{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:45:12Z","timestamp":1792788312780,"version":"4.5.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T00:00:00Z","timestamp":1618272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T00:00:00Z","timestamp":1618272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Osprey Foundation"},{"name":"Sid and Helaine Lerner MHM Faculty Support Fund"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Reprod Health"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There has been increasing recognition that certain vulnerable populations in the United States of America struggle to meet their menstruation-related needs, including people experiencing homelessness. Media and policy attention on this subject has focused on the provision of free menstrual products to vulnerable populations, including a New York City legislative bill, which guarantees access to menstrual products for Department of Homeless Services shelter residents (Intros 1123-A).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This qualitative study explored the challenges people experiencing homelessness in New York City face in accessing menstrual products. Data collection was conducted from June to August 2019 and included: Semi-structured key informant interviews with staff from relevant government agencies and homeless service providers (n\u2009=\u200915), and semi-structured in-depth interviews with individuals with experience living on the street and in shelters (n\u2009=\u200922). Data were analysed using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Key themes that emerged included: (1) insufficient and inconsistent access to menstrual products; (2) systemic challenges to providing menstrual products; and (3) creative solutions to promote access to menstrual products. Both shelter- and street-living individuals reported significant barriers to accessing menstrual products. While both populations struggle, those in shelters were more likely to be able to purchase menstrual products or access free products at their shelter, while those living on the streets were more likely to have to resort to panhandling, theft, or using makeshift materials in place of menstrual products. Across both populations, individuals described barriers to accessing free products at shelters and service providers, primarily due to distribution systems that rely on gatekeepers to provide a few pads or tampons at a time, sometimes of inadequate quality and only upon request. Shelters and service providers also described challenges providing these products, including inconsistent supply.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings highlight the critical importance of expanding and improving initiatives seeking to provide access to menstrual products for vulnerable populations. Despite policy level efforts to support menstrual product access, individuals experiencing homelessness in New York City, whether living in shelters or on the street, are often not able to access the menstrual products that they need to manage their monthly menstrual flow.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12978-021-01133-8","type":"journal-article","created":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T09:14:14Z","timestamp":1618305254000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Seeking menstrual products: a qualitative exploration of the unmet menstrual needs of individuals experiencing homelessness in New York City"],"prefix":"10.1186","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9235-5359","authenticated-orcid":false,"given":"Caitlin","family":"Gruer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Hopper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel Clark","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Maroko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marni","family":"Sommer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,13]]},"reference":[{"key":"1133_CR1","doi-asserted-by":"publisher","first-page":"169","DOI":"10.2147\/IJWH.S135587","volume":"10","author":"C VanLeeuwen","year":"2018","unstructured":"VanLeeuwen C, Torondel B. Improving menstrual hygiene management in emergency contexts: literature review of current perspectives. Int J Womens Health. 