Reproductive Health Interventions Research Articles

Factors influencing adoption of sexual and reproductive health intervention for adolescents in Ebonyi, Nigeria.

School and Community-embedded reproductive health interventions have been implemented in developing countries, with evidence that they led to improved sexual and reproductive health among adolescents. However, this type of intervention is rarely evaluated for its potential adoption and use. This study evaluated the constraints and enablers of the adoption of a school and community-embedded intervention that used community engagement, capacity building, partnerships and collaborations to deliver sexual and reproductive health services to adolescents. The intervention was implemented between 2019 and 2021 in six local government areas in Ebonyi State. The results on adoption presented here were collected four months into the mid-phase of the project, targeting adolescents, parents, adult family members, healthcare providers, local authorities, and community members. Sixteen in-depth interviews were conducted with policymakers, 14 with health service providers and 18 Focus Group Discussions (FGDs) with parents, community leaders and adolescents who were part of the implementation process. The coding reliability approach, a type of thematic data analysis was used, that involves early theme development and the identification of evidence for the themes. The adoption of school and community-embedded reproductive health intervention was strong among stakeholders at the early stages of the implementation process. Multi-stakeholder involvement and its multi-component approach made the intervention appealing, thereby enabling its adoption. However, at the later stage, the adoption was constrained by beliefs and norms about sexual and reproductive health (SRH) and the non-incentivisation of stakeholders who acted as advocates at the community level. The sustainability of the intervention may be threatened by the non-incentivisation of stakeholders and the irregular supply of materials and tools to facilitate SRH advocacy at the community level. The inclusive community-embedded reproductive health intervention was adopted by stakeholders because of the enablers which include timely stakeholder engagement. However, for it to be sustainable, implementers must address the non-incentivising of community-level advocates which serve as constraints.

High uptake of menstrual health information, products and analgesics within an integrated sexual reproductive health service for young people in Zimbabwe

BackgroundDespite being integral to women’s well-being, achieving good menstrual health (MH) remains a challenge. This study examined MH services uptake (including information, analgesics, and a choice of MH products - the menstrual cup and reusable pads) and sustained use of MH products within an integrated sexual and reproductive health intervention for young people in Zimbabwe.MethodsThis mixed-methods study was nested within a cluster randomised trial of integrated sexual and reproductive health services (CHIEDZA) for youth in three provinces (Harare, Mashonaland East, and Bulawayo). The study collected qualitative and quantitative data from 27,725 female clients aged 16–24 years, who accessed CHIEDZA from April 2019 – March 2022. Using a biometric (fingerprint recognition) identification system, known as SIMPRINTS, uptake of MH information, products, and analgesics and other services was tracked for each client. Descriptive statistics and logistic regression were used to investigate MH service uptake and product choice and use over time, and the factors associated with these outcomes. Thematic analysis of focus group discussions and interviews were used to further explore providers’ and participants’ experiences of the MH service and CHIEDZA intervention.ResultsOverall, 36,991 clients accessed CHIEDZA of whom 27,725 (75%) were female. Almost all (n = 26,448; 95.4%) took up the MH service at least once: 25433 took up an MH product with the majority (23,346; 92.8%) choosing reusable pads. The uptake of cups varied across province with Bulawayo province having the highest uptake (13.4%). Clients aged 20–24 years old were more likely to choose cups than reusable pads compared with those aged 16–19 years (9.4% vs 6.0%; p < 0.001). Over the implementation period, 300/1819 (16.5%) of clients swapped from the menstrual cup to reusable pads and 83/23346 (0.4%) swapped from reusable pads to the menstrual cup. Provision of the MH service encouraged uptake of other important SRH services. Qualitative findings highlighted the provision of free integrated SRH and MH services that included a choice of MH products and analgesics in a youth-friendly environment were key to high uptake and overall female engagement with SRH services.ConclusionsHigh uptake demonstrates how the MH service provided much needed access to MH products and information. Integration of MH within an SRH intervention proved central to young women accessing other SRH services.

Therapeutic potential of exosomes in spermatogenesis regulation and male infertility.

