Women 's Sexual And Reproductive Health Research Articles

Perspectives from the pandemic epicenter: Sexual and reproductive health of immigrant women in New York City.

The United States' response to COVID-19 created a policy, economic, and healthcare provision environment that had implications for the sexual and reproductive health (SRH) of racialized and minoritized communities. Perspectives from heterogenous immigrant communities in New York City, the pandemic epicenter in the United States (US), provides a glimpse into how restrictive social policy environments shape contraception, abortion, pregnancy preferences, and other aspects of SRH for marginalized immigrant communities. We conducted in-depth interviews in 2020 and 2021 with 44 cisgender immigrant women from different national origins and 19 direct service providers for immigrant communities in New York City to explore how immigrants were forced to adapt their SRH preferences and behaviors to the structural barriers of the COVID-19 pandemic. We coded and analyzed the interviews using a constant comparative approach. Pandemic-related fears and structural barriers to healthcare access shaped shifts in contraceptive use and preferences among our participants. Immigrant women weighed their concerns for health and safety and the potential of facing discrimination as part of their contraceptive preferences. Immigrants also described shifts in their pregnancy preferences as rooted in concerns for their health and safety and economic constraints unique to immigrant communities. Understanding how immigrant women's SRH shifted in response to the structural and policy constraints of the COVID-19 pandemic can reveal how historically marginalized communities will be impacted by an increasingly restrictive reproductive health and immigration policy landscape.

System-level factors influencing refugee women's access and utilization of sexual and reproductive health services: A qualitative study of providers' perspectives.

Refugee women have poor outcomes and low utilization of sexual and reproductive health (SRH) services, which may be driven by access to and quality of SRH services at their resettled destinations. While healthcare providers offer valuable insights into these topics, little research has explored United States (U.S.) providers' experiences. To fill this literature gap, we investigate U.S. providers' perspectives of healthcare system-related factors influencing refugee women's access and utilization of SRH services. Between July and December 2019, we conducted in-depth, semi-structured interviews with 17 providers serving refugee women in metropolitan Atlanta in the state of Georgia (United States). We used convenience and snowball sampling for recruitment. We inquired about system-related resources, facilitators, and barriers influencing SRH services access and utilization. Two coders analyzed the data using a qualitative thematic approach. We found that transportation availability was crucial to refugee women's SRH services access. Providers noted a tension between refugee women's preferred usage of informal interpretation assistance (e.g., family and friends) and healthcare providers' desire for more formal interpretation services. Providers reported a lack of funding and human resources to offer comprehensive SRH services as well as several challenges with using a referral system for women to get SRH care in other systems. Culturally and linguistically-concordant patient navigators were successful at helping refugee women navigate the healthcare system and addressing language barriers. We discussed implications for future research and practice to improve refugee women's SRH care access and utilization. In particular, our findings underscore multilevel constraints of clinics providing SRH care to refugee women and highlight the importance of transportation services and acceptable interpretation services. While understudied, the use of patient navigators holds potential for increasing refugee women's SRH care access and utilization. Patient navigation can both effectively address language-related challenges for refugee women and help them navigate the healthcare system for SRH. Future research should explore organizational and external factors that can facilitate or hinder the implementation of patient navigators for refugee women's SRH care.

Participation of young women in sexual and reproductive health decision-making in Malawi: Local realities versus global rhetoric.

Despite the global prioritization of addressing adolescent girls' and young women's sexual and reproductive health (SRH) and participatory rights, little research has examined their lived experiences in shaping their engagement in SRH decision-making processes in the global South. Further, few studies have explored how structural and societal factors influence their agency and participation. This critical and focused ethnography, informed by postcolonial feminist and difference-centred citizenship theories, conducted in Malawi (2017-2018) elicited perspectives of youth and key informants to help address these knowledge gaps. Our findings show that the effective implementation and uptake of global discourse on participation and gender equity is hindered by inadequate consideration of girls' and young women's local political, cultural and social realities. Many girls and young women demonstrate passion to participate in SRH policymaking as agents of change. However, patriarchal and gerontocratic political and social structures/institutions, and gendered and adultist norms and practices limit their active and meaningful participation in SRH decision-making. In addition, donors' roles in SRH policymaking and their prioritization of the "girl child" highlight an enduring postcolonial power over agenda-setting processes. Understanding young people's experiences of gendered participation and scrutinizing underlying systemic forces are critical steps toward realizing young women's SRH and participatory rights.

