Frontiers in reproductive health最新文献

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Racial disparities affect the association between gestational urinary phthalate mixtures and infant genital measures 种族差异影响妊娠期尿液中邻苯二甲酸酯混合物与婴儿生殖器测量值之间的联系
Frontiers in reproductive health Pub Date : 2023-12-11 DOI: 10.3389/frph.2023.1304725
Meghana Varde, Roger B. Newman, A. Wenzel, J. Kucklick, Rebecca Wineland, John W. Brock, Michael S. Bloom
{"title":"Racial disparities affect the association between gestational urinary phthalate mixtures and infant genital measures","authors":"Meghana Varde, Roger B. Newman, A. Wenzel, J. Kucklick, Rebecca Wineland, John W. Brock, Michael S. Bloom","doi":"10.3389/frph.2023.1304725","DOIUrl":"https://doi.org/10.3389/frph.2023.1304725","url":null,"abstract":"Phthalates are ubiquitous anti-androgenic endocrine disrupting chemicals found in personal care products, medications, and many plastics. Studies have shown a racial disparity in phthalates exposure among U.S. women, which may also impact fetal development.We conducted a prospective cohort study of gestational exposure to a phthalates mixture in a racially-diverse population to determine their association with genital development. Mid-gestation (18–22 weeks) urine was collected from 152 women who self-identified as non-Hispanic Black and 158 women who self-identified as non-Hispanic White in Charleston, South Carolina between 2011 and 2014. We measured eight phthalate monoester metabolites in urine using liquid chromatography tandem-mass spectrometry. Mid-gestational penile dimensions were measured using ultrasound and anogenital distances were measured postnatally. We used Bayesian kernel machine regression to estimate the associations among the mixture of phthalate metabolites and mid-gestation penile dimensions and postnatal anogenital distance measures among singleton male (n = 179) and female (n = 131) infants, adjusted for urinary specific gravity, maternal age, body mass index, education level, cigarette smoking, and gestational age at enrollment or birth weight z-score.We found a stronger association between greater phthalates and decreased anopenile distance among infants born to women who self-identified as Black. Mono (2-ethylhexyl) phthalate (MEHP) was the driving mixture component among Black women, and monobutyl phthalate (MBP) and monoethyl phthalate (MEP) were drivers among White women. We also identified a non-linear association between phthalates and lesser ultrasound penile volume among women who self-identified as Black with monoisobutyl phthalate (MiBP) and MBP being most important. We also found an association between greater phthalates and shorter anoclitoral distance among infants born to women who self-identified as Black, with MEP and monobenzyl phthalate (MBzP) contributing most to this association.Our results suggest a disparity in the association between gestational exposure to a mixture of phthalates and fetal genital development among women who self-identified as Black compared to White.","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"50 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138979247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Examining differences in menstrual and intimate care product use by race/ethnicity and education among menstruating individuals 按种族/族裔和教育程度审查月经期个人在使用月经和私密护理产品方面的差异
Frontiers in reproductive health Pub Date : 2023-12-06 DOI: 10.3389/frph.2023.1286920
A. Zota, Elissia T Franklin, Emily B. Weaver, B. Shamasunder, Astrid Williams, Eva L. Siegel, Robin E. Dodson
{"title":"Examining differences in menstrual and intimate care product use by race/ethnicity and education among menstruating individuals","authors":"A. Zota, Elissia T Franklin, Emily B. Weaver, B. Shamasunder, Astrid Williams, Eva L. Siegel, Robin E. Dodson","doi":"10.3389/frph.2023.1286920","DOIUrl":"https://doi.org/10.3389/frph.2023.1286920","url":null,"abstract":"United States consumers spend over two billion dollars a year on intimate care products. These products, along with scented menstrual products, are marketed for odor control, perceived “freshness,” and vaginal/vulvar cleanliness. However, these scent-altering products may increase exposure to carcinogenic and endocrine-disrupting chemicals. Prior research has not adequately characterized demographic differences in product use. The objective of our study is to examine racial/ethnic and educational differences in menstrual and intimate care product use among people who menstruate.We pooled data from two US-based