Partner Consent Research Articles

Public Perspectives on the Inclusion of Pregnant People in Clinical Trials [ID 2683498

INTRODUCTION: Pregnant people remain underrepresented in clinical trials despite extensive efforts to increase participation. The public’s perception about including pregnant people in research is limited, and no publications to date specifically include self-identified males. This research aims to elucidate the attitudes of reproductive-aged people in the United States regarding the inclusion of pregnant individuals in clinical trials. METHODS: An IRB-approved survey including five Likert-scale questions concerning the inclusion of pregnant patients in research was distributed via Facebook Marketing. Self-reported gender, race, ethnicity, education level, political affiliation, religion, relationship status, and contraceptive use and method were analyzed in bivariate analyses. Variables significant in the bivariate analyses were included in multivariable logistic regression models. RESULTS: Among 743 respondents, 405 (54.6%) agreed that pregnant people should be excluded from clinical trials and 392 (52.8%) agreed that the risks of including pregnant people in clinical trials outweigh the benefits. Females had lower odds of agreement (odds ratio [OR] 0.46 [95% CI, 0.33–0.65] and 0.39 [95% CI, 0.28–0.54], respectively). Most respondents (74.2%) agreed that pregnant people should obtain partner consent prior to participation; notably, males had 3.9 times greater odds of agreement (95% CI: 2.51–6.10). Paradoxically, 504 people (67.9%) agreed that including pregnant people in research is important for providing evidence-based medicine. CONCLUSION: Most participants agreed with excluding pregnant people from clinical research; however, self-identifying females were more likely than males to value the safe inclusion of pregnant people in clinical research to advance evidence-based obstetrical care. This juxtaposition highlights an important challenge to achieving equitable inclusion of pregnant people in clinical research and the importance of public perception in improving maternal and child health outcomes.

Investigating Determinants Affecting the Adoption of Contemporary Contraceptive Methods: A Cross-Sectional Analysis of Adolescent Utilization in the Nabdan District, Upper East Region, Ghana

Introduction: Promoting the use of contraception among adolescents is essential to improving their sexual and reproductive health. Teenage pregnancies are becoming more common, and the Nabdam area continues to have low rates of use of contemporary contraceptive methods. These facts highlight the urgent need to address the needs of adolescents concerning their sexual and reproductive health. This study aims to investigate the factors impacting the Upper East Region of Ghana's Nabdam District's adoption of contemporary contraceptive methods.
 Methods: 261 older teenage girls from the Nabdam district, ages 15 to 19, were included in the study, which used a quantitative technique and a descriptive cross-sectional design. Respondents were chosen using a multiphase sample technique, and data were collected over the course of 10 working days using a standardized survey form. STATA Version 14 was utilized for data analysis. A significance criterion of p < 0.05 was applied to bivariate and logistic regression models to investigate any correlations between independent factors and outcome variables.
 Results: 52.1% of respondents said they have had their first sexual experience before turning 20. The oldest stated age at first sex was 19 years old, while the youngest was 10 years old. Additionally, 97.8% of respondents reported learning about contemporary contraception via a variety of sources, such as peers, instructors, health professionals, and radio media. Even with this knowledge, 48.7% of respondents thought using a contraceptive technique would provide 100% protection against getting pregnant, while 73.6% of respondents had never used any kind of birth control. Age (p< 0.001), educational attainment (p< 0.001), marital status (p< 0.001), peer influence (p< 0.001), place of residence (p< 0.001), religious affiliation (p< 0.018), consent from a sexual partner (p< 0.001), positive attitudes from healthcare providers (p < 0.001), and the availability of contraceptives (p < 0.001) were discovered to be linked to the usage of modern contraceptives.
 Conclusion: Although a sizable percentage of respondents showed awareness of contemporary contraceptive methods, low modern contraceptive usage was significantly correlated with several factors, including age, marital status, educational attainment, peer influence, partner consent, and the unfavorable attitudes of healthcare professionals. To tackle this problem, a community-based strategy emphasizing the advancement of enabling elements and the removal of obstacles is required. The Ghana Health Service could enhance its School Health Education Program (SHEP) by increasing informational sessions, organizing theatrical productions and debates, and recruiting peer educators as invaluable resources to share experiences and instruct their peers on sexuality, reproductive health issues, and the use of modern contraceptives

