Use Of Sexual Health Services Research Articles

Implementing Quality Improvement Initiatives to Improve the Use of Adolescent- and Youth-Friendly Health Services in Zou, Benin.

In Benin, the unmet need for family planning services is especially high for adolescent girls and youth aged 15-24 years. The Challenge Initiative (TCI) supported the health system to assess and improve the quality of adolescent and youth sexual reproductive health services and enhance contraceptive uptake in 65 service delivery points (SDPs) of the Zou department. Between June 2019 and March 2021, TCI supported the health districts in Zou to train an assessment team to complete 3 cycles of quality assessments (QAs) using a QA checklist adapted to the local context. Based on assessment scores, the SDPs were categorized into poor, moderate, or good to excellent quality. The SDP managers developed remedial action plans after each cycle and for each SDP and followed up with supportive supervision. The first QA cycle showed that 52% of assessed SDPs achieved a good to excellent classification; by the second QA cycle, this reached 74%. However, the quality of adolescent- and youth-friendly health services regressed during the third QA cycle (during COVID-19 pandemic disruptions), when only 40% of SDPs achieved the good to excellent category. Between the first and second QA cycles, contraceptive uptake for adolescents and youth improved in the SDPs that had good or excellent quality of services, compared to the ones that were of lower quality (established significance level of 5% with a P value of .031). Further assessments could deepen our understanding of the internal and external factors that can affect service quality. The findings reinforce the importance of investing in quality improvement strategies to maximize the use of sexual and reproductive health services among adolescents and youth. They also underscore the need for a contextual and nuanced approach to ensure enduring results.

Quality Health Services for Adolescents: Assessing Awareness and Use of Adolescent Sexual Reproductive Health Services in Keta, Ghana

ABSTRACT Introduction Although adolescents have access to sexual and reproductive health services, they encounter a variety of obstacles, including limited access to safe abortion and contraceptives, early pregnancy and parenthood, and a high occurrence of sexually transmitted infections. This research assessed the awareness and use of adolescent sexual reproductive health services in the Keta Sub-district of Ghana. Methods A cross-sectional study using a quantitative method of analysis and the administration of a structured questionnaire to 350 adolescents between the ages of 14 and 19 in the Keta Sub-district was conducted. Results Of the 10 services covering adolescent sexual and reproductive health, 75% of participants were aware only of comprehensive sex education. Only 27% were aware of sexually transmitted infection prevention and care services. Awareness was 13% or lower for the remaining eight services. Only 24% had used an adolescent sexual reproductive health service. Conclusion Awareness of adolescent sexual reproductive health services and their use is low in the Keta Sub-district. To improve access to sexual and reproductive health information, sub-district health services should create school-based satellite clinics for adolescents. Adolescents’ ambassadors should be created to educate peers on adolescent issues, especially sexual and reproductive health.

Barriers and facilitators to access sexual and reproductive health services among young migrants in Tarapacá, Chile: a qualitative study.

Chile has become a destination country for immigrants from Latin America, including youth. Guaranteeing access and use of sexual and reproductive health services for young migrants is crucial because of their overlapping experiences of transitioning to a new country and to adulthood. However, the existing evidence shows barriers to accessing sexual and reproductive healthcare among young migrant populations. In this context, the main objective of this article is to identify the barriers and facilitators that young migrants experience to access sexual and reproductive healthcare in the Tarapacá region of Chile. A qualitative study was conducted in the Tarapacá region of Chile. Semi-structured interviews with 25 young migrants from Venezuela, Colombia, and Ecuador, as well as 10 health workers, were carried out. The interviews were transcribed and thematically analysed. The study was approved by the Ethics Committee of the Universidad del Desarrollo (#2019-22). Young migrants face barriers linked to structural shortcomings within the healthcare system, which may be similar to those faced by the local population. Barriers are also derived from reductionist sexual and reproductive health approaches, which prioritise the prevention of pregnancy, sexually transmitted infections, and HIV, with a predominantly heteronormative focus. The prevailing narratives from the health system are those of risk and lack of control and self-care among young people, and they are exacerbated in the case of migrants. Young migrants, especially from the Caribbean, are stereotyped as over-sexualised and liberal in comparison to the local population and believed to be engaging in riskier sexual behaviours that should be kept under check. This may translate into experiences of discrimination and mistreatment when receiving care. Facilitators include good-quality information and community-level interventions. This study shows a limited approach to the sexual and reproductive health of young migrants in Chile, severely hampering their reproductive and sexual rights. Policies and initiatives must work towards removing structural barriers, changing narratives, and empowering young migrants regarding their sexual and reproductive health.