cross sectional studies to examine demographic characteristics and product use in 661 participants aged 18–54 years. Participants reported use of scented and unscented menstrual products (tampons, sanitary pads, and menstrual cups) and intimate care products (vaginal douches, sprays, wipes, and powders). We examined differences by race/ethnicity and education using log-binomial regression and latent class analysis (LCA), which can identify groups based on product use patterns.Our sample was 33.4% Black, 30.9% Latina, 18.2% White, and 16.2% another identity. Approximately half the population had a bachelor's degree or more; 1.4% identified as transgender and 1.8% as non-binary. In adjusted models, scent-altering products (i.e., scented menstrual and intimate care products) were more likely to be used by those with less formal education (p < 0.05). Unscented menstrual products were more likely to be used by those with more formal education. Compared to Black participants, White participants were more likely to use unscented tampons and menstrual cups and less likely to use douches and wipes (p < 0.05). Using LCA we identified two groups: one more likely to use scent-altering products, and a second more likely to use unscented menstrual products. Less education and older age, but not race/ethnicity, was significantly associated with membership in the group more likely to use scent-altering products. While sex/gender composition did not statistically vary across groups, all non-binary participants fell in the unscented menstrual product group.Lower educational attainment was consistently associated with greater use of scent-altering menstrual and intimate care products. Future research should examine associations between body odor stigma, product use, and health risks at intersections of race, class, and gender.","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"39 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138596406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Corrigendum: How might we motivate uptake of the Dual Prevention Pill? Findings from human-centered design research with potential end users, male partners, and healthcare providers. 更正:我们该如何激励人们使用双重预防药丸?与潜在最终用户、男性伴侣和医疗服务提供者进行的以人为本的设计研究结果。
Frontiers in reproductive health Pub Date : 2023-12-05 eCollection Date: 2023-01-01 DOI: 10.3389/frph.2023.1341771
Wawira Nyagah, Kate Segal, Jess Feltham, Alex Ash, Jocelyn Major, Moowa Masani
{"title":"Corrigendum: How might we motivate uptake of the Dual Prevention Pill? Findings from human-centered design research with potential end users, male partners, and healthcare providers.","authors":"Wawira Nyagah, Kate Segal, Jess Feltham, Alex Ash, Jocelyn Major, Moowa Masani","doi":"10.3389/frph.2023.1341771","DOIUrl":"https://doi.org/10.3389/frph.2023.1341771","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/frph.2023.1254953.].</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"5 ","pages":"1341771"},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10728814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814498","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}
引用次数: 0
Sexual, reproductive and mental health among young men (10–24) in low-and-middle income countries: a scoping review 中低收入国家年轻男性(10-24 岁)的性健康、生殖健康和心理健康:范围界定审查
Frontiers in reproductive health Pub Date : 2023-12-04 DOI: 10.3389/frph.2023.1119407
Siphiwe Mhlongo, A. Mason-Jones, Keith Ford
{"title":"Sexual, reproductive and mental health among young men (10–24) in low-and-middle income countries: a scoping review","authors":"Siphiwe Mhlongo, A. Mason-Jones, Keith Ford","doi":"10.3389/frph.2023.1119407","DOIUrl":"https://doi.org/10.3389/frph.2023.1119407","url":null,"abstract":"The relationship between SRH and mental health among men is not well documented, especially in the 10–24 age group. This scoping review aimed to investigate what is known about the association between SRH and mental health among young men (10–24) in LMICs.Embase, APA PsycInfo, MEDLINE(R) ALL, ASSIA and the Cochrane Library of Database of Systematic Reviews were searched from the year of establishment up to August 2022. The review was reported using the PRISMA-ScR checklist.A total of (n = 2636) studies were identified from the five databases. After the completion of screening, only ten studies (n = 8 cross-sectional, n = 1 mixed methods and n = 1 qualitative) met the eligibility criteria and were included in the review. The findings suggest that there is a reciprocal relationship between mental health and SRH. Sperm