About

Ilene Speizer, PhD, is a professor in the Department of Maternal and Child Health at UNC Gillings School of Global Public Health and a faculty fellow at the Carolina Population Center. She is trained as a demographer and evaluation researcher with extensive experience leading research and evaluation studies on family planning, HIV prevention, intimate partner violence, and adolescent reproductive health programs in sub-Saharan Africa, Haiti, and India. Dr. Speizer has contributed to primary data collection through household-based studies and facility-based surveys, including facility audits, provider surveys, and exit interviews. Her work involves leading evaluations of adolescent health programs aimed at reducing child marriage and teen pregnancy, and she has managed large grants from organizations such as USAID and the Bill & Melinda Gates Foundation. Notably, she led projects to improve access to contraceptive methods for youth in Africa and Asia, and her research often emphasizes stakeholder engagement and capacity building in target countries to enhance monitoring, evaluation, and data-driven decision-making. Dr. Speizer's contributions include advancing global health measurement, supporting family planning programs, and informing policies to improve reproductive health outcomes worldwide.

Research topics

• Medicine
• Environmental health
• Psychology
• Nursing
• Economics
• Sociology
• Economic growth
• Political Science
• Computer Science
• Engineering
• Marketing
• Environmental planning
• Family medicine
• Geography
• Business

Selected publications

• Perspectives of religious beliefs and family planning by religious leaders and young women: results from a qualitative study of Bobo-Dioulasso and Ouagadougou in Burkina Faso

  BMC Public Health · 2026-01-08

  articleOpen accessSenior author

  Burkina Faso is religiously diverse compared to its neighbors. Religion and religious leaders are often perceived as being against family planning (FP) use. That said, the literature on different religions and religious leaders’ position on FP does not demonstrate a uniform stance and there is a dearth of perspectives related to use among young people. Qualitative data for this study were collected in July 2022 in Ouagadougou and Bobo-Dioulasso, Burkina Faso. Focus group discussions (FGD) were conducted with Catholic, Protestant, and Muslim young women who were aged 18–24 and were current users of FP. In-depth interviews (IDI) were conducted with pro-FP Catholic, Protestant, and Muslim religious leaders. The FGD and IDI data were translated and transcribed into French, thematically coded, and qualitatively analyzed. Young women of all faiths generally perceived their religions were against FP use for anyone, and especially for unmarried women. There was some openness to FP use by married women for birth spacing, especially with the consent of the husband. When young women were asked about their reasons for using FP despite their perception of their religion’s position against it, married young women said they used FP due to financial and practical difficulties inherent to modern day life, and to promote a more harmonious family life. Unmarried young women used FP to avoid social stigma and to pursue their own studies. IDI with pro-FP religious leaders of all faiths demonstrated their support of FP; they spoke of its benefits. While religious leaders did not say their religion prohibits FP use, they expressed some conditions on their support of FP such as marital status, purpose of FP use, and type of method used. This study shows that while young Christian and Muslim women largely perceive their religion to be against FP use, other factors are considered in their decision to use. While religious leaders remain influential, for young women, societal level pressures are more pressing. Religious leaders and other stakeholders should consider the current needs of young people and their own evolving beliefs around FP in their messages to their communities.

  PublisherDOI

• Advancing New Directions for Family Planning Measurement

  Studies in Family Planning · 2025-09-01 · 1 citations

  article1st authorCorresponding
  PublisherDOI

• Changing sex risk behaviors, gender norms, and relationship dynamics among couples in Cape Town, South Africa: Efficacy of an intervention on the dyad

  UNC Libraries · 2025-09-09

  articleOpen accessSenior author
  PublisherDOI

• Assessing the Effect of the COVID-19 Pandemic on Abortion Care Utilization and Delays and Whether There Was a Differential Impact Among Latinas in North Carolina

