Frontiers in reproductive health最新文献

{"title":"Policy solutions to improve access to fertility treatment and optimise patient care: consensus from an expert forum.","authors":"G David Adamson, Hannah Armstrong, Ying Cheong, Elaine Damato, Human Fatemi, Rui Ferriani, Georg Griesinger, William Leigh Ledger, Michele Pistollato, Antonio Pellicer, Angelina Petrova, Luk Rombauts, Tim Wilsdon, Søren Ziebe","doi":"10.3389/frph.2025.1605480","DOIUrl":"10.3389/frph.2025.1605480","url":null,"abstract":"<p><strong>Background: </strong>Infertility is an underrecognized disease which affects over 17% of the reproductive age population worldwide. However, availability of, and access to, assisted reproductive technology (ART) is variable across countries. There are significant challenges relating to awareness, financial and other barriers to care, cultural considerations, and the level of support provided to people undergoing care. Previous studies have explored these challenges, but less attention has been given to the policy implications. As the need for fertility care rises, we investigate the evidence that policy changes can be implemented to improve access to ART treatment.</p><p><strong>Methods: </strong>A review of literature was conducted on fertility policy challenges and developments, covering fertility recognition and awareness; cultural and religious considerations; and access to ART treatment, psycho-social care, and supplementary care. Nine medical and academic experts were invited to validate secondary research findings and provide their perspectives on policy implications. The experts covered different specialties and geographic expertise. Experts participated in individual 60-minute interviews, then a half-day Policy Forum discussion was held virtually in May 2023.</p><p><strong>Results: </strong>Lack of recognition of infertility as a disease, low financial coverage of fertility services, limited psychosocial support, and cultural considerations are substantial barriers to fertility services access. Some countries have limited reimbursement of services or offer only private care, significantly limiting treatment access. Others restrict reimbursement based on age, gender and family status, which creates access inequities. Policy action is needed to mitigate these challenges and to ensure timely and equitable access to fertility care. Decision-makers need to collectively recognize infertility as a disease, rather than just a social issue. Equity of access to infertility services should be ensured by expanding the availability of public funding, along with review and rationalisation of criteria for treatment reimbursement. To improve engagement in treatment and support through the fertility journey, access to psychosocial care should be expanded and included as a core service.</p><p><strong>Conclusion: </strong>Major obstacles to accessing ART treatment have been identified across regions globally, highlighting the urgent need for national policy action to enhance care quality by reviewing current legislation, improving patient and physician education, refining reimbursement procedures, and expanding psychosocial support services.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1605480"},"PeriodicalIF":2.9,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066531","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":"The burden of <i>Neisseria gonorrhoeae</i> infection, risky sexual behavior, and associated risk factors among sexually transmitted infections in a resource-limited setting area of Addis Ababa City, Ethiopia.","authors":"Tesfaye Andualem, Gurja Belay, Adey F Desta, Helen Nigussie, Wondemagegn Mulu, Asnake Desalegn, Gizachew Taddesse, Yonas Mekonen, Degefu Beyene","doi":"10.3389/frph.2025.1601088","DOIUrl":"10.3389/frph.2025.1601088","url":null,"abstract":"<p><strong>Introduction: </strong><i>N. gonorrhoeae</i> is the cause of gonorrhea, which is one of the most common public health problems among sexually transmitted infections. The highest incidence of disease occurs in less developed countries, and gonococcal infections are common among adolescents and young adults. Risky sexual behavior (RSB) is also the main concern. It has many consequences on the health system, which is the most risk factor for the transmission of sexually transmitted diseases, particularly gonorrheal diseases. Little is known about the magnitude of gonococcal infection and risky sexual behavior (RSB) in the reproductive age groups.</p><p><strong>Objectives: </strong>To assess the burden of <i>Neisseria gonorrhoeae</i>, Risky Sexual Behavior, and Associated Risk Factors among Sexually Transmitted Infections in a Resource-Limited Area of Addis Ababa City, Ethiopia.