Browsing by Subject "Reproductive health"

Now showing 1 - 9 of 9
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    Adolescent Women with Congenital Heart Disease: Self-Reported Reproductive Health Discussions with Health Care Providers
    (Elsevier, 2022) Katz, Amy J.; Lyon, Shannon; Farrell, Anne G.; Srivastava, Nayan; Wilkinson, Tracey A.; Shew, Marcia L.; Pediatrics, School of Medicine
    Study objective: This study evaluated self-reported discussions with health care providers (HCPs) among adolescent and young adult (AYA) women with congenital heart disease (CHD). Design: Data were collected through a one-time survey of AYA women. Setting: Participants were recruited from pediatric cardiology clinics. Participants: AYA women with CHD, ages 14-21 (N = 107) INTERVENTIONS: None MAIN OUTCOME MEASURES: Questionnaires assessed adolescent characteristics and specific HCP discussions regarding transmissibility of a cardiac condition to the infant, risk of pregnancy, and hormonal contraception. Outcome measures were self-reported discussions with HCPs about these reproductive health topics. Results: Mean age was 16.8 years (SD = 2.1). Self-reported reproductive health discussions were infrequent, including discussions on transmissibility of a heart condition to their offspring (37%), risk of pregnancy to their offspring (34%), risks of pregnancy to their health (46%), and risks of hormonal contraception given their heart condition (21%). Reported discussions were most commonly with a cardiologist. Conclusions: AYA women with CHD reported limited discussions about reproductive health topics important to those with CHD. Lack of appropriate and timely counseling could lead to poor maternal and child health outcomes. Targeted interventions that improve reproductive health discussions between HCPs and AYA women with CHD are needed to close critical information and service gaps.
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    Experiences of sexual and reproductive health screening and counseling in the clinical setting among adolescents and young adults with rheumatic disease
    (Springer Nature, 2025-01-20) Huynh, Brittany; Ott, Mary A.; Tarvin, Stacey E.; Pediatrics, School of Medicine
    Background: Our objective was to describe differences among adolescents and young adults (AYAs) with rheumatic disease using teratogens compared to non-users in receipt of sexual and reproductive health (SRH) counseling, teratogenicity knowledge, perceived importance of SRH topics, and preferences around counseling. Methods: AYAs ages 14-23 years and assigned female at birth were recruited from pediatric rheumatology clinics at a Midwest tertiary care program. Participants completed a one-time online survey assessing SRH. Results: One-hundred eight participants completed the survey, representing a range of rheumatic diseases. 24% reported ever having sex. 36% used a teratogen. Rates of screening and counseling regarding SRH topics were low. Notably, pregnancy prevention and emergency contraception (EC) counseling by rheumatologists were uncommon and not associated with teratogen use or sexual activity. Among AYAs on teratogens, only half reported screening for sexual activity or counseling on teratogenicity or pregnancy prevention. Gaps in pregnancy prevention and EC counseling remained even when accounting for counseling by other providers. Knowledge of medication teratogenicity was also low. AYAs reported SRH topics of high importance, and many reported recent concerns. They preferred to receive information from their rheumatologist, and most agreed it is important to talk to their rheumatologist regarding these topics. Conclusions: AYAs with rheumatic disease report low levels of SRH screening and counseling by their rheumatologist yet report these topics are important and want to discuss them. Gaps in teratogenicity knowledge were identified. This study identifies a need for improved communication with AYAs regarding their SRH.
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    The Intersection Between Women's Reproductive Desires and HIV Care Providers' Reproductive Health Practices: A Mixed Methods Analysis
    (Springer Nature, 2018-09) Tanner, Amanda E.; Chambers, Brittany D.; Philbin, Morgan M.; Ware, Samuella; Eluka, Nneze; Ma, Alice; Kinnard, Elizabeth N.; Fortenberry, J. Dennis; Pediatrics, School of Medicine
    Background HIV-positive women in the United States can have healthy pregnancies and avoid transmitting HIV to their children. Yet, little is known about the extent to which HIV care providers' reproductive health practices match women's pregnancy desires. Accordingly, we explored young HIV-positive women's pregnancy desires and reproductive health behaviors and examined reproductive health information offered by HIV care clinics. Methods A mixed-method analysis was conducted using data from a 14-site Adolescent Medicine Trials Network (ATN) study. We conducted descriptive statistics on data from 25 HIV-positive women (e.g., demographics, pregnancy desires, and sexual- and health-related behaviors). Qualitative interviews with 58 adolescent and adult clinic providers were analyzed using the constant comparative method. Results About half of the women reported using reproductive health care services (i.e., contraception and pregnancy tests) (n = 12) and wanted a future pregnancy (n = 13). Among women who did not desire a future pregnancy (n = 5), three used dual methods and two used condoms at last sexual encounter. Qualitative themes related to clinics' approaches to reproductive health (e.g., "the emphasis…is to encourage use of contraceptives") and the complexity of merging HIV and reproductive care (e.g., "We [adolescent clinic] transition pregnant moms from our care back and forth to adult care"). Discussion Despite regular HIV-related medical appointments, HIV-positive women may have unaddressed reproductive health needs (e.g., pregnancy desire with providers focused on contraceptive use). Findings from this study suggest that increased support for young HIV-positive women's reproductive health is needed, including supporting pregnancy desires (to choose when, how, and if, to have children).