A Prática de Planeamento Familiar em Mulheres de Baixa Renda: Caso do Município da Cidade de Cuamba entre 2019 a 2020

This article addresses the issue of family planning, with a view to evaluating its practice among low-income women in the municipality of Cuamba City, Mozambique. It recognized the rights that people have through family planning, to determine the constitution of their families and the right to choose the number of children. The study was based on direct interviews with users of the Sapura health unit. The study reveals that 66 percent of women are in a de facto union, where the man has always been dominant in couples, as the person who can decide whether the woman can have family planning or not, and 74 percent of women have family planning without their partner's consent. The most commonly used method is DEPO - a long-acting injectable hormonal contraceptive method made up of a synthetic hormone similar to progesterone.

Are Female Undergraduates at the University of Calabar Equipped with the Knowledge, Positive Attitudes, and Effective Practices of Contraceptives?

BACKGROUND: The global challenge of rapid population growth necessitates family planning programs to address reproductive health needs and control population increase. However, unintended pregnancies, particularly among adolescents, remain a significant problem, leading to increased risks of sexually transmitted infections and unsafe abortions. In Nigeria, contraceptive use is low among youths, resulting in high incidences of induced abortions and sexually transmitted infections. Barriers such as religious beliefs, cultural factors, limited availability, personal beliefs, and fear of side effects contribute to the under-utilization of contraceptives. METHODS: A descriptive cross-sectional study was conducted among female undergraduates of the University of Calabar, Cross River State. Data was collected using a 42-item questionnaire after obtaining informed consent. Multi-stage sampling was employed, and data was analyzed with IBM SPSS version 26 using descriptive and inferential statistics. RESULTS: The mean age of respondents was 21.5 ± 2.72 years. Most participants were in their first (26.7%) or second (22.6%) level of study. 28.8% were in sexual relationships, while 71.2% were not. Approximately a quarter of respondents had experienced symptoms of sexually transmitted infections. 71.5% had no knowledge of emergency contraception. Condoms (71.2%) and pills (54.5%) were the most commonly mentioned methods of contraception, while tubal ligation was the least popular (4.7%). The main benefit cited for contraception was the prevention of unwanted pregnancy (92.2%). 47.3% had no idea about the side effects of contraception, with irregular menstruation being the most commonly mentioned side effect (19.3%). Friends/peers, the internet, and school were the primary sources of information on contraception. 56.4% believed that contraception is not solely for females and should not be reserved for the literate. Over a third of respondents thought contraception encourages promiscuity and has too many side effects, with more than half demanding contraceptive services on campus. Less than half of the respondents (43.9%) reported using contraception at some point, with even smaller percentages using contraception in the last six months (25.2%) or during their last sexual intercourse (23.8%). Of the 101 who used contraceptives in their last sexual intercourse, the majority (83%) used condoms, while pills (7%) and emergency contraception (10%) were less common. Preferred sources for contraception were pharmacies (57.5%) and chemist shops/patent medicine vendors (24.7%). Religion (41.5%), fear of side effects (34.9%), and partner consent (28.3%) were the main influences on contraceptive use. Several factors were significantly associated with contraception utilization, including age, partner's educational level, knowledge of contraception, and level of study (p<0.05). CONCLUSION: The low utilization of contraception among female undergraduates at the University of Calabar despite high awareness and poor knowledge highlights the need for interventions. Factors influencing utilization include age, knowledge, and level of study. Barriers such as religion, fear of side effects, and partner consent must be addressed. Recommendations include sensitization campaigns, establishing a youth-friendly center on campus, incorporating contraception into curricula, collaborating with NGOs, and increasing funding for research.