</p><p><strong>Methods: </strong>A health institution-based cross-sectional study was conducted from April 2023 to December 2024 in Addis Ababa City. A convenient sampling method was used to collect endocervical and urethral sample swabs from 571 study subjects. Samples were cultured onto Thayer Martin Luther agar, and gram staining and biochemical tests were used to confirm the presence of gonococci. A pre-tested and well-structured questionnaire was used to assess risk factors, and data were analyzed using SPSS version 22. Descriptive and logistic analyses were computed. <i>P</i>-values ≤0.05 were considered statistically significant.</p><p><strong>Results: </strong>Of the total study subjects, 62.2% were females, and 61.6% were urban residents. Moreover, 183 (32.0%) were in the age of >35 years, followed by 170 (29.8%) in the 30-34 years old. The prevalence of <i>N. gonorrhoeae</i> among STI patients was 17.33%, and risky sexual behavior was 56.9%. The odds of <i>N. gonorrhoeae</i> infection were 1.55 times higher among chat users than the non-chat users [AOR = 1.55, 95% CI: (1.32-1.95)]. Similarly, the odds of risky sexual behavior were 10.95 [AOR = 10.95, 95% CI (5.75-20.84)] times higher among STIs who had a new sexual partner than their counterparts.</p><p><strong>Conclusion: </strong>The prevalence of <i>N. gonorrhoeae</i> and risky sexual behavior among STI patients were high. Gender, watching pornographic films, alcohol consumption, and not participating in religious education have been found to increase the risk of experiencing both <i>N. gonorrheae</i> infections and risky sexual behavior.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1601088"},"PeriodicalIF":2.9,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066536","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":"Designing and validating a health promotion program for women with endometriosis: a mixed-methods study protocol.","authors":"Sanaz Mollazadeh, Talat Khadivzadeh, Khadijeh Mirzaii Najmabadi, Mojgan Mirghafourvand, Maryam Moradi, Javad Moghri, Leili Hafizi","doi":"10.3389/frph.2025.1502323","DOIUrl":"10.3389/frph.2025.1502323","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is a benign and chronic gynecological estrogen-dependent disease. Research has shown that endometriosis can affect various dimensions of women's lives. It is recommended that programs be developed to improve the quality of life and promote the health of affected women. However, no existing studies have written programs to achieve these goals. Therefore, the present study aims to \"design and validate a health promotion program using a logical model\".</p><p><strong>Methods/design: </strong>A mixed-methods explanatory design will be used to conduct this study in three phases. The first phase (quantitative phase) is a descriptive-analytical cross-sectional study on 200 reproductive-age women with an endometriosis diagnosis. The Health-Promoting Lifestyle Profile (HPLP-II) and Endometriosis Impact Questionnaire (EIQ) will be used to collect quantitative data. The second phase (qualitative phase) will explain women's perceptions and experiences of the health-promoting lifestyle. In this phase, the conventional content analysis approach will be used to analyze the data. In the third phase (design of the health promotion program), findings of the quantitative and qualitative phases, the literature review, and focus group discussion (FGD) with a panel of experts will be used to develop a health promotion program based on a logical model, and its validation will be conducted using the Delphi method.</p><p><strong>Discussion: </strong>This is the first study to use a mixed-methods approach for designing a health promotion program for women with endometriosis. This study can reveal hidden issues in the attitude of patients, medical staff, and those involved in providing health services and provide a better understanding of the factors related to improving the health and quality of life of affected women. In addition, the results of research can be effective in formulating a suitable strategy that can be used by policymakers, planners, and health staff as well as respond to the needs of affected women.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1502323"},"PeriodicalIF":2.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041890","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":"No climate justice without sexual and reproductive health, rights and justice (SRHRJ): past, present, and future challenges faced by the Sexual and Reproductive Health and Rights and Climate Justice Coalition.","authors":"Sally Dijkerman, Heather McMullen, Natalie Hammond","doi":"10.3389/frph.2025.1569484","DOIUrl":"10.3389/frph.2025.1569484","url":null,"abstract":"<p><p>The climate crisis jeopardizes human health and is one of the greatest threats to reproductive autonomy and human rights. Witnessing these threats, the Sexual and Reproductive Health and Rights and Climate Justice Coalition was formed in 2021 to advocate on the intersections between climate change and sexual and reproductive health, rights, and justice (SRHRJ). The Coalition's purpose is to leverage intersectional approaches to