To examine how menstruation, contraceptive use and gender-based violence intersect to shape the sexual and reproductive health and autonomy of girls and young women in Kenya.

Qualitative study exploring girls and young women’s experiences with contraceptive use and menstrual management, using in-depth interviews and focus group discussions analysed through a reflexive thematic approach.

Four county-run family planning clinics in Uasin Gishu County, Kenya.

77 girls and young women aged 15–19 years (via 35 in-depth interviews and 7 focus group discussions) and 27 family planning clinic providers (via 5 focus group discussions).

Interviewees’ contributions suggest that covert contraceptive use, when discovered through menstrual monitoring, provoked intimate partner violence. Heavy menstrual bleeding, whether related to contraceptive use or not, was viewed as a sexual restriction and also fuelled intimate partner violence. Furthermore, the inability to afford sanitary pads, combined with the stigma surrounding menstruation, drove some girls and young women into exploitative sexual relationships, often resulting in unwanted or unintended pregnancies.

Menstrual bleeding and contraceptive use, both independently and in combination, affect girls and young women’s reproductive autonomy and overall health and well-being, particularly in relation to gender-based violence. Improving menstrual hygiene management, challenging the stigma and harmful norms tied to menstruation and contraception and ensuring safe contraceptive use are integral to improving sexual and reproductive health and autonomy and are requisite for preventing and eradicating gender-based violence.

To determine the prevalence and factors associated with the uptake of HIV self-testing (HIVST) among adolescent girls and young women (AGYW) attending middle learning institutions in Dodoma City, Tanzania, in 2024.

Design: A cross-sectional study design was employed.

The study was conducted in five randomly selected colleges in Dodoma City, Tanzania.

A total of 771 female students aged 15–24 years who provided informed consent were enrolled. Students who declined participation or were reported by the college matron as medically unfit were excluded. In this study, ‘sick’ referred to participants with a clinically diagnosed illness rendering them unable to participate.

The primary outcome was the uptake of HIVST among participants.

The mean age of participants was 20.78 years (SD=1.85). Overall, 360 participants (46.7% (95% CI 43.2% to 50.2%) reported having used HIVST. Among those who had not tested, the most commonly reported barriers included cultural resistance 392 (95.4%), fear of judgement from healthcare providers, 372 (90.5%); legal restrictions on kit provision, 360 (87.6%); fear of testing procedures, 291 (70.8%); concerns about test reliability, 286 (69.6%); fear of test results, 283 (68.9%); limited accessibility to HIVST kits, 280 (68.1%); fear of others discovering they had tested, 273 (66.4%); low awareness of HIVST, 193 (47.0%); and a perceived low risk of HIV infection, 73 (17.8%).

Factors significantly associated with HIVST uptake included having multiple sexual partners adjusted prevalence ratio (aPR 1.23, 95% CI 1.05 to 1.45), studying health-related courses (aPR 1.14, 95% CI 1.04 to 1.27), availability of kits (aPR 2.83, 95% CI 2.21 to 3.62), previous HIV testing experience (aPR 2.65, 95% CI 2.05 to 3.43) and perceiving oneself at risk of HIV infection (aPR 1.29, 95% CI 1.11 to 1.50).

The uptake of HIVST among AGYW in Dodoma City remains below the national target of 95% HIV awareness among people living with HIV. Uptake was influenced by factors such as multiple sexual partnerships, study discipline, kit availability, prior testing experience and perceived risk of infection. Addressing the identified barriers and improving awareness and accessibility of HIVST could enhance testing rates among AGYW.

This study explored the barriers to and facilitators of weight reduction among urban, young adults with obesity in Sri Lanka.

A qualitative descriptive study, using the framework method in thematic analysis to identify key themes for barriers and facilitators.

An urban community setting in Sri Lanka in January–March 2022.

62 young adults (18–35 years) with obesity (body mass index ≥25 kgm^-2) representing different socio-demographic characteristics were recruited into the focus group discussions (n=10).

The majority of participants were women (n=40; 64.5%). More than 70% (n=45) of the participants were classified as having class I obesity. Inconsistent knowledge, emotions and mood, poor self-control, inadequate support from others, lack of time, lack of resources and facilities and unsafe environment for physical activities were the identified barriers. The desire to improve appearance and body image, health-related concerns, limitations to day-to-day activities, previous positive experiences, support from others and weight-related victimisation were identified as facilitators.

A multitude of factors were found to interfere with weight-reduction attempts. Due consideration of these barriers and facilitators is important when planning weight management programmes targeting young adults with obesity.