Pub Date : 2022-01-01DOI: 10.1177/17455057221087117
A. Harrison, Nonhlonipho Bhengu, Lori Miller, T. Exner, Nonkululeko Tesfay, Slindile Magutshwa, Silindile Khumalo, S. Bergam, S. Hoffman, J. Hanass-Hancock
Objectives: To explore women’s willingness to consider using pre-exposure prophylaxis for HIV prevention in the context of gendered relationship dynamics, in Durban, South Africa. Methods: As formative research prior to development of a gender-informed intervention to introduce pre-exposure prophylaxis to young, urban, educated women, we conducted six focus-group discussions and eight in-depth interviews with 46 women ages 18–25 years, who were not current pre-exposure prophylaxis users. Women were recruited from clinic and community settings using a criterion-based snowball sampling technique. Qualitative data were coded and analyzed thematically, with a team-based consensus approach for final coding, analytical decisions, and data interpretation. Results: Women clearly understood the benefits of pre-exposure prophylaxis for themselves and their partners, focusing on promoting health and their right to protect themselves from HIV infection. At the same time, and in accordance with findings from other studies, women were realistic about the concerns that would arise among male partners, including disapproval, loss of trust, possible loss of the relationship, and in some instances, the potential for violence, if they were to propose pre-exposure prophylaxis use. To resolve this tension, some women advocated for covert use as the best option for themselves and others argued for disclosure, proposing various approaches to working with partners to adopt pre-exposure prophylaxis. The suggestion that both partners use pre-exposure prophylaxis was made repeatedly. Thus, women sought to avoid discussions of trust or lack of trust and a partner’s possible infidelities, choosing instead to focus on preserving or even building a relationship through suggesting pre-exposure prophylaxis use. Conclusion: Women offered diverse narratives on agency and constraint in relation to choosing pre-exposure prophylaxis as a future prevention strategy, as well as ways to engage with their male partners about pre-exposure prophylaxis. These findings speak to the need for interventions to bolster women’s confidence, sense of empowerment, and their communication and decision-making skills for successful HIV prevention.
{"title":"“You tell him that ‘baby, I am protecting myself’”: Women’s agency and constraint around willingness to use pre-exposure prophylaxis in the Masibambane Study","authors":"A. Harrison, Nonhlonipho Bhengu, Lori Miller, T. Exner, Nonkululeko Tesfay, Slindile Magutshwa, Silindile Khumalo, S. Bergam, S. Hoffman, J. Hanass-Hancock","doi":"10.1177/17455057221087117","DOIUrl":"https://doi.org/10.1177/17455057221087117","url":null,"abstract":"Objectives: To explore women’s willingness to consider using pre-exposure prophylaxis for HIV prevention in the context of gendered relationship dynamics, in Durban, South Africa. Methods: As formative research prior to development of a gender-informed intervention to introduce pre-exposure prophylaxis to young, urban, educated women, we conducted six focus-group discussions and eight in-depth interviews with 46 women ages 18–25 years, who were not current pre-exposure prophylaxis users. Women were recruited from clinic and community settings using a criterion-based snowball sampling technique. Qualitative data were coded and analyzed thematically, with a team-based consensus approach for final coding, analytical decisions, and data interpretation. Results: Women clearly understood the benefits of pre-exposure prophylaxis for themselves and their partners, focusing on promoting health and their right to protect themselves from HIV infection. At the same time, and in accordance with findings from other studies, women were realistic about the concerns that would arise among male partners, including disapproval, loss of trust, possible loss of the relationship, and in some instances, the potential for violence, if they were to propose pre-exposure prophylaxis use. To resolve this tension, some women advocated for covert use as the best option for themselves and others argued for disclosure, proposing various approaches to working with partners to adopt pre-exposure prophylaxis. The suggestion that both partners use pre-exposure prophylaxis was made repeatedly. Thus, women sought to avoid discussions of trust or lack of trust and a partner’s possible infidelities, choosing instead to focus on preserving or even building a relationship through suggesting pre-exposure prophylaxis use. Conclusion: Women offered diverse narratives on agency and constraint in relation to choosing pre-exposure prophylaxis as a future prevention strategy, as well as ways to engage with their male partners about pre-exposure prophylaxis. These findings speak to the need for interventions to bolster women’s confidence, sense of empowerment, and their communication and decision-making skills for successful HIV prevention.","PeriodicalId":47398,"journal":{"name":"Womens Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45712521","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}
Pub Date : 2022-01-01DOI: 10.1177/17455057221139664
R. Fischbein, Heather L Cook, K. Baughman, S. Díaz
Background: Despite the importance of early identification and treatment, postpartum depression often remains largely undiagnosed with unreported symptoms. While research has identified several factors as prompting help-seeking for postpartum depression symptoms, no research has examined help-seeking for postpartum depression using data from a multi-state/jurisdictional survey analyzed with machine learning techniques. Objectives: This study examines help-seeking among people with postpartum depression symptoms using and demonstrating the utility of machine learning techniques. Methods: Data from the 2016–2018 Pregnancy Risk Assessment Monitoring System, a cross-sectional survey matched with birth certificate data, were used. Six US states/jurisdictions included the outcome help-seeking for postpartum depression symptoms and were used in the analysis. An ensemble method, “Super Learner,” was used to identify the best combination of algorithms and most important variables that predict help-seeking among 1920 recently pregnant people who screen positive for postpartum depression symptoms. Results: The Super Learner predicted well and had an area under the receiver operating curve of 87.95%. It outperformed the highest weighted algorithms which were conditional random forest and stochastic gradient boosting. The following variables were consistently among the top 10 most important variables across the algorithms for predicting increased help-seeking: participants who reported having been diagnosed with postpartum depression, having depression during pregnancy, living in particular US states, being a White compared to Black or Asian American individual, and having a higher maternal body mass index at the time of the survey. Conclusion: These results show the utility of using ensemble machine learning techniques to examine complex topics like help-seeking. Healthcare providers should consider the factors identified in this study when screening and conducting outreach and follow-up for postpartum depression symptoms.
