Sarah E. Stutterheim

Menstrual leave is an emerging reproductive health organizational policy gaining attention in Europe but research remains limited. Drawing on 45 semi‐structured interviews with menstruating and nonmenstruating workers in Croatia, Germany, and Italy, we applied thematic analysis to explore workplace perceptions of menstruation and menstrual leave policies (MLPs). We found that menstruation was widely positioned as taboo in the workplace, with participants both experiencing and anticipating stigma. Menstruating was associated with incompetence, emotional instability, and unprofessionalism—as contradictory to ideal worker norms and expectations. Although participants could identify and acknowledge potential benefits of MLPs, they also expressed reluctance and even women participants felt reticent. In particular, women participants would refrain from using them and were concerned about misuse. Our research contributes to work and organizational psychology by highlighting how ideal worker norms perpetuate menstrual stigma which in turn enables the stigmatization of menstrual leave policies. Interventions that align with diffusion of innovations theory could increase awareness of menstruation and decrease menstrual stigma in the workplace to prepare workplaces before implementing menstrual leave policies.

Research grants form a cornerstone for enabling research, providing researchers with the funding and support necessary to perform research, purchase tools, and form teams. Most post-PhD early- and mid-career scholars will be required to develop research grant writing as a core professional competency, and will be — at least partly — evaluated on their ability to successfully obtain research funding by employers and academic promotion committees. Drawing on insights from an EHPS EMPOWER 2025 pre-conference workshop and a subsequent webinar on the topic, this piece serves as a practical guide designed to help health psychology scholars navigate the funding landscape and write highly competitive research proposals, covering key areas such as idea generation, aligning ideas with funding opportunities and grant writing.

We currently have a diverse toolbox of HIV prevention modalities that can be leveraged to reduce new HIV infections. Unfortunately, a focus on changing risk perceptions in HIV prevention persist despite limited evidence. In this viewpoint, I describe how an individual-level focus on risk perception fuels stigma while stigma obscures risk perception. I argue that efforts to bolster HIV prevention should focus first and foremost on ascertaining the various determinants of uptake for the various prevention modalities available, and acknowledge that people’s preferences for prevention strategies are neither universal nor static. We should therefore engage in ongoing monitoring of the many sociocognitive and structural determinants of the different prevention modalities over time, and make our sexual health services free from stigma, judgment, and risk eligibility criteria.

The historical treatment of homosexuality in psychoanalysis has ranged from pathologization to discrimination. Despite recent attempts at inclusion, gay analysts and patients still report bias within the field. This study explored the experiences of gay and heterosexual psychoanalysts regarding the discipline's attitude towards homosexuality. Semi‐structured interviews with nine analysts (four gay men, four heterosexual men, one heterosexual woman) from different theoretical traditions and countries were analysed using Interpretative Phenomenological Analysis. The sample's diversity offered a rare opportunity to compare the perspectives of gay and heterosexual analysts within the same professional community. Four major themes emerged: (1) ‘It's not a problem’, (2) experiences of discrimination, (3) critiques of psychoanalysis and its institution and (4) positive change in terms of acceptance of sexual diversity. Gay analysts reported discrimination, rejection and a sense of being wronged, while heterosexual analysts tended to lack emotional empathy and regarded discrimination as a problem of the past. Both groups acknowledged psychoanalysis as a valuable therapeutic tool but emphasized the urgency of systemic change to ensure its ethical integrity and inclusivity. The findings highlight the importance of fostering inclusive practices, addressing entrenched biases and maintaining the psychoanalytic attitude, the discipline's core, when working on issues related to homosexuality.

IntroductionReproductive health self-care interventions are growing rapidly in Ghana, but there is limited evidence on the quality-of-care provisions that ensure safety for end-users and health professionals. This study explored how quality of care and safety are experienced and maintained within reproductive health self-care interventions in Ghana, using a self-care-specific conceptual framework.Materials and MethodsUsing an exploratory qualitative approach, underpinned by the Quality-of-Care Framework for Self-Care, we interviewed 29 end-users and 19 professionals, comprising health providers, program managers, digital referral agents, and community facilitators across Accra, Tamale, Cape Coast, and Sunyani. The study spanned six sexual and reproductive health and rights (SRHR) domains: family planning, abortion, HIV/STI, maternal and child health, general SRHR, and cervical cancer. Data was analysed using thematic analysis techniques in Dedoose, grounded in both deductive and inductive principles.ResultsKey outcomes include the following: Technical Competency – Despite barriers, end-users felt sufficiently empowered to access self-care services. although professionals required continuous capacity strengthening to keep pace with the evolving ecosystem; Client Safety – End-users preferred access to medical eligibility information, but professionals were while professionals expressed concerns about potential misuse; Information Exchange – Information on family planning self-care services was more openly available than across other SRHR domains; Interpersonal Connection and Choice – End-users reported more positive experiences with remote services than facility-based care, although professionals faced operational constraints that affected consistent delivery of quality care; Continuity of Care – Follow-up care was better integrated across health facilities than alternate service delivery points, with periodic stockouts disrupting continuity efforts.ConclusionIn exploring how quality of care and safety are experienced and maintained within reproductive health self-care interventions in Ghana, this study found that end-users and professionals have adopted interim measures to maintain some level of safety amid policy and institutional inadequacies. However, the sustainability of these measures is uncertain, posing a serious risk to public health if not prioritised in the short term.

