Contraception最新文献

{"title":"Society of Family Planning Clinical Recommendation: Telemedicine in family planning care part 2 - Abortion.","authors":"Rajita Patil, Divya Dethier, Montida Fleming, Emily Godfrey, Julia E Kohn","doi":"10.1016/j.contraception.2025.110864","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.110864","url":null,"abstract":"<p><p>This Clinical Recommendation provides evidence-informed, person-centered, and equity-driven guidance to optimize medication abortion management via telemedicine in the US. Key recommendations include: We recommend telemedicine medication abortion with or without pre- or posttreatment testing as a safe option before 12 0/7 weeks of gestation. No-test telemedicine medication abortion (NTMA) and hybrid models are shown to be safe and effective (GRADE 1B). We recommend over-the-counter nonsteroidal anti-inflammatory agents as the first line for pain management for telemedicine medication abortion with consideration of opioids as needed when providing telemedicine medication abortion care (GRADE 1C). We recommend principles of noncoercive person-centered communication be applied to meet the abortion counseling needs of the person receiving care (GRADE 1B). We suggest assessing the person's desire for contraceptive counseling at the time of telemedicine medication abortion and, depending on the preference of the person receiving care, either defer it to a later time to allow for deliberation and increased autonomy or provide contraceptive counseling if desired (GRADE 2C). We recommend assessing telemedicine medication abortion completion using a standardized patient symptom checklist (such as the sample validated checklist in Table 2) two weeks after mifepristone ingestion in conjunction with a home pregnancy test (GRADE 1C). This document builds upon the Society of Family Planning Committee Statement: Telemedicine in family planning care part 1 - Background and overarching principles and parallels recommendations outlined in the Society of Family Planning Clinical Recommendation: Telemedicine in family planning care part 3 - Contraception. Readers are encouraged to review parts 1 and 3 for this additional context.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110864"},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617901","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}

{"title":"Mapping ethical concerns in algorithm-driven period and fertility tracking technologies.","authors":"Maria Carmen Punzi, Tamara Thuis","doi":"10.1016/j.contraception.2025.110837","DOIUrl":"10.1016/j.contraception.2025.110837","url":null,"abstract":"<p><strong>Objective: </strong>The proliferation of algorithms in period and fertility tracking technologies has increased reliance on data and analytics to interpret menstrual cycle symptoms and guide health and fertility-related action. We set out to map the ethical concerns of the (often invisible) algorithmic influence on users' experience of, and behavior related to their menstrual cycle and fertility.</p><p><strong>Study design: </strong>Reviewing literature and media, we map six ethical concerns of algorithms in period and fertility tracking technologies - inconclusive evidence, inscrutable evidence, misguided evidence, unfair outcomes, transformative effects, traceability - and highlight their potential implications, particularly for vulnerable groups.</p><p><strong>Results: </strong>Based on this mapping, we identify three overarching themes for further analysis: self-knowledge, power and control, representation and inclusion. We find that organizational activity, individual user activity and societal dynamics interact with each other and influence how we can prevent and address the mapped ethical concerns of algorithms.</p><p><strong>Conclusion: </strong>Algorithm-driven period and fertility tracking technologies carry more (and more nuanced) ethical concerns than those currently discussed in the literature and in media. We call for future research to integrate the ethics of (AI) algorithms into the field of sexual and reproductive health, recognizing the complex connections between individual, organizational, and societal levels.</p><p><strong>Implications: </strong>When taking the mapped ethical concerns seriously, we see a potential for algorithm-driven period and fertility tracking technologies to empower - and not discriminate - its users; for users to learn about their bodies and use the technologies responsibly; and for society to actively scrutinize its biases and achieve health equity.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110837"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384111","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}

