Reproductive intentions among HIV-negative gay and bisexual men initiating pre-exposure prophylaxis in the Sustainable Health Center Implementation pre-exposure prophylaxis pilot study, 2014–2016

Introduction We assessed reproductive intentions and associated characteristics among men enrolled in the Sustainable Health Center Implementation pre-exposure prophylaxis (PrEP) Pilot (SHIPP) Study. Methods We analyzed baseline data from 1275 men who self-identified as gay or bisexual and participated in the SHIPP study. SHIPP was a cohort study of PrEP implementation in five community health centers in Chicago, Jackson, Philadelphia, and Washington, D.C. conducted from 2014 to 2016. Participants completed audio computer-assisted self-interviews querying intentions to have a child in the future. We estimated the association between participants’ reproductive intentions and their characteristics using Poisson regression models. Results Approximately 47% of participants indicated their intentions to have a child. Black/non-Hispanic (aPR = 1.40; 95% CI: 1.10–1.78) and other/non-Hispanic participants (aPR = 1.40; 95% CI: 1.01–1.93) were more likely to report intentions to have a child than white/non-Hispanic participants. Participants were less likely to report intentions to have children as age increased (18–29 years, reference group; 30–39 years, aPR = 0.80, 95% CI: 0.64–0.99; 40–49 years, aPR = 0.49, 95% CI: 0.33–0.72; 50+ years, aPR = 0.07, 95% CI: 0.02–0.21). Conclusions Clinicians offering PrEP to black and other/non-Hispanic gay and bisexual men should assess their reproductive intentions as family-planning counseling may be an opportunity to introduce PrEP to HIV-negative gay and bisexual men.

Examining the Influence of Intimate Partner Violence on Fertility Planning Status of Couples: Evidence from the 2018 Nigeria Demographic and Health Survey

Intimate partner violence (IPV) is associated with women’s poor reproductive health outcomes. This study examined the influence of IPV on couples’ fertility planning status (FPS). Couples’ data from Nigeria’s Demographic and Health Survey (NDHS) conducted in 2018 were used. A weighted sample of 4,650 couples was analyzed from the domestic violence module of the NDHS. Complementary log-log (cloglog) models were fitted to estimate the effects on FPS. The results showed that in marital relationships where husbands were older than wives, there was a 28% higher likelihood of planned fertility than couples where husbands were younger or within the same age range (Exp.B.=1.28; CI=1.10, 1.50). Couples who practiced the same religion had a 25% higher likelihood of planning their fertility than those practicing different religions (Exp.B.=1.25; CI=1.07, 1.47). Couples with no IPV had a 13% higher likelihood of planning their fertility (Exp.B.=1.13; CI=1.04, 1.24). IPV, poverty, and child sex preference had significant negative influences on couples’ FPS. Couples should be advised against all forms of IPV, and they should be made to understand that IPV jeopardizes their reproductive intentions. Specific enlightenment programs dissuading child sex preference may also be targeted at them.

Fertility dynamics and reproductive behaviour of men and women entering into marriage in the Republic of Bashkortostan

The article is devoted to the analysis of the fertility rate dynamics in the Republic of Bashkortostan and the study of the reproductive behaviour of the population entering into a registered marriage. The author examines the crude and total fertility rates, the net population reproduction rate, the total fertility rate by the order of births, as well as age-specific fertility rates. In addition, basing on the data of population surveys, the author regards reproductive intentions of citizens applying for marriage in the registry office, as well as reasons that may prevent them from having a child. The study shows that the Republic of Bashkortostan is characterized by a low fertility rate; the generation of children does not replace the generation of parents. The reproductive intentions of the respondents measured by the desired and expected number of children correspond to the small (two-child) family model. Among the main reasons that can prevent the birth of a child, the first two are financial and housing difficulties, and third is the desire to live for oneself for a while.

