Perspectives on Sexual and Reproductive Health最新文献

{"title":"Access to Abortion in New Zealand After Law Reform and COVID-19; A National Cohort Study.","authors":"Michelle R Wise, Sanskruti Patel, Carolina Servente, Alison Knowles, Anna Hudspith, Jessica Wilson, John M D Thompson","doi":"10.1111/psrh.70041","DOIUrl":"10.1111/psrh.70041","url":null,"abstract":"<p><strong>Background: </strong>Abortion law reform (ALR) in Aotearoa New Zealand occurred in 2020 and included removing legal criteria for an abortion to be performed prior to 20 weeks' gestation, and enabling women to self-refer, abortifacients to be taken at home, and non-specialists to offer abortion care.</p><p><strong>Objective: </strong>Assess the impact of ALR on access to abortion services and contraception provision, by ethnicity.</p><p><strong>Methods: </strong>This is a retrospective national cohort study of all women in Aotearoa New Zealand who had an abortion, comparing the year before ALR (1 January to 31 December 2019) to after (1 July 2020 to 30 June 2021). We obtained anonymous datasets from the Ministry of Health. We used Poisson regression to analyze outcomes. We estimated relative risks and 95% confidence limits (CL) for the association between demographic and clinical variables and outcomes. We then performed multivariable analysis to adjust for age, parity, ethnicity, deprivation and domicile of residence. The primary outcome was the proportion of women who had an abortion prior to 10.0 weeks' gestation.</p><p><strong>Results: </strong>Post-ALR, more women accessed abortion < 10.0 weeks' gestation (78.3% vs. 64.5% pre-ALR, adjusted relative risk 1.21 (95% CL: 1.19-1.23), p < 0.0001). Post-ALR, more Māori women accessed abortion < 10 weeks' (68.4% vs. 53.3% pre-ALR, p < 0.001). Both pre- and post-ALR, fewer Māori women accessed abortion < 10 weeks' compared to non-Māori women (53.3% vs. 67.8%, and 68.4% vs. 81.2%, respectively, both p < 0.0001).</p><p><strong>Conclusions: </strong>Following ALR in Aotearoa New Zealand, women have a 21% better chance of having an abortion procedure < 10.0 weeks' gestation compared to before ALR, after adjusting for demographic variables. Although access improved for Māori women, inequity by ethnicity remains.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"557-566"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534896","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":"Enhancing Youth Access to Reproductive Health Services in Rural Communities Through Clinical and Educational Interventions in Upstate New York, USA.","authors":"Laith Abu Lekham, Olivia Catalano, Omar Abueed, Ellen Hey, Yong Wang, Mohammad T Khasawneh","doi":"10.1111/psrh.70033","DOIUrl":"10.1111/psrh.70033","url":null,"abstract":"<p><strong>Introduction: </strong>Access to sexual and reproductive health care has been a critical issue affecting public health outcomes, particularly for the youth population. This project identified common barriers to accessing sexual and reproductive health care for youth in rural areas and applied multiple educational and clinical interventions that helped enhance access to care.</p><p><strong>Methodology: </strong>We designed a three-year-long program at Finger Lakes Community Health (FLCH) in rural upstate New York that involved youth, their parents or caregivers, educators, and medical professionals to improve youth access to care. Using results from a survey with 1155 youth participants to determine the barriers to care, we designed the program to overcome the fear of seeking help, basic facts ignorance, transportation issues, parental opposition, and financial issues. We implemented multiple interventions, including providing adequate education and school services, ensuring privacy and confidentiality, changing work hours, establishing phone and online services, facilitating transportation, and reducing cost barriers.</p><p><strong>Results: </strong>The results were dramatic. Sexual and reproductive health visits to FLCH from youth in the region increased significantly from 280 in 2017 to 1100 in 2019. Even during the COVID-19 pandemic, when the number of visits slightly decreased, visits were still better than before 2018. In 2023, the number of reproductive health visits was 990, which is 3.5 times the visits in 2017.</p><p><strong>Discussion: </strong>This study emphasizes the substantial role that tailored interventions can play in enhancing reproductive health access for youth in rural areas, significantly promoting healthcare equity and service utilization. These interventions reduce healthcare use inequities and foster potential improved public health outcomes. While our study did not directly measure clinical outcomes, the substantial increase in utilization represents an important step toward achieving them and underscores the need for further research to evaluate resulting health outcomes.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"480-491"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Adolescents' Menstrual Hygiene Management Needs: Findings From Students in St. Louis, Missouri Charter Schools.","authors":"Anne Sebert Kuhlmann, Kenneth Kibii, Kirstin Palovick, Cheleia Marshall","doi":"10.1111/psrh.70043","DOIUrl":"10.1111/psrh.70043","url":null,"abstract":"<p><strong>Objective: </strong>To assess unmet menstrual hygiene needs and explore experiences with menstruation management among students at four charter high schools in the City of St. Louis, Missouri, United States in order to inform the development of future educational resources.