Partners Of Women Research Articles

Multilevel logistic regression analysis of factors associated with delivery care service utilization among childbearing women in Ethiopia.

Delivery service utilization is one of the key and proven interventions to reduce maternal death during childbearing. In Ethiopia, the utilization of health facilities for delivery service is still at a lower level. This study intends to model the determinant factors for the delivery care service utilization of childbearing mothers in Ethiopia using the 2016 Ethiopian demographic and health survey data. A cross-sectional study design was selected to assess factors associated with delivery care among mothers who had at least one child in the last 5 years before the survey aged 15-49 years in the data. Among these eligible mothers, 3,052 (27.7%) mothers had received delivery service care from health professionals. The results of multilevel logistic regression indicated that those at age 35-49 years (AOR = 0.7808, 95% CI: 0.5965-1.1132), an urban place of residence (AOR = 5.849 95% CI: 4.2755-8.0021), woman's higher level of education (AOR = 3.484, 95% CI: 2.0214-6.0038) and partner's higher educational level (AOR = 1.9335, 95% CI: 3,808-2.07352), household wealth index (AOR = 1.99, 95% CI: 1.724-2.3122), most every day exposed to mass media (AOR = 3.068, 95% CI: 1.456-6.4624), 2-4 birth order number (AOR = 0.604, 95% CI: 0.51845-1.4213), using contraceptive type (AOR = 1.4584, 95% CI: 1.2591-1.6249) and visiting more than 4 antenatal care visits (AOR = 7.574, 95% CI: 6.4824-8.84896) were more likely to give birth at a health facility compared to their counterparts. The woman's and partner's educational level, household wealth index, exposure to mass media and number of antenatal care visits had a positive association with delivery assistance whereas birth order had a negative association. The findings of this study were valuable implications to support strategies and interventions to address delivery care service in Ethiopia.

Risk factors for intimate partner violence victimization across 8 years: Contributions of the posttraumatic stress symptom domains.

Although much remains unknown about what creates risk for women's intimate partner violence (IPV) victimization across time, trauma exposure and mental health are likely contributors. Specifically, posttraumatic stress (PTS) is a risk factor for IPV victimization, yet we know less about the unique contributions of PTS symptom domains to IPV risk. Identification of PTS symptom domains that confer risk for IPV has the potential to inform novel targets of intervention. This study follows women with children (N = 118) across 8 years to identify the trauma exposure, mental health, and sociodemographic factors that contribute to IPV victimization risk using longitudinal multilevel modeling. Higher levels of PTS symptoms were associated with initially greater number of IPV victimization acts experienced (i.e., "IPV victimization"). However, across time, women with higher PTS symptoms decreased more quickly in IPV victimization than those with lower PTS symptoms. Higher levels of PTS arousal and reexperiencing were each associated with initially higher levels of IPV victimization. In addition, higher levels of PTS reexperiencing and arousal remained associated with higher levels of IPV victimization across time. Women's age was inversely related to IPV victimization over time only when accounting for the PTS symptom domains. Findings are that collapsing PTS symptoms into an overall construct may be too imprecise to identify key mechanisms for IPV victimization risk. IPV prevention should prioritize addressing reexperiencing and arousal symptoms to curb future IPV victimization. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Impact of female stress urinary incontinence and related treatments on the sexual function of male partners: a systematic review and meta-analysis.