Spermatogenesis is a fundamental process crucial for male reproductive health and fertility. Exosomes, small membranous vesicles released by various cell types, have recently garnered attention for their role in intercellular communication. This review aims to comprehensively explore the role of exosomes in regulating spermatogenesis, focusing on their involvement in testicular development and cell-to-cell communication. A systematic examination of literature was conducted to gather relevant studies elucidating the biogenesis, composition, and functions of exosomes in the context of spermatogenesis. Exosomes play a pivotal role in orchestrating the complex signaling networks required for proper spermatogenesis. They facilitate the transfer of key regulatory molecules between different cell populations within the testes, including Sertoli cells, Leydig cells, and germ cells. The emerging understanding of exosome-mediated communication sheds light on novel mechanisms underlying spermatogenesis regulation. Further research in this area holds promise for insights into male reproductive health and potential therapeutic interventions.

Assessing interprofessional and integrated care in providing sexual and reproductive health services to adolescents at primary healthcare level in Nigeria

PurposeSexual and reproductive health (SRH) interventions demand diverse services, encompassing medical, social and psychological care to ensure the overall wellbeing of service users. In the absence of multidisciplinary response to SRH interventions, service users could be deprived of crucial SRH services, which could undermine their safety and wellbeing. Based on this knowledge, our study was designed to map the interprofessional space in primary healthcare (PHC) facilities in Ebonyi State, Nigeria that deliver SRH services.Design/methodology/approachInterviews with 20 health workers and group discussions with 72 young people aged 15–24 years provided the data for the study. We analyzed data deductively, focusing on the assessments of the presence or absence of specific professionals that are typically expected to provide different aspects of SRH services.FindingsWe found conspicuous absence of laboratory diagnostic, social care, psycho-cognitive and some medical services expected of primary care. These absences necessitated unnecessary referrals, encouraged breaches in confidentiality, undermined social care and justice, increased cost of care and discouraged young clients from utilizing SRH services provided in PHCs. Our study, therefore, emphasizes the need for integrated care in the delivery of SRH services, which would involve relevant diverse professionals contributing their expertise toward comprehensive care for SRH service users.Originality/valueThe study provides human resource insights toward strengthening primary healthcare in Nigeria vis-à-vis efficient delivery of SRH services to guarantee the health security of service users.

An Overview Review of Understanding the Need for Adolescents Sexual and Reproductive Health Interventions

Adolescents are the most vulnerable group, who are denied to access information and guidance related to sexual and reproductive health needs because of the social taboos that lead them to encumbrances. This review study helps to understand the different perspectives of sexual and reproductive health based on cultural, sociological, physiological, and economical aspects. The paper explains sexuality from the theoretical perspectives. Adolescence is the transitional stage where physiological, biological, and psychological changes occur, at the same time proper knowledge about sexual and reproductive health should be provided with importance of sexual and reproductive health interventions. It intricates the availability and effectiveness of adolescent sexual and reproductive health (ASRH). The methodology is a systematic review with PRISMA guidelines sourced from various databases of PubMed databases, Research Gate, Science Direct, BMC Public Health, Web of Science, SAGE, Scopus, WHO library, and other websites relevant to this study. The recent literature highlighted the importance of sexual and reproductive health interventions among adolescents. The study has concluded with the findings impact of Adolescent Sexual and Reproductive Health (ASRH) intervention programmes and to develop an increase in effective ASRH programmes, which will help the adolescents to know the importance of sexual hygiene and reproductive hygiene.

A qualitative evaluation of stakeholder perspectives on sustainable financing strategies for ‘priority’ adolescent sexual and reproductive health interventions in Ghana

BackgroundAdolescent sexual and reproductive health (ASRH) interventions are underfunded in Ghana. We explored stakeholder perspectives on innovative and sustainable financing strategies for priority ASRH interventions in Ghana.MethodsUsing qualitative design, we interviewed 36 key informants to evaluate sustainable financing sources for ASRH interventions in Ghana. Thematic content analysis of primary data was performed. Study reporting followed the consolidated criteria for reporting qualitative research.ResultsProposed conventional financing strategies included tax-based, need-based, policy-based, and implementation-based approaches. Unconventional financing strategies recommended involved getting religious groups to support ASRH interventions as done to mobilize resources for the Ghana COVID-19 Trust Fund during the global pandemic. Other recommendations included leveraging existing opportunities like fundraising through annual adolescent and youth sporting activities to support ASRH interventions. Nonetheless, some participants believed financial, material, and non-material resources must complement each other to sustain funding for priority ASRH interventions.ConclusionThere are various sustainable financing strategies to close the funding gap for ASRH interventions in Ghana, but judicious management of financial, material, and non-material resources is needed to sustain priority ASRH interventions in Ghana.