concentration and total sperm count were found to be lower in depressed men. Poor mental health was associated with early sexual debut, higher rates of sexual activity and an increased number of sexual partners. Poor mental health was also found among men who had sex with men (MSM). In addition, we found a relationship between sexual abuse, sexual coercion and poor mental health.The findings of this unique study indicate that poor mental health is associated with poor SRH outcomes and vice versa among young men (10–24) living in LMICs. However, further research will be needed to establish the temporal relationship between SRH and mental health outcomes.","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"9 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138602937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Qualitative perspectives on COVID-19, interpersonal violence, and interventions to improve well-being from adolescent girls and young women in Kisumu, Kenya 肯尼亚基苏木少女和年轻妇女对 COVID-19、人际暴力以及改善福祉的干预措施的定性看法
Frontiers in reproductive health Pub Date : 2023-12-01 DOI: 10.3389/frph.2023.1236588
Ruby E. Reed, Mevis Omollo, I. Odero, Eucabeth Awuonda, Peter Ochere, Ken Ondeng’e, Jennifer L Kang, Jonathan Altamirano, H. Barsosio, C. Sarnquist
{"title":"Qualitative perspectives on COVID-19, interpersonal violence, and interventions to improve well-being from adolescent girls and young women in Kisumu, Kenya","authors":"Ruby E. Reed, Mevis Omollo, I. Odero, Eucabeth Awuonda, Peter Ochere, Ken Ondeng’e, Jennifer L Kang, Jonathan Altamirano, H. Barsosio, C. Sarnquist","doi":"10.3389/frph.2023.1236588","DOIUrl":"https://doi.org/10.3389/frph.2023.1236588","url":null,"abstract":"Adolescent girls and young women (AGYW) face a high burden of gender-based violence (GBV) worldwide. The COVID-19 pandemic and associated policies led to global increases in GBV, decreased access to resources, and disruptions of pathways to care. We aimed to understand the effects of COVID-19 on AGYW affected by GBV in Kisumu, Kenya, as well as to identify possible interventions to mitigate those effects.Focus group discussions (FGDs) were conducted with AGYW aged 15–25 with a history of exposure to GBV. AGYW were split into age-matched groups; aged 15–19 for younger groups and 19–25 for older groups. Discussions focused on how COVID-19 affected experiences of GBV, access to care services, economic and social outcomes, and opportunities for interventions to mitigate negative impacts of COVID-19 and violence.Five FGDs with 46 AGYW were completed in June-September 2021. AGYW described increases in all types of GBV, particularly sexual abuse and intimate partner violence. Early marriage and subsistence transactional sex also increased. AGYW described violence as both a cause and effect of poor economic, social and health consequences related to the pandemic. Notably, AGYW emphasized stress, lack of mental health support and increased substance use as risk factors for violence, and discussed the deleterious mental health effects of violence—particularly in the wake of disruption of mental health services. COVID-19 disrupted referrals to violence-related services, and reduced access to both medical services and psychosocial services. AGYW believed that interventions focused on improving mental health as well as economic empowerment would be the most feasible and acceptable in mitigating the negative effects of COVID-19 and related exacerbations in violence.AGYW reported increases in almost all forms of GBV during the pandemic, with related exacerbation in mental health. Concurrently, AGYW endorsed decreased access to care services. As there is no evidence that violence and mental health challenges will quickly resolve, there is an urgent need to identify and implement interventions to mitigate these negative effects.","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138621922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Standardized protocol for quantification of nerve bundle density as a biomarker for endometriosis. 作为子宫内膜异位症生物标志物的神经束密度量化标准化方案。
Frontiers in reproductive health Pub Date : 2023-11-30 eCollection Date: 2023-01-01 DOI: 10.3389/frph.2023.1297986
Gerbrand Zoet, Dwayne R Tucker, Natasha L Orr, Fahad T Alotaibi, Yang Doris Liu, Heather Noga, Martin Köbel, Paul J Yong
