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殷 漫, 邓 曌, 苗 娅, 张 晓. [Investigation of the Biosafety of Commercially Available Natural Rubber Latex and Synthetic Polyurethane Condom Materials]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2024; 55:958-963. [PMID: 39170021 PMCID: PMC11334296 DOI: 10.12182/20240760209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Indexed: 08/23/2024]
Abstract
Objective To investigate the biological safety of commercially available natural rubber latex and synthetic polyurethane condoms. Methods Natural rubber latex condom brands of A1 and A2 and polyurethane condom brands of B1 and B2 were purchased from large chain pharmacies in Chengdu, with three packages randomly selected for each brand. The study assessed the toxic effects of condom extracts on L-929 mouse fibroblasts according to GB/T standards. Gross observation and histopathological evaluation were conducted to assess the irritation reactions of condoms on the vagina and penis of rabbits (3 rabbits were used for each brand), as well as their sensitization effects on guinea pig skin. Additionally, the impact of continuous perfusion of condom extracts of the vaginas of SD rats for 30 days on their reproductive systems was evaluated, following GB/T standards (5 rats were used for each brand). Results Extracts from natural rubber latex condom brands A1 and A2, at concentrations of 100% and 50%, exhibited significant cytotoxicity, with optical density (OD) values being significantly lower than those of the blank control group and the polyurethane condom brands B1 and B2 (P<0.01). There was no significant difference in cell morphology and OD values between the extracts of B1 and B2 and the blank control group (P>0.05). Vaginal congestion was found in 3 rabbits from A1 group and 1 rabbit from the A2 group, while no obvious congestion was noted in rabbits from the B1 and the B2 groups. Histopathological examination showed scattered inflammatory cell infiltration in the vaginal tissue of 3 rabbits from the A1 group and 2 rabbits from the A2 group, and slight congestion in the blood vessels of the lamina propria. No obvious pathological changes were observed in the vaginal tissue of polyurethane brand rabbits. Two rabbits from the A1 group and 1 rabbit from the A2 group showed transient and mild erythema on the penis during the experiment. Histopathological examination showed that 1 rabbit from A1 group had small foci of pericapillary lymphocytes in the dermis of the penis, while no significant pathological changes were observed in the penile tissue of A2, B1, and B2 groups. After 30 days of continuous vaginal perfusion with condom extract, 3 rats in A1 group and 2 rats in the A2 group had uterine congestion, with the degree of congestion being lower in the A2 group. No significant congestion or pathological changes were observed in the vaginal and penile tissues of rabbits, or in the uterine tissues of rats from the polyurethane groups. None of the 4 groups of guinea pigs showed significant skin allergic reactions to the condom extracts. Conclusion Significant differences in biosafety exist among condoms of various materials and brands. To ensure product safety, it is crucial to strengthen quality control and regulatory oversight after condoms become commercially available.
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Affiliation(s)
- 漫 殷
- 成都上锦南府医院/四川大学华西医院上锦医院 麻醉手术中心 (成都 611730)Anesthesia and Surgery Center, Shangjin Nanfu Hospital/Shangjin Hospital, West China Hospital, Sichuan University, Chengdu 611730, China
| | - 曌曦 邓
- 成都上锦南府医院/四川大学华西医院上锦医院 麻醉手术中心 (成都 611730)Anesthesia and Surgery Center, Shangjin Nanfu Hospital/Shangjin Hospital, West China Hospital, Sichuan University, Chengdu 611730, China
| | - 娅莉 苗
- 成都上锦南府医院/四川大学华西医院上锦医院 麻醉手术中心 (成都 611730)Anesthesia and Surgery Center, Shangjin Nanfu Hospital/Shangjin Hospital, West China Hospital, Sichuan University, Chengdu 611730, China
| | - 晓梅 张
- 成都上锦南府医院/四川大学华西医院上锦医院 麻醉手术中心 (成都 611730)Anesthesia and Surgery Center, Shangjin Nanfu Hospital/Shangjin Hospital, West China Hospital, Sichuan University, Chengdu 611730, China
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Dandadzi A, Young AM, Musara P, Shapley-Quinn MK, Kemigisha D, Mutero P, Mgodi NM, Etima J, Minnis AA. Perception of couples' on multipurpose prevention technology attribute choice: the case of MTN 045. BMC Public Health 2024; 24:1876. [PMID: 39004714 PMCID: PMC11247780 DOI: 10.1186/s12889-024-19390-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 07/06/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Multipurpose prevention technologies (MPTs) are products capable of simultaneously addressing multiple sexual and reproductive health needs such as unwanted pregnancy, STIs including HIV-1, and other reproductive tract infections. MPTs are urgently needed to address the double burden of unplanned pregnancy and HIV. While condoms are currently the only accessible MPTs, they are not solely under a woman's control, and female condoms face limitations due to poor acceptability and high cost. METHODS We conducted a sub-analysis of qualitative data from 39 couples participating in the MTN 045 study to examine the perception of couples on choice and acceptability of a "2 in 1" MPT that combines HIV and pregnancy prevention. RESULTS Couples recognized the benefits of MPTs for HIV and pregnancy prevention but perceptions tied to each indication and a novel prevention technology tool raised important concerns relevant to use of future MPTs. In the study, participants' perceptions of MPT use were influenced by pregnancy planning. When the timing was less critical, they prioritized HIV prevention. Misinformation about family planning methods, including MPTs, affected decision-making with potential to hinder uptake of future MPTs. Concerns about side effects, such as weight gain and hormonal imbalances, influenced willingness to use MPTs. CONCLUSION Addressing the myths and misconceptions surrounding the use of contraceptives is crucial in promoting their acceptance and ultimate use. Strategies for addressing the drawbacks women might experience while using a particular product should be in place as new MPTs progress through the development pipeline and approach roll-out.
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Affiliation(s)
- Adlight Dandadzi
- University of Zimbabwe-Clinical Trials Research Centre, Harare, Zimbabwe.
| | - Alinda M Young
- Women's Global Health Imperative, RTI International, Berkeley, CA, USA
- Department of Maternal and Child Health, University of North Carolina, Chapel Hill, NC, USA
| | - Petina Musara
- University of Zimbabwe-Clinical Trials Research Centre, Harare, Zimbabwe
| | | | - Doreen Kemigisha
- Makerere University-Johns Hopkins Research Collaboration, Kampala, Uganda
| | - Prisca Mutero
- University of Zimbabwe-Clinical Trials Research Centre, Harare, Zimbabwe
| | - Nyaradzo M Mgodi
- University of Zimbabwe-Clinical Trials Research Centre, Harare, Zimbabwe
| | - Juliane Etima
- Makerere University-Johns Hopkins Research Collaboration, Kampala, Uganda
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Rodrigues DL, Carvalho AC, Prada M, Garrido MV, Balzarini RN, de Visser RO, Lopes D. Condom Use Beliefs Differ According to Regulatory Focus: A Mixed-Methods Study in Portugal and Spain. JOURNAL OF SEX RESEARCH 2024; 61:709-726. [PMID: 36877803 DOI: 10.1080/00224499.2023.2181305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Reports worldwide have been showing increasing rates of sexually transmitted infections (STIs) and condomless sex in recent years. Research has identified several individual and situational variables that can determine the decision to use condoms or forgo their use. We argue that such a decision can also be shaped by motives related to pleasure and safety (i.e., regulatory focus in sexuality). Using open ended questions, we asked 742 Portuguese and Spanish adults to indicate situations and reasons that could inform the decision making process with casual partners and the functions/attributes related to condoms. Using thematic analyses, we coded the drivers of condomless sex and condom use into themes and subthemes, and computed their frequencies. Using quantitative measures, we also asked participants to indicate their condom use expectancies and perceived barriers. Comparing participants according to regulatory focus revealed some differences. Pleasure promotion participants were more likely to consider that condom use decision making is driven by unexpectedness, pleasure, and intimacy pursuit, attached more pleasure reduction functions to condoms, expected more negative outcomes in condom use, and endorsed more sensation and partner barriers in condom use. In contrast, disease prevention participants were more likely to consider that condom use decision making is driven by adequate sexual education, responsibility, and behavioral control, and attached more health protective functions to condoms. These differences can inform the development of tailored intervention and awareness campaigns aimed at helping people to use condoms more consistently with casual partners and to avoid behaviors that put them at risk of STI transmission.