{"title":"Using machine learning to predict help-seeking among 2016–2018 Pregnancy Risk Assessment Monitoring System participants with postpartum depression symptoms","authors":"R. Fischbein, Heather L Cook, K. Baughman, S. Díaz","doi":"10.1177/17455057221139664","DOIUrl":"https://doi.org/10.1177/17455057221139664","url":null,"abstract":"Background: Despite the importance of early identification and treatment, postpartum depression often remains largely undiagnosed with unreported symptoms. While research has identified several factors as prompting help-seeking for postpartum depression symptoms, no research has examined help-seeking for postpartum depression using data from a multi-state/jurisdictional survey analyzed with machine learning techniques. Objectives: This study examines help-seeking among people with postpartum depression symptoms using and demonstrating the utility of machine learning techniques. Methods: Data from the 2016–2018 Pregnancy Risk Assessment Monitoring System, a cross-sectional survey matched with birth certificate data, were used. Six US states/jurisdictions included the outcome help-seeking for postpartum depression symptoms and were used in the analysis. An ensemble method, “Super Learner,” was used to identify the best combination of algorithms and most important variables that predict help-seeking among 1920 recently pregnant people who screen positive for postpartum depression symptoms. Results: The Super Learner predicted well and had an area under the receiver operating curve of 87.95%. It outperformed the highest weighted algorithms which were conditional random forest and stochastic gradient boosting. The following variables were consistently among the top 10 most important variables across the algorithms for predicting increased help-seeking: participants who reported having been diagnosed with postpartum depression, having depression during pregnancy, living in particular US states, being a White compared to Black or Asian American individual, and having a higher maternal body mass index at the time of the survey. Conclusion: These results show the utility of using ensemble machine learning techniques to examine complex topics like help-seeking. Healthcare providers should consider the factors identified in this study when screening and conducting outreach and follow-up for postpartum depression symptoms.","PeriodicalId":47398,"journal":{"name":"Womens Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47222679","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}
Pub Date : 2022-01-01DOI: 10.1177/17455057221092268
O. Ky-Zerbo, A. Desclaux, S. Boye, Anthony Vautier, Nicolas Rouveau, B. Kouadio, Arlette Simo Fotso, D. Pourette, M. Maheu-Giroux, S. Sow, Cheick Sidi Camara, Clémence Doumenc-Aïdara, A. Keita, M. Boily, R. Silhol, Marc d’Elbée, A. Bekelynck, Papa Alioune Gueye, Papa Moussa Diop, Olivier Geoffroy, Odé Kanku Kamemba, S. Diallo, E. Ehui, Cheick Tidiane Ndour, J. Larmarange
Background: In West Africa, female sex workers are at increased risk of HIV acquisition and transmission. HIV self-testing could be an effective tool to improve access to and frequency of HIV testing to female sex workers, their clients and partners. This article explores their perceptions regarding HIV self-testing use and the redistribution of HIV self-testing kits to their partners and clients. Methods: Embedded within ATLAS, a qualitative study was conducted in Côte-d’Ivoire, Mali, and Senegal in 2020. Nine focus group discussions were conducted. A thematic analysis was performed. Results: A total of 87 participants expressed both positive attitudes toward HIV self-testing and their willingness to use or reuse HIV self-testing. HIV self-testing was perceived to be discreet, confidential, and convenient. HIV self-testing provides autonomy from testing by providers and reduces stigma. Some perceived HIV self-testing as a valuable tool for testing their clients who are willing to offer a premium for condomless sex. While highlighting some potential issues, overall, female sex workers were optimistic about linkage to confirmatory testing following a reactive HIV self-testing. Female sex workers expressed positive attitudes toward secondary distribution to their partners and clients, although it depended on relationship types. They seemed more enthusiastic about secondary distribution to their regular/emotional partners and regular clients with whom they had difficulty using condoms, and whom they knew enough to discuss HIV self-testing. However, they expressed that it could be more difficult with casual clients; the duration of the interaction being too short to discuss HIV self-testing, and they fear violence and/or losing them. Conclusion: Overall, female sex workers have positive attitudes toward HIV self-testing use and are willing to redistribute to their regular partners and clients. However, they are reluctant to promote such use with their casual clients. HIV self-testing can improve access to HIV testing for female sex workers and the members of their sexual and social network.