Design and psychometric properties of a questionnaire for assessing sexual and reproductive health needs of married adolescent women: an exploratory sequential mixed methods study

To date, there is no valid and reliable instrument to specifically evaluate married adolescent women's sexual and reproductive health (SRH) needs. Hence, the aim of this study was to develop and evaluate the psychometric properties of a questionnaire for assessing married adolescent women (MAW)'s SRH needs. The current exploratory sequential mixed method study was performed in two phases. In the first phase, a preliminary questionnaire was developed based on in-depth interviews with 34 MAW and four key informants as well as a comprehensive literature review. In the second phase, validity of the questionnaire was assessed using face, content, and construct validity and reliability of the questionnaire was assessed using internal consistency and test–retest reliability. Based on qualitative content analysis and literature review, 137 items were extracted. After several modifications of the generated items, a 108-item questionnaire was prepared for the psychometric process. After checking face and content validity, 85 items remained in the study. In the exploratory factor analysis, 11 items were removed and the remaining 74 items were categorised into nine factors. Cronbach's alpha coefficient and the intraclass correlation coefficient were found to be 0.878 and 0.99 for the whole scale, respectively. Impact Statement What is already known on this subject? Sexual and reproductive health (SRH) needs of married adolescent women (MAW) are different from those of married adult women or unmarried, sexually active adolescents. However, there are to date no valid and reliable instruments to specifically evaluate the SRH needs of this group of women. What do the results of this study add? The final version of questionnaire consists of 74 items in nine domains including need to improve MAW's sexual quality of life, promote MAW's SRH self-care, improve MAW's SRH self-efficacy, increase MAW's SRH knowledge, increase husband's involvement in MAW's SRH, improve the performance of health care providers, strengthen the family support to married adolescent women, improve family involvement in SRH education of MAW, and provide specific premarital counselling to MAW. What are the implications of these findings for clinical practice and/or future research? The 74-item questionnaire has acceptable validity and reliability. Therefore, it can be used by researchers and policymakers as an appropriate instrument for assessing MAW's SRH needs.

Partner perspectives on women's sexual and reproductive healthcare in cystic fibrosis

BackgroundWomen with cystic fibrosis (CF) face many sexual and reproductive health (SRH) concerns. Studies suggest that educating and involving partners in SRH care can improve outcomes. This study investigated partners’ perceptions of and preferences for women's SRH care in CF. MethodsWe surveyed partners of women with CF from ten United States (U.S.) CF centers regarding their attitudes and preferences related to CF SRH care. Items assessed experiences with SRH care, sexual relationships, family planning, pregnancy, fertility, and parenthood. We used descriptive statistics to assess results related to the timing, content, setting and delivery of CF SRH care. ResultsA total of 94 partners completed the survey (94% male; average age 36±1 years; 70% married; 36% parents). Among those who/whose partners experienced a pregnancy, 48% received preconception counseling and 29% fertility testing/treatment. One-third of all respondents (32%) worried their children would have CF and 86% would undergo CF genetic testing if their CF partner became pregnant. One-third (34%) indicated that they did not have any SRH conversations with their partner's CF team, while 70% would like to have such discussions. The topics that respondents would most like to discuss were pregnancy (50%), fertility (43%), sexual functioning (36%), sexual activity (31%) and parenthood (29%). ConclusionsPartners report gaps in SRH care and counseling despite the majority wanting to discuss SRH concerns with their partner's CF team. CF partners serve as key supports for women with CF and results can be used to design patient-centered interventions to optimize CF SRH care.

A Mixed-Method Analysis of Inequalities Associated With Adverse Sexual and Reproductive Health Outcomes and the Requisite Interventions Among Young Women in Durban Informal Settlements, South Africa.

