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FP access reduces high school dropouts
Venus was not surprised to read that girls who have easy access to family planning (FP) services are less likely to drop out of high school. An analysis of data from the 2012–2013 American Community Surveys merged with geographical location of FP clinics in the USA concluded that even accounting for sociodemographic differences, having local access to Planned Parenthood FP services is consistently associated with fewer young women dropping out of high school, and childbearing.
Obstet Gynecol 2016;127:699–704. doi:10.1097/AOG.0000000000001344
Rapid malaria screening may improve pregnancy outcomes
Malaria during pregnancy causes maternal anaemia, low birth weight and neonatal mortality, and it's common in West Africa. One adopted strategy is intermittent screening and treatment in pregnancy, although some tests fail to detect malaria. A recent study reports high sensitivity of a rapid diagnostic test in pregnant women at antenatal booking, and in Ghana, also at subsequent antenatal appointments. Interestingly, women who tested negative but were actually infected, suffered fewer adverse outcomes.
Clin Infect Dis 2016;62:837–44. doi:10.1093/cid/civ1198
Doctors’ weekend working does not affect on pregnancy outcomes
Weekend working has been at the heart of the junior doctors’ strikes in England this year, and whether a truly 7-day National Health Service (NHS) offers anything clinically superior to what we already have is still being debated. A retrospective cohort study of maternal and neonatal outcomes in a large delivery unit in Cambridge pours further scorn on the political agenda – weekend delivery had no effect on maternal or neonatal morbidity. Moreover, adopting mandatory 7-day contracts is unlikely to make any difference to either consultant-led delivery during weekends or to patient outcomes.
Eur J Obstet Gynaecol Reprod Biol 2016; 199:5–10. doi:10.1016/j.ejogrb.2016.01.034
Menstruation does not affect HIV medication adherence
Menstrual cycles are blamed for many things but does where women are in their menstrual cycle influence whether they take their medication? According to a cross-sectional analysis of data from American women in different phases of their cycle it doesn't. Researchers found that suboptimal adherence to once-daily antiretroviral therapy wasn't linked to menstrual cycle at all, but they did find non-adherence was linked with fewer than 12 years of education, childcare responsibilities and depression.
AIDS Care 2016;28:11–21. doi:10.1080/09540121.2015.1069787
Internet dating is linked with risky sexual behaviour
Venus considers herself too romantic to put her trust in computer algorithms to find a partner, but she accepts this renders her out of step with much of the rest of the world. A population-based study of Norwegian adolescents reports that internet partners are common but girls still do it looking for love, whilst boys are generally on the hunt for sex. Both sexes, however, reported that sexual reasons for internet dating had them engaging in several risky sexual behaviours – including multiple sex partners – and a three-fold higher chlamydia prevalence.
Sex Transm Infect 2016;92:97–103. doi:10.1136/sextrans-2015-052152
The coffee economy delivers lessons for practice
People generally don't like the idea of private companies ‘making a profit’ out of NHS health services, but in reality most general practice (GP) surgeries are small businesses, trying to make a profit to pay those who hold responsibility for providing the services – the partners. One GP team describes their future as ‘caffeinated’: patient care is at the base of the cup, a steamy layer of partnership and engagement with local charities in the middle, with a top sprinkle of use of their premises after hours for health-improving activities. They'd happily sell coffee, too, and plough the proceeds back into the pot.
Br J Gen Pract 2016. doi:10.3399/bjgp16X684589.
Semen washing reduces HIV transmission and promotes pregnancy
Semen washing's significant effectiveness at preventing HIV transmission and to assist pregnancy in couples where the man is HIV-positive and the woman HIV-negative came out loud and clear in a USA-based systematic review and meta-analysis. No HIV transmission occurred in 11 585 cycles of assisted reproduction with the use of washed semen among 3994 women, and 56.3% of couples achieved clinical pregnancy using washed semen. The development of low-cost protocols are critical for countries with high HIV prevalence.
Fertil Steril 2016;105:645–55. doi:10.1016/j.fertnstert.2015.11.028
Online LARC information for teenagers is of variable quality
What's available on the internet for teenagers wanting information about long-acting reversible contraception (LARC)? Of the 238 websites reviewed in one study, 77% made no recommendation of LARC for teenage girls, and of the 55 websites that did recommend LARC, only 40% of them specifically discussed its use in teenagers. Interestingly, 16% of websites recommending LARC actually discouraged its use in teenage girls. The quality of information, when available, also varied. The paucity of appropriate web-based information is a significant barrier to LARC being adopted by girls in this age group.
J Prim Care Community Health 2016;7:76–80. doi:10.1177/2150131915621058
Abortion rates are increasing in developing countries
If we need more evidence of the importance of access to both sexual and reproductive healthcare, and safe abortion, a recent paper provides it on a global scale. Compiling data from government agencies, international sources and nationally representative studies, this study uses trends in abortion incidence for the period 1990–2014 as a basis for predicting the proportion of pregnancies that end in abortion, worldwide, region by region. While induced abortion appears to have fallen in developed countries, it has increased across the developing world, with no apparent variation according to the legal status of abortion. In addition, around three-quarters of these abortions were obtained by married women, with just over a quarter obtained by unmarried women.
Lancet 2016. doi:10.1016/S0140-6736(16)30380-4