Pub Date : 2024-04-09DOI: 10.3389/frph.2024.1134404
Delphin Kolié, Etienne Guillard, Abdoulaye Sow, Hawa Manet, B. Camara, Théophile Bigirimana, Mamane Harouna, A. Delamou
Introduction Studies on the organisation of care and the power dynamic between providers and patients with HIV in sub-Saharan Africa are rare. This study aims to describe the patient-provider relationship and explore the challenges to optimal and patient-centred care for HIV patients. Methods This was a qualitative exploratory descriptive study using in-depth individual interviews and focus group discussions. In total, 17 individual interviews and 5 focus group discussions were conducted. This was conducted in four urban health facilities in Conakry, the capital of Guinea. Three group of participants were included in this study namely patients with HIV; health providers including facilities and services managers; and psychosocial counsellors. Psychosocial counsellors provide emotional and psychosocial support to HIV patients. Their role in the organization care in Guinea is new and they contribute to strengthening adherence of patients with HIV to ARV treatment. Results Patients with HIV, health providers, and psychosocial counsellors have a positive perception of the patient-provider relationship. This relationship was characterized essentially by maintaining confidentiality of HIV status disclosure, caring attitudes towards patients (being available, adjusting locations for accessing ART, based on patients’ preferences), and participating in HIV patient’s social life. However, scolding and miscommunication about the interpretation of viral load tests were reported. The shortage of human resources, low salaries of health staff, poor infrastructure, and the financial burden borne by patients with HIV impede the implementation of optimal patient-centred care. Conclusion Integrating psychosocial counsellors in HIV care organization, improving access to ARV, infrastructure, increasing human resources, and removing the financial burden for HIV patients are needed to optimal patient-centred care in Guinea.
{"title":"Exploring experiences of HIV care to optimize patient-centred care in Conakry, Guinea: a qualitative study","authors":"Delphin Kolié, Etienne Guillard, Abdoulaye Sow, Hawa Manet, B. Camara, Théophile Bigirimana, Mamane Harouna, A. Delamou","doi":"10.3389/frph.2024.1134404","DOIUrl":"https://doi.org/10.3389/frph.2024.1134404","url":null,"abstract":"Introduction Studies on the organisation of care and the power dynamic between providers and patients with HIV in sub-Saharan Africa are rare. This study aims to describe the patient-provider relationship and explore the challenges to optimal and patient-centred care for HIV patients. Methods This was a qualitative exploratory descriptive study using in-depth individual interviews and focus group discussions. In total, 17 individual interviews and 5 focus group discussions were conducted. This was conducted in four urban health facilities in Conakry, the capital of Guinea. Three group of participants were included in this study namely patients with HIV; health providers including facilities and services managers; and psychosocial counsellors. Psychosocial counsellors provide emotional and psychosocial support to HIV patients. Their role in the organization care in Guinea is new and they contribute to strengthening adherence of patients with HIV to ARV treatment. Results Patients with HIV, health providers, and psychosocial counsellors have a positive perception of the patient-provider relationship. This relationship was characterized essentially by maintaining confidentiality of HIV status disclosure, caring attitudes towards patients (being available, adjusting locations for accessing ART, based on patients’ preferences), and participating in HIV patient’s social life. However, scolding and miscommunication about the interpretation of viral load tests were reported. The shortage of human resources, low salaries of health staff, poor infrastructure, and the financial burden borne by patients with HIV impede the implementation of optimal patient-centred care. Conclusion Integrating psychosocial counsellors in HIV care organization, improving access to ARV, infrastructure, increasing human resources, and removing the financial burden for HIV patients are needed to optimal patient-centred care in Guinea.","PeriodicalId":503122,"journal":{"name":"Frontiers in Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140721984","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 : 2024-04-03DOI: 10.3389/frph.2023.980828
Micaela Stevenson
