Frontiers in reproductive health最新文献

{"title":"Determinant of unmet need for family planning among adolescent and young women in Kenya: multilevel analysis using recent Kenyan demographic health survey.","authors":"Beyene Sisay Damtew, Hinsermu Bayu Abdi, Beker Ahemed Hussien, Getahun Tiruye, Nafyad Tolossa Urgie, Beniam Worku Yigezu, Sifan Ahmed Mohammed, Bezawit Melak Fente","doi":"10.3389/frph.2025.1511606","DOIUrl":"10.3389/frph.2025.1511606","url":null,"abstract":"<p><strong>Background: </strong>Unmet need for family planning (FP) refers to the proportion of women who are fecund, sexually active, and wish to delay or limit childbearing but are not using any effective contraceptive method. Unmet need for FP remains a significant public health concern, particularly among young women aged 15-24 years. This study explores the determinants of unmet need for FP among young women.</p><p><strong>Method and material: </strong>This study used data from the 2022 Kenyan Demography and Health Survey to investigate the relationship between various factors and a binary outcome variable of unmet need for family planning among adolescent young age group. A multilevel binary logistic regression model was used to analyze the data, accounting for the clustering effects of the survey data. The statistical significance of the relationships was assessed using adjusted odds ratios with 95% confidence intervals. The model with the lowest deviance was considered the best fit for the data.</p><p><strong>Result: </strong>Magnitude of unmet need family planning among adolescent young age in Kenya is 25% (95% CI: 24.5%-26%). Determinants of Unmet need for family planning are age 15-19 (AOR: 3.4, 95%CI (1.3-11), undecided desire number of children (AOR: 2.3, 95%CI: 1.4-2.1), age at first sex 15-29 (AOR: 2.7, 95%CI: 1.2-6.2), rural residency (AOR: 3.9, 95%CI: 1.1-14), high community level poverty (AOR: 2.1, 95%CI: 1.1-4.5).</p><p><strong>Conclusion: </strong>The study finds that 25% of young women in Kenya lack access to family planning. Factors like age, desired family size, early sex, rural life, and poverty contribute to this. These factors create barriers that hinder women's ability to plan their pregnancies and access necessary resources. Younger women, those in rural areas, and those living in poverty are particularly affected. Addressing this issue requires a comprehensive approach that considers the specific circumstances of these vulnerable populations.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1511606"},"PeriodicalIF":2.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in infections detected in women with cervicitis over a decade.","authors":"Lenka A Vodstrcil, Erica L Plummer, Thuy Vy Nguyen, Christopher K Fairley, Eric P F Chow, Tiffany R Phillips, Catriona S Bradshaw","doi":"10.3389/frph.2025.1539186","DOIUrl":"10.3389/frph.2025.1539186","url":null,"abstract":"<p><strong>Objectives: </strong>There is a growing body of evidence that in the absence of <i>Chlamydia trachomatis</i> and/or <i>Neisseria gonorrhoeae, Mycoplasma genitalium</i> and bacterial vaginosis (BV) are associated with cervicitis. We aimed to describe infections detected among cervicitis cases over a decade and establish how commonly <i>M. genitalium</i> and BV were detected among non-chlamydial/non-gonococcal cases to inform testing and treatment practices.</p><p><strong>Methods: </strong>We conducted a retrospective case-series to determine the number of cervicitis cases diagnosed with genital infections (<i>C. trachomatis</i>, <i>N. gonorrhoeae, M. genitalium</i> and BV) among women attending the largest public sexual health service in Australia from 2011 to 2021. We determined the proportion of cervicitis cases with one or more genital infections detected, and trends in testing and detection of each infection over time.</p><p><strong>Results: </strong>Over a decade 813 cervicitis cases were diagnosed; 421 (52%, 95%CI: 48%-55%) had no infection detected; 226/729 (31%, 95%CI: 28%-35%) had BV, 163/809 (20%, 95%CI: 17%-23%) <i>C. trachomatis</i>, 48/747 (6%, 95%CI: 5%-8%) <i>M. genitalium</i>, and 13/793 (2%, 95%CI: 1%-3%) <i>N. gonorrhoeae</i>. Of the 665 (82%) cases tested for all four infections, 268 (40%) had one infection and 73 (11%) had >1 infection detected. Of the 517/665 (78%) non-chlamydial/non-gonococcal cases<i>,</i> 164 (32%) had BV and 16 (3%) had <i>M. genitalium</i> as the sole infections detected; a further 13 cases (3%) were co-infected with BV and <i>M. genitalium</i>. The proportion of cases tested for BV (90%) did not change overtime, but detection increased from 32% to 45% (P_trend < 0.001). The proportion of cases tested for <i>M. genitalium</i> increased from 84% in 2011 to 96% in 2019 (P_trend = 0.006), with <i>M. genitalium</i>-detection in cervicitis increasing from 3% to 7% (P_trend = 0.046).