</p><p><strong>Methods: </strong>Using a cross-sectional design with mixed-methods data collection, we collected quantitative data from 117 participants through anonymous, electronic surveys. We conducted four focus group discussions (FDGs), one at each high school, with 7-10 participants per group.</p><p><strong>Results: </strong>Among survey respondents, 41% were in 10th grade and a majority identified as non-Hispanic Black (68%), with an average age of 16 years (15.6 ± 2.82 years). During the previous school year (2021-2022), over half of students (51%) were unable to access period products when needed at least once because they or their family could not afford them. The FDGs centered around four key domains of inquiry: (a) menstruation management-related school resources, (b) menstrual symptoms and coping strategies, (c) menstrual hygiene education, and (d) menstrual cycle tracking strategies.</p><p><strong>Conclusions: </strong>Our findings highlight how essential it is to address the issue of unmet needs for menstrual products and hygiene management to ensure all students who experience menstruation can access period products, minimize menstruation-related absenteeism, and promote the overall well-being of adolescent students.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"470-479"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Mississippi Title X Family Planning Program in Meeting Reproductive and Sexual Health Needs.","authors":"Ellie Smith, Elizabeth Sweeney, Austin Conner, Izzy Thornton, Sarah Mason","doi":"10.1111/psrh.70035","DOIUrl":"10.1111/psrh.70035","url":null,"abstract":"<p><strong>Background: </strong>The United States (US) federal Title X program provides funding for affordable and accessible family planning and sexual health services through competitive grant funding across US jurisdictions. In 2022, non-profit clinic network Converge: Partners in Access became the sole Title X grantee in the state of Mississippi. Converge developed a strategic evaluation plan to ensure efficient utilization and high-quality provision of care by eligible state residents.</p><p><strong>Purpose: </strong>The study purpose is to determine the implementation climate of the Title X clinic network, including service utilization, quality improvement opportunities and challenges, and potential patients' awareness of and experience with receiving Title X-funded services.</p><p><strong>Methods: </strong>The study utilized in-depth, semi-structured phone and in-person interviews conducted between January 2023 and May 2023 with clinic staff, administrators, providers, and potential patients to assess implementation climate, challenges in healthcare provision, and opportunities to improve Title X utilization by eligible state residents.</p><p><strong>Main findings: </strong>Researchers conducted 22 interviews with clinic staff and health care providers and 16 with potential patients. Clinic-based participants indicated the use of evidence-based practices in their respective settings-a key component of the Title X program. However, challenges to implementation were identified including understaffing, high staff turnover, difficulties with reporting and documentation, competing priorities for patients, and differences in capacity based on clinic characteristics. Potential patients identified the need for person-centered approaches to care and increased awareness and availability of Title X services in their communities.</p><p><strong>Conclusions: </strong>Results from this study can inform strategies to improve service utilization by potential patients and the quality of care for Title X funded networked clinics in Mississippi. Improving the delivery of care and service utilization can ultimately better meet the reproductive and sexual health needs of patients served through the Title X funded system.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"522-532"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432801","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":"Online Discussions About Intrauterine Devices: A Qualitative Content Analysis of Global Reddit Posts.","authors":"Georgia R Breakey, Anna Chur-Hansen","doi":"10.1111/psrh.70040","DOIUrl":"10.1111/psrh.70040","url":null,"abstract":"<p><strong>Context: </strong>Intrauterine devices (IUDs) are a type of long-acting reversible contraception (LARC) that sit inside the uterus. However, due to the internal nature of the device, pain and lack of control are major concerns for people using IUDs.</p><p><strong>Methods: </strong>We conducted conventional qualitative content analysis of posts from the global subreddit r/birthcontrol that mentioned IUDs in the month of July 2022 to answer the question \"what are people's experiences with IUDs as discussed on Reddit?\" Reddit, being an online social media platform, makes the geographic background of most of the participants unknown; however, the posts on this subreddit are written in English.</p><p><strong>Results: </strong>Of the 456 Reddit posts, four overarching categories were identified: \"Interactions with other users,\" \"Concerns,\" \"Reason for getting IUD,\" and \"Dissatisfied with treatment from medical staff.\" Despite IUD insertion being reported as painful and participants experiencing painful side effects, these concerns were not always taken seriously by medical staff. This was often in the form of feeling dismissed and not being given adequate pain management options before procedures such as IUD insertions and removals.</p><p><strong>Conclusion: </strong>Findings provide insight into IUD users' perspectives and opinions on the care they receive from medical professionals. Highlighted are areas that need improvement, such as providing more pain management options and more transparency regarding the potential risks and side effects of having an IUD.