{"title":"Suggestions for political reparations for reproductive abuses against Black women","authors":"Micaela Stevenson","doi":"10.3389/frph.2023.980828","DOIUrl":"https://doi.org/10.3389/frph.2023.980828","url":null,"abstract":"","PeriodicalId":503122,"journal":{"name":"Frontiers in Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140751071","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}
Engaging in risky sexual behaviors can lead to HIV infection, sexually transmitted infections, and unintended pregnancy among youths. University students had greater sexual risks for many reasons. Therefore, this study aimed to assess the magnitude and associated factors of risky sexual behaviors among regular undergraduate students at Injibara University, Northwest Ethiopia.A cross-sectional study was conducted at Injibara University from 20 January to 30 2020. Multistage sampling was employed to select 770 students. Data were collected using a semistructured self-administered questionnaire. A binary logistic regression model was used to identify factors associated with risky sexual behavior. Adjusted odds ratios with 95% CIs were determined, and variables with P-values <0.05 were considered significant.A total of 770 students participated in the study, providing a response rate of 100%. In this study, 294 (38%, 95% CI: 35%, 42%) students engaged in risky sexual behaviors. Risky sexual behavior was significantly associated with not tested for HIV (AOR = 1.62, 95% CI: 1.15–2.31), peer pressure (AOR = 1.90, CI: 1.37–2.64), basic HIV knowledge (AOR = 2.16, CI: 1.65–2.89), substance use (AOR = 3.56, CI: 2.11–6.06), watching pornography videos (AOR = 1.58, CI: 1.11–2.23), and HIV risk perception (AOR = 1.37, CI: 1.02–1.91).A substantial proportion of university students in this study engaged in unsafe sexual behavior. Risky sexual behaviors are more likely to occur when students are under peer pressure, use substances, have no perceived HIV risk, watch pornography, and have inadequate basic HIV knowledge. Therefore, tailored strategic interventions such as life skill training should be designed to bring about positive behavioral changes among university students.
参与危险的性行为会导致青少年感染艾滋病毒、性传播疾病和意外怀孕。由于多种原因，大学生的性风险更大。因此，本研究旨在评估埃塞俄比亚西北部因吉巴拉大学普通本科生中危险性行为的严重程度和相关因素。研究采用多阶段抽样法选出了 770 名学生。数据采用半结构式自填问卷收集。采用二元逻辑回归模型确定与危险性行为相关的因素。共有 770 名学生参与了研究，回复率为 100%。在这项研究中，294 名学生（38%，95% CI：35%，42%）有过危险性行为。危险性行为与以下因素明显相关：未接受 HIV 检测（AOR = 1.62，95% CI：1.15-2.31）、同伴压力（AOR = 1.90，CI：1.37-2.64）、HIV 基本知识（AOR = 2.16，CI：1.65-2.89）、药物使用（AOR = 3.在本研究中，相当一部分大学生参与了不安全的性行为。当学生受到同伴压力、使用药物、未感知 HIV 风险、观看色情电影以及缺乏基本的 HIV 知识时，更有可能发生危险的性行为。因此，应设计有针对性的战略干预措施，如生活技能培训，以在大学生中实现积极的行为改变。
{"title":"Prevalence of risky sexual behavior and associated factors among Injibara University students, Northwest Ethiopia","authors":"Mekdes Abera Adal, Saron Abeje Abiy, Mebratu Mitiku Reta, Mezgebu Silamsaw Asres, Yaregal Animut","doi":"10.3389/frph.2024.1356790","DOIUrl":"https://doi.org/10.3389/frph.2024.1356790","url":null,"abstract":"Engaging in risky sexual behaviors can lead to HIV infection, sexually transmitted infections, and unintended pregnancy among youths. University students had greater sexual risks for many reasons. Therefore, this study aimed to assess the magnitude and associated factors of risky sexual behaviors among regular undergraduate students at Injibara University, Northwest Ethiopia.A cross-sectional study was conducted at Injibara University from 20 January to 30 2020. Multistage sampling was employed to select 770 students. Data were collected using a semistructured self-administered questionnaire. A binary logistic regression model was used to identify factors associated with risky sexual behavior. Adjusted odds ratios with 95% CIs were determined, and variables with P-values <0.05 were considered significant.A total of 770 students participated in the study, providing a response rate of 100%. In this study, 294 (38%, 95% CI: 35%, 42%) students engaged in risky sexual behaviors. Risky sexual behavior was significantly associated with not tested for HIV (AOR = 1.62, 95% CI: 1.15–2.31), peer pressure (AOR = 1.90, CI: 1.37–2.64), basic HIV knowledge (AOR = 2.16, CI: 1.65–2.89), substance use (AOR = 3.56, CI: 2.11–6.06), watching pornography videos (AOR = 1.58, CI: 1.11–2.23), and HIV risk perception (AOR = 1.37, CI: 1.02–1.91).A substantial proportion of university students in this study engaged in unsafe sexual behavior. Risky sexual behaviors are more likely to occur when students are under peer pressure, use substances, have no perceived HIV risk, watch pornography, and have inadequate basic HIV knowledge. Therefore, tailored strategic interventions such as life skill training should be designed to bring about positive behavioral changes among university students.","PeriodicalId":503122,"journal":{"name":"Frontiers in Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140370482","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 : 2024-03-26DOI: 10.3389/frph.2024.1369762