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Affiliation(s)
- David L Rodrigues
- Iscte-Instituto Universitário de Lisboa, CIS-Iscte, Lisboa, Portugal
| | | | - Marília Prada
- Iscte-Instituto Universitário de Lisboa, CIS-Iscte, Lisboa, Portugal
| | | | - Rhonda N Balzarini
- Department of Psychology, Texas State University, San Marcos, TX, USA
- The Kinsey Institute, Indiana University, Bloomington, IN, USA
| | - Richard O de Visser
- Department of Primary Care & Public Health, Brighton and Sussex Medical School, Falmer, UK
| | - Diniz Lopes
- Iscte-Instituto Universitário de Lisboa, CIS-Iscte, Lisboa, Portugal
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Willis M, Mabelis J, Currie D, Brown J, Inchley J. Associations Between Recent Contraceptive Use and First Sex Behaviors of Scottish Adolescents: A Brief Report. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2024; 36:199-204. [PMID: 38616792 PMCID: PMC11008538 DOI: 10.1080/19317611.2024.2327360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 02/29/2024] [Indexed: 04/16/2024]
Abstract
Objectives We examined associations between recent contraceptive use and first-sex behaviors (early initiation, substance use, contraceptive use) among adolescents in Scotland. Methods We used data from the Health Behavior in School-aged Children study. Results Controlling for early initiation and substance use, girls and boys who used contraceptives at first sex were 7.5 and 12.3 times more likely to use contraceptives at most recent sexual intercourse than adolescents who did not (p < .001). We also present preliminary evidence on contraceptive use of Scottish adolescents in 2022. Conclusions Experiences during adolescents' first sex may have lasting implications for later sexual behavior.
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Affiliation(s)
- Malachi Willis
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Judith Mabelis
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Dorothy Currie
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Judith Brown
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Joanna Inchley
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Xie Z, Duan Z. Balancing public health and privacy rights: a mixed-methods study on disclosure obligations of people living with HIV to their partners in China. Harm Reduct J 2024; 21:30. [PMID: 38311762 PMCID: PMC10840163 DOI: 10.1186/s12954-023-00920-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/24/2023] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND In 2021, a Chinese court, based on the newly enacted Civil Code, first revoked a marriage license due to the spouse's failure to disclose their HIV infection before the marriage. This landmark case ignited a fresh debate on whether people living with HIV (PLHIV) have a legal duty to inform their spouses and sexual partners. Advances in medicine have partially isolated HIV transmission from sexual contact, extending the legal basis for the obligation to disclose beyond disease prevention. This study investigates some possibly unforeseen challenges for PLHIV in China to fulfill this duty, and the outcomes of their decisions in light of the government's goal to promote health. METHODS This study aims to provide a detailed examination of the legal provisions and practices concerning partner notification among PLHIV in China. A mixed-methods research approach was employed between 2019 and 2020, combining questionnaire surveys, in-depth interviews, and participatory observations. A total of 433 valid responses were obtained through a questionnaire posted on a Chinese online platform for PLHIV. Following the collection and random coding of the questionnaire data, 40 individuals living with HIV were selected for in-depth interviews. Subsequently, a six-month field investigation was conducted in Guan ai jia yuan (Caring Home) in Jinhua City to further explore this issue. RESULTS A considerable proportion of PLHIV exhibit a high rate of disclosure to their spouses (nearly 80%). In the context of sexual partners, 56% of PLHIV stated that their sexual partners were aware of their HIV infection. Whether married PLHIV disclosing to their spouses or unmarried/divorced PLHIV disclosing to sexual partners, however, a substantial majority expressed apprehension about the potential disruption to their relationships that the disclosure might cause. The sole exception was observed among married PLHIV in extramarital relationships who demonstrated a slightly diminished level of concern in this context. Reasons for non-disclosure predominantly included undetectable viral load and the adoption of protective measures. DISCUSSION This study reveals that a prevailing "HIV stigma" hinders PLHIV from voluntarily fulfilling the disclosure duties bestowed by Article 38 of the Regulations on the Prevention and Control of HIV/AIDS, and the unclear legal provisions of the new Civil Code play a significant role in this regard. Addressing this issue necessitates not only increasing societal tolerance toward PLHIV and reducing instances of social exclusion but also shifting the legal basis of disclosure duties from disease prevention to rights and obligations within the legal relationships of the parties involved. When it comes to the recipients of disclosure, for instance, it is crucial to differentiate between spouses and sexual partners. As for PLHIV failing to fulfill their disclosure duties, apart from interventions involving indirect notifications, the addition of further legal responsibilities may not be advisable. Intentional transmission actions, on the other hand, should still be subject to severe penalties. CLINICAL TRIAL NUMBER Not applicable.
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Affiliation(s)
- Ziyi Xie
- Macao Polytechnic University, Faculty of Humanities and Social Science, Macao, China
| | - Zhizhuang Duan
- Zhejiang Normal University, Xingzhi College, Jinhua, China.
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Barton BE, Erickson JA, Allred SI, Jeffries JM, Stephens KK, Hunter MI, Woodall KA, Winuthayanon W. Reversible female contraceptives: historical, current, and future perspectives†. Biol Reprod 2024; 110:14-32. [PMID: 37941453 PMCID: PMC10790348 DOI: 10.1093/biolre/ioad154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/10/2023] Open
Abstract
Contraception is a practice with extensive and complicated social and scientific histories. From cycle tracking, to the very first prescription contraceptive pill, to now having over-the-counter contraceptives on demand, family planning is an aspect of healthcare that has undergone and will continue to undergo several transformations through time. This review provides a comprehensive overview of current reversible hormonal and non-hormonal birth control methods as well as their mechanism of action, safety, and effectiveness specifically for individuals who can become pregnant. Additionally, we discuss the latest Food and Drug Administration (FDA)-approved hormonal method containing estetrol and drospirenone that has not yet been used worldwide as well as the first FDA-approved hormonal over-the-counter progestin-only pills. We also review available data on novel hormonal delivery through microchip, microneedle, and the latest FDA-approved non-hormonal methods such as vaginal pH regulators. Finally, this review will assist in advancing female contraceptive method development by underlining constructive directions for future pursuits. Information was gathered from the NCBI and Google Scholars databases using English and included publications from 1900 to present. Search terms included contraceptive names as well as efficacy, safety, and mechanism of action. In summary, we suggest that investigators consider the side effects and acceptability together with the efficacy of contraceptive candidate towards their development.
