Prevention Of Unintended Pregnancy Research Articles

HIV and induced abortion among migrants from sub-Saharan Africa living in Île-de-France: Results of the PARCOURS study

IntroductionHIV heavily affects sub-Saharan African women living in France and can impact reproductive decisions. It was investigated whether HIV was associated with induced abortion in pregnancies held after migration by women from sub-Saharan Africa living in Île-de-France. MethodsWe used data on ANRS Parcours, a retrospective life event survey conducted in health facilities in the metropolitan region of Paris, between February 2012 and May 2013, with migrants from sub-Saharan Africa. Data on the history of pregnancies were collected among women living with HIV (HIV group) and those attending primary care centers (reference group). We investigated 242 women in the reference group, who had 729 pregnancies, and the 277 women in the HIV group, who had 580 pregnancies. The association between abortion and HIV was evaluated using clustered logistic models, successively adjusted for women and pregnancy characteristics, for the whole sample, and stratified by pregnancy intendedness. ResultsIn the reference group, 11.0 % of pregnancies were terminated in abortion, the same situation as 14.1 % in the HIV group (p = 0.124). HIV was not associated with abortion in the crude and adjusted models. However, after adjustments, HIV exhibited a non-significant trend towards reducing the likelihood of abortion, particularly when considering the intendedness of pregnancy variable. ConclusionsFactors that shape the overall context of women's lives and pregnancies, which are shared with the reference group, may have a more significant impact on reproductive decision-making than HIV alone. Health services must pay attention to the intendedness of pregnancies, providing advice and support on the prevention of mother-to-child transmission to women living with HIV who intend to become pregnant, in addition to strengthening the provision of family planning and the prevention of unintended pregnancies.

Oral Hormonal Contraceptives and Cardiovascular Risks in Females.

Oral hormonal contraception (OHC) is a widely employed method in females for the prevention of unintended pregnancies, as well as for the treatment of menstrual disorders, endometriosis, and polycystic ovarian syndrome. However, it is believed that with OHCs use, some females may have higher risk of cardiovascular diseases, such as hypertension, diabetes, myocardial infarction, thrombosis, and heart failure. Although such risks are infrequently detected in healthy young females with the use of oral contraceptives, slightly elevated risks of cardiovascular diseases have been observed among reproductive-aged healthy females. However, prolonged use of OHC has also been claimed to have protective cardiac effects and may contribute to reduced risk of cardiovascular disease. In fact, the debate on whether OHC administration increases the risk of cardiovascular diseases has been ongoing with inconsistent and controversial viewpoints. Nevertheless, a great deal of work has been carried out to understand the relationship between OHC use and the occurrence of cardiovascular risk in females who use OHC for preventing the unwanted pregnancy or treatment of other disorders. Therefore, in this review we summarize the most recent available evidence regarding the association between the use of oral hormonal contraceptives and the risk for cardiovascular disease in females who are using OHC to prevent unintended pregnancy.

A Study to Determine the Quality of Life among the Permanent Contraceptive Adopters and Non-adopters at Selected Rural Areas of Dadra and Nagar Haveli

INTRODUCTION Contraceptive information and services are fundamental to the health and human rights of all individual, prevention of unintended pregnancies helps to lower maternal ill-health and the number of pregnancy-related deaths (According to WHO). Between 2000 and 2020, the contraceptive prevalence rate (percentage of women aged 15-49 who use any contraceptive method) increased from 47.7 to 49.0% and 77.5% globally in 2022. In Dadra and Nagar Haveli and Daman and Diu, total modern methods used is 59.8%, female sterilization is 41.6% male sterilization is 0.2%, IUD usage is 2.2%, pill usage is 3.1%, condom usage is 11.7%, and injectables contraceptive usage is 0.9%. AIM The aim of the study is to determine the quality of life among the permanent contraceptive adopters and non-adopters at selected rural areas of Dadra & Nagar Haveli. METHODOLOGY Non-experimental two group comparative descriptive design with non- probability, purposive sampling technique was used to select 100 samples, who fulfilled inclusion criteria. WHO quality of life scale (BREF), that is self-administered scale was used to assess the level of quality of life. RESULT The result of the study showed that the adopters mean value was 70.3450 and the standard deviation was 8.55458, non-adopters mean value was 60.4000 and the standard deviation was 6.76406, ‘t’ value was 6.448 which was higher than the table value and ‘P’ value was 0.000. So there was a highly significant difference between the quality of life among the permanent contraceptive adopters and non-adopters. Hence research hypothesis was accepted. CONCLUSION The study proved that the quality of life among the permanent contraceptive adopters is much better than non-adopters. Hence there is a need to create awareness and provide health education on Family planning methods to the non-adopters.