Katie M. Williams, Adaobi Lisa Olisa, Rose Wilcher
Short- and long-term impacts of the climate crisis continue to be felt across the public health landscape. Many individuals marginalized by the climate crisis also navigate a higher likelihood of exposure to HIV. By understanding this relationship, we can better position HIV prevention, and pre-exposure prophylaxis (PrEP) programs specifically, to meet user needs in communities experiencing the effects of the climate crisis. In support, we propose four recommendations for mitigating the impact of the climate crisis on those who may benefit from PrEP: (1) leverage existing and emerging research and lived experience to intentionally target and appropriately reach individuals affected by the climate crisis who may need or want PrEP; (2) emphasize the need for more climate-resilient PrEP products within the research and development pipeline; (3) build a continued understanding of the role of the climate crisis-HIV relationship in product introduction through national collaboration; and (4) strengthen the integration of PrEP service delivery and response to intimate partner violence. The PrEP market is set for rapid expansion with the introduction of new prevention methods to enable choice. To be comprehensively responsive to potential PrEP users, we must consider and address how the climate crisis changes not only the environmental landscape, but the prevention ecosystem.
{"title":"Exploring linkages: addressing the relationship between the climate crisis and HIV prevention with recommendations for emerging pre-exposure prophylaxis programs","authors":"Katie M. Williams, Adaobi Lisa Olisa, Rose Wilcher","doi":"10.3389/frph.2024.1369762","DOIUrl":"https://doi.org/10.3389/frph.2024.1369762","url":null,"abstract":"Short- and long-term impacts of the climate crisis continue to be felt across the public health landscape. Many individuals marginalized by the climate crisis also navigate a higher likelihood of exposure to HIV. By understanding this relationship, we can better position HIV prevention, and pre-exposure prophylaxis (PrEP) programs specifically, to meet user needs in communities experiencing the effects of the climate crisis. In support, we propose four recommendations for mitigating the impact of the climate crisis on those who may benefit from PrEP: (1) leverage existing and emerging research and lived experience to intentionally target and appropriately reach individuals affected by the climate crisis who may need or want PrEP; (2) emphasize the need for more climate-resilient PrEP products within the research and development pipeline; (3) build a continued understanding of the role of the climate crisis-HIV relationship in product introduction through national collaboration; and (4) strengthen the integration of PrEP service delivery and response to intimate partner violence. The PrEP market is set for rapid expansion with the introduction of new prevention methods to enable choice. To be comprehensively responsive to potential PrEP users, we must consider and address how the climate crisis changes not only the environmental landscape, but the prevention ecosystem.","PeriodicalId":503122,"journal":{"name":"Frontiers in Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140380305","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}
Research has shown the role of identity on future health professionals' confidence and competence in addressing the sexual and reproductive health (SRH) needs of their patients. While there has been some work in increasing the sexual health literacy of future providers via various curricular approaches and comprehensive clinical-based training, there are research gaps on how social differences around identity impact future healthcare professionals’ knowledge and practices around SRH.This article presents research findings on the experiences of US undergraduate students attending a campus that provides training in the health sciences and health professions. Our study aims to understand the perspectives of these students as they pertain to their future career choices in healthcare, with a focus on how their past experiences learning about sex, sexuality, and reproduction impact their current and future professional trajectories.We present a qualitative analysis from 40 in-depth interviews with U.S. undergraduates. The interview questions were designed in collaboration with undergraduate researchers interested in sexual health education. These student researchers collected all the interview data and worked with senior researchers to analyze some of these data.The themes that emerged from the interviews were around experiences with what students perceived as “fractured” sexual and reproductive health (SRH) knowledge they received as children and adolescents. This knowledge shaped essential aspects of their identity as young adults and future healers. Data indicated unique processes implicated in how past as well as present socialization experiences learning about sex, sexuality, and reproduction positions undergraduates in health professions to see young adulthood as a journey of “catching up” on sexual knowledge but also as an ongoing experience of anticipation and planning influencing their career-building journey.The importance of sexual health literacy among healthcare professionals cannot be overstated, as it is vital in providing patient-centered and non-judgmental sexual and reproductive health (SRH) care and services. To date, there is a shortage of studies looking at the impact of sexual health knowledge on healthcare professionals. More research is needed on educational strategies that could be implemented at the intra-personal level to assist college-aged young adults in healthcare career tracks to “catch up” or “fill in the gaps” in their sexual education journey.
{"title":"“Ripping Off the Band-Aid”: uncovering future health care Professionals' “Fractured Knowledge” about sexual and reproductive health","authors":"Angie Mejia, Kara Nyhus, Tessie Burley, Alexis Myhre, Marcela Montes, Kristin Osiecki, Anita Randolph","doi":"10.3389/frph.2024.1242885","DOIUrl":"https://doi.org/10.3389/frph.2024.1242885","url":null,"abstract":"Research has shown the role of identity on future health professionals' confidence and competence in addressing the sexual and reproductive health (SRH) needs of their patients. While there has been some work in increasing the sexual health literacy of future providers via various curricular approaches and comprehensive clinical-based training, there are research gaps on how social differences around identity impact future healthcare professionals’ knowledge and practices around SRH.This article presents research findings on the experiences of US undergraduate students attending a campus that provides training in the health sciences and health professions. Our study aims to understand the perspectives of these students as they pertain to their future career choices in healthcare, with a focus on how their past experiences learning about sex, sexuality, and reproduction impact their current and future professional trajectories.We present a qualitative analysis from 40 in-depth interviews with U.S. undergraduates. The interview questions were designed in collaboration with undergraduate researchers interested in sexual health education. These student researchers collected all the interview data and worked with senior researchers to analyze some of these data.The themes that emerged from the interviews were around experiences with what students perceived as “fractured” sexual and reproductive health (SRH) knowledge they received as children and adolescents. This knowledge shaped essential aspects of their identity as young adults and future healers. Data indicated unique processes implicated in how past as well as present socialization experiences learning about sex, sexuality, and reproduction positions undergraduates in health professions to see young adulthood as a journey of “catching up” on sexual knowledge but also as an ongoing experience of anticipation and planning influencing their career-building journey.The importance of sexual health literacy among healthcare professionals cannot be overstated, as it is vital in providing patient-centered and non-judgmental sexual and reproductive health (SRH) care and services. To date, there is a shortage of studies looking at the impact of sexual health knowledge on healthcare professionals. More research is needed on educational strategies that could be implemented at the intra-personal level to assist college-aged young adults in healthcare career tracks to “catch up” or “fill in the gaps” in their sexual education journey.","PeriodicalId":503122,"journal":{"name":"Frontiers in Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140384286","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 : 2024-01-24DOI: 10.3389/frph.2024.1241571
A. Erulkar, Eyasu Hailu
