Journal of women's health
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Journal of women's health · Oct 2020
Multicenter StudyA Prospective Study of Exposure to Gender-Based Violence and Risk of Sexually Transmitted Infection Acquisition in the Women's Interagency HIV Study, 1995-2018.
Background: Our objectives were to estimate the association of gender-based violence (GBV) experience with the risk of sexually transmitted infection (STI) acquisition in HIV-seropositive and HIV-seronegative women, to compare the STI risks associated with recent and lifetime GBV exposures, and to quantify whether these associations differ by HIV status. Methods: We conducted a multicenter, prospective cohort study in the Women's Interagency HIV Study, 1994-2018. Poisson models were fitted using generalized estimating equations to estimate the association of past 6-month GBV experience (physical, sexual, or intimate partner psychological violence) with subsequent self-reported STI diagnosis (gonorrhea, syphilis, chlamydia, pelvic inflammatory disease, or trichomoniasis). ⋯ Other important risk factors for STI acquisition included unstable housing (adjusted incidence rate ratio [AIRR] 1.81, 95% CI 1.32-2.46), unemployment (AIRR 1.42, 95% CI 1.14-1.76), transactional sex (AIRR 2.06, 95% CI 1.52-2.80), and drug use (AIRR 1.44, 95% CI 1.19-1.75). Recent physical violence contributed the highest risk of STI acquisition among HIV-seronegative women (AIRR 2.27, 95% CI 1.18-4.35), whereas lifetime GBV experience contributed the highest risk among HIV-seropositive women (AIRR 1.59, 95% CI 1.20-2.10). Conclusions: GBV prevention remains an important public health goal with direct relevance to women's sexual health.
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Journal of women's health · Oct 2020
A Cohort Study of Psychotropic Prescription Drug Use in Pregnancy in British Columbia, Canada from 1997 to 2010.
Background: Psychiatric conditions are relatively common during pregnancy, and many of these conditions are treated with psychotropic medications. In this article, we aim to quantify the rate of pregnancy-related exposures and describe how psychotropic medications are being used in pregnancy. Materials and Methods: We conducted a retrospective cohort study of all pregnancies ending in a live birth in the Canadian province of British Columbia between January 1, 1997 and December 31, 2010. We examined antipsychotic, anxiolytic, antidepressant, and stimulants use during pregnancy. ⋯ Among psychotropic medication users, the most commonly associated psychiatric diagnosis was major depressive disorder (43.2%) followed by anxiety (15.8%) and adjustment reaction and/or acute stress (15.8%). The majority of antidepressant use was prevalent (continued from preconception period), whereas most anxiolytic use was incident (no prescriptions in the 6 months before conception). Conclusions: The relatively high rate of use of psychotropic drugs in this cohort, and the existence of effective alternative treatments for the commonly treated conditions suggests a need to improve access to nondrug options before and during pregnancy. The finding that fewer women are discontinuing their antidepressants during pregnancy should be further investigated.
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Journal of women's health · Oct 2020
COVID-19, Lockdown, and Intimate Partner Violence: Some Data from an Italian Service and Suggestions for Future Approaches.
Intimate partner violence (IPV)-defined as physical, psychological, sexual, and/or economic violence typically experienced by women at home and perpetrated by their partners or expartners-is a pervasive form of violence that destroys women's feelings of love, trust, and self-esteem, with important negative consequences on physical and psychological health. Many reports from several countries have underlined a remarkable increase in the cases of IPV during the COVID-19 emergency. In this opinion article, we discussed the hypothesis that such an increase may be related to the restrictive measures enacted to contain the pandemic, including women's forced cohabitation with the abusive partner, as well as the exacerbation of partners' pre-existing psychological disorders during the lockdown. ⋯ Such a reduction should be interpreted as a negative consequence of the pandemic-related restrictive measures. Although necessary, these measures reduced women's possibilities of seeking help from antiviolence centers and/or emergency services. Owing to the COVID-19 outbreak, there is an urgent need for developing and implementing alternative treatment options for IPV victims (such as online and phone counseling and telemedicine), as well as training programs for health care professionals, especially those employed in emergency departments, to facilitate early detection of IPV.
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Journal of women's health · Oct 2020
A Systematic Review of Somatic Symptoms in Women with Depression or Depressive Symptoms: Do Race or Ethnicity Matter?
Background: Racial and ethnic minority women in the United States have an elevated risk of depression or depressive symptoms compared with White women. There is evidence to suggest that these women are more likely to report somatic symptoms. The objective of this systematic review was to determine whether there are racial and ethnic differences in somatization in women with depression or depressive symptoms. ⋯ Conclusions: A pattern emerged with African American and Hispanic/Latina women with depression or depressive symptoms more likely to report somatic symptoms compared with White women. However, it is not clear whether differences were a function of culturally acceptable presentation of symptoms or if the stress of being depressed increased somatization in minority women. Future studies should assess how depression/depressive symptoms affect racial and ethnic minority women to identify mechanisms involved in increased somatization.
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Journal of women's health · Oct 2020
Sex and Gender Analysis of Toxicity and Epidemiology Data on Environmental Chemicals in the Three Major Toxicology Databases.
Background: As sex and gender are important considerations in the assessment of toxic chemicals, we investigated whether sex and gender issues have been adequately considered in toxicological databases. Materials and Methods: A systemic review was conducted on the toxicity and epidemiology data of eight environmental chemicals (i.e., cadmium [Cd], lead [Pb], benzene, toluene, formaldehyde, and tetrachloroethylene [TCE], bis(2-ethylhexyl) phthalate [DEHP], and bisphenol A [BPA]) that appear in three toxicological databases (i.e., Hazardous Substances Data Bank, Integrated Risk Information System, and the European Chemicals Agency databases). Results: Systemic reviews on 4160 data entries pertaining to eight chemicals in three databases revealed that only 13.5% of these were sourced from male and female combined (MF) studies, whereas, 40.6% of the total number of examined entries was sourced from the study in which the sex of the subject was not mentioned. Conclusions: To accurately evaluate the hazardous effect of chemicals, toxicity tests should be designed and conducted for both sexes, and the corresponding endpoints should cover gender concerns. Therefore, databases listing toxicity data as part of the open source literature should select information from MF toxicity and epidemiology studies.