Effects of an intervention to improve sexual and reproductive health on level and predictors of awareness and knowledge of condoms and dual protection amongst adolescents in Nigeria

BackgroundAdolescents need both information about sexual behaviours and potential risks in order to make the right choices. This study compared adolescents’ level of awareness and predictors of knowledge of condoms and dual protection where a multi-component sexual and reproductive health (SRH) intervention was implemented and in communities where the intervention was not implemented, so as to understand the effect of the intervention on awareness and knowledge and also identify predictors of knowledge of contraception methods.MethodsThe study was an intervention study that was undertaken in six local government areas (three rural and three urban LGAs) in Ebonyi state, southeast Nigeria. Data were collected from 855 adolescent boys and girls, using a pre-tested interviewer administered questionnaire. Systematic random sampling technique was used to select eligible households from which adolescents were interviewed Analysis of data was carried out using bivariate and multivariate linear regression analyses. The level of statistical significance was determined by a p value of < 0.05.ResultsThe level of awareness of condoms and dual protection was similar in the intervention and non-intervention communities. However, the predictors of knowledge about condoms and dual protection were different between the intervention and non-intervention groups. The multivariate linear regression showed that the higher the level of education, the higher the level of awareness of contraception methods among adolescents (p < 0.05). Likewise, increasing age by one year and working for pay increased the awareness of condoms and dual protection(p < 0.05).ConclusionThere was no difference in the level of awareness of pregnancy prevention methods, knowledge of condoms and dual protection in both arms of the study. Higher level of education, increasing age, and working for pay are factors associated with awareness of condom and dual protection. These factors should be prioritized for effective Adolescent sexual and reproductive health (ASRH) programming.

Integrating reproductive health into community development and social work: Strategies for effective engagement and empowerment

The integration of reproductive health into community development and social work represents a critical endeavor in promoting holistic well-being and empowerment at the grassroots level. This review highlights strategies for effective engagement and empowerment within this framework. Firstly, a comprehensive understanding of the community's socio-cultural context is imperative. Cultural sensitivity and competence enable practitioners to navigate sensitive reproductive health issues within diverse communities. Utilizing ethnographic approaches and community-based participatory research facilitates the identification of local beliefs, practices, and barriers related to reproductive health. Secondly, building collaborative partnerships with key stakeholders is essential. Engaging local leaders, healthcare providers, educators, and religious institutions fosters buy-in and facilitates the development of culturally relevant interventions. These partnerships enhance the reach and sustainability of reproductive health initiatives by leveraging existing community resources and networks. Thirdly, incorporating a rights-based approach is fundamental for empowering individuals and communities. By promoting reproductive rights, including access to comprehensive sexuality education, contraception, and safe abortion services, practitioners empower individuals to make informed choices about their sexual and reproductive health. Moreover, advocating for gender equality and addressing harmful gender norms and practices are integral components of fostering reproductive autonomy and empowerment. Furthermore, capacity-building efforts play a pivotal role in enhancing community resilience and sustainability. Equipping community members with knowledge and skills in reproductive health education, advocacy, and service provision enables them to take ownership of their health and drive sustainable change within their communities. Finally, leveraging innovative technologies and communication channels enhances the accessibility and effectiveness of reproductive health interventions. Mobile health applications, telemedicine, and social media platforms provide avenues for disseminating information, delivering services, and promoting dialogue on reproductive health issues. Integrating reproductive health into community development and social work requires a multi-faceted approach that prioritizes cultural competence, collaboration, rights-based empowerment, capacity-building, and innovation. By employing these strategies, practitioners can effectively engage communities and empower individuals to achieve optimal reproductive health outcomes and overall well-being.

Long-Acting Reversible Contraception Knowledge Among Female Adolescents Presenting to a Pediatric Emergency Department.