{"title":"Use of period- or fertility-tracking technologies pre- and post-Dobbs.","authors":"Emily Neiman, Marta Bornstein, Abigail Norris Turner, Megan L Kavanaugh, Maria F Gallo","doi":"10.1016/j.contraception.2025.110812","DOIUrl":"10.1016/j.contraception.2025.110812","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate whether the use of period- or fertility-tracking technologies decreased from pre- to post-Dobbs and to identify user characteristics and changes in reasons for use.</p><p><strong>Study design: </strong>We used data from the Surveys of Women, population-based surveys on reproductive health among self-identified women aged 18 to 44 years, conducted in five states. We compared the prevalence of use of period- or fertility-tracking technologies and reasons for use pre-Dobbs (2018-2019 in Iowa and Ohio; 2019-2020 in Arizona, New Jersey, and Wisconsin) and post-Dobbs (2022-2023 in all five states), overall and stratified by state. To examine the prevalence of use, we adjusted for age, race/ethnicity, education level, and marital status.</p><p><strong>Results: </strong>Period- or fertility-tracking technology use increased from pre-Dobbs to post-Dobbs overall, with an adjusted prevalence ratio (aPR) of 1.20 (95% CI 1.15-1.26). User prevalence increased in four of the five states: Arizona (aPR = 1.17; 95% CI 1.06-1.30), Iowa (aPR = 1.32; 95% CI 1.19-1.47), New Jersey (aPR = 1.21; 95% CI 1.11-1.31), and Ohio (aPR = 1.28; 95% CI 1.16-1.40); prevalence was unchanged in Wisconsin (aPR = 1.06; 95% CI 0.95-1.18). The only change in the reason for use was a decrease in reports of using an app \"to become pregnant\" post-Dobbs (aPR = 0.85; 95% CI 0.75-0.97).</p><p><strong>Conclusions: </strong>The increase in period- or fertility-tracking technology use pre- to post-Dobbs may demonstrate that data privacy was less of an issue for users than anticipated.</p><p><strong>Implications: </strong>While the Dobbs decision led legal and data privacy experts, media, and reproductive health advocates on social media to warn period- or fertility-tracking technology users to delete their tracking technology out of concern for data privacy and potential prosecution for abortion, the prevalence of technology users instead increased from pre- to post-Dobbs.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110812"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973642","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}

{"title":"Contraception and abortion attitudes among military medical students: An exploratory study.","authors":"Nicole M Mahr, Jill E Brown","doi":"10.1016/j.contraception.2024.110489","DOIUrl":"10.1016/j.contraception.2024.110489","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate military medical students' attitudes toward contraception and abortion after clerkships.</p><p><strong>Study design: </strong>We adapted a survey of civilian medical student attitudes for military students. We asked how clerkships changed perspectives and comfort discussing these topics.</p><p><strong>Results: </strong>Eighty-five (85%) of 100 respondents felt more comfortable discussing contraception and abortion after clerkships. More students changed perspectives on contraception than abortion (29% vs 17%, p = 0.043). Students noted limited exposure to abortion.</p><p><strong>Conclusions: </strong>Clerkships increased comfort discussing contraception and abortion but were unlikely to change their attitudes.</p><p><strong>Implications: </strong>More exposure to abortion care is needed.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110489"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960838","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}

{"title":"Drug-drug interactions between antiretrovirals and hormonal contraception: An updated systematic review.","authors":"Catherine S Todd, Lara Lorenzetti, Aamirah Mussa, Kathleen Ridgeway, Chelsea Morroni, Kavita Nanda","doi":"10.1016/j.contraception.2024.110490","DOIUrl":"10.1016/j.contraception.2024.110490","url":null,"abstract":"<p><strong>Objective: </strong>To summarize and update information regarding drug-drug interactions (DDIs) between antiretrovirals (ARVs) and hormonal contraceptives (HCs).</p><p><strong>Study design: </strong>Systematic review.</p><p><strong>Results: </strong>We included 49 articles, with clinical, ARV, or HC PK outcomes reported by 39, 25, and 30 articles, respectively, with some articles reporting outcomes in two or more categories. Fifteen of 18 articles assessing DDIs between efavirenz and progestin implants, emergency contraception, or combined hormonal intravaginal rings found higher pregnancy rates, luteal progesterone levels suggesting ovulation, or reduced progestin PK values. Five studies documented that CYP2B6 single nucleotide polymorphisms exacerbated this DDI. One cohort detected doubled bone density loss with concomitant depot medroxyprogesterone acetate (DMPA) and tenofovir disoproxil fumarate (TDF)-containing ART use versus TDF alone. No other studies described DDIs impacting clinical outcomes. Few adverse events were attributed to ARV-HC use with none exceeding Grade 2. Evidence quality was generally moderate, with dis-similar treatment and control groups, identifying and controlling for confounding, and minimizing attrition bias in the study design being the most frequent limitations.</p><p><strong>Conclusion: </strong>TDF-DMPA DDIs warrant longer-term study on bone health and consideration of alternate combinations. For efavirenz-based ART, client counseling on relative risks, including both potential increase in pregnancy rate with concomitant efavirenz and implant use and lower pregnancy rates compared to other HCs even with concomitant efavirenz use, should continue to allow users comprehensive method choice.</p><p><strong>Implications: </strong>Most ARVs and HCs may be used safely and effectively together. Efavirenz-based ART requires careful counseling and data for possible interactions between HCs and new ARV classes are anticipated.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110490"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960980","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}

