Reproductive Health Research Articles

Effectiveness of Intake of Aloe Vera Juice in Reducing the Symptoms of Poly Cystic Ovarian Syndrome among Reproductive Age Group in Tertiary Care Hospital, Puducherry, India

Introduction: Polycystic ovarian syndrome is a health disorder that is prevalent among women in the child bearing age. This disease is described by the development of multiple cysts in the ovaries due to inability of follicles to release mature eggs. To evaluate the effectiveness of intake of aloe vera juice in reducing the symptoms of poly cystic ovarian syndrome among reproductive age group . Methods: Polycystic ovarian syndrome is a health disorder that is prevalent among women in the child bearing age. This disease is described by the development of multiple cysts in the ovaries due to inability of follicles to release mature eggs. Results: The finding shows that the experimental group had significant positive changes in the normal uterine size by 10% to 23.3% and positive changes in the right and left ovaries sizes which can imply that Aloe Vera has therapeutic effect on reproductive health. Post-assessment comparison revealed significant differences in uterus and left ovary sizes between the groups, with p-values of 0.005 and 0.004, respectively. Conclusion: The study concluded that aloe vera juice is effective in reducing the symptoms of poly cystic ovarian syndrome among reproductive age group. However, the results of this study need to be confirmed with larger samples and longer follow-up studies designed and powered for safety outcomes.

Knowledge and attitudes on anemia and menstrual health among Malaysian female university students

Anemia is a significant public health concern, particularly among young female adults due to its potential impact on reproductive health. This study investigated the association between anemia-related knowledge, attitudes, menstrual health, and anemia status among Malaysian university students. This was a cross-sectional study named “SCARF” - Study to Combat Anemia - Research for Female Students, involving 674 university students in Malaysia. Anemia status was determined based on haemoglobin level, while knowledge, attitude and menstrual health were measured using validated questionnaires. The mean menarche age of students in this study was 12.1 ± 1.21 years. Students who were anemic had significantly longer menstrual cycle duration (P = 0.034) and more days with heavy flow (P = 0.038). Most students had poor knowledge (44.5%) and attitudes (84.1%) towards anemia. Students with good knowledge were 1.1 times more likely to have better anemia status compared to those with poor knowledge (95% CI: 1.0–1.2, P = 0.049). This study highlighted a lack of practical application of the knowledge to dietary habits. Collaborative efforts between educators and healthcare providers are crucial in developing a comprehensive strategy, such as interventions to prioritise educational initiatives and practical support to enhance overall menstrual health among female students.

Accessibility factors associated with adherence to healthy timing and spacing of pregnancy among women of reproductive age in Kilifi County, Kenya

Background: Globally, about 25% of births occur with shorter intervals annually with over 12 million underage pregnancies mostly from Sub-Saharan Africa. Kenya records about 20% teenage pregnancies while Kilifi County reported 28.9%. In Kilifi County, 19.6% of births do not adhere to the 24-month birth-interval. The study focused on establishing accessibility factors associated with adherence to healthy timing and spacing of pregnancy (HTSP) among reproductive age women in Kilifi County, Kenya. Methods: A descriptive cross-sectional design was adopted with a sample of 293 respondents. All required approvals and consent were obtained. Quantitative data was collected using questionnaires. Descriptive data was analyzed using SPSS version 22.0 and inferential statistics computed through Chi-square tests. Results: About 60.1% respondents adhered to heathy timing and spacing of pregnancy, 69.4% teenage pregnancies occurred and 67.1% of women adhered to the 24-month inter-birth interval. Availability of family planning (FP) services (p=0.008), experience with providers (p=0.005), cost of accessing FP (p=0.001) and source of information (p=0.002) were associated with HTSP. Conclusions: About 4 out of 10 women of reproductive age in Kilifi County do not adhere to the recommended HTSP. Accessibility factors such as cost and availability of family planning services, source of information and experience with healthcare providers significantly influenced adherence to HTSP. The Ministry of Health and relevant stakeholders should scale up awareness activities, provide mobile clinics and concentrate on regular continuous medical education among healthcare providers to enhance their role in provision of reproductive health services.

Correlation of IGF2 levels with sperm quality, inflammation, and DNA damage in infertile patients.