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"506-521"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145394034","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":"\"Do You Know What Birth Control Actually Does to Your Body?\": Assessing Contraceptive Information on TikTok.","authors":"Caroline de Moel-Mandel, Arielle Donnelly, Megan Bugden","doi":"10.1111/psrh.70025","DOIUrl":"10.1111/psrh.70025","url":null,"abstract":"<p><strong>Introduction: </strong>Social media platforms have rapidly become key sources of contraceptive health information, shaping the beliefs and behaviors of individuals of reproductive age. Yet, it has become increasingly difficult to distinguish accurate content from misleading information, potentially leading to higher unintended pregnancy rates. Given the limited insights into the quality and reliability of contraceptive information on TikTok, this cross-sectional study aimed to systematically evaluate popular TikTok content on contraception created by various users to identify and analyze misinformation.</p><p><strong>Method: </strong>Between August and September 2023, we analyzed 100 videos from the top five hashtags related to contraception methods (#birthcontrol, #contraception, #thepill, #naturalbirthcontrol, and #cycletracking) to assess the characteristics of the health information presented and their quality, using the DISCERN tool.</p><p><strong>Results: </strong>The TikTok videos collectively received 4.85 billion views. Only 10% were created by medical professionals. Overall, the content showed poor reliability and quality, indicating a prominent presence of contraceptive health misinformation. Furthermore, there was a concerning trend favoring natural contraceptive methods over hormonal options, often without appropriate risk disclosures, accompanied by a growing distrust in health professionals.</p><p><strong>Discussion: </strong>The rise of contraceptive misinformation on social media is re-shaping patient-provider relationships and impacting contraceptive beliefs. TikTok offers an excellent public health opportunity to disseminate accurate contraceptive information accessible to all individuals, regardless of their background or resources. To address the observed distrust in health professionals, it is essential to improve contraceptive care quality and promote shared decision-making, which would likely increase satisfaction with contraceptive choices and mitigate negative narratives online.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"358-367"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Interval Pregnancy Following Delivery in Catholic-Affiliated Versus Non-Catholic-Affiliated Hospitals Among Patients Insured Through the Medicaid Program.","authors":"Allison Liu, Valeria Hernandez, Debra Stulberg, Phil Schumm, Manoradhan Murugesan, Ashley McHugh, Annie Dude","doi":"10.1111/psrh.70021","DOIUrl":"10.1111/psrh.70021","url":null,"abstract":"<p><strong>Background: </strong>As the number of U.S. Catholic-affiliated hospitals increases, more patients who receive care at Catholic hospitals may face restrictions to reproductive healthcare services, including postpartum contraception and sterilization. Little is known about how Catholic hospital affiliation affects the likelihood of a short-interval pregnancy following a delivery. A short interpregnancy interval is associated with poor obstetric outcomes in subsequent pregnancies.</p><p><strong>Methods: </strong>In this retrospective study of Medicaid claims data, we examined if an index delivery at a Catholic-affiliated hospital was associated with a short-interval pregnancy among patients in nine states (2010-2014). We used Cox proportional hazards regression to compare the time to subsequent pregnancy for those who delivered at Catholic-affiliated hospitals versus non-Catholic-affiliated hospitals. We also estimated the likelihood of a subsequent pregnancy by 6, 12, and 18 months following an index delivery.</p><p><strong>Results: </strong>We matched 1,197,898 index births to a provider and the religious affiliation of the delivery hospital. Across all nine states, 20.9% (249,764) of deliveries were at Catholic hospitals. After adjusting for maternal age, maternal race and ethnicity, and rural residence, subjects who delivered in a Catholic hospital had a 5% increased adjusted odds of conception by 18 months (95% confidence interval: 1.04-1.07; adjusted odds ratio: 1.07, 95% confidence interval: 1.05-1.10 by 6 months and adjusted odds ratio: 1.06, 95% confidence interval: 1.05-1.08 by 12 months for Catholic vs. non-Catholic hospitals).</p><p><strong>Discussion: </strong>Medicaid enrollees who deliver at Catholic hospitals are at increased risk for short-interval pregnancies.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"321-328"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576687","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":"Effect of Parent-Based Sexual Health Education on Parent-Adolescent Communication and Adolescent Sexual Behavior: A Systematic Review and Meta-Analysis.","authors":"Birhanu Gutu, Abela Mahimbo, Nikki Percival, Daniel Demant","doi":"10.1111/psrh.70029","DOIUrl":"10.1111/psrh.70029","url":null,"abstract":"<p><strong>Background: </strong>Parent-based sexual education interventions have a positive impact on adolescent sexual and reproductive health. However, despite these positive outcomes, there is a lack of comprehensive research to understand the effectiveness of these programs across different communities and demographics.