Sexual and reproductive health in military settings: A qualitative study

ABSTRACT Mission readiness is critical to the operational success of the United States (US) military and includes having a healthy and fit fighting force. Service members and their dependents have access to a wide range of sexual and reproductive health services with no out-of-pocket costs. Despite this access, negative outcomes such as sexually transmitted infections (STIs) and unintended pregnancy persist. Semi-structured, in-depth interviews were conducted with service members and stakeholders (e.g. medical providers). Interviews explored the individual, interpersonal, organizational, and institutional factors that inform sexual norms, behaviors, and healthcare experiences in the US military. Interview transcripts were coded manually; data were summarized for themes related to unique aspects of military culture and healthcare affecting sexual and reproductive health. Twenty-five (25) service members and 15 stakeholders completed interviews. Four themes emerged: 1) despite free access, both general and military-specific barriers to sexual and reproductive healthcare persist; 2) general and military-specific cultural norms apply to sexual behavior and care seeking; 3) sexual and reproductive health-related norms can be perceived as confusing and contradictory within the military; and 4) resources addressing sexual assault are ubiquitous in military settings, but resources addressing prevention of STIs and unintended pregnancy are limited. Both general and military-specific norms, behavior, and healthcare experiences need to be considered in clinical care, public health campaigns, and other efforts to promote sexual and reproductive health in military settings.

Evaluation of consumer self-selection of a proposed over-the-counter, progestin-only daily oral contraceptive

ObjectivesIn an effort to switch a norgestrel 0.075 mg progestin-only pill (Opill) from prescription to over-the-counter, we conducted this study to assess whether consumers can use the drug facts label alone to guide appropriate self-selection. Study designTwo studies assessed self-selection: (1) an all-comers, actual-use study evaluating self-selection before purchasing and using norgestrel 0.075 mg and (2) the Targeted Breast Cancer Self-Selection Study evaluating theoretical self-selection among participants with a history of breast cancer. ResultsIn the actual-use study, based on the label, 1670/1772 participants (94%) were appropriate for use of norgestrel 0.075 mg; 102 (6%) were not appropriate. Of the 102, 66 (65%) correctly did not select and 36 (35%) responded it was okay for them to use norgestrel 0.075 mg. Of the 36 participants who incorrectly self-selected, one had a history of breast cancer and thus might have been adversely affected had they taken norgestrel 0.075 mg. In the Targeted Breast Cancer Self-Selection Study (N = 206), 97% of participants correctly stated norgestrel 0.075 mg was not appropriate for them. ConclusionsThe proposed over-the-counter label enables 98% of potential users to self-select norgestrel 0.075 mg appropriately. Only 2% of potential purchasers may have bought and started to use norgestrel 0.075 mg inappropriately. For two-thirds of these, the potential benefits of their use of the method outweighed any theoretical risks. Adverse clinical consequences of norgestrel 0.075 mg use are unlikely even in those rare cases when the drug facts label was not followed. ImplicationsThe balance of the risk of inappropriate selection to the benefit of taking an over-the-counter progestin-only pill appears to be very much in favor of an overall benefit in terms of unintended pregnancy prevention.

