Perspectives on Sexual and Reproductive Health最新文献

{"title":"Increasing access to LARC removal in pediatrics to support adolescent reproductive justice in the United States.","authors":"Joline S Hartheimer, Bianca A Allison, Martha F Perry","doi":"10.1111/psrh.12270","DOIUrl":"10.1111/psrh.12270","url":null,"abstract":"<p><strong>Background: </strong>In the United States (U.S.), adolescents and young adults are increasingly using contraception, including long-acting reversible contraception (LARC) [e.g., subdermal implants (e.g., Nexplanon®) and intrauterine devices (IUDs)]; however, access to LARC device removal may be difficult for adolescents and young adults. Reproductive justice is the right to bodily autonomy, have children, not have children, and safely parent the children we have.</p><p><strong>Methods: </strong>In this commentary, we discuss that while the specialties of family medicine and obstetrics and gynecology have incorporated the principles of reproductive justice into their contraceptive care, further work is needed to ingrain this philosophy into pediatrics training. Since LARC devices are historically only removable by health care providers, pediatricians may act as gatekeepers to removing LARC, obstructing the reproductive justice of adolescents and young adults.</p><p><strong>Results: </strong>We describe that adolescents and young adults in the U.S. face unique barriers to LARC removal including limited access to the health care system, potential breaches in confidentiality, and provider bias. These barriers may lead adolescents and young adults to remove their own LARC device when experiencing unwanted side effects or desiring pregnancy. While IUD self-removal is a safe and accessible option, safety and efficacy data on subdermal implant self-removal is currently limited.</p><p><strong>Conclusion: </strong>In order to promote reproductive justice in adolescents and young adults, we recommend that (1) pediatricians should address potential barriers to LARC removal prior to insertion, (2) pediatricians must offer unbiased LARC removal, (3) pediatricians who place LARC must be knowledgeable about complicated LARC removal, and (4) pediatricians should discuss LARC self-removal options with adolescents and young adults.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"85-89"},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263083","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":"Assessing perspectives on an intervention connecting adolescents in outpatient psychiatry care to contraceptive counseling in the United States.","authors":"Abigail L Underwood, Kathryn A Hyzak, Ashley Ebersole, Alicia C Bunger, Elise D Berlan","doi":"10.1111/psrh.12261","DOIUrl":"10.1111/psrh.12261","url":null,"abstract":"<p><strong>Background: </strong>Adolescents with psychiatric disorders have high rates of unintended pregnancy and experience barriers to accessing sexual and reproductive health (SRH) care. Outpatient psychiatry visits are potential opportunities to connect adolescents to SRH care. This study informs the development of the Link2BC intervention which links adolescents in outpatient psychiatry care to SRH care.</p><p><strong>Methods: </strong>We conducted group interviews with adolescents (3 groups, 7 total participants) and caregivers (3 groups, 9 total participants) and individual interviews with 8 psychiatry providers who received or provided outpatient psychiatric treatment in clinics in a pediatric hospital in a city in the Midwestern United States. We asked questions about the acceptability of Link2BC, potential implementation needs, and implementation determinants. Using consensus-building techniques, two coders analyzed transcriptions using a codebook informed by the Consolidated Framework for Implementation Research 2.0.</p><p><strong>Results: </strong>Participants agreed on the need for interventions that expand access to SRH care. Adolescents emphasized that services should be confidential and accessible and were open to their psychiatrists introducing SRH topics during appointments. Providers expressed preference for training and clear workflows. Participants agreed that psychiatry providers could serve as liaisons between adolescents and their caregivers to facilitate conversations about contraception. Participants had concerns about time constraints during visits but mentioned few other barriers to the intervention.</p><p><strong>Conclusion: </strong>This study demonstrates the acceptability of connecting adolescents in outpatient psychiatry care to contraceptive counseling and informs the refinement and implementation of Link2BC. Integrating contraception counseling in outpatient psychiatry settings is an innovative approach to prevent unintended pregnancy among adolescents by increasing access to SRH care services.