Browsing by Author "Michielsen, Kristien"

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    International Sexual Health And REproductive health (I-SHARE) survey during COVID-19: study protocol for online national surveys and global comparative analyses
    (BMJ, 2021-02) Michielsen, Kristien; Larrson, Elin C.; Kågesten, Anna; Toller Erausquin, Jennifer; Griffin, Sally; Van de Velde, Sarah; Tucker, Joseph D.; Pediatrics, School of Medicine
    Background COVID-19 may have a profound impact on sexual health, reproductive health and social life across the world. Shelter in place regulations that have extended across the globe may influence condomless sex, exacerbate intimate partner violence and reduce access to essential reproductive health services. Population representative research is challenging during shelter in place, leaving major gaps in our understanding of sexual and reproductive health during COVID-19. This International Sexual Health And ReproductivE health (I-SHARE) study protocol manuscript describes a common plan for online national surveys and global comparative analyses. Methods The purpose of this cross-sectional study is to better understand sexual and reproductive health in selected countries during the COVID-19 pandemic and facilitate multinational comparisons. Participants will be recruited through an online survey link disseminated through local, regional and national networks. In each country, a lead organisation will be responsible for organising ethical review, translation and survey administration. The consortium network provides support for national studies, coordination and multinational comparison. We will use multilevel modelling to determine the relationship between COVID-19 and condomless sex, intimate partner violence, access to reproductive health services, HIV testing and other key items. This study protocol defines primary outcomes, prespecified subanalyses and analysis plans. Conclusion The I-SHARE study examines sexual and reproductive health at the national and global level during the COVID-19 pandemic. We will use multilevel modelling to investigate country-level variables associated with outcomes of interest. This will provide a foundation for subsequent online multicountry comparison using more robust sampling methodologies.
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    The International Sexual Health And Reproductive Health Survey (I-SHARE-1): A Multi-Country Analysis of Adults from 30 Countries Prior to and During the Initial COVID-19 Wave
    (medRxiv: The Preprint Server for Health Sciences, 2021-10-19) Erausquin, Jennifer Toller; Tan, Rayner K. J.; Uhlich, Maximiliane; Francis, Joel M.; Kumar, Navin; Campbell, Linda; Zhang, Wei-Hong; Hlatshwako, Takhona G.; Kosana, Priya; Shah, Sonam; Brenner, Erica M.; Remmerie, Lore; Mussa, Aamirah; Klapilova, Katerina; Mark, Kristen; Perotta, Gabriela; Gabster, Amanda; Wouters, Edwin; Burns, Sharyn; Hendriks, Jacqueline; Hensel, Devon J.; Shamu, Simukai; Strizzi, Jenna Marie; Esho, Tammary; Morroni, Chelsea; Eleuteri, Stefano; Sahril, Norhafiza; Low, Wah Yun; Plasilova, Leona; Lazdane, Gunta; Marks, Michael; Olumide, Adesola; Abdelhamed, Amr; López Gómez, Alejandra; Michielsen, Kristien; Moreau, Caroline; Tucker, Joseph D.; I-SHARE research consortium
    Background: The COVID-19 pandemic forced billions of people to shelter in place, altering social and sexual relationships worldwide. In many settings, COVID-19 threatened already precarious health services. However, there is limited evidence to date about changes to sexual and reproductive health (SRH) during the initial wave of COVID-19 disease. To address this gap, our team organized a multi-country, cross-sectional online survey as part of a global consortium. Methods: Consortium research teams conducted online surveys in 30 countries. Sampling methods included convenience, online panels, and population-representative. Primary outcomes included sexual behaviors, partner violence, and SRH service utilization, and we compared three months prior to and three months after policy measures to mitigate COVID-19. We used established indicators and analyses pre-specified in our protocol. We conducted meta-analyses for primary outcomes and graded the certainty of the evidence using Cochrane methods. Descriptive analyses included 22,724 individuals in 25 countries. Five additional countries with sample sizes <200 were included in descriptive meta-analyses. Results: Respondents were mean age 34 years; most identified as women (15160; 66.7%), cis-gender (19432; 86.6%) and heterosexual (16592; 77.9%). Among 4546 respondents with casual partners, condom use stayed the same for 3374 (74.4%) people and 640 (14.1%) people reported a decline. Fewer respondents reported physical or sexual partner violence during COVID-19 measures (1063/15144, 7.0%) compared to the period before COVID-19 measures (1469/15887, 9.3%). COVID-19 measures impeded access to condoms (933/10790, 8.7%), contraceptives (610/8175, 7.5%), and HIV/STI testing (750/1965, 30.7%). Pooled estimates from meta-analysis indicate during COVID-19 measures, 32.3% (95% CI 23.9-42.1) of people needing HIV/STI testing had hindered access, 4.4% (95% CI 3.4-5.4) experienced partner violence, and 5.8% (95% CI 5.4-8.2) decreased casual partner condom use (moderate certainty of evidence for each outcome). Meta-analysis findings were robust in sensitivity analyses that examined country income level, sample size, and sampling strategy. Conclusion: Open science methods are feasible to organize research studies as part of emergency responses. The initial COVID-19 wave impacted SRH behaviors and access to services across diverse global settings.