No conclusions have been reached on whether female stress urinary incontinence (SUI) and related treatments affect male partners' sexual function. To assess the effects of female SUI and related treatments on male partners' sexual function. A comprehensive search of the PubMed, Embase, Web of Science, Cochrane, and Scopus databases was performed up to September 6, 2022. Studies were included that investigated the effect of female SUI and related treatments on male partners' sexual function. Male partners' sexual function. Of the 2294 citations identified, 18 studies with 1350 participants were included. Two studies assessed the effect of female SUI without treatment on male partners' sexual function, finding that partners had more erectile dysfunction, more sexual dissatisfaction, and less sexual frequency than partners of women without urinary incontinence. Seven studies directly assessed the effect of female SUI treatments on male partners' sexual function by surveying the male partners. Among these, 4 assessed transobturator suburethral tape (TOT) surgery; 1 assessed TOT and tension-free vaginal tape obturator surgery; and the remaining 2 assessed pulsed magnetic stimulation and laser treatment. Among the 4 TOT studies, 3 used the International Index of Erectile Function (IIEF). TOT surgery significantly improved the total IIEF score (mean difference [MD] = 9.74, P< .00001), along with erectile function (MD = 1.49, P< .00001), orgasmic function (MD = 0.35, P= .001), sexual desire (MD = 2.08, P< .00001), intercourse satisfaction (MD = 2.36, P< .00001), and overall satisfaction (MD = 3.46, P< .00001). However, the improvements in IIEF items may be of unclear clinical significance, as 4 points in the erectile function domain of the IIEF are typically defined as the minimal clinically important difference. In addition, 9 studies indirectly assessed the effect of female SUI surgery on male partners' sexual function by surveying patients with the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire. The results demonstrated no significant differences in erectile function (MD = 0.08, P= .40) or premature ejaculation (MD = 0.07, P= .54). The effects of female SUI and related treatments on male partners' sexual function were summarized for the first time, providing a reference for future clinical practice and scientific research. A limited number of studies that used various scales met the standardized eligibility criteria. Female SUI may affect male partners' sexual function, and female patients' anti-incontinence surgery does not appear to have a clinically significant improvement on the sexual function of their partners.

Career development: A balance of opportunities and choices.

Career development: A balance of opportunities and choices.

Couvade Syndrome among partners of women with physiological and complicated pregnancy

Abstract Aim. To assess the prevalence of couvade syndrome and analyze the factors determining the occurrence of this syndrome in the partners of pregnant women. Material and method. The research material was collected by a diagnostic survey, using an author’s survey questionnaire. Results. Couvade Syndrome occurs in 94.3% of partners of women with complicated pregnancies. Among the most common somatic symptoms there are: back pain (56.2%), headaches (53.3%), appetite changes (48.6%), indigestion (34.3%) and abdominal pain of unknown origin (31.4%), while mental ones include: sleep disturbances (37.1%), irritability (34.3%), tension (32.4%), regardless of the course of partner’s pregnancy. Men, who were married, were more likely to have Couvade symptoms than those in an informal relationship, regardless of the course of partner’s pregnancy (p=0.02). Respondents without Couvade Syndrome were more likely to have low levels of involvement in their partner’s current pregnancy than those with symptoms, regardless of the course of this pregnancy (p=0.03). Men with symptoms of the syndrome were more likely to be less involved in their responsibilities at work than those without symptoms, regardless of the course of partner’s pregnancy (p=0.0006). Conclusions. The majority (94.3%) of partners of women with complicated pregnancies have a Couvade Syndrome. The most common somatic symptoms include back pain, headaches, appetite changes, indigestion and abdominal pain of unknown origin, while the mental ones: sleep disturbances, irritability, tension, anxiety and nervousness. Married men are more likely to have Couvade Syndrome than those in an informal relationship. Low levels of involvement in the current pregnancy are shown by men who do not have the syndrome. Men, who have the Couvade Syndrome, are less involved in their work responsibilities.

What do women need to know about long-acting reversible contraception? Perspectives of women from culturally and linguistically diverse backgrounds.