{"title":"Willingness to use and distribute HIV self-test kits to clients and partners: A qualitative analysis of female sex workers’ collective opinion and attitude in Côte d’Ivoire, Mali, and Senegal","authors":"O. Ky-Zerbo, A. Desclaux, S. Boye, Anthony Vautier, Nicolas Rouveau, B. Kouadio, Arlette Simo Fotso, D. Pourette, M. Maheu-Giroux, S. Sow, Cheick Sidi Camara, Clémence Doumenc-Aïdara, A. Keita, M. Boily, R. Silhol, Marc d’Elbée, A. Bekelynck, Papa Alioune Gueye, Papa Moussa Diop, Olivier Geoffroy, Odé Kanku Kamemba, S. Diallo, E. Ehui, Cheick Tidiane Ndour, J. Larmarange","doi":"10.1177/17455057221092268","DOIUrl":"https://doi.org/10.1177/17455057221092268","url":null,"abstract":"Background: In West Africa, female sex workers are at increased risk of HIV acquisition and transmission. HIV self-testing could be an effective tool to improve access to and frequency of HIV testing to female sex workers, their clients and partners. This article explores their perceptions regarding HIV self-testing use and the redistribution of HIV self-testing kits to their partners and clients. Methods: Embedded within ATLAS, a qualitative study was conducted in Côte-d’Ivoire, Mali, and Senegal in 2020. Nine focus group discussions were conducted. A thematic analysis was performed. Results: A total of 87 participants expressed both positive attitudes toward HIV self-testing and their willingness to use or reuse HIV self-testing. HIV self-testing was perceived to be discreet, confidential, and convenient. HIV self-testing provides autonomy from testing by providers and reduces stigma. Some perceived HIV self-testing as a valuable tool for testing their clients who are willing to offer a premium for condomless sex. While highlighting some potential issues, overall, female sex workers were optimistic about linkage to confirmatory testing following a reactive HIV self-testing. Female sex workers expressed positive attitudes toward secondary distribution to their partners and clients, although it depended on relationship types. They seemed more enthusiastic about secondary distribution to their regular/emotional partners and regular clients with whom they had difficulty using condoms, and whom they knew enough to discuss HIV self-testing. However, they expressed that it could be more difficult with casual clients; the duration of the interaction being too short to discuss HIV self-testing, and they fear violence and/or losing them. Conclusion: Overall, female sex workers have positive attitudes toward HIV self-testing use and are willing to redistribute to their regular partners and clients. However, they are reluctant to promote such use with their casual clients. HIV self-testing can improve access to HIV testing for female sex workers and the members of their sexual and social network.","PeriodicalId":47398,"journal":{"name":"Womens Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48102209","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}
Pub Date : 2022-01-01DOI: 10.1177/17455057221097823
Kaltrina Kelmendi, L. Jemini-Gashi
Introduction: Although investigations of changing gender roles have been performed globally, most studies have been conducted in high-income countries, and studies from emerging and developing countries are lacking. This study aims to examine the factor structure of the feminine gender role stress scale among women (FGRS) and explore its relationship with psychological distress (PD). Methods: A cross-sectional study was carried out with 656 women from Kosovo using a convenience sampling technique during October 2017 and March 2018. The data were collected through face-to-face interviews and analyzed using the Statistical Package for the Social Sciences version 21 and Mplus 7.3. Confirmatory factor analysis (CFA) and path analysis were used to understand the goodness-of-fit of the FGRS scale in the Kosovo context and explore the relationship between the FGRS scale and PD when treated as latent variables. Multivariance analysis of variance (ANOVA) was used to understand the differences between groups of women based on employment and FGRS. Multinomial logistic regression was used to assess the prediction of different domains of FGRS for PD separately for each category while controlling for age. Results: After demonstrating that the five-factor model of the FGRS showed a good fit to the data in this sample of Kosovo women, analyses revealed that the FGRS domains (fear of victimization and behaving with assertiveness) were positively associated with psychological distress. Conclusion: The findings validate the usefulness of the FGRS scale in a sample of Kosovar women. The intersectionality perspective was used to interpret the importance of multiple layers of vulnerabilities and their coexistence, including education, socioeconomic status, and their implications for health inequalities.
