Search Results (73)

Purpose: To review parental pre-pregnancy and pregnancy exposures in relation to pediatric cancer (diagnosis before age 20). Methods: We conducted literature searches using Ovid Medline and Scopus to find primary research studies, review articles, and meta-analyses published from 2014 to 17 March 2021. Results: Strong evidence links increased risk of childhood cancer with maternal diabetes, age, and alcohol and coffee consumption during pregnancy. Both paternal and maternal cigarette smoking before and during pregnancy are associated with childhood cancers. Diethylstilbestrol (DES) exposure in utero has long been known to be causally associated with increased risk of vaginal/cervical cancers in adolescent girls. More recent evidence implicates in utero DES exposure to testicular cancer in young men and possible intergenerational effects on ovarian cancer in the granddaughters of women exposed to DES during pregnancy. There is strong evidence that childhood cancer risk is also associated with both high and very low birth weight and with gestational age. Evidence is also strong for the protective effects of maternal vitamin consumption and a healthy diet during pregnancy. Unlike early studies, those reviewed here show no association between in utero exposure to medical ionizing radiation, which may be explained by reductions over time in radiation doses, avoidance of radiation during pregnancy, and/or by inadequate statistical power to detect small increases in risk, rather than a lack of causal association. Evidence is mixed or conflicting for an association between childhood cancer and maternal obesity, birth order, cesarean/instrumental delivery, and prenatal exposure to diagnostic medical radiation. Evidence is weak or absent for associations between childhood cancer and multiple gestations or assisted reproductive therapies, as well as prenatal exposure to hormones other than DES, and medications. Full article

Background: Adolescent girls and young women (AGYW) who engage in alcohol and substance abuse face more significant health and social consequences compared to the general population. This study evaluated the prevalence and associated factors of alcohol abuse and substance use among AGYW in Namibia. Methods: We conducted a retrospective analysis of programmatic data from AGYW aged 10–24 who participated in the Determined, Resilient, Empowered AIDS-free, Mentored, and Safe (DREAMS) component of the Reducing HIV Vulnerability: Integrated Child and Youth Health (REACH) Project HOPE Namibia from March to December 2024. Data analysis was conducted employing chi-squared tests alongside binomial and multinomial logistic regression. Results: Among the 19,662 participants included in this analysis, 2068 (10.5%) abused alcohol and/or substances in the previous six months. Participants who were HIV-negative or did not know their status (AOR = 1.57, 95% CI (1.15–2.14), and AOR = 1.50, 95% CI (109–2.07), respectively), from outside Windhoek, those who had failed or repeated school in the previous year (COR = 1.77, 95% CI (1.54–2.05)), those not disabled (AOR = 1.27, 95% CI (1.06–1.52)), those who had dropped out of school or had completed their studies, and those with no adult emotional support (AOR = 1.25, 95% CI (1.11–1.40)), were more likely to have abused alcohol and/or substances recently. In contrast, participants who were not depressed were less likely to have recently abused alcohol and substances. Conclusions: The prioritization of strategies to identify AGYW experiencing depression and to provide them with treatment is essential. Moreover, it is important to encourage parents and guardians to provide emotional support to AGYW, as it prevents them from abusing alcohol and substances. Full article

Background/Objectives: High rates of sexually transmitted infections (STIs) increase HIV transmission risk among adolescent girls and young women (AGYW) in South Africa. AGYW prefer discreet self-testing options for HIV and pregnancy; however, other STI self-testing options are currently unavailable in this region. Methods: Seven Chlamydia trachomatis (CT), Neisseria gonorrhea (NG) and Trichomonas vaginalis (TV) assays were validated for AGYW self-test use (using self-collected vaginal samples) in a cross-sectional study (PROVE). Paired GeneXpert^® NG/CT (Cepheid_®, Sunnyvale, CA, USA) and OSOM^® Trichomonas test (Sekisui Diagnostics, Burlington, MA, USA) results from nurse-collected samples served as reference results to calculate sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV). One test, the polymerase chain reaction (PCR)-based Visby Medical™ Sexual Health Test device (Visby Medical™, San Jose, CA, USA), was validated for accuracy of positive test results using self-collected samples and home-based testing in a longitudinal follow-up study enrolling AGYW aged 16–18 years. Paired GeneXpert^® NG/CT and TV results from nurse-collected vaginal samples served as reference tests. Results: In PROVE, 146 AGYW contributed 558 paired samples. The Visby Medical™ Sexual Health Test exhibited moderate to high sensitivity (66.7–100%), specificity (80–100%), NPV (66.7–100%), and PPV (66.7–100%) for NG, CT, and TV. The remaining tests’ performances were markedly lower. In the longitudinal study, 28 AGYW contributed 84 paired samples, and the Visby Medical™ Sexual Health Test demonstrated 100% accuracy of positive results for CT, NG, and TV. Conclusions: The Visby Medical™ Sexual Health Test demonstrated high reliability as a potential option for AGYW to discreetly self-test for multiple STIs concurrently. Testing of its acceptability, utility, and feasibility in a larger sample of AGYW is in progress. Full article