To identify components of an online education intervention to improve preference for, and uptake of, long-acting reversible contraception in women from culturally and linguistically diverse backgrounds (CALD). Women from culturally and linguistically diverse (CALD) backgrounds have greater rates of unintended pregnancies than those born locally and are less likely to use long-acting reversible contraceptives (LARCs), which are highly effective at reducing unintended pregnancy. Increasing the uptake of LARC in women from CALD backgrounds may reduce the burden of unintended pregnancy in this high-risk group. An online education intervention has been shown to be effective at increasing preference for and uptake of LARC in young women. We aimed to describe what women from CALD backgrounds thought were the potentially effective components of an online education intervention to increase preference for, and uptake of, long-acting reversible contraception. This qualitative study involved semi-structured interviews with six Australian English-speaking women from each of Chinese, Indian, and Middle Eastern cultural backgrounds. Women were recruited through targeted Facebook advertising. Data were analysed using Braun and Clarke thematic analysis. A total of 18 participants were interviewed. We have demonstrated the importance of messages tailored to cultural values, translating the video, widening the target audience to both men and women and using specific social media platforms. For all women, the video needs to highlight the covertness of contraceptive methods, alongside stating cost and approach to access. For Indian women, the video needs to highlight the effect of LARC methods on the menstrual period for Indian women and include basic information on women's health. For Middle Eastern women the video should be explicit about LARC not equating to abortion and emphasise the low efficacy of natural contraceptive methods. For Chinese women, the video should address the misconception that hormones damage the body. Regarding delivery of the video, it should be translated and delivered by a female doctor from the same culture. For Chinese women, the video should include women from the same culture sharing anecdotes and use WeChat and Chinese schools as a platform for dissemination. For Middle Eastern and Indian women government websites should be used for dissemination. The video should be made available to all decision-makers in the reproductive planning process including male partners of Middle Eastern women, parents and peers of Chinese women, and for Indian women the male partner, family, and community leaders. There is a wide range of cultural adaptations that can be made to the online education videos about LARCs to improve uptake of LARCs and hence reduce the burden of unintended pregnancy in women from CALD grounds. SO WHAT?: Our findings will be used to modify an online education video about LARCs so that it is culturally appropriate for women from CALD backgrounds.

Maternal and newborn healthcare utilization in Kampala urban slums: perspectives of women, their spouses, and healthcare providers

BackgroundIt is assumed that the health conditions of urban women are superior to their rural counterparts. However, evidence from Asia and Africa, show that poor urban women and their families have worse access to antenatal care and facility childbirth compared to the rural women. The maternal, newborn, and child mortality rates as high as or higher than those in rural areas. In Uganda, maternal and newborn health data reflect similar trend. The aim of the study was to understand factors that influence use of maternal and newborn healthcare in two urban slums of Kampala, Uganda.MethodsA qualitative study was conducted in urban slums of Kampala, Uganda and conducted 60 in-depth interviews with women who had given birth in the 12 months prior to data collection and traditional birth attendants, 23 key informant interviews with healthcare providers, coordinator of emergency ambulances/emergency medical technicians and the Kampala Capital City Authority health team, and 15 focus group discussions with partners of women who gave birth 12 months prior to data collection and community leaders. Data were thematically coded and analyzed using NVivo version 10 software.ResultsThe main determinants that influenced access to and use of maternal and newborn health care in the slum communities included knowledge about when to seek care, decision-making power, financial ability, prior experience with the healthcare system, and the quality of care provided. Private facilities were perceived to be of higher quality, however women primarily sought care at public health facilities due to financial constraints. Reports of disrespectful treatment, neglect, and financial bribes by providers were common and linked to negative childbirth experiences. The lack of adequate infrastructure and basic medical equipment and medicine impacted patient experiences and provider ability to deliver quality care.ConclusionsDespite availability of healthcare, urban women and their families are burdened by the financial costs of health care. Disrespectful and abusive treatment at hands of healthcare providers is common translating to negative healthcare experiences for women. There is a need to invest in quality of care through financial assistance programs, infrastructure improvements, and higher standards of provider accountability are needed.

Role of male partners in birth preparedness and complication readiness: A qualitative study.

Background In familial and societal matters, men are the decision-makers and economic resource providers in many patriarchal societies. It is important to assess the involvement of men in birth preparedness and complication readiness (BPCR), as men act as gatekeepers to women's health. We examined the role, motivators and barriers for participation of male partners of pregnant women in BPCR. Methods This qualitative study was based on the grounded theory approach. Data were collected through 29 in-depth interviews conducted among husbands (n=8), mothers (n=8), mothers-in-law (n=8), health professionals (n=5) and focus group discussions (FGDs) with pregnant women (FGD, n=3). Interviews and FGDs were transcribed; themes and sub-themes were generated and conclusions were drawn by triangulation of the data. Results Men were found to have a major role in BPCR. They supported their pregnant wives by maintaining their health, providing financial support and helping them in the decision-making process regarding treatment. They also provided complication readiness support by arranging transportation and facilitating the process of hospital admission. Conclusions Our study emphasizes how changes have occurred in the attitudes and practices over generations regarding men's role in BPCR and their participation during delivery. However, there is a long way to go for which transference of knowledge and cultural transformation have become necessities.