</p><p><strong>Conclusions: </strong>In our study population, chlamydia or gonorrhoea were not detected in ∼75% of cervicitis cases; 1 in 3 of these cases had BV and/or <i>M. genitalium</i>, and both increased in prevalence over time. These data highlight the need for clinicians to consider BV and <i>M. genitalium</i> when assessing and managing cervicitis.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1539186"},"PeriodicalIF":2.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Weighing the impact of being overweight on female reproductive function and fertility.","authors":"Theocharis Koufakis, Dimitrios Patoulias, Kulvinder Kochar Kaur, Djordje S Popovic","doi":"10.3389/frph.2025.1554284","DOIUrl":"10.3389/frph.2025.1554284","url":null,"abstract":"","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1554284"},"PeriodicalIF":2.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring drivers and prevention strategies for sexual violence among adolescent girls and young women in Kicukiro, Rwanda.","authors":"Wongani Patricia Kawonga, Sam M Livingstone, Augustine Ndaimani, Jean Pierre Sibomana, Tsion Yohannes Waka, Maxwell Mhlanga, Andrew Mclellan","doi":"10.3389/frph.2025.1420947","DOIUrl":"10.3389/frph.2025.1420947","url":null,"abstract":"<p><strong>Introduction: </strong>Sexual violence against adolescent girls and young women (AGYW) is a pervasive issue globally, with particularly high prevalence in sub-Saharan Africa. This study explores the drivers and prevention strategies for sexual violence among AGYW in Kicukiro, Rwanda.</p><p><strong>Methods: </strong>A descriptive exploratory design guided by the socioecological model and feminist standpoint theory was employed. In-depth interviews were conducted with 13 AGYW participating in a mentorship program and 5 male community members. Data was analyzed using thematic analysis to identify key drivers and potential prevention strategies.</p><p><strong>Results: </strong>Four themes emerged: (1) empowering mentorship programs, (2) tiered drivers of sexual violence, (3) optimizing violence-mitigating resources, and (4) interference with judicial processes. Key drivers of sexual violence included substance use, transactional sexual relationships, inadequate family protection, entrenched gender stereotypes, and limited legal literacy.</p><p><strong>Conclusion: </strong>Findings underscore the need for multifaceted interventions that address systemic and cultural barriers, strengthen legal frameworks, and expand community-based programs. Addressing sexual violence requires a holistic approach, integrating empowerment initiatives, robust community engagement, and legal reforms to create safer environments for AGYW. The mentorship program's success suggests scalability across other settings.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1420947"},"PeriodicalIF":2.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum: Oral pre-exposure prophylaxis implementation in South Africa: a case study of USAID-supported programs.","authors":"Jerome Wendoh Milimu, Lauren Parmley, Mahlodi Matjeng, Mathata Madibane, Mandisi Mabika, Jacques Livingston, Joseph Lawrence, Orapeleng Motlhaoleng, Hasina Subedar, Rethabile Tsekoa, Zandile Mthembu","doi":"10.3389/frph.2025.1561341","DOIUrl":"https://doi.org/10.3389/frph.2025.1561341","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/frph.2024.1473354.].</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1561341"},"PeriodicalIF":2.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum: Oral pre-exposure prophylaxis implementation in South Africa: a case study of USAID-supported programs.","authors":"Jerome Wendoh Milimu, Lauren Parmley, Mahlodi Matjeng, Mathata Madibane, Mandisi Mabika, Jacques Livingston, Joseph Lawrence, Orapeleng Motlhaoleng, Hasina Subedar, Rethabile Tsekoa, Zandile Mthembu","doi":"10.3389/frph.2025.1560111","DOIUrl":"https://doi.org/10.3389/frph.2025.1560111","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/frph.2024.1473354.].</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1560111"},"PeriodicalIF":2.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing factors influencing adolescent sexual debut in Nigeria: a multi-cluster survival analysis approach.","authors":"Fabio Mathias Correa, Peter Enesi Omaku, Joseph Odunayo Braimah","doi":"10.3389/frph.2025.1475421","DOIUrl":"10.3389/frph.2025.1475421","url":null,"abstract":"<p><strong>Introduction: </strong>Early sexual debut is an area of concern in Nigeria with implications for reproductive health.