Coping strategies of Ghanaian couples after unsuccessful infertility treatment: An exploratory qualitative study

by Stephen Mensah Arhin, Kwesi Boadu Mensah, Isaac Tabiri Henneh, Felix Yirdong, Evans Kofi Agbeno, Charles Ansah, Martins Ekor

Background

Psychological distress and social burdens associated with infertility among couples have been well-documented. However, little is known about the specific coping strategies employed by couples in low-middle-income countries such as Ghana, in the aftermath of unsuccessful infertility treatment attempts. In this qualitative study, we explored specific coping strategies patients adopt to address psychological distress related to unsuccessful treatment for infertility.

Methods

A semi-structured interview approach was used to elicit qualitative responses from 18 fertility clients after unsuccessful treatment at four fertility clinics in Ghana. Thematic analysis (TA) was used to examine the coping strategies adopted by participants in response to psychological distress associated with infertility treatment failures. This allowed us to explore potential culturally specific coping strategies employed by participants in response to infertility-related psychological distress.

Results

The themes that emerged as coping strategies in response to infertility-related psychological distress were diversional activities, intrapersonal cognitive reframing, social isolation, familial support, religious coping, avoidance-focused coping strategies, seeking encouragement, and professional help.

Conclusion

The findings from this study indicate that coping strategies that involve isolating oneself may not provide lasting emotional relief for individuals experiencing infertility. Relational activities contribute positively to coping. This is relevant in helping health professionals in the management of infertility treatment failures, which may include setting up support groups of similar experiences to draw strength from each. Furthermore, the results underscore the need to integrate psychological interventions into the counseling of couples following an unsuccessful infertility treatment. The clinical and research implications of these findings are discussed.

Hypertension associated with serotonin reuptake inhibitors: A new analysis in the WHO pharmacovigilance database and examination of dose-dependency

by Basile Chrétien, Andry Rabiaza, Nishida Kazuki, Sophie Fedrizzi, Marion Sassier, Charles Dolladille, Joachim Alexandre, Xavier Humbert

Introduction

Recent literature has reported instances of drug associated with hypertension with serotonin reuptake inhibitors (SRIs). Nonetheless, the association between SRIs and hypertension development is the subject of ongoing debate. It remains uncertain whether this is indicative of a class effect, and if dose-effect exist. To investigate the potential class effect associating SRIs with hypertension reporting, we utilized real-world data from VigiBase®, the World Health Organization (WHO) pharmacovigilance database.

Methods

We conducted an updated disproportionality analysis within VigiBase® to identify a signal of hypertension reporting with individual SRIs by calculating adjusted reporting odds ratios (aRORs) within a multivariate case/non-case study design. Additionally, we explored the presence of a dose-effect relationship.

Results

The database contained 13,682 reports of SRI associated with hypertension (2.2%), predominantly in women (70.0%). Hypertension was most reported in the 45-64 years old age group (44.8%). A total of 3,879 cases were associated with sertraline, 2,862 with fluoxetine, 2,516 with citalopram, 2,586 with escitalopram, 2,441 with paroxetine, 201 with fluvoxamine and 8 with zimeldine.A significant ROR was observed for all SRIs in both univariate (RORs ranging from 1.39 to 1.54) and multivariable analyses (aRORs ranging from 1.16 to 1.40) after adjustments for age group, sex, concurrent antihypertensive medication and drugs knowns to induce hypertension, except for fluvoxamine and zimeldine. No dose-response relationship was identified.

Conclusion

This investigation, conducted under real life conditions, unveils a notable pharmacovigilance safety signal associating SRI usage with hypertension reporting. No dose-response effect was detectable. Further longitudinal studies are warranted.

PrEP your step: Implementing an online crowdsourcing contest to engage young people in HIV prevention in Washington DC, USA

by Tamara Taggart, Allison Mathews, Toni Junious, Joseph A. Lindsey, Andrea Augustine, Charles Debnam, Yavonne Boyd, Seraiya Wright, Joseph D. Tucker, Manya Magnus

HIV incidence among young people (Black and Latinx women and men who have sex with men ages 16–24 years), in the United States is high. Traditional top-down approaches for pre-exposure prophylaxis (PrEP) social marketing are not effectively reaching this population. Crowdsourcing is a promising approach to engaging young people in the development of innovative solutions to raise awareness and use of PrEP among those at highest risk of HIV. This study engaged young people in the design and evaluation of an online crowdsourcing contest to promote PrEP among Washington, DC youth. The contest used standard methods recommended by the World Health Organization and feedback from our community partners. Online recruitment using social media elicited online votes and survey responses. We analyzed cross-sectional surveys using descriptive statistics, and semi-structured interviews with contest participants using thematic coding to explore barriers and facilitators to contest engagement. Approximately 82% of entries were from young people in DC. A convenience sample of 181 people voted on their favorite crowdsourced PrEP messages and shared their awareness and attitudes about PrEP. The contest website received 2,500 unique visitors and 4,600 page views. Themes from semi-structured interviews (n = 16) included the need for more community engagement in developing PrEP messaging and positive attitudes towards crowdsourcing. Survey data (n = 887) showed that the crowdsourced messages were well-liked and resonated with the community. Most preferred to see PrEP messages in social media (23%), email (17%) and videos (14%). Approximately 70% of survey participants reported that after viewing the crowdsourced message they would talk to their sexual partner or medical provider (63%) about PrEP, use PrEP (58%), and learn more about PrEP (56%). Crowdsourced messages solicit substantial online viewership. More implementation research is needed to understand the public health impact of integrating social media, crowdsourcing, and community engagement to develop PrEP promotional messages.