Altered social trajectories and risks of violence among young Syrian women seeking refuge in Turkey: a qualitative study

This work is based on the inequality that women suffer in public spaces, with fear being a constant in their lives. Women must learn to live to accept a limited and constrained existence. Based on this approach, this research establishes a European description and comparison of the insecurities, fears, or concerns expressed by women facing the risk of aggression/harassment, and the prevalence of sexual harassment in public spaces. For this, we used the Survey on Violence Against Women in the European Union (EU; 2012). In the fieldwork, we performed a factorial analysis, as well as a logistic regression analysis between the sociodemographic variables (age, educational level, income, and habitat) and prevalence of physical or virtual sexual harassment. In general, while European women report that they have suffered harassment to a considerable extent, there are even greater concerns or fear of abuse or aggression in public spaces. A fundamental fact is that there is a significant correlation between the prevalence of harassment and per capita income, such that those countries with the highest economic development show a higher incidence of harassment towards women. Similarly, European countries with higher standards of equality show a greater incidence and prevention against the risk of harassment or aggression, particularly among young women. Some results suggest that more than half of Europeans avoid certain spaces or places for fear of being attacked. The main European powers, which have higher standards of equality, report the most harmful instances of behavior against women in public spaces in relation to harassment or fear. The results obtained prompt the conclusion that socialization towards European women is both victimizing and discriminatory.

Research from several high-income countries links early menarche with an increased risk for sexual violence. However, the role of early menarche in adolescent girls’ and young women’s sexual violence risk in sub-Saharan Africa, where sexual violence rates are high, is not well understood. The current study explores the association between early menarche and sexual violence in Ghana with secondary analysis of data collected from 700 adolescent girls and young women followed over three years. Logistic regressions were used to assess the cross-sectional association between early menarche and sexual violence. Generalised estimating equations were used to assess whether the association between early menarche and sexual violence persisted over time. Inverse odds weighting was used to test potential mediators of the association between early menarche and sexual violence. Sexual violence was fairly common in the study sample, with 27% reporting having experienced sexual violence at baseline, and approximately 50% at year three. Early menarche was associated with 72% greater odds of having experienced sexual violence at baseline (95% confidence interval: 1.01–2.93). However, the odds ratio attenuated and lost significance over the three-year study period, with a lower risk of sexual violence among girls with early menarche at year three. Neither child marriage nor early sexual initiation significantly mediated the association between early menarche and sexual violence. The findings suggest that early-maturing girls may be particularly vulnerable to sexual violence in early adolescence, thus necessitating prevention interventions around the time of menarche to reduce the risk for sexual violence.

The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) relies on comprehensive and reliable population data to implement interventions to reduce HIV transmission in high-incidence areas among populations disproportionately affected by the HIV epidemic. Adolescent girls and young women in sub-Saharan Africa account for a disproportionate number of new HIV infections compared with their male peers (1). The DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) program includes multisectoral, layered interventions aimed at reducing factors that contribute to vulnerability to HIV infection among adolescent girls and young women in PEPFAR-supported sub-Saharan African countries (1). Namibia, a southern African country with a population of approximately 2.55 million among whom approximately 8% live with HIV infection, had their DREAMS program first implemented in 2017* (2,3). Data from the 2019 Namibia Violence Against Children and Youth Survey (VACS), the most recent and comprehensive nationally representative data source available to study the epidemiology of violence and other HIV risk factors, were used to estimate the percentage of adolescent girls and young women aged 13-24 years who would be eligible for DREAMS program services. The prevalence of individual DREAMS eligibility criteria, which comprise known age-specific risk factors associated with HIV acquisition, were estimated by age group. Among all adolescent girls and young women in Namibia, 62% were eligible for DREAMS based on meeting at least one criterion. Common eligibility criteria included adverse childhood experiences, specifically exposure to physical, emotional, and sexual violence and being an orphan;† and high-risk behaviors, such as early alcohol use,§ recent heavy alcohol use,¶ and infrequent condom use.** Using VACS data to estimate the prevalence of HIV risk factors and identify adolescent girls and young women at elevated risk for HIV acquisition in countries like Namibia with high HIV-incidence can inform programs and policies aimed at improving the well-being of these adolescent girls and young women and help control the HIV epidemics in these countries.

