This scoping review aims to comprehensively explore the landscape of taboos and their impact on sexual and reproductive health. Titled \"Forbidden Conversations,\" it delves into the intricate web of societal, cultural, and religious norms that have contributed to the elusive and often stigmatized nature of sexual and reproductive health topics. The review navigates through the multifaceted dimensions of these taboos, shedding light on their impact on individuals, communities, and public health while advocating for a paradigm shift toward open, inclusive, and informed dialogue. The analysis within this review spans a decade, capturing the most recent and relevant literature to map the landscape of taboos in sexual and reproductive health. It explores the persistent societal apprehensions and subsequent stigmatization surrounding topics such as menstruation, contraception, fertility, sexual orientation, and gender identity. The review contextualizes the multifaceted challenges presented by these prevailing norms by tracing historically rooted taboos and their evolution across different cultures and contexts. The scoping review identifies the profound implications of these taboos on public health, highlighting how they contribute to disparities in access to healthcare, perpetuate misinformation, and infringe upon the fundamental rights of individuals. It addresses the challenges in sexual education, emphasizing how these taboos impede comprehensive understanding and enforcement of sexual and reproductive health rights among adolescents and young adults. The intersectional approach taken in this review situates these taboos within broader systems of inequality, emphasizing the compounded impact they have on marginalized populations. Through this comprehensive exploration, the review aims to provide actionable insights and identify existing research, policy, and practice gaps. It seeks to lay the foundation for future initiatives that advocate for destigmatization, empowerment, and equity in sexual and reproductive health. Ultimately, \"Forbidden Conversations\" aims to steer the conversation toward openness and inclusivity while advocating for unbiased, comprehensive sexual and reproductive healthcare with dignity for all individuals.

OBJECTIVE: Violence against women is a widespread public health concern with severe effects to women\'s sexual and reproductive health, including higher risks for miscarriage or stillbirth, unintended pregnancy and induced abortion. This study examined the association between women exposure to physical violence, psychological violence and sexual and reproductive health outcomes (contraceptive use, miscarriage or stillbirth and abortion) in Germany.
METHODS: This study used a cross-sectional research design to analyze data on violence against women and sexual and reproductive health (SRH) outcomes collected through the German Health Interview and Examination Survey for Adults, Wave 1, between 2008 and 2011 (n = 3149 women, aged 18-64 years). Multivariable logistic regression models were used to assess the association between experiences of violence among women and the presence of sexual and reproductive health outcomes, considering the influence of socio-demographic and health-related factors (age, marital status, socioeconomic status, social support, number of children, alcohol consumption, health status, chronic conditions).
RESULTS: Three associations remained significant (p<0.05) in fully-adjusted models: (i) exposure to physical violence by a parent or caregiver and birth control pill utilization (aOR, adjusted Odds Ratio, 95% CI: 1.36, 1.02-1.81) (ii) exposure to physical violence since the age of 16 and miscarriage or stillbirth (aOR, 95%CI: 1.89, 1.17-3.04); and (iii) exposure to psychological violence by a parent or caregiver and abortion (aOR, 95%CI: 1.87, 1.30-2.70).
CONCLUSIONS: The results suggest that adult German women who experienced physical or psychological violence since the age of 16, including violence perpetrated by a parent or caregiver, were more likely to report miscarriage or stillbirth and abortion. Direct assessment of violence experiences against women should be conducted by healthcare professionals in clinical encounters, particularly by obstetrics and gynaecological specialists, for the prevention of women´s adverse sexual and reproductive health outcomes. Furthermore, violence should be treated as a major public health concern and addressed through a multisectoral approach, involving the healthcare and educational sectors, researchers and relevant policymakers.