Male Clinical Parameters (Age, Stature, Weight, Body Mass Index, Smoking History, Alcohol Consumption) Bear Minimal Relationship to the Level of Sperm DNA Fragmentation.

This retrospective cohort study reports on 1291 males who were the partners of women presenting with infertility requiring assisted reproduction and who had sperm DNA fragmentation (SDF) levels measured by the Halosperm test. These men provided clinical and biometric details which included their age, stature, weight, and body mass index (BMI). Of these men, 562 (43.5%) provided detailed historical records of their smoking and alcohol histories. The aim of this study was to determine whether any clinical and biometric parameters, or main lifestyle factors, had any influence on SDF. We found that the only clinical parameter with a direct correlation was that of advancing age (r = 0.064, p = 0.02), but none of the biometric parameters of stature, weight, or BMI showed any significant correlation. In respect to lifestyle, there were significant correlations with smoking history, but not in the way we expected. Our data showed significantly elevated SDF levels among non-smokers (p = 0.03) compared with smokers. We also found that, among the non-smokers, ex-smokers had higher SDF levels (p = 0.03). With respect to alcohol, consumers did not show any significant differences in SDF levels. These lifestyle findings did not show any significant relevance with respect to an SDF level of <15% or ≥15%. Furthermore, logistic regression analysis excluded age as a confounder in these lifestyle findings. It is therefore concluded that, apart from age, both clinical and lifestyle aspects have minimal relevance to SDF.

The association between women's disability and acceptance towards intimate partner violence among women and their male partners: A multi-country analysis.

To examine whether disabled women are more likely to report accepting attitudes towards intimate partner violence (IPV) than non-disabled women, and whether male partners of disabled women are more likely to accept IPV than male partners of non-disabled women. Secondary analysis of nationally representative cross-sectional data from the Demographic Health Survey (DHS) in nine countries. Logistic regression examined the relationship between (1) women's disability and IPV acceptance (n = 114 695) and (2) women's disability and their male partners' IPV acceptance (n = 20 566); pooled and country-specific estimates were calculated. IPV acceptance ranged from 5% to 80% among women and from 5% to 56% among male partners. Overall, disabled women were more accepting of IPV than non-disabled women (pooled adjusted odds ratio [aOR] 1.14, 95% confidence interval [CI] 1.08-1.20), with country-specific aOR ranging from 1.05 to 1.63. Overall, disabled women's male partners had higher likelihood of IPV acceptance than non-disabled women's partners (pooled aOR 1.13, 95% CI 1.00-1.28).; country-specific estimates varied (aOR range from 0.56 to 1.40). Disabled women and their male partners had higher IPV acceptance compared with non-disabled women and their male partners. More research is needed to better understand this association, including disability-associated discrimination. Findings underscore the importance of more research with disabled women and their partners to address IPV.

Serum Levels of Vitamin D in Male Partners of Women with Infertility in a Tertiary Hospital in Nigeria