Qualitative research to advance social norms initiatives of the RHRA: Mombasa County, HAKI Jamii, and the RHRA Study

Background: In Kenya, there is a general lack of knowledge on the prevention of unintended pregnancies, especially among the rural poor and women living in urban and peri-urban informal settlements. Unsafe abortion is common, and stigma directed at the woman, provider, woman’s family, and facility is common. Objective: To explore public perceptions of abortion, gather awareness of the legal provisions for abortion, and determine access to information and services. Methods: Qualitative in-depth research used four focus groups of women and men aged 18-54 years. The interactions were face-to-face and verbatim transcripts. The messages were organized, coded, and categorized into three categories using the delve software. Coding followed a mix of deductive and inductive processes. Results: There were highly resistant views on abortion across all four groups, focusing mainly on potential complications and death. Emerging voices support termination for rape, defilement, and incest. Abortion occurs more often among married women than among girls. Regarding the legal provisions, safe abortion respondents said it was illegal yet legal. It can be kept secret and influenced by one’s religion. Barriers to safe abortion access included high cost and lack of knowledge of where services are available. However, unintended pregnancies were common in informal settlements, resulting from transactional sex, sex, and gender-based violence, and lack of knowledge of and access to contraception. Conclusion: There is a need to unpack the collective social silence and the association of abortion with unpleasant social issues and to understand and target the drivers of abortion stigma, including premature death, future fertility concerns, guilt, and the murder label.

Knowledge, attitude and readiness to use contraceptives among postpartum women at a tertiary hospital in southwest Nigeria.

Background: Postpartum family planning is vital in the prevention of unintended pregnancy and closely spaced pregnancies in the first year post-delivery. This study was designed to examine the postpartum women’s knowledge, attitude, belief and readiness to contraceptive use.
 Methods: This descriptive cross-sectional study was conducted in the postnatal clinic of the University College Hospital, Ibadan, Nigeria using an interviewer-assisted structured questionnaire among one hundred and ninety-four consenting recently delivered women. Data was analysed using IBM Statistics for Windows Version 23.0. Tests of association was done using chi-square and statistical significance was set at p-value of < 0.05.
 Results: Many of the respondents (60.8%) were in the age group 30-39 years and the majority (90.3%) had tertiary level of education. Most of the respondents got their information from health talks at antenatal clinic (42.8%) and health workers (42.3%). The majority (82.5%) of respondents were aware of contraception and 157(80.9%) intended to use contraceptives, however, only 54(34.4%) were willing to adopt a method at the postnatal clinic visit. The most preferred contraceptive methods were implants (23.4%). Respondents with three or more children alive(p=0.001), had statistically significant associations with prior use of contraception while those with the tertiary level of education(p=0.001) and of the Christian religion (p=<0.001) had statistically significant associations with good knowledge of contraception. 
 Conclusion: The knowledge and readiness to use contraceptives was high but only about half were willing to adopt a method at the postnatal clinic. Robust prenatal counselling may help to increase the uptake of postpartum contraception.

Respondent Demographics and Contraceptive Use Patterns in the United States: A National Survey of Family Growth Analysis.