BackgroundOver the years, positive sexual and reproductive health (SRH) outcomes have been made possible by a series of policies such as the Sustainable Development Goals, targeted toward different aspects of young women's SRH needs. Nevertheless, inequalities in the levels and trends of adverse SRH outcomes still exist in sub-Saharan Africa (SSA), including South Africa. Thus, this study examines the inequalities associated with adverse SRH outcomes among young women in Durban informal settlements, South Africa, using a mixed-method analysis and suggested requisite interventions to reduce or eliminate the disparity.MethodsA mixed-method sequential explanatory design was used to address the research question. First, a quantitative cross-sectional survey was conducted among 547 young women aged 18 to 24 years in four informal settlements in Durban, South Africa, between April and July 2021. Thereafter, twenty (20) key informant interviews were conducted among different participants but with the same study characteristics. The study's outcome variable was adverse SRH outcomes, including HIV, STIs and unintended pregnancy, while the independent variable was inequality. The quantitative analysis employed binary and multivariable analysis to determine the association between the outcome and explanatory variables, using an alpha level of p < 0.05 to determine significance, while the qualitative analysis was done thematically.ResultsAt the quantitative level, the prevalence of adverse SRH outcomes among young women dwelling in Durban informal settlements was 82.45%, 90.86% and 81.90% for STIs, HIV and unintended pregnancy, respectively. The adjusted odds ratio showed that young women who ever discussed sexual matters with their parents had a lower likelihood of reporting having STIs [aOR = 0.20; 95% (CI = 0.15–1.01)], HIV [aOR = 0.20; 95% (CI = 0.15–1.01)] and unintended pregnancy [aOR = 0.20; 95% (CI = 0.15–1.01)] compared to young women who never had a sexual discussion with their parents. Almost all the key informant interview participants shared the same perspective and proffered possible solutions in the qualitative results.ConclusionThere are disparities in the factors associated with adverse SRH outcomes in Durban's informal settlements. Healthcare proximity, child support grants, cigarette smoking, alcohol consumption, polygamous family structures and gender based violence were associated with higher odds of reporting adverse SRH outcomes.

The solutions to increase the participation of men in sexual and reproductive health of women in Iran: an analytic hierarchy process (AHP) analysis

Ever since the Cairo Declaration in 1994, women’s Sexual and Reproductive Health (SRH) has become a priority and substantial efforts have been made to improve it. Men’s contribution to promote the SRH of women is essential. Therefore, this study aimed to identify the best solutions to increase the men’s participation in the SRH of women in Iran, using an analytic hierarchy process (AHP) approach. A cross-sectional study was conducted among 150 married men in Iran. The data was collected using a questionnaire. To determine the best solutions to improve the men’s participation in women’s SRH, the opinions of an expert group from academia, Ministry of Health (MOH) were employed and the best solution were selected based on the scores, applying analytic hierarchy process (AHP) approach. The statistical analysis was performed using SPSS V.20 and Expert Choice software. In the final analysis ‘Well-oriented sex education focused on men’s involvement’, ‘Well-trained professional employment’ and ‘Sex education in society, schools, and universities’ were the solutions with highest coefficients, respectively. Impact statement What is already known on this subject? SRH of women, is a major part of primary efforts regarding the increase of SRH’s quality; among which, the role and place of men is of utmost importance. Struggling to participate men in issues related to the health of women can not only promote inter family relationships, but also can affect the quality of relationship between man and woman in the society. What do the results of this study add? According to results of the study, one of the main obstacles of men participation was educational and information barriers, regarding which, having adjusted and improved educational systems, opportunity could be prepared for men participation. Current centres for educating those who are already getting married are the first and main places where men can be educated to meet their educational needs in their marriage life such as SRH. Through integrating three selected approaches in the experts’ meetings in the educational program of before marriage, men participation can be increased in SRH. What are the implications of these findings for clinical practice and/or future research? The findings could inform and guide the policies in formulating effective solutions to improve the men’s participation in SRH in Iran.

What contextual factors and mechanisms facilitate male involvement in women's sexual and reproductive health in Sub-Saharan Africa? A rapid realist review protocol.