2018;10:169\u201386.","journal-title":"Int J Womens Health"},{"issue":"1","key":"1133_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3402\/gha.v9.33032","volume":"9","author":"PA Phillips-Howard","year":"2016","unstructured":"Phillips-Howard PA, Caruso B, Torondel B, Zulaika G, Sahin M, Sommer M. Menstrual hygiene management among adolescent schoolgirls in low- and middle-income countries: research priorities. Glob Health Action. 2016;9(1):1\u20137.","journal-title":"Glob Health Action"},{"key":"1133_CR3","doi-asserted-by":"crossref","unstructured":"MacRae ER, Clasen T, Dasmohapatra M, Caruso BA. \u201cIt\u2019s like a burden on the head\u201d: Redefining adequate menstrual hygiene management throughout women\u2019s varied life stages in Odisha, India. Federici S, editor. PLoS One. 2019;14(8):e0220114.","DOI":"10.1371\/journal.pone.0220114"},{"key":"1133_CR4","doi-asserted-by":"crossref","unstructured":"McMahon SA, Winch PJ, Caruso BA, Ogutu EA, Ochari IA, Rheingans RD. \u201cThe girl with her period is the one to hang her head\u201d Reflections on menstrual management among schoolgirls in rural Kenya. BMC Int Health Hum Rights. 2011;11(1):7. http:\/\/www.biomedcentral.com\/1472-698X\/11\/7.","DOI":"10.1186\/1472-698X-11-7"},{"key":"1133_CR5","doi-asserted-by":"publisher","first-page":"e79132","DOI":"10.1371\/journal.pone.0079132","volume":"8","author":"L Mason","year":"2013","unstructured":"Mason L, Nyothach E, Alexander K, Odhiambo FO, Eleveld A, Vulule J, et al. \u201cWe keep it secret so no one should know\u201d\u2014a qualitative study to explore young schoolgirls attitudes and experiences with menstruation in rural Western Kenya. PLoS ONE. 2013;8:e79132.","journal-title":"PLoS ONE"},{"key":"1133_CR6","doi-asserted-by":"publisher","first-page":"1002803","DOI":"10.1371\/journal.pmed.1002803","volume":"16","author":"J Hennegan","year":"2019","unstructured":"Hennegan J, Shannon AK, Rubli J, Schwab KJ, Melendez-Torres GJ. Women\u2019s and girls\u2019 experiences of menstruation in low- and middle-income countries: a systematic review and qualitative metasynthesis. PLOS Med. 2019;16:1002803.","journal-title":"PLOS Med."},{"key":"1133_CR7","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001962","author":"M Sommer","year":"2016","unstructured":"Sommer M, Caruso BA, Sahin M, Calderon T, Cavill S. A time for global action\u202f: addressing girls \u2019 menstrual hygiene management needs in schools. PLoS Med. 2016. https:\/\/doi.org\/10.1371\/journal.pmed.1001962.","journal-title":"PLoS Med."},{"issue":"7","key":"1133_CR8","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1080\/13691058.2016.1259504","volume":"19","author":"L Scandurra","year":"2017","unstructured":"Scandurra L, Khorn D, Charles T-A, Sommer M. Cambodian boys\u2019 transitions into young adulthood: exploring the influence of societal and masculinity norms on young men\u2019s health. Cult Heal Sex. 2017;19(7):767.","journal-title":"Cult Heal Sex."},{"issue":"9","key":"1133_CR9","doi-asserted-by":"publisher","first-page":"1193","DOI":"10.3390\/w10091193","volume":"10","author":"M Schmitt","year":"2018","unstructured":"Schmitt M, Clatworthy D, Ogello T, Sommer M, Schmitt ML, Clatworthy D, et al. Making the case for a female-friendly toilet. Water. 2018;10(9):1193.","journal-title":"Water"},{"key":"1133_CR10","unstructured":"BRAWS, University of D.C. David A. Clarke School of Law Legislation Clinic. Periods, poverty, and the need for policy: a report on menstrual inequity in the United States. Washington DC; 2018. Available from: https:\/\/cdn.ymaws.com\/www.law.udc.edu\/resource\/resmgr\/LegClinic\/2018_periods_policy_report.pdf."},{"issue":"4","key":"1133_CR11","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1016\/j.jadohealth.2016.10.008","volume":"60","author":"AC Herbert","year":"2016","unstructured":"Herbert AC, Ramirez AM, Lee G, North SJ, Askari MS, West RL, et al. Puberty experiences of low-income girls in the United States: a systematic review of qualitative literature from 2000 to 2014. J Adolesc Heal. 2016;60(4):363\u201379. https:\/\/doi.org\/10.1016\/j.jadohealth.2016.10.008.","journal-title":"J Adolesc Heal."