The Experts below are selected from a list of 1512 Experts worldwide ranked by ideXlab platform
Coggins C - One of the best experts on this subject based on the ideXlab platform.
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Spermicides and Barrier Contraception.
Current opinion in obstetrics & gynecology, 1994Co-Authors: Faúndes A, Elias C, Coggins CAbstract:In addition to its contraceptive effect condom use reduces the risk of gonorrhea herpes simplex virus infection genital ulcers pelvic inflammatory disease HIV hepatitis B virus and Chlamydia trachomatis. The contraceptive failure rate of condoms varies from 2 to 13%. The rate of breakage varied from 0.8% among prostitutes in the Netherlands to 13.7% among heterosexual men in Ghana. The reported slippage rates varied from 0.3% among prostitutes in the Netherlands to 4.4% among men in Australia. Female-controlled Barrier methods may actually prevent more STDs than condoms because of their more consistent use. The main complaint of diaphragm users is that it is messy and unclean. It was recommended that patients use the diaphragm without spermicide continuously from the end of one menses to the onset of the next removing it only to wash it. These subjects were compared with patients who used the diaphragm with spermicide only during coitus. The first group had significantly lower 1-year total and patient failure rates 2.8% and 0.6% compared with 9.6% and 6.5% respectively among women who used the diaphragm in the traditional manner. The continuation rate in the continuous use group was 85% compared with 64% in the other group. Genital tract trauma changes in vaginal flora and allergic reactions have not been reported with use of Femidom (the female condom) which has a contraceptive effectiveness of 74-88% with typical use and 89-95% with perfect use. Nonoxynol-9 appears to have a protective effect against some STDs and spermicides containing nonoxynol-9 may offer some protection against HIV. Two clinical studies in the 1980s compared the contraceptive efficacy of the diaphragm the vaginal sponge and the cervical cap. The failure rate during perfect use of the sponge and the cervical cap was significantly greater among parous women (19-21% and 26-27% respectively) than among nulliparous women (9-10% and 8-10% respectively). New nondetergent spermicides which could also protect against viral infection including HIV are currently being studied.
Nontokozo Langwenya - One of the best experts on this subject based on the ideXlab platform.
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reproductive aspirations Contraception use and dual protection among adolescent girls and young women the effect of motherhood and hiv status
Journal of the International AIDS Society, 2020Co-Authors: Elona Toska, Lucie Cluver, Christina A Laurenzi, Camille Wittesaele, Lorraine Sherr, Siyanai Zhou, Nontokozo LangwenyaAbstract:INTRODUCTION There is a growing interest in adolescent motherhood and HIV among policymakers and programme implementers. To better shape services and health outcomes, we need evidence on reproductive aspirations and Contraception use in this high-risk group, including the effect of motherhood and HIV status. We report data from a large survey of adolescent girls and young women conducted in a mixed rural-urban district in South Africa. METHODS Quantitative interviews were conducted with 1712 adolescent girls and young women (ages 10 to 24): 336 adolescent mothers living with HIV (AMLHIV), 454 nulliparous adolescent girls living with HIV (ALHIV), 744 HIV-negative adolescent mothers (control adolescent mothers) and 178 HIV-negative nulliparous adolescent girls (nulliparous controls) in 2018 to 2019. Standardized questionnaires included socio-demographic measures, reproductive health and Contraception experiences. Reproductive aspirations were measured as the number of children participants wanted to have. Dual protection was computed as use of both hormonal and Barrier Contraception or abstinence. Multivariate logistic regression and marginal effects models in STATA 15 were used to test associations between HIV status, adolescent motherhood and outcomes of reproductive aspirations, Contraception use and dual protection, controlling for covariates. RESULTS AND DISCUSSION Nearly 95% of first pregnancies were unintended. Over two-thirds of all participants wanted two or more children. Hormonal Contraception, condom use and dual protection were low across all groups. In multivariate regression modelling, ALHIV were less likely to report hormonal Contraception use (aOR 0.55 95% CI 0.43 to 0.70 p ≤ 0.001). In marginal effects modelling, adolescent mothers - independent of HIV status - were least likely to report condom use at last sex. Despite higher probabilities of using hormonal Contraception, rates of dual protection were low: 17.1% among control adolescent mothers and 12.4% among AMLHIV. Adolescent mothers had the highest probabilities of not using any contraceptive method: 29.0% among control mothers and 23.5% among AMLHIV. CONCLUSIONS Among adolescent girls and young women in HIV-endemic communities, reproductive aspirations and contraceptive practices affect HIV risk and infection. Tailored adolescent-responsive health services could help young women plan their pregnancies for when they are healthy and well-supported, and help interrupt the cycle of HIV transmission by supporting them to practice dual protection.
Michael D Stein - One of the best experts on this subject based on the ideXlab platform.