Insulin-like growth factor 2 (IGF2) is a critical endocrine mediator implicated in male reproductive physiology. To investigate the correlation between IGF2 protein levels and various aspects of male infertility, specifically focusing on sperm quality, inflammation, and DNA damage, a cohort of 320 male participants was recruited from the Women's Hospital, Zhejiang University School of Medicine (Hangzhou, China) between 1st January 2024 and 1st March 2024. The relationship between IGF2 protein concentrations and sperm parameters was assessed, and Spearman correlation and linear regression analysis were employed to evaluate the independent associations between IGF2 protein levels and risk factors for infertility. Enzyme-linked immunosorbent assay (ELISA) was used to measure IGF2 protein levels in seminal plasma, alongside markers of inflammation (tumor necrosis factor-alpha [TNF-α] and interleukin-1β [IL-1β]). The relationship between seminal plasma IGF2 protein levels and DNA damage marker phosphorylated histone H2AX (γ-H2AX) was also explored. Our findings reveal that IGF2 protein expression decreased notably in patients with asthenospermia and teratospermia. Correlation analysis revealed nuanced associations between IGF2 protein levels and specific sperm parameters, and low IGF2 protein concentrations correlated with increased inflammation and DNA damage in sperm. The observed correlations between IGF2 protein levels and specific sperm parameters, along with its connection to inflammation and DNA damage, underscore the importance of IGF2 in the broader context of male reproductive health. These findings lay the groundwork for future research and potential therapeutic interventions targeting IGF2-related pathways to enhance male fertility.

Reproductive Toxicity and Multi/Transgenerational Effects of Emerging Pollutants on C. elegans

Emerging pollutants (EPs) are receiving increasing attention due to the threats they pose to the environment and human health. As EPs continue to emerge, risk assessment requires many model animals. Caenorhabditis elegans (C. elegans) has been an outstanding toxicological model organism due to its growth and development characteristics. Particularly, in studying the transgenerational influences of EPs, C. elegans has advantages in saving time and cost due to its short generation cycle. As infertility has become a major problem in human reproductive health, reproductive toxicities of EPs on contemporary nematodes and across generations of C. elegans were introduced in this review. Moreover, the underlying mechanisms involved in germ cell apoptosis, spermatogenesis, and epigenetic alteration were discussed. Future research opportunities and challenges are also discussed to expand our understanding of the reproductive influences of EPs.

An optimized fractionation method reveals insulin-induced membrane surface localization of GLUT1 to increase glycolysis in LβT2 cells

Insulin is an important regulator of whole-body glucose homeostasis. In insulin sensitive tissues such as muscle and adipose, insulin induces the translocation of glucose transporter 4 (GLUT4) to the cell membrane, thereby increasing glucose uptake. However, insulin also signals in tissues that are not generally associated with glucose homeostasis. In the human reproductive endocrine axis, hyperinsulinemia suppresses the secretion of gonadotropins from gonadotrope cells of the anterior pituitary, thereby linking insulin dysregulation to suboptimal reproductive health. In the mouse, gonadotropes express the insulin receptor which has the canonical signaling response of IRS, AKT, and mTOR activation. However, the functional outcomes of insulin action on gonadotropes are unclear. Here, we demonstrate through use of an optimized cell fractionation protocol that insulin stimulation of the LβT2 gonadotropic cell line results in the unexpected translocation of GLUT1 to the plasma membrane. Using our high purity fractionation protocol, we further demonstrate that though Akt signaling in response to insulin is intact, insulin-induced translocation of GLUT1 occurs independently of Akt activation in LβT2 cells.

"I Don’t has the Desire to has Sex”: Quality of Life and Sexual Concerns of Women with Secondary Infertility in the Tamale Metropolis

Background Infertility adversely affects the general quality of life and sexual satisfaction among women. This study explored the quality of life and sexual concerns among women with secondary infertility in the Tamale metropolis. Methods A qualitative exploratory descriptive design was used. Individual in-depth interviews were conducted using a semi-structured interview guide. Ethical approval was received from the Ghana Health Services ethics review committee. Fourteen (14) participants with secondary infertility receiving treatment at the Tamale Teaching Hospital were purposively selected and interviewed for the study, each lasting about 30 minutes to one hour. The interviews were audiotaped with permission from the participants, transcribed verbatim and content analyzed. Conclusion The findings from this study revealed that happiness, well-being and value in life were compromised among these women. Concerning sexual satisfaction, the majority of the participants experienced low sexual drive and physical pain during sexual intercourse which led to poor sexual satisfaction. There is a need for more exploration into the sexual health of women with infertility