Globally infertility affects 8-12% of couples, with male and female causes contributing equally. Micronutrient's deficiency such as vitamin D has been implicated as a cause of infertility in animal studies, there is therefore the need to evaluate its role in humans. This study determined serum levels of vitamin D in males who were partners of patients presenting with infertility.&#x0D; This was a prospective cross- sectional study involving 170 consenting male partners of women presenting with infertility at the University College Hospital (UCH), Ibadan. A structured questionnaire was administered while blood sample and semen were collected for serum vitamin D assay and seminal fluid analysis (SFA) analysis. The data was entered into the Statistical Package for Social Sciences version 21 and statistical significance was set at less than 5%.&#x0D; Eighty-four (49.4%) participants had at least one abnormal parameter on SFA. The mean vitamin D level was higher in participants with normal SFA (34.4+12.6ng/ml) compared with abnormal SFA (32.8 + 15ng/ml). None of the participants had vitamin D deficiency, however the prevalence of vitamin D insufficiency among participants with abnormal and normal SFA was 62.5 % and 37.5% and this was statistically significant. (p = 0.01). Sperm progressive motility was the only SFA parameter associated with serum Vitamin D levels. (p-value = 0.03).&#x0D; This study showed that vitamin D insufficiency is associated with male infertility, therefore it may be added as an investigation for men with infertility and Vitamin D supplement be given where insufficiency or deficiency are noted.

‘Joy, not sorrow’: Men's perspectives on gender, violence, and cash transfers targeted to women in northern Ghana

Evidence indicates that cash transfers can decrease intimate partner violence (IPV) against women, although most research has focused on women's perspectives and experiences, with less attention to men. We analyzed data from four focus group discussions with male partners of women who participated in the Ghana Livelihood Empowerment Against Poverty (LEAP) 1000 cash transfer program. We elicited men's perceptions of poverty, relationship dynamics, IPV and cash transfers targeted to their wives using thematic analysis. Men largely viewed the effects of the cash transfer as positive – they felt decreased provider role strain when women used the cash to cover household expenses such as food and school fees. Men also indicated that they felt respected when women used the cash to cover sudden expenses, such as funeral costs, thus preventing the need to borrow from community members and exposing their inability to fulfill provider roles. These feelings of relief and respect helped improve men's overall wellbeing, their marital relationships and reduced the potential for IPV. Despite these positive results, men revealed that they still expected to be informed and consulted about the transfer and its expenditure, and felt disrespected when women did not do so, thus heightening the potential for household conflict. Further research and innovation in programming is needed to integrate gender transformative strategies into cash transfer programs, explicitly aimed at changing gender norms to enhance and sustain beneficial impacts on gender relations and IPV.

The experience of being a partner to a childbearing woman whose pregnancy is complicated by pre-eclampsia: A Swedish qualitative study

BackgroundPre-eclampsia affects 3–5% of all pregnant women and is among the leading causes of maternal morbidity and mortality as well as iatrogenic preterm birth worldwide. Little is known about the experience of partners of women whose pregnancy is complicated by pre-eclampsia. AimTo describe partners’ experience of having a spouse whose pregnancy was complicated by pre-eclampsia. MethodsA qualitative study with in-depth interviews. Eight partners of women whose pregnancy was complicated by pre-eclampsia were interviewed and data were analysed using content analysis. FindingsPartners found themselves in an unfamiliar and unexpected situation. They experienced an information gap in which they tried to make sense of the situation by interpreting subtle signs. The situation left them feeling emotionally stretched, feeling like an outsider while trying to provide support for their extended family. The partners experienced a split focus after the baby was born, prioritising the baby while worrying about their spouse. Post-partum, they expressed needing time to process and heal after childbirth. A need for professional support was highlighted and concerns about a future pregnancy were voiced. ConclusionHaving a spouse who is diagnosed with pre-eclampsia is challenging and overwhelming. Our findings imply a need to develop a model of care for women with pre-eclampsia that includes their partner, i.e., the other parent.

Does seminal fluid bacterial isolate(s) affect in vitro fertilization — embryo transfer outcome?

