Evaluation of a savings and micro-credit program for vulnerable young women in Nairobi

Adolescent girls in Uganda have four-fold HIV infections than adolescent boys. Several barriers to accessing comprehensive sexual health education exist for adolescent girls in Uganda, including unequal, social, and economic statuses, limited access to education and health care services, discrimination, and violence. This study qualitatively examines sexual health behaviors and literacy among Ugandan adolescent girls and explores how technology may be leveraged to improve sexual and reproductive health outcomes in this population. Four focus group discussions (FGDs) were conducted among 32 adolescent girls aged 14-17 years enrolled in Suubi mHealth. Participants were randomly selected from four secondary schools participating in a randomized clinical trial known as Suubi4Her (N = 1260). FGDs were conducted in the local language, audio-recorded, transcribed verbatim, and translated. Translated transcripts were imported into Dedoose for data management and coding. Emerging themes included Influences for Sex/Relationships, HIV Knowledge, and Sources of Sexual Health Information. Participants reported common influences for sexual engagement included seeking resource security, limited parental communication, and peer influences. Participants also demonstrated knowledge gaps, requesting information such as how to prevent unplanned pregnancies and HIV, endorsing sexual health myths, and describing limitations to accessing sexual health information. Noticeable inconsistencies and limited access to information and resources regarding basic sexual health knowledge were reported, which inevitably increases adolescent girls' risks for adverse sexual and reproductive health outcomes. Developing culturally appropriate interventions may help advance the sexual and reproductive health needs of Ugandan adolescent girls.

Adolescent girls and young women (AGYW) in sub-Saharan Africa are at high risk of many adverse sexual and reproductive health outcomes. Small-group interventions addressing underlying vulnerabilities may influence risky sexual behaviors associated with these adverse outcomes. Girl Power-Malawi assessed whether a facilitator-led, curriculum-driven small-group behavioral intervention impacted risky sexual behaviors among AGYW in Lilongwe, Malawi. Four Health Centers were selected; two were randomly assigned to provide the intervention. Two-hundred fifty AGYW 15-24years old were enrolled in each clinic (N = 1000 total), followed for 1 year, and interviewed at baseline and endline. At both time points participants reported on two behaviors in the last month (vaginal sex and ≥ 2 sexual partners) and two behaviors in the last year (age-disparate relationships and transactional relationships). In intervention clinics, there were no declines in risk behaviors between baseline and endline. Endline behaviors were not less risky in intervention clinics than control clinics. This intervention did not have a positive effect on four risk behaviors over a 1-year period.

Transactional sexual relationships are a key driver of adverse sexual and reproductive health outcomes among adolescent girls and young women (AGYW) in South Africa. A prominent subtype, the “Blessed” relationship, involves older, relatively wealthier men (Blessers) who exchange material support for sexual relationships. While motivations within these partnerships have been studied, limited attention has been paid to the structural and economic factors shaping AGYW’s engagement in such relationships. This study explored the socio-economic conditions influencing involvement with Blessers, amongst 5025 AGYW, aged 15–24, across eight South African provinces in 2024. Key socio-economic indicators included household wealth, food insecurity, education, employment, and orphanhood. AGYW from the wealthiest households were significantly less likely to report involvement with a Blesser than those from the poorest households, underscoring the role of poverty in shaping transactional partnerships. Food insecurity further amplified vulnerability, with participants who reported going without food multiple times, substantially more likely to have a Blesser. Education appeared protective: school attendance and completion of secondary education were both associated with a reduced likelihood of involvement with a Blesser. Findings underscore the role of structural inequality, poverty, and disrupted education in shaping AGYW’s relationship choices.