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Affiliation(s)
- Brooke E Barton
- School of Medicine, University of Washington, Seattle, WA, USA
| | - Jeffery A Erickson
- OB/GYN & Women’s Health, School of Medicine, University of Missouri, Columbia, MO, USA
- Translational Bioscience Program, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Stephanie I Allred
- OB/GYN & Women’s Health, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Jenna M Jeffries
- College of Art & Science, Washington State University, Pullman, WA, USA
| | - Kalli K Stephens
- OB/GYN & Women’s Health, School of Medicine, University of Missouri, Columbia, MO, USA
- Translational Bioscience Program, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Mark I Hunter
- OB/GYN & Women’s Health, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Kirby A Woodall
- OB/GYN & Women’s Health, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Wipawee Winuthayanon
- OB/GYN & Women’s Health, School of Medicine, University of Missouri, Columbia, MO, USA
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Saavedra-Roa A, Vallejo-Medina P. A non-latex condom has no influence on male physiological sexual arousal. Int J Clin Health Psychol 2024; 24:100442. [PMID: 38348144 PMCID: PMC10859562 DOI: 10.1016/j.ijchp.2024.100442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/15/2024] [Indexed: 02/15/2024] Open
Abstract
Background/Objective Men do not use external condoms for several reasons, which can result in public health problems. One of these is related to Condom-Associated Erectile Problems. This study aimed to examine the sexual arousal response of heterosexual men when using an external condom made of synthetic resin type AT-10. Method A total of 82 Colombian young men (Mage = 23.17 years, SD = 3.04, age range = 18-30) participated in this experimental study. Two random groups (experimental and control; n = 41 each) were compared. The experimental group used condoms, whereas the control group did not. Fit and feel condom perceptions, initial erectile scores, age, and substance use were controlled for. Erection was measured while viewing a sexual video by using penile plethysmography and subjective arousal. Results The results, obtained from comparing the experimental group (using pre-erection condoms) with the control group (not using condoms), revealed no significant difference in both subjective and physiological sexual arousal. This suggests that pre-erection condoms do not have an effect on the erectile response. Discussion More research is needed in this area to provide treatment and clinical interventions or sexual and reproductive education to mitigate the occurrence of sexual dysfunction, unplanned pregnancies, or sexually transmitted infections. Also, research addresses public health issues related to the prevention and/or intervention of sexual risk behaviors and sexual dysfunctions, highlighting their significance in sexual education and clinical practice.
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Affiliation(s)
- Alejandro Saavedra-Roa
- SexLab KL - Human Sexual Laboratory, Department of Psychology, Fundación Universitaria Konrad Lorenz, Bogotá D.C., Colombia
| | - Pablo Vallejo-Medina
- SexLab KL - Human Sexual Laboratory, Department of Psychology, Fundación Universitaria Konrad Lorenz, Bogotá D.C., Colombia
- Universitat Oberta de Catalunya, Department of Psychology and Education Sciences, Barcelona, Spain
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Kawuma R, Lunkuse JF, Ssembajjwe W, Kayesu I, Price MA, Brickley DB, Abaasa A, Mayanja Y. "I fear those things": non-uptake of contraceptives, and barriers to use among adolescent girls and young women at high risk of HIV infection in Kampala, Uganda. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1198672. [PMID: 37649966 PMCID: PMC10465063 DOI: 10.3389/frph.2023.1198672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 07/31/2023] [Indexed: 09/01/2023] Open
Abstract
Background Adolescent girls and young women involved in risky behaviors are vulnerable to multiple health problems, yet sexual and reproductive health services remain underutilized. We evaluated factors associated with non-uptake of contraceptives and barriers to use among adolescent girls and young women (14-24 years old) at high risk of HIV infection in an environment where contraceptives were provided at no cost. Methods We conducted a mixed methods study, utilizing data from a baseline cross sectional survey and qualitative in-depth interviews. Survey participants tested negative for pregnancy and reported willingness to use contraception. Non-uptake of contraceptives was defined as not taking contraception at any study visit (baseline and throughout the study). Logistic regression model was used to assess factors associated with non-uptake of contraceptives. We purposively selected participants for interviews to discuss their knowledge and experiences with contraceptives and make suggestions to improve uptake. Qualitative data were analyzed thematically. Results All 285 participants were included in the analysis. Out of the 285 participants 127 were not using contraceptives and of the 127, 44 (34.6%) did not take up any method throughout the study while 43 of the 83 remaining participants (who took up a method) chose male condoms only. Non-uptake of contraceptives was less likely among older women (20-24 years) (aOR = 0.32, 95% CI 0.16-0.89) compared to younger women (less than 20 years). Qualitative data showed that concerns about future fertility, fear of associated side effects and influence from close relations contributed to non-uptake of contraception. Conclusion Non-uptake of contraceptives was common despite the promotion and provision of contraceptives in the context of a research study mainly because adolescents lack autonomy while making contraceptive decisions. Identifying and addressing their concerns and continued counselling on contraceptive use alongside condom promotion may improve uptake and utilization of contraceptives.
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Affiliation(s)
- Rachel Kawuma
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Jane Frances Lunkuse
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Wilber Ssembajjwe
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Ivy Kayesu
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Matt A. Price
- Department of Epidemiology and Biostatistics, University of California, San Francisco (UCSF), San Francisco, CA, United States
- IAVI, New York, NY, United States
| | - Debbie B. Brickley
- Institute for Global Health Sciences, University of California, San Francisco (UCSF), San Francisco, CA, United States
| | - Andrew Abaasa
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Yunia Mayanja
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
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Howard SA, Benhabbour SR. Non-Hormonal Contraception. J Clin Med 2023; 12:4791. [PMID: 37510905 PMCID: PMC10381146 DOI: 10.3390/jcm12144791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
While hormonal contraceptives are efficacious and available in several forms for women, perception of safety and concern over side effects are a deterrent for many. Existing non-hormonal contraceptives include permanent sterilization, copper intrauterine devices (IUDs), chemical/physical barriers such as spermicides and condoms, as well as traditional family planning methods including withdrawal and the rhythm method. Individuals who wish to retain their fertility in the future can achieve highest adherence and efficacy with long-acting, reversible contraceptives (LARCs), though there is only one, the copper IUD, that is non-hormonal. As rates of unintended pregnancies remain high with existing contraceptive options, it is becoming increasingly attractive to develop novel pregnancy prevention methods for both women and men. Non-hormonal contraceptives can target a variety of critical reproductive processes discussed here. This review focuses on identified non-hormonal contraceptive targets and subsequent drug candidates in development.