Rates of urbanization in Ethiopia are high and adolescent girls and young women are predominant among those who move from rural to urban areas. Young women frequently undertake rural-urban migration on their own or with a friend, and with little planning for their initial settlement in the city. They frequently rely on job placement brokers to place them into jobs upon arrival, with positions such as domestic work normally including accommodation.This is a qualitative study undertaken at the two largest bus stages in Addis Ababa, which are points of arrival for a large number of migrants from rural areas. Three categories of respondents were interviewed in-depth: migrant young women who had arrived within the last few days, job placement brokers who are located in and around the bus station, and market women/vendors at the bus stations who interact with both migrants and brokers.Migrant girls' point of arrival was an inflection point of risk, especially among girls who were on their own, not accompanied or met at the bus terminal and lacking in plans or preparation of accommodation. Such girls were targeted by thieves at the bus station and by unscrupulous brokers, some of whom forced girls into sexual relations before placing them into paid work. In contrast, market women and some well-meaning brokers took steps to protect girls such as providing temporary accommodation.This research underscores the need for intensified support to rural-urban migrants to ensure safety and security at the time of arrival at their destination. This includes promotion of pre-migration education and planning; safety assets including sufficient money, cell phones and alternative contacts in the city; and arrangement for immediate, safe and secure accommodation. As a result of the study, a pilot program has been developed, using local resources to extend support for newly arriving migrant girls and young women.
{"title":"Young female migrants and job placement brokers in Addis Ababa, Ethiopia","authors":"A. Erulkar, Eyasu Hailu","doi":"10.3389/frph.2024.1241571","DOIUrl":"https://doi.org/10.3389/frph.2024.1241571","url":null,"abstract":"Rates of urbanization in Ethiopia are high and adolescent girls and young women are predominant among those who move from rural to urban areas. Young women frequently undertake rural-urban migration on their own or with a friend, and with little planning for their initial settlement in the city. They frequently rely on job placement brokers to place them into jobs upon arrival, with positions such as domestic work normally including accommodation.This is a qualitative study undertaken at the two largest bus stages in Addis Ababa, which are points of arrival for a large number of migrants from rural areas. Three categories of respondents were interviewed in-depth: migrant young women who had arrived within the last few days, job placement brokers who are located in and around the bus station, and market women/vendors at the bus stations who interact with both migrants and brokers.Migrant girls' point of arrival was an inflection point of risk, especially among girls who were on their own, not accompanied or met at the bus terminal and lacking in plans or preparation of accommodation. Such girls were targeted by thieves at the bus station and by unscrupulous brokers, some of whom forced girls into sexual relations before placing them into paid work. In contrast, market women and some well-meaning brokers took steps to protect girls such as providing temporary accommodation.This research underscores the need for intensified support to rural-urban migrants to ensure safety and security at the time of arrival at their destination. This includes promotion of pre-migration education and planning; safety assets including sufficient money, cell phones and alternative contacts in the city; and arrangement for immediate, safe and secure accommodation. As a result of the study, a pilot program has been developed, using local resources to extend support for newly arriving migrant girls and young women.","PeriodicalId":503122,"journal":{"name":"Frontiers in Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139601197","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 : 2024-01-22DOI: 10.3389/frph.2023.1325566
T. Takeshima, Takahiro Mihara, Makoto Tomita, Shinnosuke Kuroda, Y. Yumura, H. Ueno, M. Yamamoto, M. Murase
Varicocelectomy is well known to improve the pregnancy outcome of patients with clinical varicoceles in assisted reproductive technologies as well as spontaneous conception. Therefore, this study aimed to evaluate the additional effects of oral antioxidant therapy after varicocelectomy on the pregnancy outcome in the assisted reproductive technology setting.This study was a retrospective cohort study. The subjects were couples among whom the male partner had undergone varicocelectomy and was scheduled for subsequent assisted reproductive technology. Pregnancy outcomes were followed retrospectively in 62 couples with male partners who received tocopherol (antioxidant group) and 37 couples who did not (control group). The tocopherol and control groups were assigned dependent on the decision of the physician in charge and the patient's request. The clinical pregnancy rates per couple and embryo transfer, time to pregnancy, and the number of cycles during transfer to pregnancy were evaluated.No significant