Cervical cancer, caused by oncogenic (high risk [hr]) human papillomavirus (HPV) subtypes, is the most common cancer in women in Guatemala and the most common cause of cancer mortality in women aged 15-44 years. Visual inspection with acetic acid (VIA) with onsite cryotherapy “test-and-treat” is recommended for underserved Guatemalan indigenous rural women. This research assessed: 1) hrHPV infection prevalence in women screened by VIA; 2) Sensitivity and specificity of VIA in detecting hrHPV infection and cytologically identified precancerous and cancerous lesions; and 3) Factors associated with hrHPV infection. Analysis of anonymous data collected during VIA clinics in 2013 (N = 205) and 2017 (N = 234) for indigenous women aged 21-65 years in six villages showed 22.6% (95% confidence interval [CI]=18.7%-27.2%) had hrHPV cervical infection. VIA results were abnormal in 5.9% (95%CI=3.8%-8.8%). Only nine VIA exams in 89 women with hrHPV were abnormal (Sensitivity=10.1%, 95%CI=4.7%-18.3%), although abnormal VIA was associated with hrHPV (Prevalence Ratio [PR])=1.8; 95%CI=1.1-3.1; P=.05). Of 221 women who had VIA, hrHPV nucleic acid testing and liquid preparation cytology (equivalent to Papanicolaou or “Pap”) testing, 10 (4.7% [95%CI=2.3%-8.5%]) had abnormal cytological results, including one cancer, four high- and five low-grade squamous intraepithelial lesions. VIA sensitivity and specificity for detection of precancerous cytological abnormalities and cancerous lesions were 20.0% (95%CI=2.5%-55.6%) and 96.0% (95%CI=92.3%-98.3%) respectively. In contrast, hrHPV sensitivity and specificity were 100% (95%CI=71.7%-100%) and 88.7% (95%CI: 83.9%-92.7%). In both years combined, women aged fewer than 29 years or reporting fewer than four pregnancies were more likely to have hrHPV cervical infection (36.8%, 27.3%, respectively) than those who were older or reported more pregnancies (18.7; P=.025, respectively); 60.0% reported some form of modern contraception. Progesterone injections or implant users were more likely to have hrHPV infection (31.9%) than women using other or no contraceptives (19.5%); PR=1.6; 95%CI=1.1-2.4; P=.01). These data suggest that VIA may not be sufficiently sensitive for use in cervical cancer screening. “Test-and-treat” screening using hrHPV real-time testing, as recommended by the World Health Organization may be preferable to VIA, and may be acceptable using self-collected specimens.

Since the war on drugs in the 1980s, the United States has seen an exponential rise in the number of imprisoned individuals. This increase has been particularly dramatic for women. Nationwide, the population of women in prison has grown by 834% over the past 40 years, more than double the growth rate of men. Compared with incarcerated men, women in prison have higher rates of substance abuse, histories of physical and sexual abuse, mental illness, infectious disease and chronic illness. Most women in prison are defined by a challenging intersection of lower socioeconomic status and largely racial, ethnic, and minority gender status. This combination of identity factors both contributes to their health disparities and influences their experiences with health care. Given that the majority of women in prison are of reproductive age, gynecological care is a central aspect of women’s overall health care. However, women in prison are a small minority of the overall incarcerated population, and because of this, their gender-specific health needs are frequently unacknowledged. Using a feminist epistemology, this qualitative multiple case study provides an examination of the experiences of women before prison and in prison with gynecological care and prison staff’s experiences providing this care. The Gelberg Andersen Behavioral Model for Vulnerable Populations is adapted here for the study of women in prison. The model explains factors enabling and impeding women’s utilization of health care services, including previous health care experiences, prison infrastructure, and personal autonomy. Women in contact with the criminal justice system face difficulties accessing health care both outside and inside prison. Barriers on the outside included lack of health insurance, being addicted to drugs, and prioritizing children’s needs first. On the inside women cited a lack of confidentiality, the absence of trust in providers, and the inability to participate in treatment decision-making. In the case of women in prison, multiple external oppressions result in internalized negative beliefs. Such feelings of powerlessness, lack of control, curtailed agency, and threatened self-worth ultimately influence how women experience gynecological care in prison. Policy, practice and research implications are provided to meet the gender specific health needs of women in prison.