BACKGROUND: An essential aspect of human well-being is positive sexual health outcomes. However, the issue of adverse sexual health outcomes continues to be a major public health concern, particularly for women with disabilities in sub-Saharan Africa (SSA). Therefore, this current scoping review mapped studies conducted in the last twenty-nine years on the sexual health of women with disabilities from these five dimensions: sexual activity, contraceptive use, sexual autonomy, sexual violence and risky sexual behaviour, whilst seeking to identify the current state of knowledge and address the study gaps in SSA.
METHODS: This current scoping review was informed by the methodological framework proposed by Arksey and O\'Malley. Exploratory searches were conducted in PubMed, Web of Science, African Journals Online, etc., to identify studies conducted in SSA that focus on sexual activity, contraceptive use, sexual autonomy, sexual violence and risky sexual behaviour among women with disabilities in SSA since the inception of the International Conference on Population and Development in 1994 to 30th of March 2024. This process resulted in the inclusion of seventeen (17) studies.
RESULTS: Of the 1362 identified through various databases, 34 studies were included for the full-text retrieval and screening; only 17 studies met the inclusion criteria. The eligible studies were conducted across six countries in SSA and published between 2008 and 2023. Eight studies used quantitative study type, six utilised qualitative approach, and three employed mixed-methods analysis. Two studies were conducted on sexual activity, ten were conducted on contraceptive use, four were conducted on sexual violence, and one study was conducted on risky sexual behaviour, whilst no study on sexual autonomy met the inclusion criteria.
CONCLUSIONS: This review showed that there were few or scarce studies on sexual activity, contraceptive use, sexual autonomy, sexual violence and risky sexual behaviour among women with disabilities in SSA and even where the studies were substantial (contraceptive use), the majority of the studies were conducted in a country. Future studies should consider examining dimensions of sexual health, such as sexual autonomy, sexual activity and risky sexual behaviour of women with disabilities that were not available or were scarce in the literature.
Sexual health is really important for people\'s overall well-being, and it includes aspects like how we feel socially, mentally, emotionally, and physically. In sub-Saharan Africa, especially for women with disabilities, sexual health is a big concern. So, this review looked at studies done over the last 29 years about the sexual health of women with disabilities in sub-Saharan Africa. It focused on five areas: sexual activity, contraceptive use, sexual autonomy, sexual violence, and risky sexual behaviour. Databases were searched for relevant studies and found 17 that fit the set criteria. These studies were from six countries in sub-Saharan Africa and were published between 2008 and 2023. Most of the studies were about contraceptive use, with fewer focusing on sexual activity, sexual violence, and risky behaviour. There weren\'t any eligible studies on sexual autonomy. The review concluded that there\'s not enough research on these sexual health dimensions among women with disabilities in sub-Saharan Africa, especially on sexual autonomy, and future studies should explore this further.

UNASSIGNED: Canadian Arctic communities have experienced sustained syphilis transmission, with diagnoses rates 18-times higher than the national average. Remoteness from laboratory facilities leads to delays between syphilis screening and treatment, contributing to onward transmission. Rapid diagnostic tests can eliminate treatment delays via testing at the point-of-care. This study aims to describe syphilis diagnostic gaps and to estimate the impact of introducing rapid diagnostic tests at the point-of-care on syphilis transmission.
UNASSIGNED: To assess the population-level impact of deploying rapid diagnostic tests, an individual-based model was developed using detailed surveillance data, population surveys, and a prospective diagnostic accuracy field study. The model was calibrated to syphilis diagnoses (2017-2022) from a community of approximately 1,050 sexually active individuals. The impacts of implementing rapid diagnostic tests using whole blood (sensitivity: 92% for infectious and 81% for non-infectious syphilis; specificity: 99%) from 2023 onward was calculated using the annual median fraction of cumulative new syphilis infections averted over 2023-2032.
UNASSIGNED: The median modeled syphilis incidence among sexually active individuals was 44 per 1,000 in 2023. Males aged 16-30 years exhibited a 51% lower testing rate than that of their female counterparts. Maintaining all interventions constant at their 2022 levels, implementing rapid diagnostic tests could avert a cumulative 33% (90% credible intervals: 18-43%) and 37% (21-46%) of new syphilis infections over 5 and 10 years, respectively. Increasing testing rates and contact tracing may enhance the effect of rapid diagnostic tests.
UNASSIGNED: Implementing rapid diagnostic tests for syphilis in Arctic communities could reduce infections and enhance control of epidemics. Such effective diagnostic tools could enable rapid outbreak responses by providing same-day testing and treatment at the point-of-care.
UNASSIGNED: Canadian Institutes of Health Research.

