young patients during routine clinical visits.</p><p><strong>Methods: </strong>We propose the use of a conceptual model, the Unified Theory of Behavior (UTB), as a tool that can aid healthcare providers in facilitating more comprehensive sexual health conversations with young patients.</p><p><strong>Results: </strong>We present clinical scenarios on how healthcare providers can use the UTB with existing sexual health assessments during routine, clinical visits with their patients.</p><p><strong>Conclusions: </strong>Using the UTB may be one effective tool to aid healthcare providers in initiating sexual health discussions and facilitating more comprehensive sexual health conversations with adolescent and young adult patients during routine clinical visits and sexual and reproductive health-focused visits.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140066004","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 health variation among gang-involved youth in Washington state: Social ecological implications for research and practice.","authors":"Asia S Bishop, Paula S Nurius, Sarah C Walker, Monica L Oxford","doi":"10.1111/psrh.12251","DOIUrl":"10.1111/psrh.12251","url":null,"abstract":"<p><strong>Introduction: </strong>Gang-involved youth experience greater disparities in sexual health compared to non-gang-involved youth. Yet, little is known about how and why sexual behaviors vary within the youth gang population. Developing relevant and effective service approaches requires an understanding of this variation and the environmental factors that influence patterns of sexual health risk.</p><p><strong>Methodology and results: </strong>Using latent class analysis, we identified four sexual behavior classes within a school-based sample of gang-involved youth in Washington State (N = 2060): Non-Sexually Active (54%), Limited Partners with Condom Use (14%), Multiple Partner with Sexting (19%), and High Sexual Vulnerability (13%). These classes were distinguished by age at sexual debut, number of sexual partners, condom use, and sexting. Interpersonal and macrosocial factors differentiated the classes, including multiform violence exposures, limited social support, and socioeconomic instability. We also found differences according to sexual identity and substance use.</p><p><strong>Discussion: </strong>Findings highlight the need for service approaches that are responsive to both the individual needs of gang-involved youth and the factors that shape their living environments. We discuss the implications for research and practice, including the potential utility of a harm reduction framework to promote sexual health and reduce disparities in the youth gang population.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11026090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933516","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}