Search

Objective We sought to systematically review the literature on values and preferences regarding contraception among individuals within selected key populations. Study design As part of a larger set of reviews on patients’ and providers’ values and preferences related to contraception globally, we searched ten electronic databases for articles from January 1, 2005 to July 27, 2020. No language restrictions were applied. Data was independently abstracted by two authors and study rigor was assessed using an 8-item measure developed by the Evidence Project for quantitative studies and an adapted CASP checklist for qualitative studies. Results We identified 12 studies that met our inclusion criteria examining selected key populations, including sex workers, transmasculine individuals, people who inject drugs, or those living in humanitarian contexts. Seven key themes that spoke to values and preferences emerged related to: autonomy, perceived effectiveness and safety, birth spacing and family outcomes, impacts on sexual experience, hormonal effects (e.g. desire for non-hormonal method or perception that the method is more natural as compared to hormonal methods), physical attributes (e.g. appearance and/or ease of use), and stigma. Six studies were of high rigor, five were of moderate rigor, and one was of low rigor. One study described the values and preferences of two of the selected key populations. The research available on the values and preferences of sex workers regarding methods of contraception was limited to female condoms. Conclusion Consideration of the values and preferences of individuals within selected key populations can inform providers, programme managers and policy makers participating in the delivery of contraceptive care. Contraceptive research among sex workers, transmasculine individuals, people who inject drugs, or those living in humanitarian contexts is quite limited; further research is needed to better understand the values and preferences of these populations.

Food security, nutrition, and clean water are important factors for health and well-being, particularly for people living with HIV. Global gender inequalities, including women’s dependence on men for food and financial support, lack of access to control over land and resources, and responsibilities providing for children and family members likely shape the experience and impacts of food insecurity among women living with HIV. We performed a systematic review of the impact of food insecurity on sexual risk behaviors and antiretroviral therapy (ART) adherence among women living with HIV. We searched PubMed, CINAHL, PsycINFO, and Sociological Abstracts for peer-reviewed articles through February, 2016. Secondary reference searching was conducted on included studies. Studies were eligible for inclusion if they presented primary data, either qualitative or quantitative, for women living with HIV and described the associations between food insecurity and ART adherence, safer sex, or sexual risk behaviors. Data extraction was conducted in duplicate, including assessment of study rigor. Six studies met the inclusion criteria, four from sub-Saharan Africa and two from North America. Food insecurity was associated with increased sexual risk through transactional sex and lack of ability to negotiate safer sex. Findings also identified hunger and food insecurity as a barrier to ART initiation and adherence. The limited number of studies identified suggests that more research is needed on the relationship between food insecurity and key outcomes among women living with HIV. Results reinforce the need for multidimensional programming and policies that address poverty, gender inequality, food insecurity, and HIV simultaneously.