Journal of women's health
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Journal of women's health · Sep 2019
Physician Knowledge, Attitudes, and Practices Regarding Breast Density.
Background: Many states have enacted breast density laws, requiring that women be informed of their breast density status; however there is currently no consensus for screening guidelines or recommendations for women with dense breasts. The objective of this study is to access physician views about breast density and their practices for breast cancer screening of women with dense breasts in light of breast density laws. Materials and Methods: Setting: Academic medical centers, community and private practices mostly in New York City. ⋯ More than half of the respondents (62%) were unaware of the increased risk of breast cancer related to dense breasts. Compared to specialists, PCPs were less aware of their state's breast density laws (odds ratio [OR] 0.21; 95% confidence interval [CI] 0.09-0.50) and of the increased breast cancer risk for women with dense breasts (OR 0.23; 95% CI 0.09-0.60). Conclusion: Breast density laws have not translated into greater knowledge of breast density and recommendations for supplemental screening among PCPs.
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Journal of women's health · Sep 2019
Factors Affecting Pre-Exposure Prophylaxis Implementation for Women in the United States: A Systematic Review.
Oral HIV pre-exposure prophylaxis (PrEP) is a highly effective pill that HIV-negative individuals can take once daily to prevent HIV infection. Although PrEP is a private, user-controlled method that empowers women to protect themselves without relying on a partner's behavior, women's PrEP use has been extremely low. We systematically reviewed the literature to identify and summarize factors that may be affecting PrEP implementation for women in the United States. ⋯ However, women and providers generally have positive views when aware of PrEP, including a willingness to use or prescribe PrEP to women. Most of the implementation barriers highlighted in studies were social or structural factors (e.g., access). Additional studies are needed to address research gaps, including studies of PrEP adherence and discontinuation.
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Journal of women's health · Sep 2019
Pornography and Heterosexual Women's Intimate Experiences with a Partner.
Background: Pornographic media characterized by discordant images of sexual pleasure and aggression are increasingly formulating young heterosexual women's sexual scripts. Yet there has been little work done on the downstream role of pornography consumption; how does pornography use relate to heterosexual women's thoughts and feelings during sexual experiences with a partner? Methods: We surveyed 706 heterosexual women (18-29 years of age) in the United States, associating consumption of pornography with sexual preferences, experiences, and concerns. Results: Although most heterosexual women have seen pornography (83%), a little less than half (43.5%) use it for masturbation, half of whom use it one time per month or less. Among female consumers who were sexually active, higher rates of consumption for masturbation were associated with increased mental activation of the pornographic script during sex-heightened recall of pornographic images during sex with a partner, heightened reliance on pornography for achieving and maintaining arousal, and a preference for pornography consumption over sex with a partner. Furthermore, higher activation of the pornographic script during sex, rather than simply viewing pornographic material, was also associated with higher rates of insecurities about their appearance and diminished enjoyment of intimate acts such as kissing or caressing during sex with a partner. Conclusion: These findings suggest that pornography consumption may relate to female consumers' sexual experiences indirectly and indicate that pornographic thoughts during dyadic sexual encounters may not improve heterosexual women's sexual experiences with a partner.
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Journal of women's health · Sep 2019
Pre- and Early Pregnancy Onset Depression and Subsequent Rate of Gestational Weight Gain.
Background: Depression is associated with weight change outside of pregnancy. We assessed associations of prepregnancy or early pregnancy onset depression with gestational weight gain (GWG) rate overall and according to Institute of Medicine (IOM) recommendations. Materials and Methods: Depression from 6 months prepregnancy through 20 weeks gestation was identified in a health care system in northern California with perinatal depression screening (2011-2016; n = 87,600). GWG rate (lbs/week) was calculated using weight at delivery and at diagnosis or depression screening ≤20 weeks. Results: Compared to women without prepregnancy or early pregnancy depression, women with prepregnancy onset depression had 11% greater risk of GWG rate
IOM recommendations (95% CI: 1.01-1.05), with a stronger association for >IOM in normal weight women. ⋯ Women with early onset prenatal depression may be at slightly higher risk for GWG rate above recommendations. Our results suggest that the relationship between depression and GWG may vary based on timing of depression onset, prepregnancy body mass index category, and antidepressant use. Additional research should identify factors that predict how a woman's lifestyle behaviors and weight change after depression diagnosis.