influence global and national policies, programs, and funding mechanisms to advance climate justice, gender equality, and human rights. Climate justice recognizes the climate crisis as a social, political, and environmental problem and demands fair and equitable solutions. Climate action must be participatory, bottom-up, context-specific, and rooted in locally-led evidence and solutions. Achieving climate justice requires achieving SRHRJ. We reflect on three challenges that led to our founding, and which have shaped the work and priorities of our Coalition: understanding and evidencing the links between climate change and SRHR, pushing back on harmful narratives related to population control and the suggestion that limiting reproduction is a climate solution, and finding just solutions to a complex crisis. Comprehensive SRHR empowers communities to be active participants, leaders, and decision-makers in climate action. Therefore, the Coalition continues to advocate for the importance of multisector, collaborative partnerships, oriented around our shared principles of human rights, intersectionality, bodily autonomy, justice, and inclusive organizing, so that SRHR is integrated into all aspects of climate adaptation.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1569484"},"PeriodicalIF":2.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031285","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":"A risk-based preoperative evaluation method and management strategy for removing intrauterine contraceptive devices in postmenopausal women.","authors":"Zijun Li, Yaqin Zheng, Min Liu, Linlin Pan","doi":"10.3389/frph.2025.1576265","DOIUrl":"10.3389/frph.2025.1576265","url":null,"abstract":"<p><strong>Background: </strong>A large population of women have intrauterine contractive devices (IUCDs) as a result of China's national family planning policy; this has created a significant economic burden and raised technological challenges related to the safe removal of IUCDs in postmenopausal women. It is very important to develop a risk scoring system for the removal of IUCDs (RSSR-IUCDs) to evaluate the preoperative risk of removal and offer management strategies for postmenopausal women.</p><p><strong>Methods: </strong>A systematic case retrospective analysis was conducted on 320 enrolled women who underwent IUCD removal surgery. After screening, stratifying high-risk factors, and final multifactor Logistic Stepwise Regression Analysis, a model named RSSR-IUCDs was constructed. It was verified using the Hosmer-Lemeshow test and a Receiver Operating Characteristic (ROC) curve was plotted to further analyze the predictive accuracy of IUCD removal failure.</p><p><strong>Results: </strong>Seven high-risk factors were finally selected, namely duration of menopause, IUCD retention time, a history of uterine surgery, the shape of the IUCD, IUCD position, uterine size, and uterine position. The RSSR-IUCDs was developed and demonstrated goodness of fit (χ² = 236.558, <i>P</i> = 0.000). The score range of RSSR-IUCDs (Minimum-Maximum) was 0-40. The ROC curve of RSSR-IUCDs demonstrated that the ideal cutoff value was 20 points and the sensitivity and specificity of an initial failure to remove an IUCD were 69.60% and 95.60%, respectively.</p><p><strong>Conclusions: </strong>The RSSR-IUCD is a scientific, reasonable, and feasible evaluation system which is expected to become a guiding scoring system in accordance with clinical practice for postmenopausal women before the removal of IUCDs.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1576265"},"PeriodicalIF":2.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12434697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076717","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":"Climate change and its differential impact on sexual and reproductive health and rights among women in Nepal.","authors":"Jagadishwor Ghimire, Khusbu Poudel, Kritee Lamichhane, Amit Timilsina, Madhav Prasad Dhakal, Parash Prasad Phuyal, Sumanjari Pradhan, Jivan Devkota, Sujan Karki","doi":"10.3389/frph.2025.1603370","DOIUrl":"10.3389/frph.2025.1603370","url":null,"abstract":"<p><strong>Background: </strong>Nepal is highly affected by climate change, experiencing glacier melting, untimely rainfall, floods, landslides, forest fires, and droughts, which collectively impact over 10 million people. There is a larger impact of climate change on human health, but its impact on women's and girls' sexual and reproductive health and rights is yet to be explored. Thus, this study aims to understand the linkages between climate change and the unique impact on gender and sexual, and reproductive health and rights (SRHR).