BackgroundThe chance of achieving a successful pregnancy through in vitro fertilization and embryo transfer (IVF-ET) is limited despite recent scientific advances in this field due to several factors that are known to affect the outcome. There are studies linking the presence of bacteria in the male genital tract to poor semen parameters and IVF-ET outcomes. Results are, however, contradictory. The finding of confirmed genital tract infection warrants treatment, especially when dealing with infertile couples, but treating asymptomatic bacteriospermia is controversial. This study assessed the prevalence and effects of seminal fluid bacterial isolates on semen quality and rates of fertilization and biochemical and clinical pregnancies in IVF-ET.MethodologyThis is an analytical cross-sectional study conducted at the IVF Center of National Hospital Abuja, Nigeria. Due to the low turnout of clients, we enrolled all consecutive consenting eligible male partners of women undergoing the procedure during the study period to obtain a sample size of 242. Participants observed sterile techniques to prevent contamination of the seminal fluid during collection. Growth of bacteria > 10,000 colony-forming units (CFU)/ml was considered significant and tested for sensitivity to a panel of antibiotics. We determined the influence of positive bacterial isolates on fertilization, biochemical pregnancy, clinical pregnancy (primary outcome), and multiple pregnancies. Data were analyzed using SPSS version 22. Student’s t-test, chi-square test, and Fisher’s exact tests were employed as appropriate. p-value < 0.05 at a 95% confidence interval was regarded as statistically significant.ResultsSeminal fluid culture was positive in 57 patients (47.11%). Staphylococcus aureus was the predominant organism cultured (43.90%), followed by Streptococci spp. (21.05%), Escherichia coli (17.54%), Klebsiella spp. (8.77%), Pseudomonas aeruginosa (5.26%), Staphylococcus saprophyticus (1.75%), mixed Staphylococcus aureus, and Streptococcus spp. organisms (1.75%). The fertilization rate was 95.4%, the biochemical pregnancy rate was 42.2%, the clinical pregnancy rate was 38%, and the multiple pregnancy rate was 16.53%. Significant factors found to be associated with positive clinical pregnancy were primary infertility (p-value = 0.001) and negative seminal fluid culture result (p-value = 0.033).ConclusionThe prevalence of bacteriospermia was relatively high, and the presence of bacterial isolates adversely affected fertilization and clinical pregnancy rates among couples undergoing the IVF-ET program.

A mixed-methods survey of perinatal mental health for Sri Lankan women in the UK

Background/Aims The prevalence of perinatal mental health issues is significantly higher among South Asian women in the UK. However, little attention has been given to examine the views and opinions of sub-groups of South Asians in the UK. Although the prevalence of perinatal mental health issues is much higher in Sri Lanka, so far, no studies have focused on Sri Lankan women in the UK. This study's aim was to examine the views and opinions of Sri Lankan women living in the UK about perinatal mental health. Methods A convergent mixed-method online survey was administered in English and Sinhalese. A total of 34 Sri Lankan women living in the UK, from their baby's conception to 24 months postpartum, were recruited. Qualitative responses were interpreted using thematic analysis, supported by quantitative data. Results The participants reported that they maintained good perinatal mental health with the support of their partner and family. Midwives were most involved in inquiring about and providing information on perinatal mental health. Social stigma was a dominant barrier to accessing support. Conclusions Midwives need to ensure that perinatal mental health is discussed sensitively with Sri Lankan women. Future quantitative research needs to examine if existing tools are culturally sensitive and qualitative research should include women's partners and families to explore how best to care for this population.

Males' perceptions and practices towards maternity care in rural southeast Nigeria: Policy implication of participatory action research for safe motherhood.

High maternal death is attributable to developing countries' health systems and sociocultural factors This study assessed the effect of participatory-action research on males' perception and practice towards maternity care and safe motherhood in rural southeast Nigeria. A pre-post-intervention study design was employed to study 396 male partners of pregnant women selected through cluster sampling in rural communities in southeast Nigeria. Males' perceptions and practices towards maternity care and safe motherhood were assessed using an interviewer-administered five-point Likert scale questionnaire. A community-participatory intervention was implemented comprising advocacy, and training of community volunteers, who then educated male partners of pregnant women on safe motherhood and facilitated emergency saving and transport schemes. A post-intervention assessment was conducted six months later, using the same questionnaire. Good perception and good practices were determined by mean scores >3.0. Continuous variables were summarised using mean and standard deviation, and categorical variables using frequencies and proportions. A comparison of the mean scores pre- and post-intervention mean scores were compared, and the mean difference was determined using paired T-test. Statistical significance was set at a p-value <0.05. The perception that male partners should accompany pregnant women for antenatal care had the least mean score at the pre-intervention stage, 1.92 (0.83). However, the mean score increased for most variables after the intervention (p<0.05). The mean score for maternity care practices increased post-intervention for accompanying pregnant women to antenatal care, facility delivery, and helping with household chores (p<0.001), with a composite mean difference of 0.36 (p<0.001). Birth preparedness/complication readiness practices-saving money, identifying transport, skilled providers, health facilities, blood donors and preparing birth kits, were good, with a composite mean score that increased from 3.68(0.99) at pre-intervention to 4.47(0.82) at post-intervention (p<0.001). Males' perceptions and practices towards safe motherhood improved after the intervention. This highlights that a community-participatory strategy can enhance males' involvement in maternal health and should be explored. Male partners accompanying pregnant women to clinics should be advocated for inclusion in maternal health policy. Government should integrate community health influencers/promoters into the healthcare systems to help in the provision of health services.