Background: Adolescence and young adulthood are critical periods during which psycho-emotional factors can significantly influence disease management and increase the risk of complications. This systematic review aims to examine the impact of body image, self-image, self-perception, and other psycho-emotional variables on the management of type 1 diabetes mellitus (T1DM) in this population. Methods: This review follows the Cochrane Handbook, PRISMA 2020 guidelines and the JBI Checklist for Systematic Reviews and Research Syntheses. A comprehensive search was conducted across both general and discipline-specific databases (PubMed, Web of Science, Scopus, Embase, CINAHL, APA PsycInfo, APA PsycArticles) between March and April 2025. The inclusion criteria focused on studies involving adolescents with T1DM that addressed relevant emotional or psychological aspects. Methodological quality was assessed using JBI tools. Data extraction was performed independently by four reviewers, with discrepancies resolved by consensus. A total of 25 studies met the inclusion criteria. Results: Body image concerns were found to be highly prevalent among adolescents and young adults with T1DM, and were associated with adverse outcomes such as disordered eating behaviors and suboptimal glycemic control. Gender differences were consistently reported, with adolescent girls and young women displaying greater body dissatisfaction and engaging more frequently in risky weight management practices, including insulin omission. Other factors, such as self-perception, diabetes-specific stress, and identity formation, also played significant roles in treatment adherence and psychosocial adaptation. Notably, this review reveals a lack of interventions specifically designed to address the psychological dimensions of T1DM. Conclusions: Body image and self-concept exert a substantial influence on T1DM management in adolescents and young adults, affecting both glycemic outcomes and psychosocial well-being. There is a pressing need for gender-sensitive and developmentally appropriate interventions that address body image, self-concept, and disease acceptance. Future research should prioritize longitudinal designs and the development and evaluation of targeted psycho-emotional support strategies. Full article

Background: Sexual violence against adolescents and young people (AYP) remains a public health concern. This study explores patterns of sexual violence and help-seeking behaviour as well as their associated risk/protective factors with guidance of a technical package (INSPIRE) designed to reduce sexual violence in low-resource settings. Methods: The 2019 Violence Against Children Survey (VACS) dataset comprises 788 males and 1344 females. After describing the prevalence and patterns of sexual violence and help-seeking behaviour (informal disclosure, knowledge of where to seek formal help, seeking formal help, and receipt of formal help) among 13- to 24-year-old AYP, logistic regression models were then fitted to predict past-year sexual violence and informal disclosure among adolescent girls and young women (AGYW). Results: More young women than young men informally disclosed sexual violence experience (46% versus 23%). Gender inequitable attitudes [AOR 3.07 (1.10–8.56); p = 0.03], experiencing emotional violence at home [AOR 2.11 (1.17–3.81); p = 0.01] and cyberbullying [AOR 5.90 (2.83–12.29); p = 0.00] were identified as risk factors for sexual violence among AGYW. Life skills training [AOR 0.22 (0.07–0.73); p = 0.01] and positive parental monitoring [AOR 0.31 (0.10–0.99); p = 0.05] were found to be protective against sexual violence among AGYW. Positive parental monitoring [AOR 3.85 (1.56–9.46); p = 0.00] was associated with an increased likelihood of informal disclosure among AGYW. Conclusions: As Kenya intensifies efforts towards sexual violence prevention, this study underscores the need to develop and strengthen policies and programs on life skills training, cultural norms, and positive parenting, as well as improve awareness and access to post-violence response and support services. Full article

