"Secure the bag": Young women's agencies toward better versus bare realities during COVID

Young women in township spaces aspire towards lifestyles that demonstrate affluence, a different socio-economic reality than the scarcity characterising their socio-economic space. The better lifestyles these young women aspire to, contrary to their current realities, are challenging to attain due to the unemployment underlying the livelihoods of many young women. For some young women, the experiences of unemployment intersect with other socio-economic factors such as early sexual exposure, teenage pregnancies, school dropout and experience of motherhood escalating their financial difficulties. The discussion here is drawn from a study through Ethnographic observations of young women in two South African townships. The discussion elicits a comprehensive account of young women's economic hardships in which they navigate their socio-economic realities. The discussion demonstrates that young women are active agents whose inspirations and instrumentalities struggle against the dire socio-economic conditions that characterise their township space. The awareness of their immediate conditions serves to fuel their dreams towards better realities, making them resourceful in their financial approaches: which are sometimes vulnerable. The young women's resourcefulness is however impacted by the Corona virus outbreak and the resultant lockdown regulations in a way that affects how they draw from their agencies. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Navigating visibility and risk: disabled young women's self-presentation practices on social media

Visibility is a requirement of neoliberal postfeminist girlhood and social media is often attributed with the capacity to provide disabled young women with visibility that they lack elsewhere. While some attention has been paid to the intersections of gender and disability through the self-presentations of disabled young women who are known as disabled content creators, such as bloggers and YouTubers, this article goes beyond this to examine how disabled young women represent themselves on social media as part of their everyday practices. Using a combination of discursive textual analysis of Twitter and Instagram accounts and semi-structured interviews with five disabled young women, I explore how affordances such as Twitter retweets play a key role in how disabled young women navigate their visibility online as part of their self-presentation practices. I argue that visibility is potentially risky and disabled young women's social media use is shaped by concerns about harassment and questions about the 'legitimacy' of their disabled identities that operate at the intersections of gender, disability and race, stemming from their experiences of 'systemic disbelief'. Finally, I situate these self-representation practices within the context of the COVID-19 pandemic.

Sexual and reproductive health needs of young women living with perinatally acquired HIV.

BACKGROUND: Increasingly, young women living with perinatally acquired HIV (YWLPaHIV) have transitioned from paediatric to adult services. There remains a paucity of data on the sexual and reproductive health (SRH) needs of YWLPaHIV and their access to youth-friendly care. Amidst healthcare changes due to COVID-19 pandemic restrictions, we explored SRH needs of a cohort of YWLPaHIV. METHODS: Evaluation of SRH needs of YWLPaHIV attending a UK NHS-youth HIV service with data collected from patient records and self-reported questionnaires amongst women attending between July and November 2020 following easing of the first lockdown and reintroduction of in-person appointments. RESULTS: 71 of 112 YWLPaHIV registered at the clinic completed questionnaires during the study period and were included in the analysis. Median age was 23 y (IQR 21-27, range 18-36). 51/71(72%) reported coitarche, average age 17.6 y (IQR 16-18, range 14-24). 24 women reported 47 pregnancies resulting in 16 (34%) HIV-negative live-births, 19 (40%) terminations, 9(19%) miscarriages, with 3 pregnancies ongoing. 31/48(65%) sexually active women reported current contraception: 10 (32%) condoms, 19 (62%) long-acting, and 3(10%) oral contraceptive pill. 18/51(35%) reported a previous sexually transmitted infection; human papillomavirus (HPV) (11), Chlamydia trachomatis (9) and herpes simplex (2). 27/71(38%) women had undergone cervical cytology including 20/28(71%) women aged ≥25 y with abnormalities documented in 29%. HPV vaccination was reported in 83%, with protective hepatitis B titres in 71%. CONCLUSION: High rates of unplanned pregnancy, STIs and cervical abnormalities highlight the continuing SRH needs of YWLPaHIV and requirement for open access to integrated HIV/SRH services despite pandemic restrictions.