differences were observed in the pregnancy rate per couple (antioxidant group 70.9% vs. control group 64.9%, P = 0.55) and per embryo transfer (50.4% vs. 39.6%, P = 0.22). Regarding the time to event analyzed by adjusted restricted mean survival time, the mean time to pregnancy was significantly shorter in the antioxidant (tocopherol) group (14.2 vs. 17.4 months, P = 0.025). No significant difference was observed in the embryo transfer cycle to pregnancy (mean embryo transfer cycles: 2.6 vs. 3.0, P = 0.238).Additional oral tocopherol nicotinate as antioxidant therapy after varicocelectomy was shown to shorten the time to pregnancy. It is recommended that add-on effects be tested in more well-designed randomized controlled trials to examine whether it improves assisted reproductive outcomes.
{"title":"Add-on effects of oral tocopherol supplementation to surgical varicocelectomy on the outcome of assisted reproductive technology: a single-center pilot study report","authors":"T. Takeshima, Takahiro Mihara, Makoto Tomita, Shinnosuke Kuroda, Y. Yumura, H. Ueno, M. Yamamoto, M. Murase","doi":"10.3389/frph.2023.1325566","DOIUrl":"https://doi.org/10.3389/frph.2023.1325566","url":null,"abstract":"Varicocelectomy is well known to improve the pregnancy outcome of patients with clinical varicoceles in assisted reproductive technologies as well as spontaneous conception. Therefore, this study aimed to evaluate the additional effects of oral antioxidant therapy after varicocelectomy on the pregnancy outcome in the assisted reproductive technology setting.This study was a retrospective cohort study. The subjects were couples among whom the male partner had undergone varicocelectomy and was scheduled for subsequent assisted reproductive technology. Pregnancy outcomes were followed retrospectively in 62 couples with male partners who received tocopherol (antioxidant group) and 37 couples who did not (control group). The tocopherol and control groups were assigned dependent on the decision of the physician in charge and the patient's request. The clinical pregnancy rates per couple and embryo transfer, time to pregnancy, and the number of cycles during transfer to pregnancy were evaluated.No significant differences were observed in the pregnancy rate per couple (antioxidant group 70.9% vs. control group 64.9%, P = 0.55) and per embryo transfer (50.4% vs. 39.6%, P = 0.22). Regarding the time to event analyzed by adjusted restricted mean survival time, the mean time to pregnancy was significantly shorter in the antioxidant (tocopherol) group (14.2 vs. 17.4 months, P = 0.025). No significant difference was observed in the embryo transfer cycle to pregnancy (mean embryo transfer cycles: 2.6 vs. 3.0, P = 0.238).Additional oral tocopherol nicotinate as antioxidant therapy after varicocelectomy was shown to shorten the time to pregnancy. It is recommended that add-on effects be tested in more well-designed randomized controlled trials to examine whether it improves assisted reproductive outcomes.","PeriodicalId":503122,"journal":{"name":"Frontiers in Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139608742","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 : 2024-01-22DOI: 10.3389/frph.2023.1150370
Arianna Rodriguez, Keith J. Horvath, Nadia Dowshen, Raina V. Voss, Jonathan Warus, Megan Jacobs, K. Kidd, David J. Inwards-Breland, Jill Blumenthal
Transgender and gender non-binary (TGNB) individuals are disproportionally affected by HIV and face high rates of discrimination and stigmatization, resulting in limited access to HIV prevention services. Pre-exposure prophylaxis (PrEP) is highly efficacious for reducing the risk of HIV transmission. However, little research is available regarding PrEP awareness and utilization among TGNB adolescents and young adults (AYA).TGNB AYA ages 15–24 years old were recruited between December 2021 and November 2022 for participation in a one-time, anonymous online survey study to assess PrEP awareness and perceptions, as well as barriers to its use. Participants were recruited from seven academic centers offering gender-affirming care to TGNB AYA across the United States.Of the 156 TGNB AYA individuals who completed the survey, most (67%) were aware of PrEP; however, few (7%) had been prescribed PrEP. Many (60%) had not spoken to a medical provider and, even if the medication was free and obtained confidentially, most participants did not plan to take PrEP due to low perceived HIV risk, lack of PrEP knowledge, and concern about interactions between their hormone therapy and PrEP.These findings underscore the need for broad PrEP educational efforts for both TGNB AYA and their providers to improve knowledge, identify potential PrEP candidates among TGNB AYA and improve access by addressing identified barriers.