Women as bodies. The role of ambivalent sexism and sexual objectification on non‐consensual sharing of sexting images

AbstractDiscriminatory attitudes towards women are still widespread and have also pervaded the digital world. They are often connected with the propensity to view and treat women as sexual objects, which sometimes leads to negative and harmful behaviours, such as the sharing of intimate images without the partner's consent. The present study aims at investigating the non‐consensual sharing of intimate images in relation to benevolent and hostile sexism, direct and mediated by female sexual objectification. The sample was recruited through the snowball sampling technique and was made up of 2,305 young Italian adults aged between 18 and 35. Analysis was carried out using structural equation modelling and the multigroup mediation model, allowing us to detect any gender differences. For both, males and females, results show that benevolent sexism has neither a direct nor indirect correlation with non‐consensual sharing of sexts. Instead, hostile sexism has an indirect relation with non‐consensual sharing mediated by the sexual objectification of the woman's body. Results do not show differences between male and female groups and highlight the need to focus on the socio‐cultural context that enables the non‐consensual sharing of intimate images, which is a variety of cyberviolence against women. Practical implications of the results will be extensively discussed. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

Enablers and barriers of male involvement in the use of modern family planning methods in Eastern Uganda: a qualitative study

BackgroundMale involvement plays a critical role in the utilization of various sexual and reproductive health services. We explored enablers and barriers of male involvement in the use of modern family planning methods in Eastern Uganda.MethodsThis was a qualitative study in Mbale, Eastern Uganda done between November and December 2022. We conducted three group discussions comprising of four participants each, with male partners and eight key informant interviews with midwives. We followed a group discussion guide during the group discussions and an interview guide during the key informant interviews to explore enablers and barriers of male involvement in the use of modern family planning methods. All the interviews and group discussions were audio-recorded with permission from the participants, transcribed verbatim, and analyzed following thematic content analysis approach.ResultsTwo sub-themes emerged from the analysis; perceived enablers and barriers. The perceived enablers included positive attitude, subjective norms, need to support the woman, mutual consent, limited resources and expected benefits of reducing gender-based violence and sexually transmitted infections. Lack of male partner consent, busy work engagement, social stigma, religious prohibition, desire for many children and gender roles incompatibility hindered male partner involvement in family planning. Fear of side effects and misconceptions, unconducive hospital environment in form of mistreatment, family planning considered a female’s issue, and lack of consideration of male partner needs in family planning clinic were additional barriers to male involvement.ConclusionMale involvement in family planning was related to positive attitude and subjective norms towards family planning, mutual consent, and recognition for limited resources to support a large family size. Lack of male partner approval, fear of side effects and misconceptions, unconducive hospital environment and social, cultural and religious prohibitions discouraged male partner involvement in family planning. Community based approaches to family planning sensitization, such as community education campaigns, may be an important step toward reducing barriers to male involvement in the use of modern family planning methods.

Sexual Scripts and Sexual Consent: Gender Stereotypes, Music-Media Messages, and Sexual Consent Expectancies Among College Men and Women.

The pervasiveness of sexual assault among college women prompted examination of college students' sexual-consent expectancies using sexual scripting theory as a framework. We aimed to understand how personal beliefs, experiences with sexual violence, and dominant cultural gendered sexual scripts in music media inform sexual-consent expectancies among a sample of primarily White heterosexual college students at a northwestern university (n = 364). Participants viewed music videos with sexual and objectifying content and reported their perceptions of how women were portrayed. Linear mixed modeling with Maximum Likelihood with interactions by biological sex revealed associations between past sexual victimization and lower expectancies to adhere to a sexual partner's consent wishes. Men with a history of perpetrating sexual violence had lower expectancies to ask for consent, and women with more traditional sexual stereotypes had lower expectancies to seek consent or refuse unwanted sex. Having lower expectancies to adhere to a partner's consent wishes was associated with holding more traditional sexual stereotypes for both men and women. Participants who perceived women as powerlessness in viewed music videos had lower expectancies to ask for consent from a sexual partner, to refuse unwanted sexual advances, and to adhere to a decision regarding sexual consent. Through the lens of sexual scripting theory, results advance understanding of how the intersection of biological sex, experiences of sexual violence, gendered beliefs, and cultural scripts in music media inform young adults' sexual expectancies and potential for sexual risk. Implications for prevention include addressing gendered sexual scripts to reduce ambiguity around sexual consent among college students. Media-based interventions are discussed as a strategy toward this end.