{"title":"Person-centered abortion care scale: Validation for medication abortion in the United States.","authors":"May Sudhinaraset, Jessica D Gipson, Michelle Kao Nakphong, Brenda Soun, Patience Afulani, Ushma Upadhyay, Rajita Patil","doi":"10.1016/j.contraception.2024.110485","DOIUrl":"https://doi.org/10.1016/j.contraception.2024.110485","url":null,"abstract":"<p><strong>Objective: </strong>Medication abortions now make up the majority of abortions in the US, with new service delivery models such as telehealth; however, it is unclear how this may impact patient experiences. The objective of the study is to adapt and validate a person-centered abortion care (PCAC) scale for medication abortions that was developed in a global South context (Kenya) for use in the United States.</p><p><strong>Study design: </strong>This study includes medication abortion patients from a hospital-based clinic who had one of two modes of service delivery: 1) telemedicine with no physical exam or ultrasound; or 2) in-person with clinic-based exams and ultrasounds. We conducted a sequential approach to scale development including: 1) defining constructs and item generation; 2) expert reviews; 3) cognitive interviews (n=12); 4) survey development and online survey data collection (N=182, including 45 telemedicine patients and 137 in-person patients); and 5) psychometric analyses.</p><p><strong>Results: </strong>Exploratory factor analyses identified 29-items for the US-PCAC scale with three subscales: 1) Respect & Dignity (10 items), 2) Responsive & Supportive Care (9 items for the full scale, 1 additional mode-specific item each for in-person and telemedicine), and 3) Communication & Autonomy (10 items for the full scale, 1 additional item for telemedicine). The US-PCAC had high content, construct, and criterion validity. It also had high reliability, with a standardized alpha for the full 29-item US-PCAC scale of 0.95. The US-PCAC score was associated with overall satisfaction.</p><p><strong>Conclusion: </strong>This study found high validity and reliability of a newly-developed person-centered abortion care scale for use in the US. As medication abortion provision expands, this scale can be used in quality improvement efforts.</p><p><strong>Implications: </strong>This study found high validity and reliability of a newly-developed person-centered care scale for use in the United States for in-person and telemedicine medication abortion.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110485"},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961055","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}

{"title":"Comparing hospital vs. non-hospital-affiliated clinic adoption of abortion innovations and cash-pay availability during the COVID-19 pandemic: A secondary analysis of a United States nationwide survey.","authors":"Luisa Silva, Jessica K. Lee","doi":"10.1016/j.contraception.2024.110493","DOIUrl":"https://doi.org/10.1016/j.contraception.2024.110493","url":null,"abstract":"","PeriodicalId":93955,"journal":{"name":"Contraception","volume":"33 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141057239","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}

{"title":"A retrospective analysis of factors associated with deep contraceptive implant removals compared to superficial removals.","authors":"Paige D. Kendall, Wyanet Bresnitz, Jin Huang, Jeanelle Sheeder, A. Lazorwitz","doi":"10.1016/j.contraception.2024.110486","DOIUrl":"https://doi.org/10.1016/j.contraception.2024.110486","url":null,"abstract":"","PeriodicalId":93955,"journal":{"name":"Contraception","volume":"31 1","pages":"110486"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141023941","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}

{"title":"Time to treat the climate and nature crisis as one indivisible global health emergency.","authors":"Kamran Abbasi, Parveen Ali, Virginia Barbour, Thomas Benfield, Kirsten Bibbins-Domingo, Stephen Hancocks, Richard Horton, Laurie Laybourn-Langton, Robert Mash, Peush Sahni, Wadeia Mohammad Sharief, Paul Yonga, Chris Zielinski","doi":"10.1016/j.contraception.2023.110326","DOIUrl":"10.1016/j.contraception.2023.110326","url":null,"abstract":"","PeriodicalId":93955,"journal":{"name":"Contraception","volume":"130 ","pages":"110326"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139076225","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}

{"title":"Response to the Letter to Editor","authors":"K. Henderson, Leslie Bernstein","doi":"10.1016/J.CONTRACEPTION.2008.09.013","DOIUrl":"https://doi.org/10.1016/J.CONTRACEPTION.2008.09.013","url":null,"abstract":"","PeriodicalId":93955,"journal":{"name":"Contraception","volume":"36 1","pages":"240-241"},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83310471","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}