</p><p><strong>Methods: </strong>This study addresses this by proposing a more effective survival model-one that incorporates both independent and identically distributed (IID) and Besag intrinsically conditional auto-regressive (ICAR) random effect priors, using a generalised additive model that accounts for both individual and spatial influences on age at first sex. We analyse data from the 2018 Nigerian NDHS survey and compare our model with existing models: a model without the cluster frailty effect, a model that ignores the Besag ICAR and includes the IID, and a model that ignores the IID and includes only the Besag ICAR.</p><p><strong>Results: </strong>Our approach, which combines independent and spatial random effects, outperforms others based on statistical criteria (Deviation Information Criterion and the Widely Applicable Information Criterion).</p><p><strong>Discussion: </strong>As shown in this study, the proposed model effectively captures the complexity of age at first sex. In addition, visualisations reveal significant geographic and social clusters with high rates of early sexual debut in Nigeria. These findings highlight the importance of considering multi-level clustering to better understand and promote healthy sexual behaviour among young Nigerians through targeted interventions.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1475421"},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tryptophan as a biomarker of pregnancy-related immune expression and modulation: an integrative review.","authors":"Stephanie Prescott, Natasa Billeci, Melissa Gotcher, Sapna Patel, Addison Almon, Hailey Morgan, Danielle Abukhalaf, Maureen Groer","doi":"10.3389/frph.2024.1453714","DOIUrl":"10.3389/frph.2024.1453714","url":null,"abstract":"<p><strong>Background: </strong>Degradation pathways of Tryptophan (TRP) are implicated in a spectrum of physiological adaptations and outcomes associated with pregnancy. The immunomodulatory role of TRP and its metabolites through the indoleamine 2,3-dioxygenase (IDO) pathway is particularly relevant to pregnancy due to its potential influence on maternal and fetal immune tolerance and the mother's health.</p><p><strong>Methods: </strong>A targeted literature search was conducted via PubMed, Web of Science, and Embase, focusing on maternal serum TRP levels in pregnancy. We included original human subject research on maternal serum TRP, published in English within the last five years. We included 16 quality studies with direct measurement of TRP in pregnancy including ten prospective cohorts, four case-control studies, and two cross-sectional studies.</p><p><strong>Results: </strong>TRP levels are reduced both pre- and postnatally in women with depressive symptoms, but not during pregnancy, though the TRP/Kynurenine pathway is disturbed during pregnancy in women with depressive symptoms, women with prolonged labor, women with gestational hypertension, and in adverse outcomes of pregnancy including prematurity and growth restriction.</p><p><strong>Conclusion: </strong>TRP and its metabolites hold promise as biomarkers for various pregnancy-related outcomes. Future research should aim to clarify the mechanisms by which TRP metabolism influences maternal and fetal health outcomes.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1453714"},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engaging the private sector as part of HIV pre-exposure prophylaxis service delivery in Vietnam: a comparative analysis of uptake, persistence and HIV seroconversion from 2018 to 2023.","authors":"Bao Ngoc Vu, Kimberly Green, Huong Phan, Long Tran, Phuong Phan, Tham Tran, Linh Doan, Yen Vu, Chau Pham, Dao Nguyen, Anh Doan, Trang Ngo, Phuong Tran, Vuong Nguyen, Bieu Nguyen, Thai Phan, Ha Nguyen","doi":"10.3389/frph.2024.1439461","DOIUrl":"10.3389/frph.2024.1439461","url":null,"abstract":"<p><strong>Background: </strong>In Vietnam, PrEP was introduced in 2017 and scaled up from 2019. Private sector engagement (PSE) in PrEP service delivery was deployed as a strategy from the start to increase PrEP access. We assessed the effectiveness of this approach to inform ongoing efforts to accelerate epidemic control by 2030.