  Women s Health Issues · 2025-12-27

  articleOpen access

  OBJECTIVE: We evaluated the effect of the COVID-19 pandemic on abortion service utilization and delays to care among people in North Carolina and assessed whether there was a differential impact between Latinas and non-Hispanic white patients. METHODS: We used state-level data to examine abortions performed in North Carolina health facilities from 2016 to 2021 (N = 167,058). We employed an interrupted time-series analysis to assess changes in the monthly number of abortions and the monthly proportion of abortions at 13 weeks or later gestation both at the pandemic onset (March 2020) and after (April 2020-December 2021). Primary analyses were conducted for all abortion patients and secondary analyses were limited to Latina patients and compared with non-Hispanic white patients. MAIN FINDINGS: There was no significant change in the monthly number of abortions at the pandemic onset. After March 2020, there was a significant increase in the monthly number of abortions among the total study population. The monthly abortion count also increased for both groups between April 2020 and December 2021, though Latina patients had a greater monthly increase than non-Hispanic white patients. The proportion of abortions at 13 weeks or later dropped significantly at the pandemic onset among the total population by 1.5 (95% confidence interval [-2.3, -.7]) percentage points and remained at approximately the same level thereafter. PRINCIPAL CONCLUSIONS: The COVID-19 pandemic was associated with an increase in monthly abortion counts through 2021 and a decrease in the proportion of abortions after the first trimester at the pandemic's onset.

  PublisherOA PDFDOI

• I needed somebody to encourage me to take it [PrEP], maybe it would have protected me and the baby: a qualitative study to understand prenatal oral PrEP use among pregnant adolescent girls and young women in Tshwane, South Africa

  Reproductive Health · 2025-10-14

  articleOpen access

  BACKGROUND: South Africa has the highest number of people living with HIV globally, with adolescent girls and young women (AGYW) being disproportionately affected. Pregnant AGYW are particularly vulnerable to HIV due to hormonal changes, leading to increased risks of HIV transmission, including mother-to-child transmission. Pre-exposure prophylaxis (PrEP) is recommended to prevent HIV in this population, but concerns and lack of knowledge about its safety hinder uptake and continuation during pregnancy. METHODS: This qualitative sub-study was part of a cluster-randomized controlled trial in Tshwane, South Africa, involving 12 public health clinics. The parent study aimed to enroll AGYW aged 16-24 who were HIV-negative, reported to have had condomless sex, and were interested in taking PrEP. For this sub-study, 25 AGYW who became pregnant after enrollment were invited, and 16 consented to participate in in-depth interviews. Journey mapping was used to explore participants' experiences with PrEP before and during pregnancy. Interviews were conducted in English, Sesotho, and Setswana, then transcribed and coded for analysis. Inter-coder reliability reached a Krippendorff Cu-Alpha score of 0.84. The journey maps were combined and depicted graphically to understand the AGYW PrEP use journey during pregnancy. RESULTS: Most AGYW discontinued PrEP upon discovering their pregnancy due to concerns about potential risks to the unborn baby despite evidence showing PrEP is safe during pregnancy and breastfeeding. Participants experienced common PrEP side effects such as nausea, which they found difficult to distinguish from pregnancy-related symptoms. Lack of support from healthcare providers and family members further contributed to their decision to stop PrEP. Clinicians, often unfamiliar with updated guidelines recommending PrEP for pregnant women, advised discontinuation. AGYW expressed a need for greater support and reassurance from both healthcare providers and their families. CONCLUSION: Despite the safety of oral PrEP during pregnancy, AGYW in South Africa lack the necessary information and support to continue its use. Empowering healthcare providers and family members to offer informed guidance and reassurance, AGYW may gain the confidence needed to make critical HIV prevention decisions during pregnancy. Targeted strategies, such as provider training with community PrEP education, are essential to protect pregnant AGYW's well-being and reduce their HIV risk.

  PublisherOA PDFDOI

• Use of modern contraceptives by women with disabilities in Rajasthan, India: An analysis of the annual health survey

  UNC Libraries · 2025-05-10

  articleOpen accessSenior author
  PublisherDOI

• Impact evaluation of scripted lesson plans for HIV-related content in a life orientation curriculum: results from two provinces in South Africa

  UNC Libraries · 2025-04-09

  articleOpen accessSenior author
  PublisherDOI

• Intention to Use Contraception: Promises and Pitfalls of Family Planning's Emerging Demand Indicator

  Studies in Family Planning · 2025-08-11 · 1 citations

  articleOpen access

  The "intention to use" (ITU) contraception indicator has gained recent prominence as a proposed high-level success metric for family planning (FP) programs and as a step toward identifying measures that better capture what women want. Although ITU offers advantages over traditional indicators like contraceptive prevalence and unmet need, its elevation as a key programmatic measure requires critical examination. In this commentary, we outline advantages of ITU to measure FP demand and offer critiques and considerations for reliance on ITU as a demand metric for measuring programmatic success. We argue that while ITU may be a step toward more person-centered measurement, it is not inherently person-centered. Rather than positioning ITU as an innovative person-centered breakthrough, we argue it should be considered a transitional measure-a bridge toward more comprehensive indicators that capture the complexities of contraceptive decision-making. We recognize the current lack of viable alternatives for programs seeking a singular person-centered measure; when used, ITU should be complemented by additional topline indicators that capture access, agency, and preferences. With declining research funding and data infrastructure disruptions, it is important that ITU complement, not replace, efforts to develop the next generation of FP measurement that meaningfully reflects people's contraceptive realities.