ABSTRACTYoung adulthood is a key period in which gender norms are solidified. As a result, young women are particularly vulnerable to gender-based violence. In Delhi, over 90% of women have ever experienced sexual violence in public spaces. Sexual harassment of girls and women in public spaces is commonly named ‘eve teasing’ in India. Experience of sexual harassment in public spaces has been found to be associated with restricted mobility, interrupted education, and early age at marriage. Little is known about men’s perspectives on eve teasing and how they believe it affects women and girls. This study fills that gap through qualitative research to explore the attitudes and perceptions of adolescent boys and young men on this topic. Ten focus group discussions were conducted in two slum communities in Mumbai. Coding and thematic analysis were performed. We identified themes of acceptance of harassment, weak sanctions, traditional gender norms supportive of harassment, and ideologies of male sexual entitlement. Many of the perceived risk and protective factors for sexual harassment in public spaces are operationalised at the community level. Community mobilisation is necessary in designing interventions focused on the primary and secondary prevention of sexual harassment.

BackgroundGlobally, 40% of adolescent girls and young women suffer from urogenital tract infections (UGTIs) that affect their quality of life (QOL). Despite their significant health burdens, these conditions remain underreported and understudied, particularly in Low and Middle-income Countries (LMICs)This study aimed to examine the determinants of urogenital infection-related symptoms in adolescent girls and young adult women students.MethodsThis cross-sectional study was conducted among adolescent girls and young women in ten secondary and university institutions from December 2022 to April 2023 in Bukavu, Eastern DRC. Using purposive sampling, 1,500 questionnaires were distributed with 1,048 completed responses from 1,200 returns. The variables included age, education level, origin, knowledge of infections, hygiene behaviors (self-medication, contraception, water intake, and sanitation), and urogenital infection symptoms. A logistic regression model was used to examine predictors of urogenital infections using Stata SE14.0.ResultsA total of 1048 adolescent girls and young women, aged between 12 and 30 years with a mean age of 20 years, were enrolled in the study. The prevalence of related urogenital infection symptoms was 12% among school-going adolescent girls and young women in secondary schools and universities in Bukavu town, eastern Democratic Republic of Congo. Several factors were significantly associated, notably information about UGTIs and their symptoms (AOR: 4.52; 95% CI: 2.45–8.22; p < 0.001). The use of rain, ground, river or lake water while bathing increased the risk of UGTI symptoms (AOR: 4.08; 95% CI: 2.10–7.95; p < 0.001). Adding disinfectants to water reduced this risk but did not cancel it (AOR: 1.37; 95% CI: 1.10–2.05, p = 0.034). Communal bathing vessels (AOR: 1.85; 95% CI: 1.17–2.94, p = 0.008), the habit of wearing clothing that permanently tightens the perineum(AOR: 2.12; 95% CI: 1.14–3.90, p = 0.016), and antibiotic self-medication (AOR: 2.03; 95% CI: 1.36–3.02, p < 0.001) were associated with UGTI symptoms.ConclusionUrogenital tract infections (UGTIs) are common among adolescent girls and young women in educational settings in Bukavu, DRC. Symptoms were determined by a lack of information on UGTIs, women’s hygiene practices, self-medication, and lifestyle habits. Comprehensive health education overhaul is needed to effectively address public health concerns.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12905-025-04057-8.