{"title":"An Exploratory Study of Gender Role Stress and Psychological Distress of Women in Kosovo","authors":"Kaltrina Kelmendi, L. Jemini-Gashi","doi":"10.1177/17455057221097823","DOIUrl":"https://doi.org/10.1177/17455057221097823","url":null,"abstract":"Introduction: Although investigations of changing gender roles have been performed globally, most studies have been conducted in high-income countries, and studies from emerging and developing countries are lacking. This study aims to examine the factor structure of the feminine gender role stress scale among women (FGRS) and explore its relationship with psychological distress (PD). Methods: A cross-sectional study was carried out with 656 women from Kosovo using a convenience sampling technique during October 2017 and March 2018. The data were collected through face-to-face interviews and analyzed using the Statistical Package for the Social Sciences version 21 and Mplus 7.3. Confirmatory factor analysis (CFA) and path analysis were used to understand the goodness-of-fit of the FGRS scale in the Kosovo context and explore the relationship between the FGRS scale and PD when treated as latent variables. Multivariance analysis of variance (ANOVA) was used to understand the differences between groups of women based on employment and FGRS. Multinomial logistic regression was used to assess the prediction of different domains of FGRS for PD separately for each category while controlling for age. Results: After demonstrating that the five-factor model of the FGRS showed a good fit to the data in this sample of Kosovo women, analyses revealed that the FGRS domains (fear of victimization and behaving with assertiveness) were positively associated with psychological distress. Conclusion: The findings validate the usefulness of the FGRS scale in a sample of Kosovar women. The intersectionality perspective was used to interpret the importance of multiple layers of vulnerabilities and their coexistence, including education, socioeconomic status, and their implications for health inequalities.","PeriodicalId":47398,"journal":{"name":"Womens Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45121602","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}
Pub Date : 2022-01-01DOI: 10.1177/17455057221091357
W. Molla, N. Mengistu, Aregahegn Wudneh
Background: Obstetric ultrasound is a harmless, cheap, and noninvasive imaging modality that helps to scan a pregnant mother and delivers parents with a real-time image of the fetus. As the number of pregnancies rises globally, the demand for obstetric ultrasound becomes even more pressing. Objectives: To assess pregnant women’s knowledge, attitude, and associated factors toward obstetric ultrasound in public hospitals, Ethiopia. Methods: Institutional based cross-sectional study was employed. Systematic random technique was used to select 419 pregnant women from 10 April 2021 through 2 June 2021. A structured questionnaire was used to collect data during a face-to-face interview. Then the data were coded, cleaned, and entered into Epidemiological data version (EPIDATA) 3.1 and exported to the statistical package for Social Science version 23.0 for analyses. Bivariate and multivariable logistic regression model was used to identify statistically significant associations between dependent and independent variables. The odds ratio at 95% confidence interval with p-value 0.05% was considered statistically significant. Result: The majority of the study participants, 179 (42.8%), have ages ⩾ 25 years. Magnitude of having good knowledge and positive attitude of pregnant women toward obstetric ultrasound was 35.5% and 69.5%, respectively. Residence (adjusted odds ratio: 3.934; 95% confidence interval: 3.125–6.761), educational status (adjusted odds ratio: 3.614; 95% confidence interval: 1.986–5.964), and parity (adjusted odds ratio: 2.7621; 95% confidence interval: 1.68–3.275) were significantly associated with knowledge. Whereas exposure to obstetrical ultrasound in current pregnancy (adjusted odds ratio: 2.726; 95% confidence interval: 1.632–3.629), knowledge on obstetrical ultrasound (adjusted odds ratio: 3.92; 95% confidence interval: 1.324–3.120), and educational status (adjusted odds ratio: 2.84; 95% confidence interval: 1.337–3.381) were significantly associated with attitude. Conclusion: The level of good knowledge and positive attitude toward obstetric ultrasound was 35.5% and 69.5%, respectively, and it can be improved with appropriate interventions like ensuring the practice of obstetric ultrasound scan to all antenatal women. Obstetric care providers at the antenatal care units should advice pregnant women for obstetric ultrasound scan as per World Health Organization recommendations of one obstetric ultrasound scan before 24 weeks of gestation.
{"title":"Pregnant women’s knowledge, attitude, and associated factors toward obstetric ultrasound in public hospitals, Ethiopia, 2021: Multi-centered cross-sectional study","authors":"W. Molla, N. Mengistu, Aregahegn Wudneh","doi":"10.1177/17455057221091357","DOIUrl":"https://doi.org/10.1177/17455057221091357","url":null,"abstract":"Background: Obstetric ultrasound is a harmless, cheap, and noninvasive imaging modality that helps to scan a pregnant mother and delivers parents with a real-time image of the fetus. As the number of pregnancies rises globally, the demand for obstetric ultrasound becomes even more pressing. Objectives: To assess pregnant women’s knowledge, attitude, and associated factors toward obstetric ultrasound in public hospitals, Ethiopia. Methods: Institutional based cross-sectional study was employed. Systematic random technique was used to select 419 pregnant women from 10 April 2021 through 2 June 2021. A structured questionnaire was used to collect data during a face-to-face interview. Then the data were coded, cleaned, and entered into Epidemiological data version (EPIDATA) 3.1 and exported to the statistical package for Social Science version 23.0 for analyses. Bivariate and multivariable logistic regression model was used to identify statistically significant associations between dependent and independent variables. The odds ratio at 95% confidence interval with p-value 0.05% was considered statistically significant. Result: The majority of the study participants, 179 (42.8%), have ages ⩾ 25 years. Magnitude of having good knowledge and positive attitude of pregnant women toward obstetric ultrasound was 35.5% and 69.5%, respectively. Residence (adjusted odds ratio: 3.934; 95% confidence interval: 3.125–6.761), educational status (adjusted odds ratio: 3.614; 95% confidence interval: 1.986–5.964), and parity (adjusted odds ratio: 2.7621; 95% confidence interval: 1.68–3.275) were significantly associated with knowledge. Whereas exposure to obstetrical ultrasound in current pregnancy (adjusted odds ratio: 2.726; 95% confidence interval: 1.632–3.629), knowledge on obstetrical ultrasound (adjusted odds ratio: 3.92; 95% confidence interval: 1.324–3.120), and educational status (adjusted odds ratio: 2.84; 95% confidence interval: 1.337–3.381) were significantly associated with attitude. Conclusion: The level of good knowledge and positive attitude toward obstetric ultrasound was 35.5% and 69.5%, respectively, and it can be improved with appropriate interventions like ensuring the practice of obstetric ultrasound scan to all antenatal women. Obstetric care providers at the antenatal care units should advice pregnant women for obstetric ultrasound scan as per World Health Organization recommendations of one obstetric ultrasound scan before 24 weeks of gestation.","PeriodicalId":47398,"journal":{"name":"Womens Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44248233","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}