  PublisherOA PDFDOI

• Examination of adolescent and youth modern contraceptive users’ perceptions on how religion influences contraceptive use and their rationale and circumstances of use: qualitative evidence from Burkina Faso, Kenya and Niger

  Journal of Population Research · 2025-01-17 · 1 citations

  articleOpen access1st authorCorresponding

  While religion is a key determining factor of contraceptive use, few studies examine how religion influences adolescent and youth contraceptive attitudes, beliefs, and use. We use recently collected (August-November 2022) qualitative data from Burkina Faso, Kenya, and Niger among young users of modern contraception who practice Christianity or Islam. In-depth interviews with married and unmarried young women ages 18-24 years were conducted in two sites in each country to obtain a mix of religions and method users. In each country, many young Christian and Muslim women perceived that their religion is not supportive of contraceptive use. Some nuances around perceived acceptability of use were identified in Niger and among Muslim women in Kenya particularly for married women for spacing or health reasons. Reasons given for using related to realities of life, personal choices, and that use is their prerogative and God will forgive them. Most married women felt there would be few consequences if their religious community learned of their use whereas unmarried young women feared more consequences from their religious and broader community. These findings demonstrate that while religion is important in all three study contexts, decisions around contraceptive use among the young women included were not necessarily influenced by their religious beliefs and practices. As a greater number of young people adopt contraception, with or without perceived religious support, social norms are likely to change leading to increased access to contraception for all young women, married and unmarried, when or if they need it.

  PublisherOA PDFDOI

• Neighborhood‐level racialized socioeconomic deprivation and contraceptive use in the United States, 2011–2019

  UNC Libraries · 2025-04-15

  articleOpen access

  INTRODUCTION: The social and structural environments where people live are understudied in contraceptive research. We assessed if neighborhood measures of racialized socioeconomic deprivation are associated with contraceptive use in the United States. METHODS: We used restricted geographic data from four waves of the National Survey of Family Growth (2011-2019) limited to non-pregnant women ages 15-44 who had sex in the last 12 months. We characterized respondent neighborhoods (census tracts) with the Index of Concentration at the Extremes (ICE), a measure of spatial social polarization, into areas of concentrated privilege (predominantly white residents living on high incomes) and deprivation (predominantly people of color living on low incomes). We used multivariable binary and multinomial logistic regression with year fixed effects to estimate adjusted associations between ICE tertile and contraceptive use and method type. We also assessed for an interactive effect of ICE and health insurance type. RESULTS: Of the 14,396 respondents, 88.4% in neighborhoods of concentrated deprivation used any contraception, compared to 92.7% in the most privileged neighborhoods. In adjusted models, the predicted probability of using any contraception in neighborhoods of concentrated deprivation was 2.8 percentage points lower than in neighborhoods of concentrated privilege, 5.0 percentage points higher for barrier/coital dependent methods, and 4.3 percentage points lower for short-acting methods. Those with Medicaid were less likely to use any contraception than those with private insurance irrespective of neighborhood classification. CONCLUSIONS: This study highlights the salience of structural factors for contraceptive use and the need for continued examination of structural oppressions to inform health policy.

  PublisherDOI

Recent grants

• NIH Grant R03HD055111

  NIH · $145k · 2010

Frequent coauthors

• Lisa M. Calhoun

  84 shared

• David K. Guilkey

  University of North Carolina at Chapel Hill

  36 shared

• Meghan Corroon

  China Population and Development Research Center

  31 shared

• Siân Curtis

  St Michael’s Hospital

  26 shared

• Kavita Singh

  23 shared

• John Santelli

  Columbia University

  20 shared

• Priya Nanda

  All India Institute of Medical Sciences Bhubaneswar

  19 shared

• Peter Lance

  University of Arizona

  18 shared

Education

• PhD, Population Dynamics

  Johns Hopkins Bloomberg School of Public Health

  1994

Awards & honors

• RTI University Scholar 2016-2017