L'intime au bout du fil. Enjeux méthodologiques de l'entretien biographique à distance

Résumé. La pandémie de la COVID-19 et la crise sanitaire et sociale qui en a découlé ont encouragé la conduite d'entretiens semi-directifs par téléphone ou par visioconférence. À partir de trois enquêtes réalisées par des jeunes femmes portant sur l'intime et ayant recours aux entretiens biographiques, cette note méthodologique examine les façons dont l'entretien à distance transforme la nature des matériaux collectés et recompose ce taisant le mode de production de connaissances sociologiques. Elle montre que le distanciel renouvelle les profils sociaux accessibles en ouvrant la voie à des configurations inédites. Elle donne également à voir les atouts de ce dispositif pour accéder à l'intériorité du sujet et souligne son potentiel dans les cas où des positions asymétrlques entre enquêteur/rice et enquêté·e dans les rapports de pouvolr (en particulier de genre) sont susceptibles d'entraver la relation d'enquête, risquant dès lors d'appauvrir les connaissances produites.Alternate :The COVID-19 pandemic and the health and social crisis it caused led researchers to conduct semi-directive interviews either by telephone or videoconferencing. On the basis of three surveys on intimate personal matters conducted by young women and requiring life history interviews, this methodological assessment examines the ways in which remote interviewing of these kinds changes the nature of the material collected and in so doing rearranges the sociological knowledge production mode. It shows how remote interviewing renews accessible social profiles by opening a path to previously unknown configurations. It also shows the advantages of this arrangement for accessing the subject's inner thoughts, feelings, and processes, and highlights its potential for cases where asymmetrical interviewer/respondent power positions (particularly gender positions) are likely to hinder interviewer-respondent rapport, risking an impoverishment of the knowledge produced.Alternate :Die COVID-19-Pandemie und die damit entstandene Sanitäts- und Sozialkrise haben die Leitfadengespräche über Telefon oder Videokonferenz gefördert. Ausgehend von drei von jungen Frauen durchgeführten Untersuchungen zur Intimsphäre anhand von biographischen Gesprächen prüft diese methodologische Notiz, wie das Ferngespräch die Art der gesammelten Materialen verändert und dabei den Produktionsmodus von soziologischen Kenntnissen neugestaltet. Sie zeigt, dass das Distanzgespräch die erreichbaren Sozialprofile erneuert, indem der Weg zu bisher nicht vorhandenen Konfigurationen geöffnet wird. Sie zeigt außerdem alle Pluspunkte dieser Vorgangsweise zur Erreichung der Interiorität des Subjekts und unterstreicht ihr Potential in den Fällen, in denen die asymmetrischen Positionen zwischen Befrager und Befragten innerhalb der Machtbeziehungen (besonders Gender) möglicherweise die Befragungsbeziehung einschränken und somit die produzierten Kenntnisse verringern könnten.Alternate :La pandemia de COVID-19 y la crisis sanitaria y social que ha derivado de ella han llevado a la realización de entrevistas semi-directivas por teléfono o por cia. A partir de encuestas que llevaron très mujeres jóvenes acerca de lo íntimo y que se basaban en entrevistas biográficas, nuestra nota metodológica observa de qué manera la entrevista a distancia transforma la naturaleza del material colectado y por lo tanto reorganiza el modo de producción de conocimientos sociológicos. Muestra que la comunicación a distancia renueva los perfiles sociales accesibles al posibilitar configuraciones inéditas. También revela las ventajas del dispositivo para acceder a la interioridad del sujeto y subraya su potencial en los casos en los que posiciones asimétricas entre investigador a y encuestado a en las relaciones de poder (en particular de género) podrían frenar la relación de investigación y así empobrecer los saberes producidos.

Adaptation and Resilience: Lessons Learned From Implementing a Combination Health and Education Intervention for Adolescent Girls and Young Women in South Africa During the COVID-19 Pandemic.

The COVID-19 pandemic has been associated with reduced access to health services and worsening health outcomes for HIV and sexual and reproductive health (SRH). Through the analysis of data from an evaluation study of a combination intervention for adolescent girls and young women (AGYW) in South Africa, we sought to examine the way in which implementation and service provision were impacted by the COVID-19 pandemic and related restrictions, describing the adaptation implementers made to respond to this context. The intervention was implemented from 2019 in South African districts identified as high priority, given the high rates of HIV and teenage pregnancy amongst AGYW. The South African government introduced the first COVID-19 lockdown in March 2020. We conducted in-depth interviews with 38 intervention implementers in the period from November 2020 to March 2021. Respondents described various ways in which the COVID-19 pandemic and related restrictions had limited their ability to implement the intervention and provide services as planned. As a result, AGYW intervention beneficiary access to SRH and psychosocial services was disrupted. Implementers described several ways in which they attempted to adapt to the pandemic context, such as offering services remotely or door-to-door. Despite attempts to respond to the context and adapt services, overall COVID-19 negatively affected implementation and service provision, and heightened issues around community acceptability of the programs. Our findings can help to inform efforts to reduce health service disruption, increase health system resilience, and ensure continuous SRH service provision to AGYW in times of pandemics and other crises.

