We investigated the magnitude and correlates of modern contraceptive non-use among women of reproductive age (15–49 years) in Eswatini (formerly Swaziland).

Secondary analysis of a cross-sectional, nationally representative, population-based, household survey

Eswatini

Women of reproductive age in the Swaziland HIV Incidence Measurement Survey 3 2021 dataset

The primary outcome was non-use of modern contraceptive methods.

Of 3080 reproductive age women whose data were analysed in this study, 53% were aged 20–34 years, and the majority were from rural areas (66.8%). The weighted prevalence of non-use of modern contraceptives was 33%. The risk of non-use of modern contraceptives was lower among women: aged 20–34 (adjusted risk ratio (ARR)=0.85, 95% CI 0.75 to 0.97); from households of middle wealth quintile (ARR=0.82, 95% CI 0.68 to 0.97); who had given birth at least once (ARR=0.84, 95% CI 0.73 to 0.96); who were living with HIV (ARR=0.79, 95% CI 0.70 to 0.89); and among those who reported being sexually active in the past 12 months (ARR=0.54, 95% CI 0.48 to 0.61). On the other hand, adolescent girls aged 15–19 years (ARR=1.31, 95% CI 1.04 to 1.67) and women who lived in the Manzini (ARR=1.21, 95% CI 1.01 to 1.46) and Shiselweni regions (ARR=1.21, 95% CI 1.00 to 1.45) had a higher risk of not using modern contraceptives.

Given that a third of women in Eswatini did not use modern contraceptive methods, there is a need to promote modern contraceptive methods in Eswatini, particularly long-acting methods. The Eswatini Sexual and Reproductive Health Program should strengthen initiatives aimed at promoting modern contraceptive use among adolescent girls and those living in the Manzini and Shiselweni regions, who showed a higher risk of not using modern contraceptives.

Younger female cancer survivors disproportionately suffer from treatment-related sexual dysfunction, yet evidence-based intervention for these prevalent and distressing side effects remains lacking. Previously, we developed and pilot-tested SHARE (Sexual Health and Rehabilitation), a single-session, in-person group educational intervention for younger female survivors with distressing sexual dysfunction. We recently adapted the intervention to be delivered via synchronous videoconference, now called SHAREonline. The aims of this optimisation trial are to (1) evaluate ‘proof-of-concept’, that is, clinically significant change in sexual function and psychological distress in younger female survivors, and (2) conduct pilot testing to assess feasibility of the intervention, including assessing the credibility of a control condition (ie, individual self-management (ISM)). Participant characteristics associated with clinically significant response to the intervention will also be explored to prepare for a larger efficacy trial.

This trial will enrol 84 female survivors, ages 19–49 with clinically significant treatment-related sexual dysfunction. Participants will be randomised to either the SHAREonline intervention or ISM. Sexual function and psychological distress are assessed at baseline, 8 and 16 weeks postintervention. Outcomes will be assessed by evaluating change in sexual function and psychological distress from baseline to 8 weeks (primary endpoint), and feasibility, including credibility and acceptability of the control condition, will be evaluated. Postintervention qualitative interviews will be conducted to further explore the experience of trial participants. If findings are positive, we will next evaluate the efficacy of SHAREonline in a fully powered efficacy trial.

This trial has been registered on ClinicalTrials.gov. Ethical approval has been granted by Dana-Farber Cancer Institute’s Institutional Review Board (4 January 2022) prior to data collection. Results will be published in peer-reviewed journals.

NCT06458049.

Sexual and reproductive health (SRH) is essential to women’s overall well-being, and promoting SRH depends largely on improving SRH literacy. However, existing research is predominantly situated in Western contexts and often lacks intersectional perspectives, resulting in the under-representation of the SRH experience of non-Western women, particularly those from East Asia. The aim of this scoping review is to provide an overview of the current literature on SRH literacy among East Asian women, focusing on how they access, understand, appraise and apply SRH information and services. To achieve this, we will examine how SRH literacy is conceptualised and addressed across healthcare, disease prevention and health promotion; map the characteristics of existing evidence and the population subgroups represented; compare patterns across different populations; and identify gaps, including overlooked or under-represented groups.

This review will be structured according to the Joanna Briggs Institute (JBI) recommended framework. Keywords related to ‘sexual health’, ‘reproductive health’, ‘health literacy’ and ‘East Asian women’ will be used. A comprehensive search will be performed from database inception to August 2026 across English-language, Chinese-language, Japanese-language and Korean-language electronic databases. Screening and study selection will be conducted by reviewers who are proficient in the language of the records being assessed. Data extraction and reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The findings will be synthesised and reported using the PAGER framework (Patterns, Advances, Gaps, Evidence for practice and Research recommendations).

As this scoping review involves the analysis of publicly available data, ethics approval is not required. The findings are expected to identify gaps in research on SRH literacy and inform the future development of tailored SRH promotion interventions among women especially in East Asia. Results will be disseminated through peer-reviewed publications and conference presentations.