How can HIV self-testing facilitate increased access to HIV testing among multiply marginalised populations? Perspectives from GBMSM and trans women in England and Wales

Background HIV self-testing (HIVST) may facilitate marginalised populations’ uptake of HIV testing, but whether the extent of marginalisation challenges individual uptake of HIVST remains under-researched. We aim to explore the perspectives of multiply marginalised cis-gender gay, bisexual and other men who have sex with men (GBMSM) and trans women on whether HIVST might increase their uptake of HIV testing. Methods We reanalysed qualitative interview data from SELPHI (the UK’s largest HIVST randomised trial) collected between 2017 and 2020 from marginalised populations, defined as people self-identifying as non-heterosexual, transgender, non-White ethnicity and/or with low educational attainment. Thirty-eight interviews with multiply marginalised individuals were thematically examined using the framework method. We specifically focussed on kit usability (a function of the interaction between blood-based HIVST kits and users), perspectives on how HIVST can improve access to HIV testing and suggestions on need-based scale-up of HIVST. Results HIVST kits were considered usable and acceptable by multiply marginalised GBMSM and trans women. The majority of interviewees highlighted multi-levelled barriers to accessing HIV testing services due to structural and social marginalisation. Their multiply marginalised identities did not impede HIVST uptake but often form motivation to self-test. Three potential roles of HIVST in the HIV testing landscape were identified: (1) alternation of HIVST and facility-based testing, (2) integration of HIVST into sexual health services and (3) substituting facility-based testing with HIVST in the future. Perceived beneficiaries of HIVST included trans communities, individuals with undisclosed sexuality and people with physical disabilities. Discussion HIVST can facilitate marginalised populations’ access and uptake of HIV testing by alternating with, integrating into and substituting for facility-based services in the UK. Marginalised identities did not present challenges but rather opportunities for person-centred scale-up of HIVST. Future implementation programmes should ensure equitable access to HIVST among trans people, men unable to disclose their sexuality, and perhaps people with physical disabilities.

Efficacy and Safety of Non-Ablative Dual Wavelength Diode Laser Therapy for Genitourinary Syndrome of Menopause: A Single-Center Prospective Study.

This study evaluates the efficacy and safety of non-ablative diode laser therapy for genitourinary syndrome of menopause (GSM) in post-menopausal women unable to use hormonal therapies. A pilot prospective study was conducted from September 2023 to April 2024, involving 22 post-menopausal women aged 45-73years. Participants underwent three sessions of diode laser treatment with the Leonardo® dual-wavelength Diode laser. Assessments were made at baseline, 3months, and 6months post-treatment. Main outcome measures included Visual Analog Scale (VAS) scores for GSM symptoms, Vaginal Health Index Score (VHIS), and sexual function evaluated using the Female Sexual Function Index (FSFI-6), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), and Sexual Quality of Life-Female (SQOL-F) questionnaire. Significant improvements were observed in VHIS, increasing from 12 to 19.27 at 6months (p<0.001). GSM symptoms improved significantly: vaginal dryness scores decreased from 7.72±2.37 to 3.72±2.53, burning sensation scores dropped from 6.00±3.22 to 1.90±1.81, and dyspareunia scores reduced from 8.09±2.11 to 3.90±2.58 (all p<0.016). Sexual function improved, indicated by FSFI-6 scores increasing from 12.27±7.29 to 19.30±6.24 (p<0.016) and SQOL-F scores rising from 63.18±22.93 to 71.45±23.31. No adverse events were reported. Non-ablative diode laser therapy is effective and safe for managing GSM symptoms in post-menopausal women, offering significant symptom relief and enhancing sexual health without serious side effects. Further research with a larger cohort and extended follow-up is needed to confirm these findings. Clinical Trials ID NCT06503003.