The problem of vesico-vagina fistula still remains a ravaging scourge in resource-poor countries of which Nigeria is visibly prominent. A majority of the cases are attributed to prolonged complicated labour due to inaccessibility of adequate and immediate obstetric health care. Complicated labour arises as a result of narrow pelvis bones of victims due to suffering from poor nutrition. While the above factors are noted as the direct cause to the prevalent of VVF, there are other socio-cultural conditions which predispose victims to this disease. Notable among them are the following: poverty; marital age; illiteracy; hazardous traditional practices, such as female circumcision. VVF victims often live an unworthy life. Many of them have been abandoned or divorced by their husbands and become ostracised by families and societies because of their repulsive smell and inability to engage in sexual activity and bear children. VVF victims suffer both physical and social consequences, many of them find it difficult to engage in any economic activity, surviving the hardship is very complicated and pathetic; some victims turn to street begging, while others survive through hawking of “bagged” water and selling firewood. Most studies conducted on the problem of Vesico vaginal fistula are done from the medical perspectives, often neglecting the psycho-social consequences faced by the sufferers. This study, however, discusses the socio-cultural and the psychological consequences of the disease. Locally and internationally, attempts are being made to eradicate the problem of VVF, however, if the Nigerian government does not recognise the incidence of VVF as a major public health issue, it will continue to ravage lives of Nigerian women, hence increasing maternal mortality in the country. This study proffers recommendations to help eradicate or alleviate the problem in Nigeria.

Bakgrund: Lesbiska och bisexuella kvinnor har sämre fysisk och psykisk hälsa än heterosexuella kvinnor. De är en osynliggjord grupp inom vården. Inom kvinnosjukvården (gynekologi och obstetrik) finns en tradition av heterosexualitet i och med dess fokus på reproduktion. Tidigare studier har visat att lesbiska och bisexuella undviker gynekologisk vård på grund av dåligt bemötande. Obstetriken kommer framöver att få ta emot alltfler samkönade par. Det blir därför viktigt att förstå hur kvinnosjukvården upplevs av lesbiska och bisexuella kvinnor. Syftet är att belysa lesbiska och bisexuella kvinnors upplevelser av kvinnosjukvården. Metod: Litteraturöversikt av 13 forskningsstudier. Textanalys med beskrivande sammanställning av inkluderade studiers resultat. Teoretiska referensramar är vårdrelation och heteronormativitet. Resultat: Det finns heteronormativitet och homofobi inom kvinnosjukvården på både individuell och strukturell nivå. Brister i bemötandet handlade om att bli exkluderad, samt att mötas av fientlighet, omedvetenhet eller okunskap. Detta fick negativa konsekvenser för studiernas deltagare, och ledde till olika strategier för att hantera och förebygga negativa vårdsituationer. Positiva upplevelser av vården relaterades till medvetenhet och kunskap kring sexuell läggning i form av öppenhet och kommunikation, samt när vårdpersonal signalerade acceptans och positiva attityder. Små förändringar i bemötandet kunde göra stor skillnad i mötet. Diskussion: Förutsättningarna för en god vårdrelation försvåras av heteronormativitet, och vårdpersonal behöver bli medvetna om på vilka särskilda sätt som lesbiska och bisexuella kvinnor behöver bekräftelse i form av acceptans och inkluderande. Enskild vårdpersonal kan göra stor skillnad i upplevelsen av bemötandet, och på så sätt också vara del av en större förändring kring minskad heteronormativitet inom kvinnosjukvården. / Background. Lesbian and bisexual women have worse physical and mental health than heterosexual women. They are an invisible group in health care. Within women's health care, (gynecology and obstetrics) there is a tradition of heterosexuality due to the focus on reproduction. Previous studies have shown that lesbians and bisexuals avoid gynecological care due to the way they are received. Obstetrics will now be receiving more and more same-sex couples. That makes it important to understand how lesbian and bisexual women experience women’s health care. The aim is to highlight lesbian and bisexual women's experiences of women's health care. Method. Literature review of 13 research studies. Text analysis with descriptive summary of included studies' results. The theoretical frameworks are the nurse-patient relationship and heteronormativity. Results. Heteronormativity and homophobia exist within women's health care. Deficiencies in the the ways lesbians and bisexual women were received involved being excluded and encountering hostility, unawareness or ignorance. This led to the need for various strategies to manage and prevent adverse health situations. Positive experiences of care related to awareness and knowledge of sexual orientation in terms of openness and communication, as well as health professionals signaling acceptance and positive attitudes. Marginal changes in health professionals’ response could make a big difference for the lesbian and bisexual women. Discussions. The prospects of a good caring relationship is complicated by heteronormativity. Health professionals need to be aware of the specific ways in which lesbian and bisexual women may need confirmation. Individual health professionals can make a big difference to the way lesbian and bisexual women experience health care, and thereby also contribute to a wider improvement related to reduced heteronormativity in women’s healthcare.