Work experience and development of interaction between specialists of medical organizations in conducting dynamic monitoring of pregnant women in contact with HIV-infected sexual partners in the Saratov region

BACKGROUND: In HIV-discordant couples, questions often arise about the possibility of having a child. Under current conditions, with the availability of antiretroviral therapy, such couples can have healthy children, subject to specific requirements. No approved algorithm exists for examining and monitoring of pregnant women in contact with HIV infection.&#x0D; AIM: This study uses a team approach that comprises specialists from medical organizations to monitor discordant couples in which the man is HIV positive, and the woman is HIV negative at any stage of pregnancy.&#x0D; MATERIALS AND METHODS: A retrospective study was conducted from 2018 to 2021 from medical records of 158 discordant couples in which the man is HIV positive and the woman is HIV negative. The detection results of HIV infection were evaluated by detecting HIV antibodies, HIV DNA/RNA in healthy pregnant women and CD4 lymphocytes, and HIV RNA in HIV-infected sexual partners. Safety measures were observed for medical personnel and the patient during medical interventions.&#x0D; RESULTS: Discordant couples under observation were divided into 2 groups and totaled 158 couples. They included 69 (43.3%) couples who were observed at the Center for AIDS and were planning a pregnancy and 89 couples (52.9%) who first applied to the medical organization about a pregnancy that had already occurred. In the first group, sexual partners were on antiretroviral treatment until the wife became pregnant, and the viral load was undetectable. In 100% of cases, there was no HIV transmission to a woman in this group during pregnancy. In the second group, 52 (58.4%) HIV-infected sexual partners and 37 (42.5%) couples not receiving antiretroviral therapy received antiretroviral therapy. In the second group of discordant couples, HIV transmission was 1.1% (1 woman).&#x0D; CONCLUSIONS: It is necessary to develop, approve, and implement an algorithm that includes monitoring discordant couples from the moment they are registered, examining the sexual partners of pregnant women in 100% of cases, and developing a team approach to monitor pregnant women.

Using social marketing strategies to develop and pretest PrEP education materials for transgender women

PurposeThe purpose of this study was to develop pre-exposure prophylaxis (PrEP) education materials that directly address the needs of trans women. PrEP medication is an effective HIV prevention strategy, but some groups at high risk of HIV, such as transgender (trans) women, have suboptimal uptake and adherence. Most PrEP marketing has been aimed fat men who have sex with men (MSM) and include trans women as part of that audience, but this strategy ignores important differences in perceptions of and barriers to PrEP.Design/methodology/approachThis study used a social marketing approach grounded in exchange theory to systematically develop and pretest PrEP messaging and communication materials for trans women through qualitative (focus groups: n = 5, 34 participants) and quantitative (surveys: n = 128) methods in Philadelphia and the San Francisco Bay area. Segmentation analysis, perceptual mapping and vector message modeling techniques were used to create three-dimensional visualizations of PrEP perceptions to identify highly targeted messaging. Working with trans artists, the authors developed prototype materials using the targeted messaging and pretested these (n = 11) in both locations for feedback on content, look and insight on appropriate intervention strategies.FindingsUsing segmentation and perceptual mapping, this study identified key PrEP messaging across different subgroups, including by demographic and psychographic variables. Differences by group were determined to not be significant and overall messages that would resonate with all groups were built into the materials. Pretesting sessions indicated high acceptability of the messaging and trans women-centered approach to increase PrEP uptake.Originality/valueTo the best of the authors’ knowledge, this is the first study to use a social marketing framework to create targeted PrEP communication materials for trans women in partnership with trans women.