BACKGROUND:  The South African government has pioneered several policy documents that emphasise the importance of sexual and reproductive health (SRH).
OBJECTIVE:  We examined how national policies address access and provision of contraception to adolescents in South Africa.
METHODS:  South African national policies.
METHODS:  We systematically searched various academic databases such as EbscoHost, Science Direct, Google Scholar, PubMed and Scopus, and other relevant sources to obtain 854 policy documents. Using a set of explicit inclusion criteria, we screened and selected 11 South African policies for analysis. Next, we analysed three international policies and frameworks to extract the key elements from them. Thereafter, we used these key elements to develop an analytical framework for conducting the analysis of the South African national policies.
RESULTS:  We found that South Africa\'s SRH policies largely address the provision of contraception by following international guidelines. These policies recognise the value of providing contraception to adolescent girls. However, we also found gaps in some policies, which could impede how they are translated into practice. These include recognising that adolescent boys can play a role in contraception; adolescents have varying SRH needs and are a key stakeholder not only for policy development but also for monitoring and accountability.
CONCLUSIONS:  With a specific focus on South Africa\'s contraception services in the public sector, these findings are relevant to policymakers, providers and users of contraceptives.Contribution: This review proposes recommendations that will assist with strengthening health policy development and thus improve primary health care services related to contraception for adolescents.

BACKGROUND: School-based comprehensive sexuality education (CSE) is a powerful tool that provides young people with information on all aspects of sexuality and is aimed at protecting their sexual and reproductive health and well-being throughout their lives. Currently, CSE is not integrated within the schools\' curriculum in Italy. This study describes the co-construction, implementation, and evaluation of a CSE project piloted among students attending lower secondary schools, in four regions of Italy. Evidence-based evaluation will be helpful in promote the inclusion of CSE programs in the Italian schools\' curriculum.
METHODS: The pilot scheme was co-constructed by a multidisciplinary curriculum development group through a Delphi process, including educators who conducted the activities. The evaluation followed three directions: the program (based on a literature review of CSE principles and recommended characteristics), implementation (assessing the execution of the program through the analysis of the reflection tools used by the educators), and short-term outcomes (assessing critical thinking and conscious behavioural choices through pre-post and satisfaction surveys).
RESULTS: The main goal, learning modules and content were defined and structured in five interventions with the students, and two with families and teachers. A total of 638 students were involved in the activity, across 11 schools. Data analysis of pre/post surveys reported a significant increase in knowledge in 12 of the 15 items investigated (p < 0.05), and a high level of satisfaction with the topics addressed. Qualitative analysis added information on the pivotal role of educators in CSE.
CONCLUSIONS: The national piloting of this educational activity provided positive insights regarding the co-construction, implementation and short-outcome evaluation, suggesting potential for scalability and future inclusion of CSE in the curricula of Italian schools.

OBJECTIVE: Sexuality is an important dimension of health-related quality of life (HRQOL) in cancer patients. Studies evidence that most patients report impairments of their sexual health related to their disease or its treatment. The Quality of Life Group of the European Organization for the Research and Treatment of Cancer (EORTC) developed a patient reported outcome measure assessing multidimensional aspects of sexual health. The validation study for this instrument revealed heterogenous results for patients in palliative oncological treatment. The aim of this secondary analyses is to examine differences in patient related sexual health outcomes between palliative patients with good performance status (GPS) and those with poor performance status (PPS).
METHODS: In this observational cohort study, self-reported sexual health issue scores were compared between the two groups of patients in palliative oncological treatment with GPS vs PPS status.
RESULTS: Patients with GPS experienced significantly more sexual satisfaction than patients with PPS (p = 0.015). They reported significantly more treatment effects on their sexual activity (p = 0.005) and suffer more from decreased libido (p = 0.008). Patients with PPS reported significantly more fatigue (p = 0.03) and regarded preservation of sexual activity of higher importance than did patients with GPS (p = 0.049).
CONCLUSIONS: Our study demonstrates the importance of sexuality for patients in palliative oncological treatment, especially for those with limited performance status. Considering the patients´ perspective, sexual health reaches beyond physical functioning. Patients in a palliative phase of disease report high levels of psychosexual problems while sexual performance deteriorates. Sexuality is an important aspect of HRQOL for these patients, needs to be addressed by health care providers and sensitively integrated into palliative care plans.