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Affiliation(s)
- Sarah Anne Howard
- Division of Pharmacoengineering and Molecular Pharmaceutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Soumya Rahima Benhabbour
- Division of Pharmacoengineering and Molecular Pharmaceutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Joint Department of Biomedical Engineering, North Carolina State University and The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Beksinska M, Smit J, Mona A, Maphumulo V, Mphili N, Manzini-Matebula N, Chidarikire T. Female condom color and scent preference in Durban, South Africa. Contracept X 2023; 5:100095. [PMID: 37554547 PMCID: PMC10404533 DOI: 10.1016/j.conx.2023.100095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVES To assess preferences for female condom (FC) colors and scents. STUDY DESIGN Women aged 18-40 years were randomized to one of three FCs (FC2, Cupid1, Cupid2) two of which offered a choice of color and scent (red/strawberry, purple/vanilla, natural/unscented). Women could choose any variety within condom types while participating in an FC contraceptive efficacy study in South Africa. RESULTS One hundred and thirty-three women were allocated to each FC type. Strawberry was the most popular variety for both FC2 and Cupid1 (60.9%, 78.3% respectively). Some women chose more than one variety but few chose the natural. CONCLUSIONS Data support a clear preference for colored and scented FCs. IMPLICATIONS These data can inform FC programme managers to predict demand for different varieties of FC and can adjust supply of FCs accordingly.
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Affiliation(s)
- Mags Beksinska
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Jenni Smit
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Amanda Mona
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Virginia Maphumulo
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Nonhlanhla Mphili
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
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Beksinska M, Mphili N, Smit J. Functional performance of the Wondaleaf condom: A crossover, noninferiority, randomized clinical trial. Int J STD AIDS 2023; 34:114-121. [PMID: 36426764 DOI: 10.1177/09564624221139899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND New female condom (FC) products wishing to apply for United Nations Population Fund/World Health Organisation (UNFPA/WHO) prequalification are required to conduct a randomized, controlled clinical investigation comparing the new FC to the marketed FC, in order to comply with UNFPA/WHO and International Organization for Standardization (ISO) specifications. We aimed to assess the functional performance, acceptability and safety of the Wondaleaf female condom compared to the control FC2 female condom. METHODS This randomized clinical trial enrolled 220 women in one South African site. The primary outcome of the study was the rate of female condom (FC) failure. Participants were asked to use five of each FC type and to collect information on use in a condom diary at home, and were interviewed after use of each FC type. RESULTS Noninferiority was demonstrated for the Wondaleaf with respect to the reference FC2 for all condom functions. The Wondaleaf was found to be superior to the FC2 reference condom for invagination (p > .000), misdirection (p > .000) and clinical failure (p > .000). Acceptability ratings for a range of features were similar between the two FCs. Few safety events were reported for either device. CONCLUSION The Wondaleaf performs as well as the FC2, and is equally acceptable. Results from this study will inform further refinement of this FC design. Trial registrations: ClinicalTrials.gov Identifier: NCT04076774 https://clinicaltrials.gov/. South African National Clinical Trials Database (SANCTR) number DOH-27-0319-6020.
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Affiliation(s)
- Mags Beksinska
- Match Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, 37708University of the Witwatersrand, Durban, South Africa
| | - Nonhlanhla Mphili
- Match Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, 37708University of the Witwatersrand, Durban, South Africa
| | - Jenni Smit
- Match Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, 37708University of the Witwatersrand, Durban, South Africa
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Gonçalves L, Zanlorenci S, Borges LL, de Lima TR, Silva DAS. Body Weight Dissatisfaction and Health Risk Behaviors in Adolescents. Percept Mot Skills 2023; 130:340-363. [PMID: 36330766 DOI: 10.1177/00315125221137678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Body weight dissatisfaction has been described as a marker for various health diseases, given its direct association with social, physical, and emotional suffering. We investigated the association between body weight dissatisfaction and health risk behaviors in adolescents. This was a cross-sectional study conducted with 668 adolescents aged 14-19 years in the city of São José, southern Brazil. Body weight satisfaction/dissatisfaction was assessed using a questionnaire validated for the investigated population. Health risk behaviors included smoking, alcohol, illicit drugs, medication, non-prescription anabolic steroids, not using seatbelt, unsafe sexual behavior and not knowing how to deal with day-to-day stress. Among males, 66.1% were dissatisfied with their body weight (32.1% due to thinness and 34.0% due to overweight). Among females, 80.0% were dissatisfied with their body weight (24.5% due to thinness and 55.5% due to overweight). There were no significant differences regarding health risk behaviors according to body weight satisfaction/dissatisfaction and sex. Compared to males who were satisfied with their body weight, those who were dissatisfied due to being overweight were more likely to be using tobacco (OR: 2.9; 95% CI: 2.1-4.2), alcohol (OR: 1.7; 95% CI: 1.5-1.9) and anabolic steroids (OR: 2.7; 95% CI: 1.2-5.7). Compared to females who were satisfied with their body weight, those who were dissatisfied due to thinness were more likely to be consuming alcoholic beverages (OR: 1.6; 95% CI: 1.2-2.0) and less likely to be consuming illicit drugs (OR: 0.5; 95% CI: 0.3-0.8). Interventions aimed at health education regarding the non-adoption of risk behaviors such as alcohol and tobacco use, as well as the non-use of anabolic steroids, and favoring the maintenance of general health, may be important for adolescents with body dissatisfaction. These data suggest that health risk behaviors such as adolescent male use of tobacco, alcohol, and anabolic steroids and the use of alcohol and drugs by female adolescents can be related to body weight dissatisfaction.
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Affiliation(s)
- Leticia Gonçalves
- Department of Physical Education, 28117Federal University of Santa Catarina - Sports Center, Santa Catarina, Brazil
| | - Suellem Zanlorenci
- Department of Physical Education, 28117Federal University of Santa Catarina - Sports Center, Santa Catarina, Brazil
| | - Leandro Lima Borges
- Department of Physical Education, 28117Federal University of Santa Catarina - Sports Center, Santa Catarina, Brazil
| | - Tiago Rodrigues de Lima
- Department of Physical Education, 28117Federal University of Santa Catarina - Sports Center, Santa Catarina, Brazil
| | - Diego Augusto Santos Silva
- Department of Physical Education, 28117Federal University of Santa Catarina - Sports Center, Santa Catarina, Brazil.,Faculty of Health Sciences, Universidad Autnoma de Chile, Providencia, Chile
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Wright KO, Akinyinka MR, Fagbemi T, Aderibigbe A, Banke-Thomas A, Wusu O. Contraceptive use and fertility control in rural and urban communities of Lagos Nigeria. Niger Postgrad Med J 2023; 30:31-39. [PMID: 36814161 DOI: 10.4103/npmj.npmj_268_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Background It is predicted that the population of sub-Saharan Africa will be thrice its size by the end of the 21st century. Our study compared patterns, incentives and disincentives for the uptake of contraceptives in rural and urban communities of Lagos, Nigeria. Materials and Methods This is a population-based cross-sectional study on 1445 women of reproductive ages 15-49 years using a cluster sampling technique and a pre-tested, interviewer-administered electronic questionnaire in 2020. Data were analysed using the Statistical Package for the Social Sciences (SPSS) software version 26.0 and ethical approval was obtained for the study. Results About 32.4% of the respondents were rural dwellers and 67.6% were urban residents. The overall mean age was 31.7 ± 7.8 years. In terms of pattern, slightly over half (53.3%) of all respondents had ever used family planning (FP), including modern contraceptives and slightly less than a third (30.8%) currently use FP methods in both rural and urban communities, respectively. Predominant disincentives for non-use of FP include a desire to retain fertility, lack of further need, unbearable side effects and lack of spousal support. The odds of being an urban dweller currently using a method of contraceptive method is 4.169 times higher for earners above ₦60,000, which is twice the minimum wage compared to those without income (adjusted odd's ratio: 4.169, 95% confidence interval: 1.395-12.462). Conclusion Sustained effort is required to improve contraceptive uptake, FP service delivery and demand satisfaction for modern contraceptives to enable the achievement of demographic dividends and gains.