Contraception is an important tool for helping to prevent both unintended pregnancies and sexually transmitted infections (STIs). Medical costs related to STIs are high and impose a large burden on both patients and the healthcare system. In addition, unintended pregnancies account for a large portion of pregnancies in the United States (US) and are associated with adverse maternal and infant health outcomes. Both STIs and unintended pregnancies are continuous public health concerns, and this study aims to identify patterns in contraceptive method use in relation to specific social determinants of health. Utilizing the Centers for Disease Control and Prevention (CDC)'s 2017-2019 National Survey of Family Growth report on current contraceptive status, we isolated data from 3,572 respondents who reported using one of the following contraceptive methods: oral contraceptive pills (OCPs), male condoms, partner's vasectomy, female sterilization, withdrawal, medroxyprogesterone acetate injections (Depo-Provera), hormonal implant, or an intrauterine device (IUD). We analyzed these contraceptive methods amongage, race, education, marital status, and insurance status. Data were analyzed in RStudio 2022.02.0 (RStudio Team, RStudio: Integrated Development for R. RStudio, PBC, Boston, MA) through a test of equal proportions for a significance of P< 0.05. A concurrent Yates' continuity correction was performed in order to limit erroneous significant findings based on small sample sizes where applicable.The study conception and data analysis were performed independently with oversight from our preceptor at HCA Florida Brandon Hospital, Brandon, Florida. There were statistically significant differences for all our selected methods of contraception across different age groups. There were statistically significant differences for OCPs, male condoms, partner's vasectomy, female sterilization, Depo-Provera, hormonal implant, and IUD across different race groups and different insurance statuses. There were statistically significant differences for OCPs, male condoms, partner's vasectomy, female sterilization, withdrawal, hormonal implant, and IUD across different education levels and different marital statuses. This analysis highlights gaps that are present in female reproductive autonomy through the statistical differences in contraceptive methods across various demographicsand warrants continued focus on the role that social determinants of health play in the prevention of unintended pregnancies and STIs. In order to promote fairness and equality in healthcare, it is essential to increase education on these topics both within and beyond medical settings. This effort aims to provide patients with equitable access to healthcare and attempt to address health disparities that are prevalent in multiple different sectors.

Sleep disturbance and its associated factors among pregnant women in Ethiopia: systematic review and meta-analysis

IntroductionGlobally, sleep disturbance is the foremost public health issue among pregnant women which might have undesirable birth outcome including neurocognitive impairment, preterm birth, low birth weight, and neonatal morbidity and mortality. In Ethiopia, inconsistent findings have been reported on the prevalence of sleep disturbance among pregnant women. Therefore, this review aims to estimate the pooled prevalence sleep disturbance and its associated factors among pregnant women in Ethiopia.MethodsThis systematic review and meta-analysis of observational studies was designed according to the PRISMA guideline. A systematic search of literature was conducted in PubMed, Scopus, Web of science, and Google Scholar using relevant searching key terms. The Newcastle-Ottawa scale was used to evaluate the quality of all selected articles. Data were analyzed using STATA Version 14 software. Publication bias was checked using Egger’s test and funnel plot. Cochran’s chi-squared test and I2 values were used to assess heterogeneity. A fixed-effects model was applied during meta-analysis.ResultsIn this review, six studies were included after reviewing 17,100 articles. The pooled prevalence of sleep disturbance among pregnant women in Ethiopia was 50.43% (95%CI: 39.34–61.52). Third trimester pregnancy AOR = 4.03; 95% CI: 2.84,5.71), multigravidity (AOR = 1.99; 95% CI: 1.54, 2.59), unplanned pregnancy (AOR = 2.56; 95% CI: 1.52,4.31), depression (AOR = 3.57; 95% CI: 2.04, 6.27), stress (AOR = 2.77; 95% CI: 1.57, 4.88), anxiety (AOR = 3.69; 95% CI: 1.42, 9.59) and poor sleep hygiene (AOR = 2.49; 95% CI: 1.56, 3.99) and were statistically associated with sleep disturbance among pregnant women.ConclusionThis review revealed that the magnitude of sleep disturbance among pregnant woman in Ethiopia was relatively high and multiple factors determined the likelihood of having a disturbed sleep-awake pattern. Thus, the implementation of interventions for sleep disturbance after screening pregnant women is needed. Moreover, public health interventions targeted on the prevention of unintended pregnancy and depression during pregnancy should be implemented.