{"title":"Standardized protocol for quantification of nerve bundle density as a biomarker for endometriosis.","authors":"Gerbrand Zoet, Dwayne R Tucker, Natasha L Orr, Fahad T Alotaibi, Yang Doris Liu, Heather Noga, Martin Köbel, Paul J Yong","doi":"10.3389/frph.2023.1297986","DOIUrl":"https://doi.org/10.3389/frph.2023.1297986","url":null,"abstract":"<p><strong>Introduction: </strong>We propose a standardized protocol for measurement of nerve bundle density in endometriosis as a potential biomarker, including in deep endometriosis (DE), ovarian endometriomas (OMA) and superficial peritoneal endometriosis (SUP).</p><p><strong>Methods: </strong>This was a prospective cohort of surgically excised endometriosis samples from Dec 1st 2013 and Dec 31st 2017 at a tertiary referral center for endometriosis in Vancouver, BC, Canada. Surgical data were available from linked patient registry. Protein gene product 9.5 (PGP9.5) was used to identify nerve bundles on immunohistochemistry. PGP9.5 nerve bundles were counted visually. To calculate nerve bundle density, PGP9.5 nerve bundle count was divided by the tissue surface area (total on the slide). All samples were assessed using NHS Elements software for semi-automated measurement of the tissue surface area. For a subset of samples, high power fields (HPFs) were also counted as manual measurement of the tissue surface area. Intraclass correlation was used to assess intra observer and inter observer reliability. Generalized linear mixed model (GLMM) with random intercepts only was conducted to assess differences in PGP9.5 nerve bundle density by endometriosis type (DE, OMA, SUP).</p><p><strong>Results: </strong>In total, 236 tissue samples out of 121 participants were available for analysis in the current study. Semi-automated surface area measurement could be performed in 94.5% of the samples and showed good correlation with manually counted HPFs (Spearman's rho = 0.781, <i>p</i> < 0.001). To assess intra observer reliability, 11 samples were assessed twice by the same observer; to assess inter observer reliability, 11 random samples were blindly assessed by two observers. Intra observer reliability and inter observer reliability for nerve bundle density were excellent: 0.979 and 0.985, respectively. PGP9.5 nerve bundle density varied among samples and no nerve bundles could be found in 24.6% of the samples. GLMM showed a significant difference in PGP9.5 nerve bundle density between the different endometriosis types (X<sup>2</sup> = 87.6, <i>P</i> < 0.001 after adjusting for hormonal therapy, with higher density in DE and SUP in comparison to OMA).</p><p><strong>Conclusion: </strong>A standardized protocol is presented to measure PGP9.5 nerve bundle density in endometriosis, which may serve as a biomarker reflecting local neurogenesis in the endometriosis microenvironment.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"5 ","pages":"1297986"},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10720898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814583","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}
引用次数: 0
Fertility after expanded polytetrafluoroethylene use after endometrioma cystectomy: a pilot study. 子宫内膜瘤膀胱切除术后使用膨体聚四氟乙烯后的生育能力:一项试点研究。
Frontiers in reproductive health Pub Date : 2023-11-22 eCollection Date: 2023-01-01 DOI: 10.3389/frph.2023.1231029
Patrick P Yeung, Melody S Su, John Voltz, Jeffrey A Gavard
{"title":"Fertility after expanded polytetrafluoroethylene use after endometrioma cystectomy: a pilot study.","authors":"Patrick P Yeung, Melody S Su, John Voltz, Jeffrey A Gavard","doi":"10.3389/frph.2023.1231029","DOIUrl":"https://doi.org/10.3389/frph.2023.1231029","url":null,"abstract":"<p><strong>Introduction: </strong>Pregnancy rates after the placement of expanded polytetrafluoroethylene (ePTFE, trade name Gore-Tex®) for adhesion prevention following cystectomy of endometriomas ≥3 cm and excision of endometriosis were analyzed in this pilot study.</p><p><strong>Methods: </strong>A prospective cohort study was performed at a single tertiary care center. 56 women qualified for the study and underwent surgery. Expanded polytetrafluoroethylene placement around affected ovaries was self-selected. Inclusion criteria for analysis were pathology-confirmed endometrioma ≥3 cm, no hysterectomy at time of surgery, ≥1 year of postoperative survey completion, and absence of strategies to avoid pregnancy. 18 women in the ePTFE group and 11 women in the control group met inclusion criteria for analysis. 16 of the 18 women in the ePTFE group and 7 of the 11 women in the control group were affected by infertility. Absolute pregnancy rates and cumulative 4-year pregnancy rates, which are based on survival analysis using lifetables and adjust for varying follow-up times, were calculated for all women as well as for women with infertility only.