Process evaluation of an integrated community-based intervention to improve family planning, sexual reproductive Health, and wellbeing among Syrian refugee women and girls in Lebanon during active conflict.

World AIDS Day 2025 arrives at a critical inflection point for the global HIV response. Four decades of scientific progress have transformed HIV into a manageable chronic condition, yet funding contractions, widening inequities, and persistent stigma threaten progress towards epidemic control. This review of the Special Collection highlights emerging challenges and opportunities across prevention, care, and social contexts, with a focus on resilience. Digital innovation, accelerated by COVID-19, is reshaping HIV service delivery through telehealth, remote engagement, and online research platforms. Studies of PrEP use across the Asia-Pacific region reveal cyclical patterns of prevention, varying preferences for long-acting and oral formulations, and the centrality of person-centred approaches. Other papers examine sexual satisfaction among people living with HIV, showing the ongoing influence of stigma even in the era of U=U (Undetectable equals untransmittable). Several contributions highlight enduring social and gendered inequities, including stigma among healthcare workers and gaps in menopause, reproductive health, and psychosocial care for women living with HIV. Evidence from humanitarian settings demonstrates how climate-related crises heighten HIV vulnerabilities, while peer-led navigation models illustrate community resilience. These papers underscore the need to integrate scientific innovation with equity, community leadership, and sustained solidarity as the global HIV movement adapts to a rapidly changing landscape.

The Municipal Sustainable Development Health Index (MSDHI) was developed to monitor achieving health-related targets outlined in the 2030 Agenda. This study aims to support effective, comprehensive, and context-sensitive policy formulation at the local level by developing a local index that accounts for regional health inequalities. The study addresses critical gaps in existing health equity assessments at the municipal level, where disparities exist in health outcomes due to regional inequalities. This article presents a methodological framework for calculating the index, based on secondary administrative data from various public information systems in Brazil. The MSDHI was estimated for all 5,570 Brazilian municipalities for the period from 2018 to 2022. Its construction followed a systematic eight-step procedure, ensuring consistency and reliability of the results. The municipal index combines multiple health-related indicators: values equal to 1 indicate the best national results, whereas values close to 0 indicate a greater distance from the best outcomes. The same interpretation applies to the thematic indexes: (1) Reproductive and maternal health, (2) Newborn and child health, (3) Infectious diseases, (4) non-communicable diseases, (5) Injuries and violence, (6) Environmental risks, and (7) Universal health coverage and health systems. The results of the MSDHI and its thematic indexes were classified in three tiers: Tier 1 (0 to 0.40) - insufficient; Tier 2 (0.41 to 0.69) - moderated; and Tier 3 (0.70 to 1.00) - adequate. The construct evaluation indicated positive correlations with life expectancy, HDI-M, IDB, and GDP, and a negative correlation with mortality rate. However, the magnitude of the correlations was low, suggesting that the MSDHI may be capturing additional dimensions beyond those reflected in the selected indicators. An applicability assessment was performed for the municipalities of the State of Minas Gerais, Brazil, indicating that the municipal index and the thematic indexes can identify sustainable health scenarios and highlight areas of inequality. The MSDHI is a valuable tool for local governments and policymakers to effectively implement the 2030 Agenda. Future studies should focus on developing an annual index and integrating the MSDHI into policy prioritization methods.

Vascular liver diseases (VLD) are a heterogeneous cohort of uncommon hepatic diseases which affect individuals particularly in the reproductive age group. They are typically associated with inherited or acquired thrombophilia. These diseases may influence reproductive health in women through alteration of the menstrual cycle and impact fertility. Pregnancy in this patient group may be complicated by exacerbation of portal hypertension, maternal and fetal complications due to underlying liver disease or drugs used for its management. This review focuses on the known risk factors of VLD in women, along with their prevalence and management. Special situations such as impact and use of anti-coagulants in pregnancy, management of portal hypertension and variceal bleeding, safe contraceptive use in this patient group and safety and risk of in-vitro fertilization are also discussed.

Challenging content: a mixed-methods evaluation of a novel sexual health curriculum in doctor of physical therapy education.

Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder affecting reproductive-aged women, characterized by a combination of hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. It has been an emerging health issue for the last decade. The exact aetiology is still unknown, but it is observed that behavioural, hormonal, and environmental factors play a pivotal role. Pathophysiology of the disease comprises dysregulation of the Hypothalamic-Pituitary-Ovarian axis, insulin resistance leading to increased luteinizing hormone (LH) secretion, and androgen excess. Clinical manifestations include menstrual irregularities, hirsutism, obesity, and acne, etc. While Ayurveda does not possess a specific term for PCOD/PCOS, comparable symptoms can be identified through concepts like Vandhya yonivyapad, Artavkshaya, and puspaghni jataharini. Nidra (sleep), being a component of Trayopastambha (the three fundamental pillars that sustain life), plays a crucial role in reproductive health. Improper Ahar (diet) and Nidra (sleep) lead to the pathogenesis of this disease, as well as act as modifiable drivers of these pathophysiologic loops. Ayurveda has emphasized the importance of Nidra (sleep) in reproductive health, and poor sleep can lead to reproductive health issues. The practice of proper sleep is getting deprioritized due to shift work, late-night screen usage, and workload. The evidence (meta-analyses, observational studies, disease-modifying guidelines, and clinical trials), suggests that sleep health is linked to PCOS pathophysiology, risk, and severity. The article highlights the role of Nidra, relevant to circadian rhythm disruption, insulin resistance, hormonal axis dysregulation, and metabolic effects, in pathophysiological aspects of PCOS, and outlines clinical implications and research priorities.

Knowledge, attitudes, and practices towards reproductive health among secondary school girls, Tanta City, Egypt

The implementation of menstrual leave for female workers represents a significant component of the protection of reproductive rights, as outlined in Indonesia’s Labour and Health Laws. Law No. 13 of 2003 provides female workers with the entitlement to refrain from work on the first and second days of their menstrual period, ensuring that they continue to receive their wages during this time. Nonetheless, implementing this is frequently obstructed by insufficient understanding among companies and prevailing negative perceptions of women who assert this right. Conversely, Law Number 17 of 2023 regarding Health establishes a legal framework to safeguard women’s reproductive health, including the provision of quality health services. For the effective implementation of menstrual leave rights, it is essential to foster collaboration among the government, employers, and relevant agencies. This can be achieved through socialisation and education that promote equality and welfare for female workers in Indonesia.

Feminist Organizing in HIV Nursing Professional Societies: A Case Study From the Philippines.

Microplastics and nanoplastics (MNPs) have emerged as ubiquitous environmental contaminants that are increasingly detected in human biological matrices, including blood, urine, placenta, and reproductive tissues [1–3]. Due to their small size, persistence, and physicochemical properties, these particles are capable of entering the human body through ingestion and inhalation, followed by systemic distribution [4]. Endometriosis is a chronic, estrogen-dependent inflammatory disease affecting approximately 10% of women of reproductive age and is characterized by immune dysregulation, oxidative stress, mitochondrial dysfunction, and altered hormonal signaling [5–7]. Growing evidence indicates that exposure to environmental pollutants may modulate molecular pathways relevant to the development and progression of endometriosis [8]. Experimental studies demonstrate that MNPs can induce oxidative stress, activate inflammatory signaling cascades, disrupt endocrine function, and alter immune cell behavior—mechanisms that overlap with the established pathophysiology of endometriosis [9–12]. Recent reports describing the presence of microplastics in human endometrial tissue further raise concerns regarding direct tissue-level exposure [13]. This narrative review summarizes current PubMed-indexed evidence on human exposure to microplastics and nanoplastics, their biological effects relevant to female reproductive health, and the mechanistic plausibility of their involvement in endometriosis pathogenesis, while highlighting existing knowledge gaps and methodological limitations.

Instances of withdrawal, the practice of removing a penis from a vagina before ejaculation to prevent pregnancy, have increased in some US populations over the past two decades. There is a paucity of research, however, on the prevalence and correlates of withdrawal among adolescents and young adults (AYAs). This study sought to determine the prevalence and correlates of withdrawal use in a representative sample of AYAs in the US, highlighting the association between receipt of informal sexuality education and withdrawal use. We analyzed cross-sectional National Survey of Family Growth data from AYAs surveyed between 2011 and 2019 (15-24 years; N = 14,262). Prevalence of withdrawal was determined using different sexual activity time-points (at first sex and ever) and reference periods (past 3 and 12 months). Logistic regression models were used to identify correlates of withdrawal alone and combined with at least one other method. Across all waves and reference periods, the prevalence of withdrawal was higher among AYAs who combined it with at least one other method (ever [overall]=15.15, SE = 0.58) compared with those who used it as the only method (ever [overall]=8.32, SE = 0.38). Compared to the 2011-2013 wave, those in the 2015-2017 wave had greater odds of reporting using only withdrawal in the past 3 months (AOR: 1.50; 95% CI: 1.02, 2.21). The same trend was seen in those who used withdrawal with another method at last sex in the past 3 and 12 months. Withdrawal alone or combined with another method varied by receipt of informal sexuality education topics (e.g., methods of birth control vs STIs). Variations in use of withdrawal based on type of informal sexuality education received suggests that different motivations might inform interventions in promoting effective reproductive health practices.