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women at risk for sexually transmitted diseases correlates of intercourse without Barrier Contraception
American Journal of Obstetrics and Gynecology, 2007Co-Authors: Jeffrey F Peipert, Kate L Lapane, Jennifer Allsworth, Colleen A Redding, Jeffrey L Blume, Faye Lozowski, Michael D SteinAbstract:Objective The purpose of this study was to evaluate the correlates of vaginal intercourse without Barrier Contraception (unprotected intercourse). Study Design Baseline data from a randomized trial were analyzed to evaluate factors that are associated with intercourse without Barrier method use among women Results Intercourse without Barrier Contraception was common; 65% of participants had ≥2 episodes of intercourse without Barrier Contraception use in the past month. Factors that were associated with increased odds of unprotected intercourse included the number of coital episodes, a male partner's unwillingness to use condoms (adjusted odds ratio, 4.1; 95% CI, 2.3-6.9), and, among women Conclusion Risk factors for unprotected intercourse included coital frequency and the male partner's unwillingness to use condoms. Self-efficacy for condom use was especially important for women
Camille Wittesaele - One of the best experts on this subject based on the ideXlab platform.
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reproductive aspirations Contraception use and dual protection among adolescent girls and young women the effect of motherhood and hiv status
Journal of the International AIDS Society, 2020Co-Authors: Elona Toska, Lucie Cluver, Christina A Laurenzi, Camille Wittesaele, Lorraine Sherr, Siyanai Zhou, Nontokozo LangwenyaAbstract:INTRODUCTION There is a growing interest in adolescent motherhood and HIV among policymakers and programme implementers. To better shape services and health outcomes, we need evidence on reproductive aspirations and Contraception use in this high-risk group, including the effect of motherhood and HIV status. We report data from a large survey of adolescent girls and young women conducted in a mixed rural-urban district in South Africa. METHODS Quantitative interviews were conducted with 1712 adolescent girls and young women (ages 10 to 24): 336 adolescent mothers living with HIV (AMLHIV), 454 nulliparous adolescent girls living with HIV (ALHIV), 744 HIV-negative adolescent mothers (control adolescent mothers) and 178 HIV-negative nulliparous adolescent girls (nulliparous controls) in 2018 to 2019. Standardized questionnaires included socio-demographic measures, reproductive health and Contraception experiences. Reproductive aspirations were measured as the number of children participants wanted to have. Dual protection was computed as use of both hormonal and Barrier Contraception or abstinence. Multivariate logistic regression and marginal effects models in STATA 15 were used to test associations between HIV status, adolescent motherhood and outcomes of reproductive aspirations, Contraception use and dual protection, controlling for covariates. RESULTS AND DISCUSSION Nearly 95% of first pregnancies were unintended. Over two-thirds of all participants wanted two or more children. Hormonal Contraception, condom use and dual protection were low across all groups. In multivariate regression modelling, ALHIV were less likely to report hormonal Contraception use (aOR 0.55 95% CI 0.43 to 0.70 p ≤ 0.001). In marginal effects modelling, adolescent mothers - independent of HIV status - were least likely to report condom use at last sex. Despite higher probabilities of using hormonal Contraception, rates of dual protection were low: 17.1% among control adolescent mothers and 12.4% among AMLHIV. Adolescent mothers had the highest probabilities of not using any contraceptive method: 29.0% among control mothers and 23.5% among AMLHIV. CONCLUSIONS Among adolescent girls and young women in HIV-endemic communities, reproductive aspirations and contraceptive practices affect HIV risk and infection. Tailored adolescent-responsive health services could help young women plan their pregnancies for when they are healthy and well-supported, and help interrupt the cycle of HIV transmission by supporting them to practice dual protection.
Luchters Stanley - One of the best experts on this subject based on the ideXlab platform.