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Affiliation(s)
- Kikelomo Ololade Wright
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine; Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital; Centre for Reproductive Health Research and Innovation, Lagos State University College of Medicine, Lagos, Nigeria
| | - Modupe Rebekah Akinyinka
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine; Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Temiloluwa Fagbemi
- Centre for Reproductive Health Research and Innovation, Lagos State University College of Medicine, Lagos, Nigeria
| | - Adedayo Aderibigbe
- Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital; Centre for Reproductive Health Research and Innovation, Lagos State University College of Medicine, Lagos, Nigeria
| | - Aduragbemi Banke-Thomas
- Centre for Reproductive Health Research and Innovation, Lagos State University College of Medicine, Lagos, Nigeria; Centre for Vulnerable Children and Families, Institute for Life Course Development, University of Greenwich, London, United Kingdom
| | - Onipede Wusu
- Department of Sociology, Faculty of Social Sciences, Lagos State University, Lagos, Nigeria
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Picchetti V, Stamatakis C, Annor FB, Massetti GM, Hegle J. Association between lifetime sexual violence victimization and selected health conditions and risk behaviors among 13-24-year-olds in Lesotho: Results from the Violence Against Children and Youth Survey (VACS), 2018. CHILD ABUSE & NEGLECT 2022; 134:105916. [PMID: 36215756 PMCID: PMC9691579 DOI: 10.1016/j.chiabu.2022.105916] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 09/21/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Sexual violence is a serious public health concern worldwide. In Lesotho, one in seven women and one in twenty men aged 18 years and older experienced sexual violence during childhood. Sexual violence victimization may lead to long-term mental and physical health issues among victims, regardless of gender. OBJECTIVE To estimate the prevalence of lifetime sexual violence victimization (SV) among 13-24-year-olds in Lesotho and assess its association with selected health conditions and risk behaviors. PARTICIPANTS AND SETTING Data from 13 to 24-year-old participants (n = 8568) of the 2018 Lesotho Violence Against Children and Youth Survey were analyzed. METHODS SV was defined as reporting one or more types of sexual violence at any age. Logistic regression analyses measured associations between SV and selected health conditions (suicidal thoughts, self-harm behaviors, mental distress, STIs, and HIV), and risk behaviors (binge drinking in the past 30 days, drug use in the past 30 days, infrequent condom use in the past 12 months, multiple sex partners in the past 12 months, and transactional sex in the past 12 months). RESULTS After controlling for study covariates, SV was significantly associated with self-harm behaviors, suicidal thoughts, ever having an STI, binge drinking in the past 30 days, infrequent condom use in the past 12 months, and multiple sex partners in the past 12 months for both males and females; and mental distress and transactional sex in the past 12 months for females. CONCLUSIONS Preventing SV against children and youth in Lesotho may improve their health and wellbeing.
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Affiliation(s)
- Viani Picchetti
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
| | - Caroline Stamatakis
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Francis B Annor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Greta M Massetti
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Jennifer Hegle
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
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Sheridan T, Gómez-Torres P, Vera Cruz G, Martínez-Pérez GZ. A global grounded theory exploration of investigators' perspectives on male hormonal contraceptive development and acceptability. Glob Public Health 2022; 17:3760-3772. [PMID: 35901059 DOI: 10.1080/17441692.2022.2102201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
While best practices have been proposed on how to engage men in family planning (FP), the limited options of male hormonal contraceptives (MHC) are a barrier to reaching men as clients of FP programs. The lack of alternative MHC is preventing the global health community from providing holistic reproductive healthcare. A qualitative grounded theory study was conducted in 2020 to explore MHC experts' perceptions around the development and theoretical acceptability of MHCs. Individual in-depth interviews were conducted with 15 key informants. The informants cited evidence that there is a demand for MHC. The inability to access this data by the pharmaceutical industry was acknowledged. Many informants expressed concern of the possibility for MHC to increase male power in a predominantly patriarchal world. To most informants, at least for the initial introduction of MHC, fertility sharing is something that will largely happen among couples alone rather than individually. There is proven demand among women and men for MHC, however industries may still be reluctant to invest. Effort is needed by the sexual and reproductive health and rights community to include male engagement in FP and to advocate for the development and use of MHC as a tool for women's empowerment.
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Affiliation(s)
- Taylor Sheridan
- The Barcelona Institute for Global Health Foundation (ISGlobal), Barcelona, Spain
| | - Piedad Gómez-Torres
- Department of Physiatrics and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Germano Vera Cruz
- Department of Psychology, UR 7273 CRP-CPO, University of Picardie Jules Verne, Amiens, France
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Fu TC, Rosenberg M, Golzarri-Arroyo L, Fortenberry JD, Herbenick D. Relationships between Penile-Vaginal Intercourse Frequency and Condom/Contraceptive Use from 2009 to 2018: Findings from the National Survey of Sexual Health and Behavior. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2022; 34:716-727. [PMID: 37008894 PMCID: PMC10062058 DOI: 10.1080/19317611.2022.2132340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/11/2022] [Accepted: 09/20/2022] [Indexed: 06/19/2023]
Abstract
Objectives To examine changes over time in event-level condom/contraceptive use and the association between past year penile-vaginal intercourse frequency and event-level condom/contraceptive use. Methods Data were from the 2009 and 2018 National Survey of Sexual Health and Behavior, an online probability survey of U.S. adolescents and adults. Results Use of condoms and highly effective hormonal contraceptives decreased while long-acting reversible contraceptive use increased from 2009 to 2018 among adults. Increased penile-vaginal intercourse frequency was associated with decreased use of most contraceptive methods but an increase in condom use for adolescents. Conclusions Sexual frequency should be considered when assessing condom/contraceptive use.