Bias-based bullying describes bullying behavior in an intergroup context in which someone is bullied because of their membership of a particular group. This constitutes a significant health concern for children with socially devalued identities, characteristics, and attributes. Compared to interpersonal bullying, bias-based bullying is driven by processes of stigma and, therefore, strategies focusing on stigma reduction need to be incorporated in intervention development. Chapter 21 aims to support intervention developers, policymakers, school personnel, and other professionals by providing an overview of evidence-based behavior change methods, with examples of practical applications, for tackling bias-based bullying. The first part of the chapter explains bias-based bullying within the context of stigma theory. We utilize Pryor and Reeder's (2011) model of stigma as a framework to differentiate between public stigma, stigma-by-association, structural stigma, and self-stigma. A brief literature review illustrates how these stigma types apply to key actors involved in bias-based bullying in schools. We identify main determinants that facilitate or reduce bias-based bullying. Building on these determinants, the second part of the chapter presents an overview of relevant behavior change methods derived from stigma theory to address bias-based bullying. The chapter concludes with the recommendation that addressing bias-based bullying requires comprehensive stigma-focused interventions.

Introduction: In border regions like the EuRegio Meuse‐Rhine (EMR), mobility does not stop at the border. HIV risk may therefore not only be determined by within‐country factors but also by between‐country differences. We explored between‐country differences in HIV indicators in the EMR using two complementary data‐driven approaches. Methods: First, we used 2019–2021 surveillance data from the German Robert Koch Institute, the Belgian Health Institute Sciensano and the Dutch HIV Monitoring Foundation to report on the EMR‐specific 95‐95‐95 goals. Second, we used the cross‐sectional EMIS‐2017 survey, including (trans)men who have sex with men (MSM), to report on determinants of HIV testing in the EMR. We employed multilevel multinomial regression modelling to identify sociodemographic factors associated with recent (n = 1335/2669) tested recently, 26% tested not‐recently ( n = 693) and 24% ( n = 641) never tested for HIV; with 8% of HIV‐testing variance explained by between‐country differences. Non‐recent and never‐testing were both associated with socio‐demographic factors, suggesting that some key populations (e.g., with transgender identity) and lack of resources determined differences in HIV testing. Conclusion: Targeted approaches to address regional and socio‐demographic differences are urgently needed, especially to tackle HIV‐testing barriers and reach individuals undiagnosed.

Introduction: Across Europe, many people with HIV are diagnosed late despite repeated contact with hospital services for HIV indicator conditions. These conditions flag a possible underlying HIV infection for which HIV testing is recommended. They provide an opportunity to identify people with HIV, yet implementation of indicator condition based testing remains insufficient in hospital practice. The #aware.hiv Europe study was developed to address this gap by embedding HIV teams into routine care to normalise HIV testing. Methods and analysis: #aware.hiv Europe is a stepped-wedge cluster randomised trial in 30 hospitals across ten European countries. Five clusters of 6 hospitals each will sequentially transition from control to implementation periods when local HIV teams led by an infectious diseases specialist will be installed. Intervention activities include hospital-wide peer audit and feedback on missed testing opportunities, targeted education, stigma reduction activities, and strengthening of linkage to HIV prevention and care. Patients with predefined HIV indicator conditions are identified using International Classification of Diseases, 10th Revision (ICD-10) diagnosis codes, confirmed through manual review. The primary outcome is the change in HIV testing rate among patients with confirmed HIV indicator conditions. Secondary outcomes include HIV case detection, cascades of diagnosis, care and prevention, variation in testing practices, healthcare professional knowledge and stigma, and implementation outcomes. Analyses will use mixed effects regression models accounting for clustering and time within the stepped-wedge design. Ethics and dissemination: The study has ethical approval in all hospitals to use routinely collected clinical data under exemption from informed consent for patient level data. Results will be disseminated through peer reviewed publications, conferences, and collaboration with clinical and community partners with the goal to inform HIV testing policies. Trial registration: ClinicalTrials.gov NCT06900829 . https://clinicaltrials.gov/study/NCT06900829 Strengths and limitations of this study: + Large, multinational, real-world, stepped-wedge, cluster randomized trial design. + Primary outcome derived from routinely collected clinical data, using a GDPR- and GCP-compliant approach with exemption from informed consent. + Hospital-wide intervention targeting care professionals, delivered through proactive expert HIV teams across departments powered to conclude on hard HIV care cascade clinical endpoints and stigma reducing interventions. + Implementation science design informed by established frameworks (CFIR and RE-AIM) to strengthen cross-continental generalisability. - Variation in healthcare systems and baseline testing practices across countries may contribute to heterogeneity in implementation and outcomes. - Despite standardised SOPs, local clinical judgement influences the assessment of HIV indicator conditions.

Homelessness among Central and Eastern European (CEE) migrant communities is a concern in several Western European countries, including the Netherlands, where migration from other EU countries is often motivated by perceived employment opportunities. This study aimed to better understand the emergence of CEE labour migrants' homelessness. Based on interviews with 42 Polish and Romanian labour migrants, we explored patterns of events and situations they described in relation to becoming homeless in the Netherlands. We identified five unique pathways to homelessness, named based on what appeared to be key events and situations: (1) Loss of work as a singular event, (2) Prior vulnerabilities and multiproblem situations, (3) Dissolution from a romantic relationship and loss of work, (4) Homelessness upon arrival and (5) Serious health problems. These pathways and the underlying experiences can inform policy in several ways. Implications include providing more information about living and working in the host country, more thorough recruitment processes, reconsidering combined contracts (work and housing), strengthening the labour market position of labour migrants, providing timely support to people who become unemployed, and sheltering and supporting people in cases of homelessness.