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    Online health survey research during COVID-19
    (Elsevier, 2021-02) Hlatshwako, Takhona G.; Shah, Sonam J.; Kosana, Priya; Adebayo, Emmanuel; Hendriks, Jacqueline; Larsson, Elin C.; Hensel, Devon J.; Toller Erausquin, Jennifer; Marks, Michael; Michielsen, Kristien; Saltis, Hanna; Francis, Joel M.; Wouters, Edwin; Tucker, Joseph D.; Pediatrics, School of Medicine
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    The International Sexual Health And REproductive Health during COVID-19 (I-SHARE) Study: A Multicountry Analysis of Adults from 30 Countries Prior to and During the Initial Coronavirus Disease 2019 Wave
    (Oxford University Press, 2022) Toller Erausquin, Jennifer; Tan, Rayner K.J.; Uhlich, Maximiliane; Francis, Joel M.; Kumar, Navin; Campbell, Linda; Zhang, Wei Hong; Hlatshwako, Takhona G.; Kosana, Priya; Shah, Sonam; Brenner, Erica M.; Remmerie, Lore; Mussa, Aamirah; Klapilova, Katerina; Mark, Kristen; Perotta, Gabriela; Gabster, Amanda; Wouters, Edwin; Burns, Sharyn; Hendriks, Jacqueline; Hensel, Devon J.; Shamu, Simukai; Strizzi, Jenna Marie; Esho, Tammary; Morroni, Chelsea; Eleuteri, Stefano; Sahril, Norhafiza; Low, Wah Yun; Plasilova, Leona; Lazdane, Gunta; Marks, Michael; Olumide, Adesola; Abdelhamed, Amr; López Gómez, Alejandra; Michielsen, Kristien; Moreau, Caroline; Tucker, Joseph D.; International Sexual Health And REproductive Health during COVID-19 Research Consortium; Pediatrics, School of Medicine
    Background: There is limited evidence to date about changes to sexual and reproductive health (SRH) during the initial wave of coronavirus disease 2019 (COVID-19). To address this gap, our team organized a multicountry, cross-sectional online survey as part of a global consortium. Methods: Consortium research teams conducted online surveys in 30 countries. Sampling methods included convenience, online panels, and population-representative. Primary outcomes included sexual behaviors, partner violence, and SRH service use, and we compared 3 months prior to and during policy measures to mitigate COVID-19. We conducted meta-analyses for primary outcomes and graded the certainty of the evidence. Results: Among 4546 respondents with casual partners, condom use stayed the same for 3374 (74.4%), and 640 (14.1%) reported a decline. Fewer respondents reported physical or sexual partner violence during COVID-19 measures (1063 of 15 144, 7.0%) compared to before COVID-19 measures (1469 of 15 887, 9.3%). COVID-19 measures impeded access to condoms (933 of 10 790, 8.7%), contraceptives (610 of 8175, 7.5%), and human immunodeficiency virus/sexually transmitted infection (HIV/STI) testing (750 of 1965, 30.7%). Pooled estimates from meta-analysis indicate that during COVID-19 measures, 32.3% (95% confidence interval [CI], 23.9%-42.1%) of people needing HIV/STI testing had hindered access, 4.4% (95% CI, 3.4%-5.4%) experienced partner violence, and 5.8% (95% CI, 5.4%-8.2%) decreased casual partner condom use (moderate certainty of evidence for each outcome). Meta-analysis findings were robust in sensitivity analyses that examined country income level, sample size, and sampling strategy. Conclusions: Open science methods are feasible to organize research studies as part of emergency responses. The initial COVID-19 wave impacted SRH behaviors and access to services across diverse global settings.