},{"key":"1133_CR12","unstructured":"McNamara B. How periods perpetuate homelessness. Teen. 2017. https:\/\/www.teenvogue.com\/story\/homelessness-and-periods."},{"key":"1133_CR13","unstructured":"Parrillo A, Feller E. Menstrual hygiene plight of homeless women, a public health disgrace. R I Med J. 2017;(December):14\u20135. Available from: http:\/\/www.rimed.org\/rimedicaljournal\/2017\/12\/2017-12-14-pov-parrillo.pdf."},{"key":"1133_CR14","unstructured":"Ensign J. Reproductive health of homeless adolescent women in Seattle, Washington, USA Reproductive Health of Homeless Adolescent Women in Seattle, Washington, USA. Women Health. 2008;0242."},{"key":"1133_CR15","unstructured":"Levit R. Waiting and menstruation: a look at homeless and at-risk women\u2019s experiences. University of Albany, State University of New York; 2017."},{"issue":"2","key":"1133_CR16","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1097\/AOG.0000000000003060","volume":"133","author":"SA Kuhlmann","year":"2019","unstructured":"Kuhlmann SA, Bergguist PE, Danjoint D, Wall L. Unmet menstrual hygiene needs among low-income women. Obstet Gynecol. 2019;133(2):238\u201344.","journal-title":"Obstet Gynecol"},{"key":"1133_CR17","unstructured":"Durfor SL. Personal hygiene self-management of chronically unsheltered homeless women. University of Wisconsin Milwaukee; 2015."},{"issue":"1","key":"1133_CR18","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1007\/s12147-017-9192-y","volume":"35","author":"MK Mitchell","year":"2018","unstructured":"Mitchell MK, Ramsey LR, Nelson S. The body image of women at a homeless service group. Gend Issues. 2018;35(1):38\u201351.","journal-title":"Gend Issues"},{"key":"1133_CR19","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1007\/978-981-15-0614-7_4","volume-title":"The Palgrave handbook of critical menstruation studies","author":"S Vora","year":"2020","unstructured":"Vora S. The realities of period poverty: how homelessness shapes women\u2019s lived experiences of menstruation. In: Bobel C, Winkler IT, Fahs B, Hasson KA, Kissling EA, Roberts T-A, editors. The Palgrave handbook of critical menstruation studies. Singapore: Springer Singapore; 2020. p. 31\u201347. https:\/\/doi.org\/10.1007\/978-981-15-0614-7_4."},{"issue":"3","key":"1133_CR20","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1353\/hpu.2010.0797","volume":"12","author":"SL Wenzel","year":"2019","unstructured":"Wenzel SL, Andersen RM, Gifford DS, Gelberg L. Homeless women \u2019 s gynecological symptoms and use of medical care. J Health Care Poor Underserved. 2019;12(3):323\u201341.","journal-title":"J Health Care Poor Underserved"},{"key":"1133_CR21","unstructured":"Routhier G. State of the Homeless 2019. New York City; 2019. https:\/\/www.coalitionforthehomeless.org\/wp-content\/uploads\/2019\/04\/StateOfThe-Homeless2019.pdf. Accessed 17 Dec 2020."},{"key":"1133_CR22","unstructured":"NYC Department of Homeless Services. NYC Hope 2019 Results. 2019."},{"issue":"8","key":"1133_CR23","doi-asserted-by":"publisher","first-page":"1438","DOI":"10.2105\/AJPH.2005.083600","volume":"98","author":"K Hopper","year":"2008","unstructured":"Hopper K, Shinn M, Laska E, Meisner M, Wanderling J. Estimating numbers of unsheltered homeless people through plant-capture and postcount survey methods. Am J Public Health. 2008;98(8):1438\u201342. https:\/\/doi.org\/10.2105\/AJPH.2005.083600.","journal-title":"Am J Public Health."},{"key":"1133_CR24","unstructured":"Romero AP, Goldberg SK, Vasquez LA. LGBT people and housing affordability, and homelessness. 2020. https:\/\/williamsinstitute.law.ucla.edu\/wp-content\/uploads\/LGBT-Housing-Apr-2020.pdf."},{"key":"1133_CR25","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1007\/s11199-011-0052-z","volume":"68","author":"I Johnston-Robledo","year":"2013","unstructured":"Johnston-Robledo I, Chrisler JC. The menstrual mark: menstruation as social stigma. Sex Roles. 