Hospitalizations for alcoholic liver disease during the COVID-19 pandemic increased more for women, especially young women, compared to men.

BACKGROUND: Alcoholic liver disease (ALD) remains one of the major indications for liver transplantation in the United States and continues to place a burden on the national healthcare system. There is evidence of increased alcohol consumption during the coronavirus disease 2019 (COVID-19) pandemic, and the effect of this on the already burdened health systems remains unknown. AIM: To assess the trends for ALD admissions during the COVID-19 pandemic, and compare it to a similar pre-pandemic period. METHODS: This retrospective study analyzed all admissions at a tertiary health care system, which includes four regional hospitals. ALD admissions were identified by querying a multi-hospital health system's electronic database using ICD-10 codes. ALD admissions were compared for two one-year periods; pre-COVID-19 from April 2019 to March 2020, and during-COVID-19 from April 2020 to March 2021. Data were analyzed using a Poisson regression model and admission rates were compared using the annual quarterly average for the two time periods, with stratification by age and gender. Percent increase or decrease in admissions from the Poisson regression model were reported as incident rate ratios. RESULTS: One thousand three hundred and seventy-eight admissions for ALD were included. 80.7% were Caucasian, and 34.3% were female. An increase in the number of admissions for ALD during the COVID-19 pandemic was detected. Among women, a sharp rise (33%) was noted in those below the age of 50 years, and an increase of 22% in those above 50 years. Among men, an increase of 24% was seen for those below 50 years, and a 24% decrease in those above 50 years. CONCLUSION: The COVID-19 pandemic has had widespread implications, and an increase in ALD admissions is just one of them. However, given that women are often prone to rapid progression of ALD, this finding has important preventive health implications.

Correlates of psychological distress among undergraduate women engaged in remote learning through a New York City college during the COVID-19 pandemic.

OBJECTIVE: The study's objective is to explore psychological distress (PD) among remote learners during COVID-19. PARTICIPANTS: Female undergraduates matriculated at an NYC college in Winter 2020. METHODS: Using the Kessler-6 scale, we defined PD as no/low (LPD), mild/moderate (MPD), and severe (SPD) and assessed if residing in/near NYC modified associations. RESULTS: PD was common (MPD: 34.1%, SPD: 38.9%). Students identifying as Other/Multiracial had lower MPD odds (aOR = 0.39 [0.17-0.88]). SPD was associated with identifying as White (aOR = 2.02 [1.02-3.99]), unbalanced meals (aOR = 2.59 [1.06-6.30]), violence experience (aOR = 1.77 [1.06-2.94]), no social support (aOR = 3.24 [1.37-7.64]), and loneliness (aOR = 2.52 [1.29-4.95]). Among students in/near NYC, moderate/high drug use (aOR = 2.76 [1.15-6.61]), no social support (aOR = 3.62 [1.10-1.19]), and loneliness (aOR = 2.92 [1.11-7.63]) were SPD correlates. CONCLUSIONS: PD was high and associated with food insecurity, violence experience, no social support, and loneliness. Living in/near NYC modified drug use, loneliness, and social support associations. Mental health initiatives should address modifiable risk factors to ameliorate pandemic-associated PD.

The controversy around the vaccine against Covid-19

Since the beginning of the Covid-19 pandemic, the phenomenon known as conspiracy theories started to develop under the uncertainty of what is going to happen next and why we are forced to live in times like that. Meanwhile, researchers tried to develop as soon as possible a vaccine that would mitigate the damage caused by the SARS-CoV-2 virus, and eventually put an end to this pandemic. But, the effort of creating a vaccine is threatened by a vast number of people that tend to reject the idea of vaccination because of distrust in vaccine efficiency, fear related to side effects, the composition of vaccine and so on. What fuels these negative attitudes towards anti-Covid-19 vaccination are the controversies born from conspiracy theories, that tend to be attractive to some categories of people, such as younger individuals, women, people with low-income levels, a low level of education and people from ethnic minorities. In this paper, I tried to capture what are the reasons for people's vaccine hesitancy, and how we can resolve this problem.

Acceptability and feasibility of leveraging community-based HIV counselling and testing platforms for same-day oral PrEP initiation among adolescent girls and young women in Eastern Cape, South Africa.