Background: Sexual and reproductive health (SRH) outcomes of women within low resource contexts continue to be of concern to policymakers. Notably, sub-Saharan Africa (SSA) continues to lag behind other regions of the world in improving SRH outcomes for women in the region. A key suggested strategy is male involvement through interventions that respect, promote and facilitate women in taking care of themselves and their new-borns. However, factors such as social-cultural barriers may preclude men's involvement in these programmes. There is a need for a context-specific understanding of gender dynamics and interaction and the mechanisms that enhance or impede men's involvement. Methods: We will employ a rapid realist review (RRR) methodology to examine what mechanisms and contextual factors are essential to facilitate the involvement of men in women's SRH programmes in SSA. In keeping with the realist literature we will follow six steps, which will include: (1) developing a theory, (2) developing a search strategy, (3) selecting and appraising documents, (4) extracting data, (5) analysing data and synthesising the evidence, and (6) presenting and disseminating a revised theory. We will also engage with key stakeholders who will provide local contextual insights and with experts in the subject area. The review findings will be shared with relevant stakeholders using a variety of avenues including through publications, at conferences and on social media platforms. Discussion: This review will identify the mechanisms and contextual factors that facilitate or hinder men's involvement in women's SRH programmes in SSA. The rationale for adopting an RRR approach is to help gather the information within a relatively short period to ensure relevance of findings to policymakers in SSA. Results from this work also have the potential to be adapted to the other contexts, for example, Ireland and the UK, which have a growing population of people from SSA.

What contextual factors and mechanisms facilitate male involvement in women's sexual and reproductive health in Sub-Saharan Africa? A rapid realist review protocol

Background: Sexual and reproductive health (SRH) outcomes of women within low resource contexts continue to be of concern to policymakers. Notably, sub-Saharan Africa (SSA) continues to lag behind other regions of the world in improving SRH outcomes for women in the region. A key suggested strategy is male involvement through interventions that respect, promote and facilitate women in taking care of themselves and their new-borns. However, factors such as social-cultural barriers may preclude men's involvement in these programmes. There is a need for a context-specific understanding of gender dynamics and interaction and the mechanisms that enhance or impede men's involvement. Methods: We will employ a rapid realist review (RRR) methodology to examine what mechanisms and contextual factors are essential to facilitate the involvement of men in women's SRH programmes in SSA. In keeping with the realist literature we will follow six steps, which will include: (1) developing a theory, (2) developing a search strategy, (3) selecting and appraising documents, (4) extracting data, (5) analysing data and synthesising the evidence, and (6) presenting and disseminating a revised theory. We will also engage with key stakeholders who will provide local contextual insights and with experts in the subject area. The review findings will be shared with relevant stakeholders using a variety of avenues including through publications, at conferences and on social media platforms. Discussion: This review will identify the mechanisms and contextual factors that facilitate or hinder men's involvement in women's SRH programmes in SSA. The rationale for adopting an RRR approach is to help gather the information within a relatively short period to ensure relevance of findings to policymakers in SSA. Results from this work also have the potential to be adapted to the other contexts, for example, Ireland and the UK, which have a growing population of people from SSA.

Sexual and reproductive health knowledge, perceptions and experiences of women in Saudi Arabia: a qualitative study

ABSTRACT Background There is no formal sexual and reproductive health (SRH) education currently offered in Saudi Arabia. Lack of knowledge and misconceptions are evident among Saudi women, which can lead to negative sexual and reproductive experiences. The aim of this study is to explore Saudi women's SRH knowledge, perceptions and experiences. Methods Qualitative semi-structured interviews with Saudi women were conducted. Interviews took place in a public hospital in Riyadh, Saudi Arabia. Interviews were conducted in Arabic, recorded and transcribed verbatim, to allow for thematic analysis of the data. The following themes were identified: experience with menarche, deep-rooted negative views towards sex, difficulty discussing SRH topics, knowledge of sex and reproduction, generational gap, sources of SRH information and the role of the mother. Results A total of 28 women, both married and unmarried, aged 20–50 years were interviewed. A profound lack of SRH knowledge was observed among Saudi women which contributed greatly to negative experiences both in childhood and adulthood. Lack of knowledge about menstruation often caused emotional distress for young girls, and menarche was associated with bad memories and negative emotions. Lack of knowledge about sexual intercourse and the deep-rooted negative views towards sex were linked with physical and psychological issues for women. Women rarely received information from their parents or teachers and preferred the internet for their SRH information. Conclusion There is a substantial unmet need for SRH education for women in Saudi Arabia. It is our recommendation that SRH education should be tailored to meet Saudi women's unique needs, while understanding specific socio-cultural barriers to SRH education and discussions. Research and policy efforts should be directed towards regulating and producing evidence-based health information on the internet, particularly Arabic language websites.