Adolescent girls and young women ages 15–24 experience high rates of gender-based violence (GBV), underpinned by gender and social norms that shape their transitions to adulthood. For interventions that seek to leverage and build on existing infrastructure for health service provision, it is important to understand how gender norms operate in the background and how they shape service engagement or non-engagement. In formative work for our project, Screen & Support, outside of Lusaka, Zambia, we engaged in community conversations with adolescent girls and young women to understand common types and experiences of violence, perceptions of what causes violence, and pathways to post-violence service access. This manuscript explores emerging findings surrounding social and gender norms. We engaged n = 12 adolescent girls and young women ages 15–24, including survivors of GBV, young women living with HIV, and young married women in separate conversations conducted in a mix of Nyanja, Bemba, and English. Arts-based activities accompanied guided focus group discussions. Translated transcripts were coded and thematically analysed by two authors using Dedoose software. Key themes emerged around two major themes—understanding the norms underpinning violence, and observing how these norms were activated in the aftermath of violence. Sub-themes focused on power differentials supporting violence, social expectations and community-enacted sanctions, and understanding dominant norms and assumptions. Considering what unfolded in the aftermath of violence, young women participants considered key reference groups upholding norms, explored the contexts where norms may be contested or become more complicated, and described how accepting silence was a common means of closure. We discuss the implications of these findings for programme design, delivery, and evaluation, as well as the potential, and roadmap, for shifting norms that negative affect adolescent girls and young women.

Reproductive Injustice at the Southern Border and Beyond: An Analysis of Current Events and Hope for the Future.

BackgroundEarly sexual debut among young women is associated with adverse sexual and reproductive health outcomes, including unintended pregnancies and sexually transmitted infections. Despite its negative impact, there is limited research on this issue in Sierra Leone. This study aims to address this gap by examining the prevalence of early sexual debut and its associated factors among adolescent girls and young women aged 15–24 years in Sierra Leone.MethodsData from the 2019 Sierra Leone Demographic and Health Survey was used for the study. Provincial variations in the proportion of early sexual debut were visualised using a spatial map. A mixed-effect multilevel binary logistic regression analysis was performed to examine the factors associated with early sexual debut. The results were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI) and intraclass correlation coefficients.ResultsThe prevalence of early sexual debut was 26.1% [24.3, 28.0]. Adolescent girls and young women aged 20–24 were less likely to engage in early sexual debut [aOR = 0.52; 95% CI: 0.41, 0.65] than those aged 15–19. The odds of early sexual debut was lower among adolescent girls and young women with secondary/higher education [aOR = 0.62; 95% CI: 0.45, 0.85] compared to those with no education. Adolescent girls and young women who used the internet in the last 12 months [aOR = 0.50; 95% CI: 0.34, 0.73] and those who belonged to the Fullah ethnic group [aOR = 0.25; 95% CI: 0.07, 0.85] were less likely to engage in early sexual debut relative to those who did not use the internet and those belonging to the Creole ethnic group respectively. Adolescent girls and young women who intend to use contraceptives [aOR = 0.60; 95% CI: 0.46, 0.77] and those who do not intend to use contraceptives [aOR = 0.65; 95% CI: 0.49, 0.88] were less likely to engage in early sexual debut than those who were using contraceptives. Conversely, adolescent girls and young women who were working [aOR = 1.41; 95% CI: 1.12, 1.77] had higher odds for early sexual debut than those not working. The odds of early sexual debut were higher among adolescent girls and young women who were married/cohabiting [aOR = 1.72; 95% CI: 1.32, 2.22] and previously married [aOR = 3.26; 95% CI: 1.61, 6.56] than those who were never married. Adolescent girls and young women living in the North Western area [aOR = 1.81; 95% CI: 1.05, 3.13] had higher odds for early sexual debut than those living in the Eastern province.ConclusionEarly sexual debut is prevalent among adolescent girls and young women in Sierra Leone. Age, education, internet use, ethnicity, contraceptive use intention, marital status, employment status, and province of residence were the factors associated with early sexual debut. The study underscores the need for policymakers, government, and non-governmental organisations to design and implement comprehensive and multifaceted interventions to promote informed decision-making and reproductive health among adolescent girls and young women in Sierra Leone.