The objective of this study was to assess awareness and use of long-acting reversible contraception (LARC) among female adolescents presenting to a pediatric emergency department (PED). During routine presentation to an urban PED in New Jersey, female adolescents, aged 15-19 years, were asked to voluntarily complete an electronic survey about sexual practices and contraception. The PED is in an urban teaching hospital, treating 35,000 children annually. Patients could schedule a follow-up appointment at the hospital's obstetrics/gynecology clinic. Data were collected over 13 months, and follow-up was monitored to determine if they attended an outpatient appointment, and if so, what the outcome was. Data for 199 participants were analyzed. The median age of participants was 18 years, whereas 79% self-identified as Black, and 17.6% self-identified as Latina. Twenty-one percent of participants used a form of birth control during their first sexual encounter, the largest percentage being condoms (77.8%). Forty percent of participants reported some prior knowledge about contraceptive implants, and 20% had knowledge about intrauterine devices, whereas only 3 (1.5%) intrauterine devices and 2 (1%) arm implants had been previously used. Of the 78 participants that requested a follow-up, 14 (17.9%) completed their appointment. Of those, 2 (14%) were prescribed contraception (Depo-Provera shot and oral contraceptive pills). Knowledge about LARC remains low in our PED, despite it being the most effective method of contraception. Even when interventions were made to link interested respondents to outpatient women's health services, follow-up attendance was poor, and no patients obtained LARC. There is a significant discrepancy between the consensus standard of contraception care across all relevant medical specialties and current utilization by high-risk populations. Future efforts must focus on how to close this gap, and the ED could be pivotal for improving both reproductive health education and intervention among adolescent patients.

Sexual behaviour among Kenyan adolescents enrolled in an efficacy trial of a smartphone game to prevent HIV: a cross-sectional analysis of baseline data

ABSTRACT Sexual behaviour of adolescents is contextual, with various determinants affecting sexual activity and age of sexual debut. Insight into sexual activity among young adolescents has the potential to influence appropriate sexual and reproductive health interventions. For this analysis, adolescents were recruited as part of the Tumaini smartphone game efficacy trial. Data collection included a self-administered behavioural survey and blood test for HIV and HSV-2. Descriptive statistics were calculated for demographics and measures of sexual behaviour and behavioural intent based on gender and sexual experience, with associations assessed using chi-square tests, t-tests and Wilcoxon rank sum tests as appropriate. We enrolled 996 adolescents, mean age 14 years and 2.2% HSV-2 positivity. Overall, 15% of the adolescents were sexually experienced, this being associated with lower socio-economic status (p = 0.01), household food insecurity (p = 0.008), a living situation without both parents (p < 0.01), substance use (p = 0.02), no adult conversation about future goals (p = 0.003), conversations about condoms (p = 0.01), with some gender disparity within these factors. Among those sexually experienced, 21.7% reported unwilling sex; 17.5% had engaged in transactional sex; 57.8% had willing first sex, of whom 60.9% reported no condom use. Among those abstaining, female adolescents were less likely to contemplate condom use at first sex (p = 0.006). Our findings determine that young sexually active adolescents are likely engaging in unprotected sex and having unwilling sexual experiences. Socio-economic status, living situation and parental monitoring remain significant factors associated with sexual experience among young adolescents. In this context, early adolescence is an opportunity to provide age- and developmentally appropriate education about safer sex practices. Trial registration: ClinicalTrials.gov identifier: NCT04437667.

Adherence to a reproductive health intervention for young adults with sickle cell.

The CHOICES intervention is tailored specifically for young adults with sickle cell disease (SCD) or sickle cell trait (SCT). The face-to-face (F2F) delivery format is feasible with efficacy for improving knowledge about reproductive health for those with SCD or SCT. The purpose of the study was to compare the participant adherence to a remote online CHOICES intervention study (N = 107) and a F2F CHOICES intervention study (N = 234). In both studies, participants with SCD or SCT were randomized into experimental or usual care control groups. Descriptive statistics were collected for all participants by group in both studies. Adherence was measured by retention at each data collection time point. Independent t-tests were conducted to compare mean participant adherence of the F2F and online studies postbaseline (6, 12, 18, and 24 months). There was a significant difference in mean adherence postbaseline between the studies (p = .005). The results suggest that more research is necessary for proper online participant retention. Advance practice nurses that are well informed on CHOICES can transmit the availability of this evidence-based intervention to this special population. Special referral for the CHOICES intervention, which is tailored specifically for young adults with SCD or SCT, may increase adherence to the intervention if it comes from trusted health care providers. Nurse practitioners are educators in primary and acute care settings. Encounters with reproductive age populations with SCD or SCT can occur in both settings.

A composite index; socioeconomic deprivation and coverage of reproductive and maternal health interventions.

