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Sexual and reproductive health needs of women with severe mental illness in low- and middle-income countries: A scoping review

Author

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  • Shilpa Sisodia
  • Zara Hammond
  • Jo Leonardi-Bee
  • Charlotte Hanlon
  • Laura Asher

Abstract

Background: This scoping review aimed to understand the extent and type of evidence in relation to sexual and reproductive health needs of women with severe mental illness (SMI) in low- and middle-income countries (LMIC) and to summarise those needs. Methods: Inclusion criteria were 1) focus on sexual and reproductive health needs 2) women or girls with SMI, professionals, caregivers of women with SMI and community members 3) study set in a LMIC 4) peer reviewed literature (no restriction on study date or design). Studies were identified from comprehensive searches of Medline, EMBASE, CINAHL and PsycINFO (to July 2023). Results: The review included 100 papers. Most studies were cross-sectional and set in hospital outpatient departments. Only 20 of 140 LMIC countries were included in this review and only 15 studies were set-in low-income countries (LIC). Included studies often had multiple focus areas and were grouped by frequency of topic into categories of HIV (prevalence, risk behaviour and knowledge), other sexually transmitted infections (STIs), sexual function, contraception use and family planning, sexual violence, fertility, pregnancy and postpartum. Included studies indicated women with SMI have worse outcomes and worse sexual and reproductive health compared to both women without SMI and men with SMI. Women with SMI were shown to have higher rates of HIV and low levels of contraception knowledge and use, with little advice offered by professionals. Conclusions: This review highlights the need for a greater diversity of study methodology, robustness of ethical and consensual reporting when researching vulnerable populations and for further research on interventions and models of care aimed at addressing stigma, discrimination and improving the sexual and reproductive health of women with SMI. Future research should better represent the breadth of LMIC, investigate cultural adaptability of interventions and consider sexual health needs across the life course.

Suggested Citation

  • Shilpa Sisodia & Zara Hammond & Jo Leonardi-Bee & Charlotte Hanlon & Laura Asher, 2025. "Sexual and reproductive health needs of women with severe mental illness in low- and middle-income countries: A scoping review," PLOS ONE, Public Library of Science, vol. 20(1), pages 1-25, January.
    • Handle: RePEc:plo:pone00:0311554
    DOI: 10.1371/journal.pone.0311554
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    References listed on IDEAS

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    1. Wainberg, Milton L. & Alfredo González, M. & McKinnon, Karen & Elkington, Katherine S. & Pinto, Diana & Gruber Mann, Claudio & Mattos, Paulo E., 2007. "Targeted ethnography as a critical step to inform cultural adaptations of HIV prevention interventions for adults with severe mental illness," Social Science & Medicine, Elsevier, vol. 65(2), pages 296-308, July.
    2. Ashlesha Bagadia & Madhuri H Nanjundaswamy & Sundarnag Ganjekar & Harish Thippeswamy & Geetha Desai & Prabha S Chandra, 2020. "Factors influencing decision-making around pregnancy among women with severe mental illness (SMI): A qualitative study," International Journal of Social Psychiatry, , vol. 66(8), pages 792-798, December.
    3. Kwamina Abekah-Carter & George Ofosu Oti, 2022. "Perspectives of community members on homeless people with mental illness in Nsawam, Ghana," International Journal of Social Psychiatry, , vol. 68(1), pages 196-202, February.
    4. Neslihan Keser Özcan & Nur E Boyacıoğlu & Semra Enginkaya & Hüsniye Dinç & Hülya Bilgin, 2014. "Reproductive health in women with serious mental illnesses," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(9-10), pages 1283-1291, May.
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