Pub Date : 2022-01-01DOI: 10.1177/17455057221090829
A. Kaida, B. Cameron, Tracey Conway, Jasmine Cotnam, Jessica Danforth, A. de Pokomandy, Brenda Gagnier, S. Godoy, Rebecca Gormley, S. Greene, Muluba Habanyama, Mina Kazemi, C. Logie, M. Loutfy, J. MacGillivray, R. Masching, D. Money, V. Nicholson, Zoë Osborne, N. Pick, Margarite Sánchez, W. Tharao, S. Watt, Manjulaa Narasimhan
Action on the World Health Organization Consolidated guideline on sexual and reproductive health and rights of women living with HIV requires evidence-based, equity-oriented, and regionally specific strategies centred on priorities of women living with HIV. Through community–academic partnership, we identified recommendations for developing a national action plan focused on enabling environments that shape sexual and reproductive health and rights by, with, and for women living with HIV in Canada. Between 2017 and 2019, leading Canadian women’s HIV community, research, and clinical organizations partnered with the World Health Organization to convene a webinar series to describe the World Health Organization Consolidated guideline, define sexual and reproductive health and rights priorities in Canada, disseminate Canadian research and best practices in sexual and reproductive health and rights, and demonstrate the importance of community–academic partnerships and meaningful engagement of women living with HIV. Four webinar topics were pursued: (1) Trauma and Violence-Aware Care/Practice; (2) Supporting Safer HIV Disclosure; (3) Reproductive Health, Rights, and Justice; and (4) Resilience, Self-efficacy, and Peer Support. Subsequent in-person (2018) and online (2018–2021) consultation with > 130 key stakeholders further clarified priorities. Consultations yielded five cross-cutting key recommendations: 1. Meaningfully engage women living with HIV across research, policy, and practice aimed at advancing sexual and reproductive health and rights by, with, and for all women. 2. Centre Indigenous women’s priorities, voices, and perspectives. 3. Use language that is actively de-stigmatizing, inclusive, and reflective of women’s strengths and experiences. 4. Strengthen Knowledge Translation efforts to support access to and uptake of contemporary sexual and reproductive health and rights information for all stakeholders. 5. Catalyse reciprocal relationships between evidence and action such that action is guided by research evidence, and research is guided by what is needed for effective action. Topic-specific sexual and reproductive health and rights recommendations were also identified. Guided by community engagement, recommendations for a national action plan on sexual and reproductive health and rights encourage Canada to enact global leadership by creating enabling environments for the health and healthcare of women living with HIV. Implementation is being pursued through consultations with provincial and national government representatives and policy-makers.
{"title":"Key recommendations for developing a national action plan to advance the sexual and reproductive health and rights of women living with HIV in Canada","authors":"A. Kaida, B. Cameron, Tracey Conway, Jasmine Cotnam, Jessica Danforth, A. de Pokomandy, Brenda Gagnier, S. Godoy, Rebecca Gormley, S. Greene, Muluba Habanyama, Mina Kazemi, C. Logie, M. Loutfy, J. MacGillivray, R. Masching, D. Money, V. Nicholson, Zoë Osborne, N. Pick, Margarite Sánchez, W. Tharao, S. Watt, Manjulaa Narasimhan","doi":"10.1177/17455057221090829","DOIUrl":"https://doi.org/10.1177/17455057221090829","url":null,"abstract":"Action on the World Health Organization Consolidated guideline on sexual and reproductive health and rights of women living with HIV requires evidence-based, equity-oriented, and regionally specific strategies centred on priorities of women living with HIV. Through community–academic partnership, we identified recommendations for developing a national action plan focused on enabling environments that shape sexual and reproductive health and rights by, with, and for women living with HIV in Canada. Between 2017 and 2019, leading Canadian women’s HIV community, research, and clinical organizations partnered with the World Health Organization to convene a webinar series to describe the World Health Organization Consolidated guideline, define sexual and reproductive health and rights priorities in Canada, disseminate Canadian research and best practices in sexual and reproductive health and rights, and demonstrate the importance of community–academic partnerships and meaningful engagement of women living with HIV. Four webinar topics were pursued: (1) Trauma and Violence-Aware Care/Practice; (2) Supporting Safer HIV Disclosure; (3) Reproductive Health, Rights, and Justice; and (4) Resilience, Self-efficacy, and Peer Support. Subsequent in-person (2018) and online (2018–2021) consultation with > 130 key stakeholders further clarified priorities. Consultations yielded five cross-cutting key recommendations: 1. Meaningfully engage women living with HIV across research, policy, and practice aimed at advancing sexual and reproductive health and rights by, with, and for all women. 2. Centre Indigenous women’s priorities, voices, and perspectives. 3. Use language that is actively de-stigmatizing, inclusive, and reflective of women’s strengths and experiences. 4. Strengthen Knowledge Translation efforts to support access to and uptake of contemporary sexual and reproductive health and rights information for all stakeholders. 5. Catalyse reciprocal relationships between evidence and action such that action is guided by research evidence, and research is guided by what is needed for effective action. Topic-specific sexual and reproductive health and rights recommendations were also identified. Guided by community engagement, recommendations for a national action plan on sexual and reproductive health and rights encourage Canada to enact global leadership by creating enabling environments for the health and healthcare of women living with HIV. Implementation is being pursued through consultations with provincial and national government representatives and policy-makers.","PeriodicalId":47398,"journal":{"name":"Womens Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45387187","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}