ObjectiveYoung women bear the greatest burden of sexually transmitted infections (STIs), so it is important to identify and address barriers to STI screening in this population. We conducted a qualitative study to explore the feasibility of STI screening among adolescent girls and young women in Mombasa, Kenya.MethodsWe conducted 17 in-depth interviews (IDIs) (8 with adolescent girls and 9 with young women) and 6 focus group discussions (FGDs) (4 with adolescent girls and 2 with young women, total 55 participants). The audio recordings for the IDIs and FGDs were translated and transcribed into English. Transcripts were independently reviewed by two researchers, and a set of codes was designed to help analyze the data using the content analysis approach. Data content was then analyzed manually and digitally using ATLAS.ti, and consensus was reached on central and specific emergent themes discussed by the research team.ResultsAdolescent girls and young women in Mombasa, Kenya expressed willingness to participate in STI screening. A major incentive for screening was participants’ desire to know their STI status, especially following perceived high-risk sexual behavior. Lack of symptoms and fear of positive test results were identified as barriers to STI screening at the individual level, while parental notification and stigmatization from parents, family members and the community were identified as barriers at the community level. Uncomfortable or embarrassing methods of specimen collection were an additional barrier. Thus, urine-based screening was felt to be the most acceptable.ConclusionKenyan adolescent girls and young women seem willing to participate in screening for STIs using urine testing. Addressing stigmatization by parents, health care workers and the community could further facilitate STI screening in this population.

IntroductionUnintended pregnancies are associated with a number of risk factors such as malnutrition, mental illness, unsafe abortion, maternal mortality and horizontal transmission of HIV to children. These risks are predominant among adolescent girls and young women compared to older women. This study examined the individual and contextual factors associated with unintended pregnancy among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa.Materials and methodsData for this study was obtained from recent Demographic and Health Surveys carried out between 2010 and 2018 in 10 countries in sub-Sahara Africa. The sample size for this study was made up of 6,791 adolescent girls and young women (aged 15–24), who were pregnant during the surveys and had complete responses on all the variables considered in the study. Unintended pregnancy was the outcome variable in this study. Descriptive and multilevel logistic regression analyses were performed and the fixed effect results of the multilevel logistic regression analysis were reported as adjusted odds ratios at 95% confidence interval.ResultsUnintended pregnancy in the selected countries was 22.4%, with Angola, recording the highest prevalence of 46.6% while Gambia had the lowest prevalence of 10.2%. The likelihood of unintended pregnancy was high among adolescent girls and young women aged 15–19 [aOR = 1.48; 95% CI = 1.26–1.73], those with primary [aOR = 1.99; 95% CI = 1.69–2.33] and secondary/higher [aOR = 2.30; 95% CI = 1.90–2.78] levels of education, single (never married/separated/divorced/widowed) adolescent girls and young women [aOR = 9.23; 95% CI = 7.55–11.28] and those who were cohabiting [aOR = 2.53; 95% CI = 2.16–2.96]. The odds of unintended pregnancy also increased with increasing birth order, with adolescent girls and young women having three or more births more likely to have unintended pregnancies compared to those with one birth [aOR = 1.99; 95% CI = 1.59–2.48]. Adolescent girls and young women who had ever used contraceptives (modern or traditional), had higher odds of unintended pregnancies compared to those who had never used contraceptives [aOR = 1.32; 95% CI = 1.12–1.54]. Finally, adolescent girls and young women who belonged to the rich wealth quintile were more likely to have unintended pregnancy compared to those in the poor wealth quintile [1.28; 95% CI = 1.08–1.51].ConclusionThe study found that age, marital status, level of education, parity, use of contraceptives and wealth quintile are associated with unintended pregnancy among adolescent girls and young women in high fertility sub-Saharan African countries. These findings call for the need for government and non-governmental organisations in high fertility sub-Saharan African countries to restructure sexual and reproductive health services, taking into consideration these individual and contextual level characteristics of adolescent girls and young women.