Sexual and reproductive health knowledge, attitudes, and behaviors: A survey of 12-17 year old Sudanese refugees in Chad.

Adolescents living in humanitarian settings are often at a higher risk of negative sexual and reproductive health outcomes, and yet, limited information is available on adolescents' experiences and needs in these settings while available services do not always correspond to their needs. This study explored knowledge, attitudes, and behaviors relating to sexual and reproductive health among 12-17 year old refugees from Darfur currently living in two refugee camps in eastern Chad. The research team conducted a cross-sectional survey of 689 adolescent girls and boys, informed by participatory research activities, to explore key sexual and reproductive health topics. This study found that sexual and reproductive health knowledge among adolescents is low, with only 69.1% able to identify at least one modern contraceptive method. Early marriage was uncommon (5% of girls, 0.8% of boys), but 17.6% of adolescents had already had a romantic relationship. Few adolescents (11.4%) had ever had sex, but among these adolescents,18.4% reported using a condom the last time they had sex. No boys reported current modern contraceptive use, but 28.3% of girls, both married and unmarried, reported current use. These findings demonstrate the importance of making sexual and reproductive health services in humanitarian settings more adolescent-responsive and minimizing barriers to access, including addressing community stigma surrounding adolescents' use of sexual and reproductive health services and increasing trust in the confidentiality of sexual and reproductive health services in the camps.

Exploring the perceptions of health service providers and adolescents on the utilization of adolescent sexual and reproductive health services in Tikur, 2023: A qualitative study.

Globally, twenty-three million adolescents aged 15-19 years have an unmet need for sexual and reproductive health services and are at risk of unintended pregnancy. In Sub-Saharan Africa, including Ethiopia, it might be difficult for adolescents to get access to sexual and reproductive health services that are acceptable to use. Privacy, a fear of sharing health concerns, a sociocultural environment, the unfriendliness of current services, and traditional taboos are some of the key reasons. This study aimed to explore the perspectives of service providers and adolescents on the use of sexual and reproductive health services. A qualitative phenomenological study was conducted from January to February 2023 in the Tikur Anbessa specialized hospital. Purposive sampling was applied to select the study participants. A total of 17 in-depth interviews (with 7 adolescents and 10 health providers) were held. Instead of relying on the number of participants, data saturation was used. Thematic analysis was employed in analyzing the data. The findings indicate that obstacles to the use of sexual and reproductive health services include challenges related to the availability of resources and accessibility; resistance from religious beliefs, cultural beliefs, and customs; quality and institutional-related challenges; and stigma and discrimination in sexual and reproductive health services, which pose the biggest barrier to health professionals providing standardized sexual and reproductive health services. A multi-pronged approach should be created to overcome these challenges, including community outreach for sexual and reproductive health and increasing awareness of the importance of early access to sexual and reproductive health through appropriate community forums. Existing sexual and reproductive health services are not promoted to adolescents and youth, and a lack of and difficulty getting resources for sexual and reproductive health services should be resolved.