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Mycoplasma genitalium and Other Reproductive Tract Infections in Pregnant Women, Papua New Guinea, 2015–2017
eCommons@AKU, 2021Co-Authors: Scoulla, Michelle J.l., Boeuf Philippe, Peach Elizabeth, Fidelis Ruth, Tokmun Kerryanne, Melepia Pele, Elijah Arthur, Bradshaw, Catriona S., Fehler Glenda, Luchters StanleyAbstract:Much about the range of pathogens, frequency of coinfection, and clinical effects of reproductive tract infections (RTIs) among pregnant women remains unknown. We report on RTIs (Mycoplasma genitalium, Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Treponema pallidum subspecies pallidum, bacterial vaginosis, and vulvovaginal candidiasis) and other reproductive health indicators in 699 pregnant women in Papua New Guinea during 2015–2017. We found M. genitalium, an emerging pathogen in Papua New Guinea, in 12.5% of participants. These infections showed no evidence of macrolide resistance. In total, 74.1% of pregnant women had \u3e1 RTI; most of these infections were treatable. We detected sexually transmitted infections (excluding syphilis) in 37.7% of women. Our findings showed that syndromic management of infections is greatly inadequate. In total, 98.4% of women had never used Barrier Contraception. These findings will inform efforts to improve reproductive healthcare in Papua New Guinea
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HIV pre‐exposure prophylaxis for female sex workers: ensuring women’s family planning needs are not left behind
eCommons@AKU, 2020Co-Authors: Bowring, Anna L., Luchters Stanley, Ampt, Frances H, Schwartz Sheree, Stoove, Mark A., Baral Stefan, Hellard MargaretAbstract:Introduction: Female sex workers (FSWs) experience overlapping burdens of HIV, sexually transmitted infections and unin- tended pregnancy. Pre-exposure prophylaxis (PrEP) is highly efficacious for HIV prevention. It represents a promising strategy to reduce HIV acquisition risks among FSWs specifically given complex social and structural factors that challenge consistent condom use. However, the potential impact on unintended pregnancy has garnered little attention. We discuss the potential concerns and opportunities for PrEP to positively or negatively impact the sexual and reproductive health and rights (SRHR) of FSWs. Discussion: FSWs have high unmet need for effective Contraception and unintended pregnancy is common in low- and mid- dle-income countries. Unintended pregnancy can have enduring health and social effects for FSWs, including consequences of unsafe abortion and financial impacts affecting subsequent risk-taking. It is possible that PrEP could negatively impact condom and other contraceptive use among FSWs due to condom substitution, normalization, external pressures or PrEP provision by single-focus services. There are limited empirical data available to assess the impact of PrEP on pregnancy rates in real-life set- tings. However, pregnancy rates are relatively high in PrEP trials and modelling suggests a potential two-fold increase in con- domless sex among FSWs on PrEP, which, given low use of non-Barrier contraceptive methods, would increase rates of unintended pregnancy. Opportunities for integrating family planning with PrEP and HIV services may circumvent these con- cerns and support improved SRHR. Synergies between PrEP and family planning could promote uptake and maintenance for both interventions. Integrating family planning into FSW-focused community-based HIV services is likely to be the most effec- tive model for improving access to non-Barrier Contraception among FSWs. However, Barriers to integration, such as provider skills and training and funding mechanisms, need to be addressed. Conclusions: As PrEP is scaled up among FSWs, there is growing impetus to consider integrating family planning services with PrEP delivery in order to better meet the diverse SRHR needs of FSWs and to prevent unintended consequences. Programme monitoring combined with research can close data gaps and mobilize adequate resources to deliver comprehensive SRHR ser- vices respectful of all women’s rights
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HIV pre-exposure prophylaxis for female sex workers : ensuring women's family planning needs are not left behind
'Wiley', 2020Co-Authors: Al Bowring, Luchters Stanley, Fh Ampt, Schwartz S, Baral S, Hellard MAbstract:Introduction Female sex workers (FSWs) experience overlapping burdens of HIV, sexually transmitted infections and unintended pregnancy. Pre-exposure prophylaxis (PrEP) is highly efficacious for HIV prevention. It represents a promising strategy to reduce HIV acquisition risks among FSWs specifically given complex social and structural factors that challenge consistent condom use. However, the potential impact on unintended pregnancy has garnered little attention. We discuss the potential concerns and opportunities for PrEP to positively or negatively impact the sexual and reproductive health and rights (SRHR) of FSWs. Discussion FSWs have high unmet need for effective Contraception and unintended pregnancy is common in low- and middle-income countries. Unintended pregnancy can have enduring health and social effects for FSWs, including consequences of unsafe abortion and financial impacts affecting subsequent risk-taking. It is possible that PrEP could negatively impact condom and other contraceptive use among FSWs due to condom substitution, normalization, external pressures or PrEP provision by single-focus services. There are limited empirical data available to assess the impact of PrEP on pregnancy rates in real-life settings. However, pregnancy rates are relatively high in PrEP trials and modelling suggests a potential two-fold increase in condomless sex among FSWs on PrEP, which, given low use of non-Barrier contraceptive methods, would increase rates of unintended pregnancy. Opportunities for integrating family planning with PrEP and HIV services may circumvent these concerns and support improved SRHR. Synergies between PrEP and family planning could promote uptake and maintenance for both interventions. Integrating family planning into FSW-focused community-based HIV services is likely to be the most effective model for improving access to non-Barrier Contraception among FSWs. However, Barriers to integration, such as provider skills and training and funding mechanisms, need to be addressed. Conclusions As PrEP is scaled up among FSWs, there is growing impetus to consider integrating family planning services with PrEP delivery in order to better meet the diverse SRHR needs of FSWs and to prevent unintended consequences. Programme monitoring combined with research can close data gaps and mobilize adequate resources to deliver comprehensive SRHR services respectful of all women's rights