BackgroundSierra Leone faces a significant challenge in addressing HIV/AIDS, particularly among adolescent girls and young women. This age group is considered highly vulnerable due to biological factors and social inequalities. Understanding the prevalence of HIV testing in this demographic is crucial for designing effective prevention and treatment strategies. This study investigated the spatial distribution of HIV testing and its associated factors among adolescent girls and young women in Sierra Leone.MethodsData from the 2019 Sierra Leone Demographic and Health Survey was used for the study. The sample comprised 6,062 adolescent girls and young women between the ages of 15 and 24. Spatial autocorrelation and Moran’s I statistic were employed to analyze the spatial distribution of HIV testing. An analysis utilising mixed-effect multilevel binary logistic regression was performed to determine the factors associated with HIV testing. The findings were presented as adjusted odds ratios (aOR) and a 95% confidence interval (CI).ResultsThe national prevalence of HIV testing among adolescents and young women in Sierra Leone was 42.1% [40.3,43.9]. Kailahun, Kambia, Tonkolil, some parts of the Western rural area, and Bonthe districts were found to be statistically significant hotspot for HIV testing. Whereas, Karene, Falaba, Bo, kenema, and some parts of Pujuhun were statistically cold spot districts. Adolescent girls and young women aged 20–24 [aOR = 1.63, 95% CI = 1.29, 2.07] had higher odds of HIV testing than those aged 15–19. Those with secondary/higher education [aOR = 1.87, 95% CI = 1.40, 2.51] had higher odds of HIV testing than those with no education. The odds of HIV testing was higher among adolescent girls and young women who use the Internet [aOR = 1.75, 95% CI = 1.32, 2.33] than those who did not use internet. Adolescent girls and young women with one [aOR = 16.56, 95% CI = 12.31, 22.29] and two or more parity [aOR = 16.37, 95% CI = 10.86, 24.68] had higher odds of HIV testing than those with no parity. The likelihood of HIV testing was higher among adolescent girls and young women who had sex below 18 [aOR = 4.54, 95% CI = 3.25, 6.34] and those who had sex at 18+ [aOR = 5.70, 95% CI = 3.84, 8.45] compared to those who had never had sex. Adolescent girls and young women who visited health facilities in the past 12 months [aOR = 1.82, 95% CI = 1.46, 2.26] had higher odds of HIV testing than those who did not.ConclusionDespite some positive trends, HIV testing rates among adolescent girls and young women in Sierra Leone remain moderate. Spatial autocorrelation analysis consistently revealed hotspots and cold spots for HIV testing, with Kailahun, Kambia, Tonkolil, some parts of the Western rural area, and Bonthe districts remaining persistent hotspots. Age, education, internet use, sexual history, parity, and healthcare access are significant factors influencing testing behaviour. To improve testing rates, the government and policymakers should prioritize educational campaigns, expand internet access, integrate HIV testing into routine healthcare, and address stigma associated with HIV.

BackgroundGiven the instrumental role long-acting reversible contraceptives (LARCs) play in reducing unintended pregnancies, there is a need to understand the factors that predict their use among adolescent girls and young women in high fertility countries. Our study examined the prevalence and predictors of LARCs use among adolescent girls and young women in high fertility countries in sub-Saharan Africa.Materials and methodsWe pooled data from the women’s files of the most recent Demographic and Health Surveys (DHS) from 2010 to 2020 of the top ten high fertility countries in sub-Saharan Africa, which are part of the DHS programme. The total sample was 5854 sexually active adolescent girls and young women aged 15–24 who were using modern contraceptives at the time of the survey. Descriptive and multilevel logistic regression models were used in the analyses. The results were presented using percentages and adjusted odds ratio (AOR) with their respective 95% confidence intervals (CIs).ResultsAt the descriptive level, the overall prevalence of LARCs utilisation was 17.6% in the ten countries, with the lowest of 1.7% in Angola and the highest of 55.8% in Mali. Adolescent girls and young women who were married had a lower likelihood of LARCs utilisation than those who were never married [AOR = 0.63, 95% CI = 0.45, 0.88]. Adolescent girls and young women who wanted no more children had higher odds of LARCs use compared to those who wanted more children [AOR = 1.56, 95% CI = 1.09, 2.26]. Adolescent girls and young women with one to three births [AOR = 6.42, 95% CI = 4.27, 9.67], and those with four or more births [AOR = 7.02, 95% CI = 3.88, 12.67] were more likely to use LARCs compared to those who had no children. Countries in sub-Saharan Africa with lower probability of utilizing LARCs were Angola, Niger and Mozambique, whereas adolescent girls and young women in Mali had higher probability of utilizing LARCs.ConclusionOur findings suggest that LARCs utilisation among adolescent girls and young women is low in high fertility countries in sub-Saharan Africa. To reduce the rates of unplanned pregnancies and induced abortions, it is imperative that adolescent girls and young women in sub-Saharan Africa are educated on the advantages of utilising LARCs. Additionally, governments, policymakers, and stakeholders in sub-Saharan Africa should raise awareness by executing health promotion measures to enhance the demand for LARCs among adolescent girls and young women. Achieving these would not only prevent unplanned pregnancies and induced abortions, but also help meet the United Nation’s health and well being for all as enshrined in Sustainable Development Goals 3 and 5.

