BMC Women's Health最新文献

Introduction: Female sex workers (FSWs) remain highly vulnerable to HIV, other sexually transmitted infections (STIs) and broader sexual and reproductive health challenges. Peer-led interventions are widely recommended, yet their specific contributions and implementation gaps are poorly synthesised. This scoping review mapped peer-education strategies used globally to promote sexual health among FSWs, with emphasis on intervention components, outcomes, and evidence gaps, including the role of peers.

Methods: This scoping review followed the Joanna Briggs Institute (JBI) manual and Arksey and O'Malley's methodological framework. A comprehensive search was conducted across PubMed, Scopus, Web of Science, and Google Scholar for peer-reviewed studies published between January 1993 and December 2023. The search used the keywords "sex worker," "sexual health," and "peer education." Eligible studies were required to focus on peer-led sexual health interventions among female sex workers (FSWs) and be published in English. The studies meeting these criteria were screened, charted, and narratively synthesized.

Results: Of 15,488 records, 31 studies from 16 countries (97% in low- and middle-income settings) were included. All incorporated peer-led components and consistently showed positive effects across three outcome domains: behavioural (increased consistent condom use and reduced high-risk behaviours in 23 studies), clinical/biomedical (higher HIV/STI testing, clinic referrals and, in several large-scale programmes, reduced HIV/STI incidence in 12 studies), and psychosocial & structural (improved knowledge, self-efficacy, mental health, human rights awareness and reduced violence in 11 studies). However, peer recruitment, training, supervision and compensation were described in detail in only a minority of studies, no study addressed ethical concerns including burnout, payment inequity and potential exploitation of peer educators.

Conclusion: Peer-led interventions are highly effective across behavioural, clinical/biomedical and psychosocial & structural domains among FSWs, primarily due to peers' unique ability to build trust and access hidden networks. To strengthen evidence and equity, future research must systematically document peer processes, evaluate comparative effectiveness, and proactively address ethical and sustainability challenges for peer educators themselves.

Background: Syrian refugee women in Lebanon face significant barriers to accessing family planning (FP) due to cultural norms, financial constraints, and disrupted healthcare systems.

Objectives: This study aimed to assess the knowledge, attitudes, and practices related to FP and contraception among these women.

Methods: A survey of 790 married Syrian refugee women (aged 18-50) was conducted between November 2023 and March 2024 across four Lebanese governorates. Participants were selected through stratified cluster sampling with household-level convenience sampling. Data on knowledge, attitudes, and practices regarding FP and contraception were collected through structured face-to-face interviews.

Results: The mean age of participants was 31.86 ± 8.09 years, with most showing moderate knowledge of FP (mean score: 8.08 ± 2.11). Younger women, recent arrivals, and those with lower education had lower knowledge levels. Misconceptions about oral contraceptive pills (OCPs) were widespread. Overall, 67.1% of women reported using contraception, with withdrawal (33.2%), intrauterine devices (30.4%), and OCPs (19.8%) being the most common methods. Attitudes were influenced by patriarchal norms, with male approval playing a key role in decision-making. Positive attitudes were more common among women with higher education and employment status.

Conclusion: Syrian refugee women in Lebanon face multiple barriers to effective FP use, including cultural misconceptions and limited autonomy in reproductive decisions. Educational interventions, alongside efforts to involve men in FP discussions, are essential to improve reproductive health outcomes and contribute to sustainable development efforts in Lebanon.

Background: Sexual assault (SA) is a pervasive global health problem with long-term psychological and physical consequences. While the mental health effects of SA are well documented, growing evidence suggests that SA may increase cancer vulnerability through biological, behavioural, and healthcare-access mechanisms.

Objective: To examine the relationship between SA and cancer-related outcomes with a focus on behavioural and infection-related mechanisms reported in empirical studies.

Methods: A scoping review was conducted of studies published between 2000 and 2025 in PubMed. Eligible studies reported cancer outcomes among SA survivors. Data were extracted on study design, population characteristics, and effect measures. This scoping review followed PRISMA-ScR reporting guidance.