South Africa’s health system was affected by the various mitigation measures implemented to control the rapid spread of the COVID-19 pandemic. However, innovative interventions were introduced to ensure service continuity. This study sought to explore the perspectives of stakeholders regarding the pre-exposure prophylaxis (PrEP) innovative interventions implemented during the COVID-19 lockdown period among adolescent girls and young women (AGYW), as well as their successes and improvements. We selected and interviewed 12 PrEP stakeholders, including professional nurses, case managers, peer educators, and counselors from the TB HIV Care programme in the Dr. Kenneth Kaunda District, in the North-West Province. The qualitative questions explored (1) how PrEP services were disrupted during the lockdown period, (2) how the disruptions were managed, and (3) the challenges and successes of the innovative interventions implemented. The interviews were audio-taped, transcribed, and thematically analyzed through Tesch’s eight steps of analysis. The stakeholders confirmed that COVID-19 disruptions affected the provision of PrEP services in terms of recruitment, counseling, HIV testing, and adherence support offered in different community hotspots. Responding to these difficulties, alternative avenues such as social media platforms were implemented and used for service continuity. The themes that emerged were organized into the following two categories: PrEP services provided during and after the COVID-19 lockdown period, as well as the successes and challenges. The current study provides further insight into COVID-19, aiming to inform preparations for future pandemics. Innovative PrEP interventions alleviated COVID-19 disruptions in some settings and improved HIV services, but this was not the case in the selected study area. Full article

Physical activity interventions and programming for Black American girls often overlook racism and sexism as a fundamental cause of the differences in engagement between their white and male peers. Deficit framing is a standard where Black girls are often compared to the health, physical activity, and beauty standards driven by white feminine or masculine norms, suggesting there is only one way to be fit and healthy. Approaches that lack cultural and historical relevance, including the effects of systemic racism and sexism, are seldom considered before aiming to increase physical activity engagement and favorable health outcomes for Black teenage girls. Aim: This paper presents a brief overview of physical activity programming for Black adolescent girls and young women (aged 14–18) and proposes theoretical frameworks and approaches to consider before implementing physical activity interventions and programs. Concluding Remarks: Voice, intersectionality, misogynoir, representation, and gendered racism as a root cause should inform physical activity programming designed for Black adolescent girls. Culturally equitable approaches for real and sustainable change are required to increase physical activity engagement. Full article

Objective: We evaluate ovarian cancer (OC) in women with intellectual disability (ID). Methods: We reviewed the literature and added personal observations. The literature search included data from epidemiological studies on cancer incidence and mortality, institutional experiences, and case reports. We also used data from the Hérault Tumor Registry (HTR) in southern France. Results: A total of 72 articles met the inclusion criteria, which included 41 cases of OC. The review yielded 29 (74%) germ cell tumors, mainly in girls and young women, and only 4 (10%) ovarian carcinomas, all in adult women. In contrast, the HTR contained six cases of OC and one borderline tumor in adult women with ID aged > 45 years, but no cancer in children and adolescents with ID. These OC cases in adults were discovered at an advanced stage. We found that symptoms revealing OC in women with ID do not differ from those in the general population. However, diagnosis is more complicated in women with ID because they do not communicate easily and may express pain and unease in an unusual way, often through behavioral changes. Conclusion: OC could be as frequent in women with ID as in the general population and discovered at a late stage. The literature review indicates that girls and adolescents with ID develop mainly germ cell OC, and few carcinomas have been reported in women with ID. In contrast, the HTR was similar to the general population, with carcinomas in women with ID and no OC in children with ID. Full article

In the world of sports today, young people have access to models of women athletes who seem to have it all, women whose actions push on gendered assumptions of love and the associated roles of women as sacrificial and subservient. And yet, young people, particularly young girls, wanting to navigate their worlds in ways that challenge conventional love, do not have the same power and privilege given their gender, age, and lack of financial autonomy. The young adult novel Furia invites young readers to evidence an adolescent character whose love of sport serves as a form of liberation from social constraints in a way that likely feels more resonant and doable, more real somehow. The protagonist’s engagement with and dedication to sport invite complications of ideological assumptions about love, particularly gendered narratives that position girls and women as bound by devotion This paper draws upon the youth lensand methods of critical context analysis to better understand how the protagonist is positioned as an athlete and a young woman and to offer interpretative thinking that explores how this title can help us (and young readers) think about love through the lens of sport. Full article