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    The National Physicians Cooperative: transforming fertility management in the cancer setting and beyond.
    (Future Medicine, 2018-12) Smith, Brigid M.; Duncan, Francesca E.; Ataman, Lauren; Smith, Kristin; Quinn, Gwendolyn P.; Chang, R. Jeffrey; Finlayson, Courtney; Orwig, Kyle; Valli-Pulaski, Hanna; Moravek, Molly B.; Zelinski, Mary B.; Irene Su, H.; Vitek, Wendy; Smith, James F.; Jeruss, Jacqueline S.; Gracia, Clarisa; Coutifaris, Christos; Shah, Divya; Nahata, Leena; Gomez-Lobo, Veronica; Appiah, Leslie Coker; Brannigan, Robert E.; Gillis, Valerie; Gradishar, William; Javed, Asma; Rhoton-Vlasak, Alice S.; Kondapalli, Laxmi A.; Neuber, Evelyn; Ginsberg, Jill P.; Muller, Charles H.; Hirshfeld-Cytron, Jennifer; Kutteh, William H.; Lindheim, Steven R.; Cherven, Brooke; Meacham, Lillian R.; Rao, Pooja; Torno, Lilibeth; Sender, Leonard S.; Vadaparampil, Susan T.; Skiles, Jodi L.; Schafer-Kalkhoff, Tara; Frias, Oliva J.; Byrne, Julia; Westphal, Lynn M.; Schust, Danny J.; Klosky, James L.; McCracken, Kate A.; Ting, Alison; Khan, Zaraq; Granberg, Candace; Lockart, Barbara; Scoccia, Bert; Laronda, Monica M.; Mersereau, Jennifer E.; Marsh, Courtney; Pavone, Mary Ellen; Woodruff, Teresa K.; Pediatrics, School of Medicine
    Once unimaginable, fertility management is now a nationally established part of cancer care in institutions, from academic centers to community hospitals to private practices. Over the last two decades, advances in medicine and reproductive science have made it possible for men, women and children to be connected with an oncofertility specialist or offered fertility preservation soon after a cancer diagnosis. The Oncofertility Consortium's National Physicians Cooperative is a large-scale effort to engage physicians across disciplines - oncology, urology, obstetrics and gynecology, reproductive endocrinology, and behavioral health - in clinical and research activities to enable significant progress in providing fertility preservation options to children and adults. Here, we review the structure and function of the National Physicians Cooperative and identify next steps.
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    The Need for Reproductive Justice in Pediatrics
    (American Medical Association, 2021) Cohen, Rachel E.; Wilkinson, Tracey A.; Staples-Horne, Michelle; Pediatrics, School of Medicine
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    Overlapping needs for sexual and reproductive health and HIV prevention in women with substance use disorders
    (Sage, 2022) Gibson, Britton; Hoff, Emily; Haas, Alissa; Adams, Zoe M.; Price, Carolina R.; Goddard-Eckrich, Dawn; Sheth, Sangini S.; Dasgupta, Anindita; Meyer, Jaimie P.; Medicine, School of Medicine
    Objectives: Women with substance use disorders have high unmet needs for HIV prevention and drug treatment and face challenges accessing care for other unique health issues, including their sexual and reproductive health. Methods: We did a cross-sectional evaluation of sexual and reproductive health behaviors and outcomes among women with substance use disorders, who were enrolled in one of two concurrent clinical trials of pre-exposure prophylaxis for HIV prevention. Descriptive analyses and bivariate logistic regression were used to assess factors driving contraceptive use, and other essential sexual and reproductive health services utilization and outcomes. Results: Among 226 women, 173 (76.5%) were of reproductive age. Most women had histories of unintended pregnancy (79.2%) or miscarriage (45.1%) and high HIV risk behaviors (53.5%). Most (61%) participants did not use any form of contraception at the time of assessment, although few (15%) reported pregnancy intentions. In bivariate models, ongoing criminal justice involvement was associated with 2.22 higher odds of not using contraception (95% confidence interval = 1.09-4.53; p = 0.03) and hazardous drinking was protective against not using contraception (odds ratio = 0.33, 95% confidence interval = 0.13-0.81; p = 0.02). Contraception use was not significantly associated with any other individual characteristics or need factors. Conclusions: This is the first study that identifies the unmet sexual and reproductive health needs of women with substance use disorders who are engaging with pre-exposure prophylaxis. We found that women accessed some health services but not in a way that holistically addresses the full scope of their needs. Integrated sexual and reproductive care should align women's expressed sexual and reproductive health intentions with their behaviors and outcomes, by addressing social determinants of health.