INTRODUCTION: Community-based delivery of HIV pre-exposure prophylaxis (PrEP) to South African adolescent girls and young women's (AGYW) could increase access but needs evaluation. We integrated PrEP services via home-based services and pop-up tents into existing community-based HIV testing services (CB-HTS) in Eastern Cape Province, South Africa. METHODS: After accessing CB-HTS via a "pop-up" tent or home-based services, HIV-negative AGYW aged 16-25 years were invited to complete a baseline questionnaire and referred for PrEP services at a community-based PrEP site co-located with pop-up HTS tents. A 30-day supply of PrEP was dispensed. PrEP uptake, time-to-initiation, cohort characteristics and first medication refill within 90 days were measured using descriptive statistics. RESULTS: Of the 1164 AGYW who tested for HIV, 825 (74.3%) completed a questionnaire and 806 (97.7%) were referred for community-based PrEP. Of those, 624 (77.4%) presented for PrEP (482/483 [99.8%] from pop-up HTS and 142/323 [44.0%] from home-based HTS), of which 603 (96.6%) initiated PrEP. Of those initiating PrEP following home-based HTS, 59.1% initiated within 0-3 days, 25.6% within 4-14 days and 15.3% took ≥15 days to initiate; 100% of AGYW who used pop-up HTS initiated PrEP the same day. Among AGWY initiating PrEP, 37.5% had a detectable sexually transmitted infection (STI). Although AGYW reported a low self-perception of HIV risk, post-hoc application of HIV risk assessment measures to available data classified most study participants as high risk for HIV acquisition. Cumulatively, 329 (54.6%) AGYW presented for a first medication refill within 90 days of accepting their first bottle of PrEP. CONCLUSIONS: Leveraging CB-HTS platforms to provide same-day PrEP initiation and refill services was acceptable to AGYW. A higher proportion of AGYW initiated PrEP when co-located with CB-HTS sites compared to those referred following home-based HTS, suggesting that proximity of CB-HTS and PrEP services facilitates PrEP uptake among AGYW. The high prevalence of STIs among those initiating PrEP necessitates the integration of STI and HIV prevention programs for AGYW. Eligibility for PrEP initiation should not be required among AHYW in high HIV burden communities. Community-based service delivery will be crucial to maintaining access to PrEP services during the COVID-19 pandemic and future health and humanitarian emergencies.

Posicionamiento frente a los confinamientos obligatorios y el control social durante la pandemia en Chile: un análisis a partir de perfiles emocionales

The control of the pandemic generated by COVID-19 rely, to a large extent, on the disposition that people have or not to comply with the measures ordered by the health authority. In this study, the degrees of rejection and assimilation that different groups of people maintain regarding two types of measures designed to control the pandemic are analyzed: mandatory confinement and modification of daily routines. To do this, the emotions of a sample of 1911 people were evaluated using a questionnaire with Likert response options, an instrument constructed and validated for this research. The results allowed the identification of six emotional profiles with different sociodemographic conditions. In a pole, characterized by experiences of anger, sadness, and distrust in the face of the measures, there is a profile made up of young women, students and with a low level of economic income. At the other pole, characterized by presenting a state of comfort in the face of the pandemic and confidence in the proposed measures, there is a group made up of men, aged between 40 and 69 years, with a high educational level and high economic income. In between, we find four more profiles, with different emotional characteristics and sociodemographic conditions. The results are discussed considering their contribution to the design of non- “homogenizing” public policies for the control of the pandemic.Alternate :El control de la pandemia generada por la COVID-19 pasa, en gran parte, por la disposición que las personas tengan o no para cumplir las medidas dispuestas por la autoridad sanitaria. En el presente estudio se analizan los grados de rechazo y asimilación que diferentes grupos de personas manifiestan acerca de dos tipos de medidas diseñadas para el control de la pandemia: los confinamientos obligatorios y la modificación de las rutinas diarias. Para ello, se evaluaron las emociones de una muestra de 1911 personas mediante un cuestionario con opciones de respuesta Likert, instrumento construido y validado para esta investigación. Los resultados permitieron identificar seis perfiles emocionales asociados a diferentes condiciones sociodemográficas. En un polo, caracterizado por experiencias de rabia, tristeza y desconfianza frente a las medidas, se encuentra un perfil compuesto por mujeres jóvenes, estudiantes y con bajo nivel de ingresos económicos. En el otro polo, caracterizado por presentar comodidad frente al estado de pandemia y confianza frente a las medidas propuestas, se encuentra un grupo conformado por hombres, con edades entre los 40 y 69 años, con un alto nivel educacional y de elevados ingresos económicos. Entre medio, encontramos cuatro perfiles más, con distintas características emocionales y condiciones sociodemográficas. Se discuten los resultados considerando su aporte para el diseño de políticas públicas para el control de la pandemia.Alternate :O controle da pandemia gerada pela COVID-19 depende, em grande parte, da vontade ou da falta de vontade das pessoas em cumprir as medidas ordenadas pelas autoridades sanitárias. Este estudo analisa os graus de rejeição e assimilação que diferentes grupos de pessoas expressam sobre dois tipos de medidas destinadas a controlar a pandemia: o confinamento obrigatório e a modificação das rotinas diárias. Para este fim, as emoções de uma amostra de 1911 pessoas foram avaliadas usando um questionário com opções de resposta Likert, um instrumento construído e validado para esta pesquisa. Os resultados nos permitiram identificar seis perfis emocionais associados a diferentes condições sociodemográficas. Em um pólo, caracterizado por experiências de raiva, tristeza e desconfiança das medidas, há um perfil composto de jovens mulheres, estudantes e com um baixo nível de renda econômica. No outro pólo, caracterizado pelo conforto com o estado da pandemia e confiança nas medidas propostas, está um grupo de homens, com idade entre 40 e 69 anos, com alto nível de educação e alta renda. No meio, encontramos outros quatro erfis, com características emocionais e condições sócio-demográficas diferentes. Os resultados são discutidos em termos de sua contribuição para a concepção de políticas públicas para o controle da pandemia.