The co-creation and evaluation of a recovery community center bundled model to build recovery capital through the promotion of reproductive health and justice

People who can get pregnant who use drugs face disproportionate harms such as violence, exploitation and trauma and have unmet reproductive health needs as they have the greatest burden of unintended pregnancy (>75%). Recovery community centers (RCCs) provide recovery support services and are primarily staffed with people with lived experience using drugs. RCCs employ recovery coaches who are entrusted with helping participants improve their recovery capital, health, and wellbeing through person-centered strengths-based approaches. Although reproductive health and the prevention of unintended pregnancy can greatly impact all domains of recovery capital, recovery coaches generally do not have training to address this complex issue. We aimed to fill this gap by co-creating and evaluating a bundled model as an intervention tailored for RCCs (training & low-barrier resources including pregnancy tests, prenatal vitamins, and emergency contraception) to promote more equitable outcomes in reproductive health. We described the training and used mixed methods to assess pre-post knowledge, belief, and comfort with the bundled model (n = 20) and further explored perceptions of the model qualitatively to inform future iterations (n = 58). Results included significant gains in all three domains following the training, as well as favorable perceptions that the model will enhance recovery capital. Most were empowered to champion the model, asking for more information about the three resources, perinatal health, and referral information. We seek to begin to expand the theoretical construct of recovery capital by pilot testing an intervention to promote recovery through enhancing reproductive health and justice for people who use drugs (PWUD) who can get pregnant.

Pharmacokinetic Study of Islatravir and Etonogestrel Implants in Macaques.

The prevention of HIV and unintended pregnancies is a public health priority. Multi-purpose prevention technologies capable of long-acting HIV and pregnancy prevention are desirable for women. Here, we utilized a preclinical macaque model to evaluate the pharmacokinetics of biodegradable ε-polycaprolactone implants delivering the antiretroviral islatravir (ISL) and the contraceptive etonogestrel (ENG). Three implants were tested: ISL-62 mg, ISL-98 mg, and ENG-33 mg. Animals received one or two ISL-eluting implants, with doses of 42, 66, or 108 µg of ISL/day with or without an additional ENG-33 mg implant (31 µg/day). Drug release increased linearly with dose with median [range] plasma ISL levels of 1.3 [1.0-2.5], 1.9 [1.2-6.3] and 2.8 [2.3-11.6], respectively. The ISL-62 and 98 mg implants demonstrated stable drug release over three months with ISL-triphosphate (ISL-TP) concentr54ations in PBMCs above levels predicted to be efficacious for PrEP. Similarly, ENG implants demonstrated sustained drug release with median [range] plasma ENG levels of 495 [229-1110] pg/mL, which suppressed progesterone within two weeks and showed no evidence of altering ISL pharmacokinetics. Two of the six ISL-98 mg implants broke during the study and induced implant-site reactions, whereas no reactions were observed with intact implants. We show that ISL and ENG biodegradable implants are safe and yield sufficient drug levels to achieve prevention targets. The evaluation of optimized implants with increased mechanical robustness is underway for improved durability and vaginal efficacy in a SHIV challenge model.

Turning the promise of multipurpose prevention technologies into a market reality: a commentary.

The promise of multipurpose prevention technologies (MPTs) for the prevention of HIV and unintended pregnancy are on the horizon. While many are still in clinical development, others are closer to becoming a realistic, accessible option for users, like the dual prevention pill (DPP). Researchers, governments, donors, and implementers will have to collaboratively address systemic challenges to successfully introduce and scale-up MPTs. To ensure the rollout of MPTs is successful, the global community should address user and country-specific needs, coordinate with advocates and policymakers, and set a realistic plan for product introduction and scale-up that considers the needs of both family planning (FP) and HIV programs, while laying the groundwork for future new product introduction. To achieve these aims, global and regional stakeholder coordination should emphasize country-led, person-centered decision-making while addressing: (1) procurement and supply chain barriers; (2) the potential burden on health systems; and (3) the impact on current programs.