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"171-181"},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307395","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":"High variability in self-pay pricing for vasectomy and vasectomy reversal in the United States.","authors":"Aaron Brant, Patrick Lewicki, Alec Zhu, Stephen Rhodes, Camilo Arenas-Gallo, Jonathan E Shoag, Peter N Schlegel, Joshua Halpern","doi":"10.1111/psrh.12266","DOIUrl":"10.1111/psrh.12266","url":null,"abstract":"<p><strong>Context: </strong>In the United States (US) men who undergo vasectomy and/or vasectomy reversal (vasovasotomy) are likely to pay out-of-pocket for these procedures. We characterized the publicly disclosed pricing of both procedures with a focus on variability in self-pay prices.</p><p><strong>Methods: </strong>We queried all US hospitals for publicly disclosed prices of vasectomy and vasovasotomy. We assessed interhospital variability in self-pay pricing and compared hospitals charging high (≥75th percentile) and low (≤25th percentile) self-pay prices for either procedure. We also examined trends in pricing after the 2022 US Supreme Court decision that allowed individual states to ban abortion.</p><p><strong>Results: </strong>Of 6692 hospitals, 1375 (20.5%) and 281 (4.2%) disclosed self-pay prices for vasectomy and vasovasotomy, respectively. There was a 17-fold difference between the 10th and 90th percentile self-pay prices for vasectomy ($421-$7147) and a 39-fold difference for vasovasotomy ($446-$17,249). Compared with hospitals charging low (≤25th percentile) self-pay prices for vasectomy or vasovasotomy, hospitals charging high (≥75th percentile) prices were larger (median 150 vs. 59 beds, p < 0.001) and more likely to be for-profit (31.2% vs. 7.8%, p < 0.001), academic-affiliated (52.7% vs. 23.1%, p < 0.001), and located in an urban zip code (70.1% vs. 41.3%, p < 0.001). From October 2022 to April 2023, the median self-pay price of vasectomy increased by 10% (from $1667 to $1832) while the median self-pay price of vasovasotomy decreased by 16% (from $3309 to $2786).</p><p><strong>Conclusion: </strong>We found large variability in self-pay pricing for vasectomy and vasectomy reversal, which may serve as a barrier to the accessibility of male reproductive care.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"98-105"},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088879","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":"Research in brief: How prevalent is rough sex? Results from a national online sample of adults in Germany","authors":"Nicola Döring, M. Rohangis Mohseni, Laura Pietras, Arne Dekker, Peer Briken","doi":"10.1111/psrh.12267","DOIUrl":"https://doi.org/10.1111/psrh.12267","url":null,"abstract":"BackgroundRough sex refers to consensual sexual activities that incorporate playful aggression, such as hair pulling, spanking, or choking. It is relevant in the context of sexual health as it can enhance sexual arousal, pleasure, and intimacy among consenting partners. However, it can also be associated with consent violations, discomfort, and injuries ranging from mild to severe or even fatal. The prevalence of rough sex in Germany is widely unknown. Our study aims to establish, for the first time, the overall age‐related and gender‐related prevalence rates of active and passive rough sex involvement among adults in Germany.MethodsA national online sample of 1101 adults from Germany, aged 18–69 years (50% men, 49% women, 1% gender‐diverse individuals) gave informed consent and reported on their lifetime engagement in rough sex in active and passive roles. We recruited participants through a professional panel provider for a multi‐themed sexual health survey. Data analysis was conducted using R, with 95% confidence intervals of prevalence rates computed to answer the research questions.ResultsLifetime prevalence of rough sex involvement was 29%. Adults below the age of 40 reported higher rates of involvement (up to 43%) than people over 40 (up to 26%). Men reported predominantly active role involvement and women reported primarily passive role involvement.DiscussionResults show that rough sex is common. Sexual health professionals, educators, and researchers should be prepared to guide current and aspiring practitioners of rough sex, helping them understand potential benefits, risks, and age‐ and gender‐related differences.","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":"38 1","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140826651","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":"2017 1","pages":""},"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":"12 1","pages":""},"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":"95 1","pages":""},"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":" ","pages":"30-40"},"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":" ","pages":"4-15"},"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":" ","pages":"16-29"},"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}