Product-access challenges to menstrual health throughout the COVID-19 pandemic among a cohort of adolescent girls and young women in Nairobi, Kenya.

Background: Access to menstrual hygiene products enables positive health for adolescent girls and young women (AGYW). Among AGYW in Nairobi, Kenya, this prospective mixed-methods study characterised menstrual health product-access challenges at two time points during the COVID-19 pandemic; assessed trajectories over the pandemic; and examined factors associated with product-access trajectories. Methods: Data were collected from an AGYW cohort in August-October 2020 and March-June 2021 (n=591). The prevalence of menstrual health product-access challenges was calculated per timepoint, with trajectories characterizing product-access challenges over time. Logistic regression models examined associations with any product-access challenge throughout the pandemic; multinomial and logistic regressions further assessed factors associated with trajectories. Qualitative data contextualize results. Findings: In 2020, 52·0% of AGYW experienced a menstrual health product-access challenge; approximately six months later, this proportion dropped to 30·3%. Product-access challenges during the pandemic were heightened for AGYW with secondary or lower education (aOR=2·40; p<0·001), living with parents (aOR=1·86; p=0·05), not the prime earner (aOR=2·27; p=0·05); and unable to meet their basic needs (aOR=2·25; p<0·001). Between timepoints, 38·0% experienced no product-access challenge and 31·7% resolved, however, 10·2% acquired a challenge and 20·1% experienced sustained challenges. Acquired product-access challenges, compared to no challenges, were concentrated among those living with parents (aOR=3·21; p=0·05); multinomial models further elucidated nuances. Qualitative data indicate deprioritization of menstrual health within household budgets as a contributor. Interpretation: Menstrual health product-access challenges are prevalent among AGYW during the pandemic; barriers were primarily financial. Results may reflect endemic product-access gaps amplified by COVID-specific constraints. Ensuring access to menstrual products is essential to ensure AGYW's health needs. Funding: This work was supported, in whole, by the Bill & Melinda Gates Foundation [010481].

Safe spaces for beneficiaries of a combination HIV prevention intervention for adolescent girls and young women in South Africa: access, feasibility, and acceptability.

