"I am putting my fear on them subconsciously": a qualitative study of contraceptive care in the context of abortion bans in the U.S.

Background: Since the Dobbs vs. Jackson Women's Health Organization decision in June 2022, providers throughout the U.S.

Provider perceptions of young people living with HIV and unhealthy alcohol use in Southwestern Uganda: a qualitative study.

Background: Unhealthy alcohol use is a common public health problem in HIV care settings in Africa and it affects the HIV continuum of care. In Uganda and other low-income countries, HIV care providers are a key resource in caring for young people (15-24 years) living with HIV (YPLH) with unhealthy alcohol use. Caring for YPLH largely depends on care providers' perceptions of the problem.

The association of experiences of medical mistrust and mistreatment and ever considering self-managing an abortion.

Objective: To assess the prevalence of ever considering self-managing an abortion (SMA) and its associations with experiences of medical mistrust and mistreatment in a nationally representative sample.

Study Design: In 2021-22, we conducted a national, cross-sectional, online probability-based survey of US people assigned female at birth ages 15-49. Among those who had ever been pregnant, we ran weighted multivariable logistic regressions to examine whether having had difficulty trusting medical providers and/or experiencing medical mistreatment was associated with SMA consideration.

Impact of management guidelines for abnormal cervical cytology on colposcopy procedure rates among young women.

Objective: In 2012, updated ASCCP management guidelines for abnormal cervical cytology recommended observation rather than immediate referral to colposcopy for low-grade abnormalities in women ages 21-24. We evaluated the impact of these guidelines on changes in colposcopy procedure rates among young women.

Methods: We analyzed administrative and claims data from the largest statewide family planning program between July 2011 and June 2015.

Young People's Support for and Personal Interest in an Advance Provision Model for Medication Abortion.

Purpose: To assess young people's interest in advance provision (AP) of medication abortion-receiving mifepristone and misoprostol from a clinician in advance for their future use.

Methods: From November 2022-August 2023 we administered an electronic survey regarding advance provision to patients assigned female at birth at four Bay Area youth-serving clinics.

Results: Among 152 people ages 14-24 years (mean 17.

Self-Managed Abortion Attempts Before vs After Changes in Federal Abortion Protections in the US.

Importance: With decreasing access to facility-based abortion in the US, an increase in self-managed abortion (SMA) using various methods is anticipated. To date, no studies have examined changes in SMA in the shifting policy landscape.

Objective: To estimate changes in SMA prevalence among the general US population from before to after the Supreme Court's June 2022 decision overturning federal abortion protections.

Corrigendum: Patterns of within-host spread of between vagina, endocervix and rectum revealed by comparative genomic analysis.

[This corrects the article DOI: 10.3389/fmicb.2023.

Mixed influence of COVID-19 on primary maternal and child health services in sub-Saharan Africa: a scoping review.

Introduction: The COVID-19 pandemic profoundly affected the provision of and demand for routine health services in the world. The objective of this scoping review was to synthesize the influence of the COVID-19 pandemic on primary maternal and child health (MCH) services in sub-Saharan Africa.

Methods: The studies searched original studies reporting on the influence of the COVID-19 pandemic on primary MCH services.

Mail-Order Pharmacy Dispensing of Mifepristone for Medication Abortion After In-Person Screening.

Importance: Before 2021, the US Food and Drug Administration required mifepristone to be dispensed in person, limiting access to medication abortion.

Objective: To estimate the effectiveness, acceptability, and feasibility of dispensing mifepristone for medication abortion using a mail-order pharmacy.

Design, Setting, And Participants: This prospective cohort study was conducted from January 2020 to May 2022 and included 11 clinics in 7 states (5 abortion clinics and 6 primary care sites, 4 of which were new to abortion provision).

Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus.

Objective: There are no globally agreed on strategies on early detection and first response management of postpartum haemorrhage (PPH) during and after caesarean birth. Our study aimed to develop an international expert's consensus on evidence-based approaches for early detection and obstetric first response management of PPH intraoperatively and postoperatively in caesarean birth.

Design: Systematic review and three-stage modified Delphi expert consensus.