</p><p><strong>Methodology: </strong>This is an exploratory cross-sectional study conducted using a mixed method in Kailali, Arghakhanchi, and Kapilvastu districts. A total of 384 women were selected using systematic random sampling from the upper, middle, and downstream of Khutiya and Banganga river basins. Focus group discussions and key informant interviews were conducted to capture their experiences. Descriptive, bivariate, and multivariate analyses were carried out for quantitative data using SPSS, and a thematic analysis for qualitative data.</p><p><strong>Results: </strong>The women who experienced two or more climate-included disasters were more likely to face gender-based violence (<i>P</i> < .05). The study also showed that women's autonomy in making decisions on Sexual and Reproductive Health and Rights has increased among women exposed to a higher number of climate-related risk (<i>P</i> < .001). Though more than 3/4th of women did not want more children, women who are exposed to more climate-related risks wanted more children (<i>P</i> < .001). The survey found that more than three-quarters (76.3%) of respondents knew about the legality of abortion, and 85% of respondents knew the place to go for abortion services. The result also revealed a significant reduction in sexual desire among women who were exposed to a higher number of climate events. These findings are also aligned with the qualitative information in the study.</p><p><strong>Conclusion: </strong>The findings demand strengthening the resilience of healthcare systems to withstand the impact of climate change, ensuring that essential sexual and reproductive health services, including abortion, contraception, and maternal healthcare, are available and accessible even during the climate crisis. The findings indicate the need for interventions that empower women, address gender-based violence, and integrate sexual and reproductive health into climate change adaptation in policies and programs.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1603370"},"PeriodicalIF":2.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016739","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":"Vitamin D in male sexual functions: unwrapping the sunshine hormone activities in erectile function and beyond.","authors":"Adeyemi Fatai Odetayo, Grace Edet Bassey, Grace Ayobami Fajemidagba, Kazeem Bidemi Okesina, Moses Agbomhere Hamed","doi":"10.3389/frph.2025.1594664","DOIUrl":"10.3389/frph.2025.1594664","url":null,"abstract":"<p><strong>Background: </strong>Vitamin D, sometimes referred to as the \"sunshine vitamin\", is well-known for its role in maintaining bone health processes that are highly dependent on calcium regulation. However, there is an emerging wealth of evidence that this fat-soluble vitamin has an important role in male sexual health regarding erectile function, production of testosterone, and overall fertility. Due to the increased vitamin D deficiency rates in most populations, the implications of its deficiency on male sexual functions have gained great interest.</p><p><strong>Materials and methods: </strong>This review, therefore, sums up recent publications that detail the association of vitamin D with male sexual functions regarding its potential roles in erectile function regulation, testosterone levels, and semen characteristics.</p><p><strong>Results: </strong>Vitamin D contributed positively to sexual and erectile functions. These were mediated via hormone-dependent mechanisms through its inhibitory role on prolactin and steroidogenic activities. It also improves endothelial functions by stimulating the secretion and release of nitric oxide, which is important for erection. Furthermore, it acts by mediating the activities of monoamine neurotransmitters, which are responsible for the motor activities involved in sexual function.</p><p><strong>Conclusion: </strong>Vitamin D acts via multiple mechanisms to enhance sexual and erectile functions.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1594664"},"PeriodicalIF":2.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016778","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: HIV/HBV and/or HCV infections and hepatotoxicity in pregnant and non-pregnant women.","authors":"George Uchenna Eleje, Chinyere Ukamaka Onubogu, Emeka Philip Igbodike, Sayeed Mohammed Firdous","doi":"10.3389/frph.2025.1538380","DOIUrl":"10.3389/frph.2025.1538380","url":null,"abstract":"","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1538380"},"PeriodicalIF":2.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016748","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":"HIV risk perception and associated factors among pregnant and breastfeeding women in Zambia: implications for PrEP uptake in antenatal and postnatal settings.","authors":"Twaambo Euphemia Hamoonga, Wilbroad Mutale, Karen Hampanda, Benjamin H Chi","doi":"10.3389/frph.2025.1540248","DOIUrl":"10.3389/frph.2025.1540248","url":null,"abstract":"<p><strong>Introduction: </strong>HIV risk perception is seen as a key motivation for individuals to use biomedical HIV prevention interventions, including pre-exposure prophylaxis (PrEP). We determined HIV risk perception and associated factors among pregnant and breastfeeding women in Lusaka, Zambia.