BACKGROUND: Safe Spaces are a feature of combination HIV prevention interventions for adolescent girls and young women (AGYW) in South Africa. We investigated whether AGYW at risk for adverse sexual and reproductive health (SRH) outcomes accessed Safe Spaces that were part of an intervention, as well as their feasibility and acceptability. METHODS: In December 2020 to February 2021, as part of a process evaluation of a combination HIV prevention intervention, we randomly sampled 2160 AGYW intervention beneficiaries aged 15-24 years from 6 of the 12 intervention districts. We invited them to participate in a phone survey, with questions about their vulnerability to adverse SRH outcomes, and participation in intervention components including Safe Spaces. We examined factors associated with use of Safe Spaces using bivariate analyses and Pearson's chi squared tests. We also conducted in-depth interviews with 50 AGYW beneficiaries, 27 intervention implementers, 4 health workers, 7 social workers, and 12 community stakeholders, to explore perceptions and experiences of the intervention. Thematic analysis of the qualitative data was performed. RESULTS: At least 30 Safe Spaces were established across 6 districts. Five hundred fifteen of two thousand one hundred sixty sampled AGYW participated in the survey of whom 22.6% visited a Safe Space, accessing HIV testing (52.2%), mobile health services (21.2%) and counselling for distress (24.8%) while there. Beneficiaries of lower socioeconomic status (SES) were less likely to have visited a Safe Space, compared with those of higher SES (13.6% versus 25.3%; p < 0.01). Implementers described political, structural and financial challenges in identifying and setting up Safe Spaces that were safe, accessible and adequately-resourced, and challenges with AGYW not utilising them as expected. AGYW shared positive views of Safe Spaces, describing benefits such as access to computers and the internet, support with homework and job and education applications, and a space in which to connect with peers. CONCLUSION: AGYW are attracted to Safe Spaces by educational and employment promoting interventions and recreational activities, and many will take up the offer of SRH services while there. The poorest AGYW are more likely to be excluded, therefore, an understanding of the obstacles to, and enablers of their inclusion should inform Safe Space intervention design.

Exploring the Factors Affecting Travel Intention During the COVID-19 Pandemic: A Structural Analysis

The purpose of this study was to identify structural relationships between factors affecting domestic tourism intentions in Iran under COVID-19 conditions, taking into account the importance of behavioral intention in predicting behavior. Therefore, it adds to the emerging body of knowledge about travel intentions during the pandemic. Structural equation modelling was used to analyze 383 online questionnaires, which revealed a positive impact of "frequency of past travel" and a negative effect of "Covid-19 risk knowledge," "perceived risk," and "risk aversion attitudes" on "travel intentions." Furthermore, "perceived risk" and "risk aversion attitudes" mediated the relationship between "frequency of past travel" and "Covid-19 risk knowledge" with "travel intentions." Meanwhile, "socio-demographic variables" and "travel purposes" moderated the relationships between "risk aversion attitudes" and "travel intentions" and between "perceived risks" and "travel intentions." The findings enable tourism policy-makers, marketers, and businesses to take purposeful measures to recover domestic tourism.

Oral pre-exposure prophylaxis preference, uptake, adherence and continuation among adolescent girls and young women in Kampala, Uganda: a prospective cohort study.

INTRODUCTION: Oral pre-exposure prophylaxis (PrEP) has been scaled up; however, data from real-world settings are limited. We studied oral PrEP preference, uptake, adherence and continuation among adolescent girls and young women (AGYW) vulnerable to HIV in sub-Saharan Africa. METHODS: We conducted a prospective cohort study among 14- to 24-year-old AGYW without HIV who were followed for 12 months in Kampala, Uganda. Within at least 14 days of enrolment, they received two education sessions, including demonstrations on five biomedical interventions that are; available (oral PrEP), will be available soon (long-acting injectable PrEP and anti-retroviral vaginal ring) and in development (PrEP implant and HIV vaccine). Information included mode and frequency of delivery, potential side effects and method availability. Volunteers ranked interventions, 1 = most preferred to 5 = least preferred. Oral PrEP was "preferred" if ranked among the top two choices. All were offered oral PrEP, and determinants of uptake assessed using Poisson regression with robust error variance. Adherence was assessed using plasma tenofovir levels and self-reports. RESULTS: Between January and October 2019, 532 volunteers were screened; 285 enrolled of whom 265 received two education sessions. Mean age was 20 years (SD±2.2), 92.8% reported paid sex, 20.4% reported ≥10 sexual partners in the past 3 months, 38.5% used hormonal contraceptives, 26.9% had chlamydia, gonorrhoea and/or active syphilis. Of 265 volunteers, 47.6% preferred oral PrEP. Willingness to take PrEP was 90.2%; however, uptake was 30.6% (n = 81). Following enrolment, 51.9% started PrEP on day 14 (same day PrEP offered), 20.9% within 30 days and 27.2% after 30 days. PrEP uptake was associated with more sexual partners in the past 3 months: 2-9 partners (aRR = 2.36, 95% CI: 1.20-4.63) and ≥10 partners (aRR 4.70, 95% CI 2.41-9.17); oral PrEP preference (aRR 1.53, 95% CI 1.08-2.19) and being separated (aRR 1.55, 95% CI 1.04-2.33). Of 100 samples from 49 volunteers during follow up, 19 had quantifiable tenofovir levels (>10 µg/L) of which only three were protective (>40 µg/L). CONCLUSIONS: Half of AGYW preferred oral PrEP, uptake and adherence were low, uptake was associated with sexual behavioural risk and oral PrEP preference. Development of alternative biomedical products should be expedited to meet end-user preferences and, community delivery promoted during restricted movement.