The protocol of this review has been registered within the Open Science Framework (https://osf.io/f8r69) on 23 March 2026.

Teenage pregnancy remains a major public health challenge in Uganda, with Northern Uganda accounting for approximately 25% of the national burden. Inadequate knowledge on reproductive health among adolescents predisposes them to early childbearing, thereby increasing the risk of adverse outcomes for both the mother and the infant. This study aimed to assess the knowledge and attitudes regarding the risks associated with teenage pregnancy among adolescent girls at selected secondary schools in Lira City to determine whether these factors contribute to the persistently high rates of teenage pregnancy in the region.

A cross-sectional study design was employed using quantitative data collected through structured questionnaires. Data analysis was conducted at both univariate and bivariate levels using SPSS V.26. The 2 test was applied to assess associations, and p≤0.05 indicated statistical significance.

The study was conducted in selected secondary schools located in Lira City, Northern Uganda.

The study was conducted among 384 adolescent girls aged 18–19 years, recruited from three secondary schools in Lira City.

The primary outcome measures included participants’ socio-demographic characteristics as well as their knowledge and attitude towards the risk of teenage pregnancy. Secondary outcomes comprised the levels of knowledge and attitude and the factors associated with these outcomes.

The majority of participants (67.2%) demonstrated adequate knowledge regarding the risks of teenage pregnancy, whereas 76.3% exhibited negative attitudes towards teenage pregnancy, perceiving it as inappropriate. The participants’ class level and family type were significantly associated with both knowledge and attitude (p

Adolescent girls in secondary schools in Lira City demonstrated adequate knowledge of the risks associated with teenage pregnancy and generally held negative attitudes towards it. Families, schools and the general community should actively monitor and mentor adolescents within their care to limit the occurrence of teenage pregnancy. Moreover, further research is warranted to explore the underlying factors contributing to the persistently high rates of teenage pregnancy in the region, despite this level of awareness and the negative attitudes.

To characterise current practices in adolescent sexual and reproductive health (SRH) assessment during routine clinical encounters in a tertiary care setting and to triangulate these findings with young adults’ experiences of adolescent healthcare, identifying gaps between recommended assessment approaches and real-world clinical practice.

Qualitative study using semistructured in-depth interviews (IDIs) and group discussions with clinicians, followed by a sequential triangulation phase involving IDIs with young adults. Data were analysed using Braun and Clarke’s reflexive thematic analysis.

A tertiary care hospital in South Karnataka, India.

33 clinicians across six departments participated in four IDIs and five group discussions (focus-group or small-group discussions). 10 undergraduate young adults were recruited for IDIs in the triangulation phase. Sampling was guided by the information power principle.

Not applicable.

Current patterns and practices of SRH assessment, perceived barriers and challenges and concordance between clinician-reported practices and young adults’ experiences of care.

Three domains emerged: current assessment practices, contextual challenges and improvement strategies. SRH assessment was largely symptom-driven and reactive rather than routinely integrated into consultations. Clinicians described practices shaped by sociocultural stigma, parental presence, privacy limitations and medicolegal uncertainty. In response, many relied on informal strategies such as rapport-building, indirect questioning or referral pathways. Triangulation with young adults’ experiences confirmed the reactive nature of SRH enquiry, but revealed critical mismatches: young adults perceived consent processes as opaque, investigations as unexplained and confidentiality as inconsistently protected, contrasting with clinician intentions to be protective and pragmatic.

Adolescent SRH assessment in tertiary care settings remains constrained by sociocultural, infrastructural and communication barriers. Clinicians often compensate through informal practices that lack standardised protocols. Integrating adolescent-focused communication training, standardised assessment approaches and supportive system-level and community interventions may strengthen disclosure and improve adolescent-centred SRH care. By triangulating provider and patient perspectives, this study reveals a systematic gap between clinician adaptive strategies, constructed as protective and adolescents’ experiences as opaque, non-participatory care offering contextually grounded implications for strengthening adolescent-centred SRH services in comparable LMIC settings.

Not applicable (Qualitative Study)

Comprehensive sexuality education is an educational approach that addresses the cognitive, emotional, physical and social aspects of sexuality. When taught consistently and age-appropriately, it expands survival, health and life benefits for young people everywhere. To provide an efficient, comprehensive sexuality education curriculum, educators must be equipped with proper training.

This scoping review aimed to map and identify research gaps in the existing literature on educators’ training in comprehensive sexuality education, examine facilitators and barriers to training and curriculum implementation, and highlight areas requiring further investigation.

A comprehensive search of six academic databases was conducted, followed by a mixed-methods approach to analyse the data. Narrative synthesis and data mapping were used to analyse study characteristics for all the included studies. Descriptive statistics were used to analyse quantitative data and thematic analysis guided by an inductive approach was used to analyse common themes and sub-themes for qualitative data.

A total of 74 studies (qualitative n=31; quantitative n=24; mixed methods n=19) were included in this review. The results of this review found that preservice educator training to be the most effective training approach. Additionally, results found that the best training duration is context-dependent but should incorporate a combination of in-person and online training methods that include follow-up technical support strategies.