2013;68:9\u201318.","journal-title":"Sex Roles"},{"key":"1133_CR26","volume-title":"Stigma: notes on the management of spoiled identity","author":"E Goffman","year":"1963","unstructured":"Goffman E. Stigma: notes on the management of spoiled identity. New York: Simon & Schuster; 1963."},{"key":"1133_CR27","doi-asserted-by":"crossref","unstructured":"Sommer M, Gruer C, Smith RC, Maroko A, Hopper K. Menstruation and homelessness: challenges faced living in shelters and on the street in New York City. Health Place. 2020;66:1353\u20138292. http:\/\/creativecommons.org\/licenses\/by\/4.0\/","DOI":"10.1016\/j.healthplace.2020.102431"},{"key":"1133_CR28","unstructured":"The New York City Council. File #: Int 1123-2016. 2016. https:\/\/legistar.council.nyc.gov\/LegislationDetail.aspx?ID=2637112&GUID=31322AF8-376A-4D7F-93B2-4243BA5E4181. Accessed 20 Nov 2020"},{"issue":"8","key":"1133_CR29","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1177\/1403494812465030","volume":"40","author":"K Malterud","year":"2012","unstructured":"Malterud K. Systematic text condensation: a strategy for qualitative analysis. Scand J Public Health. 2012;40(8):795\u2013805.","journal-title":"Scand J Public Health"},{"key":"1133_CR30","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780190604981.001.0001","volume-title":"Down girl: the logic of misogyny","author":"K Manne","year":"2017","unstructured":"Manne K. Down girl: the logic of misogyny. Oxford: Oxford University Press; 2017."},{"key":"1133_CR31","unstructured":"Henry M, Watt R, Mahathey A, Ouellette J, Sitler A. The 2019 annual homeless assessment report (AHAR) to Congress. 2020."},{"key":"1133_CR32","unstructured":"Specia M. Scotland is 1st nation to make period products free. The New York Times. 2020. https:\/\/www.nytimes.com\/2020\/11\/24\/world\/europe\/scotland-free-period-products.html. Accessed 18 Dec 2020."},{"key":"1133_CR33","unstructured":"Barajas J. \u201cMenstrual equity\u201d: L.A. may offer free tampons and pads in public bathrooms - Los Angeles Times. Los Angeles Times. 2019. https:\/\/www.latimes.com\/california\/story\/2019-12-28\/la-moves-to-provide-free-tampons-and-pads-in-public-restrooms. Accessed 21 Aug 2020."},{"key":"1133_CR34","unstructured":"Berkowitz K. A new initiative is trying to make searching for tampons easier for Highland Park women. It\u2019s part of a national movement. Chicago Tribune. 2019. https:\/\/www.chicagotribune.com\/suburbs\/highland-park\/ct-hpn-free-tampons-feminine-hygiene-tl-0919-20190912-24sfihe3pngsjeit6pg4qdbptu-story.html. Accessed 21 Aug 2020."},{"key":"1133_CR35","unstructured":"Simmons-Duffin S. Coronavirus Legislation Allows For OTC Drugs\u202f: Coronavirus Updates\u202f: NPR. NPR. 2020. https:\/\/www.npr.org\/sections\/coronavirus-live-updates\/2020\/04\/01\/825490269\/save-those-pharmacy-receipts-new-payment-flexibility-courtesy-of-covid-rescue-ac. Accessed 20 Nov 2020."}],"container-title":["Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12978-021-01133-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12978-021-01133-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12978-021-01133-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T09:28:34Z","timestamp":1618306114000},"score":1,"resource":{"primary":{"URL":"https:\/\/reproductive-health-journal.biomedcentral.com\/articles\/10.1186\/s12978-021-01133-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,13]]},"references-count":35,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1133"],"URL":"https:\/\/doi.org\/10.1186\/s12978-021-01133-8","relation":{},"ISSN":["1742-4755"],"issn-type":[{"value":"1742-4755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,13]]},"assertion":[{"value":"13 January 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 April 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical review and approval was obtained from the Columbia University Institutional Review Board to allow human participant research. To participate in the qualitative interview participants provided verbal consent to participate and be recorded. No respondents declined participation. Participants were informed that they could decline to answer any question.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"77"}}