Couple-based expanded carrier screening provided by general practitioners to couples in the Dutch general population: psychological outcomes and reproductive intentions

Purpose The aim of expanded preconception carrier screening (ECS) is to inform any couple wishing to conceive about their chances of having children with severe autosomal or X-linked recessive conditions. Responsible implementation of ECS as reproductive genetic screening in routine care requires assessment of benefits and harms. We examined the psychological outcomes of couple-based ECS for 50 autosomal recessive (AR) conditions provided by general practitioners (GPs) to couples from the Dutch general population. Methods Dutch GPs invited 4,295 women aged 18–40. We examined anxiety (State-Trait Anxiety Inventory, STAI-6), worry, decisional conflict (DCS) over time in participants declining GP counseling or attending GP counseling with/without testing. Results One hundred ninety couples participated; 130 attended counseling, of whom 117 proceeded with testing. No carrier couples were identified. Before counseling, worry (median 6.0) and anxiety (mean 30–34) were low and lower than the population reference (36.4), although some individuals reported increased anxiety or worry. At follow-up, test acceptors reported less anxiety than test decliners (mean 29 vs. 35); differences in anxiety after testing compared to before counseling were not meaningful. Most participants (90%) were satisfied with their decision (not) to undergo testing. Conclusion Some individuals reported temporarily clinically relevant distress. Overall, the psychological outcomes are acceptable and no barrier to population-wide implementation.

A study to assess the unmet need for contraception among married women in the rural field practice area of a medical college Jhansi

Background: The concept of unmet need for family planning points to the gap between some women’s reproductive intentions and their contraceptive behaviour.Methods: A community based cross-sectional study was conducted from April 19 to March 20 in rural Jhansi. 520 married women (15-49 years) were interviewed by house to house survey.Results: Out of 520 participants 124 (23.8%) had unmet need, out of them 73 (14.03%) had unmet need for spacing births and 41 (9.8%) of the participants had unmet need for limiting births.Conclusions: The unmet need for contraceptives was 23.8% in the study which is much higher compared to NFHS-4 data for urban UP (19.6%), and it has to be taken in to consideration by policy makers.

Reproductive Potential and Outcomes in Patients with Hidradenitis Suppurativa: Clinical Profile and Therapeutic Implications

There are scarce data available regarding the impact of hidradenitis suppurativa (HS) on fertility, course and outcome of pregnancy and risk associated with treatments. The aims of this study are (1) to describe the clinical profile of HS women of childbearing age with and without accomplished reproductive desires and (2) to describe the prescribed treatments based on the fulfillment of reproductive intentions. We conducted a prospective observational study that included 104 HS women of childbearing age, 50.96% (53/104) with unfulfilled reproductive desires. These women were younger (29.08 vs. 42.06 years, p < 0.001), less frequently married and higher educated than women with fulfilled reproductive desires. Their age of disease onset was lower, but disease duration was shorter, in concordance with a lower International Hidradenitis Suppurativa Severity Score System (IHS4) and lower number of draining tunnels. Combined oral contraceptives were more frequently prescribed in women with unfulfilled reproductive desires (30.19% vs. 9.80%, p = 0.013) while biologics were less used in this group (3.77% vs. 13.73%, p = 0.08). In conclusion, a higher educational level and an earlier disease onset, with potential implications in finding a partner, may make the fulfillment of reproductive desires difficult for patients with HS. This study could help clinicians to achieve a better understanding of the specific characteristics of HS during childbearing age and consider reproductive desires when making treatment decisions.

Reproductive intentions and corresponding use of safer conception methods and contraception among Ugandan HIV clients in serodiscordant relationships

Context Among people living with HIV in Uganda, desires to have a child and unplanned pregnancies are both common, while utilization of safer conception methods (SCM) and modern contraceptives are low. Methods Three hundred eighty-nine HIV clients who reported considering childbearing with their uninfected partner enrolled in a safer conception counseling intervention trial in Uganda. Multiple regression analysis and baseline data were used to examine correlates of reproductive intentions and behaviors, including use of safer conception methods and contraception. Results Most (n = 313; 80.5%) reported that both they and their partner wanted to have a child now, which was associated with being married, in a longer relationship, not having a child with partner, greater SCM knowledge, lower internalized childbearing stigma, and higher perceived community stigma of childbearing. However, just 117 reported trying to conceive in the prior 6 months, which was associated with being female, not having a child with their partner, less decision-making control within the relationship, and greater perceived cultural acceptability of SCM. Among those who had tried to conceive in the past 6 months, 14 (11.9%) used SCM, which was associated with greater control in decision making. Of the 268 who were not trying to conceive, 69 (25.7%) were using a modern contraceptive, which was associated with being in a shorter relationship, less control over decision-making, more positive attitudes towards contraception and lower depression. Conclusion Methods to promote reproductive goals are underused by HIV serodiscordant couples, and relationships characteristics and childbearing-related stigma appear to be most influential and thus targets for intervention. Trial registration Clinicaltrials.gov, NCT03167879; date registered May 23, 2017.