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INTRODUCTION: Adolescents and young women in low-middle-income countries face obstacles to accessing HIV, Sexual and Reproductive Health (SRH), and related Gender-Based Violence (GBV) services. This paper presents facilitators, opportunities, and barriers to enhance uptake of HIV, GBV, and SRH services among Adolescent Girls and Young Women (AGYW) in selected districts in Zambia. METHODS: This study was conducted in Chongwe, Mazabuka, and Mongu Districts among adolescent girls and young women in Zambia. Key informants (n = 29) and in and out-of-school adolescents and young people (n = 25) were interviewed. Purposive sampling was used to select and recruit the study participants. Interviews were transcribed verbatim, and a content analysis approach was used for analysis. RESULTS: The facilitators that were used to enhance the uptake of services included having access to health education information on comprehensive adolescent HIV and gender-based violence services. Non-governmental organisations (NGOs) were the main source of this information. The opportunities bordered on the availability of integrated approaches to service delivery and strengthened community and health center linkages with referrals for specialised services. However, the researchers noted some barriers at individual, community, and health system levels. Refusal or delay to seek the services, fear of side effects associated with contraceptives, and long distance to the health facility affected the uptake of services. Social stigma and cultural beliefs also influenced the understanding and use of the available services in the community. Health systems barriers were; inadequate infrastructure, low staffing levels, limited capacity of staff to provide all the services, age and gender of providers, and lack of commodities and specialised services. CONCLUSION: The researchers acknowledge facilitators and opportunities that enhance the uptake of HIV, GBV, and SRH services. However, failure to address barriers at the individual and health systems level always negatively impacts the uptake of known and effective interventions. They propose that programme managers exploit the identified opportunities to enhance uptake of these services for the young population.

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This proof of concept, controlled pilot study expands on existing dissonance-based body image promotion programs by testing a modified version of the Body Project for 136 mothers and daughters aged 11-18 years old in church settings called Reclaiming Beauty. Mothers (n = 30) and their daughters (n = 35) who participated in Reclaiming Beauty were compared to mothers (n = 32) and daughters (n = 39) in a waitlist, assessment-only, control group on body image, eating psychopathology, and risk factor measures (thin-ideal internalization, physical appearance comparison) at pre-, post-, and 6-month-follow-up assessments. Intent-to-treat, multilevel modeling indicated that mothers and daughters in the Reclaiming Beauty group experienced significant improvement in body appreciation, body shape concerns, eating psychopathology, thin-ideal internalization, and physical appearance comparison over a six-month period compared to control participants. Changes in thin-ideal internalization and appearance comparison did not predict body image and eating psychopathology at follow-up. Baseline levels of body satisfaction did not moderate the effect of the program, except for its effect on body shape concerns. Findings provide preliminary support for delivering a dissonance-based body image promotion intervention to mothers and their daughters and the feasibility of leveraging the mother-daughter relationship as well as delivering interventions in church settings.

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Aim: To study the psychosocial problems of adolescent girls during menstruation. Methods: Cross-sectional study was conducted in Chennai. Descriptive research design was used. Sample size: Sixty students were selected randomly by the teacher from Bhoodhur Govt high school, Sholavaram, Chennai and referred to researcher for the study purpose. Inclusion criteria: Adolescent girls who were aged 13-16 years and attained menarche. Results: Majority (71.7%) of adolescent girls belong to the age group of 14 - 15 years, 68% were in ninth standard. Nearly half of the respondents were using pads (45%) and clothes (42%) as absorbent, majority (65%) preferred to discuss about their menstrual problems with mother, 28% with friends about menarche, 7% do not discuss with anyone. Most of them (58%) as faced physical problems during menstruation such as pre-menstrual syndrome (55%), menorrhagia (12%), sleep disturbance (12%), body pain (68%), head ache (45%), leg pain (55%).Majority (67%) had psychological problems such as change in the mood (70%) irritability, (78%) restlessness, (63%) unstable mood, (58%) feeling stressed). One-third had faced psychosocial problems in terms of unaware of menarche before the onset (65%), 10% do not have privacy to change sanitary pad and do not know how to use pad, 32% faced restrictions during menarche. Conclusion: Mental health education of adolescent girls is essential to deal with psychosocial problems related to menstruation.

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BACKGROUND: Polycystic ovary syndrome (PCOS) is a common reproductive endocrinopathy in women of childbearing age, affecting 5-15% women in this age group. Suggestive cardinal features comprise hyperandrogenism, ovulatory dysfunction and/or polycystic ovary appearance. The gold standard radiological tool is the pelvic ultrasound (PUS) whose yield may be limited in overweight and obese adolescent girls. OBJECTIVE AND HYPOTHESES: To evaluate the contribution of pelvic MRI to the diagnosis of PCOS in a specific group of virginal overweight and obese adolescent girls. METHOD: Eight adolescent girls seen for menstrual irregularities or amenorrhea, with features of hyperandrogenism were biochemically screened (LH, FSH, testosterone, S-DHEA, delta-4 androstenedione, 17 (OH) P, SHBG, TSH, free T4, prolactin and lipid profile, fasting blood sugar and HOMA-IR and HOMA-B). Each had PUS and/or pelvic MRI (PMRI) performed. Other causes of hyperandrogenism were excluded. IMAGING: PUS with the trans-abdominal transducer was attempted in only one patient Acuson© scanner, using 3.5-7.5 MHz transducer; PMRI was performed in all patients with phased array coil of 1.5 T Siemens MRI scanner, with T1 and T2-weighted axial and coronal images. PCOS was defined according to the Rotterdam PCOS consensus Workshop. RESULTS: Eight girls (mean age 14,6 ± 1.47 years) are reported, one was overweight (BMI Z-score > 1 SDS), seven others were obese (BMI Z-score > 2 SDS). Mean age at menarche was 11.58 ± 1.11 years, except for one who had not yet entered menarche. All had menstrual irregularities, acanthosis nigricans, acne, hirsutism, and biochemical characteristics of PCOS (high plasma androgens, insulin resistance, glucose/insulin ratio <4.5, decreased SHBG).PUS was not contributive to the diagnosis of PCOS, whereas PMRI showed typical aspect (well delineated peripheral ovarian cysts), with increased ovarian volume and stroma. CONCLUSION: Although PUS remains the gold standard for the diagnosis of PCOS in most cases, its limitations in overweight and obese girls are real and must be considered.If utilization of endovaginal transducer not being feasible in young virginal girls, PMRI could be a useful alternative, allowing greater delineation of structural components of the ovary and better appreciation of both its volume and structural alterations.