Varicocele-induced decline in sperm quality is a common cause of male infertility. While varicocelectomy improves semen parameters, the mechanisms remain unclear. Recent studies suggested that small noncoding RNAs (sncRNAs) in sperm play a significant role in male reproductive health. This study investigated whether varicoceles and surgical treatment influence the expression profiles of sperm sncRNAs and explored the related epigenetic mechanisms. This study included 63 infertile males undergoing varicocelectomy. Semen analysis was performed, followed by high-throughput deep sequencing of sperm sncRNAs both before and after surgery. The results indicated that semen parameters improved significantly following varicocelectomy. The expression profiles of sncRNAs were altered, with 10 microRNAs (miRNAs; 3 upregulated: hsa-miR-486-3p, hsa-miR-486-5p, and hsa-miR-874-3p; and 7 downregulated: hsa-miR-132-3p, hsa-miR-202-3p, hsa-miR-34c-5p, hsa-miR-499a-5p, hsa-miR-499b-3p, hsa-miR-520a-3p, and hsa-miR-92b-3p) showing significant changes post-surgery, which correlated with the improvement in sperm quality. Microinjection experiments demonstrated that the abnormally elevated expression of miRNAs in zygotes (miR-132-3p, miR-34c-5p, and miR-520a-3p) may negatively affect early embryonic development. Together, these results suggest that abnormal miRNA expression is a potential epigenetic mechanism underlying varicocele-associated sperm quality impairment. Moreover, the study findings provide evidence that varicocelectomy can relieve this process. Furthermore, the differentially expressed miRNAs may serve as potential predictors for diagnosing different pathological types of infertility and represent new molecular targets for improving fertility in males with varicoceles.

ObjectivesInstances of withdrawal, the practice of removing a penis from a vagina before ejaculation to prevent pregnancy, have increased in some US populations over the past two decades. There is a paucity of research, however, on the prevalence and correlates of withdrawal among adolescents and young adults (AYAs). This study sought to determine the prevalence and correlates of withdrawal use in a representative sample of AYAs in the US, highlighting the association between receipt of informal sexuality education and withdrawal use.Study designWe analyzed cross-sectional National Survey of Family Growth data from AYAs surveyed between 2011 and 2019 (15–24 years; N = 14,262). Prevalence of withdrawal was determined using different sexual activity time-points (at first sex and ever) and reference periods (past 3 and 12 months). Logistic regression models were used to identify correlates of withdrawal alone and combined with at least one other method.ResultsAcross all waves and reference periods, the prevalence of withdrawal was higher among AYAs who combined it with at least one other method (ever [overall]=15.15, SE = 0.58) compared with those who used it as the only method (ever [overall]=8.32, SE = 0.38). Compared to the 2011–2013 wave, those in the 2015–2017 wave had greater odds of reporting using only withdrawal in the past 3 months (AOR: 1.50; 95% CI: 1.02, 2.21). The same trend was seen in those who used withdrawal with another method at last sex in the past 3 and 12 months. Withdrawal alone or combined with another method varied by receipt of informal sexuality education topics (e.g., methods of birth control vs STIs).ConclusionVariations in use of withdrawal based on type of informal sexuality education received suggests that different motivations might inform interventions in promoting effective reproductive health practices.