跨性别者和性别非二元者（TGNB）受艾滋病毒的影响尤为严重，他们面临着严重的歧视和侮辱，导致他们获得艾滋病毒预防服务的机会有限。暴露前预防（PrEP）对降低艾滋病毒传播风险非常有效。在 2021 年 12 月至 2022 年 11 月期间，我们招募了 15-24 岁的 TGNB AYA 参与一次性匿名在线调查研究，以评估 PrEP 的认知和看法以及使用障碍。在完成调查的 156 名 TGNB AYA 中，大多数人（67%）知道 PrEP；但是，很少有人（7%）开过 PrEP 处方。许多人（60%）没有与医疗服务提供者交谈过，即使药物是免费的，而且是在保密的情况下获得的，大多数参与者也不打算服用 PrEP，原因是他们认为感染 HIV 的风险较低、缺乏 PrEP 知识，以及担心他们的激素治疗与 PrEP 之间会产生相互作用。这些发现强调，有必要对 TGNB AYA 及其医疗服务提供者开展广泛的 PrEP 教育工作，以提高他们对 PrEP 的认识，在 TGNB AYA 中确定潜在的 PrEP 候选者，并通过消除已发现的障碍来改善获取机会。
{"title":"Awareness and utilization of pre-exposure prophylaxis and HIV prevention services among transgender and non-binary adolescent and young adults","authors":"Arianna Rodriguez, Keith J. Horvath, Nadia Dowshen, Raina V. Voss, Jonathan Warus, Megan Jacobs, K. Kidd, David J. Inwards-Breland, Jill Blumenthal","doi":"10.3389/frph.2023.1150370","DOIUrl":"https://doi.org/10.3389/frph.2023.1150370","url":null,"abstract":"Transgender and gender non-binary (TGNB) individuals are disproportionally affected by HIV and face high rates of discrimination and stigmatization, resulting in limited access to HIV prevention services. Pre-exposure prophylaxis (PrEP) is highly efficacious for reducing the risk of HIV transmission. However, little research is available regarding PrEP awareness and utilization among TGNB adolescents and young adults (AYA).TGNB AYA ages 15–24 years old were recruited between December 2021 and November 2022 for participation in a one-time, anonymous online survey study to assess PrEP awareness and perceptions, as well as barriers to its use. Participants were recruited from seven academic centers offering gender-affirming care to TGNB AYA across the United States.Of the 156 TGNB AYA individuals who completed the survey, most (67%) were aware of PrEP; however, few (7%) had been prescribed PrEP. Many (60%) had not spoken to a medical provider and, even if the medication was free and obtained confidentially, most participants did not plan to take PrEP due to low perceived HIV risk, lack of PrEP knowledge, and concern about interactions between their hormone therapy and PrEP.These findings underscore the need for broad PrEP educational efforts for both TGNB AYA and their providers to improve knowledge, identify potential PrEP candidates among TGNB AYA and improve access by addressing identified barriers.","PeriodicalId":503122,"journal":{"name":"Frontiers in Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139606422","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 : 2024-01-04DOI: 10.3389/frph.2023.1339278
Catherine C. Davis, Kenneth W. Miller, Julie A. Peterson
{"title":"Editorial: Female urogenital devices used during their lifetime—managing menstruation including pelvic health","authors":"Catherine C. Davis, Kenneth W. Miller, Julie A. Peterson","doi":"10.3389/frph.2023.1339278","DOIUrl":"https://doi.org/10.3389/frph.2023.1339278","url":null,"abstract":"","PeriodicalId":503122,"journal":{"name":"Frontiers in Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139385132","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 : 2024-01-04DOI: 10.3389/frph.2023.1321284
Phil Boyle, Karolina Andralojc, Susanne van der Velden, Shahpar Najmabadi, Theun de Groot, Craig Turczynski, Joseph B. Stanford