Results: Twelve studies met inclusion criteria. Survivors demonstrated lower participation in cervical and breast cancer screening (reductions of 20-40%), higher cancer-related infection rates (relative risk 1.13-1.9), and greater odds of cancer or precancerous disease (OR 1.27-4.5). Qualitative findings described distress and re-traumatisation during pelvic examinations as major screening barriers.

Conclusion: Sexual assault is associated with increased cancer vulnerability through converging biological, behavioural, and structural pathways. Incorporating trauma-informed approaches into cancer prevention, screening, and treatment is essential to addressing this overlooked aspect of survivor health.

Introduction: The number of postmenopausal women is expected to grow dramatically in the coming decades in Iran. Adopting a health-promoting lifestyle (HPL) is essential for improving health and quality of life of this population. This study pursues two objectives: (1) to assess the HPL levels among Iranian postmenopausal women and (2) to investigate the socio-demographic and psychological variables including self-efficacy and self-esteem associated with HPL.

Methods: In this cross-sectional study with correlational design, 400 married postmenopausal women in Shiraz (southwestern Iran) were selected via stratified random sampling. The data collection tools were the Health-Promoting Lifestyle Profile-II (HPLP-II), General Self-Efficacy Scale (GSE), the Rosenberg Self-Esteem Scale, and a sociodemographic information questionnaire. Pearson's correlation coefficient test, independent samples t-tests, and stepwise multiple linear regression were used for analyzing the data in SPSS v. 22.

Results: The average age of natural menopause among participants was 49.33 ± 3.43 years, and they had relatively good HPLP (136.52 ± 21.46). The results highlighted that among all the HPLP subscales, the highest mean score was observed for health responsibility (33.62 ± 6.98), whereas the lowest scores were observed for stress management (12.26 ± 3.13) and physical activity (17.64 ± 6.52). Both self-efficacy (r = 0.445, p < 0.01) and self-esteem (r = 0.425, p < 0.01) demonstrated significant, moderate positive correlations with the total HPL score. Also, there was a significant association between the total HPLP score and two demographic variables: women's education (r = 0.17, p < 0.01) and husband's educational level (r = 0.113, p < 0.05). In addition, the HPLP total score had a significant negative relationship with the number of children (r=-0.114, p < 0.05). The stepwise multiple linear regression analysis revealed that the variables independently associated with the HPL of participants were self-efficacy (β = 0.32, p < 0.001), self-esteem (β = 0.27, p < 0.001), and occupation (β = 0.144, p < 0.001).

Conclusion: It is suggested that health care professionals implement comprehensive planning to enhance the HPL of postmenopausal women. Interventions aimed at improving HPL in this population should prioritize strategies to enhance self-efficacy and self-esteem. Particular attention should be paid to women with lower education, unemployment, and a higher number of children.

Objective: To explore the dynamic evolution of symptom clusters in patients with gynecologic malignancies during the early postoperative period and identify key transition points and influencing factors, providing evidence for precision symptom management in clinical nursing.

Methods: A longitudinal study was conducted among 324 patients using the MDASI-PeriOp-GYN on postoperative days 1 (T1), 5 (T2), and 7 (T3). Exploratory factor analysis identified symptom clusters at each time point, and growth mixture modeling (GMM) was applied to examine trajectory patterns. Latent profile analysis (LPA) and network analysis were performed at T2 to identify patient subgroups, influencing factors, and core symptoms.

Results: Five symptom clusters were identified: disease behavior, gastrointestinal, endocrine, neurological, and emotional. The emotional cluster, independent at T1 and T3, merged with the disease behavior cluster at T2. GMM indicated that all clusters declined from T1 to T2, followed by divergence after T2. LPA identified high- and low-symptom subgroups. Patients with ovarian cancer and those with KPS_1 were more likely to belong to the high-symptom group. Network analysis revealed "poor appetite" as the most central symptom at T2.

Conclusion: Postoperative day 5 (T2) represents a critical transition point in symptom evolution. Ovarian and KPS_1 are at higher risk for severe symptoms, and "poor appetite" plays a key driving role. Targeted assessment and intervention at T2 may reduce symptom burden and improve recovery outcomes in patients with gynecologic malignancies.