Fertility-related research needs among women at the margins

Figures & data

Figure 1 Women on the margins of fertility-related research and evidence^a

Figure 2 Overview of fertility-related research areas for women of reproductive age.

Table 1 Summary of Research Gaps among Marginalized Women of Reproductive Age.

	Key research gaps
Women living with or affected by HIV	• Conclusive evidence of the impact of hormonal contraception on HIV transmission and acquisition • Effective integration models for HIV and family planning • Evaluation of safer conception approaches in resource limited settings, including safety and efficacy of approaches, adherence to methods, time-to-pregnancy, comparative effectiveness of approaches and feasibility and optimal models for scale-up. • Infertility or sub-fertility in the context of HIV • Impact of lifelong maternal antiretroviral initiation during pregnancy on long-term maternal and child outcomes
Female sex workers	• Demonstration of the impact of integration of reproductive health programming into HIV prevention and care programmes for female sex workers • Additional understanding of fertility intentions, services needed to ensure safer pregnancy • Information around sex work and pregnancy, post-partum breastfeeding, depression and return to sex work • HIV mother-to-child transmission rates in the context of frequent sexually transmitted co-infections and structural barriers to ART care and adherence
LGBT women	• Additional examination of fertility intentions and experiences attempting conception among lesbians, gay and bisexual women and couples • Social science and programming evidence on fertility-related needs and services for transgender women • Comparative effectiveness of conception approaches for lesbian/gay/bisexual women with no known fertility issues which account for costs and time-to-conception across methods • Donor anonymity and health outcomes of children • Short and long-term post-partum depression and mental health outcomes of gestational and non-gestational LGBT mothers
Women who use drugs	• Fertility intentions of women who use drugs • Models for integration of family planning and reproductive health care into harm reduction programmes for women who use drugs • Barriers and facilitators to engagement in antenatal and postnatal care • Long-term maternal and infant outcomes (cohorts) of women who used drugs during or after pregnancy • More research in income limited settings