Next generation 3D-printed intravaginal ring for prevention of HIV and unintended pregnancy

Globally, there are 20 million adolescent girls and young women living with HIV who have limited access to long-acting, effective, women-controlled preventative methods. Additionally, although there are many contraceptive methods available, globally, half of all pregnancies remain unintended. Here we report the first 3D-printed multipurpose prevention technology (MPT) intravaginal ring (IVR) for HIV prevention and contraception. We utilized continuous liquid interface production (CLIP™) to fabricate MPT IVRs in a biocompatible silicone-based resin. Etonogestrel (ENG), ethinyl estradiol (EE), and islatravir (ISL) were loaded into the silicone poly(urethane) IVR in a controlled single step drug loading process driven by absorption. ENG/EE/ISL IVR promoted sustained release of drugs for 150 days in vitro and 14 days in sheep. There were no adverse MPT IVR-related findings of cervicovaginal toxicity or changes in vaginal biopsies or microbiome community profiles evaluated in sheep. Furthermore, ISL IVR in macaques promoted sustained release for 28 days with ISL-triphosphate levels above the established pharmacokinetic benchmark of 50–100 fmol/106 PBMCs. The ISL IVR was found to be safe and well tolerated in the macaques with no observed mucosal cytokine changes or alterations in peripheral CD4 T-cell populations. Collectively, the proposed MPT IVR has potential to expand preventative choices for young women and girls.

Knowledge and Practice on Emergency Contraceptive Pills Among Non-Health Bachelor Level Female Students in Kathmandu

Introduction: Emergency contraception (ECPs) is hormonal contraception that is used within 72 to 120 hours after unprotected and unsafe sexual intercourse for the prevention of unintended pregnancies. It is important to prevent unwanted pregnancy and there by induced abortion. This study aimed to evaluate the knowledge and practice on ECPs among non-health bachelor level female students in Kathmandu. Methodology: This was a descriptive cross-sectional study of 388 female respondents at non-health bachelor colleges in Kathmandu, Nepal. Simple random sampling technique was used. Pre-tested self-administered questionnaire were used for data collection. Result: The study analyzed the knowledge levels of the study participants, finding that 55.15% had adequate knowledge, while 44.84% had inadequate knowledge. 21.64% practiced ECPs. The study also found a significant association (p value= 0.04) between knowledge level and ECPs practice. Conclusion: The study found that most respondents had adequate knowledge and a significant prevalence of ECP use in Kathmandu district. It is suggested that ECPs not intended to be used as regular form of contraception and should only be used in emergency situation. Frequent use can lead to irregular menstrual cycle and hormonal imbalances.

Reasons and prevention strategies of unintended pregnancy in Addis Ababa, Ethiopia: a phenomenological qualitative study

ObjectivesTo explore the reasons for unintended pregnancy and effective prevention measures from the perspectives of women and healthcare providers in Addis Ababa, Ethiopia.DesignPhenomenological qualitative study.Setting and participantsThis study was conducted...

Role of the COVID-19 Pandemic on Sexual Behaviors and Receipt of Sexual and Reproductive Health Services Among U.S. High School Students - Youth Risk Behavior Survey, United States, 2019-2021.

Disproportionate rates of sexually transmitted diseases (STDs), including HIV, and unintended pregnancy among adolescents persist and might have been affected by the COVID-19 pandemic. This study uses 2019 and 2021 data from the nationally representative Youth Risk Behavior Surveys to characterize changes in sexual behaviors and receipt of sexual and reproductive health services among U.S. high school students before and during the pandemic. Outcomes included HIV testing (lifetime), STD testing (past 12 months), condom use (last sexual intercourse), and primary contraceptive method used to prevent pregnancy (last sexual intercourse). Except for HIV testing, all analyses were limited to currently sexually active students. Weighted prevalence and 95% CIs of outcomes for 2019 and 2021 were calculated for each year by demographics (sex [female or male], age, and race and ethnicity) and sex of sexual contacts (opposite sex only, both sexes, same sex only). For each year, pairwise t-tests with Taylor series linearization were used to identify demographic differences among outcomes. Across years, change in prevalence of outcomes was assessed by using absolute and relative measures of association overall and by demographics. During 2019-2021, the prevalence of HIV testing decreased by 3.68 percentage points, from 9.4% to 5.8%. Among sexually active students, prevalence of STD testing decreased by 5.07 percentage points, from 20.4% to 15.3%. Among sexually active students reporting opposite sex or both sexes sexual contact, intrauterine device or implant use at last sexual intercourse increased by 4.11 percentage points, from 4.8% to 8.9%, and no contraceptive method use increased by 2.74 percentage points, from 10.7% to 13.4%. Because of disruptions throughout the pandemic, results underscore the importance of improving access to a range of health services for adolescents and improving STD/HIV and unintended pregnancy prevention.