Low serum estradiol in early pregnancy is associated with an elevated risk of miscarriage. We sought to determine whether efforts to restore low blood estradiol via estradiol or dehydroepiandrosterone (DHEA) supplementation would reduce the risk of miscarriage as part of a multifactorial symptom-based treatment protocol.This retrospective cohort study included women with low serum estradiol levels in early pregnancy, defined as ≤50% of reference levels by gestational age. Estradiol or DHEA were administered orally, and the primary outcome measure was serum estradiol level, in reference to gestational age. The secondary outcome measures included miscarriage, birth weight, and gestational age at birth.We found no significant effect of estradiol supplementation on serum estradiol levels referenced to gestational age, while DHEA supplementation strongly increased estradiol levels. For pregnancies with low estradiol, the miscarriage rate in the non-supplemented group was 45.5%, while miscarriage rate in the estradiol and DHEA supplemented groups were 21.2% (p = 0.067) and 17.5% (p = 0.038), respectively. Birth weight, size, gestational age, and preterm deliveries were not significantly different. No sexual abnormalities were reported in children (n = 29) of DHEA-supplemented patients after 5–7 years follow-up.In conclusion, DHEA supplementation restored serum estradiol levels, and when included in the treatment protocol, there was a statistically significant reduction in miscarriage.
{"title":"Restoration of serum estradiol and reduced incidence of miscarriage in patients with low serum estradiol during pregnancy: a retrospective cohort study using a multifactorial protocol including DHEA","authors":"Phil Boyle, Karolina Andralojc, Susanne van der Velden, Shahpar Najmabadi, Theun de Groot, Craig Turczynski, Joseph B. Stanford","doi":"10.3389/frph.2023.1321284","DOIUrl":"https://doi.org/10.3389/frph.2023.1321284","url":null,"abstract":"Low serum estradiol in early pregnancy is associated with an elevated risk of miscarriage. We sought to determine whether efforts to restore low blood estradiol via estradiol or dehydroepiandrosterone (DHEA) supplementation would reduce the risk of miscarriage as part of a multifactorial symptom-based treatment protocol.This retrospective cohort study included women with low serum estradiol levels in early pregnancy, defined as ≤50% of reference levels by gestational age. Estradiol or DHEA were administered orally, and the primary outcome measure was serum estradiol level, in reference to gestational age. The secondary outcome measures included miscarriage, birth weight, and gestational age at birth.We found no significant effect of estradiol supplementation on serum estradiol levels referenced to gestational age, while DHEA supplementation strongly increased estradiol levels. For pregnancies with low estradiol, the miscarriage rate in the non-supplemented group was 45.5%, while miscarriage rate in the estradiol and DHEA supplemented groups were 21.2% (p = 0.067) and 17.5% (p = 0.038), respectively. Birth weight, size, gestational age, and preterm deliveries were not significantly different. No sexual abnormalities were reported in children (n = 29) of DHEA-supplemented patients after 5–7 years follow-up.In conclusion, DHEA supplementation restored serum estradiol levels, and when included in the treatment protocol, there was a statistically significant reduction in miscarriage.","PeriodicalId":503122,"journal":{"name":"Frontiers in Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139385175","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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