Anorexia nervosa is classified by the American Psychological Association as an eating-related mental disorder, which affects mostly young adult women and adolescent girls. Although refeeding programs are often used to recover bodyweight in patients with anorexia nervosa, treatment failures are high, and the determinants of the disorder remain unknown. The present paper uses a nutritional epidemiology perspective to examine determinants of anorexia nervosa from the patients’ point of view. A grounded-theory literature-review method was used to search and review research findings from the peer-reviewed literature related to the etiology of anorexia nervosa, including recent qualitative interviews with patients. Unlike a systematic review, a grounded theory method is more appropriate for developing a new theory to explain phenomena like the cause, recovery, and prevention of anorexia nervosa. Reviewed research suggests that anorexia nervosa may be a problematic body-change strategy rather than a mental disorder. Additionally, the present paper proposes that replacing the drive for thinness in anorexia nervosa with a drive for leanness may help patient recovery, especially when guided by easily accessible body-composition estimates. Fat-free mass restoration in the recovery of anorexia nervosa may also be facilitated by resistance training, which improves patients’ psychological status and body composition. Additionally, replacing a dysfunctional dieting strategy in anorexia nervosa with knowledge, skills, and experience in proper weight management has a potential preventive effect against the disorder. More research is needed to investigate the applied effects of the drive for leanness, body-composition assessments, resistance-training programs, and weight-management skills associated with the recovery and prevention of anorexia nervosa. Furthermore, successful application of the information in this paper may be adapted to peer role model programs to prevent anorexia nervosa. Full article

Background: Human Papillomavirus (HPV) is the primary cause of cervical cancer. Single-dose HPV vaccination can effectively prevent high-risk HPV infection that causes cervical cancer and accelerate progress toward achieving cervical cancer elimination goals. We modelled the potential impact of adopting single-dose HPV vaccination strategies on health and economic outcomes in Kenya, where a two-dose schedule is the current standard. Methods: Using a validated compartmental transmission model of HPV and HIV in Kenya, we evaluated the costs from the payer’s perspective to vaccinate girls by age 10 with either one or two doses and increasing coverage levels (0%, 70%, 77%, 90%). Additionally, we modelled single-dose strategies supplemented with either catch-up vaccination of adolescent girls and young women or vaccination for all by age 10, funded with the first five-years of cost savings of switching from a two- to one-dose schedule. Costs and outcomes were discounted at 3% annually, and incremental cost-effectiveness ratios (ICERs) were calculated per disability-adjusted-life-year (DALY) averted. Results: All one-dose and the two-dose 90% coverage strategies were on the efficiency frontier, dominating the remaining two-dose strategies. The two-dose 90% coverage strategy had a substantially higher ICER (US$6508.80/DALY averted) than the one-dose 90% coverage (US$197.44/DALY averted). Transitioning from a two- to one-dose schedule could result in US$21.4 Million saved over the first five years, which could potentially fund 2.75 million supplemental HPV vaccinations. With this re-investment, all two-dose HPV vaccination scenarios would be dominated. The greatest DALYs were averted with the single-dose HPV vaccination schedule at 90% coverage supplemented with catch-up for 11–24-year-old girls, which had an ICER of US$78.73/DALYs averted. Conclusions: Considering the logistical and cost burdens of a two-dose schedule, a one-dose schedule for girls by age 10 would generate savings that could be leveraged for catch-up vaccination for older girls and accelerate cervical cancer elimination in Kenya. Full article

Background: Dysmenorrhea, characterised by painful menstrual cramps, is a pressing issue among adolescent girls globally. It significantly impacts their quality of life and has been associated with increased mental health issues and engagement in risky behaviours like smoking. In Poland, there is limited research on menstrual health, emphasising the need for a study to understand dysmenorrhea experiences and their impact on young menstruating individuals. Methods: This research project investigated the effects of dysmenorrhea on quality of life and school attendance, as well as its associations with non-communicable diseases, including mental health among adolescent girls in Poland. Additionally, the study examined risk factors for non-communicable disease development, including high-risk health behaviours and exposure to violence. The study utilised a cross-sectional design, administering self-reported questionnaires in high schools and vocational schools in six voivodeships (regions) in Poland. The analysis was performed using the R language in the Rstudio environment. p-value < 0.05 was considered significant. Results: A significant percentage of respondents experienced heavy menstruation, irregularity, and pain. Adolescents with dysmenorrhea reported higher rates of school absenteeism, mental health issues (such as anxiety and panic attacks), and a higher likelihood of engagement in risk behaviours like smoking and illicit drug use. The study also identified associations between dysmenorrhea and experiences of violence, including sexual abuse and intimate partner violence, as well as links to self-harm and suicidal ideation. Conclusions: These findings contribute to understanding dysmenorrhea among Polish adolescent girls, emphasising the need for tailored interventions and support services. The study underscores the necessity of addressing menstrual health comprehensively, considering its impact on various aspects of young women’s lives and promoting their overall well-being. Full article

