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Young feminist organizing in the state of Yucatán, Mexico: A case study
No full textAs part of the Participatory Action Research (PAR) Study on Young Feminist Organizing in Mexico and Kenya, this case study was conducted in the Yucatán, Mexico to understand the particularities of the feminist movement and organization led by young women in this state. The case study included in-depth interviews and focus groups with representatives of feminist organizations and collectives, civil society organizations, and public institutions. These were conducted in Mérida, the capital of the state of Yucatán, as described in the methodological note.
This brief summarizes the current issues that mobilize young feminists in the state of Yucatán, their forms of organization, and the difficulties they identify in implementing and sustaining their actions and activities, respectively. Finally, we summarize some lessons and offer recommendations for working with them
Effects of tampon co-usage on the pharmacokinetics of segesterone acetate and ethinyl estradiol released from Annovera Vaginal Ring System
No full textObjective: To evaluate the effects of tampon co-usage on the pharmacokinetics (PK) of segesterone acetate (SA) and ethinyl estradiol (EE) released from Annovera Contraceptive Vaginal Ring System (CVS) with a 21-day in/7-day out regimen. Study Design: We enrolled 24 participants in an open-label crossover study in Canada and the United States. Participants used combined oral contraceptive pills for 28 days before randomization (1:1) to either Annovera and tampon co-usage (using four tampons daily on days 2-5 keeping Annovera in place) or Annovera alone for one 28-day cycle; in the next cycle participants switched treatments. We evaluated the steady-state interval for SA and EE from day 2-5 for concomitant Annovera and tampon use. We measured serum SA and EE at each timepoint using fully validated LCMS/MS methods. The primary PK endpoint was AUC of SA and EE on cycle days 2 to 3 (AUC(2-3)). Bioequivalence is established if the 90% CI of the geometric mean ratio (GMR) for AUC(2-3) is wholly contained within (0.80-1.25). Results: We observed bioequivalence for both SA and EE with GMRs of 0.98 (90% CI: 0.921, 1.043) and 0.97 (90% CI: 0.91, 1.026), respectively for AUC(2-3), and also for AUC from day 2 to day 5 for both SA and EE with GMRs of 1.02 (90% CI: 0.99, 1.06) and 1.02 (90% CI: 0.97, 1.087), respectively. We observed no significant safety issues or serious adverse events. Conclusions: Individuals using Annovera with four consecutive days of tampon use did not experience a change to SA or EE absorption. Thus, light/regular tampon co-usage for up to four consecutive days should not impact contraceptive efficacy or bleeding profile. Implications statement: A significant proportion of reproductive-age women use tampons when experiencing vaginal bleeding; they can be reassured that tampon and contraceptive ring co-usage should not affect contraceptive efficacy of the segesterone acetate/ethinyl estradiol contraceptive vaginal ring
Influence de la connectivité sociale des adolescentes sur leur santé de la reproduction et résultats scolaires au Sénégal
No full textDistrict Vulnerability Index for Pakistan (DVIP): Harnessing multisectoral data to inform equitable policy and climate action
No full textPakistan’s highly heterogeneous population faces significant development challenges, including unequal resource distribution and disparities in access to services, which create varying levels of vulnerability across communities. While existing studies have primarily examined vulnerability through climate, economic, or other disaster lenses, they often overlook underlying structural and systemic factors. This study aims to address that gap by developing an index that incorporates domains of vulnerability typically underrepresented in analyses of Pakistan
A drug-drug interaction study to evaluate the effects of strong CYP3A4 inducer on the pharmacokinetics of segesterone acetate and ethinyl estradiol in a contraceptive vaginal system
No full textBackground: In 2018, the US FDA approved a long-acting contraceptive vaginal system (CVS) releasing a new progestin, segesterone acetate (SA) and ethinyl estradiol (EE). As most progestins and EE used in hormonal contraceptives are metabolized via the CYP3A4 pathway, drug-drug interactions within the CYP3A4 network are a potential concern for contraceptive efficacy and/or safety. SA and EE systemic exposure could be reduced following administration of a strong CYP3A4 inducer such as rifampin, thus influencing risk of pregnancy or side effects. The study aimed to assess the pharmacokinetics of SA and EE from the CVS in healthy women when co-administered with rifampin. Materials and methods: This randomized, open-label, cross-over study was conducted at two Canadian sites to evaluate potential drug-drug interaction between rifampin (600 mg once daily) and the CVS releasing on average 150 µg of SA and 13 µg of EE daily. Blood samples were collected at predetermined