Empowerment and intervention strategies to strengthen the use of sexual and reproductive health services by ensuring continuity of care for adolescent girls and internally displaced women in Burkina Faso

Background: In Burkina Faso, a security crisis has displaced families within the country, fleeing high-risk areas. One of the major consequences of this displacement is the low use of sexual and reproductive health care and services, and the reduced empowerment of adolescent girls and internally displaced women (IDP). This research aims to analyze the situation and co-develop intervention strategies to strengthen the empowerment of these adolescent girls and IDP women for the use of these services by ensuring the continuity of this care.
 Methods: This study is based on a mixed approach (quantitative and qualitative). The quantitative component is based on a survey of 1,474 randomly selected households in temporary IDP reception sites in the cities of Kaya and Kongoussi in Burkina Faso. Empowerment was analyzed in terms of motivational autonomy and exercise of choice in family planning. Descriptive analysis and multivariate logistic regression have allowed us to describe the empowerment of IDP women and adolescent girls and identify the determinants of the use of modern contraception among IDP adolescents and women. The qualitative component has enabled to co-construct intervention strategies to strengthen empowerment and also ensure continuity of care, using a participatory approach supported by a deliberative workshop.
 Results: Out of a sample of 1,220, adolescent girls (12-19 years old) and women (20-49 years old) represented respectively 17.5% and 82.5%. The analysis showed that 42.5% of IDP adolescent girls and women were using a modern method of contraception at the time of the survey. The analysis also showed that 89.2% and 79.5% of adolescent girls and IDP women have low levels of motivational autonomy and exercise of choice in family planning, respectively. A poor perception of contraceptives side effects and possible difficulties with the partner or even the fear of having difficulties returning to fertility after contraception ""damage"" women's motivation to use contraception methods. In addition, the ability to discuss with the partner hinders the exercise of choice in contraception. Intervention strategies based on community dialogue and communication with IDPs and community members have emerged as those promoted to facilitate the use and continuity of health services. 
 Recommendations: Empowerment appears as a determining factor to enhance the contraceptive demand by adolescent girls and internally displaced women. Community dialogue and communication sessions on family planning for IDPs and the population must be well implemented.

Adolescent perception of sexual and reproductive health rights and access to reproductive health information and services in Adaklu district of the Volta Region, Ghana

BackgroundOne of the key targets of Ghana’s Adolescent Health Service Policy and Strategy is to ensure that 90% of adolescents and young people have knowledge of sexual and reproductive health services and rights. This phenomenon has led to the establishment of adolescent-friendly health facilities to increase access to health information and services among adolescents. Despite these efforts, access to health information and service utilisation remains low among adolescents. Our study seeks to examine adolescents’ perception of sexual and reproductive health rights (SRHR) and access to reproductive health information and services in the Adaklu district of the Volta region of Ghana.MethodsA baseline cross-sectional household survey of 221 adolescents aged 10–19 years in 30 randomly selected communities was used. A structured questionnaire was developed and administered to the respondents. A binary logistic regression analysis was used to examine the association between adolescents’ perception of adolescent sexual and reproductive health rights (ASRHR) and access to reproductive health information and services.ResultsAdolescents’ perception of SRHR was poor, and this poor perception may have been reflected in a few proportions (10%) of adolescents accessing SRH information and services. Majority (91.9%) of adolescents do not use sexual and reproductive health (SRH) services in the Adaklu district. Adolescents who attained primary education (aOR = 5.99, CI: 1.16–30.95), those who never had sexual communication with their father (aOR = 8.89, CI: 1.99–39.60) and adolescents who never experienced any form of sexual coercion (aOR = 11.73, CI: 1.61–85.68) had a higher likelihood of not utilising SRH services in Adaklu district. Regarding access to SRH information, adolescents who ever discussed sexual matters with their fathers, those who ever used contraceptives and adolescents who ever experienced sexual coercion had lower odds of accessing information on contraception, sexually transmitted infections, and teenage pregnancy.ConclusionsAccess to and use of sexual and reproductive information and health services among adolescents in Adaklu district remain very low, which has implications for adolescents’ knowledge and perception of their SRHR. Considering the factors predicting this phenomenon, it is recommended that interventions can be tailored to address the unique challenges faced by adolescent in accessing comprehensive SRH support.