Besides bacteria, fungi, protists and archaea, the vaginal ecosystem also contains a range of prokaryote- and eukaryote-infecting viruses, which are collectively referred to as the “virome”. Despite its well-described role in the gut and other environmental niches, the vaginal virome remains understudied. With a focus on sexual and reproductive health, we summarize the currently known components of the vaginal virome, its relationship with other constituents of the vaginal microbiota and its association with adverse health outcomes. While a range of eukaryote-infecting viruses has been described to be present in the female genital tract (FGT), few prokaryote-infecting viruses have been described. Literature suggests that various vaginal viruses interact with vaginal bacterial microbiota and host immunity and that any imbalance thereof may contribute to the risk of adverse reproductive health outcomes, including infertility and adverse birth outcomes. Current limitations of vaginal virome research include experimental and analytical constraints. Considering the vaginal virome may represent the missing link in our understanding of the relationship between FGT bacteria, mucosal immunity, and adverse sexual and reproductive health outcomes, future studies evaluating the vaginal microbiome and its population dynamics holistically will be important for understanding the role of the vaginal virome in balancing health and disease.

BackgroundEnvironmental influence plays a major role in determining health status of individuals. Punjab has been reported as having a high degree of water pollution due to heavy metals from untreated...

Non-Partner Sexual Violence (NPSV) is under reported in many low-income countries including Nigeria. This study was conducted to assess the prevalence and factors associated with NPSV experience among in-school adolescent girls in low-income communities of Ibadan, Southwestern Nigeria. A cross-sectional survey was conducted among 376 in-school adolescent girls in Ibadan, Nigeria. Multistage sampling technique was used to select respondents from senior secondary schools in two Local Government Areas with largest number of low-income communities. Respondents were assessed on experience of lifetime NPSV. Data were analysed using bivariate and multivariable logistic regression. Level of significance was set at 5%. Mean age of the respondents was 16.2 (SD 1.0) years. Majority of respondents were Muslims (57.7%) and only 29.3% had ever been in a relationship. The prevalence of lifetime NPSV among the respondents was 16.5%. The most frequently reported form of NPSV was being threatened or pressured to have sex (13.3%) and made to do something sexually when girl didn’t want to (2.9%). Reported perpetrators who were known vs. unknown was 56.5% vs. 21%. Significant predictors of experience of NPSV were, age 18 to 19 years (AOR = 2.60, 95% CI: 1.06–6.4) and witnessing violence in childhood (AOR = 2.33, 95% CI:1.27–4.28). Non-partner sexual violence is prevalent among adolescent girls in low-income communities of Ibadan, Nigeria, with most girls reporting that perpetrators were known to them. These findings underscore the urgent need for preventive efforts, particularly those that consider perpetration as occurring in girls’ immediate social and familial environments. Non-Partner Sexual Violence (NPSV) is defined as a sexual act that is committed or attempted by someone (stranger, acquaintance, friend and other family member) other than husband or partner, without the consent of the victim or against someone who is unable to consent or refuse. NPSV is a traumatic experience with serious lifelong impact on the health and wellbeing of girls including physical, psychological health such as anxiety, depression, and suicidal ideation. Adverse sexual and reproductive health outcomes have also been associated with NPSV, including unwanted pregnancy, unsafe abortion, high risk sexual behaviour, sexually transmitted diseases, including HIV and death. Social consequences have also been reported which include school absenteeism, school drop-out, and engaging in high-risk behaviours such as alcohol and substance use. NPSV is under reported in many low-income countries including Nigeria. This study was conducted to assess the prevalence and factors associated with non-partner sexual violence experience among in-school adolescent girls in Ibadan, Southwestern Nigeria. We found that NPSV is common among the adolescent girls. The perpetrators of the act were males known to the girls who pressure them into unwanted sex. Most notably, the experience of NPSV was positively associated with having been in a relationship with male partner and witnessing violence in childhood.