Beyond the Glass Ceiling: Panes of Equity Partnership

This Article, prepared for a “micro-symposium” on Professor Kerri Stone’s monograph Panes of the Glass Ceiling (2022), explores the partnership pay gap in large law firms and the role of high-profile litigation in facilitating pay equity. There is a rich literature and extensive data on the gender attainment gap in elite law firms, particularly with regard to women’s attrition from practice and poor representation within the partnership ranks. Less attention has been paid to the way in which the exceptional women who achieve equity partner status continue to lag behind their male peers. This Article explores “Women v. BigLaw,” a cluster of equal pay cases brought by women partners in the late 2010s against elite firms. Using Stone’s work as a lens, it reveals how the same unspoken beliefs that underlie the law firm glass ceiling operate above it, placing women partners at the bottom of a new compensation hierarchy centered on origination credit. Due to historical allocations, a culture of deference toward male rainmakers, and implicitly biased attorney development and evaluation practices, origination operates as a form of “legacy credit” that locks in preexisting entitlements favoring male partners. Despite this, gender equity in law practice has been framed principally as a professional value, not a legal imperative. Women v. BigLaw and the unprecedented use of the court system by women lawyers reveals, however, that partnership pay practices pose a liability risk to firms. This new reality may incentivize structural change in ways that attention to gender equity as a managerial and professional goal could not.

Paternal preconception modifiable risk factors for adverse pregnancy and offspring outcomes: a review of contemporary evidence from observational studies

BackgroundThe preconception period represents transgenerational opportunities to optimize modifiable risk factors associated with both short and long-term adverse health outcomes for women, men, and children. As such, preconception care is recommended to couples during this time to enable them to optimise their health in preparation for pregnancy. Historically, preconception research predominately focuses on maternal modifiable risks and health behaviours associated with pregnancy and offspring outcomes; limited attention has been given to inform paternal preconception health risks and outcomes. This systematic review aims to advance paternal preconception research by synthesising the current evidence on modifiable paternal preconception health behaviours and risk factors to identify associations with pregnancy and/or offspring outcomes.MethodsMedline, Embase, Maternity and Infant care, CINAHL, PsycINFO, Scopus, and ISI Proceedings were searched on the 5th of January 2023, a date limit was set [2012–2023] in each database. A Google Scholar search was also conducted identifying all other relevant papers. Studies were included if they were observational, reporting associations of modifiable risk factors in the preconception period among males (e.g., identified as reproductive partners of pregnant women and/or fathers of offspring for which outcomes were reported) with adverse pregnancy and offspring outcomes. Study quality was assessed using the Newcastle–Ottawa Scale. Exposure and outcome heterogeneity precluded meta-analysis, and results were summarised in tables.ResultsThis review identified 56 cohort and nine case control studies. Studies reported on a range of risk factors and/or health behaviours including paternal body composition (n = 25), alcohol intake (n = 6), cannabis use (n = 5), physical activity (n = 2), smoking (n = 20), stress (n = 3) and nutrition (n = 13). Outcomes included fecundability, IVF/ISCI live birth, offspring weight, body composition/BMI, asthma, lung function, leukemia, preterm birth, and behavioural issues. Despite the limited number of studies and substantial heterogeneity in reporting, results of studies assessed as good quality showed that paternal smoking may increase the risk of birth defects and higher paternal BMI was associated with higher offspring birthweight.ConclusionThe current evidence demonstrates a role of paternal preconception health in influencing outcomes related to pregnancy success and offspring health. The evidence is however limited and heterogenous, and further high-quality research is needed to inform clinical preconception care guidelines to support men and couples to prepare for a health pregnancy and child.