Effect of Manual Therapy Compared to Ibuprofen on Primary Dysmenorrhea in Young Women-Concentration Assessment of C-Reactive Protein, Vascular Endothelial Growth Factor, Prostaglandins and Sex Hormones.

BACKGROUND: The study aimed to assess if manual therapy, compared to ibuprofen, impacts the concentration of inflammatory factors, sex hormones, and dysmenorrhea in young women Methods: Thirty-five women, clinically diagnosed with dysmenorrhea, were included in the study. They were divided into group A-manual therapy (n = 20) and group B-ibuprofen therapy (n = 15). Inflammatory factors such as vascular endothelial growth factor (VEGF), C-reactive protein (CRP), prostaglandin F2α (PGF2α), E2 (PGE2) and sex hormones levels were measured. Dysmenorrhea assessed with the numerical pain rating scale (NPRS), myofascial trigger points, and muscle flexibility were examined before and after the interventions. RESULTS: The difference in the level of 17-ß-estradiol after manual and ibuprofen therapy was significant, as compared to baseline (p = 0.036). Progesterone levels decreased in group A (p = 0.002) and B (p = 0.028). The level of CRP was negatively correlated with sex hormones. Decrease in dysmenorrhea was significant in both groups (group A p = 0.016, group B p = 0.028). Non-significant differences were reported in prostaglandins, VEGF and CRP levels, in both groups. CONCLUSIONS: There were no significant differences in CRP, prostaglandins and VEGF factors after manual or ibuprofen therapy. It has been shown that both manual therapy and ibuprofen can decrease progesterone levels. Manual therapy had a similar effect on the severity of dysmenorrhea as ibuprofen, but after manual therapy, unlike after ibuprofen, less muscles with dysfunction were detected in patients with primary dysmenorrhea.

Do we have friendly services to meet the needs of young women exposed to intimate partner violence in the Madrid region?

INTRODUCTION: Women experiencing intimate partner violence (IPV) do not tend to go very frequently to formal support services. The objective of this study is to identify barriers related to the accessibility, acceptability, equity, appropriateness and effectiveness of IPV services from the perspective of the professionals working in the IPV public services. METHODS: A qualitative study was carried out in the Madrid region based on 13 semi-structured interviews of young women who had survived IPV as well as 17 interviews with professionals. A thematic content analysis was performed, guided by the dimensions proposed by the World Health Organization (WHO) for friendly services for young people. RESULTS: From the perspective of the young women and professionals, barriers were identified for all the dimensions of the WHO's friendly services for young people: accessibility: lack of information and support from the social setting, scarce dissemination of the services, economic cost, non-adapted schedules, inadequate locations or lack of services in settings close to young people; acceptability: lack of protocols to guarantee confidentiality, lack of speed in the provision of services or their referral, unwelcoming environments or unsympathetic professional malpractice; equity: discriminatory professional attitudes towards groups with different social status and lack of protocols to ensure the care of these groups; appropriateness: unmet needs and lack of multidisciplinary teams; and effectiveness: shortage of time, resources, competent professionals, protocols and coordination. CONCLUSIONS: Strategies are needed to make the necessary changes to promote friendly services for the care of young people exposed to IPV. Additionally, it must be emphasized that resources are needed to raise awareness and disseminate IPV services, as well as to train professionals in this area. PATIENT OR PUBLIC CONTRIBUTION: This paper is based on professionals' perspectives of public IPV-related services of different areas such as Psychology, Social Work, Nursing, Psychiatry, Social Education and young women exposed to IPV. They either work in the public administration at the local, regional or state level or in NGOs in Spain.