Despite routine law enforcement use of chemical agents for crowd control, the reproductive health safety profiles of these products are unknown. Moreover, limited evidence has documented a link between such exposures and adverse reproductive health outcomes including abnormal uterine bleeding and potential pregnancy disruption. This cross-sectional study examined reproductive outcomes in adults with uteri exposed to chemical agents used by law enforcement, more commonly known as "tear gas". Participants were recruited through social media in the wake of police violence protests. Of the 1,276 participants included in analysis, 83% reported experiencing at least one of the outcomes of interest, included uterine cramping (69%), early menstrual bleeding (55%), breast tenderness (30%), and delayed menstrual bleeding (19%). Chemical agent exposure was significantly associated with higher odds of an adverse reproductive health outcome, those with 5 days or more of exposure have 2.6 times the odds (CI: 1.61, 4.22) of adverse outcomes and having a perception that one's menstruation may fluctuate according to psychosocial stressors was associated (OR = 1.94, CI: 1.36, 2.79) with a higher odds of an adverse reproductive health experience. These findings suggest a potential relationship between exposure to chemical agents and adverse reproductive health outcomes. Given the pervasive use of these chemical agents and their potential for reproductive health harm, further investigation into the safety of these products and their impacts on individual and community health is warranted urgently.

Investigation of Laboratory Values and Ultrasonographic Characteristics in Adolescent Girls with Polycystic Ovarian Syndrome

Background. Due to their intersecting racial identity and gender identity, Black women are characterized by stigmatizing race-based sexual stereotypes (RBSS) that may contribute to persistent, disproportionately high rates of adverse sexual and reproductive health outcomes. RBSS are sociocognitive structures that shape Black women's social behavior including their sexual scripts. Objective. The purpose of this study was to explore the influence of RBSS on the sexual decision making of young Black women (YBW). Methods. We conducted four focus groups with 26 YBW between the ages of 18 and 25, living in a New York City neighborhood with a high HIV prevalence. Qualitative analysis was used to identify emergent themes within the domains of sexual decision making as it relates to safer sex practices and partner selection. Results. Thematic analyses revealed that RBSS may cause women to adopt more traditional gender stereotypes and less likely to feel empowered in the sexual decision making. Participants reported that RBSS may lead Black women to being resistant to learning new information about safer sex practices, feeling less empowered within intimate relationships, and jeopardizing their sexual well-being to affirm themselves in other social areas encouraging unprotected sex and relationships with men who have multiple sex partners. Discussion and Conclusion. Future research should focus on understanding the social and cultural factors that influence Black women's power in maintaining and improving their sexual health, including the aforementioned stereotypes that have influenced how others may view them as well as how they view themselves.

Background: Early menarche is always a challenging one for adolescent girls since it is often associated with inadequate knowledge regarding puberty, adverse reproductive health outcomes and mental health problems. The objective of this study was to explore the perception and attitude of adolescent girls towards early menarche. Methods: A qualitative study was conducted in the rural field practice area of a Medical College in Puducherry during January to March 2022. The study participants (adolescent girls) were selected by means of purposive sampling. Four Focus Group Discussions were conducted among adolescent girls using an interview guide. The contents were transcribed and codes were derived. The codes were combined to form categories and finally, themes were generated and were interpreted. Results: Menarche was a shocking experience for the adolescent girls and there was no mental preparedness for accepting it and attaining menarche even earlier, made it still worse. They felt that they lost their childhood identity at a younger age as they looked more matured compared to their peers. They were unable to adjust themselves and it affected their psychosocial state. According to them, factors such as obesity, improper dietary habits, physical inactivity, and also mothers with early age of menarche were the causes of early menarche. Conclusions: The study participants felt that they had an inadequate knowledge about early menarche and they also found it difficult to cope up with ‘sudden changes into womanhood’. Assuming gender specific roles in their families made them stressed and feels helpless.