</p><p><strong>Results: </strong>High cumulative 4-year pregnancy rates were observed for women with expanded polytetrafluoroethylene compared to women without (85% vs. 65%, p = 0.69). High cumulative 4-year pregnancy rates for women with infertility prior to surgery were observed for women with expanded polytetrafluoroethylene compared to women without (83% vs. 33%, p = 0.89).</p><p><strong>Discussion: </strong>There are consistent trends, although not statistically significant, seen in pregnancy rates for women with ePTFE compared to women without, particularly in those with a history of infertility prior to ePTFE use. This is the first study examining how adhesion prevention strategy targeting the adnexa during surgery for endometriosis affects pregnancy rates. The trend towards increased pregnancy rates with expanded polytetrafluoroethylene use, particularly in patients with a history of infertility, is promising and warrants further study with larger groups.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"5 ","pages":"1231029"},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10703387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814580","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}
引用次数: 0
Corrigendum: Editorial: Period poverty. 更正:社论:贫困时期。
Frontiers in reproductive health Pub Date : 2023-11-20 eCollection Date: 2023-01-01 DOI: 10.3389/frph.2023.1308137
Lea Sacca, Christine Margaret Markham, Jhumka Gupta, Melissa Peskin
{"title":"Corrigendum: Editorial: Period poverty.","authors":"Lea Sacca, Christine Margaret Markham, Jhumka Gupta, Melissa Peskin","doi":"10.3389/frph.2023.1308137","DOIUrl":"https://doi.org/10.3389/frph.2023.1308137","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/frph.2023.1140981.].</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"5 ","pages":"1308137"},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10694433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138489280","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}
引用次数: 0
An implementation strategy package (video education, HIV self-testing, and co-location) improves PrEP implementation for pregnant women in antenatal care clinics in western Kenya. 一揽子实施战略(视频教育、艾滋病毒自我检测和合址)改善了肯尼亚西部产前保健诊所孕妇的PrEP实施情况。
IF 2.3
Frontiers in reproductive health Pub Date : 2023-11-17 eCollection Date: 2023-01-01 DOI: 10.3389/frph.2023.1205503
Joseph Sila, Anjuli D Wagner, Felix Abuna, Julia C Dettinger, Ben Odhiambo, Nancy Ngumbau, George Oketch, Enock Sifuna, Laurén Gómez, Sarah Hicks, Grace John-Stewart, John Kinuthia
{"title":"An implementation strategy package (video education, HIV self-testing, and co-location) improves PrEP implementation for pregnant women in antenatal care clinics in western Kenya.","authors":"Joseph Sila, Anjuli D Wagner, Felix Abuna, Julia C Dettinger, Ben Odhiambo, Nancy Ngumbau, George Oketch, Enock Sifuna, Laurén Gómez, Sarah Hicks, Grace John-Stewart, John Kinuthia","doi":"10.3389/frph.2023.1205503","DOIUrl":"10.3389/frph.2023.1205503","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pre-exposure prophylaxis (PrEP) is recommended by the World Health Organization and the Kenyan Ministry of Health for HIV prevention in pregnancy and postpartum for women at risk for HIV. Integration of PrEP into antenatal care is promising, but delivery gaps exist in the face of healthcare provider shortages in resource-limited settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Between May and November 2021, we conducted a difference-in-differences study (3 months pre-intervention data collection and 3 months post-intervention data collection) analyzing four intervention facilities, where the strategies were implemented, and four comparison facilities, where no strategies were implemented. We tested a combination of three implementation strategies-video-based PrEP information in the waiting bay, HIV self-testing, and dispensing of PrEP in the antenatal care rooms-to improve PrEP delivery. We compared absolute changes in the proportion of antenatal attendees screened for PrEP (PrEP penetration), the proportion receiving all PrEP-specific steps in a visit (HIV testing, risk screening, and PrEP counseling) (PrEP fidelity), and client PrEP knowledge, client satisfaction, and waiting time and service time (&lt;i&gt;a priori&lt;/i&gt; outcomes); &lt;i&gt;post hoc,&lt;/i&gt; we compared the proportion offered PrEP (PrEP offer) and completing HIV testing. We measured provider