Explaining sexual self-care status and its predictor factors in women referring to healthcare centers of Sari, Iran, 2021

IntroductionWith the increase in the prevalence of non-communicable diseases and chronic health problems along with population growth, one of the definitions that is expanding is the ability to adapt and self-manage against diseases and self-care. Although there are several studies to examine self-care in medical conditions, there are not enough concepts and data related to sexual self-care. Therefore, the present study was conducted with the aim of explaining the status of sexual self-care and its predictor factors in women of reproductive age referring to healthcare centers.Material and methodsThis research was a cross-sectional study that was conducted on 400 women of reproductive age that referring to healthcare centers affiliated to Mazandaran University of Medical Sciences, Sari in 2021. Data were collected using personal-obstetric characteristics and sexual self-care questionnaires in women of reproductive age. Pearson correlation coefficients, independent t-test, one-way analysis of variance and multiple linear regression model were used to analyze the data.ResultsThe average total score of sexual self-care in reproductive age women participating in the research was 70.66% ± 12.52%. In addition, the prevention of women's cancers and the prevention of unintended pregnancies obtained the lowest and highest scores, respectively. Factors such as age, education, education related to medical sciences, history of HIV testing, history of HPV vaccination, source of sexual information, method of contraception and infection-related action in a person can affect the level of sexual self-care in women. Based on the final regression model, education related to medical sciences (B = 5.46, P = 0.035), family income (B = 5.58, P = 0.025), prevention method (B = 10.127, P = 0.000) and action related to infection in the person (B = 12.27, P = 0.047) were the final predictors of sexual self-care score in reproductive age women.ConclusionBased on the findings of the study, development of self-care promotion programs for reproductive aged women are necessary in all areas of reproductive health, with a priority for women’s cancer prevention, and focusing on promoting education and related economic assistance. The results of this study can be available to experts and policy makers to design programs to promote sexual self-care in women.

Dual contraception method utilization and associated factors among women on anti-retroviral therapy in public facilities of Bishoftu town, Oromia, Ethiopia.

Dual contraception is a method used to prevent sexually transmitted infections (STIs) including Human Immunodeficiency Virus (HIV) and unintended pregnancies. Prevention of unintended pregnancy in people living with HIV (PLHIV) and ART given to pregnant women to suppress viral load prevent transmission of HIV to children. Counseling and provision of dual contraceptive methods is a very cost-effective method to tackle this double burden among women living with HIV. However, little has been known about utilization of dual methods among HIV positive women in Bishoftu town and its surroundings. The aim of this study was to assess dual contraception method utilization and associated factors among reproductive age women who were on antiretroviral therapy in public health facilities of Bishoftu town. A facility based cross- sectional study was conducted from November 01 to December 30, 2020. The study participants were selected by using simple random sampling technique. Data were collected using a pretested and structured questionnaire through a face to face interview. Data were processed and analyzed using SPSS version 20. Frequencies and percentages were used to describe characteristics of participants. Bivariable and multivariable logistic regression analyses were used to identify variables which had an independent association with the dependent variable. The degree of association between dependent and independent variables were measured using odds ratio with 95% confidence interval. Level of significance was set at a p-value less than 0.05. The Magnitude of dual contraceptive utilization of women living with HIV in Bishoftu town was 56.9% (95% Cl (51.6, 62.1). Being married (AOR = 4.33; 95% Cl (1.67, 11.27), not getting pregnant since the start of chronic care follow up (AOR = 2.19; 95% Cl (2.90, 3.70), having a partner positive for HIV (AOR = 2.67; 95% Cl (1.34, 5.32) and having a partner negative for HIV (AOR = 2.38; 95% Cl (1.09, 5.20) were factors independently associated with dual method contraceptive use. The study showed that use of dual contraceptive methods was low; factors like marital status, partner HIV status, and pregnancy after chronic HIV care follow up were found to be significantly associated with dual contraceptive method use. In addition to ART, use of dual contraceptive methods utilization may play a role in prevention of HIV infection in children and is important in the prevention of unintended pregnancy.