Sexual health communication targeting adolescents in public service Media: the case of Finland

Abstract Background Given the substantial time adolescents spend online, sexual health promotion and education through online media constitute a promising public health action. However, monitoring of sexual health-related online media content is warranted, and considering the scope and aims of public service media, this forum can be regarded as being of particular interest. This study aimed to analyze how and to what extent sexuality and sexual health-related content targeting adolescents is communicated and portrayed in public service media in Finland, with a particular interest in health promotion perspectives and participatory practices. Methods Based on predetermined inclusion criteria and guidance from professionals at the Finnish public service company Yle, podcasts were specified as the media format of interest. Three Finnish podcasts (a total of 66 episodes) produced during the years 2021-2023, targeting young people and focusing on sexual health, were included in this study and subject to critical content analysis. Results Most podcast episodes focused equally on the sexual health resource and risk perspectives, while a third emphasized a resource perspective. Concerning participatory practices, adolescents participate in only five episodes in total, and most often, the podcast hosts’ own experiences are at the center of the episodes. Conclusions The findings highlight how sexuality and sexual health content is communicated in public service media podcasts targeting adolescents in Finland, as well as how the communication aligns with health education and promotion guidelines. The study sheds light on participatory practices, emphasizing a lack of stakeholder involvement, i.e., dialogue between podcast hosts and listeners. Results carry implications for developing sexual health promotion through public service media targeting young people in Finland and other European countries alike. Key messages • The findings highlight how sexuality and sexual health content is portrayed in public service media podcasts in Finland and how the communication aligns with health promotion values and principles. • The findings show a lack of participatory practices in Finnish public service media podcasts targeting adolescent sexual health - a health promotion concern also pertinent to other countries.

Family-based sexual health intervention for adolescents; A systematic review and meta-analysis

Abstract Background Family-based interventions are important in promoting adolescent sexual health outcomes. However, the effectiveness of these interventions in promoting adolescent sexual and reproductive health (ASRH) in Lower and middle-income countries (LMIC) has not been empirically evaluated. This review aimed to summarise the effectiveness of family-based sexual and reproductive health interventions in promoting ASRH in LMIC. Methods We conducted a systematic search for studies published in English from 2000 to October 2023 using MEDLINE, PsyINFO, CINAHL, Web of Science, and EMBASE databases. Studies were included if they involved adolescents aged 10-19 years, included family members in a key intervention component, evaluated the effectiveness of the interventions using an experimental or quasi-experimental design, assessed ASRH outcomes reported by adolescents and were conducted in LMIC setting. Standardized mean difference (SMD) and 95% confidence intervals were computed and meta-analyses were conducted using random effect models. Results Ten articles involving 2,246 participants were included in the review. The studies were nostly conducted in Africa. Across studies, there was no significant impact of family-based interventions in improving adolescent sexual health knowledge (SMD=0.5, 95%CI: -1.98 to 2.98), attitudes (SMD= -0.05, 95%CI: -1.92 to 1.82), practices (SMD=0.53, 95%CI: -0.69 to 1.75), or sexual communication with their family (SMD= 0.14, 95%CI: -0.42 to 0.7). Although individual studies reported a mixed effect of family-based interventions in improving sexual health outcomes, the pooled results from the meta-analysis showed no significant impact of family-based interventions. Conclusions Our review did not find any significant impact of family-based interventions in improving ASRH in LMIC. We recommend interventions using innovative approaches and novel strategies to align with the socio-cultural and economic background of the study setting. Key messages • This study found no significant impact of family-based interventions in improving ASRH in LMIC. • Additional studies, particularly from Asia, using culturally relevant interventions is required in this area.

Documenting the availability and accessibility of reproductive health services for youth in Albania

Abstract Youth in Albania are initiating sexual activity at an earlier age. However, use of all forms of contraception has declined in the last decade and uptake now stands at 4%. The self-reported prevalence of sexually transmitted infections (STIs) and STI symptoms has risen dramatically, as has reliance on abortion as a predominant method of family planning. In 2020-2022, we conducted a multi-method qualitative study in Albania to document the availability and accessibility of sexual and reproductive health (SRH) services and examine challenges that youth face when seeking SRH care. This study comprised a document review, a curriculum review, a community-based survey with 273 youth, semi-structured interviews with 15 youth, semi-structured interviews with 15 key informants, and a service mapping exercise in Tirana. Lack of adequate infrastructure and bureaucratic hurdles make it difficult for youth to navigate and access SRH services in Albania. A third of survey participants (n = 90, 33%) expressed discomfort inquiring about SRH matters, while nearly two-thirds rarely or never sought SRH services from a doctor or clinic. Furthermore, Albania’s school-based sexuality education curriculum lacks in topics, content, and responsiveness, resulting in inconsistent learning experiences and limited knowledge of SRH. Sexuality education is primarily focused on the anatomy and physiology of reproduction, leading to significant knowledge gaps in other aspects of SRH. Only half of survey participants (n = 150, 55%) had received any education on birth control, contraception, or family planning; and only few had knowledge about gender identity (n = 103, 38%), or consent (n = 77; 28%). Widespread lack of awareness and fear of judgment contribute to the underutilization of SRH services among youth in Albania. Improving knowledge and awareness, alongside investing in infrastructure and capacities, are essential to enhancing accessibility and quality of SRH services for Albanian youth. Key messages • Lack of knowledge and awareness prevent youth from accessing SRH services. • Establishing youth-friendly services and training health providers and educators are crucial to delivering confidential and non-judgmental youth-friendly SRH care.