Interest in and Support for Alternative Models of Medication Abortion Provision Among Patients Seeking Abortion in the United States.

Introduction: Medication abortion is safe and effective, but restrictions still limit patients from accessing this method. Alternative models of medication abortion provision, namely advance provision, over-the-counter (OTC), and online, could help improve access to care for some, although there is limited evidence about abortion patients' interest in these models.

Methods: Between 2017 and 2019, we administered a cross-sectional survey to abortion patients at 45 clinics across 15 U.

Experiences of delay-causing obstacles and mental health at the time of abortion seeking.

Objectives: The delays and challenges people encounter when seeking abortion are well-documented, but their psychological implications are understudied. Aiming to fill this gap, we explored the associations between experiences of delay-causing obstacles to abortion care and adverse mental health symptoms among individuals seeking abortion care.

Study Design: In 2019, we surveyed 784 people (of 1092 approached) ages 15-45 accessing abortion care in four clinics in abortion-supportive states: California, Illinois, and New Mexico.

Use of telemedicine to obtain contraception among young adults: Inequities by health insurance.

Objectives: The objective of this study was to describe the use of telemedicine for contraception in a sample of young adults and examine differences by health insurance coverage.

Study Design: We analyzed survey data collected from May 2020 to July 2022 from individuals at risk of pregnancy aged 18 to 29 recruited at 29 community colleges in California and Texas. We used multivariable mixed-effects logistic regression models with random effects for site and individual to compare the use of telemedicine to obtain contraception by insurance status, sociodemographic characteristics, and state.

Mental Health Distress and Delayed Contraception Among Older Adolescents and Young Adults.

Symptoms of mental distress increased sharply during the COVID-19 pandemic, especially among older adolescents and young adults. Mental health distress may make it more challenging for young people to seek other needed health care, including contraception. This study explored the association of symptoms of depression, anxiety, and stress with delays in getting a contraceptive method or prescription.

In the Know: A Cluster Randomized Trial of an In-person Sexual Health Education Program Integrating Digital Technologies for Adolescents.

Purpose: Integrating digital technologies into sexual health education can offer advantages for connecting with adolescents, particularly populations who may be underserved through common school-based approaches. This study assessed the effectiveness of In the Know, an in-person, group-based sexual health education program integrating digital technologies, codesigned with adolescents.

Methods: The study design was a cluster randomized trial with 1,263 adolescents aged 13-19 in 95 cohorts, implemented in community-based organizations and schools throughout Fresno County, California.

"They call me the 'Great Queen'": implementing the Malkia Klabu program to improve access to HIV self-testing and contraception for adolescent girls and young women in Tanzania.

Background: Adolescent girls and young woman (AGYW) comprise a significant proportion of new HIV infections and unintended pregnancies in sub-Saharan Africa yet face many barriers to accessing family planning and reproductive health (FPRH) information and services. Developed via human-centered design, the Malkia Klabu ("Queen Club") program aimed to facilitate access to HIV self-testing (HIVST) and FPRH information and products at privately-owned drug shops. We sought to understand barriers and facilitators to program implementation in a 4-month pilot in Tanzania.

Social networks and HIV treatment adherence among people with HIV initiating treatment in rural Uganda and peri-urban South Africa.

Timely initiation of and adherence to antiretroviral therapy (ART) is critical for improving HIV outcomes and reducing HIV transmissibility. Social networks, or the social relationships individuals have with each other, have been linked with positive health outcomes, but less is known about the extent to which social network composition and structure are associated with improved ART adherence among people living with HIV (PLWH). We conducted an ego-centric network study among 828 previously ART-naïve PLWH presenting for ART initiation at 11 clinics in Mbarara, Uganda (rural population) and Gugulethu, South Africa (peri-urban population).

Measuring a Critical Component of Contraceptive Decision Making: The Contraceptive Concerns and Beliefs Scale.

Introduction: Concerns about safety and side effects from contraceptives are widespread and related to reluctance to use them. Measuring these concerns is an essential component of understanding contraceptive decision-making and guiding contraceptive and interpregnancy clinical care.

Methods: We used qualitative research and item response theory to develop and test a psychometric instrument to measure contraceptive concerns and beliefs.