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Affiliation(s)
- Tsung-chieh Fu
- Center for Sexual Health Promotion, Indiana University, Bloomington, IN, USA
- Department of Applied Health Science, Indiana University, Bloomington, IN, USA
| | - Molly Rosenberg
- Department of Biostatistics and Epidemiology, Indiana University, Bloomington, IN, USA
| | | | - J. Dennis Fortenberry
- Division of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Debby Herbenick
- Center for Sexual Health Promotion, Indiana University, Bloomington, IN, USA
- Department of Applied Health Science, Indiana University, Bloomington, IN, USA
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Examining the place of the female condom in india's family planning program aqualitative investigation of the attitudes, opinions of key stakeholders in Pune, India. BMC Public Health 2022; 22:1675. [PMID: 36064344 PMCID: PMC9442954 DOI: 10.1186/s12889-022-14054-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 08/24/2022] [Indexed: 11/14/2022] Open
Abstract
Background With overpopulation contributing to the depletion of planetary resources, the high rates of unintended pregnancies in India are a cause for concern. Despite the free supply of contraception options within India’s national family planning initiatives, women are generally offered hormonal options as temporary spacing methods. However, female condoms, a much neglected but potent woman initiated, non-hormonal multipurpose prevention device, are yet to be considered for inclusion in India’s contraceptive cafeteria. Thus, we aim to examine the place of female condoms among the contraceptive options, by analysing the perceptions of key stakeholders regarding its advantages and disadvantages, along with their opinions on how female condoms should be promoted. Methods We used purposive sampling to recruit and interview potential users and dispensers of the female condom. The interview participants visited or worked at family planning clinics in Pune at Smt. Kashibai Navale Medical College and General Hospital (SKNMC-GH), its urban and rural outreach clinics, and at Saheli (a non-governmental organisation for female sex workers). We conducted semi-structured interviews and coded our data inductively. Results We interviewed 5 rural women, 20 urban women (including 10 female sex workers), 5 male partners of female sex workers, and 5 family planning healthcare providers. Nearly half (12/25) of the women we interviewed, said that they were eager to use female condoms in the future. Many participants perceived female condoms to be an instrument to empower women to be in control of their sexual and reproductive lives (15/35), and that it provided user comfort and confidence (4/35). Their perceived disadvantages are that they are relatively more expensive (6/35), users have limited experience (9/35), and women who buy or use them may be stigmatised and feel embarrassed (4/35). Yet, nearly three-quarters of potential users (21/30) and most healthcare providers (4/5), were confident that female condoms could become popular following extensive promotional campaigns, interventions to improve availability and access, and initiatives to enhance the knowledge of female users. Conclusions Female condoms have garnered support from both users and dispensers and have the potential to be widely adopted in India if family planning initiatives which increase awareness, knowledge, and access are systematically undertaken as with other contraceptive options.
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Zhang R, Liu Z, Zhang Y, Zhang D, Liao Q. Natural progress history of asymptomatic bacterial vaginosis in Chinese Han women and associated risk factors. Postgrad Med 2022; 134:659-667. [PMID: 35968669 DOI: 10.1080/00325481.2022.2113286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVE Asymptomatic bacterial vaginosis (aBV) is prevalent in the general population, while a previous study only investigated the natural history of aBV in women at high-risk. This stage study was to investigate the natural history of aBV in Chinese Han women at general risk and examine risk factors associated with different outcomes. METHODS Women of reproductive age with aBV were enrolled and prospectively followed up with for four months. Participants were classified into one of three outcomes: progress, self-cure or no-change. Univariate and multivariate analyses were used to determine the association between potential risk factors and outcomes. RESULTS A total of 3420 subjects were screened and 1014 women with aBV were enrolled. Eventually, 984 participants completed the study, with 30 patients dropped out. Among the 984 cases, 42 cases self-cured spontaneously, while 433 cases progressed and 509 cases did not change significantly. Of the 433 cases that progressed, several types of mixed infections were observed in addition to 196 symptomatic bacterial vaginosis. According to univariate analysis, frequent travel (OR, 95% CI, 2.73 [2.09 ~ 3.55]) and history of bacterial vaginosis (BV) (5.47, [4.15 ~ 7.21]) exhibited significant associations with aBV progression, while condom contraception (0.46 [0.36 ~ 0.61]) and lower Nugent score (0.49, [0.37 ~ 0.64]) demonstrated protective effects for self-cure. According to multivariate regression analysis, the risk factors for aBV progression were history of BV (6.67, [4.86 ~ 9.15]) and frequent travel (3.57, 2.59 ~ 4.92). Condom contraception (0.36, 0.26 ~ 0.49) exhibited a protective effect against aBV progression. CONCLUSION Without intervention, a large proportion of aBV would progress, compared to the very few patients whose aBV self-cured spontaneously. It is necessary to clinically intervene aBV patients. Condom utilization can be used as an effective method to improve the outcome of aBV.
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Affiliation(s)
- Rui Zhang
- Department of Obstetrics & Gynecology, Peking University First Hospital, Beijing, China
| | - Zhaohui Liu
- Department of Obstetrics & Gynecology, Beijing Obstetrics and Gynecology Hospital, Beijing, China
| | - Yan Zhang
- Department of Obstetrics & Gynecology, Peking University First Hospital, Beijing, China
| | - Dai Zhang
- Department of Obstetrics & Gynecology, Peking University First Hospital, Beijing, China
| | - Qinping Liao
- Department of Obstetrics & Gynecology, Beijing Tsinghua Changgung Hospital, Beijing, China
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Gollub EL, Vaughan R. U.S. Women Need the Dapivirine Ring, Too: FDA as Structural Barrier to HIV Prevention for Women. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:311-324. [PMID: 35994576 DOI: 10.1521/aeap.2022.34.4.311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The dapivirine monthly vaginal ring-a discreet, anti-HIV microbicide created specifically for women-has received a positive scientific opinion by the European Medicines Agency and is included in the WHO HIV prevention guidelines. It has received regulatory approvals in several countries in southern and eastern Africa. During the review of the New Drug Application that was submitted in December 2020, FDA advised the developer, International Partnership for Microbicides, that it was unlikely to be approved in the United States; the application has since been withdrawn. This commentary will present the case for FDA approval for the dapivirine ring. Advocacy is urgently needed to protect U.S. women's access to user-controlled HIV prevention technologies, consistent with both global regulatory decisions to date and with a reproductive justice framework. Women continue to need the fullest range of HIV prevention methods to integrate into their lives in the most practical and effective way possible.
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Affiliation(s)
- Erica L Gollub
- Health Science Program, College of Health Professions, Pace University, Pleasantville, New York
| | - Raven Vaughan
- Health Science Program, College of Health Professions, Pace University, Pleasantville, New York
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de Wit JBF, Adam PCG, den Daas C, Jonas K. Sexually transmitted infection prevention behaviours: health impact, prevalence, correlates, and interventions. Psychol Health 2022; 38:675-700. [PMID: 35748408 DOI: 10.1080/08870446.2022.2090560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Sexually transmitted infections (STIs) remain a major public health threat, disproportionately affecting young people, and men who have sex with men. In this narrative review of the current state of behavioural science research on STI prevention, we consider the definition, health impacts, correlates and determinants, and interventions to promote STI prevention behaviour. Research on STI prevention behaviour has extended from a focus on abstinence, partner reduction and condom use, to also include novel preventive behaviours, notably treatment-as-prevention, pre-exposure prophylaxis (i.e., the preventive use of medicines by uninfected people), and vaccination for some STIs. Social-cognitive factors specified by, for instance the theory of planned behaviour, are critical proximal determinants of STI prevention behaviours, and related interventions can effectively promote STI prevention behaviours. Social-ecological perspectives highlight that individual-level determinants are embedded in more distal environmental influences, with social stigma especially affecting STI prevention behaviours and requiring effective intervention. Further to providing a major domain of application, STI prevention also poses critical challenges and opportunities for health psychology theory and research. We identify a need for health behaviour theory that addresses the processes linking multiple levels of influence on behaviour and provides practical guidance for multi-level behaviour change interventions adapted to specific contexts.