time intervals after CVS insertion with and without concomitant Rifampin treatment. Serum concentrations of SA and EE were measured by validated LCMS/MS method. Concentrations were used to calculate pharmacokinetic parameters for comparison. Results: Twenty-one healthy women were enrolled and randomized (1:1) to sequence A (CVS alone in treatment cycle 1; CVS + rifampin in treatment cycle 2) or sequence B (CVS + rifampin in treatment cycle 1; CVS alone in treatment cycle 2); 18 women completed the study. Rifampin co-treatment had no significant impact on PK parameters of SA. The 90% confidence intervals of geometric mean ratios (GMR) for AUC and Cmax were wholly contained within 0.8–1.25, supportive of bioequivalence. Serum concentrations of EE were significantly decreased: the GMR and 90% confidence intervals for AUC were 0.44 (0.39–0.50) and Cmax was 0.55 (0.47–0.65). No new or unexpected safety concerns were observed during the study conduct. Conclusions: We report a drug-drug interaction of rifampin on systemic exposure of EE but not SA. As the progestin seems to be the major driver of contraceptive efficacy, we do not expect co-administration of a CYP3A4 inducer to reduce contraceptive effectiveness. These results suggest that this CVS may be used with rifampin without additional precautions to prevent unintended pregnancy. Trial registration: This trial was registered with ClincalTrials.gov Identifier NCT04290390
Family planning knowledge, attitudes, and practices among male and female garment factory workers in Alexandria, Egypt
No full textMost evidence on factory workers’ family planning (FP) needs has primarily focused on female workers. This study examines knowledge, attitudes, and practices of male and female garment factory workers in Alexandria, Egypt, and identifies factors associated with the use of modern contraception among these two groups. Data were collected through face-to-face interviews with married male and female workers (406 and 393, respectively) in 14 factories whose owners agreed to participate in the study, whereas the sample of workers was composed of those whose supervisors approved of their participation in the interview. Bivariate analysis was used to measure differences in FP knowledge, attitudes, and behaviors. Factors associated with workers’ (or their spouse\u27s) use of modern contraceptives were uncovered through separate logistic regression models. Although female workers could list more modern contraceptives than their male counterparts, female workers expressed more concerns and misconceptions about FP. The reported use of modern contraceptives was higher among male workers (or their spouses) than female workers. Factors predictive of modern contraceptive use among men were the number of children, the respondent\u27s age, more positive attitudes, and knowledge of more FP methods, whereas among women, the only significant factor was having more children. The study highlights the need for gender-responsive interventions to address the distinctive FP needs of male and female factory workers, on-site provision of FP information and services in factory settings, and broader interventions to address inequitable gender norms
Screening for sexual violence against children in humanitarian settings: A feasibility study of a para-social worker-led intervention in Uganda
No full textBackground: Sexual violence against children (SVAC) is an acknowledged concern in humanitarian settings; yet, effective, tested interventions to support disclosure and access to care remain limited. This study assessed the feasibility of implementing SVAC screening, referral protocols, and service provision, in a bid to rectify these limitations within two primary schools in Uganda’s Kiryandongo Refugee Settlement. Methods: A mixed-methods concurrent triangulation design was used to implement and assess the feasibility of a seven-month intervention (April–October 2024) in two primary schools. Para-Social Workers, trained under Uganda’s Ministry of Gender, Labour and Social Development, screened Primary 6 and 7 pupils, aged 11 to 35 years old, for SVAC. Older pupils (Primary 6–7) were selected for their perceived capacity to engage on the topic. Survivors received school-based psychological first aid and were referred to additional services as needed. Results: The intervention demonstrated strong demand and acceptability among the target populations. All 831 eligible pupils assented to intervention participation, and the majority (96%, n = 794) ended up actually participating in the screening exercise. Of these, 82% (n = 653) disclosed experiencing SVAC, with 100% receiving care. In contrast, in the absence of screening in the 12-month period before the intervention, only 16 pupils in the same primary schools disclosed experiencing SVAC and obtained care. Stakeholders – including parents, teachers, government, and humanitarian actors – expressed strong support for expanding the model, while pupils reported high levels of satisfaction with the intervention. Conclusions: Proactive SVAC screening in schools within humanitarian settings is both feasible and holds promise for effectively identifying and supporting child and adolescent survivors of sexual violence. The intervention significantly increased disclosure and service uptake and was well received by all stakeholders. Findings support the adaptation and cautious scale-up of this model in similar, carefully selected and adequately resourced, crisis-affected contexts