Most existing evidence-based sexual health interventions focus on individual-level behavior, even though there is substantial evidence that highlights the influential role of social environments in shaping adolescents' behaviors and reproductive health outcomes. We developed Yo Puedo, a combined conditional cash transfer and life skills intervention for youth to promote educational attainment, job training, and reproductive health wellness that we then evaluated for feasibility among 162 youth aged 16-21 years in a predominantly Latino community in San Francisco, CA. The intervention targeted youth's social networks and involved recruitment and randomization of small social network clusters. In this paper we describe the design of the feasibility study and report participants' baseline characteristics. Furthermore, we examined the sample and design implications of recruiting social network clusters as the unit of randomization. Baseline data provide evidence that we successfully enrolled high risk youth using a social network recruitment approach in community and school-based settings. Nearly all participants (95%) were high risk for adverse educational and reproductive health outcomes based on multiple measures of low socioeconomic status (81%) and/or reported high risk behaviors (e.g., gang affiliation, past pregnancy, recent unprotected sex, frequent substance use; 62%). We achieved variability in the study sample through heterogeneity in recruitment of the index participants, whereas the individuals within the small social networks of close friends demonstrated substantial homogeneity across sociodemographic and risk profile characteristics. Social networks recruitment was feasible and yielded a sample of high risk youth willing to enroll in a randomized study to evaluate a novel sexual health intervention.

Renewed interest in developing vaccines against Neisseria gonorrhoeae has been sparked by the increasing threat of gonococcal antimicrobial resistance (AMR) and growing optimism that gonococcal vaccines are biologically feasible. Evidence suggests serogroup B Neisseria meningitidis vaccines might provide some cross-protection against N. gonorrhoeae, and new gonococcal vaccine candidates based on several approaches are currently in preclinical development. To further stimulate investment and accelerate development of gonococcal vaccines, greater understanding is needed regarding the overall value that gonococcal vaccines might have in addressing public health and societal goals in low-, middle-, and high-income country contexts and how future gonococcal vaccines might be accepted and used, if available. In January 2019, the World Health Organization (WHO) convened a multidisciplinary international group of experts to lay the groundwork for understanding the potential health, economic, and societal value of gonococcal vaccines and their likely acceptance and use, and for developing gonococcal vaccine preferred product characteristics (PPCs). WHO PPCs describe preferences for vaccine attributes that would help optimize vaccine value and use in meeting the global public health need. This paper describes the main discussion points and conclusions from the January 2019 meeting of experts. Participants emphasized the need for vaccines to control N. gonorrhoeae infections with the ultimate goals of preventing adverse sexual and reproductive health outcomes (e.g., infertility) and reducing the impact of gonococcal AMR. Meeting participants also discussed important PPC considerations (e.g., vaccine indications, target populations, and potential immunization strategies) and highlighted crucial research and data needs for guiding the value assessment and PPCs for gonococcal vaccines and advancing gonococcal vaccine development.

Introduction As adolescents and young women become sexually active, they are at risk of adverse reproductive health outcomes including sexually transmitted infections (STIs). We assessed feasibility and acceptability of STI screening among 15–24 year-old women in Mombasa County, Kenya. Methods Participants were recruited from three high schools and one university. Study staff conducted informational sessions. Students interested in participating were given informed assent/consent forms to take home, and asked to visit our clinic for STI screening. During clinic visits, participants completed a self-administered questionnaire and provided a urine specimen to test for Neisseria gonorrhoeae , Chlamydia trachomatis , and Trichomonas vaginalis using the Hologic Aptima Detection System. Results Between August 2014 and March 2015, 463 high school and 165 university students collected assent/consent forms. Of these, 293 (63%) from high schools versus 158 (95%) from university attended clinic for STI screening (p N. gonorrhoeae , 16 [3.6%] with C. trachomatis and 3 [0.7%] with T. vaginalis ). Older age (OR 1.28; 95% CI 1.07–1.53), reporting vaginal sex (OR 5.89; 95% CI 2.42–14.36), non-penetrative sex (OR 3.47; 95% CI 1.56–7.75), alcohol use (OR 3.34; 95% CI 1.26–8.87), smoking (OR 5.82; 95% CI 1.12–30.37), chewing khat (OR 3.19; 95% CI 1.27–8.01), and being at university rather than high school (OR 4.58; 95% CI 1.94–10.79) were associated with increased likelihood of STI (p ≤ 0.05). Condom use was protective (OR 0.32; 95% CI 0.11–0.94). Conclusion There was considerable demand for STI screening, and a substantial burden of STIs was observed. These findings support the need for reproductive health interventions to reduce adolescent risk for STIs, pregnancy, and their complications. Disclosure of interest statement This research was funded by a 2011 developmental grant from the University of Washington Global Centre for Integrated Health of Women, Adolescents, and Children (Global WACh).