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Affiliation(s)
- John B. F. de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
- Centre for Social Research in Health, UNSW Sydney, Kensington, Australia
| | - Philippe C. G. Adam
- Centre for Social Research in Health, UNSW Sydney, Kensington, Australia
- Institute for Prevention and Social Research, Bangkok, Thailand
| | - Chantal den Daas
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland
| | - Kai Jonas
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
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Faridi N, Vakilian K, Yousefi AA. The effect of empowerment-based counseling on increasing the main indices of safe sex in women with substance use disorder. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2071804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Parmejiani EP, Queiroz ABA, Cunha MPL, Carvalho ALDO, Santos GSD, Bezerra JDF, Figueiredo EMC, Santos CAD. SABERES E MODOS DE AGIR DE HOMENS RIBEIRINHOS SOBRE O USO DE PRESERVATIVO. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2022-0155pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO Objetivo analisar os saberes e modos de agir de homens ribeirinhos acerca o uso do preservativo, a partir de suas representações sociais sobre o dispositivo. Método estudo qualitativo ancorado na Teoria das Representações Sociais, realizado com 21 homens ribeirinhos da comunidade São Carlos do Jamari, em Porto Velho, Rondônia, Brasil. A coleta de dados ocorreu entre janeiro e julho de 2019, por meio de entrevista com questionário semiestruturado. Para o processamento dos dados utilizou-se os softwares Statistical Package for the Social Sciences, obtendo-se a caracterização dos participantes por meio da estatística descritiva e o IRAMUTEq®, para análise lexical dos discursos, pela classificação hierárquica descente, obtendo-se cinco classes temáticas, dentre as quais, aprofundou-se neste estudo a classe cinco. Resultados as representações sociais foram produzidas por participantes adultos, com ensino médio completo, renda familiar per capita de até um salário-mínimo, sexualmente ativos com uso irregular do preservativo. Identificou-se que os participantes elaboram uma dimensão cognitiva, que revela seus saberes sobre o preservativo como forma de prevenção, contudo, elementos como interferência no prazer, relacionamento estável e uma dimensão avaliativa negativa resultam no uso irregular do dispositivo e num comportamento de risco, em suas práticas sexuais. Conclusão as representações sociais se ancoram no conhecimento reificado, no discurso da funcionalidade preventiva do preservativo e em estereótipos de masculinidade. Com isso, os homens ribeirinhos possuem um conhecimento que não se manifesta em seus comportamentos. Portanto, esse grupo social carece de ações de promoção da saúde que possibilitem mudanças em seus comportamentos e práticas de cuidados.
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Parmejiani EP, Queiroz ABA, Cunha MPL, Carvalho ALDO, Santos GSD, Bezerra JDF, Figueiredo EMC, Santos CAD. RIVERSIDE MEN'S KNOWLEDGE AND WAYS OF ACTING REGARDING CONDOM USE. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2022-0155en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
ABSTRACT Objective to analyze riverside men's knowledge and ways of acting regarding condom use, based on the social representations about the device. Method a qualitative study anchored in the Theory of Social Representations and conducted with 21 riverside men from the São Carlos do Jamari community, Porto Velho, Rondônia, Brazil. Data collection was performed between January and July 2019 by means of an interview with a semi-structured questionnaire. For data processing, the Statistical Package for the Social Sciences software was used, obtaining the participants' characterization through descriptive statistics, in addition to IRAMUTEq® for the lexical analysis of the speeches, by means of the Descending Hierarchical Classification, obtaining five thematic classes, among which Class 5 was deepened on in this study. Results the social representations were produced by adult participants, with complete High School, per capita family income of up to one minimum wage, and sexually active with irregular condom use. It was identified that the participants develop a cognitive dimension, which reveals their knowledge about condoms as a form of prevention; however, elements such as interference in pleasure, stable relationship and a negative evaluative dimension result in irregular use of the device and in risky behaviors in their sexual practices. Conclusion social representations are anchored in reified knowledge, in the discourse of the preventive functionality of condoms, and in masculinity stereotypes. Consequently, the riverside men's knowledge is not manifested in their behaviors. Therefore, this social group lacks health promotion actions that enable changes in their care behaviors and practices.
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Stone N, Bedford R, Newby K, Brown K, Jackson L, Bremner S, Morrison L, McGrath N, Nadarzynski T, Bayley J, Perry N, Graham C. Reducing new chlamydia infection among young men by promoting correct and consistent condom use: Protocol for a randomised controlled trial. (Preprint). JMIR Res Protoc 2021; 11:e35729. [PMID: 35947422 PMCID: PMC9403823 DOI: 10.2196/35729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 05/22/2022] [Accepted: 05/25/2022] [Indexed: 11/25/2022] Open
Abstract
Background The health, social, and economic costs of sexually transmitted infections (STIs) represent a major public health concern. Young people are considered one of the groups most at risk for acquiring and transmitting STIs. Correct and consistent condom use has been shown to be the most effective method for reducing STIs; however, condoms are often not used properly. Evidence shows that brief behavior change interventions that focus on skills, communication, and motivation to acquire safe sex practices should be adopted into routine care to reduce STIs. Funding for sexual health services in England has declined dramatically, so novel ways of reducing clinic attendance are being sought. The home-based intervention strategy (HIS-UK) to promote condom use among young men has shown promise in feasibility and pilot studies by demonstrating high acceptability of the intervention in participant and health professional feedback, including aiding men to find condoms they like and feel more confident when using condoms. Objective The aim of this study is to determine the effectiveness and cost-effectiveness of HIS-UK when compared to usual condom distribution care among young men. Methods The 3 trial arms consisting of “e-HIS” (HIS-UK delivered digitally), “ProHIS” (HIS-UK delivered face-to-face), and control condition (usual National Health Service [NHS] care) will be compared against the following 3 primary outcomes: the extent to which correct and consistent condom use is increased; improvement of condom use experiences (pleasure as well as fit and feel); and decrease in chlamydia test positivity. Eligibility criteria include men aged 16-25 years at risk of STIs through reporting of condom use errors (ie, breakage or slippage) or condomless penile-vaginal or penile-anal intercourse with casual or new sexual partners during the previous 3 months. Prospective participants will be recruited through targeted advertisements and an opportunistic direct approach at selected sexual health and genitourinary medicine services and university-associated health centers and general practitioner practices. Community and educational establishments will be used to further advertise the study and signpost men to recruitment sites. Participants will be randomly allocated to 1 of 3 trial arms. A repeated measures design will assess the parallel arms with baseline and 12 monthly follow-up questionnaires after intervention and 3 chlamydia screening points (baseline, 6, and 12 months). Results Recruitment commenced in March 2020. Due to the COVID-19 pandemic, the study was halted and has since reopened for recruitment in Summer 2021. A 30-month recruitment period is planned. Conclusions If effective and cost-effective, HIS-UK can be scaled up into routine NHS usual care to reduce both STI transmission in young people and pressure on NHS resources. This intervention may further encourage sexual health services to adopt digital technologies, allowing for them to become more widely available to young people while decreasing health inequalities and fear of stigmatization. Trial Registration ISRCTN Registry ISRCTN11400820; https://www.isrctn.com/ISRCTN11400820
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Affiliation(s)
- Nicole Stone
- Department of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Rowena Bedford
- Department of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Katie Newby