The health of women is compromised by the experience of sexual abuse in childhood. Women who have been sexually abused in childhood say they are `healing', but there is little literature on this healing process. The purpose of my research is to gather stories of healing from women who were sexually abused in childhood, analyze them, and learn about healing. The themes that emerged were integrated with a chronological restorying of the women's narratives and the literature, resulting in a model of healing that addresses the complexities of women's lives.

The health of women is compromised by the experience of sexual abuse in childhood. Women who have been sexually abused in childhood say they are `healing', but there is little literature on this healing process. The purpose of my research is to gather stories of healing from women who were sexually abused in childhood, analyze them, and learn about healing. The themes that emerged were integrated with a chronological restorying of the women's narratives and the literature, resulting in a model of healing that addresses the complexities of women's lives.

<p>The problem of vesico-vagina fistula still remains a ravaging scourge in resource-poor countries of which Nigeria is visibly prominent. A majority of the cases are attributed to prolonged complicated labour due to inaccessibility of adequate and immediate obstetric health care. Complicated labour arises as a result of narrow pelvis bones of victims due to suffering from poor nutrition. While the above factors are noted as the direct cause to the prevalent of VVF, there are other socio-cultural conditions which predispose victims to this disease. Notable among them are the following: poverty; marital age; illiteracy; hazardous traditional practices, such as female circumcision. VVF victims often live an unworthy life. Many of them have been abandoned or divorced by their husbands and become ostracised by families and societies because of their repulsive smell and inability to engage in sexual activity and bear children. VVF victims suffer both physical and social consequences, many of them find it difficult to engage in any economic activity, surviving the hardship is very complicated and pathetic; some victims turn to street begging, while others survive through hawking of “bagged” water and selling firewood.</p><p>Most studies conducted on the problem of Vesico vaginal fistula are done from the medical perspectives, often neglecting the psycho-social consequences faced by the sufferers. This study, however, discusses the socio-cultural and the psychological consequences of the disease. Locally and internationally, attempts are being made to eradicate the problem of VVF, however, if the Nigerian government does not recognise the incidence of VVF as a major public health issue, it will continue to ravage lives of Nigerian women, hence increasing maternal mortality in the country. This study proffers recommendations to help eradicate or alleviate the problem in Nigeria.</p>

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2009.

Thesis (doctoral)--University of Arizona, 2002. / Includes bibliographical references (p. 464-478).

Thesis (Ph.D.)--University of Wisconsin--Madison, 2003. / Includes bibliographical references (p. 210-219). Also available on the Internet.