Due to the regional disparities identified in this review, future research needs to focus on the Eastern Mediterranean and Southeast Asia regions. The findings of this scoping review provide researchers with evidence-based knowledge to make practical recommendations for an efficient comprehensive sexuality education training programme for educators while addressing barriers to training, as well as facilitators and barriers to implementation.

Doxycycline as post-exposure prophylaxis (doxy-PEP) has emerged as an efficacious strategy to reduce Chlamydia trachomatis (C. trachomatis), Neisseria gonorrhoeae (N. gonorrhoeae) and syphilis (sexually transmitted infections (STIs)) among gay, bisexual and other men who have sex with men (GBM). There is a need to identify prescribing criteria that maximise the number of STIs averted while minimising excessive use.

In this prospective longitudinal cohort study with repeated measures and biobehavioural data collection, participants completed a questionnaire and tested for STIs at each visit.

Community-based, population-level study conducted in three large Canadian cities between February 2017 and July 2023.

2449 GBM were recruited through respondent-driven sampling (RDS); 1998 had ≥1 follow-up visit, contributing 7551 person-years of observation. Eligible participants were aged ≥16 years, cis- or transgender men, reported sex with another man in the past 6 months and resided in Montreal, Toronto or Vancouver.

Adjusted rate ratios (aRR) of STIs, accounting for RDS recruitment, loss to follow-up and confounding were estimated using generalised estimating equations (GEE) Poisson regression. For identified STI risk factors, the proportions of STIs averted through doxy-PEP prescription (based on the efficacy of doxy-PEP for each bacterial STI) and the number needed to treat (NNT) for 1 year to avert one STI, assuming 100% adherence, were calculated.

Among 1998 participants, the combined incidence rate of any C. trachomatis, N. gonorrhoeae and syphilis infection was 29.5 (95%CI 27.3 to 31.9) per 100 person-years. STI risk factors that had the most impact as doxy-PEP criteria were history of any of the three STIs in the past 12 months (P12M) (aRR=2.0, 95% CI 1.8 to 2.2, 36% STI averted, NNT=2.1); ≥10 male sexual partners in the past 6 months (P6M) (aRR=3.8, 95% CI 3.0 to 4.9, 41% STI averted, NNT=2.4); HIV-pre-exposure prophylaxis (PrEP) use P6M (aRR=1.7, 95% CI 1.5 to 2.0, 29% STI averted, NNT=2.5); use of any chemsex-related substance P6M (aRR=1.2, 95% CI 1.1 to 1.4, 28% STI averted, NNT=2.6); and group sex event attendance P6M (aRR=1.2, 95% CI 1.1 to 1.3, 27% STI averted, NNT=2.3). Reporting≥10 male sex partners P6M represented the most useful criterion for syphilis prevention (52% syphilis infections averted, NNT=20). Prescribing doxy-PEP to GBM having any of the following STI risk factors, namely, ≥1 bacterial STI P12M, ≥10 male sex partners P6M, or HIV-PrEP use P6M, would substantially increase the proportion of all STI diagnoses potentially averted (60%) with minimal increase of the NNT (2.7).

This work informs on the impact of various doxy-PEP clinical prescribing criteria and demonstrates the benefit of focusing on any of the following three criteria: ≥1 bacterial STI P12M, ≥10 male sex partners P6M or HIV-PrEP use P6M.

Technology-enabled approaches are increasingly used to support health education, yet the extent and characteristics of digital interventions addressing sexual health promotion for individuals with intellectual and developmental disabilities (IDD) remain unclear. Individuals with IDD often experience limited access to developmentally appropriate sexuality education, highlighting the need to understand how technology is being used to support learning, safety and autonomy. This scoping review aims to map peer-reviewed evidence on technology-enabled sexual health promotion for individuals with IDD, including intervention characteristics, target populations, sexual health content and reported outcomes.

This protocol follows the Population–Concept–Context framework and is developed in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidance; the scoping review will be reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Electronic database searches will be conducted in PubMed, Scopus, Web of Science and Embase for studies published in English between 2010 and 2025. The preliminary search strings were developed in consultation with a health sciences librarian and will be refined iteratively, if required, during the review process. Eligible studies will include peer-reviewed empirical research examining technology-enabled sexual health promotion for individuals with IDD. Two reviewers will independently conduct screening and data charting using Rayyan, with disagreements resolved through discussion and adjudication by a third reviewer. Data will be synthesised through descriptive mapping and thematic organisation. Given anticipated heterogeneity in technologies, settings and outcome measures, findings will be synthesised narratively rather than pooled quantitatively. Expert consultation will support interpretation without influencing study selection decisions.

Ethical approval is not required as the review uses published literature only. Findings will be disseminated through peer-reviewed publications and academic conferences to inform clinicians, educators, researchers and policymakers working in disability and sexual health.

Open Science Framework, DOI: 10.17605/OSF.IO/X7HQW.