perceptions of the acceptability and appropriateness of the implementation strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We observed significant improvements in PrEP penetration, PrEP offer, satisfaction, and knowledge (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) and improvements in fidelity that trended towards significance (&lt;i&gt;p&lt;/i&gt; = 0.057). PrEP penetration increased 5 percentage points (&lt;i&gt;p&lt;/i&gt; = 0.008), PrEP fidelity increased 8 percentage points (&lt;i&gt;p&lt;/i&gt; = 0.057), and PrEP offer increased 4 percentage points (&lt;i&gt;p&lt;/i&gt; = 0.003) in intervention vs. comparison facilities. Client PrEP knowledge increased by 1.7 out of 6 total points (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) and client satisfaction increased by 0.7 out of 24 total points (&lt;i&gt;p&lt;/i&gt; = 0.003) in intervention vs. comparison facilities. We observed no changes in service time (0.09-min decrease; &lt;i&gt;p&lt;/i&gt; = 0.435) and a small increase in waiting time (0.33-min increase; &lt;i&gt;p&lt;/i&gt; = 0.005). HIV testing among those eligible did not change (1.5 percentage point decrease, &lt;i&gt;p&lt;/i&gt; = 0.800). Providers felt the implementation strategies were acceptable and appropriate (median acceptability: 20/20; median appropriateness: 19.5/20). However, absolute levels of each step of the PrEP cascade remained suboptimal.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;An implementation strategy package with video information, HIV self-testing, and co-location of medication dispensing enhanced PrEP delivery across several implementation outcomes and client satisfaction, while not substantially increasing wait time or decreasing provider-client contact time.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical trial registration: &lt;/","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"5 ","pages":"1205503"},"PeriodicalIF":2.3,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10690761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479671","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}
引用次数: 0
Contraceptive use and discontinuation among women aged 15-24 years in Kenya. 肯尼亚15-24岁妇女避孕药具的使用和停止。
Frontiers in reproductive health Pub Date : 2023-11-15 eCollection Date: 2023-01-01 DOI: 10.3389/frph.2023.1192193
Wambui Kungu
{"title":"Contraceptive use and discontinuation among women aged 15-24 years in Kenya.","authors":"Wambui Kungu","doi":"10.3389/frph.2023.1192193","DOIUrl":"10.3389/frph.2023.1192193","url":null,"abstract":"<p><strong>Introduction: </strong>The 15-24-year-old age group of young women make up about 15% of the population of 47 million Kenyans which comes to 7 million. Addressing the reproductive health goals of this cohort is thus a policy priority because of the high potential they pose for unintended pregnancy through incorrect and intermittent use of contraception.</p><p><strong>Objective: </strong>The study sought to present evidence on contraceptive use among women aged 15-24 in Kenya between 2012 and 2014 using Kenya Demographic and Health Survey (KDHS) 2014 Contraceptive calendar data and make recommendations on enhancing the correct and consistent use of contraception.</p><p><strong>Methodology: </strong>The data used was obtained from the Choices and Challenges tool developed by Population Reference Bureau (PRB) and visualized innovatively using Sankey Diagrams that show contraceptive use/non-use, continuation, switching/discontinuation, and pregnancy.</p><p><strong>Results: </strong>The use of contraceptives went up by about 30% during the study period while the use of modern methods went up by 83%. The uptake of Long-Acting Reversible Contraception (LARC) went up by 87% while that of Short Acting Methods (SAM) went up by 70% but the progress was clouded by discontinuation rates of 35% with side effects being the leading reason for the abandonment of contraception.</p><p><strong>Conclusion: </strong>For Kenya to achieve transformative results in ending the unmet need for contraception and preventable maternal deaths, it is critical to sustaining the current gains in contraceptive prevalence rate (CPR) by promoting the retention of youth users and encouraging new users.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"5 ","pages":"1192193"},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10684736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464777","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}
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