ObjectivesSexual harassment among adolescent girls and young women (AGYW) is a prevalent and understudied form of gender-based violence (GBV) with negative impacts on health and well-being. The COVID-19 pandemic raised...

BackgroundDespite increased prevention efforts, HIV remains the leading cause of death among adolescent girls and young women in South Africa. Although research indicates important determinants of HIV acquisition at the individual and interpersonal levels, structural-level stigma and discrimination continue to be critical barriers to reaching and retaining this key population for HIV prevention and sexual and reproductive health services. Innovative and multilevel interventions are needed that can address the intersectional structural and gender issues that young women face, including stigma, alcohol and drug use, gender-based violence, and other risk factors when seeking health services. Oral pre-exposure prophylaxis (PrEP) taken daily has been found to be an effective biomedical HIV prevention tool. Testing a comprehensive gender-focused biobehavioral HIV prevention intervention that is inclusive of social ecological determinants, such as stigma and discrimination reduction in clinics, is critical for reducing HIV among adolescent girls and young women.MethodsThis project involves both a Community Collaborative Board and a Youth Advisory Board in helping to adapt the Young Women’s Health CoOp intervention and the Health Policy Project (HPP) Stigma and Discrimination (S&D) reduction training curriculum to the setting and population. This study uses a two-by-two factorial design with stratified randomization of 12 clinics, each with distinct catchment areas. The Young Women’s Health CoOp addresses substance use, sexual risk, violence prevention and sexual negotiation, condom demonstration, and problem solving with the following additions: knowledge of PrEP, the importance of PrEP adherence, and sexual and reproductive health. Adolescent girls and young women will be assessed with behavioral and biological measures at baseline, 3-, 6- and 9-month follow-up. The S&D reduction training is provided for all staff in the clinics randomized to this condition. Clinic staff will be surveyed at baseline, 4- and 8-month follow-up. We will recruit 900 AGYW from communities in the 12 clinic catchment areas.DiscussionThe study findings, if efficacious across the outcomes, will be incorporated into the gender-focused HIV prevention intervention toolkit and disseminated to inform multilevel prevention approaches.Trial registrationClinicalTrials.gov. Identifier: NCT04048551 (Recruiting). Registered: August 7, 2019 (Retrospectively registered).

In South Africa (SA), HIV prevalence is significantly higher in young women than in young men. Intergenerational relationships and women's dependence on men are known HIV risks. To qualitatively explore young women's perceptions and experiences of dating younger and older men and their perceived risks for gender-based violence. From July to September 2011, we conducted eight focus group discussions (FGDs) and 20 in-depth interviews (IDIs) with young women aged 15 - 24 years. Women were recruited from two SA communities: one urban location in Gauteng Province and one rural location in Limpopo Province. All interviews were recorded, transcribed and translated from local languages into English. The study team then analysed the transcripts thematically, using an inductive approach, with ATLAS-ti (v6.2) software. In total, 110 young women participated, 20 of them in both the FGDs and the IDIs. Young men were viewed by the participants as immature, unable to provide financially and likely to be HIV-positive, although young women sought out young men for 'love', mutual understanding and intimacy. In contrast, older men were perceived as easy to respect, ready for marriage and able to provide for women's needs. Young women sought older men as providers, but acknowledged that older men were more likely to be violent and that discussing sexual and reproductive health and HIV with them was difficult. Young women expressed the belief that if a man was providing for them financially, he had 'the right' to use violence. The interviews highlighted young women's mixed views on the 'value' of older v. younger partners, and the perceived and real risks of violence in intergenerational relationships. There is a need for interventions addressing power dynamics in relationships, including healthy communication. However, to address young women's vulnerability to violence, ultimately young women and their families need access to economic opportunities that reduce dependence on transactional relationships.