Exploring Access, Barriers, and Opportunities in Digital Health to Improve Sexual and Reproductive Health amongst Youth in Bamenda, Cameroon, During the Anglophone Crisis: A Qualitative Study

Background There exists several unmet sexual and reproductive health needs in sub-Saharan African countries like Cameroon. Youths in Bamenda, Northwest Region of Cameroon face particular difficulties accessing sexual and reproductive health services fully. This is partly due to the ongoing socio-economic crisis in the region which has disrupted provision of health care services, but also due to other issues that youths must contend with to access sexual and reproductive healthcare. Methods To explore this topic, we conducted a qualitative study. Two focus group discussions were done in Bamenda: One with boys and another with girls aged between 15-24 years old. Questions focused on access and use of sexual and reproductive health services like contraception, pregnancy, menstrual hygiene, sexually transmitted diseases, HIV, and gender-based violence. A thematic data analysis grouped data into themes and sub-themes. Results Twelve youth leaders participated in the focus group discussions: Three boys and nine girls. In this study, we found that several sexual and reproductive health services are available to youths. However, their ability to fully access these services is compromised by certain fundamental barriers like stigma and equally the socio-political crisis. Conclusion There are several barriers to sexual and reproductive services amongst youths in the conflict-affected town of Bamenda. Digital health can significantly bridge the gap to improve access to sexual and reproductive health.

Factors associated with use of community-based, peer-led sexual and reproductive health services by adolescent boys and young men aged 18-24 in Lusaka, Zambia: A case control study nested in the Yathu Yathu trial.

Adolescents and young people (AYP) aged 15-24 years have the least access to facility-based sexual and reproductive health (SRH) services, including HIV services. The Yathu-Yathu cluster-randomized trial (CRT) in Zambia tested whether a novel peer-led community-based approach increased knowledge of HIV status amongst AYP. In this nested case-control study, we aimed to identify factors associated with non-attendance to the Yathu Yathu hubs by adolescent boys and young men (ABYM) aged 18-24-years. Yathu Yathu was a CRT conducted in two communities in Lusaka, Zambia, with 10 intervention and 10 control zones. AYP in all zones were offered prevention points cards (PPC), which incentivized and tracked service use at the hubs and health facility. In intervention zones, services were provided to AYP through community-based spaces (hubs) led by peer support workers. In these zones, cases were defined as those not having accessed any service at a hub and controls as those that accessed at least one service. Data were collected from October 2020 to January 2021 and analysed using methods appropriate for unmatched case-control studies. 161 cases and 160 controls consented to participate in the study. Participants aged 20-24 years (adjOR 1.99, 95%CI 1.26-3.12, p = 0.003), who were educated up to college level (adjOR 8.47,95%CI 2.08-34.53, p = 0.001) or who reported being employed in the last 12 months (adjOR 2.15, 95%CI 1.31-3.53, p = 0.002) were more likely to not attend the hubs. ABYM who had a friend with a PPC were more likely to attend the hubs (adjOR 0.18 95%CI 0.09-0.35, p<0.001). Most cases reported having their last HIV test at the local government health facility (58%) while most controls reported HIV-testing at a Yathu Yathu hub (82%). Among the controls, 84% (134/160) rated the hub experience as excellent. Among cases, 65% (104/161) stated they didn't visit the hubs "due to employment". Despite Yathu Yathu services being community-based and more accessible compared to health facilities, we found age, education and employment were associated with not attending hubs. Strategies are needed to reach employed young men who may not have access to SRH/HIV services during conventional working hours and to better utilise peer networks to increase service use.