Examining Variations in Participation and Outcomes of Consensual and Nonconsensual Extradyadic Behavior among Ashley Madison Users

ABSTRACT Despite the abundance of studies investigating individual differences associated with extradyadic behavior (EB), nearly all have adopted retrospective measures in which the data is likely plagued by recall biases. In addition, few studies have explored individual differences or outcomes associated with EB between those with consenting and nonconsenting primary partners. Thus, the current study investigated the extent to which Ashley Madison users participated in a wide range of EBs, whether age, gender, and sexual identity predicted participation, and the extent to which outcomes were impacted by partner consent. The results from 1460 adults (962 men, 498 women) revealed that users reported engaging in three categories of behaviors: sexual/explicit, technology/online, and emotional/affectionate behaviors and that women and those older in age reported participating in EBs more frequently than men and those younger in age. Finally, 16.9% of the sample had a primary partner that consented to their Ashley Madison use and those with consenting partners reported greater perceived improvement in their primary relationship than did those with nonconsenting partners. Our findings highlight the importance of assessing the multitude of behaviors that Ashley Madison users participate in and whether consent was obtained. Implications for educators and practitioners are discussed.

Predictive factors to access and use of family planning services by rural and semi-urban dwellers in Afikpo North Local Government area, Ebonyi State, Nigeria.

Pregnancy and childbirth are important periods when women of reproductive age frequently come in contact with healthcare facilities and providers. These periods afford them the privilege for discussion and decision on post-partum family planning with healthcare providers. Male partner consent has been shown to have a positive impact on access and uptake of modern contraception. This study was aimed at assessing the availability, uptake and male partner consent for post-partum family planning (PPFP) amongst rural and semi-urban dwellers in Afikpo North local government area of Ebonyi state, Nigeria. The study conducted on 205 postpartum women, 40 health workers at the primary health centres (PHCs) and traditional birth attendants (TBAs) in Afikpo North LGA were selected by a random sampling technique. Information was obtained via 3 categories of interviewer-administered questionnaire for the different categories of individuals involved in the study. Data analyses was done using SPSS version 21.0. The overall findings showed a high prevalence of grand multiparity (51.2%) and child-bearing at extremities of reproductive age (20.5%) despite generally good awareness of modern contraception (92.7%) and availability of family planning services and modern birth control methods in all the PHC facilities. Of note is that a good percentage of the women received antenatal care (38.1%) or had their last delivery at TBAs places (42.4%) despite the fact that only 60% of the TBAs are aware of modern family planning methods and none of them offer family planning services. The prevalence of modern contraceptive usage was 41.5% and the male partner consent was present in 72.9% of modern contraceptive users. Despite high level of awareness and availability of modern family planning services, the TBAs should be more sensitized in order to improve the uptake of PPFP.

What Is Title IX? Toward a Campus-Based Pedagogy to Study Inequality

In this article, we propose a campus-based pedagogy to teach sociology. We offer the example of a project designed to critically assess university Title IX policy and situate it within existing sociological research on gender-based inequalities and violence. Students engage in sociological research regarding issues such as sexual harassment and assault, intimate partner violence, consent, and rape culture, among others, and develop a tool to create greater awareness among the student body of university policy in these areas. Drawing surveys and focus group interviews with students who completed the project, we found that students acquire a historical and sociological understanding of gender-based violence and institutional sexism and consequently adopt a critical lens toward university Title IX policy regarding these issues. By situating students as central to the process of analyzing and critiquing university policy, this exercise fosters an intellectual efficacy among students to embark on sociologically informed interventions in their university’s campus culture.