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    Provider Attitudes, Preferences, and Practices Regarding Sexual and Reproductive Health for Adolescents and Young Adults with Sickle Cell Disease
    (Elsevier, 2021) Leroy-Melamed, Maayan; Jacob, Seethal; Shew, Marcia L.; Kazmerski, Traci M.; Pediatrics, School of Medicine
    Purpose: With improvements in life expectancy, adolescents and young adults (AYAs) with sickle cell disease (SCD) increasingly face sexual and reproductive health (SRH) concerns. As subspecialists often serve as primary care providers for those with chronic disease, this study examines pediatric SCD providers' practices and attitudes related to SRH of AYA women with SCD. Methods: We developed an adapted survey to identify SCD provider attitudes and practices in addressing menses, sexual activity, contraception, and pregnancy for their female patients. We electronically distributed this survey to the American Society of Pediatric Hematology/Oncology SCD interest group. We used descriptive statistics to analyze results. Results: A total of 78 pediatric SCD providers completed the survey. A majority (95%) rated SRH discussions as moderately important or higher, with 89% agreeing this care should be standardized. Most respondents reported discussing SRH, such as menses (78%), teratogenic medications (61%), and contraception (90%), with their female patients with SCD at least annually. Although most refer AYAs with SCD for birth control (83%), 39% endorsed a preferred method, with 33% of these favoring levonorgestrel intrauterine devices in this population and 40% injectable contraception. Approximately half of respondents (57%) reported that the use of combined hormonal contraceptives was unacceptable despite published guidelines that support potential benefits outweighing theoretical risk in AYAs with SCD. Conclusions: The range of SRH conversations and contraceptive recommendations for AYAs from pediatric SCD providers is broad. SCD providers and AYAs with SCD would benefit from improved evidence and educational resources related to contraception as well as coordinated SRH counseling.
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    Racial Differences in Retention in a Community-based Addiction Reduction Program Implemented by Peer Recovery Coaches for Women of Reproductive Age
    (Sage, 2023) Yakovlyeva, Anastasiya; Griffin, Wilma; Worden, Allison; Roth, Sarah; DeChant, Paige; Butler, Dawn; Tang, Qing; Litzelman, Debra K.; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public Health
    To identify program characteristics that influence the retention of women of reproductive age in the Community-based Addiction Reduction program (CARE), mixed-method analyses of CARE survey data and CARE Peer Recovery Coach (PRC) narrative entries of participant encounters were performed. About 251 women were enrolled in this prospective community-based implementation science intervention. We compared survey responses by race for treatment status, treatment motivation scales, and retention in the program at intake, 2-, 6-, 9-, and 12-month follow ups using Chi-square/T-tests. Qualitative analysis of PRC narrative entries was conducted following thematic analysis and crystallization immersion analytic methods. White compared with Black women in CARE were significantly more likely to be in treatment at intake (P < .001) and more motivated to engage in recovery treatment (P < .001). However, Black women were retained longer in CARE at 2- (P < .006), 6- (P < .011), and 9- (P < .004) months. PRC narrative entries were coded, and emergent themes mapped well to the 4 types of supports provided by PRC as outlined by the Substance Abuse and Mental Health Services Administration: emotional, instrumental, informational, and affiliational. Analysis of narrative entries by race revealed that Black women were given more detailed information, communications with PRC were more encouraging and proactive in identifying and meeting needs, and PRC took a more hands-on approach when assisting and linking to resources. The inclusion of PRC as integral members of SUD recovery programs may preferentially provide Black women with SUD the opportunity to build more trusting relationships with these peer coaches, thereby increasing their participation and retention.
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    Sexual and reproductive health considerations in the care of young adults with inflammatory bowel disease: A multidisciplinary conversation
    (Elsevier, 2023-12-07) Reed, Sydney; Bugwadia, Amy K.; Dave, Sneha; Wilson, Hannah E.; Ramesh, Prathikka; Michel, Hilary K.; Anatomy, Cell Biology and Physiology, School of Medicine
    The effects of inflammatory bowel disease (IBD) and the medications used to treat it on sexual and reproductive health can be significant, impacting the quality of life of patients across gender identities. This article presents insights from a roundtable discussion facilitated by the Crohn's and Colitis Young Adults Network (CCYAN) between young adult patients with IBD and medical professionals, including physicians, nurses, psychologists, and trainees/medical students. It underscores the distinction between sexual and reproductive health, emphasizing the need to address both aspects comprehensively. The discussion identified key themes, including sexual dysfunction and well-being in IBD patients; discussing sexual health with young adult IBD patients; current research in reproductive health: gaps and opportunities; discussing reproductive health with young adult IBD patients; and providing resources and comprehensive multidisciplinary care.