An episiotomy is one of the most commonly performed obstetrics surgeries indicated in emergencies during the second stage of labor like fetal distress, dystocia, and tight perineum. As a result, this systematic review and meta-analysis aimed to assess the prevalence of episiotomy practice and associated factors in Ethiopia. Ten cross-sectional studies with a total population of 3718 were included in this study. The search was done using online databases like PubMed, HINARI, Web of Science, other gray, and online repositories of Universities. All the included papers were extracted and appraised using the standard extraction sheet format of JOANNA Briggs Institute. The Cochran Q-test and I2 statistics test were used to test the heterogeneity of studies. To detect the publication bias of the included studies, a funnel plot and Egger’s test were used. The pooled prevalence of episiotomy practice and the odds ratio with a 95% confidence interval were presented using forest plots. The overall pooled prevalence of episiotomy practice was 45.11% (95% CI; 37.04–53.18; I2 = 96.3%). Prolonged second stage of labor (OR: 4.79, 95% CI: 3.03, 7.57), face presentation (OR: 4.26, 95% CI: 1.21, 15.07), birth weight > 4000 g (OR: 6.71, 95% CI: 3.14–14.33), instrumental delivery (OR: 4.26, 95% CI 2.95, 6.14), and primiparity (OR: 3.70, 95% CI: 1.90, 7.2) were factors associated with episiotomy practice. The overall prevalence of episiotomy practice was higher in Ethiopia compared to studies conducted in other countries. The prolonged second stage of labor, face presentation, birth weight > 4000 g, instrumental delivery, and primiparity of women were the factors associated with episiotomy practice. Therefore, efforts should be made to prevent routine episiotomy practice through creating awareness, adjusting national guidelines, affecting the World Health Organization episiotomy policy, and monitoring the activities of the health care facilities in executing the protocols.
{"title":"Prevalence of episiotomy practice and factors associated with it in Ethiopia, systematic review and meta-analysis","authors":"Zerihun Figa Deyaso, Tesfaye Temesgen Chekole, Rediet Gido Bedada, W. Molla, Etaferahu Bekele Uddo, Tizalegn Tesfaye Mamo","doi":"10.1177/17455057221091659","DOIUrl":"https://doi.org/10.1177/17455057221091659","url":null,"abstract":"An episiotomy is one of the most commonly performed obstetrics surgeries indicated in emergencies during the second stage of labor like fetal distress, dystocia, and tight perineum. As a result, this systematic review and meta-analysis aimed to assess the prevalence of episiotomy practice and associated factors in Ethiopia. Ten cross-sectional studies with a total population of 3718 were included in this study. The search was done using online databases like PubMed, HINARI, Web of Science, other gray, and online repositories of Universities. All the included papers were extracted and appraised using the standard extraction sheet format of JOANNA Briggs Institute. The Cochran Q-test and I2 statistics test were used to test the heterogeneity of studies. To detect the publication bias of the included studies, a funnel plot and Egger’s test were used. The pooled prevalence of episiotomy practice and the odds ratio with a 95% confidence interval were presented using forest plots. The overall pooled prevalence of episiotomy practice was 45.11% (95% CI; 37.04–53.18; I2 = 96.3%). Prolonged second stage of labor (OR: 4.79, 95% CI: 3.03, 7.57), face presentation (OR: 4.26, 95% CI: 1.21, 15.07), birth weight > 4000 g (OR: 6.71, 95% CI: 3.14–14.33), instrumental delivery (OR: 4.26, 95% CI 2.95, 6.14), and primiparity (OR: 3.70, 95% CI: 1.90, 7.2) were factors associated with episiotomy practice. The overall prevalence of episiotomy practice was higher in Ethiopia compared to studies conducted in other countries. The prolonged second stage of labor, face presentation, birth weight > 4000 g, instrumental delivery, and primiparity of women were the factors associated with episiotomy practice. Therefore, efforts should be made to prevent routine episiotomy practice through creating awareness, adjusting national guidelines, affecting the World Health Organization episiotomy policy, and monitoring the activities of the health care facilities in executing the protocols.","PeriodicalId":47398,"journal":{"name":"Womens Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46043644","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}
Pub Date : 2022-01-01DOI: 10.1177/17455057221096218
Hayedeh Hoorsan, M. Simbar, F. Tehrani, F. Fathi, N. Mosaffa, H. Riazi, L. Akradi, Sherko Nasseri, Shayan Bazrafkan
Objectives: This study investigates the therapeutic effect of vitamin C on the development of endometrial lesions and fecundity disorders in the ovarian induction model of mouse endometriosis. Methods: Ovarian endometriosis was surgically induced in 14 NMRI female mice (treatment group, N = 7) and (control group, N = 7). Three days after the second surgery (to assess endometriotic implant), the mice were randomized into two intervention groups: control (placebo) and treatment (50 mg/kg vitamin C every two days orally for four weeks) groups. In the oestrus phase, the mice were sacrificed. In macroscopic assessment, endometriotic implants were evaluated in size, volume, weight, growth score and adhesion score. The microscopic assessment examined the ovarian tissue (the number of antral follicles, corpus luteum and atretic follicles) and endometriotic lesion (histologic and trichrome fibrosis scores). Results: Post-treatment implant volume, growth score, adhesion extent score and adhesion severity score were significantly lower in the treatment group (vitamin C) in comparison with the control group (placebo) (p < 0.0001). The difference between the median weight of endometriotic implants, epithelialization of implant tissue, trichrome fibrosis scores and follicle number in the two groups (treatment and control) was statistically significant (p < 0.05). Atretic follicles were significantly decreased after vitamin C therapy (p < 0.05). Although the numbers of corpus luteum seemed to be more preserved in specimens from the control group, there was no statistical significance between the two groups’ histological scores. Conclusion: As a result, we may imply that vitamin C has a significant effect on reducing the induction and growth of endometrial implants, improving the fecundity function of ovaries, and consequently prevention of endometriosis-associated cancers. Further research is needed to improve targeted interventions resulting in the prevention and treatment of human endometriosis.