Barriers to young people’s use of sexual and reproductive health services in Asia-Pacific

Abstract Background Qualitative literature extensively documents young people’s barriers to accessing sexual and reproductive health (SRH) services in Asia-Pacific countries. However, efforts to synthesise this research for practical use in healthcare policy and practice are lacking. This systematic review aims to systematically review and synthesise published qualitative literature focusing on young people’s utilisation of SRH services and understanding common access barriers. Methods We systematically searched five electronic databases from inception until 24 June 2022: MEDLINE, EMBASE, PsycINFO, CINAHL, and Web of Science. Google Scholar and reference lists of all included studies were also searched. We used the Critical Appraisal Skills Programme (CASP) checklist for appraising the quality of included studies and analysed the data using a thematic synthesis approach. Results We included 31 papers reporting the experiences of over 1800 young people from 16 Asia-Pacific countries. Thematic synthesis identified several factors affecting adolescents’ utilisation of SRH services, which were grouped into six descriptive themes: navigating puberty; lack of SRH knowledge; embarrassment and confidentiality concerns; low decision-making autonomy; traditional practices and religious beliefs; and socio-cultural norms. Our overreaching analytical theme highlighted the role of shame as a key emotion hindering young people’s utilisation of SRH services. Conclusions Direct communication about SRH issues is crucial for teenagers. Embarrassment, privacy concerns, and stigma significantly affect their service utilisation decisions. Inclusive interventions for both youth and their communities by addressing socio-cultural factors are essential for optimising service accessibility and guiding evidence-based interventions and policies across diverse cultural contexts. Key messages • Understanding young people’s SRH service barriers in Asia-Pacific countries: Socio-cultural norms are highlighted as crucial for optimising service utilisation among young individuals in this area. • Inclusive interventions and policies are needed for enhanced accessibility.

Promoting sexual health in schools: a systematic review of the European studies

Abstract Background Sexual ill-health causes a high health burden. There is, therefore, a need for more effective sexual health promotion interventions. Previous research has focused on preventive sexual health interventions and the limited evidence concerning school-based sexual health promotion interventions has not been synthesized. Hence, this study aimed to systematically review the current evidence on the effects of sexual health promotion interventions conducted in European schools. Methods A systematic review based on the JBI and PRISMA standards was performed, encompassing searches in seven databases to identify sexual health promotion interventions conducted in European schools between 2012 and 2022. Data coding was performed according to a predetermined protocol and a narrative synthesis of the included studies was performed, highlighting the collective results. Results The review included 17 records, reporting 16 individual studies conducted in 7 European countries. Of the 16 included studies, 13 had a quantitative research design, and three had a qualitative design. All qualitative studies described positive effects as experienced by the participants, and ten of the quantitative studies showed statistically significant positive effects on at least one of the outcomes of interest. Conclusions The findings indicate good evidence for the effectiveness of interventions with a health promotion approach, underscoring the importance of sexual health resources such as respect, communication skills, and attitudes. Most sexual health promotion intervention studies have focused on sexual health resource outcomes connected to attitudes and skills, whereas, e.g., sexual health literacy is less studied and can be recommended to be included in future research. Key messages • The synthesized evidence sheds light on the lack of evaluated interventions employing holistic and positive, resource-focused sexual health promotion interventions targeting European adolescents. • The included school-based sexual health promotion studies, although limited in number, show evidence of promising effects on sexual health outcomes among participants.

Availability of Adolescent and Young Adult-Specific Sexual and Reproductive Health Programs and Resources: A Review of the Websites of National Cancer Institute-Designated Cancer Centers.