Are Women In Lomé Getting Their Desired Methods Of Contraception? Understanding Provider Bias From Restrictions To Choice.

BackgroundDespite improvements in contraception availability, women face persistent barriers that compromise reproductive autonomy and informed choice. Provider bias is one way in which access to contraception can be restricted within clinical encounters and has been established as common in sub-Saharan Africa. This analysis assessed the prevalence of provider restrictions and the potential impact on women’s method uptake in Lomé, Togo.MethodsThis sub-analysis used survey data from provider and client interviews collected to assess the impacts of the Agir pour la Planification Familiale (AgirPF) program in Togo. The relationships between provider restrictiveness and women’s receipt of their desired method of contraception were modelled using mixed effects logistic regressions looking at all women and among subgroups hypothesized to be at potentially higher risk of bias.ResultsAround 84% of providers reported a restriction in contraceptive provision for the five contraceptive methods explored (pill, male condom, injectable, IUD, and implant). Around 53% of providers reported restricting at least four of the five methods based on age, parity, partner consent, or marital status. Among all women, there were no significant associations between provider restrictiveness and women’s receipt of desired method, including among those who desired long-acting methods. In adjusted modeling, marital status was a covariate significantly associated with desired method, with married women more likely to receive their desired method than unmarried women (aOR 2.73, 95% CI 1.45–5.13).ConclusionProvider reports of high levels of restrictions in this population are concerning and should be further explored, especially its effects on unmarried women. However, restrictions reported by providers in this study did not appear to statistically significantly influence contraceptive method received.

“We know this will be hard at the beginning, but better in the long term”: understanding PrEP uptake in the general population in Eswatini

ABSTRACTInformation regarding HIV pre-exposure prophylaxis (PrEP) for the general population is largely lacking, because the majority of PrEP demonstration projects have focused on key populations. This qualitative study examines barriers and facilitators to PrEP uptake and adherence among the general population in Eswatini, where PrEP is offered through public-sector primary-care clinics. We analysed 106 semi-structured in-depth interviews with healthcare workers (n = 26), stakeholders (n = 30), and clients who initiated, continued, declined or discontinued PrEP (n = 50). Some healthcare workers and stakeholders feared that PrEP would reduce condom use and cause drug resistance, while some clients feared possible side effects and the reaction of family members when learning of PrEP use. At the same time, respondents across all groups valued that PrEP could be taken without partner knowledge or consent, and that PrEP was available via public sector clinics. Clients felt that PrEP relieved the fear of HIV infection and thus bolstered enjoyment during sex. Overall, respondents described the general population approach to PrEP delivery as enabling and life-improving, despite the above concerns. Respondents recommended to create community PrEP promotion and delivery, gain community leaders' approval and understanding of PrEP, shorten the PrEP initiation process, and target men and adolescent girls.

“That’s not what was originally agreed to”: Perceptions, outcomes, and legal contextualization of non-consensual condom removal in a Canadian sample