BackgroundGlobally, 40% of adolescent girls and young women suffer from urogenital tract infections (UGTIs) that affect their quality of life (QOL). Despite their significant health burdens, these conditions remain underreported and understudied, particularly in Low and Middle-income Countries (LMICs)This study aimed to examine the determinants of urogenital infection-related symptoms in adolescent girls and young adult women students.MethodsThis cross-sectional study was conducted among adolescent girls and young women in ten secondary and university institutions from December 2022 to April 2023 in Bukavu, Eastern DRC. Using purposive sampling, 1,500 questionnaires were distributed with 1,048 completed responses from 1,200 returns. The variables included age, education level, origin, knowledge of infections, hygiene behaviors (self-medication, contraception, water intake, and sanitation), and urogenital infection symptoms. A logistic regression model was used to examine predictors of urogenital infections using Stata SE14.0.ResultsA total of 1048 adolescent girls and young women, aged between 12 and 30 years with a mean age of 20 years, were enrolled in the study. The prevalence of related urogenital infection symptoms was 12% among school-going adolescent girls and young women in secondary schools and universities in Bukavu town, eastern Democratic Republic of Congo. Several factors were significantly associated, notably information about UGTIs and their symptoms (AOR: 4.52; 95% CI: 2.45–8.22; p < 0.001). The use of rain, ground, river or lake water while bathing increased the risk of UGTI symptoms (AOR: 4.08; 95% CI: 2.10–7.95; p < 0.001). Adding disinfectants to water reduced this risk but did not cancel it (AOR: 1.37; 95% CI: 1.10–2.05, p = 0.034). Communal bathing vessels (AOR: 1.85; 95% CI: 1.17–2.94, p = 0.008), the habit of wearing clothing that permanently tightens the perineum(AOR: 2.12; 95% CI: 1.14–3.90, p = 0.016), and antibiotic self-medication (AOR: 2.03; 95% CI: 1.36–3.02, p < 0.001) were associated with UGTI symptoms.ConclusionUrogenital tract infections (UGTIs) are common among adolescent girls and young women in educational settings in Bukavu, DRC. Symptoms were determined by a lack of information on UGTIs, women’s hygiene practices, self-medication, and lifestyle habits. Comprehensive health education overhaul is needed to effectively address public health concerns.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12905-025-04057-8.

The Vietnam Experience Study was a multidimensional assessment of the health of Vietnam veterans. From a random sample of enlisted men who entered the US Army from 1965 through 1971, 7924 Vietnam and 7364 non-Vietnam veterans participated in a telephone interview; a random subsample of 2490 Vietnam and 1972 non-Vietnam veterans also underwent a comprehensive medical examination. During the telephone interview, Vietnam veterans reported more adverse reproductive and child health outcomes than did non-Vietnam veterans. However, children of Vietnam veterans were not more likely to have birth defects recorded on hospital birth records than were children of non-Vietnam veterans. The rates of total, major, minor, and suspected defects were similar among children of Vietnam and non-Vietnam veterans (odds ratios, 1.0, 1.1, 1.0, and 0.9, respectively). These results are consistent with the findings of three epidemiologic studies conducted since 1981 on the relationship of Vietnam service and birth defects in children of male veterans. ( JAMA 1988;259:2715-2719)