Sexual health literacy (SHL) is a set of skills related to sexual behaviors that can affect sexual behavior and empower individuals to maintain as well as improve their sexual health. This study aimed to investigate the rural women\'s sexual health literacy and its related factors in Iran. This cross-sectional study was conducted on 200 married women of reproductive ages referring to health center in Benaroyeh region along with six sub-villages in the South of Fars, Iran. Using convenience sampling method, we collected data via demographic-reproductive characteristics questionnaire and sexual health literacy for adult\'s questionnaire. We analyzed data using SPSS-16. Approximately 33.5% of the women obtained their sexual information online. The mean total SHL score was 75.64 ± 12.81. The SHL level was considered desirable in 82.5% of the participants. Among the four domains of SHL, the scores of most subjects on access skills and analysis-evaluation skills were unfavorable, 24.5% and 35.5%, respectively. The results show that the SHL level was correlated with education (P = 0.021) and inversely related to the gravidity (P = 0.04). There was also a statistically significant relationship between SHL level and women\'s career (P = 0.026), spouse\'s career (P = 0.01), and parity (P = 0.05). Most rural women had desirable levels of SHL. Given the lower levels of SHL in access and analysis-evaluation skills, and given the prevalence of Internet use, the provision of high quality and accessible online sexual health content within social and cultural norms is recommended.

BACKGROUND: Sexually transmitted infections (STIs) in adolescents are among the major public health challenges that have to be prevented in time. Traditional education falls short of reach; social media offers accessible ways. However, there is no research on such an issue in Nepal. Accordingly, this study was conducted to assess the effectiveness of a social media-based health education intervention in changing the intention of promoting sexual health among adolescents in Nepal. Study Design: A quasi-experimental study.
METHODS: A total of 160 adolescent students aged 14-19 years old from four purposively selected schools were evenly divided into intervention and non-intervention groups. Sampling and data collection were performed between May and June 2023. Data were collected through self-administered questionnaires for pretest and posttest evaluation. The intervention was delivered and followed up through a Facebook Messenger group. The obtained data were managed and analyzed using SPSS 21, with a significance level of 5%.
RESULTS: Social media-based health education interventions played a significant role in promoting the sexual health behavior of adolescents. The adolescents\' knowledge and attitude scores on STIs increased from 2.33 to 4.62 and from 21.87 to 26.30. In addition, their scores on subjective norms, perceived behavioral control, and intentions in promoting sexual behavior increased from 13.93 to 17.59, from 19.96 to 25.40, and from 13.07 to 18.06, respectively, which were statistically significant.
CONCLUSIONS: The utilization of social media platforms such as Facebook Messenger groups is an effective medium for delivering health educational messages. Hence, increasing social media-based health education is a cost-effective intervention for promoting the health and sexual behaviors of adolescents.

Equitable access to sexual and reproductive health (SRH) care is key to reducing inequities in SRH outcomes. Publicly funded family-planning services are an important source of SRH care for people with social risk factors that impede their access. This study aimed to create a new index (Local Social Inequity in SRH [LSI-SRH]) to measure community-level risk of adverse SRH outcomes based on social determinants of health (SDoH). We evaluated the validity of the LSI-SRH scores in predicting adverse SRH outcomes and the need for publicly funded services. The data were drawn from more than 200 publicly available SDoH and SRH measures, including availability and potential need for publicly supported family planning from the Guttmacher Institute. The sample included 72 999 Census tracts (99.9%) in the 50 states and the District of Columbia. We used random forest regression to predict the LSI-SRH scores; 42 indicators were retained in the final model. The LSI-SRH model explained 81% of variance in the composite SRH outcome, outperforming 3 general SDoH indices. LSI-SRH scores could be a useful for measuring community-level SRH risk and guiding site placement and resource allocation.