</p><p><strong>Methods: </strong>We implemented a process evaluation with longitudinal design using retrospective programmatic data collected and uploaded onto a secure online system (HMED) from 23 public and 17 private PrEP clinics in Hanoi, Ho Chi Minh City (HCMC), and Dong Nai. We measured the effectiveness of PrEP service delivery by PrEP initiation/reinitiation, uptake, persistence, discontinuation, and HIV seroconversion. We used the Kaplan-Meier time-to-event approach to estimate PrEP persistence and mixed-effects logistic regression analysis to assess factors associated with the PrEP persistence.</p><p><strong>Results: </strong>From October 2017 to September 2023, 29,944 individuals initiated PrEP, and among these, 79.3% started PrEP at a private sector clinic while 20.7% initiated in a public sector clinic. The median duration of PrEP use persistence at private clinics was significantly longer than that at public clinics (268 days vs. 148 days, respectively). Mixed-effects logistic regression analysis results indicated a significant statistical association between PrEP persistence for at least three months and initiating PrEP at a private clinic [adjusted odds ratio [aOR] = 4.28; 95% confidence interval [CI]: 2.96-6.19], opting for TelePrEP (aOR = 3.42; 95% CI: 2.12-5.53), or being 20 years of age or older (aOR = 1.86; 95% CI: 1.62-2.13). HIV seroconversion was significantly lower among PrEP users at private clinics compared to public clinics (0.03 vs. 0.13 per 100 person-years, respectively; <i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>Offering choice in PrEP service delivery options is essential to increase access and uptake. Private-sector PrEP providers play a pivotal role in increasing PrEP uptake and coverage in Vietnam, and will be critical to delivery of new long-acting options.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1439461"},"PeriodicalIF":2.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generational trends in education and marriage norms in rural India: evidence from the Pune Maternal Nutrition Study.","authors":"Akanksha A Marphatia, Jonathan C K Wells, Alice M Reid, Marios Poullas, Aboli Bhalerao, Pallavi Yajnik, Chittaranjan S Yajnik","doi":"10.3389/frph.2024.1329806","DOIUrl":"10.3389/frph.2024.1329806","url":null,"abstract":"<p><strong>Introduction: </strong>Globally in 2024, 1 in 5 women aged 20-24 years worldwide had been married before the age of 18 years. One reason for this persistent prevalence of underage marriage may be the slow change in social norms relating to education levels and women's marriage age. However, we know little about how norms change, and whether they vary by socio-demographic characteristics. We aimed to investigate changes in social norms across generations in rural Maharashtra, India.</p><p><strong>Methods: </strong>To understand the status quo, we identified education levels and marriage ages typical of contemporary young adults in rural Maharashtra using the National Family Health Survey. To see if norms have shifted across generations, we analysed data on education and marriage age in 659 parent-adolescent dyads from the Pune Maternal Nutrition Study (PMNS) in rural Maharashtra. To ascertain if norms might shift in the future, we investigated adolescents' aspirations for their future hypothetical children's education and marriage, and classified adolescents as wanting (a) their children to decide themselves, (b) more education and later marriage age, or (c) the status quo. We assessed whether these aspirations differed by socio-demographic characteristics.</p><p><strong>Results: </strong>Compared to the status quo and PMNS adults, PMNS adolescents had substantially more education, and girls were marrying slightly later. About 70% of the adolescents wanted their children to themselves decide their schooling. The remainder of both sexes wanted their children to have the same education as them (15 years). Only 10% of adolescent girls and 14% of boys wanted their child to decide their own marriage age. Most adolescents wanted a later marriage age for their children than their own experience. Lower educated and early married girls aspired for greater education for their children. More educated boys aspired for later marriage for their children.</p><p><strong>Discussion: </strong>Education norms have changed by a larger magnitude than marriage age norms. Adolescents are already attaining their education aspirations, but aspire for later marriage of their children, more so for their hypothetical sons than daughters. Since senior household members remain influential in marriage decisions, it may take time before adolescents' aspirations for their children become a new norm.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1329806"},"PeriodicalIF":2.3,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}