Introduction More than 50 thousand people lost their lives in the earthquake that occurred in Türkiye in 2023. This study aimed to evaluate the Sexual and Reproductive Health (SRH) services provided in earthquake region in Hatay province in Türkiye with qualitative and quantitative methods. Materials and methods The research type is mixed; cross-sectional and phenomenological. The recorded data were evaluated for cross-sectional phase and purposeful and snowball sampling was conducted for qualitative phase. Data were collected through five focus group interviews (one healthcare workers group-−5 staff- and four women group-−16 women-) and 13 in-depth interviews (4 academics, 6 NGO, 3 service providers) as totally 34 participants. Thematic content analysis was conducted. Results Eighty three percentage of 15,841 women's applications were reached by mobile services. All of women were given health education. The frequency of genitourinary infection is 25.0%. Family Planning (FP) method was given to 35.3% of the women, cotton underwear was given to 72.0%, and sanitary pads were given to 22%. Emerging themes included social determinants, the gap in SRH services, community based mobile services and service provision by NGOs like HASUDER (Association of Public Health Specialists) and intersectoral collaboration. Reported that pre-existing gaps in SRH services were exacerbated after the earthquake, with major barriers including lack of privacy, poor hygiene, limited family planning access, low SRH awareness. Related to social determinants, gender and migration-related challenges such as language barriers, economic hardship, cultural isolation restricted service access. NGOs played a crucial role in addressing unmet needs. However, bureaucratic barriers and limited public sector collaboration were noted. Deteriorated living conditions, and widespread healthcare disruptions across all service levels further deepened vulnerabilities. The HASUDER mobile services were highlighted as critical in reaching women, adolescents, and migrants. Discussion The earthquake deepened health system gaps, while NGOs became essential in bridging services and building resilience. Strengthened coordination, infrastructure, and inclusive SRH integration are urgently needed. Community-based mobile service delivery is vital.

The Reproductive Mental health of Ontario Virtual Intervention Network (MOVIN) aims to improve perinatal depression care across a large Canadian health jurisdiction. It involves a web-based platform, care coordinator for personalized treatment planning, and psychiatrist to liaise with primary care clinicians, and provide direct consultation as needed. This was a pilot randomized controlled trial (RCT) of MOVIN. Participants aged ≥18 years, pregnant or within 12 months postpartum and with Edinburgh Postnatal Depression Scale (EPDS) score >12 recruited from across Ontario, Canada, were randomized 1:1 to MOVIN for 24 weeks or a control condition. The primary outcome was feasibility, inclusive of recruitment, acceptability, and research protocol follow-up. Depression symptom remission was a main secondary outcome for the pilot trial. EPDS scores and remission (EPDS ≤ 12) were compared between groups. Of 101 participants (n = 48 MOVIN; n = 53 control), 80% completed 24-week follow-up. Participant views of MOVIN were very positive (high acceptability) and multiple opportunities for protocol adjustment in a larger future study were identified. At 24 weeks post-randomization, EPDS scores were lower in MOVIN vs. controls, with a mean difference adjusted for baseline score of -2.32 (95% Confidence Interval, CI -4.23 to -0.42). At the same time point, 75.0% of the MOVIN group vs. 51.1% of controls were in remission (chi-square=4.83, p = 0.03). With high feasibility, including in recruitment, acceptability, and research protocol adherence, and preliminary suggestion of efficacy, the results of this study support proceeding to a large-scale RCT of MOVIN to definitively evaluate its efficacy at a larger scale.

Do U.S males receive contraceptive counseling during medical visits? Insights from the National Survey for Family Growth.

Objective This narrative review aims to synthesize and evaluate existing evidence and practices regarding discharge readiness services for patients undergoing endometrial cancer (EC) surgery, with the goal of providing a reference for clinical practice and future research. Background The incidence of EC is rising globally. With the widespread adoption of enhanced recovery after surgery (ERAS) protocols and minimally invasive techniques, hospital stays are shortening, making effective discharge planning crucial for ensuring a safe transition to home and preventing readmissions. Methods As a narrative review, this article involved a comprehensive but non-systematic examination of literature from PubMed, Web of Science, CNKI, and Wanfang databases, focusing on key components of discharge readiness. These components include assessment tools, service content development, implementation processes, and outcome evaluation. The synthesis prioritized recent evidence and internationally recognized guidelines. Results The review identifies that while generic discharge assessment tools are valuable, they require adaptation to address the specific needs of EC patients (e.g., lymphedema risk, sexual health). Effective service implementation relies on a systematic interdisciplinary collaboration model and nurse-led, personalized education (e.g., using the teach-back method). The integration of digital health platforms shows promise for supporting post-discharge care. Outcome evaluation should encompass both clinical indicators (e.g., 30-day readmission rates) and patient-reported outcomes (e.g., using the Health Education Impact Questionnaire). Current challenges include a lack of standardized pathways and fragmented community resources. Conclusion Discharge readiness is a critical determinant of recovery quality for EC surgical patients. This review consolidates core components and processes into a practical framework, highlighting the need for multidisciplinary collaboration, patient-centered education, and technology integration. Future efforts should focus on developing standardized, culturally adapted pathways and conducting robust comparative effectiveness research to establish high-quality, evidence-based service systems. Relevance to clinical practice This study focuses on the development of core components and processes for systematic discharge readiness services for postoperative endometrial cancer patients, as well as the identification of practice challenges. The findings advocate for the clinical adoption of standardized frameworks and the enhancement of implementation capacity to optimize discharge transitions, patient recovery, and continuity of care.