- Department of Psychology and Sports Science, Faculty of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, United Kingdom
| | - Katherine Brown
- Department of Psychology and Sports Science, Faculty of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, United Kingdom
| | - Louise Jackson
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Stephen Bremner
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Leanne Morrison
- Department of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Nuala McGrath
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- Department of Social Statistics and Demography, Faculty of Economic, Social and Political Sciences, University of Southampton, Southampton, United Kingdom
| | - Tom Nadarzynski
- School of Social Sciences, University of Westminster, London, United Kingdom
| | - Jake Bayley
- Barts Health NHS Trust, London, United Kingdom
| | - Nicky Perry
- University Hospitals Sussex NHS Trust, Brighton, United Kingdom
| | - Cynthia Graham
- Department of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
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Impacts of Plastic Pollution on Ecosystem Services, Sustainable Development Goals, and Need to Focus on Circular Economy and Policy Interventions. SUSTAINABILITY 2021. [DOI: 10.3390/su13179963] [Citation(s) in RCA: 135] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Plastic pollution is ubiquitous in terrestrial and aquatic ecosystems. Plastic waste exposed to the environment creates problems and is of significant concern for all life forms. Plastic production and accumulation in the natural environment are occurring at an unprecedented rate due to indiscriminate use, inadequate recycling, and deposits in landfills. In 2019, the global production of plastic was at 370 million tons, with only 9% of it being recycled, 12% being incinerated, and the remaining left in the environment or landfills. The leakage of plastic wastes into terrestrial and aquatic ecosystems is occurring at an unprecedented rate. The management of plastic waste is a challenging problem for researchers, policymakers, citizens, and other stakeholders. Therefore, here, we summarize the current understanding and concerns of plastics pollution (microplastics or nanoplastics) on natural ecosystems. The overall goal of this review is to provide background assessment on the adverse effects of plastic pollution on natural ecosystems; interlink the management of plastic pollution with sustainable development goals; address the policy initiatives under transdisciplinary approaches through life cycle assessment, circular economy, and sustainability; identify the knowledge gaps; and provide current policy recommendations. Plastic waste management through community involvement and socio-economic inputs in different countries are presented and discussed. Plastic ban policies and public awareness are likely the major mitigation interventions. The need for life cycle assessment and circularity to assess the potential environmental impacts and resources used throughout a plastic product’s life span is emphasized. Innovations are needed to reduce, reuse, recycle, and recover plastics and find eco-friendly replacements for plastics. Empowering and educating communities and citizens to act collectively to minimize plastic pollution and use alternative options for plastics must be promoted and enforced. Plastic pollution is a global concern that must be addressed collectively with the utmost priority.
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Antich-Isern P, Caro-Barri J, Aparicio-Blanco J. The combination of medical devices and medicinal products revisited from the new European legal framework. Int J Pharm 2021; 607:120992. [PMID: 34390808 DOI: 10.1016/j.ijpharm.2021.120992] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/20/2021] [Accepted: 08/08/2021] [Indexed: 02/06/2023]
Abstract
Medical devices and medicinal products have many similarities in their nature, scope or specific medical purposes, and despite the differences in their principal means of action, they are often used in combination. Indeed, many medicinal products depend on medical devices for their administration, and it is increasingly common for medical devices to contain medicinal substances to support their action. Therefore, the combination of medicinal products and medical devices provides additional benefits for patients. However, their higher technical complexity requires a strengthening of their authorisation and certification requirements. In this regard, more comprehensive requirements and classification rules are introduced by a new European regulation on medical devices that fully applies from May 26th 2021. On account of their therapeutic significance, this review aims at gaining insight into the borderline between medical devices and medicinal products in this new 2021 regulatory framework. For the first time, any item containing a medical device and a medicinal product will have both parts evaluated. Through exemplification of both marketed and investigational devices incorporating medicinal substances and drug-device combinations, the new European requirements and their implications are thoroughly illustrated herein.
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Affiliation(s)
- Pau Antich-Isern
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain
| | - Julia Caro-Barri
- Notified Body 0318, Spanish Agency of Medicines and Medical Devices (AEMPS), Madrid, Spain
| | - Juan Aparicio-Blanco
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain; Institute of Industrial Pharmacy, Complutense University of Madrid, Madrid, Spain.
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The importance of condom use – from contraception to solving public health issues. GINECOLOGIA.RO 2021. [DOI: 10.26416/gine.31.1.2021.4332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Beksinska M, Nkosi P, Mabude Z, Mantell JE, Zulu B, Milford C, Smit JA. Lessons from the evaluation of the South African National Female Condom Programme. PLoS One 2020; 15:e0236984. [PMID: 32790677 PMCID: PMC7425948 DOI: 10.1371/journal.pone.0236984] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 07/18/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Understanding of the facilitators and challenges to female condom (FC) uptake has been limited due to lack of evaluation of national FC programmes. SETTING The FC has been an integral component of South Africa's (SA) HIV prevention programme for 20 years and is the largest government-funded FC programme worldwide. METHODS The national FC evaluation used a mixed-methods approach and consisted of key informant interviews and a telephone survey in a national sample of public and non-public sites. A sub-sample of sites participated in client and provider interviews, and a self-administered client survey. A review of distribution statistics from South Africa's District Health Information System was also conducted. RESULTS All 256 public-sector and 28 non-public-sector facilities reported having ever distributed FCs. Less than 5% of these facilities reported stock-outs and less than 3% reported they had a supply of expired female condoms. Systems for male condom (MC) and FC distribution were complementary, with similar ordering, delivery and reporting processes. FC promotion by providers (n = 278) varied with regard to FC training, whether attitudes about FCs influenced providers offer of FCs, and how they counselled clients about FCs. Of the 4442 self-administered client surveys in 133 facilities, similar proportions of women (15.4%) and men (15.2%) had ever used FCs. Although FCs were available at almost all sites surveyed, only two-thirds of clients were aware of their availability. CONCLUSION Data highlight the role of providers as gatekeepers to FC access in public and non-public sectors and provide support for further FC programme expansion in SA and globally.
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Affiliation(s)
- Mags Beksinska
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Phumla Nkosi
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Zonke Mabude
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Joanne E. Mantell
- Division of Gender, Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, Sexuality and Health, New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, New York, United States of America
| | - Bongiwe Zulu
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Cecilia Milford
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jennifer A. Smit
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Festin MPR. Preface - Modern contraception. Best Pract Res Clin Obstet Gynaecol 2020; 66:1-3. [PMID: 32622630 DOI: 10.1016/j.bpobgyn.2020.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Mario Philip R Festin
- Department of Obstetrics and Gynecology, University of the Philippines College of Medicine, Philippine General Hospital, Taft Avenue, Ermita, Manila, Philippines.
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