Integration of HIV prevention and sexual and reproductive health in the era of anti-retroviral-based prevention: findings from assessments in Kenya, Malawi and Zimbabwe: [version 2;peer review: 3 approved with reservations]

Background: Though substantial progress has helped curb the HIV epidemic, high rates of new HIV infections persist among adolescent girls and young women (AGYW) in sub-Saharan Africa, reflecting critical gaps in reaching them with integrated HIV prevention and sexual and reproductive health (SRH) services. The scale-up of oral pre-exposure prophylaxis (PrEP) and multiple novel HIV prevention products on the horizon offer countries a unique opportunity to expand innovative approaches to deliver comprehensive, integrated HIV prevention/SRH services. Methods: This article comparatively analyzes findings from rapid assessments in Kenya, Malawi and Zimbabwe across key themes to highlight cross-country trends and contextual realities around HIV prevention/SRH integration, with a focus on oral PrEP and contraception. In Kenya and Zimbabwe, assessments were completed by Ministries of Health (MOH) and the HIV Prevention Market Manager and include 20 health facility assessments, 73 key informant interviews (KIIs) and six community dialogues. In Malawi, the assessment was completed by the MOH and Georgetown University Center for Innovation in Global Health and includes 70 KIIs and a review of national policies and program implementation in Blantyre. Findings were contextualized through a review of literature and policies in each country. Results: Across countries, the policy environment is conducive to HIV prevention/SRH integration, though operationalization presents ongoing challenges, with most policies preceding and not accounting for oral PrEP rollout. National coordination mechanisms, youth-friendly health services and prevention of mother-to-child transmission programs are promising practices, while siloed and resource-constrained health systems, limited provider capacity, underfunded demand generation and structural factors exacerbate barriers to achieving integration. Conclusions: As new HIV prevention products are introduced, demand for integrated HIV prevention/SRH services is likely to grow. Investing in HIV prevention/SRH integration can help to ensure a sustainable response to the HIV epidemic, streamline service delivery and improve the health outcomes and lives of AGYW.

Navigating Education in the Context of COVID-19 Lockdowns and School Closures: Challenges and Resilience Among Adolescent Girls and Young Women in South Africa

Gender related vulnerabilities and inequalities place female learners at high risk of school disengagement due to COVID-19 disruptions. Understanding the impacts of school closures and educational disruptions on female learners in South Africa is critical to inform appropriate, gender-sensitive policies, and programs, to mitigate further exacerbation of educational inequalities. We examined the effects that COVID-19 and lockdowns have had on the educational experiences of adolescent girls and young women (AGYW) aged 15–24, in six districts of South Africa characterized by high rates of HIV, teenage pregnancy and socio-economic hardship. Following a concurrent triangulation mixed-methods approach, we conducted a cross-sectional survey with 515 AGYW, and qualitative interviews with 50 AGYW. More than half of survey participants enrolled in education had been unable to continue with their studies. Factors associated with educational disruption included low socio-economic status, lack of cell phone access and household food insecurity. Qualitative narratives included challenges with online learning and studying at home in resource restricted settings, and insufficient support from schools and teachers. However, despite multiple barriers to continuing education, some AGYW demonstrated educational resilience, enabled by psychosocial and structural support, and resource access. Our findings lend support to an emerging evidence base showing that the closure of schools and tertiary institutions, combined with challenging home environments, and a lack of access to appropriate technology, has disproportionately impacted the most vulnerable AGYW, exacerbating pre-existing educational inequalities within the South African education system. Addressing structural barriers to educational equity, particularly in the pandemic context, including access of technology and the internet, is urgent. Copyright © 2022 Duby, Jonas, Bunce, Bergh, Maruping, Fowler, Reddy, Govindasamy and Mathews.

A BLOODY SHAME: THE JOURNAL OF THE HEALTH VISITORS' ASSOCIATION

'I do think pads should be free because it's a natural thing--every girl will end up having her period at some point in their life and not everyone can afford 'em.' That's the view of Sophie, 14, from Hull. She is not alone in this perception. More than a third of UK girls and young women aged 14 to 21 have struggled to afford period products since the pandemic began, up from one in 10 pre-pandemic. Among those who can afford products, almost a quarter struggled to get hold of them, mostly because of shortages in the shops. 'Periods don't stop in a pandemic,' says Rachel Grocott, director of communications and public fundraising at Bloody Good Period (BGP). BGP focuses mostly on asylum seekers and refugees, but at one point during the pandemic it was supplying period products to NHS hospitals because staff were struggling to find supplies in the shops after working long shifts.