Although South Africa was the first country to register and roll out oral pre-exposure prophylaxis (PrEP) biomedical human immunodeficiency virus (HIV) prevention intervention in sub-Saharan Africa (SSA), its uptake remains low, particularly among adolescent girls and young women (AGYW). The uptake of PrEP may have worsened during the Coronavirus disease 2019 (COVID-19) pandemic. Some innovative interventions to improve PrEP uptake among AGYW have been implemented. This study aims to evaluate the effectiveness of PrEP innovative interventions implemented during COVID-19 towards reducing the risk of HIV infection among AGYW in South Africa. An exploratory, descriptive design will be conducted to carry out four study objectives. Firstly, to carry out a systematic review of innovative PrEP interventions implemented during COVID-19 in SSA countries. Secondly, to conduct a stakeholder analysis to identify PrEP stakeholders and interview them on their views on the implemented interventions. Thirdly, to assess the implementation outcomes of the innovative interventions using document reviews and Consolidated Framework for Implementation Research. Fourthly, to develop a framework for an improved PrEP service delivery among AGYW. Qualitative data will be captured in ATLAS.ti software (Technical University, Berlin, Germany) version 23 and analysed via thematic analysis. A statistical software package (STATA) version 18 (College Station, TX, USA) will be used to capture quantitative data and analyse them via descriptive analysis. The generated evidence will be used towards the development of framework, guidelines, and policies to strengthen the uptake of, scale-up, and adherence to PrEP among AGYW. Full article

Introduction: Adolescent girls and young women (AGYW) in India face additional health inequities compared to their male peers, as gender norms constrain agency for prevention and self-care. The onset of the COVID-19 pandemic and associated lockdowns deepened health inequities and often worsened mental health, but the impacts on agency are unclear. This exploratory sequential mixed methods paper examined mental health and COVID-19 elements that exacerbated or mitigated adverse consequences for AGYW in low-income communities in Mumbai. Methods: We conducted semi-structured interviews with AGYW (aged 15–25 years; N = 60) and adults (parents, healthcare providers, community-based organization representative; N = 30). We administered a structured survey to AGYW (N = 150) to assess health concerns, depression and anxiety symptoms (using the PHQ-8 and GAD-7 scales), and experiences during COVID-19. We analyzed qualitative data using the constant comparative approach in Atlas.ti, and quantitative data using R and SPSS. Results: Qualitative data revealed that AGYW faced stressors and had limited agency during lockdowns due to limited access to education, financial insecurity, and community violence. Quantitative data indicated that limited agency in the context of COVID-19 was significantly associated with depression and anxiety. Financial resources to address COVID-19 created new employment and leadership opportunities for AGYW to become COVID educators and preschool teachers; participation in these opportunities was associated with less anxiety. Discussion: Pandemic stress was difficult for low-income AGYW in Mumbai. Mitigating programs for COVID-19 control helped address acute needs and enable capabilities. Exploring similar themes among a broader population of youth can help design strategies and opportunities for young people in low-income communities during health emergencies. Full article

Evidence suggests an association between food insecurity and depressive symptomatology; however, little is known about the association between adolescent girls and young women (AGYW) in the context of COVID-19. This study aimed to investigate the relationship between household food insecurity (HFI) and depressive symptomology among AGYW in South Africa during the COVID-19 pandemic. Secondary data analysis was conducted using cross-sectional data collected from the HERStory2 study conducted during the COVID-19 pandemic. The data were collected from 515 AGYW (aged 15–24 years) recruited from six South African districts using a demographic detail and socio-economic questionnaire as well as the Center for Epidemiological Studies Depression (CESD-10) Scale. Data were fitted using a multi-variable robust Poisson regression model and controlled for sociodemographic and health factors. The results suggest that the majority of the sample of AGYW were 20 years old, with 74% exposed to HFI and 30.29% experiencing depressive symptomology. AGYW exposed to HFI were 1.80 times at risk of depressive symptomology compared to those from food-secure households [adjusted risk ratio (aRR): 1.80; 95% CI: 1.35–2.42, p < 0.0001)]. Future pandemic-preparedness strategies should incorporate screening for HFI as a means to identify AGYW who may require psychosocial support. Full article