</p><p><strong>Methodology: </strong>We conducted a cross sectional study among pregnant and breastfeeding women not living with HIV in a hospital setting in Lusaka, Zambia. Study team members administered a structured questionnaire to pregnant and breastfeeding women at the hospital's maternal and child health clinic to get information on socio-demographics, obstetrics and pregnancy history, sexual behavior and HIV risk perception. Participants assessed their HIV risk perception (outcome variable) as no, low, moderate, or high; these were later collapsed into a binary variable of lower vs. higher risk. Logistic regression analysis was used to determine factors associated with high HIV self-risk perception.</p><p><strong>Results: </strong>From September to December 2021, we recruited 389 pregnant and breastfeeding women in our study. Of these, 172 (44%) were pregnant and 217 (56%) were breastfeeding. Most participants were aged between 25 and 34 years 181 (47%), and the majority 338 (87%) never used a condom with their regular sexual partner. About 129 (33%) of participants perceived higher HIV risk. This appeared higher in breastfeeding vs. pregnant women (40% vs. 25%).Over half (52%) of participants with unknown partner HIV status and one-third (33%) of those who never used condoms with their regular sexual partners perceived higher HIV risk. In adjusted models, higher HIV self-risk perception was associated with breastfeeding status (AOR = 1.82; 95% CI: 1.14-2.91), having more than 5 lifetime sexual partners (AOR = 4.27; 95% CI: 1.84-9.90), and having a partner of unknown HIV status (AOR = 2.15; 95% CI: 1.22-3.78).</p><p><strong>Conclusion: </strong>A low proportion of women perceived higher HIV risk, even when their sexual behaviours and partner characteristics would suggest HIV exposure. HIV prevention programs should focus on the accurate assessment of HIV risk to improve uptake of PrEP in the study population.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1540248"},"PeriodicalIF":2.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016801","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":"'Better she gets infected by other diseases but not pregnancy'. Narratives from adolescent girls and community males following pregnancy escalation during COVID-19 lockdown.","authors":"Linda Mason, Enid Awiti, Sophie Young, Fredrick Otieno, Garazi Zulaika, Penelope Phillips-Howard, Supriya D Mehta","doi":"10.3389/frph.2025.1643865","DOIUrl":"10.3389/frph.2025.1643865","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescent sexual and reproductive health in low- and middle-income countries is critical to address following the COVID-19 pandemic. Growing evidence of its' impact includes increased teenage pregnancies and higher rates of unsafe abortion. Our qualitative study sought to understand perspectives and behaviours around these escalations.</p><p><strong>Methods: </strong>Using random sampling we conducted focus group discussions with adolescent girls and young women (AGYW) from western Kenya to understand perceptions and behaviours that drove high rates of pregnancy and abortion. Alongside, male opinions were sought using opportunistic sampling to recruit participants.</p><p><strong>Results: </strong>Six FGDs with AGYW (<i>n</i> = 54) and five with community males (<i>n</i> = 53) were conducted with data analysed using thematic analysis. Results were grouped under 4 themes: (1) Fear, responsibility and blame; (2) Drivers of abortion; (3) Accessing an abortion; (4) Family planning including condom use. AGYW narratives revealed a dread of unintended pregnancy fearing parental and community reactions whilst men feared unfair blame from the community for impregnating AGYW despite admissions of sexual relationships with schoolgirls. Abortion attempts were common, girls described clandestine bids, including ingestion of dangerous or ineffective products, methods corroborated by the men. Many participants, male and female did nothing to mitigate pregnancy risks, disliking condoms and perceiving family planning as a threat to future fertility, or giving license to girls' promiscuity.</p><p><strong>Conclusion: </strong>AGYW remain at high pregnancy and unsafe abortion risk until community attitudes and knowledge are challenged. Our findings highlight the need for information and education to dispel myths and misinformation regarding family planning methods, and address inequities in gender norms. Safe, legal and affordable abortion is also paramount. Follow-up is required to assess long term physical and psychological consequences of the high number of unwanted pregnancies and abortions, particularly amongst those who had a failed abortion.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1643865"},"PeriodicalIF":2.9,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016804","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}