Factors impacting HIV testing among young sexually active women migrant workers in Vietnamese industrial zones

BackgroundYoung migrant workers living in low- and middle-income countries often experience barriers and inadequate access to HIV prevention and treatment services. This study examines the prevalence of HIV testing, associated factors, and reasons for obtaining and not obtaining HIV testing among young sexually active women migrant workers in an industrial zone in Hanoi, Vietnam.MethodsA cross-sectional study was conducted among 512 sexually active young women migrant workers (aged 18 to 29) working in the Thang Long industrial zone in Hanoi, Vietnam. Data was collected via a face-to-face interview from January 2020 to June 2021. Multivariable logistic regression analysis was used to explore factors associated with ever-testing for HIV among sexually active participants.ResultsThe study found a low level of HIV testing and high rates of unprotected sex. Among those who reported being sexually active, only 23.7% of participants (n = 126) reported having ever been tested for HIV. Among those who reported never having tested for HIV, 38.2% reported not using condoms during their most recent sexual encounter. Factors associated with engaging in HIV testing included being older (25–29 years), having greater knowledge about HIV, past use of sexual and reproductive health and HIV services, and familiarity with HIV testing locations.ConclusionsOverall, a low level of HIV testing, high rates of unprotected sex, and low perceived risks regarding HIV among the study participants point to a need to implement targeted HIV interventions that can improve both safe sex practices and perceptions of and knowledge about risky sexual behaviors. Such interventions should use insights from this study to address factors facilitating HIV testing among industrial zones’ women migrant workers.

Paternal Communication and Sexual Health Clinic Visits Among Latino and Black Adolescent Males With Resident and Nonresident Fathers

PurposeLatino and Black adolescent males experience sexual health inequities, and their engagement in sexual health services remains low. Parents shape adolescent sexual health behavior and other youth outcomes. However, the role of Latino and Black fathers in promoting male adolescent sexual health is understudied, in part because about one in four fathers resides apart from their children and nonresident fathers are presumed to be less influential. We examined associations of paternal communication with sexual health service use and perceived paternal role modeling among Latino and Black adolescent males with resident and nonresident fathers. MethodsWe recruited 191 Latino and Black adolescent males aged 15–19 years and their fathers in the South Bronx, New York City, using area sampling methods; dyads completed surveys. We estimated bivariate and adjusted associations of paternal communication with adolescent male sexual health service use and perceived paternal role modeling using logistic and linear regressions. Effect measure modification by paternal residence was assessed. ResultsA unit increase on a five-point paternal communication scale was associated with approximately twice and 1.7 times the likelihood of clinical sexual health service use during adolescent males' lifetime and in the past 3 months, respectively; there was no significant effect measure modification by paternal residence. Paternal communication was associated with increased levels of perceived paternal role modeling and usefulness of paternal advice, with stronger associations for nonresident fathers. DiscussionBoth resident and nonresident Latino and Black fathers warrant greater consideration as partners in promoting male adolescent sexual health service use.

Trends in Patient's Use of Sexual Health Services During COVID-19 in a Network of STD Clinics, STD Surveillance Network, 2019 to 2021.

The initial years of the COVID-19 pandemic disrupted sexual health care clinic's services. We describe use patterns by patient characteristics, and the use of telehealth (TH) services among a network of sexually transmitted disease (STD) clinics. Data were collected using a survey to assess the impact of COVID-19 from March to December 2020 among 7 jurisdictions who contribute STD visit-level data as part of the STD Surveillance Network. As a complement to the survey, retrospective data from January 2019 to December 2021 from these 7 STD clinics in the same 7 jurisdictions were examined for monthly utilization trends by overall visits, patient characteristics, and TH visits. Survey results indicated 7 clinics prioritized patients for in-person visits and 4 jurisdictions reported urgent care centers were the most common referral location. In April 2020 (relative to April 2019) clinic visits and unique patients decreased by 68.0% and 75.8%, respectively. Telehealth were documented in 4 clinics, beginning in March 2020, peaking in December 2020, and tapering until December 2021. We observed the number of clinic visits (-12.2%) and unique patients presenting for care (-27.2%) in December 2021 had yet to return to levels to that seen in December 2019. Sexually transmitted disease clinics showed fragility and resiliency in their adjustment to the pandemic; allowing for the continuation of services. Overall patient census has been slow to return to prepandemic levels, and many patients may still not be seeking timely care. This could result in missed opportunities to screen and treat STIs and increasing the possibility of harmful sequelae.