{"title":"The effectiveness of antioxidant therapy (vitamin C) in an experimentally induced mouse model of ovarian endometriosis","authors":"Hayedeh Hoorsan, M. Simbar, F. Tehrani, F. Fathi, N. Mosaffa, H. Riazi, L. Akradi, Sherko Nasseri, Shayan Bazrafkan","doi":"10.1177/17455057221096218","DOIUrl":"https://doi.org/10.1177/17455057221096218","url":null,"abstract":"Objectives: This study investigates the therapeutic effect of vitamin C on the development of endometrial lesions and fecundity disorders in the ovarian induction model of mouse endometriosis. Methods: Ovarian endometriosis was surgically induced in 14 NMRI female mice (treatment group, N = 7) and (control group, N = 7). Three days after the second surgery (to assess endometriotic implant), the mice were randomized into two intervention groups: control (placebo) and treatment (50 mg/kg vitamin C every two days orally for four weeks) groups. In the oestrus phase, the mice were sacrificed. In macroscopic assessment, endometriotic implants were evaluated in size, volume, weight, growth score and adhesion score. The microscopic assessment examined the ovarian tissue (the number of antral follicles, corpus luteum and atretic follicles) and endometriotic lesion (histologic and trichrome fibrosis scores). Results: Post-treatment implant volume, growth score, adhesion extent score and adhesion severity score were significantly lower in the treatment group (vitamin C) in comparison with the control group (placebo) (p < 0.0001). The difference between the median weight of endometriotic implants, epithelialization of implant tissue, trichrome fibrosis scores and follicle number in the two groups (treatment and control) was statistically significant (p < 0.05). Atretic follicles were significantly decreased after vitamin C therapy (p < 0.05). Although the numbers of corpus luteum seemed to be more preserved in specimens from the control group, there was no statistical significance between the two groups’ histological scores. Conclusion: As a result, we may imply that vitamin C has a significant effect on reducing the induction and growth of endometrial implants, improving the fecundity function of ovaries, and consequently prevention of endometriosis-associated cancers. Further research is needed to improve targeted interventions resulting in the prevention and treatment of human endometriosis.","PeriodicalId":47398,"journal":{"name":"Womens Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49468677","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}
Pub Date : 2021-11-11DOI: 10.1177/17455057221097554
G. Veillette, M. Castaldi, S. Roberts, A. Parsikia, A. Choubey, K. Okumura, R. Latifi, Jorge Ortiz
Purpose: The incidence of breast cancer following solid organ transplantation is comparable to the age-matched general population. The rate of de novo breast cancer following liver transplantation varies. Furthermore, there is limited information on the management and outcomes of breast cancer in liver transplant recipients. We aim to evaluate the impact of liver transplantation on breast cancer surgery outcomes and compare the outcomes after breast cancer surgery in liver transplant recipient in transplant versus non-transplant centers. Methods: National Inpatient Sample database was accessed to identify liver transplant recipient with breast cancer. Mortality, complications, hospital charges, and total length of stay were evaluated with multivariate logistic regression testing. Weighted multivariate regression models were employed to compare outcomes at transplant and non-transplant centers. Results: Ninety-nine women met inclusion criteria for liver transplantation + breast cancer and were compared against women with breast cancer without liver transplantation (n = 736,527). Liver transplantation + breast cancer had lower performance status as confirmed via higher Elixhauser Comorbidity Index (20.5% vs 10.2%, p < 0001). There were significantly more complications in the liver transplantation cohort when compared to the non-liver transplant recipient (15.0% vs 8.2%, p = 0.012). However, on multivariate analysis, liver transplantation was not an independent risk factor for post-operative complications following breast cancer surgery (odd ratio, 1.223, p = 0.480). Cost associated with breast cancer care was significantly higher in those with liver transplantation (2.621, p < 0.001). Breast conservation surgery in liver transplantation had shorter length of stay as compared to breast cancer alone (odds ratio, 0.568, p = 0.027) in all hospitals. Conclusion: Liver transplantation does not increase short-term mortality when undergoing breast cancer surgery. Although there were significantly more complications in the liver transplantation cohort when compared to the non-liver transplant recipient (15.0% vs 8.2%, p = 0.012), on multivariate analysis, liver transplantation was not an independent risk factor for postoperative complications following breast cancer surgery. Breast cancer management in liver transplant recipient at non-transplant centers incurred higher charges but no difference in complication rate or length of stay when compared to transplant centers.