Assessment of content, behavior change techniques, and quality of unintended pregnancy apps in Spain: Systematic search on app stores.

Unintended pregnancies are a public health problem that represents 48% of global pregnancies. Despite the proliferation of smartphones there is limited data on the app's features on unintended pregnancy. The purpose of this research was to identify free apps available in Spanish, in the iOS Store and Google Play, which can be recommended to prevent unintended pregnancies in adolescents. A systematic search to identify apps was performed in the iOS App Store and in Google Play aiming to replicate the way a patient might access an "unintended pregnancy prevention" app. Additionally, the quality, using the Mobile Application Rating Scale, and content were assessed. A total of 4614 apps were identified, of which 8 were retrieved for assessment (0.17%). The mean for objective and subject quality was 3.39 (standard deviation (SD) = 0.694) and 1.84 (SD = 0.626), respectively. A total of 16 thematic categories were identified. The mean of topics covered in the apps was 5.38 (SD = 2.925) being those related to contraception the more frequent. The results of the present study suggest that only a small percentage of free pregnancy prevention apps in Spanish should be recommended. The contents of the apps retrieved meet the potential necessities of adolescents.

Barriers and facilitators for access and utilization of reproductive and sexual health services among Female Sex Workers in urban and rural Maharashtra, India.

The public health interventions among Female Sex Workers (FSWs) have mainly addressed HIV/ STI prevention. The focus of the HIV prevention program on FSWs' Reproductive and Sexual Health (RSH) has been limited, thus, rendering them at a higher risk of unintended pregnancies, delayed pregnancy detection, and utilizing unsafe abortion methods. A multistakeholder analysis was performed to study access and use of RSH services among FSWs in urban and rural India. Between January 2016 and June 2019, a qualitative grounded theory approach was used to explore the FSWs' perspectives and experiences about services pertaining to HIV prevention, Antenatal Care (ANC), child delivery, abortion, and pregnancy prevention. Using purposive and convenience sampling, 29 In-Depth Interviews (IDIs), 2 Focus Group Discussions (FGDs) and 22 Key Informant Interviews (KIIs) were conducted with consenting FSWs and indirect stakeholders, respectively. Verbatim translated data was entered in NVivo12 Software and analyzed inductively. The following themes emerged: (1) Condomless sex, unintended pregnancy, vertical transmission, (2) Signs/ indication used for pregnancy detection causing delay (3) Pregnancy prevention methods used, (4) Pregnancy prevention or AIDS prevention, (5) Legal formalities as a barrier to access RSH, (6) Differential facility preference. Pregnancy prevention is a greater motivation for condom use than HIV prevention among FSWs. Therefore, there is an emerging need to reallocate public health resources and redesign policies to meet the RSH needs of FSWs, especially for the prevention of unintended pregnancies. FSW-focused Information Education Communication (IEC) strategies for RSH service utilization are essential to reduce the burden of unintended pregnancies. The National HIV Targeted Intervention (TI) program needs to include pregnancy testing services and information to non-barrier contraceptive methods. An ambient policy environment calls for examining the need for male involvement in pregnancy, family planning and abortion decisions.