What contextual factors and mechanisms facilitate male involvement in women's sexual and reproductive health in Sub-Saharan Africa? A rapid realist review protocol

Background: Sexual and reproductive health (SRH) outcomes of women within low resource contexts continue to be of concern to policymakers. Notably, sub-Saharan Africa (SSA) continues to lag behind other regions of the world in improving SRH outcomes for women in the region. A key suggested strategy is male involvement through interventions that respect, promote and facilitate women in taking care of themselves and their new-borns. However, factors such as social-cultural barriers may preclude men's involvement in these programmes. There is a need for a context-specific understanding of gender dynamics and interaction and the mechanisms that enhance or impede men's involvement. Methods: We will employ a rapid realist review (RRR) methodology to examine what mechanisms and contextual factors are essential to facilitate the involvement of men in women's SRH programmes in SSA. In keeping with the realist literature we will follow six steps, which will include: (1) developing a theory, (2) developing a search strategy, (3) selecting and appraising documents, (4) extracting data, (5) analysing data and synthesising the evidence, and (6) presenting and disseminating a revised theory. We will also engage with key stakeholders who will provide local contextual insights and with experts in the subject area. The review findings will be shared with relevant stakeholders using a variety of avenues including through publications, at conferences and on social media platforms. Discussion: This review will identify the mechanisms and contextual factors that facilitate or hinder men's involvement in women's SRH programmes in SSA. The rationale for adopting an RRR approach is to help gather the information within a relatively short period to ensure relevance of findings to policymakers in SSA. Results from this work also have the potential to be adapted to the other contexts, for example, Ireland and the UK, which have a growing population of people from SSA.

'I am the master key that opens and locks': Presentation and application of a conceptual framework for women's and girls' empowerment in reproductive health.

Rationale: A renewed focus on women's and girls' empowerment in the era of Sustainable Development Goals reflects the belief that empowerment is central to health and development. Sexual and reproductive health (SRH) outcomes, including pregnancy and contraceptive use, may contribute to and result from empowerment. However, enhanced understanding of how women become empowered for SRH requires clear conceptualization of empowerment. Objective: We aimed to assess the applicability of a proposed framework for women's and girls' SRH empowerment (WGE-SRH) in sub-Saharan Africa. We sought to understand what shapes and motivates preferences for childbearing and contraception, exploring how women and girls navigate external pressures or rewards to exercise and achieve their reproductive goals. Methods: Grounded in the WGE-SRH framework, we conducted a qualitative study in four distinct contexts (Ethiopia, Kano and Anambra States in Nigeria, and Uganda). We implemented and analyzed 120 in-depth interviews and 38 focus group discussions with 440 women and men and translated results to refine the WGE-SRH framework. Results: Findings demonstrate the salience of women's internal motivations, including the social value and joys of motherhood, in shaping existence of reproductive choices. However, existence of choice was limited by couples' economic situations, pressures from providers, partners, and family members, and women's fears of contraceptive side effects or relationship dissolution. Despite these constraints, many found ways to exercise their reproductive choices through negotiation with partners, third party involvement in reproductive discussions, non-verbal communication, and covert use of contraception. Conclusions: The WGE-SRH framework is useful for exploring SRH empowerment, embracing the multilevel, dynamic nature of empowerment, as a process transitioning from existence of choice (autonomy) to exercise of choice (self-efficacy, decision-making, negotiation), and, ultimately, to achievement of choice. Future research and programs related to SRH empowerment should distinguish between existence and exercise of choices to promote the health and well-being of women and girls.

A Multi-Methods Qualitative Study of the Delivery Care Experiences of Congolese Refugees in Uganda

Uganda hosts over 1.4 million refugees and is regarded as one of the world's most hospitable places for displaced populations. However, reports suggest that comprehensive sexual and reproductive health (SRH) services remain inadequate. We aimed to explore the SRH experiences of Congolese refugees living in Uganda and ways that services could be improved. We focus this article on delivery care-related results. In 2017, we assessed Congolese women's SRH, including pregnancy and delivery care, needs in the Nakivale Refugee Settlement and Kampala. We conducted a review of published literature and institutional records, 11 key informant interviews, four focus group discussions with married and unmarried Congolese women, and 21 in-person in-depth interviews with Congolese women refugees. We analyzed these data for content and themes using inductive and deductive techniques. In the final analytic phase, we integrated findings from each study component to identify concordant and discordant results. Our findings indicate that Congolese refugees experience significant challenges accessing delivery care in both camp and urban settings. The availability of trained healthcare staff is limited, health facilities and medication supplies are inadequate, and referral systems are deficient. Refugee women report that corruption, discrimination, language barriers, and lack of privacy characterize their delivery experiences. Efforts to increase trained healthcare staff, improve supply-chain management, and maintain infrastructure and equipment are imperative. Ensuring compliance with anti-bribery and anti-corruption policies and supporting respectful maternity care is also important. Creating approaches to overcome language barriers is crucial to minimizing miscommunication and building patient-provider trust.

