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. 2025 Jan 16;20(1):e0311554.
doi: 10.1371/journal.pone.0311554. eCollection 2025.

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

Shilpa Sisodia  1 , Zara Hammond  2 , Jo Leonardi-Bee  1 , Charlotte Hanlon  3   4 , Laura Asher  1   5
Affiliations

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

Shilpa Sisodia et al. PLoS One. .

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.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow diagram.
Fig 2
Fig 2. Number of included studies by publication year.
Fig 3
Fig 3. Number of included studies by country.
See this image and copyright information in PMC

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References

    1. United Nations Population Fund. Sexual & reproductive health 2023. https://www.unfpa.org/sexual-reproductive-health (accessed January 4, 2024).
    1. Peixoto ER de M, Barros FCR de, Guimarães MDC. Fatores associados com a prática do sexo desprotegido entre homens e mulheres com transtornos mentais no Brasil. Cad Saude Publica 2014;30:1475–86. 10.1590/0102-311X00029313. - DOI
    1. Chopra MP, Eranti SSV, Prabha SC. HIV-Related Risk Behaviors Among Psychiatric Inpatients in India. Psychiatric Services 1998;49. doi: 10.1176/ps.49.6.823 - DOI - PubMed
    1. Matshoba T, Mashaphu S, Tomita A, Paruk S. HIV knowledge, attitudes and practices amongst patients with severe mental illnesses and chronic medical illnesses in Durban, South Africa. S Afr J Psychiatr 2021;27:1586. doi: 10.4102/sajpsychiatry.v27i0.1586 - DOI - PMC - PubMed
    1. Melo APS, Cesar CC, Acurcio F de A, Campos LN, Ceccato M das GB, Wainberg ML, et al.. Individual and treatment setting predictors of HIV/AIDS knowledge among psychiatric patients and their implications in a national multisite study in Brazil. Community Ment Health J 2010;46:505–16. 10.1007/s10597-010-9303-7. - DOI - PubMed

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