Non-consensual condom removal (NCCR) is the removal of a condom before or during sexual intercourse without one’s partner's consent. Despite considerable news and media attention devoted to the trend (as stealthing), little empirical research to date has examined people’s views of the practice. The present study aimed to contribute toward generating empirical evidence to guide the discussion surrounding NCCR. We asked participants about whether or not they felt NCCR is wrong, whether there should be consequences for its perpetration, and contextualized responses within legal context. A total of 592 undergraduate students took part in an online survey inquiring about their experiences with and views of NCCR. We used descriptive statistics to determine sample prevalence and outcomes of NCCR and qualitatively analyzed responses to open-ended questions asking about perceptions of NCCR. Of participants who had engaged in penetrative sexual intercourse with a male partner using an external condom, 18.7%, 95% CI [14.4, 22.7] reported that they had NCCR perpetrated against them. The majority of these participants reported that they experienced NCCR negatively and encountered related consequences; several reported contracting an STI, experiencing an unplanned pregnancy, or both. Nearly all participants expressed that NCCR is wrong, citing reasons that included the lack of consent, possibility of unplanned or unwanted outcomes, and a betrayal of trust. In this study, we found that there was agreement that NCCR is wrong, but variability in responses regarding the circumstances under which there should be consequences for the action. These perceptions reflect the current uncertainty in law. We recommend researchers refer to the phenomenon as NCCR (rather than stealthing) and discuss related issues to encourage future research to adopt consistent and accurate labels and definitions for NCCR. We hope that our findings will guide future research and spur public and legal discussion on NCCR.

The Discriminatory Legal Barrier of Partner Consent in Victorian ART Law: EHT18 v Melbourne IVF.

In September 2018, the Federal Court of Australia found that a Victorian woman did not need her estranged husband's consent to undergo in vitro fertilisation treatment (IVF) using donor sperm. The woman, who was 45 years of age, made an urgent application to the Court for permission to undergo IVF using donor sperm. In a single judge ruling, Griffiths J held that the requirement in the Assisted Reproductive Treatment Act 2008 (Vic) ('ART Act') for a married woman to obtain the consent of her husband discriminated against the woman in question on the basis of her marital status in contravention of the Commonwealth Sex Discrimination Act 1984 (Cth) ('SD Act'). His Honour declared the Victorian law in this instance 'invalid and inoperable' by operation of section 109 of the Commonwealth Constitution to the extent it was inconsistent with the Commonwealth law. Although the declarations by the Federal Court were limited in their terms to the circumstances of the case, the judgment raises broader issues about equity of access to assisted reproductive treatment (ART) in Victoria. The issue of partner consent as a barrier to access to ART was specifically raised by an independent review of the ART Act in Victoria. The Victorian Government released an interim report late last year as a first stage of the review, which canvasses some options for reform. This raises a broader question as to whether prescriptive legislation imposing detailed access requirements for ART is necessary or even helpful.

Modern contraceptive use among reproductive-aged women in Ghana: prevalence, predictors, and policy implications

BackgroundModern contraceptive use remains an important public health intervention and a cost-effective strategy to reduce maternal mortality, avert unintended pregnancies and to control population explosion, especially in developing countries. Despite these benefits, there are reports of low usage among reproductive-aged women in most developing countries. This study examined the prevalence and predictors of use of modern contraceptive among reproductive-aged women in an urban center with a high density population in Ghana.MethodsA cross-sectional, interviewer-administered survey was conducted with 217 randomly selected reproductive-aged women. Data was analyzed with STATA. Logistic regression was performed to identify factors influencing modern contraceptive use.ResultsAlthough we found high levels of knowledge and awareness (98%; n = 213) of modern contraception use, only 21% of participants were using modern contraceptives. Marital status, partner consent and support, and religious beliefs strongly predicted usage.ConclusionUsage of modern contraceptives among reproductive-aged women in the Ledzokuku Krowor Municipality is lower than the national target. A multilevel family planning intervention program that primarily focuses on promoting inclusive participation of husbands, targets the unmarried and non-literates reproductive-aged women, and dispels misconceptions, misinformation and religious myths about modern contraceptives has been discussed.

Feasibility and acceptability of pre-exposure prophylaxis use among women in violent relationships

ABSTRACTIntimate partner violence (IPV) is associated with a high risk of HIV acquisition. Pre-exposure prophylaxis (PrEP), which does not require partner knowledge or consent, is a promising HIV risk reduction option for women experiencing IPV. Drawing on semi-structured interviews with 26 women experiencing IPV within the last six months, this study explored the feasibility and acceptability of PrEP use in this population. Slightly more than half of the women in this study expressed interest in taking PrEP when in a relationship with an abusive partner. Potential barriers to PrEP, discussed regardless of women's expressed interest in PrEP, included fear of side effects and long-term health concerns, low risk perceptions, potential partner interference, and prioritizing coping with the relationship over HIV prevention. When offering PrEP counseling, providers should inquire about IPV, as women in violent relationships may require tailored counseling to address barriers and concerns specific to their situation.