Designing and determining psychometric properties of a questionnaire on assessment of men's attitudes toward male participation in women's sexual and reproductive health issues

Context: Men's participation in sexual and reproductive health (SRH) issues can help countries achieve their national development goals, such as reducing maternal mortality, increasing the use of contraceptives, and reducing the prevalence of human immunodeficiency virus infection and acquired immunodeficiency syndrome. Aims: The purpose of this study is to design and to determine the psychometric properties of a questionnaire on the assessment of men's attitudes toward male participation in women's SRH issues. Setting and Design: In this study, 449 married men from cities of Nowshahr and Chalus in Iran who were selected by the available sampling method completed Questionnaire on Assessment of Men's Attitudes in 2018. Materials and Methods: An exploratory sequential mixed-methods approach was used in the present study and focused on research instrument design performed in two qualitative and quantitative phases. Statistical Analysis: The formal validity, content, and structure (convergent and divergent validity) and the reliability of the scale were investigated. Confirmatory and exploratory factor analysis was performed using SPSS Amos 24 software. Results: Four factors fit to the assessment of men's attitudes are confirmed according to standard indicators that include “emotional and gender-based attention,” “support for girls,” “attention and supply of SRH, and prevention of violence.” Convergent and divergent validity for all factors, as well as internal consistency and structural stability, are acceptable. Conclusions: Given the importance and the necessity of male participation in women's reproductive health, this questionnaire was endowed with sufficient validity and reliability and could be useful to precisely assess men's attitudes in this regard.

Insights from outside BJOG

Insights from outside BJOG

Preparedness of Health Care Professionals for Delivering Sexual and Reproductive Health Care to Refugee and Migrant Women: A Mixed Methods Study.

Past research suggests that factors related to health care professionals’ (HCPs) knowledge, training and competency can contribute to the underutilisation of sexual and reproductive health (SRH) care by refugee and migrant women. The aim of this study was to examine the perceived preparedness of HCPs in relation to their knowledge, confidence and training needs when it comes to consulting refugee and migrant women seeking SRH care in Australia. A sequential mixed methods design, comprising an online survey with 79 HCPs (45.6% nurses, 30.3% general practitioners (GPs), 16.5% health promotion officers, and 7.6% allied health professionals) and semi-structured interviews with 21 HCPs, was utilised. HCPs recognised refugee and migrant women’s SRH as a complex issue that requires unique skills for the delivery of optimal care. However, they reported a lack of training (59.4% of nurses, 50% of GPs, and 38.6% of health promotion officers) and knowledge (27.8% of nurses, 20.8% of GPs, and 30.8% of health promotion officers) in addressing refugee and migrant women’s SRH. The majority of participants (88.9% of nurses, 75% of GPs, and 76% of health promotion officers) demonstrated willingness to engage with further training in refugee and migrant women’s SRH. The implications of the findings are argued regarding the need to train HCPs in culturally sensitive care and include the SRH of refugee and migrant women in university and professional development curricula in meeting the needs of this growing and vulnerable group of women.

The validity and reliability of sexual and reproductive health needs questionnaire among Persian infertile women

Context: Infertile women may have a lot of problems in the sexual and reproductive health (SRH) area. Some of these problems are sexually transmitted infections, sexual risky behaviors, high-risk pregnancy history, HIV/AIDS, and sexual violence. There are some reliable questionnaires for infertility health needs, but no comprehensive instrument was available to address their SRH needs. Aims: This article aimed to assess validity and reliability of Persian version of SRH needs questionnaire among Iranian infertile women. Settings and Design: In this psychometric study, validate SRH needs questionnaire in infertility Center of Imam Khomeini Hospital in Sari. Material and Methods: The Persian version of the SRH needs questionnaire by Khani et al. was selected to validate for infertile women. Face validity, content validity and reliability were assessed. Impact score to assess quantitative face validity, content validity ratio (CVR) and content validity index (CVI) to assess the content validity and Cronbach's alpha and intera-class correlation coefficient (ICC) to assess its reliability were calculated. Statistical Analysis: Analysis of ICC, Reliability was used for data analysis. Results: In the qualitative content validity process, 25 questions were added and 5 questions were omitted in the panel of experts. Furthermore, 29 questions achieved a CVR Conclusions: The Persian version of SRH questionnaire prepared for infertile women is a valid and reliable questionnaire and can be used by healthcare providers for assessing of infertile women's SRH needs. Context: Infertile women may have a lot of problems in the sexual and reproductive health (SRH) area. Some of these problems are sexually transmitted infections, sexual risky behaviors, high-risk pregnancy history, HIV/AIDS, and sexual violence. There are some reliable questionnaires for infertility health needs, but no comprehensive instrument was available to address their SRH needs.