To examine inequalities in the coverage of reproductive and maternal health interventions in low- and middle-income countries and territories using a composite index of socioeconomic deprivation status. We obtained data on education and living standards from national household surveys conducted between 2015 and 2019 to calculate socioeconomic deprivation status. We assessed the coverage of reproductive and maternal health interventions, using three indicators: (i)demand for family planning satisfied with modern methods; (ii)women who received antenatal care in at least four visits; and (iii)the presence of a skilled attendant at delivery. Absolute and relative inequalities were evaluated both directly and using the slope index of inequality and the concentration index. In the 73 countries and territories with available data, the median proportions of deprivation were 41% in the low-income category, 11% in the lower-middle-income category and less than 1% in the upper-middle-income category. The coverage analysis, conducted for 48 countries with sufficient data, showed consistently lower median coverage among deprived households across all health indicators. The coverage of skilled attendant at delivery showed the largest inequalities, where coverage among the socioeconomically deprived was substantially lower in almost all countries. Antenatal care visits and demand for family planning satisfied with modern methods also showed significant disparities, favouring the less deprived population. The findings highlight persistent disparities in the coverage of reproductive and maternal health interventions, requiring efforts to reduce those disparities and improve coverage, particularly for skilled attendant at delivery.

Program evaluation of postgraduate obstetrics and gynecology training in Lao people’s democratic republic - using the CIPP model

BackgroundThe obstetrics and gynaecology (OB-GYN) residency training program in Lao People’s Democratic Republic (PDR) began in 2003 based on the Millennium Development Goals (MDGs) and ‘Reproductive, maternal, newborn, and child health interventions (RMNCH) strategies and action plan’. However, the training program had not been properly evaluated previously. The purpose of this study is to evaluate the current postgraduate OB-GYN residency training program in Lao PDR by using CIPP model to identify the current problems (the strengths and weaknesses) and suggest a future plan to promote continuous improvement.MethodThe context, input, process, and product classification (CIPP) model was used to develop criteria and indicators. A mixed-methods approach was used for this study. To capture instructional material for quantitative analysis, a Google survey with 38 items and a t-test were used to determine a significant difference in responses between residents and lecturers (N = 120). Based on qualitative analysis, an in-depth interview was done (four questions based on study outcomes, including satisfaction, strengths and weaknesses, and future opportunities), and six interviews provided different viewpoints on the course. The SPSS software program was used to measure validity, with p-values = 0.05.ResultsThe overall average response rate was 97.5%. Two significant differences in program perspectives were revealed between lecturers and residents, difficulties in maintaining the course (professors 3.66 ± 1.03 and residents 3.27 ± 0.98, p = 0.04) and learning outcomes achieved (professors 3.57 ± 0.85 and residents 3.14 ± 0.95, p = 0.01 The overall average for the context part of the questionnaire was under 3.00, with the lowest scores for overlapped learning outcomes and difficulties in maintaining the course. The input part, lack of the classroom, skills lab and staff; the process part, lecturer to collect student opinions and the product part on learning outcomes.ConclusionCurriculum improvement based on the program evaluation results, including regular evaluation and feedback, will advance the residency training program based on the RMNCH strategy and contribute to the promotion of maternal health in the Lao PDR.

Reproductive health issues of concern among Nigerians: an online survey

Background: Reproductive health is often neglected due to various reasons including poor access to information and services. This study was undertaken to get an understanding of what reproductive health issues are of concern to Nigerians and their suggestions for improvement of services in order to meet their needs. Methods: The study was an anonymous online survey carried out using Google Forms. Statistical analyses including rates and comparative analyses were carried out using MINITAB statistical software version 19. Results: The most common reproductive health issues of concern to respondents were sexual health (29.59%), contraception (23.47%), infections (21.43%), fertility issues (17.35%, and female reproductive tract cancer (13.27%). Other concerns were limited access to reproductive health information and services including awareness and education of men and young people (5.10%), availability and affordability (2.04%), getting the right information (1.02%), and ability to discuss reproductive health issues (1.02%). The most common suggestions for improvement included having more information (65.00%), greater involvement of men (62.00%), improved access to services (56.00%), and greater involvement of young people (39.00%). The preferred media of information included social media (20.00%), email (20.00%), and health workers including door-to-door services and seminars in schools (13.85%). Other preferred media of information included radio (4.62%), print media (3.08%), parents/family (1.54%), and SMS messages (1.54%). Conclusions: For meaningful impact, reproductive health interventions should ensure availability of information and services that are inclusive of adolescents and young people, men and older persons, through various channels such as school seminars, health workers, traditional and social media, and other technologies.