Acceptability of and preferences for long-acting injectable hormonal contraception among US women: Evidence from a national cross-sectional online survey
No full textBackground: Long-acting injectable (LAI) hormonal contraception offers a promising approach to meet women’s pregnancy prevention needs. We sought to understand acceptability of and preferences for LAI hormonal contraception among US women, to optimize the design of a sustained-release LAI in development – including which durations to pursue. Methods: We implemented a national cross-sectional online survey including a discrete choice experiment (DCE) with women ages 18–44 years currently using or interested in using contraception. Recruitment was via Prime Panels. DCE attributes included potential duration of effectiveness (6/12/24-months), effect on menses, side effects, and timing of return-to-fertility after use. We used mixed-multinomial logit models to analyze the data. Results: Women (n = 1,029) were 28.6 years old on-average, from 49 US states. 30.9% were Black/African American; 11.6% Hispanic/Latina. 71.6% were nulliparous; 49.0% did not want a(nother) child. Common current contraceptive methods were birth control pills (37.4%), male condoms (35.7%), and withdrawal (19.8%); 18.9% reported having had an unintended pregnancy. In the DCE, women had strong negative preferences for: may cause heavier/unpredictable periods, mild headaches/nausea, slight weight gain, and delayed return-to-fertility (6–12 vs. 3 months), and positive preferences for: may cause no period, and shorter/lighter periods (all p \u3c 0.001). Women also preferred the 12-month to the 6-month duration (p = 0.03). When asked directly about their interest in an LAI with no/minimal side effects/effects on menses and quick return-to-fertility, 92.4% expressed interest, with two-thirds preferring a longer duration (12 or 24-months), and one-third the 6-month duration. Preference for the 6-month duration (vs. 12 or 24) was most highly associated with wanting a child within five years, and higher discomfort with hormones (both p \u3c 0.001). Conclusions: US women report high interest in an LAI. Interest substantially decreases if the LAI may cause unwanted effects such as heavier/unpredictable periods, mild headaches/nausea, slight weight gain, or delayed return-to-fertility. While longer duration (12 + months) is preferred overall, having a 6-month option appears important especially for women who may want to get pregnant within the next few years, and those concerned about hormones (to try it before using a longer duration)
“…this could be a noble idea and a game changer.” The potential of a dual prevention pill for HIV and pregnancy prevention among adolescent girls and young women in Zimbabwe
No full textAdolescent girls and young women (AGYW) in Zimbabwe bear a double burden of HIV and unmet need despite the progress made in provision of family planning and oral pre-exposure prophylaxis (PrEP). We elicited opinions from AGYW and health care providers (HCPs) about a dual prevention pill (DPP) in development that combines oral contraceptives (OCs) with oral PrEP to simultaneously prevent unintended pregnancy and HIV, and potentially increase uptake and adherence to oral PrEP. We enrolled 44 participants (March–June 2021) and conducted 12 in-depth interviews with HCPs (nurses, counselors, social workers, pharmacists, clinicians) from public and private health facilities offering HIV and family planning services in Harare, and four focus group discussions (FGDs) with 32 AGYW who were current OC users, stratified by age (16–19, 20–24). The HCPs and AGYW welcomed the idea of the DPP. Both groups perceived the benefits of the DPP as lessening the burden of taking two separate pills and giving AGYW the option to protect themselves discreetly, potentially increasing adherence and ease of use. HCP’s had favorable attitudes toward the DPP and highlighted that the DPP regimen is already similar to the OCs women are taking and would allow for regular menses and quick return to fertility. Despite concerns about potential side effects and lack of protection against sexually transmitted infections (STIs) other than HIV, HCPs noted the potential benefits of the DPP in reducing their workload and increasing the uptake of PrEP services. From the end user perspective, the DPP size, color, and packaging should be appealing and distinct from HIV medications to minimize stigma. Clear guidelines are deemed necessary for DPP service provision for adolescents, emphasizing the importance of tailored approaches for different age groups. Educating male partners and the broader community about the DPP could enhance its use among AGYW