A Review of HIV Pre-Exposure Prophylaxis: The Female Perspective.

When taken consistently, pre-exposure prophylaxis (PrEP) against human immunodeficiency virus (HIV) with once daily tenofovir disoproxil fumarate-emtricitabine (TDF-FTC) has been shown to safely reduce the incidence of HIV infection in high-risk individuals by more than 90%. Yet, according to the Centers for Disease Control and Prevention, there were about 2.1 million new cases of HIV reported worldwide in 2015. Undoubtedly, there is significant room for improvement to prevent the transmission of HIV. Research to date has been heavily focused on the high-risk men who have sex with men (MSM) population, yet, many women worldwide remain at high risk of HIV transmission. PrEP offers women a protection method that is discrete, does not require partner consent, and may be compatible with both contraception or conception as desired. However, women often remain under-represented in HIV prevention literature and are reported to have lower real-world uptake in comparison to men. Furthermore, clinical trials that do focus on the female population demonstrate mixed efficacy results that highlight the adherence challenges in this population. It is essential to identify factors that contribute to PrEP non-adherence as well as barriers to preventative treatment. This review will discuss the clinical evidence behind PrEP in women, current barriers to use afflicting this population, pharmacotherapy considerations for the female patient, alternative and future agents, and the current real-world application of PrEP.

ACOG Committee Opinion No. 646 Summary: Ethical Considerations for Including Women as Research Participants.

Inclusion of women in research studies is necessary for valid inferences about health and disease in women. The generalization of results from trials conducted in men may yield erroneous conclusions that fail to account for the biologic differences between men and women. Although significant changes in research design and practice have led to an increase in the proportion of women included in research trials, knowledge gaps remain because of a continued lack of inclusion of women, especially those who are pregnant, in premarketing research trials. This document provides a historical overview of issues surrounding women as participants in research trials, followed by an ethical framework and discussion of the issues of informed consent, contraception requirements, intimate partner consent, and the appropriate inclusion of pregnant women in research studies.

ACOG Committee Opinion No. 646: Ethical Considerations for Including Women as Research Participants.

Inclusion of women in research studies is necessary for valid inferences about health and disease in women. The generalization of results from trials conducted in men may yield erroneous conclusions that fail to account for the biologic differences between men and women. Although significant changes in research design and practice have led to an increase in the proportion of women included in research trials, knowledge gaps remain because of a continued lack of inclusion of women, especially those who are pregnant, in premarketing research trials. This document provides a historical overview of issues surrounding women as participants in research trials, followed by an ethical framework and discussion of the issues of informed consent, contraception requirements, intimate partner consent, and the appropriate inclusion of pregnant women in research studies.

Intimate partner violence, consenting to HIV testing and HIV status among Zambian women.

Sub-Saharan African countries are heavily burdened with HIV, which disproportionately affects women of reproductive age. Extant literature is inconsistent regarding the link between intimate partner violence and HIV. Data from the 2007 Zambian Demographic Health Survey of women aged 15-49 (n = 5014) were analysed. The influence of abuse by a current or former husband on consent to HIV testing and HIV positivity were evaluated. The unadjusted analysis showed a statistically significant association between intimate partner violence and consent to testing for HIV. Stratified analysis showed that there was a statistically significant association between intimate partner violence and HIV testing in rural areas but not in urban areas. However, the association lost its significance when adjusted for confounding factors. No statistically significant association was found between intimate partner violence and HIV-positive status. It is encouraging that women who experienced intimate partner were testing for HIV. Prevention efforts should continue addressing the needs of this population.