{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:54:13Z","timestamp":1787061253209,"version":"build-2736575974"},"reference-count":15,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"unspecified","delay-in-days":82,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009410","name":"SC CTSI","doi-asserted-by":"crossref","award":["UL1TR001855"],"award-info":[{"award-number":["UL1TR001855"]}],"id":[{"id":"10.13039\/100009410","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2026,2,22]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Systemic lupus erythematosus (SLE) primarily affects women of reproductive age, necessitating complex conversations surrounding pregnancy and contraception use. Hispanic women in the USA bear a disproportionate and severe burden of SLE, facing language and cultural barriers to care, and higher rates of unplanned pregnancy and under-representation in reproductive health research. This study explores patient-reported barriers and facilitators to reproductive health conversations as well as their attitudes and perceptions on how these conversations can be improved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted 30 semistructured interviews in both English and Spanish with Hispanic women aged 18\u201345 with SLE. Participants were recruited from Los Angeles General Medical Center and Lupus LA. Eligible participants were heterosexually active or considering pregnancy within 3 years. Interviews were analysed using grounded theory to identify themes related to barriers and facilitators in clinical reproductive health interactions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three major themes emerged: (1) barriers to reproductive health conversations were often driven by competing clinical priorities as well as discomfort discussing sensitive topics; (2) facilitators to reproductive health conversations included the presence of genuine clinician\u2013patient rapport, well-controlled disease activity and patient proactiveness; (3) areas of improvement included both a more encompassing and thorough data-driven approach to reproductive health discussions throughout disease course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Findings reported herein underscore the importance of early, individualised reproductive health counselling for women with SLE. Enhanced clinician communication with sensitive topics, refined patient education and frequent interdisciplinary collaboration can help address the emotional, medical and informational needs of Hispanic women with SLE navigating reproductive decisions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/lupus-2025-001867","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T15:27:06Z","timestamp":1774366026000},"page":"e001867","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["\u2018Getting comfortable with the uncomfortable\u2019: barriers, facilitators and influences on reproductive health discussions from Hispanic women with systemic lupus erythematosus in the USA \u2013 a qualitative study"],"prefix":"10.1136","volume":"13","author":[{"given":"Martha","family":"Delgado","sequence":"first","affiliation":[{"name":"University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexa","family":"Montes De Oca","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mellissa","family":"Withers","sequence":"additional","affiliation":[{"name":"University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilyana","family":"Amezcua","sequence":"additional","affiliation":[{"name":"University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Weisman","sequence":"additional","affiliation":[{"name":"Stanford University, Palo Alto, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6172-9474","authenticated-orcid":false,"given":"Leanna Marderian","family":"Wise","sequence":"additional","affiliation":[{"name":"University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"key":"2026032408150919000_13.1.e001867.1","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1002\/art.41191","article-title":"2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases","volume":"72","author":"Sammaritano","year":"2020","journal-title":"Arthritis Rheumatol"},{"key":"2026032408150919000_13.1.e001867.2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209770"},{"key":"2026032408150919000_13.1.e001867.3","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1016\/j.rdc.2020.07.004","article-title":"Socioeconomic Status, Health Care, and Outcomes in Systemic Lupus Erythematosus","volume":"46","author":"DeQuattro","year":"2020","journal-title":"Rheum Dis Clin North Am"},{"key":"2026032408150919000_13.1.e001867.4","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1002\/acr.25359","article-title":"Multiplicative impact of adverse social determinants of health on outcomes in Lupus Nephritis: A Meta-analysis and Systematic Review","volume":"76","author":"Garg","year":"2024","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2026032408150919000_13.1.e001867.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2015.09.027"},{"key":"2026032408150919000_13.1.e001867.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1506575"},{"key":"2026032408150919000_13.1.e001867.7","doi-asserted-by":"crossref","unstructured":"Buie J , Fisher MP , Backor K . Identifying High\u2010Impact Solutions to Address Racial and Ethnic Health Disparities in Lupus: A Consensus\u2010Based Approach. Arthritis Care Res (Hoboken) 2025. doi:10.1002\/acr.25635","DOI":"10.1002\/acr.25635"},{"key":"2026032408150919000_13.1.e001867.8","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"2026032408150919000_13.1.e001867.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2012.05.013"},{"key":"2026032408150919000_13.1.e001867.10","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-022-06268-y"},{"key":"2026032408150919000_13.1.e001867.11","unstructured":"New estimates highlight differences in growth between the U.S. Hispanic and non-hispanic populations [press release]. United States Census Bureau; 2024."},{"key":"2026032408150919000_13.1.e001867.12","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1002\/acr.24249","article-title":"Exploring the Preferences of Women Regarding Sexual and Reproductive Health Care in the Context of Rheumatology: A Qualitative Study","volume":"73","author":"Wolgemuth","year":"2021","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2026032408150919000_13.1.e001867.13","doi-asserted-by":"crossref","DOI":"10.1080\/07853890.2024.2401610","article-title":"Exploring intimacy and family planning in Inflammatory Bowel Diseases: a qualitative study","volume":"56","author":"Gabova","year":"2024","journal-title":"Ann Med"},{"key":"2026032408150919000_13.1.e001867.14","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2024-086351","article-title":"Sexual and reproductive health from the perspective of patients with autoimmune rheumatic diseases in Mexico: a qualitative study","volume":"15","author":"Skinner-Taylor","year":"2025","journal-title":"BMJ Open"},{"key":"2026032408150919000_13.1.e001867.15","doi-asserted-by":"crossref","unstructured":"Guba EG , Lincoln YS . Naturalistic inquiry. Sage Publications, Inc, 1985.","DOI":"10.1016\/0147-1767(85)90062-8"}],"container-title":["Lupus Science &amp; Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/lupus-2025-001867","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T15:27:10Z","timestamp":1774366030000},"score":1,"resource":{"primary":{"URL":"https:\/\/lupus.bmj.com\/lookup\/doi\/10.1136\/lupus-2025-001867"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,3,24]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/lupus-2025-001867"],"URL":"https:\/\/doi.org\/10.1136\/lupus-2025-001867","relation":{},"ISSN":["2053-8790"],"issn-type":[{"value":"2053-8790","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}