Use of Sexual and Reproductive Health Services Among Women Living in Rural and Urban Oregon: Impact of the Affordable Care Act Medicaid Expansion.

Objectives: We compared the use of sexual and reproductive health (SRH) services for Medicaid-enrolled women of reproductive age (WRA) living in Oregon by urban/rural status and examined the effect of the Affordable Care Act (ACA) Medicaid expansion on the use of SRH services for these women. Methods: We linked Oregon Medicaid enrollment files and claims for the years 2008-2016 to identify 392,111 WRA. Outcome measures included receipt of five key SRH services. The main independent variables were urban/rural status (urban, large rural cities, and small rural towns) and an indicator for the post-Medicaid expansion time period (2014-2016). We performed (conditional) fixed-effects logistic regression and multiple-group interrupted time-series analyses. Results: Women living in small rural towns were less likely than women living in urban areas to receive well-woman visits (odds ratio [OR] = 0.87; 95% confidence interval [95% CI] [0.80-0.94]), sexually transmitted infection (STI) screening (OR = 0.81; 95% CI [0.72-0.90]), and pap tests (OR = 0.91; 95% CI [0.84-0.99]). Women living in large rural cities were less likely than women living in urban areas to receive STI screening (OR = 0.91; 95% CI [0.84-0.98]). Following the implementation of ACA Medicaid expansion, the average number of all five SRH services increased for all women. With the exception of contraceptive services, the average number of SRH services examined increased more for urban women than for women living in small rural towns. Conclusions: Although Medicaid expansion contributed to increased use of SRH services for all WRA, the policy was unsuccessful in reducing disparities in access to SRH services for WRA living in rural areas compared with urban areas.

Sexual and reproductive health rights and the use of reproductive health services among women in Ile-Ife, Nigeria

Background/Aims Reproductive health is an important part of a woman's general health and wellbeing. Being aware of one's sexual and reproductive health rights enables women to make informed decisions about and improve their sexual and reproductive health. This study assessed women's awareness of sexual and reproductive health rights and the use of sexual and reproductive health services in Ile-Ife, Nigeria. Methods A descriptive cross-sectional design was used for this study. Stratified random sampling was used to select 341 women of reproductive age in Ile-Ife. Data were collected with a structured questionnaire and analysed using descriptive and inferential statistics, with P&lt;0.05 indicating significance. Results The majority (89.7%) of respondents had high awareness of sexual and reproductive health rights but reported poor use of sexual and reproductive health services (58.7%). The participants' age, marital status, occupation and distance to sexual and reproductive health facilities significantly influenced the uptake of sexual and reproductive health services. Conclusions Women in Ile-Ife were aware of their sexual and reproductive health rights but did not use sexual and reproductive health services. There is a need for health education to improve women's self-efficacy to use these services.

Perceived facilitators and barriers to the provision of sexual and reproductive health services in response to the Syrian refugee crisis in Lebanon.