Adolescent and young adult (AYA) cancer survivors often search online for information about cancer-related sexual and reproductive health concerns. A review of the websites of National Cancer Institute-designated cancer centers (n = 9) and comprehensive cancer centers (n = 58) was conducted to identify the presence of AYA-specific sexual and reproductive health programming and resources. No AYA-specific sexual health programs were found. Oncofertility programs were presented on 56% (n = 5) of cancer centers and 50% (n = 29) of comprehensive cancer center websites. As the population grows, it is imperative that cancer centers provide services to meet AYAs' sexual and reproductive health needs and highlight these services on their websites.

Sexual health education in Italian schools: preliminary results of EduForIST3 national project

Abstract Background School-based comprehensive sexuality education (CSE) is the best approach to disseminate scientific evidence and promote healthier sexual behaviours among young people. However, in Italy, CSE is not included in schools curricula. This study, funded by the Ministry of Health, seeks to investigate information uptake and attitudes towards sexuality among adolescents included in a pilot CSE intervention in 6 Italian regions, from December 2023 to June 2024. Methods A 10-hours education intervention was implemented in a convenient sample of 26 upper and lower secondary schools (U/LSS), covering topics such as changes in adolescence, relationships and consent, sexual identity, sexually transmitted infections (STIs), contraception and sexual health services. Students’ evaluation comprised pre/post tests assessing knowledge, attitudes towards sexuality and satisfaction. A Solomon 4-group design study was used to compare intervention and control classes. A follow-up test will be conducted 4-6 months post-intervention. Results Preliminary analysis of available data as of 30 April, 510 pre-tests and 266 post-tests, showed incremented correct answers in all items. A significant increase (p&amp;lt;.05) was found in 12/21 items for USS and in 9/19 items for LSS, especially in the domain STIs symptoms and prevention, among those mostly appreciated. Over 90% of students considered schools as suitable setting to receive CSE, preferably by external experts. Ongoing qualitative and long-term analysis will provide further insights of the overall impact of the activity. Conclusions The pilot CSE intervention increased the knowledge and attitudes of the students involved. Additional insights will be available after study completion. Findings from this study will contribute to evaluate the effects of CSE initiatives on sexual health knowledge and attitudes among Italian secondary schools students, as well as the effectiveness of such programs in fostering healthier behaviours. Key messages • Providing evidence-based, relevant information and education on sexual health to young people in secondary schools increases their knowledge and improves attitudes towards sexuality. • CSE should be included in Italian school curricula in order to promote an incremental uptake of information and to improve young people’s sexual health.

Analysis of parents’ needs regarding sexual and reproductive health issues of their children

Abstract Background Promoting sexual and reproductive health is a key intervention for young people’s health and well-being. Studies have shown that young people have a need to be supported by a strong network and that parents are considered an important source of information. The aim of our work was to understand the needs and critical issues parents face when raising the topic of sexual and reproductive health with their children in order to strengthen their skills and provide the best tools to support young people. Methods A qualitative focus group research methodology was used; a sexual psychologist facilitated the meetings. Parents of children attending secondary schools in Udine (Italy) in the 2022/2023 school year were invited to participate in the project. The meetings were recorded and transcribed verbatim by two independent researchers. Following an inductive method, recurring themes were extrapolated to represent the main categories and more specific subcategories. Results 46 parents participated in the focus group; 76% of them had no experience with sexual and affective education. Parents felt that sex education was useful in providing accurate information, preventing risks and promoting respect and relationships with others; however, there were concerns that the values taught were not consistent with those of the family. The topic was found to be difficult to discuss with children, both in terms of technical/scientific aspects and addressing issues such as gender identity and sexual orientation. Parents would like to understand what the right communication key is to discuss with their children in an atmosphere of trust. Conclusions Parents recognized the importance of the topic and saw the need to deepen some aspects, especially in terms of relationship and communication. The results of this work will be a useful starting point for the creation of ad hoc pathways aimed at parents to strengthen the relationship with their children. Key messages • Parents want to overcome difficulties by finding the right key to communicate with their children. • Supporting young people and their network to promote sexual and reproductive health is essential.