</p><p><strong>Methods: </strong>We conducted a systematic search of databases from January 2013 to April 2023 and identified 51 published studies conducted globally on the effects of parent-based sexual education. We conducted meta-analyses to understand the pooled effect of interventions on parent-adolescent communication outcomes and adolescent sexual and reproductive behaviors.</p><p><strong>Results: </strong>This review includes 51 studies. Most of the included studies (n = 36, 68.6%) were conducted in high-income countries; 17 (33.3%) involved only mothers, and 37 (72.5%) stated they were based on theoretical frameworks. The systematic review showed that interventions on sexual communication had mixed effects on parent and adolescent-related outcomes. The meta-analysis, however, showed positive effects on parent-reported sexual health communication frequency, adolescent-reported sexual health communication frequency, parental attitude, and parental self-efficacy, Cohen's d = 0.32, 0.26, 0.38, and 0.41, respectively.</p><p><strong>Conclusion: </strong>Parent-based sexual health education interventions positively impact various aspects of parent-adolescent sexual health communication and behavior, suggesting the effectiveness of the intervention in different social, cultural, and economic contexts. The lack of research in low- and middle-income nations and limited paternal participation highlights the need for further research.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"374-422"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Women Feel Unprepared for the Experience of an Intrauterine Device Insertion: Findings From an Australian Study.","authors":"Cassandra Caddy, Meredith Temple-Smith, Jacqueline Coombe","doi":"10.1111/psrh.70023","DOIUrl":"10.1111/psrh.70023","url":null,"abstract":"<p><strong>Objective(s): </strong>The experience of pain during intrauterine insertion can be highly variable, ranging from none to severe. The objective of this study was to explore the experience of intrauterine device (IUD) insertion from the perspective of contraceptive users.</p><p><strong>Study design: </strong>We conducted a qualitative study using individual semi-structured Zoom interviews with women living in Australia. We recruited participants from a larger study exploring the information needs of contraceptive users. We audio-recorded and transcribed interviews and thematically analyzed the data.</p><p><strong>Results: </strong>Eighteen women described their experiences of IUD insertion. Although most participants described mild to moderate pain, some described severe pain exceeding their expectations and reported being unprepared for this experience. In some cases, these experiences had unexpected short and long-term consequences such as impacts on intimate relationships and fear of other gynecological procedures.</p><p><strong>Conclusion: </strong>Intrauterine device users should be informed of the range of pain experiences that may occur during insertion, including the risk of a vasovagal reaction, and all pain management options available to them. Experiences of pain during insertion did not appear to deter contraceptive users' continued IUD use or planned future use.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"368-373"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I Don't Even Understand How They Function\": Contraception Information, Motivation, and Behavioral Skills Among Women Experiencing Homelessness.","authors":"Ashvita Garg, Annalynn M Galvin, Anelise Diener, Stacey B Griner, Idara N Akpan, Erika L Thompson","doi":"10.1111/psrh.70024","DOIUrl":"10.1111/psrh.70024","url":null,"abstract":"<p><strong>Background: </strong>Women experiencing homelessness have higher rates of unintended pregnancies than stably housed women. Given that some of this may be attributed to nonuse or inconsistent use of contraception, we explored the behavioral cognitions for contraceptive use among women experiencing homelessness. The Information-Motivation-Behavioral Skills (IMB) model can examine health behavior cognitions, while acknowledging the macro-level context. Therefore, this study explored the IMB characteristics related to contraception use among women experiencing homelessness.</p><p><strong>Methods: </strong>We conducted interviews (n = 19) among pregnancy-capable women 18-45 years old experiencing homelessness. We recruited women between 2019 and 2020 in North Texas. Interviews were thematically analyzed based on the IMB framework.</p><p><strong>Results: </strong>The mean age of women in the study sample was 33.4 years (SD = 7.6). In the information construct, most women were aware of different contraceptive methods; however, many desired to learn more about the side effects. For motivation, most women had a positive attitude toward their current contraception, but their motivation to use a type of contraceptive method depended on side effects and comfort with the method. Additionally, their trusted social connections influenced their contraception decisions. When examining behavioral skills, uncertainty of being able to obtain contraception was a barrier, especially with macro-level context related to lack of adequate insurance coverage and transportation.</p><p><strong>Conclusions: </strong>Improving knowledge about side effects of contraceptive methods, addressing misconceptions, and increasing accessibility to contraceptive methods by providing transportation and financial assistance while maintaining reproductive autonomy may be effective strategies to improve equitable access to contraception and reduce unintended pregnancies among this population.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":"340-349"},"PeriodicalIF":3.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508855","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}