The Syrian crisis has resulted in one of the worst humanitarian disasters in modern history. Inadequate access to and use of sexual and reproductive health services is a prevailing issue among adolescent girls and young refugee women in humanitarian settings. This article aimed to explore and describe the perceived extent of implementation of the different objectives and activities outlined within the minimum initial service package for reproductive health in crisis services in Lebanon, from the perspectives of a diverse set of stakeholders from leading organizations (public, private, primary health centers, nongovernmental organizations) that were directly engaged with the Syrian refugee crisis response. This study is a cross-sectional survey conducted using a standardized and validated questionnaire. Centers that provided sexual and reproductive health services to Syrian refugees in Lebanon were mapped. The study was based on a purposive sampling approach, retrieving 52 eligible organizations to cover most areas in the country. A total of 43 centers accepted to take part in the study. The head of the center was then asked to identify one person in their center who holds adequate knowledge of the explained objectives of the survey. Accordingly, the identified person was asked to fill out the survey. A considerable portion of the respondents had limited knowledge about the specific minimum initial service package objectives and related sexual and reproductive health services. The study found the presence of a leading reproductive health agency, the Lebanese MoPH, as an essential facilitating factor for sexual and reproductive health service provision in Lebanon and has helped in overseeing the overall sexual and reproductive health coordination response for Syrian refugees (76.74% of all respondents). The identified challenges impeding adequate sexual and reproductive health services provision for Syrian refugees included (1) insufficient supplies (46.51%); (2) insufficient funds (39.53%); and (3) shortage of staff (39.53%). The recommendations for improved sexual and reproductive health service provision include the need for (1) enforcing the lead minimum initial service package agency for adequate and effective coordination, reporting, and accountability and (2) increasing funding for training staff and healthcare workers, as well as improving the overall quality of services available with the inclusion of family planning services, purchasing the necessary commodities, supplies and equipment, and covering fees associated with the different sexual and reproductive health services.

Women Empowerment and Demand for Sexual and Reproductive Health Services

We analyze the effect of women's empowerment on their demand for reproductive and sexual health services. In particular, we explore their use of modern contraceptive methods, if the women have had an HIV screening and if they have made a health consultation after experiencing symptoms of sexually transmitted infections. We calculate four women empowerment indexes, proxies to the economic dimension of empowerment, the freedom of movement to visit family or friends, the respect of their couple to their opinions, wishes and rights, and the ability of women to decide about their health. We found that freedom of movement for women at a medium level increases the probability of using modern contraceptive methods as well as screening for HIV/AIDS and that the couple's respect for the views and rights of women positively influences the use of modern contraceptive methods. However, women´s autonomy to make decisions regarding their health is the empowerment indicator with the most robust results on the use of sexual and reproductive health services, increasing the probability of using modern contraceptive methods and consulting for STI symptoms.

Factors associated with access to sexual and reproductive health services among women with disabilities in Nepal.

The aim of the study is to investigate the relationships between social determinants and disability status and access and use of sexual and reproductive health services among women with disabilities in Nepal. This study used data on women with disability from the Multiple Indicator Cluster Survey (MICS) of 2019, in which 13,320 women and 290 women with disabilities were included for the analysis. We used bivariate analysis to compare the social determinants with disability status and multivariate logistic regression to determine the association between social determinants and access and use of sexual and reproductive health services among women with disabilities. The findings showed, in comparison with non-disabled women, women with disabilities had low education, low economic status, low media exposure and low access to sexual and reproductive health. On provincial level, those from Madesh [AOR = 0.22 (95%CI:0.06, 0.76)] and Lumbini [AOR = 0.24 (95%CI:0.06,0.88)] had lower attitude to violence. The usage of family planning (FP) methods among women with disabilities in Karnali [AOR = 3.57 (95% CI: 1.42-13.22)] and Sudurpashchim [AOR = 1.05 (95% CI: 1.01-1.071)] was higher than those in Province 1. Women with disabilities with secondary education were more than nine times [AOR = 9.28(95%CI:2.67,32,26)] and primary education had more than three times [AOR = 3.59 (95%CI:1.07, 12.02)] of knowledge on HIV/AIDS compared to those of no education. The odds of being tested for HIV/AIDS among women with disabilities with secondary education was more than eight times [AOR = 8.8 (95% CI:2.23-34.6)] than those of no education. This study provides noteworthy findings that women with disabilities have poor socioeconomic status, high-risk behavior, and low access to sexual and reproductive health services in Nepal. This study highlights the significance of actions needed to address sexual and reproductive health services in Nepal that unfairly impact women with disabilities.