{"title":"Liver transplantation does not increase morbidity or mortality in women undergoing surgery for breast cancer","authors":"G. Veillette, M. Castaldi, S. Roberts, A. Parsikia, A. Choubey, K. Okumura, R. Latifi, Jorge Ortiz","doi":"10.1177/17455057221097554","DOIUrl":"https://doi.org/10.1177/17455057221097554","url":null,"abstract":"Purpose: The incidence of breast cancer following solid organ transplantation is comparable to the age-matched general population. The rate of de novo breast cancer following liver transplantation varies. Furthermore, there is limited information on the management and outcomes of breast cancer in liver transplant recipients. We aim to evaluate the impact of liver transplantation on breast cancer surgery outcomes and compare the outcomes after breast cancer surgery in liver transplant recipient in transplant versus non-transplant centers. Methods: National Inpatient Sample database was accessed to identify liver transplant recipient with breast cancer. Mortality, complications, hospital charges, and total length of stay were evaluated with multivariate logistic regression testing. Weighted multivariate regression models were employed to compare outcomes at transplant and non-transplant centers. Results: Ninety-nine women met inclusion criteria for liver transplantation + breast cancer and were compared against women with breast cancer without liver transplantation (n = 736,527). Liver transplantation + breast cancer had lower performance status as confirmed via higher Elixhauser Comorbidity Index (20.5% vs 10.2%, p < 0001). There were significantly more complications in the liver transplantation cohort when compared to the non-liver transplant recipient (15.0% vs 8.2%, p = 0.012). However, on multivariate analysis, liver transplantation was not an independent risk factor for post-operative complications following breast cancer surgery (odd ratio, 1.223, p = 0.480). Cost associated with breast cancer care was significantly higher in those with liver transplantation (2.621, p < 0.001). Breast conservation surgery in liver transplantation had shorter length of stay as compared to breast cancer alone (odds ratio, 0.568, p = 0.027) in all hospitals. Conclusion: Liver transplantation does not increase short-term mortality when undergoing breast cancer surgery. Although there were significantly more complications in the liver transplantation cohort when compared to the non-liver transplant recipient (15.0% vs 8.2%, p = 0.012), on multivariate analysis, liver transplantation was not an independent risk factor for postoperative complications following breast cancer surgery. Breast cancer management in liver transplant recipient at non-transplant centers incurred higher charges but no difference in complication rate or length of stay when compared to transplant centers.","PeriodicalId":47398,"journal":{"name":"Womens Health","volume":"18 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44575931","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}
Pub Date : 2020-02-13DOI: 10.15406/mojwh.2020.09.00264
Oreekha Amin, Nasira Tasnim, S. Naeem
Pre-eclampsia is a multi-system disorder of pregnancy associated with hypertension and proteinuria. Its incidence varies between 2-10%, depending on the population studied. Moreover, it is the second leading cause of direct maternal and fetal deaths in Pakistan.1 Although, there is obvious predisposition in certain people to develop pre-eclampsia, the risk is 5-7% among primigravida women.2 Further, while the origin of the pre-eclampsia remains unclear, it is believed that pre-eclampsia is associated with the deep placentation disorders. The physiological change-over of uterine spiral arteries between 8-16weeks of gestation is the classical placental disorder associated with the pre-eclampsia.3 Moreover; elevated platelet triggering is the set component of pathophysiology of pre-eclampsia. This may persuade to platelet utilization and ensuing the microvasculature’s coagulation system set off, which sequentially leads to endothelial injury, vasospasm and end organ damage.
{"title":"Prevention of pre-eclampsia with low dose aspirin in primigravida","authors":"Oreekha Amin, Nasira Tasnim, S. Naeem","doi":"10.15406/mojwh.2020.09.00264","DOIUrl":"https://doi.org/10.15406/mojwh.2020.09.00264","url":null,"abstract":"Pre-eclampsia is a multi-system disorder of pregnancy associated with hypertension and proteinuria. Its incidence varies between 2-10%, depending on the population studied. Moreover, it is the second leading cause of direct maternal and fetal deaths in Pakistan.1 Although, there is obvious predisposition in certain people to develop pre-eclampsia, the risk is 5-7% among primigravida women.2 Further, while the origin of the pre-eclampsia remains unclear, it is believed that pre-eclampsia is associated with the deep placentation disorders. The physiological change-over of uterine spiral arteries between 8-16weeks of gestation is the classical placental disorder associated with the pre-eclampsia.3 Moreover; elevated platelet triggering is the set component of pathophysiology of pre-eclampsia. This may persuade to platelet utilization and ensuing the microvasculature’s coagulation system set off, which sequentially leads to endothelial injury, vasospasm and end organ damage.","PeriodicalId":47398,"journal":{"name":"Womens Health","volume":"9 1","pages":"28-32"},"PeriodicalIF":2.4,"publicationDate":"2020-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43882688","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}
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