Applying Human-Centered Design to Replicate an Adolescent Sexual and Reproductive Health Intervention: A Case Study of Binti Shupavu in Kenya.

We present a case study describing the use of human-centered design (HCD) to determine how to adapt intervention components from an existing contraceptive uptake program for adolescent girls in 4 geographical contexts (Ethiopia, northern Nigeria, southern Nigeria, and Tanzania) for use in Kenya. First, we prioritized existing intervention components to be tested in Kenya using sacrificial concepts. Through these concepts, we identified key insights and behavioral archetypes from which to build higher-fidelity prototypes, leveraging existing program knowledge and resources while responding to unique opportunities for Kenyan adolescent girls. After 2 rounds of prototyping, we launched a high-fidelity intervention designed to improve contraceptive uptake among girls. We used program experience to identify strategies for improvement during early implementation. The resulting model, Binti Shupavu, is designed to tap into girls' aspirations and connect them with contraceptive use, build their trust in the health system, and work with influencers to build support for adolescent contraceptive use, following the global user journey. In the first year of implementation (January-December 2022), the intervention was scaled from 90 facilities to 360 facilities and reached 60,111 adolescent girls aged 10-19 years. Of these, 21,698 were new voluntary contraceptive users (36%) and an additional 3,873 (19%) were continuing users.Our design process suggests that HCD is a promising tool for navigating replication. The emphasis on users' perspectives, testing to learn, and collaboration facilitated a deep understanding of the new user population, thus guiding program designers to balance using existing components with developing new ones based on the population's unique needs. Finally, HCD has potential to support the localization agenda if design teams are supported by national, regional, and global experts to be aware of and use the evidence and implementation experience from earlier work.

Assessing acceptability and effectiveness of a pleasure-oriented sexual and reproductive health chatbot in Kenya: an exploratory mixed-methods study

Integrating pleasure may be a successful strategy for reaching young people with sexual and reproductive health and rights (SRHR) interventions. However, sexual pleasure-related programming and research remains sparse. We aimed to assess chatbot acceptability and describe changes in SRHR attitudes and behaviours among Kenyan young adults engaging with a pleasure-oriented SRHR chatbot. We used an exploratory mixed-methods study design. Between November 2021 and January 2022, participants completed a self-administered online questionnaire before and after chatbot engagement. In-depth phone interviews were conducted among a select group of participants after their initial chatbot engagement. Quantitative data were analysed using paired analyses and interviews were analysed using thematic content analysis. Of 301 baseline participants, 38% (115/301) completed the endline survey, with no measured baseline differences between participants who did and did not complete the endline survey. In-depth interviews were conducted among 41 participants. We observed higher satisfaction at endline vs. baseline on reported ability to exercise sexual rights (P ≤ 0.01), confidence discussing contraception (P ≤ 0.02) and sexual feelings/needs (P ≤ 0.001) with their sexual partner(s). Qualitative interviews indicated that most participants valued the chatbot as a confidential and free-of-judgment source of trustworthy “on-demand” SRHR information. Participants reported improvements in sex-positive communication with partners and safer sex practices due to new learnings from the chatbot. We observed increases in SRHR empowerment among young Kenyans after engagement with the chatbot. Integrating sexual pleasure into traditional SRHR content delivered through digital tools is a promising strategy to advance positive SRHR attitudes and practices among youth.

Condom use correlates among youth living with HIV in South Africa: lessons for promoting safer sex

ABSTRACT Identifying factors associated with condom use can help inform the design of sexual reproductive health interventions for young people living with HIV. Data were collected from 294 sexually active youth in South Africa aged 14–24 years, living with HIV and aware of their status. Logistic regression found condom use was associated with partner status, disclosure, treatment adherence, knowledge, alcohol use, enacted stigma, and age at known status. Seventy-seven percent reported condom use at last sex, with higher odds among those who: disclosed their status to their last partner (OR = 2.13, 95% CI = 1.09–4.15), had not missed any ART doses in the previous week (OR = 2.67, 95% CI = 1.35–5.27), knew to use condoms when both partners have HIV (OR = 2.65, 95% CI = 1.34–5.25) and learned their status by age 12 (OR = 2.89, 95% CI = 1.30–6.43). Lower odds of condom use were among participants with an HIV-positive partner (OR = 0.36, 95% CI = 0.18–0.73), those who experienced recent stigma (OR = 0.55, 95% CI = 0.31–1.00), who drank at least 1 day per month (OR = 0.43, 95% CI = 0.22–0.84) and females (OR = 0.41, 95% CI = 0.20–0.84). Condom education and services promoting stigma management and safe disclosure could increase condom use among young people living with HIV. Lower condom use among adolescents reporting non-adherence to treatment underscores the critical need for effective interventions.