The use of digital technologies to promote sexual health in young adults: a narrative review

Abstract Background New technologies have the potential to play an important role in promoting sexual health, especially among young people, who are the biggest users and those at greatest risk of contracting Sexually Transmitted Infections (STI). The risk behavior assumed by young people today highlights this vulnerability in several contexts, such as individual, social, economic, and family. In this sense, it becomes relevant to approach sex education in schools using digital technologies. Objectives To identify the evidence in the literature on the use of digital technologies to promote the sexual health of young adults. Methods Narrative literature review. Three independent reviewers extracted, analyzed and synthesized the articles and results. Results Through the selection process, four studies were included. The articles show that the use of digital technologies (mobile phones/applications) leads to increased knowledge, improved attitudes and sexual behavior among young adults. The interventions studied in the studies were based on Short Message Service, electronic mail interventions and the MyPEEPS mobile application, with the following main focuses: Increased knowledge, attitudes, and behaviors of young adults. Considering the results of the studies, all interventions proved to be effective as facilitators of sexual health promotion. Conclusions The use of digital technologies allowed an increase in the promotion of the sexual health of the participants, since there was an increase in the level of knowledge with the use of digital technologies such as SMS, emails and mobile applications when comparing the experimental and control groups. The use of these digital technologies also allowed for a change in attitudes and behaviors, such as a significant increase in serological testing for STIs and an increase in health care seeking. Key messages • The use of digital technology promotes the sexual health of young adults, so these strategies should be implemented by health professionals. • The dissemination of these digital strategies will have an impact on Public Health, specifically regarding the sexual health of young adults.

Development of Digital Health Gender and Sexual Health Literacy scale

Abstract Introduction Health literacy, as the ability to obtain, process and understand health information, including gender and sexuality awareness, appears to be underdeveloped in terms of measurement tools and thematic materials. The literature indicates the existence of serious deficits in gender and sexual health literacy at all levels, with implications for relationships with citizens and patients. Methods Delphi study agreement was conducted and a pool of potential scale items was generated, reflecting a range of skills and abilities within each domain. Items were carefully worded to ensure clarity, cultural sensitivity and relevance to different gender identities and sexual orientations. Expert review and cognitive pre-testing were employed to refine item wording, assess content validity, and ensure that the 10-item scale was comprehensible and relevant to the target population. Results The theoretical development of the 10-item Digital Health Gender and Sexual Health Literacy Scale was successfully completed. The scale items were designed to provide a comprehensive measure of an individual’s ability to navigate the digital landscape for gender and sexual health information. Conclusions The theoretical validation of the Digital Health Gender and Sexual Health Literacy Scale (DiGeSHeL) provides the community with a promising tool to assess individuals’ confidence and ability to use digital technologies for sexual health information and resources. However, further research is needed to validate the scale and test its reliability with a diverse group of participants. Once validated, this scale could be a valuable tool for sexual health promotion programmes to identify gaps and evaluate the impact of digital literacy interventions. Key messages • Gender and sexual literacy are crucial for health. • Health literacy as six vital sign.

Online Forum Conversations on Abortion in Poland: Navigating Medical, Emotional, and Legal Challenges

Abstract Background Abortion is a common medical procedure worldwide, but access is restricted in Poland, forcing many women to seek abortions without medical supervision. This can lead to health risks and reflects broader challenges regarding reproductive rights and healthcare. Methods We conducted a qualitative and quantitative analysis of online forums discussing abortion to understand the challenges faced by women in Poland. Data was gathered from popular abortion forums identified through Google searches, with a pilot study refining the research focus. Results A total of 13,397 responses from 370 threads across 4 forums were analyzed. The most prevalent theme was the ‘Abortion Process Progression,’ indicating a strong need for information and support. Discussions on ‘Emotional and Psychological Aspects’ and ‘Medical and Pharmacological Aspects’ highlighted the need for holistic care. This suggests that legal restrictions and fear of repercussions hinder women’s access to professional assistance, exacerbating health disparities and inequalities. Conclusions This study offers a general look at the abortion experiences of Polish women, revealing challenges that often go unnoticed by policymakers and healthcare professionals. By analyzing online forums, it uncovers nuanced issues such as the lack of access to medical supervision, information gaps, and emotional support, highlighting discrepancies between policy and needs. The findings call for decriminalizing abortion, launching educational campaigns to combat misinformation, and strengthening support systems, aligning Poland’s reproductive health services with European Union standards, ensuring women’s access to safe and supportive healthcare. Key messages • This study shows how Poland’s restrictive abortion laws push women to online forums, revealing medical, emotional, and logistical challenges, emphasizing the need for care and accurate information. • The research highlights the need for decriminalizing abortion, addressing misinformation, and support Poland’s reproductive health services with EU standards, ensuring safer care for women.