Prevalence and risk factors of perinatal depression among women in South Asian countries: A systematic review and meta-analysis.

Background High-quality family planning (FP) counselling is essential for informed contraceptive choice, reducing discontinuation, and improving reproductive health. However, many women in sub-Saharan Africa continue to face barriers. This study examined client-, provider-, and facility-level determinants of FP counselling quality in Ethiopia using nationally representative, multi-source data. Methods We analysed data from the 2021/22 Ethiopia Service Provision Assessment, including 2,224 women who received or were prescribed injectables, pills, or implants. Counselling quality was assessed using a 15-item checklist derived from direct observations and client exit interviews. Multilevel ordinal logistic regression was applied to identify predictors at the client-, provider-, and facility-levels. Results Only 32% of clients received high-quality FP counselling, with key information on side effects, STI protection, and a follow-up frequently omitted. High-quality counselling was more likely among women who had never used FP (aOR 1.40; 95% CI: 1.01–1.95) or were past users (aOR 2.05; 95% CI: 1.44–2.92), those counselled by providers with more than five years of experience (aOR 1.91; 95% CI: 1.26–2.89), and those served by providers with high adherence to medical-eligibility screening (aOR 1.67; 95% CI: 1.22–2.29). The presence of a FP-trained provider and national FP guidelines was also positively associated. Marked regional disparities were observed, with facilities in Sidama performing better and those in emerging regions lagging behind. Facility-level factors accounted for approximately 52% of the variation in counselling quality. Conclusion The quality of FP counselling in Ethiopia remains suboptimal and is largely driven by provider and facility-level factors. Strengthening provider training, ensuring guideline availability, addressing regional disparities, and improving counselling for current users are essential for enhancing service quality, reducing discontinuation, and improving reproductive health outcomes.

BackgroundStreet adolescents often engage in early sexual activity, have multiple partners, and are at high risk of sexual abuse and exploitation. Despite the significance of this issue, there is a critical gap in understanding the sexual and reproductive health (SRH) needs, practices, and challenges of this marginalized population in Bangladesh, which this study aimed to explore.MethodsA cross-sectional study was conducted from August to December 2023, involving 311 street adolescents aged 16–19 years in Sylhet City Corporation, Bangladesh. Data were collected through face-to-face interviews using a semi-structured questionnaire. The questionnaire covered sociodemographic characteristics, pubertal changes, SRH status, and SRH-seeking behaviors.ResultsOf all participants, 62.8% were males and 37.2% were females, with a mean age of approximately 17.3 years for both sexes. Sexual intercourse was reported by 32.56% of participants, with a significant gender disparity (76.79% females vs. 6.35% males, p < 0.001). Contraceptive use was low at 14.14%, primarily condoms. Among female participants who ever had sex, 81.13% reported pregnancy, with 50.67% having had an abortion. Knowledge of sexually transmitted diseases (STDs) was alarmingly low, with only 2.33% aware of transmission methods. Less than half (45.97%) of participants utilized SRH services. Sexual abuse was reported by 61.79% of participants. Logistic regression revealed that younger age (Adjusted Odds Ratio [AOR]: 0.62, 95% CI: 0.48–0.79), being female (AOR: 9.10, 95% CI: 3.58–25.3) and longer duration of stay on the streets (AOR: 1.14, 95% CI: 1.02 to 1.27) were associated with higher odds of experiencing sexual abuse.ConclusionStreet adolescents in Sylhet City face severe SRH challenges, including high rates of sexual abuse, low contraceptive use, and limited STD knowledge, with significant gender disparities, which should be addressed through appropriate and urgent interventions.