Glucose transporters (GLUTs): Underreported yet crucial molecules in unraveling testicular toxicity

Glucose transporters (GLUTs) are crucial in maintaining glucose homeostasis and supporting energy production in various tissues, including the testes. This review article delves into the distribution and function of GLUTs in distinct testicular cell types, namely Leydig cells, Sertoli cells, germ cells, and spermatozoa, shedding light on their significance in the context of male reproductive health—an issue of mounting global concern. Furthermore, this article examines the implications of GLUT dysregulation in testicular dysfunction. Altered GLUT expression has been associated with impaired steroidogenesis, spermatogenesis, sperm count, and motility in various animal models. Lastly, the article underscores the potential therapeutic implications of targeting GLUTs concerning testicular toxicity. Insights gleaned from studies in diabetes and cancer suggest that modulating GLUT expression and translocation could present novel strategies for mitigating testicular dysfunction and safeguarding male fertility. In summary, the intricate interplay between GLUTs, glucose metabolism, and testicular health underscores the significance of sustaining testicular glucose homeostasis for male reproductive health. Manipulating GLUTs presents an innovative avenue to address testicular dysfunction, potentially revolutionizing therapeutic strategies to restore male fertility and overall reproductive well-being. Future research in this field holds great promise for advancing male fertility treatments and reproductive health interventions.

“Too weak to fight, too scared to scream”: Understanding experiences of sexual coercion of Black female adolescents through digital storytelling

Black female adolescents are less frequently viewed as victims of violence or as agents of resistance. This study analyzed the experiences of sexual coercion of Black female adolescents on the South Side of Chicago through narrative scripts used to create digital stories. Using Sexual Script Theory and applying an intersectional lens, we analyzed a collection of 46 narrative transcripts from Black female youth, living on the South Side of Chicago, five of which specifically focused on the theme of sexual coercion. Under the broader theme of sexual coercion, the following subthemes were identified: (1) broken expectations of romance, (2) sex as a means of seeking attention from a male partner, (3) sex as a means of maintaining a partner, and (4) rape. By better understanding the social context of relationships for Black adolescent girls in heterosexual relationships, we may be able to better design sexual and reproductive health interventions for young women of color.

Understanding how social norms influence access to and utilization of adolescent sexual and reproductive health services in Northern Nigeria.

This study explored the influence of social norms on the access and utilization of sexual and reproductive health services by adolescents. Apart from individual and environmental barriers, social norms influence contraceptive decisions and ultimately sexual and reproductive health outcomes. Social norms that shape group behavior describe acceptable standards of behavior and evoke sanctions when such behavior standards are not adhered to. Sexually active adolescents in Nigeria have a relatively low level of modern contraceptive use being influenced by social norms. Scaling up adolescent reproductive health interventions that integrate normative change for a wider impact of programs remains challenging. Using data from 18 communities, 188 married and unmarried adolescents (F52% and M48%) and 69 (F37%; M63%) reference group participants were purposively sampled and participated in a social norms exploration intervention study conducted through focus group discussion and in-depth interviews between October and November 2019. The Advancing Learning and Innovation on Gender Norms (ALIGN) Social Norms Exploration Tool (SNET) was adapted for the data collection into discussion guides and vignettes. Pilot testing of the tools informed review and validation prior to actual data collection. Low contraceptive uptake by adolescents was characterized by early and forced marriage in childhood; a prominent practice enshrined in social norms around girl-childchastity, family honor, and disapproval of pre-marital sex and pregnancy out of wedlock. The understanding of harmful social norms, normative change actors, and potential norm-shifting factors for contraceptive decisions by adolescents is essential for effective adolescent sexual and reproductive health interventions for wider impact and adaptive programming in behavior change interventions for improving the access to and utilization of modern contraceptives by adolescents for improved sexual health outcomes, the attainment of the Family Planning (FP) 2030 commitment and universal health coverage policy.