Does service integration improve the sexual and reproductive healthcare of women living with HIV?

The sexual and reproductive health (SRH) care needs of a cohort of HIV-positive women were studied pre- and post-integration of genitourinary medicine (GUM) and SRH services. Pre-integration, 24.9% of women at risk of pregnancy were using an effective method of contraception, with a non-significant improvement post-integration to 39.3%. Pre-integration, 47.6% of pregnancies were unplanned, whilst 50% were still unplanned post-integration. Cervical cytology uptake within the previous 12 months improved significantly. It appears that the integration of services alone does not improve all aspects of the SRH of women living with HIV and additional novel strategies should be explored.

Sexual and reproductive health perceptions and practices as revealed in the sexual history narratives of South African men living in a time of HIV/AIDS

The frequent positioning of men's sexual risk-taking as driving the HIV/AIDS epidemic in South Africa has triggered interest in men's sexual and reproductive health (SRH) perceptions, attitudes, and practices. Much research, however, presents men as a homogenous group, and focuses on the quantifiable aspects of male sexual behaviors, providing an inadequate basis for understanding men's SRH needs and addressing the gendered aspects of HIV prevention. This study used sexual history narratives to yield more nuanced and contextualized understandings of male sexuality as it relates to SRH. Fifty sexual life history individual interviews and 10 focus-group discussions (FGDs) with men, as well as 25 sexual life history interviews with women, were conducted with participants purposively sampled from three age categories: (18–24, 25–55, and 55+ years), a wide range of cultural and racial backgrounds, and in urban and rural sites across 5 provinces in South Africa. Interviews and FGDs elicited stories of participant's early knowledge of sex and sexual experimentation and then explored sexual relationships and experiences in adulthood—including engagement with HIV risks and SRH management. The data were analyzed using a thematic approach. Many male participants conformed to dominant norms of masculinity associated with a high risk of sexually transmitted infections including HIV, such as having regular unprotected sex, reluctance to test for HIV, and poor SRH-seeking behaviors. Yet, the narrative accounts reveal instances of men taking steps to protect their own SRH and that of their partners, and the complex ways in which hegemonic gender norms influence men and women's SRH. Ultimately, the study points to the value of sexual biographies for gaining a deeper understanding of male sexuality, and the social structures, meanings, and experiences that underlie it. Such insights are critical to more effectively engaging men in HIV prevention efforts.

The relational dynamics of hegemonic masculinity among South African men and women in the context of HIV

In South Africa, the frequent positioning of men's sexual behaviours as a prime driver of the HIV epidemic has generated much interest in men's sexuality. However, the relational nature of dominant male norms that exacerbate the risk of HIV transmission is inadequately understood. This study used sexual biographies to explore how men and women negotiate gendered norms and how this affects their sexual and reproductive health (SRH). A total of 50 sexual-history interviews and 10 focus group discussions were conducted with men, and 25 sexual-history interviews with women, with participants sampled from three age categories (ages 18–24, 25–55 and 55+years), a range of cultural and racial backgrounds and urban and rural sites across five provinces in South Africa. The narratives illustrate that men and women's SRH is largely dependent on the type and quality of their relationships. Men's sexuality was regularly depicted as being detached from intimacy and uncontrollable, which was premised as being opposite from and/or superior to women's sexuality and could justify men's high-risk sexual behaviours. Yet many participants also supported gender equitable relationships and endorsed accountable and healthy SRH behaviours. The narratives reveal that HIV-risky dominant male norms should be addressed relationally for the sake of better SRH outcomes.