Sexual health behavior, health status, and knowledge among queer womxn and trans men in Kenya: An online cross-sectional study.

Little research has been conducted on the sexual health needs and risk behaviors of queer womxn and trans men, making it difficult to identify specific health needs and disparities. This is especially the case in the Global South, where their needs are poorly understood. This study presents findings on demographics, sources of information, sexual (risk) behaviors, and substance use in Kenyan queer womxn and trans men. An online survey among 335 Kenyan queer womxn and trans men was used to collect data on sexual health, risk behavior, health information sources, and substance use. The participants needed to have had at least one self-identified female sexual partner. The sample presented young, highly-educated queer womxn and trans men. A high incidence of childhood sexual trauma found was found. Risk behaviors included sexual activities with partners of multiple genders, violence, and low use of barrier methods. One in three participants had been treated for an STD in the previous year. The incidences of smoking and drinking were high, and a quarter of participants indicated having taken drugs at least once a month or more. The internet was either the first or second most important source of sexual health information for 44.1% of the participants, followed by schools (30.9%). Our findings indicate that queer womxn and trans men are at risk of negative sexual health outcomes due to a lack of appropriate information, risk behavior, substance use, and low uptake of sexual health services. Kenya's Penal Code still criminalizes consensual same-sex activities and may play a role in perpetuating barriers that prohibit them from making healthier choices. Developing tailored programming and policies require local, national, and global stakeholders to engage with the inclusion of queer womxn and trans men's sexual health needs within strategic planning and healthcare delivery.

Adolescents' knowledge and use of sexual and reproductive health services in the Federal Capital Territory, Nigeria.

Contraceptive knowledge is vital to promoting youth health. It has been proven to lower the high rates of unwanted pregnancies, and STIs including HIV/AIDS. The aim of the study was to examine the level of contraceptive knowledge and use among youths in Federal Capital Territory (Abuja) Nigeria. The study adopted an explanatory sequential mixed-method research design. A total of 500 young people between the ages of 15 and 25 were interviewed. The majority of the youth (58.2%) were sexually active, with sexual debut starting within age 15-19. The prevalence of contraceptive knowledge was very high (78.8%), while (34.6%) were not using any type of contraceptives, even among the educated youth notwithstanding their level of education. It was concluded that there is a wide disparity between contraceptive knowledge and use which need to be bridged. There is a need to review policies regarding sexual and reproductive health, as well as sexuality education among youth in Nigeria.

Factors Influencing Sexual Health Service Use by South Asian Immigrant Men Living in Ontario, Canada: A Qualitative Study

Introduction: South Asian communities comprise one of the fastest-growing populations in Canada, but there is a paucity of research on if and how immigrant men use sexual health services. Objectives: Our study aimed to understand factors influencing sexual health service use by South Asian immigrant men living in Ontario, Canada. Methods: An interpretive description (ID) research methodology was used, followed by Braun and Clarke’s thematic guidelines to collect and analyze data. Altogether, 18 semi-structured interviews were conducted between May and July 2021 with South Asian immigrant men between 20 and 45 years of age in Ontario. Results: We found that culture shaped the overall perception and use of sexual health services, while the perceived severity of sexual illness also affected the utilization of preventative care. Moreover, there are taboos about sexual health, and while sex positivity and sex negativity exist, sexual health information is shared with trusted sources. We also found South Asian men shared sexual health more openly by following a lifestyle that normalizes sexual health discussions rather than South Asian cultural norms. Conclusions: This study provides a comprehensive understanding of the individual, structural and cultural determinants of health influencing sexual health service use to strengthen existing health communication strategies to improve service utilization for diverse communities in Canada.